Articles: low-back-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cognitive-behavioural therapy versus EMG biofeedback in the treatment of chronic low back pain.
Forty-four chronic, but relatively well functioning, low back pain patients were assigned to either Cognitive Behaviour Therapy (CBT). Electromyographic Biofeedback (EMGBF) or Wait List Control (WLC). Both treatments were conducted over eight sessions in groups of four subjects. ⋯ At 6 months follow-up, treatment gains were maintained in the areas of pain intensity, pain beliefs, and depression, for both treatment groups, with further improvements occurring in anxiety and use of active coping skills. No significant differences were found between CBT and EMGBF on any of the outcome measures at either post-treatment or at 6 months follow-up. Further research is required to determine the degree to which these results reflect the mild level of psychological impairment and disability status of patients in the present study.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Behavioural rehabilitation of chronic low back pain: comparison of an operant treatment, an operant-cognitive treatment and an operant-respondent treatment.
Seventy-one chronic low back pain patients were assigned to one of three behavioural rehabilitation treatments or a waiting-list condition. The first intervention consisted of an operant treatment, aimed at increasing health behaviours and activity levels and at reducing pain and illness behaviours. In the second intervention, a cognitive treatment, aimed at the reinterpretation of catastrophizing pain cognitions and at enhancing self-control, was combined with an operant treatment. ⋯ This differential effect among the conditions is maintained at follow-up. Patients who received the OC and OR treatments catastrophize less than OP patients, and OC patients showed better scores on outcome-efficacy than OR patients. In general, the results suggest that behavioural rehabilitation programmes for chronic low back pain are effective and that the effects of an operant treatment are magnified when self-control techniques are added.
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Randomized Controlled Trial Clinical Trial
Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain.
To evaluate a progressive fitness programme for patients with chronic low back pain. ⋯ There is a role for supervised fitness programmes in the management of moderately disabled patients with chronic low back pain. Further clinical trials, however, need to be established in other centres to confirm these findings.
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Acta Neurochir. Suppl. · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialSpinal cord stimulation versus reoperation for failed back surgery syndrome: a prospective, randomized study design.
Retrospectively reported results of spinal cord stimulation compare favorably with those of neurosurgical treatment alternatives for the treatment of failed back surgery syndrome, including reoperation and ablative procedures. There has been no direct prospective comparison, however, between SCS and other techniques for pain management. Therefore, we have designed a prospective, randomized comparison of spinal cord stimulation and reoperation in patients with persistent radicular pain, with and without low back pain, after lumbosacral spine surgery. ⋯ The primary outcome measure is the frequency of crossover to the alternative procedure, if the results of the first have been unsatisfactory after 6 months. Results for the first 27 patients reaching the 6-month crossover point show a statistically significant (p = 0.018) advantage for spinal cord stimulation over reoperation. Many other potentially important outcome measures will now be followed long-term as a larger overall study population accumulates.
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J Orthop Sports Phys Ther · Dec 1994
Randomized Controlled Trial Clinical TrialA randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy.
The professional literature contains relatively few randomized-control studies that have assessed the efficacy of physical therapy approaches to the management of patients with chronic low back pain (CLBP). The purposes of this study were: 1) to investigate the effects of physical agents, joint manipulation, low-tech exercise, and high-tech exercise on objective measures of CLBP; 2) to track the length of CLBP relief; and 3) to determine treatment cost-effectiveness. Two-hundred-fifty subjects (68 females, 182 males; ages 34-51 years) with CLBP following an L5 laminectomy were randomly assigned into five separate groups for a treatment period of 8 weeks. ⋯ Results revealed that: 1) only low-tech and high-tech exercise produced significant improvements (p < .05) in CLBP, 2) the mean period of CLBP relief ranged from 1.6 weeks (control) to 91.4 weeks (low-tech exercise), and 3) low-tech exercise was most cost-effective. It was concluded that: 1) low-tech and high-tech exercise were the only effective treatments for CLBP, 2) low-tech exercise produced the longest period of CLBP relief, and 3) low-tech exercise was the most cost-effective form of treatment. Clinically, low-tech exercise may be the treatment method of choice for the effective management of chronic low back pain.