Abstract
BackgroundNon-specific chronic low back pain (NSCLBP) is one of the most common musculoskeletal disorders around the world including Iran. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US). Despite its common use, there is still inconclusive evidence to support its effectiveness in patients with NSCLBP. The objective of this study was to evaluate the effect of continuous US compared with placebo US additional to exercise therapy for patients with NSCLBP.MethodsIn this single blind placebo controlled study, 50 patients with NSCLBP were randomized into two treatment groups: 1) continuous US (1 MHz &1.5 W/cm2) plus exercise 2) placebo US plus exercise. Patients received treatments for 4 weeks, 10 treatment sessions, 3 times per week, every other day. Treatment effects were assessed in terms of primary outcome measures: 1) functional disability, measured by Functional Rating Index, and 2) global pain, measured by a visual analog scale. Secondary outcome measures were lumbar flexion and extension range of motion (ROM), endurance time and rate of decline in median frequency of electromyography spectrum during a Biering Sorensen test. All outcome variables were measured before, after treatment, and after one-month follow-up. An intention to treat analysis was performed. Main effects of Time and Group as well as their interaction effect on outcome measures were investigated using repeated measure ANOVA.ResultsAnalysis showed that both groups had improved regarding function (FRI) and global pain (VAS) (P < .001). Lumbar ROM as well as holding time during the Sorensen test and median frequency slope of all measured paravertebral muscles did not change significantly in either group (P > .05). Improvement in function and lumbar ROM as well as endurance time were significantly greater in the group receiving continuous US (P < .05).ConclusionsThe study showed that adding continuous US to a semi supervised exercise program significantly improved function, lumbar ROM and endurance time. Further studies including a third group of only exercise and no US can establish the possible effects of placebo US.Trial registrationNTR2251
Highlights
Non-specific chronic low back pain (NSCLBP) is one of the most common musculoskeletal disorders around the world including Iran
Chronic Non-specific LBP (NSLBP) refers to an episode of activity-limiting Low back pain (LBP) that lasts for 3 months or more [7]
Possible effect of endurance time at baseline was measured by evaluating the effect of adding this variable to the model using analysis of covariance (ANCOVA)
Summary
Non-specific chronic low back pain (NSCLBP) is one of the most common musculoskeletal disorders around the world including Iran. LBP is a common health and socioeconomic problem in Iran. As part of a World Health Organization study, LBP was detected in 15.4% of the population under survey in Tehran (urban area) [3] and in 23.4% of the population in rural areas in Iran [4]. For the majority of patients with LBP a specific diagnosis cannot be defined on the basis of anatomical or physiological abnormalities. Non-specific LBP (NSLBP) is assumed to be inflammatory or mechanical in nature [6]. Chronic NSLBP refers to an episode of activity-limiting LBP (with no pain referred into either lower limb) that lasts for 3 months or more [7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
