Effect of global postural reeducation on chronic low pain patients with lower cross syndrome

Realizou-se um estudo clínico comparativo com o objetivo de avaliar o efeito da Reeducação Postural Global (RPG) no tratamento da lombalgia durante a gravidez e sua relação com limitações funcionais das gestantes. Os sujeitos foram 34 gestantes nulíparas atendidas em três centros de saúde e um hospital privado de Campinas, com idade gestacional entre 20 e 25 semanas e queixa de dor lombar. Dezessete gestantes foram submetidas a sessões de RPG durante oito semanas consecutivas, e as demais seguiram orientações de rotina para controle da dor lombar. Em cada sessão de RPG avaliou-se a intensidade da dor percebida pela mulher, antes e após os procedimentos. O grupo controle foi avaliado quanto à intensidade da dor na admissão, às quatro e oito semanas do estudo. Aplicou-se o questionário Roland-Morris para avaliar limitações funcionais, ao início e final do acompanhamento. O grupo de RPG apresentou decréscimo estatisticamente significativo na intensidade da dor antes e depois das sessões. Ao longo do estudo, as mulheres submetidas a RPG tiveram medianas de intensidade da dor e médias do escore de limitações funcionais significativamente menores que as do grupo controle. Análise de covariância indicou que o tratamento com RPG estava associado à menor intensidade da dor percebida ao final do estudo. Conclui-se que a RPG pode dar importante contribuição no tratamento da dor lombar durante a gestação, reduzindo, ao mesmo tempo, as limitações funcionais.

Global Postural Re-Education (RPG®) method, developed by the French physiotherapist Philippe E. Souchard, is based on progressing knowledge of human biomechanics and motor coordination, all applied to postural re-education and neuromusculoskeletal rehabilitation. It requires an active role to the patient can be applied to patients of any age, respecting each person’s capability and is indicated in for people presenting postural ailments and musculoskeletal disorder. In the same way, Mezieres Method end point is regain “body harmony”. Raggi® Method and Pancafit ® apply the principles previously theorized and combine them to diaphragmatic breathing. Our asses was to evaluate the effect of muscle chain stretching, as proposed by the global posture reeducation method, in the therapy of patients with chronic lower back pain. Eight patients (6 male and 2 female, aged 52.0 +/- 7.3 years old), performed global posture re-education using Pancafit according Raggi Method, once a week. The treatment program consisted of 1-hour individual sessions per week for eight weeks. Patients were evaluated before and after treatment and tested for Platform Lizard ( Stabilometry and postural assessment), pain intensity (by means of visual analog scale), range of motion (bending test), and health-related quality of life (by the SF-36 questionnaire). Significant pain relief and range of motion improvement were observed after treatment; quality of life also improved. Muscle chain stretching was effective in reducing pain and improving the range of motion and quality of life of patients with chronic lower back pain, suggesting that stretching exercises should be prescribed to chronic back pain patients.

Low back pain is one the most common forms of musculoskeletal disorders. Thus, several physiotherapeutic strategies (e.g., global postural re-education therapy) have been used for reducing low back pain. The aim of this study was to determinate if acute application of global postural re-education session associated effects are influenced by the time-of-day when this physical therapy is applied. Eight participants in a randomized, counterbalanced order were acutely tested both before and 24 h after a global postural re-education therapy session (10 min session) in three different time-of-day points; morning (i.e., AM; 7:00–9:00 h), midday (i.e., AM; 12:00–14:00 h) and afternoon (i.e., PM; 18:00–20:00 h). In each session, low back pain Visual Analogue Pain Scale [VAS]), flexibility, function capacity (Roland Morris Questionnaire [RMQ], and physical functioning Oswestry Disability Index [ODI]) were recorded. Results showed a pain reduction (VAS Scale) 24 h post Global postural re-education [GPR] session (p = 0.001) and increasing of flexibility pre-post GPR session in all the time-of-day points (morning, midday, and afternoon) (p = 0.001) while no differences were reported in RMQ (p = 0.969) and ODI (p = 0.767). Thus, acute GPR session produces the same effects on flexibility, low back pain, function capacity, and physical functioning values independently of time-of-day when it is applied.

BackgroundLow back pain (LBP) is a major cause of physical limitations and absenteeism at work throughout the world1. A number of studies have demonstrated the effectiveness of therapeutic exercises on...

Objective. Comparing global postural reeducation (GPR) to a standard physiotherapy treatment (PT) based on active exercises, stretching, and massaging for improving pain and function in chronic low back pain (CLBP) patients. Design. Prospective controlled study. Setting. Outpatient rehabilitation facility. Participants. Adult patients with diagnosis of nonspecific, chronic (>6 months) low back pain. Interventions. Both treatments consisted of 15 sessions of one hour each, twice a week including patient education. Measures. Roland Morris Disability Questionnaire to evaluate disability, and Numeric Analog Scale for pain. A score change >30% was considered clinically significant. Past treatments, use of medications, smoking habits, height, weight, profession, and physical activity were also recorded on baseline, on discharge, and 1 year after discharge (resp., T0, T1, and T2). Results. At T0 103 patients with cLBP (51 cases and 52 controls) were recruited. The treatment (T1) has been completed by 79 (T1) of which 60 then carried out the 1-year follow-up (T2). Both GPR and PT at T1 were associated with a significant statistical and clinical improvement in pain and function, compared to T0. At T2, only pain in GPR still registered a statistically significant improvement.

Оптимізація терапії у пацієнтів з болем в нижній частині спини в залежності від наявності синдрому доброякісної гіпермобільності суглобів

Percutaneously-quantified advanced glycation end-products (AGEs) accumulation associates with low back pain and lower extremity symptoms in middle-aged low back pain patients

Global postural reeducation (GPR) has been developed over recent decades and has shown success in the treatment of chronic low back pain (LBP). The aim of this study was to compare the effectiveness of GPR associated with a conventional reeducation protocol to that of the conventional reeducation protocol alone on pain, mobility, function and psychological symptoms in patients with non-specific LBP. This randomized controlled trial enrolled patients diagnosed with chronic LBP. The patients were randomized into two groups: a GPR group who received GPR associated with a conventional reeducation protocol and a control group who received conventional reeducation alone. Two evaluations were performed for both groups: at baseline (T0) and at the end of the 4-week session period (T1). The parameters evaluated comprised pain (measured using the Visual Analog Scale, VAS), mobility (by the Fingertip-to-floor test (FFT) and the Schober index), muscle endurance (by the Shirado and the Sorensen tests), function (by the Oswestry Disability index (ODI)) and anxiety-depressive symptoms (by the Hospital Anxiety and Depression scale (HADs)). A total of 26 patients were enrolled, with 13 in the GPR group and 13 in the control group. At the 4 weeks' evaluation, the GPR group showed significantly greater improvements in pain (p=0.04), lumbar mobility (p=0.007) and functional disability (p=0.02) compared to the control group. No differences between the two groups were found regarding muscular endurance and anxiety-depressive symptoms at the 4-weeks evaluation. Our findings suggested that GPR combined with conventional reeducation methods holds promise as an effective treatment approach for common LBP, particularly in improving pain levels, lumbar mobility and functional disability.

Background:Chronic low back pain (LBP) is one of the most common musculoskeletal disorders. It represents a healthcare issue as it is often associated with loss of work productivity and thus...

Subcutaneous Stimulation as an Additional Therapy to Spinal Cord Stimulation for the Treatment of Lower Limb Pain and/or Back Pain: A Feasibility Study

BACKGROUND: low back pain is a common problems that encountered in physical therapy clinic. Many treatment regime are present. Kinesio-taping is a newly treatment introduced for patients with low back pain. OBJECTIVES: To investigate the effect of kinesio-taping on pain, range of motion, and back muscle strength in non-specific low back pain patients. METHODS AND MEASURES: Twenty four patients were involved in this study. Informed consent were signed by the patients and patients were divided into two groups by randomization ,thirteen in Group A and eleven in Group B. Pain, range of motion, and back muscle strength were assessed on day one and six by VAS scale, modified-modified schober test (MMST), isokinetic dynamometer. Kinesio-taping (KT) was applied twice per six days. Group A patients were receiving I-shape KT longitudinally .Group B patients were receiving K taping Horizontally. RESULTS: The results of this study showed significant improvement in pain intensity and functional disability within groups. No significant differences between both groups. CONCLUSION: The Kinesio-taping with conventional physiotherapy will be more beneficial than kinesio- taping alone when treating nonspecific low back pain patients.

The purpose is to explore the brain’s structural difference in local morphology and between-region networks between two types of peripheral neuropathic pain (PNP): postherpetic neuralgia (PHN) and lower back pain (LBP). A total of 54 participants including 38 LBP and 16 PHN patients were enrolled. The average pain scores were 7.6 and 7.5 for LBP and PHN. High-resolution structural T1 weighted images were obtained. Both grey matter volume (GMV) and morphological connectivity (MC) were extracted. An independent two-sample t-test with false discovery rate (FDR) correction was used to identify the brain regions where LBP and PHN patients showed significant GMV difference. Next, we explored the differences of MC network between LBP and PHN patients and detected the group differences in network properties by using the two-sample t-test and FDR correction. Compared with PHN, LBP patients had significantly larger GMV in temporal gyrus, insula and fusiform gyrus (p < 0.05). The LBP cohort had significantly stronger MC in the connection between right precuneus and left opercular part of inferior frontal gyrus (p < 0.05). LBP patients had significantly stronger degree in left anterior cingulate gyrus and left rectus gyrus (p < 0.05) while had significantly weaker degree than PHN patients in left orbital part of middle frontal gyrus, left supplementary motor area and left superior parietal lobule (p < 0.05). LBP and PHN patients had significant differences in the brain’s GMV, MC, and network properties, which implies that different PNPs have different neural mechanisms concerning pain modulation.

Abstract: Low back pain (LBP) is the most disabling condition worldwide. The point prevalence of LBP in a given adult population is 12% and the overall lifetime prevalence is about 40% and the most common is chronic nonspecific LBP (CNSLBP). Nonpharmacological interventions are the first-line therapies for its treatment. Since there is now long list of different physical and psychological interventions for patients of CNSLBP, the important question is how to select better modality of intervention for a given patient? A variety of studies on nonpharmacological therapies for chronic low back pain (CNSLBP) and chronic low back pain in people older than 18 years old were searched for on Google Scholar, the Cochrane Library, and PubMed between 2014 and 2023. The studies chosen, included outcome criteria of pain intensity and disability. A total of 40 systematic reviews, Cochrane reviews, and meta-analyses were analyzed for various physical and psychobehavioral interventions. Various interventions reviewed were: (1) aerobics exercises, (2) resistance training, (3) motor control exercises (MCE), (4) stabilization techniques, (5) sling, (6) McKenzie, (7) pilates, (8) yoga, (9) traditional Chinese exercises (TCE), (10) manual therapy, (11) massage therapy, (12) global postural re-education, (13) cognitive behavioral therapy, (14) mindfulness-based stress reduction, (15) cognitive functional therapy, and (16) pain education-based therapy. Findings in our review suggested that at present, physical interventions (among aerobic exercises, MCE, Pilates, and TCE) with combination of psychological interventions based on individualized parameters can be the best option for the patients having CNSLBP.

Disturbed muscular adaptation and changed motor strategies in recurrent low back pain patients during stair walking after experimental back-muscle fatigue

BackgroundThe aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months).MethodsAccording to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned.ResultsOf the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group.The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7).ConclusionsOur findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects.Trial registrationNCT00789204