Abstract
Non-specific low back pain (NSLBP) affects many people and represents a high cost for health care. Manual pressure release of myofascial trigger points is used to treat NSLBP and is very effective but difficult to standardize since it is provided by different therapists, which also suffer musculoskeletal complications from this highly repetitive activity. A robot designed for this purpose may help in reducing these problems. Here, we present data from a two-arm, single-blinded, randomized controlled clinical trial evaluating the efficiency of a therapeutic massage robot (ADAMO) in reducing NSLBP (clinicaltrials.gov, registration number: NCT04882748). Forty-four patients were randomly distributed into the two arms of the study (robot vs. control). A physician filled the Oswestry disability index (ODI) before starting the treatment and at the end of it, in a blind fashion. In addition, patients filled a visual analogue scale (VAS) after each of the 10 treatment sessions. The ODI and the VAS were analyzed as the primary and secondary outcome measures. Both treatments (robot and control) resulted in a significantly lower ODI (p < 0.05). On the other hand, robot-treated patients significantly reduced their VAS levels (p = 0.0001) whereas control treatment did not reach statistical significance. Patients of both sexes obtained similar benefits from either treatment. Overweight patients (body mass index ≥ 25kg/m2) in the robot arm benefited more from the treatment (p = 0.008) than patients with normal weight. In conclusion, the ADAMO robot is, at least, as efficient as regular treatment in reducing low back pain, and may be more beneficial for specific patients, such as those with excessive weight.
Highlights
Low back pain is defined as a musculoskeletal syndrome, or group of symptoms, whose main characteristic is the pain, which is focalized in the lumbar area of the spine
The study follows all tenets of the Declaration of Helsinki and was conducted at the Rehabilitation Service, High Resolution Center San Millán, in Logroño (Spain) between October 2020 and February 2021. Patients of both sexes that arrived to the Rehabilitation Service seeking treatment for Non-specific low back pain (NSLBP) were included in the trial if they were suffering from NSLBP, had between 18 and 60 years of age, and they signed the informed consent form
All individual participant data are available in Supplementary Material. The aim of this randomized controlled trial was to evaluate the effectiveness of adding a robot-mediated massage to the usual treatment to alleviate NSLBP, consisting of thermotherapy and rehabilitation exercises
Summary
Low back pain is defined as a musculoskeletal syndrome, or group of symptoms, whose main characteristic is the pain, which is focalized in the lumbar area of the spine. The diagnosis is rather easy since symptoms are very evident When this pain cannot be attributed to a known cause (traumatism, systemic diseases, nerve root compression, etc), it is called non-specific low back pain (NSLBP) (Maher et al, 2017), which may represent 90–95% of all cases of back pain (Bardin et al, 2017). NSLBP cannot be considered a benign pathology On the contrary, it is responsible for a high index of work absenteeism and early retirement (Ekman et al, 2005; Hoy et al, 2014). It is responsible for a high index of work absenteeism and early retirement (Ekman et al, 2005; Hoy et al, 2014) This syndrome affects 70–80% of the population of developed countries at some stage during their lifetime, representing the main cause of motility restriction, long-term incapacity, and reduction in the quality of life. In Europe, it has an associated cost of between 1.7 and 2.1% of the gross domestic product (Lambeek et al, 2011), while in the US it costs about $ 100 billion a year (Dieleman et al, 2016)
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