Medicine in spine exercise (MiSpEx) for nonspecific low back pain patients: study protocol for a multicentre, single-blind randomized controlled trial

Niederer, Daniel; Vogt, Lutz; Wippert, Pia-Maria; Puschmann, Anne-Katrin; Pfeifer, Ann-Christin; Schiltenwolf, Marcus; Banzer, Winfried; Mayer, Frank

doi:10.1186/s13063-016-1645-1

Cited by 32 publications

(44 citation statements)

References 36 publications

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“…The exercise intervention included four different sensorimotor exercises, of which two directly trained the core stabilizing and core surrounding muscles, while the other two indirectly trained upper and/or lower extremities (detailed description see [27,29,30]). At the centre-based phase, the subjects were guided by sports-and physiotherapists, while the home training was audio-guided by a DVD.…”

Section: Interventionmentioning

confidence: 99%

“…A further external validation with all RPI-S domains and a comparison to the STarTBack [24] was conducted in a one-year two-armed randomized controlled multicenter trial (Trial No. DRKS 00010129, [30]) with 1600 participants, but not published yet. Finally, a further consecutively three-armed randomized controlled multicenter trial (Trial No.…”

Section: Prognostic Variablesmentioning

confidence: 99%

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Personalized Treatment Suggestions: The Validity and Applicability of the Risk-Prevention-Index Social in Low Back Pain Exercise Treatments

Wippert

Puschmann

Drießlein

et al. 2020

JCM

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Background: The back pain screening tool Risk-Prevention-Index Social (RPI-S) identifies the individual psychosocial risk for low back pain chronification and supports the allocation of patients at risk in additional multidisciplinary treatments. The study objectives were to evaluate (1) the prognostic validity of the RPI-S for a 6-month time frame and (2) the clinical benefit of the RPI-S. Methods: In a multicenter single-blind 3-armed randomized controlled trial, n = 660 persons (age 18–65 years) were randomly assigned to a twelve-week uni- or multidisciplinary exercise intervention or control group. Psychosocial risk was assessed by the RPI-S domain social environment (RPI-SSE) and the outcome pain by the Chronic Pain Grade Questionnaire (baseline M1, 12-weeks M4, 24-weeks M5). Prognostic validity was quantified by the root mean squared error (RMSE) within the control group. The clinical benefit of RPI-SSE was calculated by repeated measures ANOVA in intervention groups. Results: A subsample of n = 274 participants (mean = 38.0 years, SD 13.1) was analyzed, of which 30% were classified at risk in their psychosocial profile. The half-year prognostic validity was good (RMSE for disability of 9.04 at M4 and of 9.73 at M5; RMSE for pain intensity of 12.45 at M4 and of 14.49 at M5). People at risk showed significantly stronger reduction in pain disability and intensity at M4/M5, if participating in a multidisciplinary exercise treatment. Subjects at no risk showed a smaller reduction in pain disability in both interventions and no group differences for pain intensity. Regarding disability due to pain, around 41% of the sample would gain an unfitted treatment without the back pain screening. Conclusion: The RPI-SSE prognostic validity demonstrated good applicability and a clinical benefit confirmed by a clear advantage of an individualized treatment possibility.

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Section: Interventionmentioning

confidence: 99%

Section: Prognostic Variablesmentioning

confidence: 99%

Personalized Treatment Suggestions: The Validity and Applicability of the Risk-Prevention-Index Social in Low Back Pain Exercise Treatments

Wippert

Puschmann

Drießlein

et al. 2020

JCM

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“…The (back) pain questionnaire consisted of 7 items, including pain intensity and disability (recently and last 3 months) [29,30,31]. Six items are conducted of a numeric rating scale ranging from 0 (no pain/disability) to 10 (highest pain/ disability (incapable of doing anything)).…”

Section: Methodsmentioning

confidence: 99%

Effects of sudden walking perturbations on neuromuscular reflex activity and three-dimensional motion of the trunk in healthy controls and back pain symptomatic subjects

et al. 2017

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BackgroundBack pain patients (BPP) show delayed muscle onset, increased co-contractions, and variability as response to quasi-static sudden trunk loading in comparison to healthy controls (H). However, it is unclear whether these results can validly be transferred to suddenly applied walking perturbations, an automated but more functional and complex movement pattern. There is an evident need to develop research-based strategies for the rehabilitation of back pain. Therefore, the investigation of differences in trunk stability between H and BPP in functional movements is of primary interest in order to define suitable intervention regimes. The purpose of this study was to analyse neuromuscular reflex activity as well as three-dimensional trunk kinematics between H and BPP during walking perturbations.MethodsEighty H (31m/49f;29±9yrs;174±10cm;71±13kg) and 14 BPP (6m/8f;30±8yrs;171±10cm;67±14kg) walked (1m/s) on a split-belt treadmill while 15 right-sided perturbations (belt decelerating, 40m/s2, 50ms duration; 200ms after heel contact) were randomly applied. Trunk muscle activity was assessed using a 12-lead EMG set-up. Trunk kinematics were measured using a 3-segment-model consisting of 12 markers (upper thoracic (UTA), lower thoracic (LTA), lumbar area (LA)). EMG-RMS ([%],0-200ms after perturbation) was calculated and normalized to the RMS of unperturbed gait. Latency (TON;ms) and time to maximum activity (TMAX;ms) were analysed. Total motion amplitude (ROM;[°]) and mean angle (Amean;[°]) for extension-flexion, lateral flexion and rotation were calculated (whole stride cycle; 0-200ms after perturbation) for each of the three segments during unperturbed and perturbed gait. For ROM only, perturbed was normalized to unperturbed step [%] for the whole stride as well as the 200ms after perturbation. Data were analysed descriptively followed by a student´s t-test to account for group differences. Co-contraction was analyzed between ventral and dorsal muscles (V:R) as well as side right:side left ratio (Sright:Sleft). The coefficient of variation (CV;%) was calculated (EMG-RMS;ROM) to evaluate variability between the 15 perturbations for all groups. With respect to unequal distribution of participants to groups, an additional matched-group analysis was conducted. Fourteen healthy controls out of group H were sex-, age- and anthropometrically matched (group Hmatched) to the BPP.ResultsNo group differences were observed for EMG-RMS or CV analysis (EMG/ROM) (p>0.025). Co-contraction analysis revealed no differences for V:R and Srigth:Sleft between the groups (p>0.025). BPP showed an increased TON and TMAX, being significant for Mm. rectus abdominus (p = 0.019) and erector spinae T9/L3 (p = 0.005/p = 0.015). ROM analysis over the unperturbed stride cycle revealed no differences between groups (p>0.025). Normalization of perturbed to unperturbed step lead to significant differences for the lumbar segment (LA) in lateral flexion with BPP showing higher normalized ROM compared to Hmatched (p = 0.02). BPP showed a significant ...

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“…Characteristic chronic pain intensity and disability was assessed by means of the Chronic Pain Grade questionnaire (CPG) [16]. The CPG assesses pain and disability for the past 3 months and allows a differentiation in the subscales pain intensity (PI: 0 = "no pain" to 100 = "the worst pain imaginable"), and disability (DS: 0 = "no disability" to 100 = "I was incapable of doing anything") [18,19].The incidence of recurrences was also continuously monitored for twelve months after the end of the therapy. A recurrence is given when a participant was seeking help or treatment in a medical clinic or practice due to low back pain.…”

Section: Measurements and Data Processingmentioning

confidence: 99%

Medical exercise and physiotherapy frequency and compliance as predictors for a recurrence of chronic nonspecific low back pain

Krause¹,

Niederer²,

Banzer³

et al. 2020

Preprint

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Purpose A considerable part of nonspecific low back pain patients suffer from a recurrence of symptoms after therapy cessation. The aim of this study was to evaluate the predictive value of active and passive treatments and treatment modalities on a recurrence of back pain after cessation of medically prescribed therapy. Methods Patients with unspecific low back pain from a health- and therapy-center were included. Treatments and treatment modalities as therapy measures were monitored and categorized as active or passive measures. During the year after therapy cessation, patients were monitored to retrieve information about recurrence of symptoms. Patients were dichotomized (recurrence versus no recurrence). An ROC-Analysis was used to determine optimal cut-offs for relevant treatment characteristics’ impact on recurrence risk. The relative risk for a recurrence was calculated based on Chi 2 -test. Results Data from 96 patients (56f, 49±11 years) were analysed. A total of 34 patients had recurring back pain. The frequency of active treatment differed significantly between groups with or without recurrence. A therapy frequency of 1.45 active treatments/week was a sensitive cut-off (sensitivity: 0.73) to discriminate the recurrence groups. Participants with a therapy frequency of less than 1.45 treatments per week showed an 82% increased relative recurrence risk (RR: 1.824 (95%-CI: 1.077-3.087)). Conclusions The results empathize the importance of active treatments (i.e. exercise) in the therapy and (secondary) prevention of unspecific low back pain. Less than 1.45 active treatment sessions/week increases the 1-year-risk of a recurrence by 82%.

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Medicine in spine exercise (MiSpEx) for nonspecific low back pain patients: study protocol for a multicentre, single-blind randomized controlled trial

Cited by 32 publications

References 36 publications

Personalized Treatment Suggestions: The Validity and Applicability of the Risk-Prevention-Index Social in Low Back Pain Exercise Treatments

Personalized Treatment Suggestions: The Validity and Applicability of the Risk-Prevention-Index Social in Low Back Pain Exercise Treatments

Effects of sudden walking perturbations on neuromuscular reflex activity and three-dimensional motion of the trunk in healthy controls and back pain symptomatic subjects

Medical exercise and physiotherapy frequency and compliance as predictors for a recurrence of chronic nonspecific low back pain

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