Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: a non-randomized controlled trial

Abstract

BackgroundThe aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months).MethodsAccording to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned.ResultsOf the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group.The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7).ConclusionsOur findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects.Trial registrationNCT00789204

Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial

“…The patients were evaluated again after three and six months, a procedure that was not performed in this study. The improvement in pain intensity and functional capacity with the GPR in Bonetti et al's study (39) corroborates the indings of this study, but it should be noted that these authors used conventional stretching for comparison, whereas this method was not superior to isostretching in the present study.…”

“…However, it is dif icult to compare these results with the indings of the present study, because all patients in the Heredita and Rodrigues study (36) had a diagnosis of speci ic low back pain and had previously undergone a surgical procedure. Bonetti et al (39) evaluated 78 patients with low back pain regarding pain intensity by VAS and functional capacity by the Roland-Morris Questionnaire. Fortytwo of these patients underwent three GPR postures, maintained for 15 -20 minutes, whereas 36 underwent conventional stretching in ten sessions, twice a week, for one hour each.…”

“…Bonetti et al's GPR protocol (39) included only the coxo-femural angle closure, because these are the most common retractions in the population. This statement disagrees with the present study, in which changes in both chains were found, with the former chain being prevalent in 61.9% of patients in the GPR group and 50% in the isostretching group.…”

Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

“…In general, as the central control of efferents in PD was compromised in our study (56), PD patients might benefit from ABCT. Considering the scarcity of recent studies on the effects of rehabilitation programs on reducing falls in PD patients (57), only few researchers have evaluated falls as a mixed outcome in combination with other factors (e.g., balance, fall risk, and FOF) (45,46,(57)(58)(59)(60).…”

Magnitude of physiological curvatures of the spine and the incidence of contractures of selected muscle groups in students

“…Here, the postural muscles must be active enough to oppose the force of gravity, but not so active as to generate an excessive energy cost. The structure of the human body is such that the postural tension is distributed globally, rather than being focused locally [5,6,8,23,29].…”