Effects of the Multidimensional Treatment on Pain, Disability, and Sitting Posture in Patients with Low Back Pain: A Randomized Controlled Trial

Abstract

The purpose of this study was to investigate the effects of multidimensional approach model on the pain, disability, and sitting posture in patients with nonspecific low back pain (LBP). Sixty LBP patients were recruited and were randomly divided into two groups: multidimensional treatment (MT) group (n = 30) and unimodal treatment (UT) group (n = 30). All participants underwent 48 sessions of treatment (40 min/session, two sessions per day, 2 days per week) for 12 weeks. The MT group conducted a core stability exercise twice a day and additionally provided training on pain principles and management methods. The UT group only performed a core stability exercise twice a day. The visual analog scale (VAS) and Oswestry Disability index (ODI) were used to measure pain intensity and disability. Thoracolumbar kyphosis and lumbar lordosis in the sitting position were measured using a motion capture system. After training, the pain and disability in the MT group improved significantly greater than the UT group ( p < 0.05 ). In the MT group, the pain relief effect persisted 3 months after the end of training. Thoracolumbar kyphosis and lumbar lordosis in the MT group were significantly improved compared to the UT group ( p < 0.05 ). Thus, MT combined with core stability exercise may be used to improve the pain, disability, and sitting posture in patients with LBP.

Exercise Therapy in Nonspecific Low Back Pain among Individuals with Lower-Limb Amputation: A Systematic Review

“…Taking into account the results of the presented studies, it seems very reasonable to address stability exercise and strengthening trunk movements as a golden standard of rehabilitation. A similar approach was taken on the able-bodied population resulting in very satisfying outcomes [ 50 , 51 ]. To maintain mobility after LLA, patients must adopt movement compensations to account for loss of knee or ankle function in the amputated limb.…”

Effects of a multidimensional approach based on exercise and mindfulness on pain, disability, quality of life, mental health, and gait parameters in patients with non-specific chronic low back pain: the BACKFIT randomized controlled trial.

“…All the professionals will have previous experience with this population. The supervised exercise program will be applied by adapting rehabilitation exercise methods used in previous literature [32,35] and will be analysed with the Consensus on Exercise Reporting Template (CERT) [36]. It will follow the National Strength and Conditioning Association [37] and American College of Sports Medicine[38] recommendations, which suggest performing between 6 and 12 repetitions for each muscle-strengthening physical activity at a moderate-to-vigorous intensity, that equals to > 5 (1'no effort' to 10 'maximal effort') on the Rating of Perceived Exertion (RPE) scale [39].…”

“…The intervention program will focus on working the core muscles, starting with low-intensity isometric contraction of this musculature to stabilize the trunk and mobility exercises, increasing intensity by performing functional tasks. The exercise intensity will be determined a moderate-to-vigorous intensity assessed with a RPE scale [39] while ensuring the absence of pain, and the progression will be based on the following phases, according to previous literature [32]: (i) Phase 1: mobility, isometric and motor control exercises that will include full body, with special emphasis on core muscles. A particular attention will be paid to the isometric contraction of the transversus abdominis muscle.…”

“…It is a 20-item self-administered questionnaire which patients are asked to indicate the score from 0 to 3 that best indicates how they feel at the time they are lling in the questionnaire. The range of score is 20-80: no anxiety (≤ 20), mild (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), moderate (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59), and severe anxiety (60-80).…”

“…Multidimensional approaches have been barely studied in patients with NSCLBP. A recent study based on exercise program and patient's education (self-management) showed the great potential of these approaches in patients with NSCLBP [32]. Furthermore, an intervention that included exercise and meditation was effective at decreasing self-reported perceptions of LBP from baseline [25] in this population.…”