Articles: low-back-pain.
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Randomized Controlled Trial
Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial.
Several treatment principles for the reduction of chronic low back pain associated disability have been postulated. To examine whether a combination of a physical training and an operant-behavioral graded activity with problem solving training is more effective than either alone in the long-term, a cluster randomized controlled trial was conducted. In total 172 patients, 18-65 years of age, with chronic disabling non-specific low back pain referred for rehabilitation treatment, were randomized in clusters of four consecutive patients to 10 weeks of aerobic training and muscle strengthening of back extensors (active physical treatment; APT), 10 weeks of gradual assumption of patient relevant activities based on operant-behavioral principles and problem solving training (graded activity plus problem solving training; GAP), or APT combined with GAP (combination treatment; CT). ⋯ During the one-year follow-up, there were no significant differences between each single treatment and the combination treatment on the primary outcome, the Roland Disability Questionnaire. Among multiple other comparisons, only one significant difference emerged, with GAP and APT showing higher self-perceived improvement than CT. We conclude that the combination treatment integrating physical, graded activity with problem solving training is not a better treatment option for patients with chronic low back pain.
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Complement Ther Med · Feb 2008
Randomized Controlled TrialReflexology in the management of low back pain: a pilot randomised controlled trial.
The current study was designed as a pilot study for a randomised controlled trial to investigate the effectiveness of reflexology in the management of low back pain (LBP). ⋯ Reflexology appears to offer promise as a treatment in the management of LBP; however, an adequately powered trial is required before any more definitive pronouncements are possible.
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Randomized Controlled Trial
Effects of education on return-to-work status for people with fear-avoidance beliefs and acute low back pain.
People with acute low back injury and fear-avoidance beliefs are at risk for remaining off work for an extended period of time. However, the effectiveness of intervention strategies for improving return-to-work status in people with acute low back pain and fear-avoidance beliefs has not been reported. The objective of this study was to determine whether education and counseling on pain management, physical activity, and exercise could significantly decrease the number of days that people with low back injury are off work. ⋯ Education and counseling regarding pain management, physical activity, and exercise can reduce the number of days off work in people with fear-avoidance beliefs and acute low back pain.
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Randomized Controlled Trial Comparative Study
Self-report measures best explain changes in disability compared with physical measures after exercise rehabilitation for chronic low back pain.
Sixteen-week intervention for chronic patients with low back pain (LBP) with 9-month follow-up. Primary randomization at 4 weeks into either supervised Swiss ball exercise or an exercise advice group. ⋯ Supervised exercise is a more successful subsequent to manual treatment compared with exercise advice. The improvements associated with this type of program were primarily manifested in the psychologic self-report measures rather than physical measurements.
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J Spinal Disord Tech · Feb 2008
Clinical TrialIntradiscal electrothermal therapy (IDET) provides effective symptom relief in patients with discogenic low back pain.
Single-arm, prospective clinical trial. ⋯ The findings of this study suggest that durable clinical improvements can be realized after IDET in highly selected patients with mild disc degeneration, confirmatory imaging evidence of annular disruption, and concordant pain provocation by low pressure discography.