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Baroncini A, Maffulli N, Schäfer L, Manocchio N, Bossa M, Foti C, Klimuch A, Migliorini F. Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis. Sci Rep 2024; 14:11546. [PMID: 38773302 PMCID: PMC11109223 DOI: 10.1038/s41598-024-62276-9] [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: 09/12/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement. This analysis is rendered more difficult by the vast number of available therapies and a lack of a widely accepted classification that can effectively highlight the differences in the outcomes of different management options. This study was conducted according to the PRISMA guidelines. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which compared the efficacy of physiotherapy programs in patients with cLBP were accessed. Studies reporting on non-specific or mechanical cLPB were included. Data concerning the Visual Analogic Scale (VAS) or numeric rating scale (NRS), Roland Morris Disability Questionnaire (RMQ) and Oswestry Disability Index (ODI). Data from 12,773 patients were collected. The mean symptom duration was 61.2 ± 51.0 months and the mean follow-up was 4.3 ± 5.9 months. The mean age was 44.5 ± 9.4 years. The mean BMI was 25.8 ± 2.9 kg/m2. The Adapted Physical Exercise group evidenced the lowest pain score, followed by Multidisciplinary and Adapted Training Exercise/Complementary Medicine. The Adapted Physical Exercise group evidenced the lowest RMQ score followed by Therapeutic Exercises and Multidisciplinary. The Multidisciplinary group evidenced the lowest ODI score, followed by Adapted Physical Exercise and Physical Agent modalities. Within the considered physiotherapeutic and non-conventional approaches to manage nonspecific and/or mechanic cLBP, adapted physical exercise, physical agent modalities, and a multidisciplinary approach might represent the most effective strategy to reduce pain and disability.
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Affiliation(s)
- Alice Baroncini
- GSpine4, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano, Italy
| | - Nicola Maffulli
- Department of Orthopaedics, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke on Trent, ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK
| | - Luise Schäfer
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Nicola Manocchio
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Michela Bossa
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Alexandra Klimuch
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany.
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
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Puntumetakul R, Chatprem T, Saiklang P, Leungbootnak A. The Effect of Two Types of Back Pillow Support on Transversus Abdominis and Internal Oblique Muscle Fatigue, Patient Satisfaction, and Discomfort Score during Prolonged Sitting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3742. [PMID: 36834436 PMCID: PMC9964691 DOI: 10.3390/ijerph20043742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Natural rubber is considered an economic plant in Thailand and is used to manufacture many products. Foam back pillows have proven to have various benefits for the lower back. However, no study has compared the effects of foam and rubber pillows. Therefore, the current study aimed to compare the efficacy of foam and rubber pillows on transversus abdominis and internal oblique muscle fatigue, patient satisfaction, and discomfort scores during 60 min of prolonged sitting. Thirty healthy participants were invited to the study and randomized into three sitting conditions over three consecutive days. The three groups were as follows: control, foam pillow, and rubber pillow. Our results revealed that the discomfort score increased with the sitting time in all three groups (p < 0.05). The control group had the highest discomfort when compared to the rubber pillow group at 30 min (T4; p = 0.007) and 60 min (T7; p = 0.0001), as well as the foam pillow group at 60 min (T7; p = 0.0001). Participants were more satisfied sitting with the two types of back pillows at the initial time (T1; p = 0.0001) and at 60 min (T7; p = 0.0001) when compared with the control group. Furthermore, the participants were more satisfied with using rubber pillows rather than foam pillows throughout the sitting period (p = 0.0001). The control group experienced more transversus abdominis and internal oblique muscle fatigue at 60 min (T7) of sitting compared to the initial time (T1) (p = 0.038). Thus, sitting with pillow support can decrease deep trunk muscle fatigue, and using a pillow made from natural rubber may ensure greater satisfaction and less discomfort for the user.
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Affiliation(s)
- Rungthip Puntumetakul
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Thiwaphon Chatprem
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Pongsatorn Saiklang
- Division of Physical Therapy, Faculty of Physical Therapy, Srinakharinwiroj University, Nakhon Nayok 26120, Thailand
| | - Arisa Leungbootnak
- Human Movement Sciences, Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
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Nascimento DP, Costa LOP, Gonzalez GZ, Maher CG, Moseley AM. Abstracts of low back pain trials are poorly reported, contain spin of information and are inconsistent with the full text: An overview study. Arch Phys Med Rehabil 2019; 100:1976-1985.e18. [PMID: 31207219 DOI: 10.1016/j.apmr.2019.03.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/09/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate trials abstracts evaluating treatments for low back pain with regards to completeness of reporting, spin (i.e., interpretation of study results that overemphasizes the beneficial effects of the intervention), and inconsistencies in data with the full text. DATA SOURCES The search was performed on Physiotherapy Evidence Database (PEDro) in February 2016. STUDY SELECTION This is an overview study of a random sample of 200 low back pain trials published between 2010 and 2015. The languages of publication were restricted to English, Spanish and Portuguese. DATA EXTRACTION Completeness of reporting was assessed using the CONSORT for Abstracts checklist (CONSORT-A). Spin was assessed using a SPIN-checklist. Consistency between abstract and full text were assessed by applying the assessment tools to both the abstract and full text of each trial and calculating inconsistencies in the summary score (paired t test) and agreement in the classification of each item (Kappa statistics). Methodological quality was analyzed using the total PEDro score. DATA SYNTHESIS The mean number of fully reported items for abstracts using the CONSORT-A was 5.1 (SD 2.4) out of 15 points and the mean number of items with spin was 4.9 (SD 2.6) out of 7 points. Abstract and full text scores were statistically inconsistent (P=0.01). There was slight to moderate agreement between items of the CONSORT-A in the abstracts and full text (mean Kappa 0.20 SD 0.13) and fair to moderate agreement for items of the SPIN-checklist (mean Kappa 0.47 SD 0.09). CONCLUSIONS The abstracts were incomplete, with spin and inconsistent with the full text. We advise health care professionals to avoid making clinical decisions based solely upon abstracts. Journal editors, reviewers and authors are jointly responsible for improving abstracts, which could be guided by amended editorial policies.
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Affiliation(s)
- Dafne P Nascimento
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil.
| | - Leonardo O P Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
| | - Gabrielle Z Gonzalez
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
| | - Christopher G Maher
- Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne M Moseley
- Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, Sydney, Australia
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METİN ÖKMEN B, KOYUNCU E, UYSAL B, ÖZGİRGİN N. The effects of the number of physical therapy sessions on pain, disability,and quality of life in patients with chronic low back pain. Turk J Med Sci 2017; 47:1425-1431. [DOI: 10.3906/sag-1607-78] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Tupimai T, Peungsuwan P, Prasertnoo J, Yamauchi J. Effect of combining passive muscle stretching and whole body vibration on spasticity and physical performance of children and adolescents with cerebral palsy. J Phys Ther Sci 2016; 28:7-13. [PMID: 26957720 PMCID: PMC4755966 DOI: 10.1589/jpts.28.7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/05/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study evaluated the immediate and short-term effects of a combination of
prolonged passive muscle stretching (PMS) and whole body vibration (WBV) on the
spasticity, strength and balance of children and adolescents with cerebral palsy.
[Subjects and Methods] A randomized two-period crossover trial was designed. Twelve
subjects with cerebral palsy aged 10.6 ± 2.4 years received both PMS alone as a control
group (CG) and a combination of PMS and WBV as an experimental group (EG). After random
allocation to the trial schedules of either EG-CG or CG-EG, CG received prolonged PMS
while standing on a tilt-table for 40 minutes/day, and EG received prolonged PMS for 30
minutes, followed by 10 minutes WBV. Both CG and EG received the treatment 5 days/week for
6 weeks. [Results] Immediately after one treatment, EG resulted in better improvement in
scores on the Modified Ashworth Scale than CG. After the 6-week intervention, EG also
showed significantly decreased scores on the Modified Ashworth Scale compared to CG. Both
CG and EG showed significantly reduced the performance times in the five times sit to
stand test, and EG also showed significantly increased scores on the pediatric balance
scale. [Conclusion] This study showed that 6 weeks of combined prolonged PMS and WBV had
beneficial effects on the spasticity, muscle strength and balance of children and
adolescents with CP.
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Affiliation(s)
- Teeraporn Tupimai
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand
| | - Punnee Peungsuwan
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand; School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | | | - Juinichiro Yamauchi
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand; Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan; Future Institute for Sport Sciences, Japan
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Chatchawan U, Jupamatangb U, Chanchitc S, Puntumetakul R, Donpunha W, Yamauchi J. Immediate effects of dynamic sitting exercise on the lower back mobility of sedentary young adults. J Phys Ther Sci 2015; 27:3359-63. [PMID: 26696698 PMCID: PMC4681905 DOI: 10.1589/jpts.27.3359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 07/31/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the effects of dynamic sitting
exercises during prolonged sitting on the lower back mobility of sedentary young adults.
[Subjects and Methods] Seventy-one subjects aged between 18–25 years participated in this
study. Following a randomized crossover study design, subjects were randomly assigned to
two groups: sitting only and dynamic sitting exercise. The dynamic sitting exercise was a
combination of lower back hyperextension and abdominal drawing-in movements which were
repeated 6 times in a 1-minute period and performed every 20 minutes during a 2-hour
sitting session. Lumbar range of movement was measured with the modified-modified Schober
test, and the pain intensity was evaluated using the visual analog scale. [Results] After
the experiment, the lumbar range of movement was significantly impaired in the sitting
only group; however, it was significantly improved in the dynamic sitting exercise group.
There were significant differences in lumbar range of movement of both flexion and
extension between the groups. No significant difference in pain intensity between the
groups was found. [Conclusion] These results suggest that dynamic sitting exercises during
prolonged sitting can prevent decreases in lumbar range of movement in both back flexion
and extension following a 2-hour sitting period.
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Affiliation(s)
- Uraiwan Chatchawan
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | | | | | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Wanida Donpunha
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Junichiro Yamauchi
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Thailand ; Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan ; Future Institute for Sport Sciences, Japan
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Keawduangdee P, Puntumetakul R, Swangnetr M, Laohasiriwong W, Settheetham D, Yamauchi J, Boucaut R. Prevalence of low back pain and associated factors among farmers during the rice transplanting process. J Phys Ther Sci 2015; 27:2239-45. [PMID: 26311961 PMCID: PMC4540856 DOI: 10.1589/jpts.27.2239] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the prevalence of low back pain and
associated factors in Thai rice farmers during the rice transplanting process. [Subjects
and Methods] Three hundred and forty-four farmers, aged 20–59 years old, were asked to
answer a questionnaire modified from the Standard Nordic Questionnaire (Thai version). The
questionnaire sought demographic, back-related, and psychosocial data. [Results] The
results showed that the prevalence of low back pain was 83.1%. Farmers younger than
45 years old who worked in the field fewer than six days were more likely to experience
low back pain than those who worked for at least six days. Farmers with high stress levels
were more likely to have low back pain. [Conclusion] In the rice transplanting process,
the low back pain experienced by the farmers was associated with the weekly work duration
and stress.
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Affiliation(s)
- Petcharat Keawduangdee
- Faculty of Public Health, Khon Kaen University, Thailand ; Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Thailand ; School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Manida Swangnetr
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Thailand ; Program of Production Technology, Faculty of Technology, Khon Kaen University, Thailand
| | - Wongsa Laohasiriwong
- Department of Public Health Administration, Faculty of Public Health, Board Committee of Research and Training Centre for Enhancing Quality of Life of Working Age People (REQW), Khon Kaen University, Thailand
| | - Dariwan Settheetham
- Department of Environmental Health Science, Faculty of Public Health, Khon Kaen University, Thailand
| | - Junichiro Yamauchi
- Graduate School of Human Health Science, Tokyo Metropolitan University, Japan ; Future Institute for Sport Science, Japan
| | - Rose Boucaut
- School of Health Science (Physiotherapy), University of South Australia, Australia
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