Abstract
SummaryThe treatment effect of an activating spinal orthosis on back pain and back extensor strength was compared to a training group and to a control group. Between the groups, there was no significant difference in back pain, back extensor strength, or kyphosis index after the 6 months of treatment.PurposeThe aim of this study was to study the effect of treatment with an activating spinal orthosis on back pain, back extensor strength, and kyphotic index. Our hypothesis was that an activating spinal orthosis may be an alternative treatment to decrease back pain and increase back extensor strength.MethodsA total of 113 women aged ≥ 60 years with back pain and osteoporosis, with or without vertebral fractures, were randomized to three groups: a spinal orthosis group, an equipment training group, and a control group. All three groups were examined at baseline and followed up after 3 and 6 months. Statistical analyses were performed with a mixed model for repeated measures according to intention to treat (ITT) and per protocol (PP).ResultsA total of 96 women completed the study. Between the groups, there was no significant difference in baseline characteristics. Comparison between groups showed no significant difference in back pain, back extensor strength, or kyphosis index at the follow-up after 6 months according to ITT and PP analyses. Analysis in each group showed that the back extensor strength had increased by 26.9% in the spinal orthosis group, by 22.1% in the exercise training group and by 9.9% in the control group.ConclusionsSix months’ treatment by an activating spinal orthosis showed no significant difference in back pain, back extensor strength, or kyphosis index between the three groups. In the spinal orthosis group, present back pain decreased slightly and back extensor strength increased by 26.9% which indicates that the spinal orthosis may become an alternative training method.Clinicaltrials.com ID: NCT03263585
Highlights
Osteoporosis is a common health problem among older women and often results in chronic back pain and reduced healthrelated quality of life, often as a consequence of vertebral fractures [1]
Baseline characteristics of the study participants showed no significant difference between the groups for any variable besides present back pain measured by Borg CR-10 which was higher in the spinal orthosis group (p < 0.05)
In a prospective comparative study of rehabilitation after an acute vertebral fracture, where pain was measured with Visual Analogue Scale (VAS) and Oswestry Low Back Pain Disability Questionnaire (OLBPDQ), two types of spinal orthosis were compared, a three-point orthosis and an activating orthosis, with 140 women split into two groups wearing the orthosis for 6 months [38]
Summary
Osteoporosis is a common health problem among older women and often results in chronic back pain and reduced healthrelated quality of life, often as a consequence of vertebral fractures [1]. Women suffering from osteoporosis have a lower quality of life than healthy women and it may be associated with increased thoracic kyphosis and reduced back muscle strength. Several studies are suggesting positive effects of exercise programs on pain, quality of life, and daily functioning in postmenopausal women and men with or without kyphosis and vertebral fractures and training of the back extensor muscles and posture training may reduce the kyphosis and further be associated with the risk of future vertebral fractures [8,9,10,11,12,13,14,15,16,17,18]
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