Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial

Matheve, Thomas; Brumagne, Simon; Demoulin, Christophe; Timmermans, Annick

doi:10.1186/s12984-018-0423-6

Cited by 31 publications

(55 citation statements)

References 32 publications

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“…The electrocardiogram, the blood glucose meter, and the blood pressure meter connected through Bluetooth could automatically upload health-related data to the medical system [43-45]. With the advancement of technology, motion-capture devices may also be applied in telerehabilitation [46]. Until then, the compliance could be better improved with remote monitoring of the patients’ rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness and Safety of Utilizing Mobile Phone–Based Programs for Rehabilitation After Lumbar Spinal Surgery: Multicenter, Prospective Randomized Controlled Trial

Hou

Yang

Tang

et al. 2019

JMIR Mhealth Uhealth

107

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Background Rehabilitation is crucial for postoperative patients with low back pain (LBP). However, the implementation of traditional clinic-based programs is limited in developing countries, such as China, because of the maldistribution of medical resources. Mobile phone–based programs may be a potential substitute for those who have no access to traditional rehabilitation. Objective The aim of this study was to examine the efficacy of mobile phone–based rehabilitation systems in patients who underwent lumbar spinal surgery. Methods Patients who accepted spinal surgeries were recruited and randomized into 2 groups of rehabilitation treatments: (1) a mobile phone–based eHealth (electronic health) program (EH) or (2) usual care treatment (UC). The primary outcomes were (1) function and pain status assessed by the Oswestry Disability Index (ODI) and (2) the visual analog scale (VAS). Secondary outcomes were (1) general mental health and (2) quality of life (Likert scales, EuroQol-5 Dimension health questionnaire, and 36-item Short-Form Health Survey). All the patients were assessed preoperatively and then at 3, 6, 12, and 24 months postoperatively. Results A total of 168 of the 863 eligible patients were included and randomized in this study. Our analysis showed that the improvement of primary outcomes in the EH group was superior to the UC group at 24 months postoperatively (ODI mean 7.02, SD 3.10, P <.05; VAS mean 7.59, SD 3.42, P <.05). No significant difference of primary outcomes was found at other time points. A subgroup analysis showed that the improvements of the primary outcomes were more significant in those who completed 6 or more training sessions each week throughout the trial (the highest compliance group) compared with the UC group at 6 months (ODI mean 17.94, SD 5.24, P <.05; VAS mean 19.56, SD 5.27, P <.05), 12 months (ODI mean 13.39, SD 5.32, P <.05; VAS mean 14.35, SD 5.23, P <.05), and 24 months (ODI mean 18.80, SD 5.22, P <.05; VAS mean 21.56, SD 5.28, P <.05). Conclusions This research demonstrated that a mobile phone–based telerehabilitation system is effective in self-managed rehabilitation for postoperative patients with LBP. The effectiveness of eHealth was more evident in participants with higher compliance. Future research should focus on improving patients’ compliance. Trial Registration Chinese Clinical Trial Registry ChiCTR-TRC-13003314; http://www.chictr.org.cn/showproj.aspx?proj=6245 (Archived by WebCite at http://www.webcitation.org/766RAIDNc)

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Section: Discussionmentioning

confidence: 99%

The Effectiveness and Safety of Utilizing Mobile Phone–Based Programs for Rehabilitation After Lumbar Spinal Surgery: Multicenter, Prospective Randomized Controlled Trial

Hou

Yang

Tang

et al. 2019

JMIR Mhealth Uhealth

107

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“…This cross-sectional study is a pre-planned analysis of baseline measurements of a randomized controlled trial (Matheve, Brumagne, Brumagne, Demoulin, & Timmermans, 2018). All the data presented in this paper were collected on the same day.…”

Section: Designmentioning

confidence: 99%

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

Matheve

Baets

Bogaerts

et al. 2019

European Journal of Pain

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Background Most studies fail to show an association between higher levels of pain‐related fear and protective movement behaviour in patients with chronic low back pain (CLBP). This may be explained by the fact that only general measures of pain‐related fear have been used to examine the association with movement patterns. This study explored whether task‐specific, instead of general measures of pain‐related fear can predict movement behaviour. Methods Fifty‐five patients with CLBP and 54 healthy persons performed a lifting task while kinematic measurements were obtained to assess lumbar range of motion (ROM). Scores on the Photograph Daily Activities Series‐Short Electronic Version (PHODA‐SeV), Tampa Scale for Kinesiophobia and its Activity Avoidance and Somatic Focus subscales were used as general measures of pain‐related fear. The score on a picture of the PHODA‐SeV, showing a person lifting a heavy object with a bent back, was used as task‐specific measure of pain‐related fear. Results Lumbar ROM was predicted by task‐specific, but not by general measures of pain‐related fear. Only the scores on one other picture of the PHODA‐SeV, similar to the task‐specific picture regarding threat value and movement characteristics, predicted the lumbar ROM. Compared to healthy persons, patients with CLBP used significantly less ROM, except the subgroup with a low score on the task‐specific measure of pain‐related fear, who used a similar ROM. Conclusions Our results suggest to use task‐specific measures of pain‐related fear when assessing the relationship with movement. It would be of interest to investigate whether reducing task‐specific fear changes protective movement behaviour. Significance This study shows that lumbar range of motion in CLBP is predicted by task‐specific, but not by general measures of pain‐related fear. This suggests that both in clinical practice and for research purposes, it might be recommended to use task‐specific measures of pain‐related fear when assessing the relationship with movement behaviour. This may help to disentangle the complex interactions between pain‐related fear, movement and disability in patients with CLBP.

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“…Feedback can help overcome limitations in motor learning caused by these deficits in people with LBP [ 23 ]. Nevertheless, in a recent study investigating different feedback conditions, no differences between people with chronic LBP and people without LBP were found in learning to keep the spine in a constant position during motor control tasks [ 62 ]. In this study, practice with graphical displays of data from wearable sensors resulted in superior performance compared with practice without any feedback or practice in front of a mirror [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Exergaming Using Postural Feedback From Wearable Sensors and Exercise Therapy to Improve Postural Balance in People With Nonspecific Low Back Pain: Protocol for a Factorial Pilot Randomized Controlled Trial

Meinke¹,

Peters²,

Knols³

et al. 2021

JMIR Res Protoc

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Background Physical exercise is a common treatment for people with low back pain (LBP). Wearable sensors that provide feedback on body movements and posture during exercise may enhance postural balance and motor control in people with LBP. Objective This study aims to investigate whether physical exercising with postural feedback (EPF) improves postural balance, motor control, and patient-reported outcomes in people with LBP. Methods The study was an assessor-blinded 2×2 factorial trial. We planned to recruit 80 participants with nonspecific LBP who did not receive treatment for LBP. In addition, we aimed to recruit 40 patients with chronic, nonspecific LBP who were receiving exercise therapy (ET) at the University Hospital Zurich. Both ET patients and participants without treatment were randomized to receive either an additional EPF intervention or no additional intervention. This resulted in four different combinations of interventions: ET+EPF, ET, EPF, and no intervention. The participants underwent outcome assessments at inclusion (T1); 3 weeks later, at randomization (T2); after an intervention period of 3 weeks with a predefined exercise schedule for participants receiving EPF (T3); and after an additional 6 weeks, during which participants assigned to the EPF groups could exercise as much as they wished (T4). Patients receiving ET completed their regularly prescribed therapies during the study period. Balance was assessed during quiet standing on a force platform, and motor control was assessed during a lifting task and a waiter’s bow task. Physical activity was recorded using an activity tracker and the participants’ mobile phones during the study. The predefined EPF schedule consisted of nine sessions of 20 minutes of exercise with a tablet and inertial measurement unit sensors at home. Participants performed a series of trunk and hip movements and received feedback on their movements in a gamified environment displayed on the tablet. Results The first participant was recruited in May 2019. Data collection was completed in October 2020, with 3 patients and 32 eligible people without therapy who passed the eligibility check. Conclusions Although it will not be possible to investigate differences in patients and people without other therapies, we expect this pilot study to provide insights into the potential of EPF to improve balance in people with LBP and adherence to such interventions. International Registered Report Identifier (IRRID) DERR1-10.2196/26982

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Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial

Cited by 31 publications

References 32 publications

The Effectiveness and Safety of Utilizing Mobile Phone–Based Programs for Rehabilitation After Lumbar Spinal Surgery: Multicenter, Prospective Randomized Controlled Trial

The Effectiveness and Safety of Utilizing Mobile Phone–Based Programs for Rehabilitation After Lumbar Spinal Surgery: Multicenter, Prospective Randomized Controlled Trial

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

Exergaming Using Postural Feedback From Wearable Sensors and Exercise Therapy to Improve Postural Balance in People With Nonspecific Low Back Pain: Protocol for a Factorial Pilot Randomized Controlled Trial

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