Clinical approach to chronic lumbar pain: a systematic review of recommendations included in existing practice guidelines
01 Jan 2015-Anales Del Sistema Sanitario De Navarra (An Sist Sanit Navar)-Vol. 38, Iss: 1, pp 117-130
TL;DR: In this article, a systematic review of clinical practice guidelines based on evidence, with explicit recommendations on the treatment of chronic low back pain, was presented, where the main objective was to analyze their content and provide a synthesis in order to improve the translation of this evidence into practice.
Abstract: This paper presents a systematic review of clinical practice guidelines based on evidence, with explicit recommendations on the treatment of chronic low back pain. The main objective was to analyze their content and provide a synthesis in order to improve the translation of this evidence into practice. The recommendations were analyzed and then classified by treatment; evidence level and strength of recommendation were identified and translated into our gradation system. Eight guidelines met the inclusion criteria. Exercise and back school treatment are shown as the best therapies. Pharmacotherapy is indicated during short periods of time. The guidelines analyzed show similar therapeutic approaches. The recommendations have been synthesized in order to allow clinical selection of the best treatment and avoid bad practices with their corresponding costs, providing a more efficient management of the patient.
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TL;DR: ClBP patients undergoing an 8-week intensive exercise approach incorporating both behavioral and physical conditioning principles showed both significant and clinically significant improvements in this observational case series.
Abstract: Background Approaches in the treatment of general chronic low back pain (CLBP) are multifaceted relative to specific interventions. In the past, passive interventions have commonly been employed with little evidence to support their effectiveness. Recent reviews suggest a focus on active exercises programs that includes pain education and cognitive behavioral therapy. Objective To investigate the outcomes of CLBP patients and describe the approach in persons undergoing a group spinal rehabilitation program using graded exercise, and operant conditioning. Methods Adult patients with CLBP participated in a twice weekly 90 minute exercise sessions for 8-weeks (n= 201). The program consisted of behavioral education, stretching, aerobic exercises, graded progressive resistance exercise, MedX isotonic strengthening, and functional bending lifting task exercises. Results A total of 201 patient records were evaluated where the overall ODI improvement was 13.2% (± 14.0) (p Conclusion CLBP patients undergoing an 8-week intensive exercise approach incorporating both behavioral and physical conditioning principles showed both significant and clinically significant improvements in this observational case series. Long-term benefits were also seen in both the 6 and 12 month follow-up questionnaires although further investigation is warranted due to limited survey return rate and study design.
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TL;DR: In this article, a quasi-experimental study was conducted with 56 healthy participants who were divided into an experimental group (n = 30), who underwent the programme consisting of a total of 16 sessions, and a control group(n = 26), who did not undergo the intervention.
Abstract: Background: Low back pain is highly prevalent and has a major socio-economic impact worldwide. Among the rehabilitation options is the Back School, which consists of programmes that include exercise and educational interventions to treat and prevent back pain. The effects of this type of programme are usually evaluated in patients with low back pain. The aim of this study was to evaluate the effects on low back functionality and the prevention of medical visits due to low back pain during one year of follow-up in a healthy adult population. Methods: A quasi-experimental study was conducted with 56 healthy participants who were divided into an experimental group (n = 30), who underwent the programme consisting of a total of 16 sessions, and a control group (n = 26), who did not undergo the intervention. All participants were administered the Partial Curl-up Test, Biering Sorense Test, Modified Schober Test, and Toe Touch Test, and they completed the Short Form 36 Health Survey before and after the intervention. In addition, a telephone call was made to ask whether they attended a doctor for low back pain in the following year post-intervention. Results: In the experimental group, statistically significant improvements were observed in trunk muscle strength, spinal flexion joint range of motion, and hamstring flexibility, and they had fewer visits to the doctor for low back pain in the following year. Conclusions: The theoretical–practical programme based on the Back School seems to have beneficial effects on low back functionality by increasing its strength and flexibility in an adult population. In addition, this programme reduced the number of medical visits due to low back pain during the following year after the intervention.
2 citations