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Am J Phys Med Rehabil · Aug 2021
Randomized Controlled TrialLumbar Bracing for Chronic Low Back Pain: A Randomized Controlled Trial.
- Thiru M Annaswamy, Kegan J Cunniff, Mitchell Kroll, Lori Yap, Matthew Hasley, Chung-Kuang Lin, and Jason Petrasic.
- From the Physical Medicine & Rehabilitation Service, VA North Texas Health Care System, Dallas, Texas (TMA); Department of Physical Medicine & Rehabilitation, UT Southwestern Medical Center at Dallas, Dallas, Texas (TMA, KJC); Edward Via College of Osteopathic Medicine-Louisiana Campus, Monroe, Louisiana (MK); Physical Medicine & Rehabilitation Service, VA North Texas Health Care System, Fort Worth, Texas (LY); Infirmary Medical Clinics, Mobile, Alabama (MH); Riverside Community Hospital, Riverside, California (C-KL); and Star Orthopedics and Sports Medicine, Coppell, Texas (JP).
- Am J Phys Med Rehabil. 2021 Aug 1; 100 (8): 742-749.
PurposeWe performed this study to evaluate the effect of back bracing to treat patients with chronic low back pain.MethodsThis was a prospective, unblinded, randomized controlled trial of 61 adults with uncomplicated chronic low back pain (>12 wks) and imaging findings of degenerative spondylosis, to assess the effectiveness of a semirigid back brace. All study participants received back school instruction. The treatment group also received a lumbar orthosis and was instructed to wear it as needed for symptom relief. At baseline, 6 wks, 12 wks, and 6 mos after intervention, we collected: Numerical Rating Scale to measure pain intensity, Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EuroQol 5-Dimension (EQ-5D) to measure patient-reported function and quality of life.ResultsAn interim analysis at the halfway point in enrollment (61 of 120 planned participants) revealed the Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EQ-5D scores in the treatment group to be worse than in the control group, but no significant group differences in Numerical Rating Scale scores. Outcome differences between groups analyzed over time revealed (effect [P]): Pain Disability Questionnaire = 0.84 (0.04); Patient-Reported Outcome Measurement Information System = 0.78 (0.005); EQ-5D = 0.06 (0.01); and Numerical Rating Scale = 0.02 (0.6). We halted the study because continuation was unlikely to produce significant changes to the results.ConclusionsIn patients with uncomplicated chronic low back pain, a back brace when combined with education and exercise instruction did not provide any pain relief compared with education and exercise instruction alone.To Claim Cme CreditsComplete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.Cme ObjectivesUpon completion of this article, the reader should be able to: (1) Describe the effect of lumbar back bracing on pain intensity in patients with chronic low back pain; (2) Discuss the effects of lumbar back bracing on pain-related disability, function, and quality of life in patients with chronic low back pain; and (3) Understand the role of lumbar back bracing in the treatment of patients with chronic low back pain.LevelAdvanced.AccreditationThe Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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