scholarly journals Economic evaluation of a healthy lifestyle intervention for chronic low back pain: a randomised controlled trial

2018 ◽  
Author(s):  
A Williams ◽  
JM van Dongen ◽  
SJ Kamper ◽  
KM O’Brien ◽  
L Wolfenden ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Lifestyle Intervention ◽  
Chronic Low Back Pain ◽  
Healthy Lifestyle ◽  
Intervention Group ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Low Back

AbstractWe performed an economic evaluation of a healthy lifestyle intervention targeting weight loss, physical activity and diet for patients with chronic low back pain, who are overweight or obese. Eligible patients with chronic low back pain (n=160) were randomised to an intervention or usual care control group. The intervention included brief advice, a clinical consultation and referral to a 6-month telephone-based healthy lifestyle coaching service. The primary outcome was quality-adjusted life years (QALYs). Secondary outcomes were pain intensity, disability, weight, and body mass index. Costs included intervention costs, healthcare utilisation costs and work absenteeism costs. An economic analysis was performed from the societal perspective. Mean total costs were lower in the intervention group than the control group (-$614; 95%CI: -3133 to 255). The intervention group had significantly lower healthcare costs (-$292; 95%CI: -872 to -33), medication costs (-$30; 95%CI: -65 to -4) and absenteeism costs (-$1000; 95%CI: -3573 to -210). For all outcomes, the intervention was on average less expensive and more effective than usual care, and the probability of the intervention being cost-effective compared to usual care was relatively high (i.e. 0.81) at a willingness-to-pay of $0/unit of effect. However, the probability of cost-effectiveness was not as favourable among sensitivity analyses. The healthy lifestyle intervention seems to be cost-effective from the societal perspective. However, variability in the sensitivity analyses indicates caution is needed when interpreting these findings.

scholarly journals Causal mechanisms of a healthy lifestyle intervention for patients with musculoskeletal pain who are overweight or obese

2019 ◽  
Vol 33 (6) ◽  
pp. 1088-1097 ◽  
Author(s):  
Amanda Williams ◽  
Hopin Lee ◽  
Steven J Kamper ◽  
Kate M O’Brien ◽  
John Wiggers ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Knee Osteoarthritis ◽  
Lifestyle Intervention ◽  
Chronic Low Back Pain ◽  
Healthy Lifestyle ◽  
Low Back ◽  
Pain Beliefs ◽  
Causal Mechanisms

Purpose: To assess the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis, who are overweight or obese. Methods: We conducted causal mediation analyses of aggregated data from two randomized controlled trials (RCTs); which included 160 patients with chronic low back pain, and 120 patients with knee osteoarthritis. The intervention consisted of brief advice and referral to a six-month telephone-based healthy lifestyle coaching service. We used causal mediation to estimate the indirect, direct and path-specific effects of hypothesized mediators including: self-reported weight, diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Results: The intervention did not reduce weight, improve diet or physical activity or change pain beliefs, and these mediators were not associated with the outcomes. Sensitivity analyses showed that our estimates were robust to the possible effects of unknown and unmeasured confounding. Conclusions: Our findings show that the intervention did not cause a meaningful change in the hypothesized mediators, and these mediators were not associated with patient-reported outcomes.

Effects of whole-body vibration exercise for non-specific chronic low back pain: an assessor-blind, randomized controlled trial

2019 ◽  
Vol 33 (9) ◽  
pp. 1445-1457 ◽  
Author(s):  
Xue-Qiang Wang ◽  
Wei Gu ◽  
Bing-Lin Chen ◽  
Xin Wang ◽  
Hao-Yu Hu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Functional Disability ◽  
Whole Body Vibration ◽  
Intervention Group ◽  
Whole Body ◽  
Control Group ◽  
Low Back ◽  
Body Vibration

Objective: To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: Eighty-nine patients with non-specific chronic low back pain met the inclusion criteria, they were randomly allocated to either the intervention group ( n = 45) or the control group ( n = 44). Intervention: The intervention group received whole-body vibration exercises three times a week for 12 weeks. The control group received general exercise protocol three times a week for 12 weeks. Main outcomes: The primary outcome measures were pain intensity and functional disability measured by the visual analog scale scores and Oswestry Disability Index. The secondary outcome measures included lumbar joint position sense, quality of life (Short Form Health Survey 36) and overall treatment effect (Global Perceived Effect). Results: A total of 84 subjects completed the 12-week study program. After 12 weeks, compared with the control group, the mean visual analog scale and Oswestry Disability Index scores decreased by additional 1 point (95% confidence interval (CI) = –1.22 to −0.78; P < 0.001), 3.81 point (95% CI, −4.98, −2.63; P < 0.001) based on adjusted analysis in the intervention group. And the intervention group provided additional beneficial effects for in terms of lumbar joint position sense ( P < 0.05), quality of life ( P < 0.05), and Global Perceived Effect ( P = 0.012). Conclusion: The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.

scholarly journals Effectiveness of a healthy lifestyle intervention for chronic low back pain

Pain ◽  
2018 ◽  
Vol 159 (6) ◽  
pp. 1137-1146 ◽  
Author(s):  
Amanda Williams ◽  
John Wiggers ◽  
Kate M. OʼBrien ◽  
Luke Wolfenden ◽  
Sze Lin Yoong ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lifestyle Intervention ◽  
Chronic Low Back Pain ◽  
Healthy Lifestyle ◽  
Low Back

scholarly journals Causal mechanisms of a healthy lifestyle intervention for patients with musculoskeletal pain who are overweight or obese

2018 ◽  
Author(s):  
A Williams ◽  
H Lee ◽  
SJ Kamper ◽  
KM O’Brien ◽  
J Wiggers ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Healthy Lifestyle ◽  
Sensitivity Analyses ◽  
Low Back ◽  
Pain Beliefs ◽  
Mediation Analyses

AbstractWe assessed the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis (OA), who are overweight or obese. We conducted causal mediation analyses of aggregated data from two RCTs; which included 160 patients with chronic low back pain, and 120 patients with knee OA. Participants were randomised via one central randomisation schedule, to the intervention, or usual care. The intervention consisted of brief advice and referral to a 6-month telephone-based healthy lifestyle coaching service. Participants in the back pain trial were also offered a single physiotherapy consultation. The hypothesised primary mediator was self-reported weight, and alternative mediators were diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Data were analysed using causal mediation analyses with sensitivity analyses for sequential ignorability. All mediation models were specified a priori. The intervention had no effect on pain intensity, disability or physical QoL. The intervention significantly improved mental QoL, however, the intervention effect was not channelled via the selected mediators. The intervention did not reduce weight, or the alternative mediators (diet, physical activity, pain beliefs), and these mediators were not associated with the outcomes (with one exception; poor diet was associated with lower mental QoL). The sensitivity analyses showed that our estimates were stable across all possible levels of residual confounding. Our findings show that the intervention did not cause a meaningful change in the hypothesised mediators, and these mediators were not associated with patient outcomes.

Cupping as An Effective Complementary Therapy to Reduce Chronic Low Back Pain in Medical Rehabilitation Subdivision Perkebunan Hospital Jember

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Debie Saktyana Iriawandani ◽  
Hanik Badriyah Hidayati ◽  
Wahyudi Widada ◽  
Zuhrotul Eka Yulis ◽  
Azham Purwandhono
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Intervention Group ◽  
Cupping Therapy ◽  
Medical Rehabilitation ◽  
Control Group ◽  
P Value ◽  
Low Back

Pain, especially chronic pain lasts prolonged weariness, usually persistent and recurring. Thus, pain is often found in patients with Chronic Low Back Pain (CLBP). One alternative treatment to reduce chronic low back pain is cupping therapy. The main principle of cupping therapy is using of negative pressure to attract toxin substances, free radicals in the blood, inflammation cells, metabolic waste or Causative Pathological Substances (CPS), scarification in the form of skin removal and removing CPS. The aim of this study was to analyze the effect of cupping therapy on pain intensity of CLBP patients in Medical Rehabilitation Sub Division Perkebunan Hospital Jember. The design in this study was quasi experiment nonequivalent control group. The population was all CLBP patients who underwent physiotherapy in the physiotherapy room at Perkebunan Hospital Jember. The sample consisted of 34 respondents (17 respondents in the intervention group and 17 respondents in the control group) using purposive sampling. A cupping therapy was done once in the intervention group. Statistical test results using Wilcoxon obtained p value 0.000 with a value of α <0.05, so it can be concluded that there is an effect of cupping therapy on pain intensity of CLBP patients in Medical Rehabilitation Sub Division Perkebunan Hospital Jember. Cupping Therapy can be used as a complementary or alternative therapy to reduce pain of CLBP patients at Perkebunan Hospital Jember.

scholarly journals Economic evaluation of a healthy lifestyle intervention for chronic low back pain: A randomized controlled trial

2018 ◽  
Vol 23 (3) ◽  
pp. 621-634 ◽  
Author(s):  
Amanda Williams ◽  
Johanna M. van Dongen ◽  
Steven J. Kamper ◽  
Kate M. O'Brien ◽  
Luke Wolfenden ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Economic Evaluation ◽  
Lifestyle Intervention ◽  
Chronic Low Back Pain ◽  
Healthy Lifestyle ◽  
Controlled Trial ◽  
Low Back ◽  
Randomized Controlled

scholarly journals Custom-Made Foot Orthoses as Non-Specific Chronic Low Back Pain and Pronated Foot Treatment

2021 ◽  
Vol 18 (13) ◽  
pp. 6816
Author(s):  
Aurora Castro-Méndez ◽  
Inmaculada Concepción Palomo-Toucedo ◽  
Manuel Pabón-Carrasco ◽  
Javier Ramos-Ortega ◽  
Juan Antonio Díaz-Mancha ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Control Group ◽  
Foot Orthoses ◽  
Low Back ◽  
Custom Made ◽  
Foot Posture ◽  
Foot Pronation ◽  
Pain Symptoms

Excessive foot pronation has been reported as being related to chronic low back pain symptoms and risk factors in sports-specific pathologies. Compensating custom-made foot orthotics treatment has not been entirely explored as an effective therapy for chronic low back pain (CLBP). This study aims to observe the effects of custom-made foot orthoses, in subjects with foot pronation suffering from CLBP. A total of 101 patients with nonspecific CLBP and a pronated foot posture index (FPI) were studied. They were randomized in two groups: an experimental one (n = 53) used custom-made foot orthotics, and the control group (n = 48) were treated with non-biomechanical effect orthoses. The CLBP was measured using the Oswestry Disability Index (ODI) Questionnaire and a visual analogue scale (VAS), both for lower back pain. The symptoms were evaluated twice, at first when the subject was included in the study, and later, after 4 weeks of treatment. The analysis of outcomes showed a significant decrease in CLBP in the custom-made foot orthoses participants group (p < 0.001 ODI; p < 0.001 VAS). These findings suggest that controlling excessive foot pronation by using custom-made foot orthoses may significantly contribute to improving CLBP.

scholarly journals Deficits in the Star Excursion Balance Test and Golf Performance in Elite Golfers with Chronic Low Back Pain

2021 ◽  
pp. 229-236
Author(s):  
Yi-Chien Peng ◽  
Chung-Yuan Hsu ◽  
Wen-Tzu Tang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Golf Swing ◽  
Control Group ◽  
Low Back ◽  
Balance Test ◽  
Star Excursion Balance Test ◽  
Pain Symptoms ◽  
The Right

The purpose of this study was to investigate whether low-handicap elite golfers with chronic low back pain (CLBP) exhibit deficits in dynamic postural control and whether CLBP affects golfers in terms of their golf swing parameters. A total of fifteen Division 1 college golfers were recruited as participants. Of these, six of whom experienced CLBP, while the remaining participants were healthy. In this study, CLBP was defined as experiencing chronic pain symptoms for more than six months. The Star Excursion Balance Test (SEBT) was administered to examine dynamic posture control in both groups. The TrackMan Golf Launch Monitor Simulator was used to collect data on the performance parameters of the swing of the participants. The results for both feet in the medial, lateral, posterior, posteromedial, and posterolateral directions indicated that the CLBP group scored lower than the control group. However, the CLBP group scored higher for the right foot in the anterolateral direction. The parameters for the club speed and ball carry of the CLBP group were lower than those of the control group. Further, the CLBP group exhibited a more upright swing plane relative to the control group. Taken together, our findings suggest that SEBT may be feasible and highly accessible to assess golf swing performance of elite players with CLBP.

Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

2021 ◽  
Author(s):  
Ecenur Atli ◽  
Dilber Karagozoglu Coskunsu ◽  
Zeynep Turan ◽  
Ozden Ozyemisci Taskiran
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Control Group ◽  
Low Back

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p<0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p>0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p>0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.

The Effects of a Digital Health Program Using Chatbot Through a Mobile Messaging App on Musculoskeletal Problems: Randomized Controlled Trial of the Self-Management Program in Workers with Neck/Shoulder Pain/Stiffness and Low Back Pain (Preprint)

2021 ◽  
Author(s):  
Tomomi Anan ◽  
Shigeyuki Kajiki ◽  
Hiroyuki Oka ◽  
Tomoko Fujii ◽  
Kayo Kawamata ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Shoulder Pain ◽  
Health Program ◽  
Digital Health ◽  
Intervention Group ◽  
Musculoskeletal Symptoms ◽  
Control Group ◽  
Low Back ◽  
Musculoskeletal Problems

BACKGROUND Musculoskeletal symptoms, such as neck and shoulder pain and stiffness and low back pain, are common health problems in the working population. They are the leading causes of presenteeism (employees being physically present at work but unable to be fully engaged). However, current medical systems do not spare sufficient resources for non-specific musculoskeletal problems. OBJECTIVE This study aimed to evaluate the improvements in musculoskeletal symptoms after use of an exercise-based artificial intelligence (AI)-assisted interactive health promotion system that operates through a mobile messaging app (the AI-assisted health program). METHODS We conducted a two-armed, randomized, controlled, and unblinded trial in workers with neck/shoulder stiffness and/or low back pain. We recruited participants with these symptoms through email notifications. We obtained 48 participants in the intervention group and 46 in the control group. The intervention group received the AI-assisted health program, in which the chatbot sent messages to users with the exercise instructions at a fixed time every day through the smart phone’s chatting app (LINE) for 12 weeks. The exercises could be performed within 1 minute. The control group continued with their usual care routines, which included exercising for 3 minutes at recess time provided by the company to prevent stiff shoulders and back pain. We assessed the subjective severities of the neck and shoulder pain/stiffness and low back pain in participants using a scoring scale of 1 to 5 for both the intervention and the control group at baseline and after 12 weeks of intervention using an online form. RESULTS We analyzed 47 patients in the intervention group and 40 in the control group. The participants in the intervention group showed significant improvements in the severities of the neck/shoulder pain/stiffness and low back pain compared to those in the control group (OR 12.74, P <.001). Based on the subjective assessment of the improvement of the pain/stiffness at 12 weeks, 36 (77%) participants in the intervention group and 3 (8%) in the control group had improved (improved, slightly improved) (OR 54.23, P <.001). CONCLUSIONS This study showed that the short exercises provided by the AI-assisted health program improved both neck/shoulder pain/stiffness and low back pain in 12 weeks. Digital health programs are low cost and safe and can save experts’ working hours and labor costs. Further studies are needed to identify the elements of the AI-assisted health program that worked. CLINICALTRIAL University hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000033894; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000038307.

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