Evaluation of biofeedback based bridging exercises on older adults with low back pain: A randomized controlled trial

Abstract

BACKGROUND: Low back pain (LBP) is a common cause for disabilities and reduced autonomy in older adults. Exercise therapy has shown to be effective in the reduction of the symptoms of LBP with bridging exercises as a commonly used intervention. Exercise therapy can be supported with biofeedback-based methods in order to further improve motor control. The availability of relatively inexpensive devices like the Nintendo Wii opens up new methods for the treatment for biofeedback-based exercises for patients with LBP. METHODS: We conducted a 3-armed randomized controlled trial (biofeedback, standard care and control) with 62 older adults aged 66 to 89 years and an intervention period of twelve weeks with 2 sessions/week. Primary outcome was the perceived disability using the Oswestry Disability Index (ODI). Additionally, we evaluated usability and user acceptance of the feedback system. RESULTS: The biofeedback group demonstrated significantly lower levels of perceived disability compared to the control group. Additionally, the Biering-Sørensen test was significantly better in the standard care group compared to both other groups. Usability and user-acceptance for the biofeedback system was low, mostly because of connectivity and comfort problems during exercising. CONCLUSIONS: The biofeedback system was able to significantly improve perceived disability and back extensor muscle endurance in older people with subacute low back pain. As the user-acceptance issues were mostly based on technical reasons, higher levels of comfort and dependability of the system could provide an effective method to perform bridging exercises to alleviate the consequences of episodes of low back pain.