Combined physiotherapy and education is efficacious for chronic low back pain
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TL;DR: The findings support the efficacy of combined physiotherapy treatment in producing symptomatic and functional change in moderately disabled chronic low back pain patients.
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Abstract: Manual therapy, exercise and education target distinct aspects of chronic low back pain and probably have distinct effects. This study aimed to determine the efficacy of a combined physiotherapy treatment that comprised all of these strategies. By concealed randomisation, 57 chronic low back pain patients were allocated to either the four–week physiotherapy program or management as directed by their general practitioners. The dependent variables of interest were pain and disability. Assessors were blind to treatment group. Outcome data from 49 subjects (86%) showed a significant treatment effect. The physiotherapy program reduced pain and disability by a mean of 1.5/10 points on a numerical rating scale (95% CI 0.7 to 2.3) and 3.9 points on the 18–point Roland Morris Disability Questionnaire (95% CI 2 to 5.8), respectively. The number needed to treat in order to gain a clinically meaningful change was 3 (95% CI 3 to 8) for pain, and 2 (95% CI 2 to 5) for disability. A treatment effect was maintained at one–year follow–up. The findings support the efficacy of combined physiotherapy treatment in producing symptomatic and functional change in moderately disabled chronic low back pain patients.
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Citations
The effect of manual therapy and neuroplasticity education on chronic low back pain: a randomized clinical trial
Adriaan Louw,Kevin Farrell,Merrill R. Landers,Martin Barclay,Elise Goodman,Jordan Gillund,Sara McCaffrey,Laura Timmerman +7 more
TL;DR: The results of this study show that a neuroplasticity explanation, compared to a traditional biomechanical explanation, resulted in a measureable difference in SLR in patients with CLBP when receiving manual therapy.
Physiotherapy Based on a Biobehavioral Approach with or Without Orthopedic Manual Physical Therapy in the Treatment of Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial.
Mónica Grande-Alonso,Luis Suso-Martí,Ferran Cuenca-Martínez,Joaquín Pardo-Montero,Alfonso Gil-Martínez,Roy La Touche +5 more
TL;DR: The results of this study suggest that orthopedic manual physical therapy does not increase the effects of a treatment based on biobehavioral therapy in the short or medium term, but these results should be interpreted with caution.
High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up.
TL;DR: No difference was observed between the high low load lifting and low load motor control interventions and both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.
Effects of a Progressive Stabilization Exercise Program Using Respiratory Resistance for Patients with Lumbar Instability: A Randomized Controlled Trial
Sam-Ho Park,Myung-Mo Lee +1 more
TL;DR: Progressive stabilization exercise program with respiratory resistance is an effective method with clinical significance in pain reduction, psychosocial stability, and enhancement of motor and respiratory functions.
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Contemporary biopsychosocial exercise prescription for chronic low back pain: questioning core stability programs and considering context.
Peter Stilwell,Katherine Harman +1 more
TL;DR: To improve exercise adherence and outcomes in the CLBP population, the context in which exercise is delivered and the meaning patients embody need to be considered and shaped by clinicians.
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