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Yu D, Wu M, Zhang J, Song W, Zhu L. Effect of qigong on pain and disability in patients with chronic non-specific low back pain: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2025; 20:194. [PMID: 39994723 PMCID: PMC11849339 DOI: 10.1186/s13018-025-05576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 02/05/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND Chronic non-specific low back pain (CNLBP) is a common health problem worldwide. Patients with CNLBP often suffer from persistent pain, with a few being disabled by their pain, affecting their daily functioning and social participation. This study aims to systematically evaluate the effects of pain and dysfunction in Qigong patients with chronic non-specific back pain through systematic evaluation and gathered analysis of random control test data. METHODS We searched nine databases from their inception dates until April 2024. Relevant randomized controlled trials (RCTs) were included. Patients were assessed for pain using the Visual Analog Scale and Numeric Pain Rating Scale and for disability using the Oswestry Disability Index and Roland-Morris disability questionnaire. The risk of bias was assessed using the Cochrane Collaboration tool. CMA V3.0 was used to analyze data. RESULTS Sixteen RCTs involving 1175 participants were included. These studies have different designs, and the participants are mainly around 60 years old. The results showed that the qigong practice improved pain significantly more than the control measures ([Mean Difference MD] = - 1.34, 95% confidence intervals [CI] - 1.76 to - 0.92, p < 0.001 Minimal Clinically Important Differences MCID = 1.5), and the efficacy of short-term interventions (MD = - 1.88, 95% CI - 2.87 to - 0.9, p < 0.001) was superior to that of long-term interventions (MD = - 1.07, 95% CI - 1.49 to - 0.65, p < 0.001). For improvement in the degree of dysfunction, qigong practice showed a higher effect size (MD = - 5.88, 95% CI - 7.98 to - 3.78, p < 0.001 MCID = 5) than that observed in the control group. CONCLUSION Qigong practice is effective in improving disability in patients with CNLBP, but has no significant effect on improving pain. However, due to the high heterogeneity, the results need to be interpreted with caution.
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Affiliation(s)
- Donghui Yu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Minmin Wu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | | | - Wenjing Song
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.
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Wami SD, Chala MB, Wolde SY, Donnelly C, Gelaye KA, Pullatayil A, Adefris E, Miller J. Clarifying the characteristics of interprofessional rehabilitation programs for adults with chronic low back pain: A scoping review. J Back Musculoskelet Rehabil 2025; 38:4-18. [PMID: 39970450 DOI: 10.1177/10538127241290643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Abstract
BACKGROUND Interprofessional rehabilitation programs are recommended by practice guidelines based on their effectiveness in improving health-related quality of life, pain, and function for people with chronic low back pain (CLBP). However, the most appropriate program characteristics are poorly described in the literature. OBJECTIVE This scoping review aimed to synthesize the characteristics of interprofessional rehabilitation programs for people living with CLBP. METHODS The scoping review was guided by the framework developed by Arksey and O'Malley, which has been further enhanced by the Joanna Briggs Institute (JBI). Electronic databases, including Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, SCOPUS, PubMed, Web of Science, and Cochrane Library, were searched to identify relevant published studies. RESULTS Out of 13370 articles identified through our search, seventy-nine studies fulfilled our eligibility criteria. In the majority of the studies (n = 75), interprofessional rehabilitation programs for people with CLBP consisted of two or more of the following interventions: physical activity and exercise (n = 68), education (n = 61), psychotherapy (n = 52), and vocational support/advice (n = 31). In a few studies describing the underlying theories, the biopsychosocial model, which emphasizes the need to address social, psychological, and physical components in the management of CLBP, was the most often cited theoretical framework. CONCLUSION There is substantial variation in how interprofessional rehabilitation programs for people with CLBP are conceptualized and evaluated. A detailed description of the intervention evaluated, and the underlying theoretical frameworks was also lacking in most studies. We recommend the use of a consistent term and components aligned with practice guidelines.
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Affiliation(s)
| | - Mulugeta Bayisa Chala
- Gray Centre for Mobility & Activity, Parkwood Institute, St Joseph's Health Care London, London, ON, Canada
| | | | - Catherine Donnelly
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abdul Pullatayil
- Health Sciences Library, Queen's University, Kingston, ON, Canada
| | - Esayas Adefris
- Department of Surgery, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jordan Miller
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Wan J, Kim J, Tsujimoto T, Mizushima R, Shi Y, Kiyohara K, Nakata Y. Effectiveness and Components of Health Behavior Interventions on Increasing Physical Activity Among Healthy Young and Middle-Aged Adults: A Systematic Review with Meta-Analyses. Behav Sci (Basel) 2024; 14:1224. [PMID: 39767365 PMCID: PMC11673272 DOI: 10.3390/bs14121224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 12/16/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
Physical inactivity contributes to various health risks; however, approximately one-third of the global population remains insufficiently active. Many researchers have attempted to increase physical activity levels; however, the effectiveness and the specific components of these interventions remain unclear. This systematic review with meta-analyses utilized a behavior change technique taxonomy to identify and extract effective intervention components, aiming to develop more efficient programs to promote physical activity. We searched the PubMed and Ichu-shi Web databases for studies targeting healthy young and middle-aged adults with data on physical activity changes and extracted the intervention components. A random-effects model was used for the primary meta-analysis, and a meta-regression was conducted for the selected outcomes. Overall, 116 studies were included, with 102 used for the primary analysis. The interventions showed a small effect on overall physical activity promotion. Subsequent meta-regressions identified 1.5 Review behavior goal(s) as a significant positive intervention component, as well as four and three potential positive and negative components, respectively. This systematic review and meta-analysis demonstrated the effectiveness of physical activity interventions and highlighted effective and negative components. These findings may inform the design of future programs aimed at promoting physical activity.
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Affiliation(s)
- Jiawei Wan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8574, Japan; (J.W.); (Y.S.)
| | - Jihoon Kim
- Institute of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8574, Japan; (J.K.); (R.M.)
| | - Takehiko Tsujimoto
- Faculty of Human Sciences, Shimane University, 1060 Nishikawatsucho, Matsue 690-8504, Japan;
| | - Ryoko Mizushima
- Institute of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8574, Japan; (J.K.); (R.M.)
| | - Yutong Shi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8574, Japan; (J.W.); (Y.S.)
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women’s University, 12 Sanbancho, Chiyoda, Tokyo 102-8357, Japan;
| | - Yoshio Nakata
- Institute of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8574, Japan; (J.K.); (R.M.)
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Navas-Otero A, Calvache-Mateo A, Martín-Núñez J, Valenza-Peña G, Hernández-Hernández S, Ortiz-Rubio A, Valenza MC. The Effectiveness of Combined Exercise and Self-Determination Theory Programmes on Chronic Low Back Pain: A Systematic Review and Metanalysis. Healthcare (Basel) 2024; 12:382. [PMID: 38338267 PMCID: PMC10855905 DOI: 10.3390/healthcare12030382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Low back pain is a pervasive issue worldwide, having considerable prevalence and a significant impact on disability. As low back pain is a complicated condition with many potential contributors, the use of therapeutic exercise, combined with other techniques such as self-determination theory programmes, has the potential to improve several outcomes. The aim of this systematic review was to explore the effectiveness of combined exercise and self-determination theory programmes on chronic low back pain. This study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A systematic search in three databases (PubMed/MEDLINE, Web of Science, and Scopus) was conducted from September to November 2023. After screening, a total of five random control trials with patients with chronic low back pain were included in this systematic review and meta-analysis. The results showed significant differences in disability (SMD = -0.98; 95% CI = -1.86, -0.09; p = 0.03) and in quality of life (SMD = 0.23; 95% CI = 0.02, 0.44; p = 0.03) in favour of the intervention group versus the control group.
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Affiliation(s)
| | | | | | | | | | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.N.-O.); (A.C.-M.); (J.M.-N.); (G.V.-P.); (S.H.-H.); (M.C.V.)
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Ceulemans D, Moens M, Reneman M, Callens J, De Smedt A, Godderis L, Goudman L, Lavreysen O, Putman K, Van de Velde D. Biopsychosocial rehabilitation in the working population with chronic low back pain: a concept analysis. J Rehabil Med 2024; 56:jrm13454. [PMID: 38226563 PMCID: PMC10802789 DOI: 10.2340/jrm.v56.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/29/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE To identify the essential attributes of biopsychosocial rehabilitation for chronic low back pain in the working population. DESIGN A concept analysis was conducted according to the 8-step method of Walker and Avant. This framework provides a clear concept and theoretical and operational definitions. METHODS Five databases were searched, followed by a systematic screening. Subsequently, attributes, illustrative cases, antecedents, consequences and empirical referents were formulated. RESULTS Of the 3793 studies identified, 42 unique references were included. Eleven attributes were identified: therapeutic exercise, psychological support, education, personalization, self-management, participation, follow-up, practice standard, goal-setting, social support, and dietary advice. Subsequently, illustrative cases were described. Antecedents, such as motivation, preparedness and a multidisciplinary team, were found, together with consequences such as decreased pain, less sick-leave and increased function and work status. Finally, examples of empirical referents were given. CONCLUSION This study identified the attributes that are necessary to develop biopsychosocial rehabilitation intervention programmes for chronic low back pain. The defined concept of biopsychosocial rehabilitation for chronic low back pain may serve as a solid base to further develop and apply interventions. Future research should focus on the objectification of biopsychosocial rehabilitation and conceptualization regarding how personalization is done.
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Affiliation(s)
- Dries Ceulemans
- Faculty of Medicine and Healthcare Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium; STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium.
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Michiel Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Jonas Callens
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium
| | - Ann De Smedt
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Olivia Lavreysen
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Healthcare Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium
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Bemani S, Sarrafzadeh J, Dehkordi SN, Talebian S, Salehi R, Zarei J. Effect of multidimensional physiotherapy on non-specific chronic low back pain: a randomized controlled trial. Adv Rheumatol 2023; 63:57. [PMID: 38049905 DOI: 10.1186/s42358-023-00329-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/27/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Many people with non-specific chronic low back pain (NSCLBP) do not recover with current conventional management. Systematic reviews show multidimensional treatment improves pain better than usual active interventions. It is unclear whether multidimensional physiotherapy improves pain better than usual physiotherapy. This study determines the effectiveness of this treatment to reduce pain and disability and improve quality of life, pain cognitions, and electroencephalographic pattern in individuals with NSCLBP. METHODS 70 eligible participants aged 18 to 50 years with NSCLBP were randomized into either the experimental group (multidimensional physiotherapy) or the active control group (usual physiotherapy). Pain intensity was measured as the primary outcome. Disability, quality of life, pain Catastrophizing, kinesiophobia, fear Avoidance Beliefs, active lumbar range of motion, and brain function were measured as secondary outcomes. The outcomes were measured at pre-treatment, post-treatment, 10, and 22 weeks. Data were analyzed using intention-to-treat approaches. RESULTS There were 17 men and 18 women in the experimental group (mean [SD] age, 34.57 [6.98] years) and 18 men and 17 women in the active control group (mean [SD] age, 35.94 [7.51] years). Multidimensional physiotherapy was not more effective than usual physiotherapy at reducing pain intensity at the end of treatment. At the 10 weeks and 22 weeks follow-up, there were statistically significant differences between multidimensional physiotherapy and usual physiotherapy (mean difference at 10 weeks, -1.54; 95% CI, -2.59 to -0.49 and mean difference at 22 weeks, -2.20; 95% CI, - 3.25 to - 1.15). The standardized mean difference and their 95% confidence intervals (Cohen's d) revealed a large effect of pain at 22 weeks: (Cohen's d, -0.89; 95% CI (-1.38 to-0.39)). There were no statistically significant differences in secondary outcomes. CONCLUSIONS In this randomized controlled trial, multidimensional physiotherapy resulted in statistically and clinically significant improvements in pain compared to usual physiotherapy in individuals with NSCLBP at 10 and 22 weeks. TRIAL REGISTRATION ClinicalTrials.gov NCT04270422; IRCT IRCT20140810018754N11.
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Affiliation(s)
- Sanaz Bemani
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran
| | - Javad Sarrafzadeh
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran.
| | - Shohreh Noorizadeh Dehkordi
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran
- Department of Rehabilitation Management, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Geriatric Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jamileh Zarei
- Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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Impact of Active Physiotherapy Rehabilitation on Pain and Global and Functional Improvement 1-2 Months after Lumbar Disk Surgery: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10101943. [PMID: 36292390 PMCID: PMC9601491 DOI: 10.3390/healthcare10101943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction: Lumbar disc surgery is a common procedure for patients with lower back pain associated with lumbar disc herniation. This study aims to evaluate the impact of active physiotherapeutic rehabilitation on global/functional improvement and subjective pain score reduction among patients 1–2 months following lumbar disc surgery. The outcomes of this study are to assess the impact of active physiotherapeutic rehabilitation on functional improvement and subjective improvement in pain behavior post active rehabilitation. The outcomes are measured as pain assessed using the visual analog scale, global measurement of improvement, back pain functional status, and return to work. Methods: Databases, including MEDLINE/PubMed (10 June 1996, 2022), Web of Science (10 June 1997, 2022), Scopus (15 March, 10 June 2004, 2022), CINAHL Plus (10 June 1961, 2022), and Cochrane (10 June 1993, 2022) were reviewed without any language restrictions. All studies were systematically screened; however, only randomized controlled trials were eligible against the inclusion/exclusion criteria. All statistical tests were conducted in Review Manager (RevMan) 5.4. The quality of studies was appraised using the grading of recommendations assessment, development, and evaluation (GRADE) approach and the risk-of-bias 2 (RoB 2) tool. Results: Fifteen articles were identified, enrolling a total of 2188 patients, where the majority of active rehabilitation interventions continued for 3 months. All these interventions began 1–2 months postoperatively, and quantitative findings were presented as mean scores. The subjective pain scores were significantly lower in the interventional group, with a mean difference (MD) of −7.01 (p = 0.004). The pain disability score was considerably lower in the interventional group, with an MD of −3.94 (p = 0.002). Global improvement was higher in the interventional group (OR = 1.94, p = 0.0001). Conclusions: This study presents significant improvement in all parameters concerning pain and functionality. Postoperative rehabilitation requires optimization concerning timing, duration, intensity, and associated components to benefit patients post lumbar disc surgery.
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Ferlito R, Blatti C, Lucenti L, Boscarino U, Sapienza M, Pavone V, Testa G. Pain Education in the Management of Patients with Chronic Low Back Pain: A Systematic Review. J Funct Morphol Kinesiol 2022; 7:74. [PMID: 36278735 PMCID: PMC9590060 DOI: 10.3390/jfmk7040074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 12/04/2022] Open
Abstract
New prospective of chronic low back pain (CLBP) management based on the biopsychosocial model suggests the use of pain education, or neurophysiological pain education, to modify erroneous conceptions of disease and pain, often influenced by fear, anxiety and negative attitudes. The aim of the study is to highlight the evidence on the outcomes of a pain education-oriented approach for the management of CLBP. The search was conducted on the Pubmed, Scopus, Pedro and Cochrane Library databases, leading to 2673 results until September 2021. In total, 13 articles published in the last 10 years were selected as eligible. A total of 6 out of 13 studies support a significant reduction in symptoms in the medium term. Disability is investigated in only 11 of the selected studies, but 7 studies support a clear reduction in the medium-term disability index. It is difficult to assess the effectiveness of the treatments of pain education in patients affected by CLBP, due to the multimodality and heterogeneity of the treatments administered to the experimental group. In general, methods based on pain education or on cognitive-behavioral approaches, in association with physical therapy, appear to be superior to physiotherapeutic interventions alone in the medium term.
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Affiliation(s)
- Rosario Ferlito
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Chiara Blatti
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. Policlinico Rodolico-San Marco, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | - Ludovico Lucenti
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. Policlinico Rodolico-San Marco, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | - Umberto Boscarino
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Marco Sapienza
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. Policlinico Rodolico-San Marco, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | - Vito Pavone
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. Policlinico Rodolico-San Marco, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | - Gianluca Testa
- Department of General Surgery and Medical-Surgical Specialties, A.O.U. Policlinico Rodolico-San Marco, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
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Cocca A, Greier K, Drenowatz C, Lovecchio N, Baños R, Wirnitzer K, Ruedl G. Relation between Physical Fitness Components and the Occurrence and Subjective Intensity of Back Pain in Secondary School Adolescents. Behav Sci (Basel) 2022; 12:353. [PMID: 36285922 PMCID: PMC9598372 DOI: 10.3390/bs12100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Despite the well documented benefits of physical fitness (PF) on general health, its role in back pain (BP) is still unclear. The objective of this study was to assess the association between different PF profiles and BP in a sample of adolescents. The study assessed PF and BP in a sample of 919 youth (age = 15.5 ± 1.3 years) from North and South Tyrol. A total of 531 participants (57.8%) reported no BP, whereas 4.7% (n = 43) reported severe BP. A two-step cluster analysis detected three main groups: the “less fit”, with significantly lower scores in all PF tests (p < 0.001); the “strong sprinters”, with higher speed and muscular strength than the others (p < 0.001); and the “flexible marathoners”, with higher flexibility and cardiorespiratory fitness (p < 0.001). The “flexible marathoners” showed significantly better BP scores than the “less fit” (p = 0.029). Cardiorespiratory fitness and trunk flexibility are potential preventive components of BP in adolescents. Since the decline in flexibility starts very early in life, it is recommended to put a particular emphasis on this component of PF. The role of other components of PF should be further investigated in the future.
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Affiliation(s)
- Armando Cocca
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Klaus Greier
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Division of Physical Education, Private Educational College (KPH-ES), 6422 Stams, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
| | - Nicola Lovecchio
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
| | - Raúl Baños
- Faculty of Humanities and Social Sciences, University of Zaragoza, 44003 Teruel, Spain
| | - Katharina Wirnitzer
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, 6020 Innsbruck, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
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Booth G, Howarth A, Stubbs B, Ussher M. The Effectiveness of Interventions and Intervention Components for Increasing Physical Activity and Reducing Sedentary Behaviour in People With Persistent Musculoskeletal Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2022; 23:929-957. [PMID: 34856410 DOI: 10.1016/j.jpain.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
This systematic review and meta-analysis investigated the effectiveness of physical activity (PA) and sedentary behavior (SB) interventions on PA and SB levels in people with persistent musculoskeletal pain. We explored the effectiveness of behavior change techniques (BCTs), the use of behavior change theory and non-PA/SB outcomes. Randomized controlled trials of PA or SB interventions for people with persistent musculoskeletal pain were eligible. Twenty-three studies were included. Quality of evidence was assessed using the GRADE approach. Meta-analysis demonstrated a small effect for PA post-intervention (Hedge's g = .321, CI .136-.507, P = .001, very low-quality evidence). There was no effect for longer-term follow-up PA (low quality evidence) or SB outcomes (very low-quality evidence). There was a small effect for studies with low risk-of-bias at longer-term follow-up PA. Self-report PA outcomes, PA and education interventions, non-self-selected PA, a combination of supervised and unsupervised PA and a combination of individual and group-based interventions had larger effects. Heterogeneity was moderate to considerable. Risk-of-bias, assessed using Cochrane risk-of-bias tool (version two), was generally low. Five promising BCTs were identified: "adding objects to the environment," "goal setting (outcome)," "action planning," "monitoring outcome(s) of behaviour by others without feedback" and "feedback on outcome(s) of behaviour." In conclusion, there is evidence for a modest benefit for PA interventions immediately post-intervention, however the quality of evidence is very low. There was no evidence for longer-term follow-up PA or SB. Higher quality studies of PA and SB interventions that use objective measures are needed. PROSPERO registration: CRD42020180260. PERSPECTIVE: This review investigated the effects of physical activity and sedentary behavior interventions on physical activity and sedentary behavior levels in people with persistent musculoskeletal pain. Current evidence shows a modest benefit for interventions on physical activity post-intervention but not at longer-term follow-up or on sedentary behavior at any time-point, however quality of evidence is low to very low.
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Affiliation(s)
- Gregory Booth
- Therapies Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK; Population Health Research Institute, St George's, University of London, London, UK.
| | - Ana Howarth
- Population Health Research Institute, St George's, University of London, London, UK
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George's, University of London, London, UK; Institute of Social Marketing and Health, University of Stirling, Stirling, UK
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Sullivan MJL, Wideman TH, Gauthier N, Thibault P, Ellis T, Adams H. Risk-targeted behavioral activation for the management of work disability associated with comorbid pain and depression: a feasibility study. Pilot Feasibility Stud 2022; 8:90. [PMID: 35461255 PMCID: PMC9034524 DOI: 10.1186/s40814-022-01040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/30/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose The purpose of the present study was to conduct a preliminary evaluation of the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with comorbid pain and depression. Methods The design of the study was a single-arm non-randomized trial. The sample consisted of 66 work-disabled individuals with comorbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice, and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were “very” or “completely” satisfied with their involvement in the treatment program. Significant reductions in pain (Cohen’s d = 0.71), depression (d = 0.86), catastrophic thinking (d = 1.1), and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, and perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with comorbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with comorbid pain and depression. Trial registration ClinicalTrials.gov: NCT0517442. Retrospectively registered.
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Affiliation(s)
| | - Timothy H Wideman
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Nathalie Gauthier
- Clinique de Consultation Conjugale et Familiale Poitras-Wright, Coté, Longueuil, QC, Canada
| | - Pascal Thibault
- Department of Psychology, McGill University, Montreal, QC, H3A 1G1, Canada
| | - Tamra Ellis
- Centre for Rehabilitation and Health, Toronto, ON, Canada
| | - Heather Adams
- University Centre for Research and Disability, Halifax, Nova Scotia, Canada
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Xu W, Gu R. In Reply to the Letter to the Editor Regarding "Is Lumbar Fusion Necessary for Chronic Low Back Pain Associated with Degenerative Disk Disease? A Meta-Analysis". World Neurosurg 2021; 156:163. [PMID: 34802679 DOI: 10.1016/j.wneu.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Wenbo Xu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, P.R. China
| | - Rui Gu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, P.R. China.
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