Back Pain Intensity Research Articles

Differential target multiplexed spinal cord stimulation in patients with Persistent Spinal Pain Syndrome Type II: a study protocol for a 12-month multicentre cohort study (DETECT)

IntroductionDifferential target multiplexed spinal cord stimulation (DTM SCS) is a new stimulation paradigm for chronic pain management with the aim of modulating glial cells and neurons in order to rebalance...

Therapeutic exercise is effective in reducing the intensity of non-specific low back pain in children and adolescents: a systematic review and network meta-analysis

Therapeutic exercise is effective in reducing the intensity of non-specific low back pain in children and adolescents: a systematic review and network meta-analysis

Postoperative early initiation of sequential exercise program in preventing persistent spinal pain syndrome type-2 after modified transforaminal lumbar interbody fusion: a prospective randomized controlled trial.

This prospective randomized controlled trial aimed to investigate the impact of early postoperative sequential motor control (starting first day post-operatively) and core stabilization training (starting fifth week post-operatively) compared to conventional exercise (starting fifth weeks post-operatively) on the risk of developing persistent spinal pain syndrome type-2 (PSPS-T2). 395 patients with lumbar degenerative diseases (LDDs) undergoing modified transforaminal lumbar interbody fusion and a 12-week postoperative exercise program (sequential vs. conventional exercise: 214 vs. 181) were evaluated for low back pain (LBP) intensity, Oswestry Disability Index (ODI), pressure pain threshold (PPT), temporal summation (TS), fatty infiltration of paraspinal muscles, transversus abdominis (TrA) activation capacity and Fear-Avoidance Beliefs Questionnaire (FABQ) pre-operatively, 3 months post-operatively, and 1 year post-operatively. At 3-month postoperative assessment, LBP in sequential exercise group were lower than those in conventional exercise group (P < 0.05), and sequential-exercise patients had greater local-area PPTs, lower TS, lower TrA activation capacities and less fatty infiltration of erector spinae than did the conventional-exercise patients (P < 0.05). At 1-year postoperative assessment, fewer sequential-exercise patients had PSPS-T2 compared with conventional-exercise patients (11/214 vs. 20/181; P < 0.05). LBP at rest and FABQ were lower in sequential-exercise patients than conventional-exercise patients (P < 0.05). Furthermore, both PPT and TS at 1-year postoperative assessment were associated with these measurements at 3-month postoperative assessment in patients with PSPS-T2 (P < 0.05). Postoperative sequential exercise has more positive effects to avoid PSPS-T2 than conventional exercise in patients with LDDs possibly because of its advantages in improving central and peripheral sensitization.

Relationship of chronic low back pain intensity with functional activity, stress and quality of life in working-age adults

Background. Low back pain (LBP) is a global problem in the modern world. A detailed study of the relationship between pain intensity and the indicators with which it may be associated will allow optimising approaches to the treatment and rehabilitation of patients with chronic LBP. The purpose was to eva­luate the relationship between the intensity of chronic LBP and indicators of functional activity, stress and quality of life in subjects of working age. Materials and methods. A survey was conducted among 159 persons aged 18-65 years with LBP lasting more than 3 months. Using a Google-form, the participants were given a questionnaire that included socio-demographic, anthropometric characteristics, lifestyle data, bad habits, physical activity (PhA) and stress levels, quality of life, and impairment. The intensity of pain was measured at the first visit to a PhRM doctor using a visual analogue scale (VAS). Results. The study involved 159 patients, 65.7 % women and 34.3 % men, with a mean VAS pain intensity of 46.5 ± 18.6 mm. A weak positive correlation was found between pain intensity and age (r = 0.30, p &lt; 0.001), but no significant relationship was found between pain intensity and anthropometric parameters. Subjects who smoke, have insufficient PhA and sleep disturbance had higher pain intensity scores (57.6 ± 15.2 mm (p = 0.04), 49.0 ± 18.8 mm (p = 0.12), 49.7 ± 19.9 mm (p = 0.002), respectively). Sitting time more than 6 hours had significant associations with pain intensity (p &lt; 0.001). A weak positive correlation was found between pain intensity on the VAS scale and stress le­vel (r = 0.24, p = 0.002), a moderate positive correlation between pain intensity and impairment (r = 0.36, p &lt; 0.001) and a mo­derate negative correlation between quality of life and pain intensity. ­Conclusions. There was a significant association between pain intensity and age, smoking, sleep disturbance, sedentary work for more than 6 hours, higher stress levels, impaired functioning and lower quality of life.

Outcome prediction following lumbar disc surgery: a longitudinal study of outcome trajectories, prognostic factors, and risk models.

This study aimed to 1) describe the 2-year postoperative trajectories of leg pain and overall clinical outcome after surgery for radiculopathy, 2) identify the preoperative prognostic factors that predict trajectories representing poor clinical outcomes, and 3) develop and internally validate multivariable prognostic models to assist with clinical decision-making. This retrospective cohort study included patients enrolled in the Canadian Spine Outcomes and Research Network who were diagnosed with lumbar disc pathology and radiculopathy and had undergone lumbar discectomy at one of 18 spine centers. Potential outcome predictors included preoperative demographic, health-related, and clinical prognostic factors. Clinical outcomes were 1) 2-year univariable latent trajectories of leg pain intensity (numeric pain rating scale) and 2) overall outcomes comprising multivariable trajectories showing the combined postoperative courses of leg and back pain intensity (numeric pain rating scale) together with pain-related disability (Oswestry Disability Index). Each outcome model identified a subgroup of patients classified as experiencing a poor outcome based on minimal change in their clinical status after surgery. Multivariable risk model performance and internal validity were evaluated with discrimination and calibration statistics based on bootstrap shrinkage with 500 resamplings. The authors included data from 1142 patients (47.6% female). The trajectory models identified 3 subgroups based on the patients' postoperative courses of pain or disability: 88.6% of patients in the leg pain model and 71.9% in the overall outcome model experienced a good-to-excellent outcome. The models classified 11.4% (leg pain outcome) and 28.2% (overall outcome) of patients as experiencing a poor clinical outcome, which was defined as minimal improvement in pain or disability after surgery. Eleven individual demographic, health, and clinical factors predicted patients' poor leg pain and overall outcomes. The performance of the multivariable risk model for leg pain was inadequate, while the overall outcome model had acceptable discrimination, calibration, and internal validity for predicting a poor surgical outcome. Patients with lumbar radiculopathy experience heterogeneous postoperative trajectories of pain and disability after lumbar discectomy. Individual preoperative factors are associated with postoperative outcomes and can be combined within a multivariable risk model to predict overall patient outcome. These results may inform clinical practice but require external validation before confident clinical implementation.

Effect of chiropractic care on low back pain for active-duty military members: Mediation through biopsychosocial factors.

This study evaluates biopsychosocial factors as mediators of the effect of chiropractic care on low back pain (LBP) intensity and interference for active-duty military members. Data from a multi-site, pragmatic clinical trial comparing six weeks of chiropractic care plus usual medical care to usual medical care alone for 750 US active-duty military members with LBP were analyzed using natural-effect, multiple-mediator modeling. Mediation of the adjusted mean effect difference on 12-week outcomes of PROMIS-29 pain interference and intensity by 6-week mediators of other PROMIS-29 physical, mental, and social health subdomains was evaluated. The effect difference on pain interference occurring through PROMIS-29 biopsychosocial factors (natural indirect effect = -1.59, 95% CI = -2.28 to -0.88) was 56% (95% CI = 35 to 96) of the total effect (-2.82, 95% CI = -3.98 to -1.53). The difference in effect on pain intensity occurring through biopsychosocial factors was smaller (natural indirect effect = -0.32, 95% CI = -0.50 to -0.18), equaling 26% (95% CI = 15 to 42) of the total effect (-1.23, 95% CI = -1.52 to -0.88). When considered individually, all physical, mental, and social health factors appeared to mediate the effect difference on pain interference and pain intensity with mental health factors having smaller effect estimates. In contrast with effects on pain interference, much of the effect of adding chiropractic care to usual medical care for US military members on pain intensity did not appear to occur through the PROMIS-29 biopsychosocial factors. Physical and social factors appear to be important intermediate measures for patients receiving chiropractic care for low back pain in military settings. Further study is needed to determine if the effect of chiropractic care on pain intensity for active-duty military occurs through other unmeasured factors, such as patient beliefs, or if the effect occurs directly.

Effects of reducing sedentary behaviour on back pain, paraspinal muscle insulin sensitivity and muscle fat fraction and their associations: a secondary analysis of a 6-month randomised controlled trial

ObjectivesSedentary behaviour (SB) is a plausible intervention target for back pain mitigation. Therefore, this study aimed to investigate the effects of a 6-month SB reduction intervention on back pain and...

Effectiveness of back therapeutic exercises and Pilates on the clinical improvement of the intensity of chronic low back pain and determination of the minimal clinically important improvement threshold from treatments in a hospital setting

The primary aim was to compare the effectiveness of therapeutic back exercises and Pilates in reducing chronic low back pain and to determine the threshold of improvement and the difference in pre- and post-treatment scores considered clinically relevant for patients. Methodology: A total of 53 patients with chronic low back pain were randomly assigned to two groups: one with 27 participants performing Pilates and another with 26 participants following a back exercise program. The treatment consisted of sessions twice a week for three months. Pain intensity was assessed before and after treatment using the Visual Analog Pain Scale. A clinically relevant threshold was defined as a sufficient reduction in pain score for patients to feel "very satisfied." A Receiver Operating Characteristic Curve analysis was used to determine the sensitivity and specificity of the improvement threshold. Additionally, a linear regression model was applied to analyze the relationship between score difference and the percentage of improvement. Results: Although both groups showed significant improvements in pain reduction after treatment, there were no statistically significant differences between them. The average reductions in both groups did not exceed two points (Back Exercise Group = 1.43 points, Pilates Group = 1.82 points), thus not reaching the two-point average improvement required to meet the clinically relevant improvement threshold. However, at an individual level, 45.83% of the Pilates group and 37.5% of the back exercise group achieved a clinically relevant improvement (≥30% improvement). The improvement threshold of 31.4%, equivalent to a two-point reduction, was correlated with greater clinical satisfaction (sensitivity 84%, specificity 87%). Conclusions: Both treatments produced beneficial effects in reducing chronic low back pain. However, the average improvement was not clinically relevant for the overall sample. At an individual level, a significant proportion of patients achieved clinically relevant improvement, particularly in the Pilates group. The 31.4% improvement threshold serves as an additional indicator for evaluating the clinical relevance of treatments. Keywords: Therapeutic back exercises, Pilates, chronic low back pain, Visual Analog Scale for Pain, Minimal Clinically Important Change.

The Effect of Warm Compress on the Intensity of Back Pain in Pregnant Women in the Third Trimester: Scoping Review

Background: Pregnancy is a natural process. During pregnancy, a mother experiences discomfort, one of which is back pain, there are several treatments to treat back pain, namely pharmacological and non-pharmacological therapies. One of the nonpharmacological therapies that can be done is with warm compresses because it is safer, cheaper, effective, cheap and without adverse effects.Purpose : This article aims to identify literature related to the effect of warm compresses on the intensity of back pain in pregnant women in the third trimester.Methods: The method used is scoping review which consists of 5 phases, namely identifying scoping review questions using the PICO framework; identifying relevant articles; searching for articles using relevant databases, namely PubMed, Wiley, and Google Scholar; creating PRISMA flowcharts; conducting critical appraisals to assess the quality of articles; charting data; compiling, summarizing and reporting results.Results: The results of the review of 15 selected articles obtained 8 articles with grade A, 7 articles grade B, 11 articles using quasi experiment, and 4 articles pre experiment. Two themes that emerged based on the results of the Scoping Review are the concept of back pain, and the concept of warm compresses.Conclusion: Warm compresses are effective in reducing back pain in pregnant women in the third trimester, so they can be recommended as complementary therapy to reduce the intensity of back pain.

Effectiveness of Prenatal Gentle Yoga and Effleurage Massage in Low Back Pain Third Trimester Pregnant Women

Background: Pregnant women often complain of low back pain, typically becoming more intense as pregnancy progresses due to changes in posture, such as increased lordosis and a shift in the center of gravity. If not addressed, this pain can negatively impact the quality of life by interfering with daily activities. However, Prenatal gentle yoga and effleurage massage are effective ways to avoid back pain. Objective: To examine how women in their third trimester of pregnancy might manage their lower back discomfort using effleurage massage and gentle yoga. Methods: In the quasi-experimental design of this research, selective sampling approaches are used. Additionally, a two-group pretest-posttest design is utilized, and there is no control group provided. The research was conducted in the PMB Ika Winoto area, and forty expectant mothers with back pain who were in the third trimester were among them. The Effleurage treatment consisted of a 30-minute massage session, with each movement performed for about 10 minutes, administered twice to each participant. Prenatal yoga sessions were also conducted twice a week, with each session lasting 60 minutes. A numerical rating scale, also known as the NRS, was used to assess the amount of back pain that the patient was experiencing). To fully examine the data, a Wilcoxon Signed Rank Test was used. Results: P-values for the Effleurage massage group and the Prenatal Gentle Yoga group were 0.000 and 0.005, respectively, according to the analysis findings. The average reduction in low back pain intensity was 9.86 for the Effleurage massage group and 6.87 for the Prenatal Gentle Yoga group. Conclusion: Both pregnancy gentle yoga and effleurage massage work well to relieve low back pain. Regarding how pregnant women who are still in the third trimester of their pregnancy should be treated for low back pain, the effleurage massage method works better than prenatal yoga. Therefore, for expectant mothers who are suffering from low back discomfort, these techniques represent effective alternative medicines that are simple to use and have few adverse effects.

Lumbar foraminal stenosis was associated with back pain and leg pain: epidemiological evidence from a population-based cohort.

To determine the characteristics of lumbar foraminal stenosis (LFS) on magnetic resonance (MR) images and their association with back pain and radiating leg pain in a population-based sample of Chinese subjects. This study was an extension of the Hangzhou Lumbar Spine Study, a cross-sectional study focusing on back pain and lumbar spine MR imaging findings. Questionnaire data, including demographics, lifestyle, occupational exposures, back pain and radiating leg pain were included. On lumbar spine MR images, disc degeneration was assessed using Pfirrmann grade and Modic changes were evaluated. Using Lee's scale, the L3-S1 intervertebral foramina were evaluated, with grade 2-3 representing substantial LFS and grade 0-1 no LFS. Characteristics of LFS were noted, and associations of LFS with back pain and radiating leg pain were examined. Among the 644 study subjects, 141 (21.9%) had at least one LFS, and its occurrence was associated with greater age (OR = 1.93 for each 10 years, p < 0.001). Substantial LFS was associated with the presence of back pain (OR = 1.92, p = 0.001) and the intensity of the worst back pain (Coef = 8.30, p < 0.001) over the past 12 months, and disabling back pain during their lifetime (OR = 2.25, p < 0.001). Substantial LFS was also associated with leg pain (OR = 14.27, p < 0.001), with a sensitivity of 75.7% for the presence of radiating leg pain and a specificity of 81.4%. Substantial LFS on MR images was a common age-related degenerative phenotype in adults, and appears to be an independent risk factor for back pain and leg pain.

The relationship between chronic nonspecific low back pain intensity and postural sway during single and double leg standing

The relationship between chronic nonspecific low back pain intensity and postural sway during single and double leg standing

The Effect of Warm Water Compress on Back Pain Intensity in Pregnant Women in The Thirty Trimester

Pregnancy is a physiological thing that in the process will undergo adaptation changes both physiologically and psychologically. Changes in physiological adaptation will affect psychologic adaptation starting from the first trimester to the third trimester. This study aims to find out the effect of warm water compresses on back pain intensity in pregnant women in the third trimester in the independent practice of Midwife Siti Hapsah, S.Tr.Keb in 2024. The design of this study is by using the Quasy Experimental research method with a design used by one group of pre-test post-test with 53 respondents and data collection using observation sheets and then analyzed using non-parametric tests of the Wilcoxon test. The results of the study found that the most respondents were aged 20-35 years as many as 37 people (69.85), the most respondents' education was elementary school 17 people (32.15), respondents who did not work were 30 people (56.6%) and multipara 40 people (11.3%). The results of the analysis obtained a significance value of 0.000 which was smaller than the significance result of 5% (p-value = 0.000 &lt;0.05) so the conclusion is that Ha is accepted, meaning that there is an effect of warm water compresses on the intensity of reducing back pain in pregnant women in the third trimester.

COMPREHENSIVE MIDWIFERY CARE FOR A PRIMIGRAVIDA WITH BACK PAIN

During the third trimester of pregnancy, a woman will usually experience changes that will cause a lot of discomfort, one of which is back pain. This complaint can be overcome with non-pharmacological treatment, one of which is endorphin massage. Based on data at PMB "N" in 2023, out of 82 third trimester pregnant women, 73.58% experienced back pain discomfort. This study aims to determine midwifery care to reduce the intensity of back pain in third trimester pregnant women. Data collection methods with interviews, observations, and documentation studies. The subject of this midwifery care is Mrs. "A" G1P0A0 37 weeks gestation with complaints of back pain discomfort. The results showed that the comprehensive midwifery care carried out took place normally without any complication. During pregnancy, Mrs. "A" experienced back pain discomfort in the third trimester and was given endorphin massage care to relieve back pain. After the intervention was carried out 5 times, namely with the frequency of endorphin massage starting on the first day of the visit to the PMB and carried out again on day 3, day 5, day 6 and day 7 after the visit to the PMB, the back pain in Mrs. "A" decreased and she said she felt comfortable and more relaxed. It can be concluded comprehensive midwifery care in Mrs. "A" runs normally and effectively to overcome the discomfort experienced. This comprehensive midwifery care is expected to be applied to minimize complications that may occur during pregnancy, childbirth, newborn, postpartum to contraceptive services. Keywords: Back Pain, Endorphin Massage, Use of Video

The Functional Efficiency of Older Patients after Lumbar Spine Surgery, the Impact of Pain, and the Passage of Time: Tips for Care Providers.

Chronic back pain in adults is often a cause of absenteeism from work, limitations in social interactions, and difficulties in performing daily activities. This study aimed to check whether the functioning of everyday activities in elderly patients after neurosurgery improved over time compared to their condition before the procedure and whether there is a connection between fitness, self-esteem, and pain intensity. This was a cross-sectional study carried out using an anonymous survey. This study included patients over 60 years of age from the neurosurgical ward. The following scales were used to assess cognitive functioning, depression, functional status: basic and instrumental activities of daily living (IADL), back pain disability (QBPDS), pain intensity, and self-esteem. The level of independence in terms of IADL and QBPDS increased, and the intensity of pain decreased. Surgery reduced pain intensity from 8 ± 0.8 to 6.1 ± 1.4 points. The level of self-esteem (RSES) remained at a low level. The passage of time after neurosurgical treatment has a beneficial effect on reducing pain intensity and increasing independence in life activities. Daily physical activity and rehabilitation are important factors supporting the return to independence.

CHARACTERISTICS OF SCIATICA PATIENTS LISTED FOR A SPINAL EPIDURAL STEROID INJECTION AND CLINICAL OUTCOMES: RESULTS FROM THE POISE COHORT STUDY

BackgroundClinical guidelines recommend epidural steroid injection (ESI) for severe sciatica but there is uncertainty of effectiveness. The POiSE study aims to identify factors, routinely collected in clinical practice that predict outcome in patients who have ESI. This presentation describes characteristics and early clinical outcomes of POiSE participants.MethodsProspective cohort study in 19 NHS spinal services in England, inviting patients with sciatica listed for an ESI. Participant baseline characteristics and 6-week follow-up outcomes are presented. Outcomes include pain intensity (0–10 NRS), disability (Oswestry Disability Index 0–100) and global change in symptoms.ResultsOver 24 months, 693 patients were invited to participate and 353 (51%) completed baseline questionnaires. Mean (SD) age 49.0 years (14.4), 60% female, and 46% (n=101) of those in work had certified time-off for sciatica. Mean pain intensity was 7.2 (2.0) and 6.2 (2.7) for leg and back pain respectively and mean disability (ODI) was 46.5 (18). 60% (n=210) had leg pain for &gt;6 months. Average confidence at baseline (0 to 10) that the ESI would help symptoms was 5.7 (2.4).Of 217 patients reaching 6-week follow-up, mean leg and back pain intensity is 5.0 (2.8) and 4.9 (2.9) respectively and ODI 36.6 (20.4), with 57% reporting improvement (completely recovered/much better/better). Follow-up data collection at 6, 12 and 24-weeks post-ESI is ongoing.ConclusionInterim analysis shows only just over half of patients are reporting improvement at 6 weeks post ESI. The POiSE cohort study will help better identify the patients with sciatica who are most likely to benefit from this treatment.Conflicts of interestNoneSources of fundingThis study is supported by Health Education England and the National Institute for Health and Care Research (HEE/ NIHR ICA Programme Clinical Lectureship, Dr Siobhan Stynes, NIHR300441). The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care

Predictors of Postoperative Persistent Low Back Pain Following Lumbar Fusion in Patients Older than 75 Years: An Analysis of a Minimum 2-Year Follow-Up

PurposeThis study aimed to evaluate pre- and perioperative predictors associated with persistent low back pain (LBP) following lumbar fusion in patients aged > 75 years. MethodsThis single-center retrospective study examined 310 patients aged > 75 years who underwent lumbar fusion for lumbar degenerative disease (104 males, 206 females; mean age, 79 [75–90] years). The visual analog scale (VAS) score for LBP was examined preoperatively and 2-year postoperatively. The persistent LBP group comprised patients with a 2-year postoperative LBP-VAS score ≥ 3. The demographic and preoperative radiographic parameters were also reviewed. A multivariate stepwise logistic regression analysis was performed of variables with values of P < 0.2 on the univariate analysis. ResultsNinety-nine patients (32%) experienced persistent postoperative LBP. Multivariate logistic regression analysis revealed that age < 82 years, history of previous lumbar decompression, and greater preoperative VAS score for LBP were associated with greater postoperative persistent LBP after lumbar fusion, whereas other factors, such as gender, body mass index, osteoporosis, diabetes mellitus, depression, symptom duration, operative time, estimated blood loss, and spinopelvic sagittal parameters, were not. ConclusionsThis study showed that a relatively younger age, history of preoperative lumbar decompression, and greater preoperative VAS score for LBP were preoperative predictors of postoperative persistent LBP following lumbar fusion in elderly patients. In contrast, preoperative spinopelvic sagittal parameters were not associated with persistent postoperative LBP. Although lumbar fusion is expected to improve LBP, surgeons should pay attention to age, surgical history, and preoperative back pain intensity.

Effectiveness of biobehavioral therapeutic education in chronic low back pain intensity and disability: a systematic review

Background: Chronic low back pain (CLBP) is a prevalent musculoskeletal issue that could lead to significant disability. CLBP involves persistent pain and psychological factors contributing to its complexity. Therapeutic education combining cognitive-behavioral approaches may aid in managing CLBP. Objectives: This systematic review evaluates the efficacy of therapeutic education based on a biobehavioral approach in modifying beliefs and promoting active coping strategies in CLBP patients. Methods: Following PRISMA guidelines, we searched PubMed, EBSCO host, and Google Scholar for randomized controlled trials (RCTs) and quasi-experimental studies from March 27 to April 16, 2022, with an update on June 15, 2024. Inclusion criteria focused on adults with CLBP undergoing therapeutic education aimed at behavioral modification. Methodological quality was assessed using the PEDro scale, and risk of bias was evaluated using RoB 2.0. Results: Out of 532 studies, four met the inclusion criteria. The interventions combined therapeutic education with therapeutic exercise or conventional physical therapy. Pain intensity and disability were the main outcomes measured. One study found significant improvements in pain and disability, while others showed trends towards improvement without statistical significance. The quality of evidence was very low. Conclusion: Combining therapeutic education with active coping strategies and other therapies may reduce pain intensity and disability in CLBP patients. However, the evidence quality is very low, highlighting the need for further research.

Meta Analysis: Effects Of Mckenzie Exercise And Other Treatment Techniques In Reducing Pain and Disability In Chronic Nonspecific Low Back Pain

Background Low back pain (LBP) is rising globally due to increase in population and ageing. In adults below 45 years of age, work-related injury leads to nonspecific pain resulting in disability. Exercise therapy has proven to be effective in reducing pain and associated disability in these patients. McKenzie exercises focus on repeated end-range movement and posture correction, thereby reducing pain and disability. This study aims to compare the effectiveness of McKenzie exercise with other techniques in reducing pain and disability in nonspecific chronic LBP (NSCLBP). Objectives To compare the effect of alternate treatment approaches and McKenzie exercises in nonspecific chronic low back pain. Methods Studies that satisfied the inclusion and exclusion criteria for the review were found by searching databases like Google Scholar, Pub Med and Cochrane CENTRAL. This study comprised randomized controlled trials that compared McKenzie treatment with other therapeutic approaches for treating NSCLBP. Two independent reviewers extracted the data and evaluated the trials' quality. Forest plots were used to display the results. Results Eleven full-text articles were included in this study for review in order to conduct a meta-analysis and qualitative analysis. The meta-analysis of pain and functional impairment related to back pain comprised ten studies each. When comparing patients undergoing McKenzie treatment to other treatment techniques, there was a slight overall decrease in the intensity of low back pain (SMD: -0.83 [95% CI: -1.11, -0.55], I2= 80.8%; p&lt; 0.000). After doing McKenzie exercises, low back patients' functional impairment did not improve in comparison to other therapy methods (SMD: 0.07 [95% CI: -0.54, 0.68], I2= 71.5%; p&lt; 0.000). Conclusion McKenzie exercise is equally effective to other manual therapy techniques but slightly effective than passive treatments in decreasing pain &amp; disability in NSCLBP.

Changes in isokinetic trunk muscle strength and endurance after two different restoration programs in people with chronic low back pain: A longitudinal retrospective study

BackgroundMultidisciplinary functional restoration programs (FRPs) aim to improve pain and function in people with chronic low back pain (CLBP). The intensity and content of FRPs varies; the benefits of one program over another are unclear. ObjectiveTo assess changes in trunk muscle strength and endurance after an intensive (IFRP) (for people on sick leave for >6 months with high levels of fear-avoidance beliefs about physical activity and work) or semi-intensive (SIFRP) (for people working) FRP in people with CLBP. MethodsLongitudinal retrospective study from March 2016 to December 2019. Setting: rehabilitation department of a tertiary care center. Trunk flexor and extensor muscle strength (60°.s−1) and endurance (120°.s−1) were measured with the Humac NORM isokinetic dynamometer at pre and post FRP. Change in isokinetic variables (peak torque, total work and flexor/extensor ratio) after each program was assessed with a paired t-test (p < 0.05). Pearson's rho and multiple linear regression assessed associations between changes in isokinetic and clinical variables and demographic characteristics. Results125 individuals, 63.2 % female, age 43.5 (10.3) years, were included. Mean low back pain intensity was 49.8 (24.9) and 37.2 (25.8)/100 and mean activity limitation (QBPDS) was 38.8 (16.4) and 32.0 (14.6)/100 in the IFRP and SFRP groups, respectively. Trunk extensor peak torque, flexor total work, extensor total work and flexor/extensor peak ratio improved significantly in both FRPs, p < 0.001. The flexor/extensor total work ratio improved in the IFRP group only, p = 0.003. Trunk extensor endurance increased more in the IFRP than the SIFRP group, the absolute pre-post differences for extensor total work [95%CI] N.m were 611.7 [495.2; 728.3] in the IFRP group and 380.0 [300.8; 459.3] in the SIFRP group. No variables were correlated and none predicted improvement in extensor total work in either group. ConclusionThis study highlights the short-term independence of clinical and trunk muscle strength and endurance changes.