Clinical rheumatology
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Clinical rheumatology · Jul 2012
Randomized Controlled TrialDeep water running and general practice in primary care for non-specific low back pain versus general practice alone: randomized controlled trial.
There is equivocal evidence regarding the benefits of aquatic aerobic exercise for non-specific chronic low back pain (NSCLBP) in addition to standard care in general practice consisting of education and advice. The purpose of this study was to compare the addition of deep water running (DWR) to standard general practice (GP) on NSCLBP versus GP care alone on pain, physical and mental health and disability. In this single-blind randomised controlled trial, 58 subjects with NSCLBP were recruited from primary care. ⋯ Both groups showed improvement. The difference between treatment effects at longest follow-up of 1 year was -26.0 (-40.9 to -11.1) mm on the VAS (p < 0.05), -2.5 (-5.7 to -0.2) points in RMQ for disability (p < 0.05), 3.3 (10.0 to 24.7) points on physical health in the physical summary component of the Spanish Short Form 12 (SF-12; p < 0.05) and 5.8 (8.6 to 34.7) points on the mental summary component of the SF-12 (p < 0.05), in favour of the DWR group. For patients with NSCLBP, the addition of DWR to GP was more effective in reducing pain and disability than standard GP alone, suggesting the effectiveness and acceptability of this approach with this group of patients.
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Clinical rheumatology · Jul 2012
Controlled Clinical TrialA cohort-controlled trial of the addition of customized foot orthotics to standard care in fibromyalgia.
Customized foot orthotics are widely prescribed for patients with chronic, non-specific low back pain and lower limb pain, but there are few trials demonstrating effectiveness, and none for fibromyalgia. A total of 67 consecutive patients presenting with chronic, widespread pain, who met the 1990 American College of Rheumatology criteria for fibromyalgia, were included in the study. A total of 32 subjects were prescribed a spinal exercise therapy program along with analgesics. ⋯ The two groups were well matched in terms of age (45.3 ± 11.5 years in the Orthotics group vs. 47.2 ± 8.7 years in the cohort Control), medication use, duration of pain (6.5 ± 4.3 years in the Orthotics group vs. 6.2 ± 3.4 years in the cohort Control group), as well as baseline FIQR scores (55.2 ± 11.0 in the Orthotics group vs. 56.3 ± 12.2 in the cohort Control group). At 8 weeks, the Orthotics group had a greater reduction in the FIQR score than the cohort Control group (reduction of 9.9 ± 5.9 vs. 4.3 ± 4.4, respectively), and this was mainly due to changes in the 'function' domain of the FIQR (reduction of 19.6 ± 9.4 in the Orthotics group vs. 8.1 ± 4.3 in the cohort Control group). As part of a complex intervention, in a cohort-controlled trial of primary care patients with fibromyalgia, the addition of custom-made foot orthotics to usual care appears to improve functioning in the short term.
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Clinical rheumatology · Jul 2012
Validity and reliability of the Persian versions of WOMAC Osteoarthritis Index and Lequesne Algofunctional Index.
The WOMAC Osteoarthritis Index and Lequesne Algofunctional Index have not been translated and validated for Iranian patients with osteoarthritis (OA) of the knee or hip. The aim of this study was to validate the Persian form of WOMAC OA Index and Lequesne Algofunctional Index and to assess their test-retest reliability and convergent validity. Forward/backward translations and consensus panels were conducted to obtain the Persian versions of WOMAC OA Index and Lequesne Algofunctional Index. ⋯ Statistically significant correlations were found between WOMAC OA Index, Algofunctional Index and SF-20 subscales and VAS for pain. The Persian version of WOMAC demonstrated a more acceptable validity, internal consistency and reliability compared with the Lequesne Algofunctional Index. However, both indices are valid and reliable instruments for evaluating the OA severity of knee/hip in Iran.