Articles: low-back-pain.
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Bmc Musculoskel Dis · Jan 2010
Randomized Controlled Trial Multicenter StudyAcupuncture for chronic low back pain: protocol for a multicenter, randomized, sham-controlled trial.
Use of acupuncture has widely increased in patients with chronic low back pain. However, the evidence supporting its efficacy remains unclear. In this article, we report the design and the protocol of a multi-center randomized sham-controlled trial to treat chronic low back pain. Our goal is to verify the effect of acupuncture on chronic low back pain. ⋯ The result of this trial (which will be available in 2010) will demonstrate the efficacy of using acupuncture to treat chronic low back pain.
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Randomized Controlled Trial
Individualized chiropractic and integrative care for low back pain: the design of a randomized clinical trial using a mixed-methods approach.
Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM) and conventional therapies, while also incorporating patient choice, has yet to be tested for chronic LBP.The primary aim of this study is to determine the relative clinical effectiveness of 1) monodisciplinary chiropractic care and 2) multidisciplinary integrative care in 200 adults with non-acute LBP, in both the short-term (after 12 weeks) and long-term (after 52 weeks). The primary outcome measure is patient-rated back pain. Secondary aims compare the treatment approaches in terms of frequency of symptoms, low back disability, fear avoidance, self-efficacy, general health status, improvement, satisfaction, work loss, medication use, lumbar dynamic motion, and torso muscle endurance. Patients' and providers' perceptions of treatment will be described using qualitative methods, and cost-effectiveness and cost utility will be assessed. ⋯ This mixed-methods randomized clinical trial assesses clinical effectiveness, cost-effectiveness, and patients' and providers' perceptions of care, in treating non-acute LBP through evidence-based individualized care delivered by monodisciplinary or multidisciplinary care teams.
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Randomized Controlled Trial
Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study.
To contrast the efficacy of two exercise programs, segmental stabilization and strengthening of abdominal and trunk muscles, on pain, functional disability, and activation of the transversus abdominis muscle (TrA), in individuals with chronic low back pain. ⋯ Both techniques lessened pain and reduced disability. Segmental stabilization is superior to superficial strengthening for all variables. Superficial strengthening does not improve TrA activation capacity.
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Bmc Musculoskel Dis · Jan 2010
Randomized Controlled Trial Comparative StudyAn educational approach based on a non-injury model compared with individual symptom-based physical training in chronic LBP. A pragmatic, randomised trial with a one-year follow-up.
In the treatment of chronic back pain, cognitive methods are attracting increased attention due to evidence of effectiveness similar to that of traditional therapies. The purpose of this study was to compare the effectiveness of performing a cognitive intervention based on a non-injury model with that of a symptom-based physical training method on the outcomes of low back pain (LBP), activity limitation, LBP attitudes (fear-avoidance beliefs and back beliefs), physical activity levels, sick leave, and quality of life, in chronic LBP patients. ⋯ An educational approach to treatment for chronic LBP resulted in at least as good outcomes as a symptom-based physical training method, despite fewer treatment sessions.
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Review
A systematic review of multidisciplinary outcomes in the management of chronic low back pain.
Previous research has provided an inconsistent message as to the effectiveness of multidisciplinary programs to improve employment outcomes in clients with Chronic Low Back Pain (CLBP). The primary aims of this review were to: 1) update the evidence for the multidisciplinary treatment of CLBP to improve employment outcomes 2) assess what knowledge supports occupational therapy as contributing to a multidisciplinary approach in the treatment of CLBP. ⋯ The results are discussed with reference to current methodological limitations found in the literature. Furthermore, occupational therapists were found to be underutilized in the included studies and future multidisciplinary programs should take advantage of the wide range of skills that occupational therapists can contribute in this practice area.