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We assessed the test-retest reliability and discriminative ability of a somatosensory temporal discrimination (SSTD) assessment tool for fibromyalgia syndrome (FMS) and determined if pain-related variables were associated with SSTD performance. Twenty-five women with FMS and twenty-five asymptomatic women were assessed during two sessions 7 to 10 days apart. The proportion of correct responses (range 0-100) was calculated. Sociodemographic information was collected for both groups. The participants with FMS also completed the widespread pain index and the Brief Pain Inventory. Test-retest reliability was verified by calculating intraclass correlation coefficients. Discriminative ability was verified by a between-group comparison of scores using a t-test. Associations between SSTD score and pain variables were tested using Pearson or Spearman correlation coefficients. The test-retest reliability of the SSTD score was excellent (ICC > 0.9, CI: 0.79-0.96) for the asymptomatic group and good for the FMS group (ICC: 0.81, 95% CI: 0.62-0.91). The median (Q1-Q3) test session SSTD score differed significantly between the FMS 84.1 (71-88) and the asymptomatic 91.6 (83.4-96.1) groups (p < 0.001). Only pain duration was associated with the SSTD score. In conclusion, the new SSTD test seems reliable for people with FMS and is discriminative. Further studies should examine its sensitivity to change and correlations with other SSTD tests.
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Fibromialgia , Humanos , Fibromialgia/fisiopatología , Fibromialgia/diagnóstico , Femenino , Persona de Mediana Edad , Adulto , Reproducibilidad de los Resultados , Dimensión del Dolor/métodosRESUMEN
BACKGROUND: Many applied postgraduate pain training programs are monodisciplinary, whereas interdisciplinary training programs potentially improve interdisciplinary collaboration, which is favourable for managing patients with chronic pain. However, limited research exists on the development and impact of interdisciplinary training programs, particularly in the context of chronic pain. METHODS: This study aimed to describe the development and implementation of an interdisciplinary training program regarding the management of patients with chronic pain, which is part of a type 1 hybrid effectiveness-implementation study. The targeted groups included medical doctors, nurses, psychologists, physiotherapists, occupational therapists, dentists and pharmacists. An interdisciplinary expert panel was organised to provide its perception of the importance of formulated competencies for integrating biopsychosocial pain management with a cognitive behavioural approach into clinical practice. They were also asked to provide their perception of the extent to which healthcare professionals already possess the competencies in their clinical practice. Additionally, the expert panel was asked to formulate the barriers and needs relating to training content and the implementation of biopsychosocial chronic pain management with a cognitive behavioural approach in clinical practice, which was complemented with a literature search. This was used to develop and adapt the training program to the barriers and needs of stakeholders. RESULTS: The interdisciplinary expert panel considered the competencies as very important. Additionally, they perceived a relatively low level of healthcare professionals' possession of the competencies in their clinical practice. A wide variety of barriers and needs for stakeholders were formulated and organized within the Theoretical Domain Framework linked to the COM-B domains; 'capability', 'opportunity', and 'motivation'. The developed interdisciplinary training program, including two workshops of seven hours each and two e-learning modules, aimed to improve HCP's competencies for integrating biopsychosocial chronic pain management with a cognitive behavioural approach into clinical practice. CONCLUSION: We designed an interdisciplinary training program, based on formulated barriers regarding the management of patients with chronic pain that can be used as a foundation for developing and enhancing the quality of future training programs.
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Dolor Crónico , Humanos , Dolor Crónico/terapia , Manejo del Dolor , Personal de Salud , Atención a la Salud , CogniciónRESUMEN
The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.
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Dolor de la Región Lumbar , Enfermedades del Sistema Nervioso Periférico , Humanos , Dolor de la Región Lumbar/diagnóstico , Consenso , Nocicepción , Dimensión del Dolor/métodos , AnalgésicosRESUMEN
BACKGROUND: In 2013, physical therapy students demonstrated low guideline-adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work. OBJECTIVES: To assess the differences in physical therapy students' attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis between 2013 and 2020. METHODS: In 2013 and 2020, second and fourth-year physical therapy students were recruited from 6 Belgian and 2 Dutch institutions. Attitudes and beliefs regarding CLBP and knee OA were evaluated using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), and a questionnaire regarding therapeutic exercise and knee osteoarthritis. A clinical vignette was used to measure guideline-adherent recommendations regarding spinal pathology, activity, and work. RESULTS: In 2013, 927 second-year and 695 fourth-year students; in 2020, 695 second-year and 489 fourth-year students; were recruited to participate in the study. Compared to 2013, students had less biomedical and stronger biopsychosocial attitudes and beliefs regarding CLBP, more guideline-adherent recommendations for activity, and more biopsychosocial beliefs regarding the benefits of exercise for patients with knee osteoarthritis in both the second and fourth year. Only fourth-year students in 2020 scored significantly better on HC-PAIRS and guideline-adherent recommendation relating to spinal pathology. No differences were found regarding work recommendations. CONCLUSIONS: Between 2013 and 2020, physical therapy students made a positive shift towards a more biopsychosocial approach to CLBP and knee osteoarthritis management. Guideline-adherent recommendations for CLBP concerning activity improved, however, concerning work and spinal pathology, it remained low.
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Dolor de la Región Lumbar , Osteoartritis de la Rodilla , Fisioterapeutas , Humanos , Actitud del Personal de Salud , Dolor de la Región Lumbar/rehabilitación , Modalidades de Fisioterapia , Estudiantes , Encuestas y CuestionariosRESUMEN
BACKGROUND: Lumbosacral radicular pain diagnosis remains challenging. Diffusion tensor imaging (DTI) and diffusion weighted imaging (DWI) have potential to quantitatively evaluate symptomatic nerve root, which may facilitate diagnosis. PURPOSE: To determine the ability of DTI and DWI metrics, namely fractional anisotropy (FA) and apparent diffusion coefficient (ADC), to discriminate between healthy and symptomatic lumbosacral nerve roots, to evaluate the association between FA and ADC values and patient symptoms, and to determine FA and ADC reliability. STUDY TYPE: Systematic review. SUBJECTS: Eight hundred twelve patients with radicular pain with or without radiculopathy caused by musculoskeletal-related compression or inflammation of a single, unilateral lumbosacral nerve root and 244 healthy controls from 29 studies. FIELD STRENGTH/SEQUENCE: Diffusion weighted echo planar imaging sequence at 1.5 T or 3 T. ASSESSMENT: An extensive systematic review of the literature was conducted in Embase, Scopus, and Medline databases. FA and ADC values in symptomatic and contralateral lumbosacral nerve roots were extracted and summarized, together with intra- and inter-rater agreements. Where available, associations between DWI or DTI parameters and patient symptoms or symptom duration were extracted. STATISTICAL TESTS: The main results of the included studies are summarized. No additional statistical analyses were performed. RESULTS: The DTI studies systematically found significant differences in FA values between the symptomatic and contralateral lumbosacral nerve root of patients suffering from radicular pain with or without radiculopathy. In contrast, identification of the symptomatic nerve root with ADC values was inconsistent for both DTI and DWI studies. FA values were moderately to strongly correlated with several symptoms (eg, disability, nerve dysfunction, and symptom duration). The inter- and intra-rater reliability of DTI parameters were moderate to excellent. The methodological quality of included studies was very heterogeneous. DATA CONCLUSION: This systematic review showed that DTI was a reliable and discriminative imaging technique for the assessment of symptomatic lumbosacral nerve root, which more consistently identified the symptomatic nerve root than DWI. Further studies of high quality are needed to confirm these results. EVIDENCE LEVEL: N/A TECHNICAL EFFICACY: Stage 2.
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OBJECTIVE: To review the use (dosage parameters and combination with other therapeutic interventions) of cervical extensor muscle exercises and their effect on pain, disability (primary outcomes), range of motion, endurance and strength (secondary outcomes) in people with neck pain. DATA SOURCES: An extensive literature search was conducted through MEDLINE (Ovid), Scopus (Elsevier) and Physiotherapy Evidence Database (PEDro) up to May 2023. The reference lists of all included studies and relevant reviews were screened for additional studies. REVIEW METHODS: Randomised controlled trials reporting the use of cervical extensor muscle exercises (alone or combined) applied to adults with idiopathic or traumatic neck pain were included. Study selection, data extraction and critical appraisal (PEDro assessment scale) were performed by two blinded reviewers. Data extraction included dosage parameters, other modalities combined with these exercises and outcomes. RESULTS: Thirty-five randomised controlled trails (eight of which were complementary analyses) with 2409 participants fulfilled the inclusion criteria. Twenty-six were of moderate to high quality. In most studies, cervical extensor muscle exercises were combined with various other therapeutic modalities and applied at different dosages. Only two studies (one high and one low quality) specifically assessed their effectiveness. The high-quality study showed significant improvements in neck pain and disability, pressure point threshold and neck mobility after both low load and high load training for 6 weeks. CONCLUSION: The results suggest cervical extensor muscle exercises may reduce neck pain and disability; however firm conclusions cannot be drawn because of the few studies that addressed this question and the heterogeneity of the dosage parameters.
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Background: To evaluate the burden of overuse injuries, the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems (OSTRC-H2) was developed in English in 2013. Purpose: To translate and culturally adapt the OSTRC-H2 into French and investigate the reliability and validity of this new version. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The OSTRC-H2 was translated from English to French according to international guidelines. A total of 80 elite athletes were then invited to complete the OSTRC-H2 weekly for 3 months. Potential ceiling effects, construct validity, and reliability were investigated. Convergent validity was measured using Pearson correlations for continuous items and kappa coefficients for binary items; internal consistency was measured using the Cronbach alpha coefficient; and test-retest reliability was measured using the intraclass correlation coefficient (ICC). Separate analyses were performed on the entire cohort of athletes (population 1 [P1]) and on athletes who reported a health problem during the follow-up (P2). Results: A total of 80 elite athletes took part in this study. The response rate was very high, with 909 of 960 questionnaires returned (95%). The mean weekly prevalence of health problems was 19.6% during the follow-up period. Nineteen participants reported a health problem during the follow-up (P2). The OSTRC-H2 showed very good test-retest reliability for both populations (ICC, 0.85 [95% CI, 0.77-0.90] for P1; ICC, 0.90 [95% CI, 0.68-0.98] for P2). Internal consistency was very good for P2 (Cronbach α = .94). The OSTRC-H2 demonstrated high concordance with the visual analog scale of symptom intensity (r = 0.52; P < .05), and low concordance with the overtraining questions from the Questionnaire de la Société Française de Médecine du Sport (κ from -0.01 to 0.12; P > .05). Conclusion: The French version of the OSTRC-H2 was found to be valid and reliable when applied to French-speaking elite athletes.
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The majority of non-specific low back pain has a favourable evolution within a short period of time but in some cases the pain becomes persistent or recurrent. These chronic forms are responsible for most of the social and economic burden of low back pain. The crucial role of psycho-social factors in the chronicisation of low back pain justifies a thorough bio-psycho-social assessment. An active semi-intensive ambulatory multidisciplinary programme (Spine Unit Center) that complies with international and national recommendations (KCE and INAMI) has demonstrated its effectiveness in chronic low back pain in terms of algo-functional, physical and psycho-social components. In contrast to intensive programmes requiring hospitalisation, this outpatient treatment allows the patient to remain in his/her social and professional network. The active participation and motivation of the patient are essential for the success of the treatment. The multidisciplinary team will help the patient to define his/her functional objectives and to manage, via the psychologist, emotional aspects. The programme includes therapeutic education and physical reconditioning sessions including progressive aerobic training, group exercises, and individualised and progressive strengthening of the trunk muscles. The introduction of physical activity at home will be encouraged in order to sustain the changes in the patient's behaviour.
La majorité des lombalgies non spécifiques présente une évolution favorable dans un délai assez court, mais, dans certains cas, les douleurs deviennent persistantes ou récurrentes. Ces formes chroniques sont responsables de l'essentiel du poids social et économique des lombalgies. Le rôle crucial des facteurs psycho-sociaux dans la chronicisation de la lombalgie justifie une évaluation bio-psycho-sociale approfondie. Un programme pluridisciplinaire ambulatoire actif semi-intensif («Clinique du Dos¼) répondant aux recommandations internationales et nationales (KCE et INAMI) a démontré une efficacité sur les composantes algo-fonctionnelles, physiques et psycho-sociales du patient lombalgique chronique. Contrairement aux programmes intensifs imposant une hospitalisation, cette prise en charge ambulatoire permet au patient de rester dans son réseau social et professionnel. La participation active et la motivation du patient constituent les éléments essentiels pour la réussite du traitement. L'équipe pluridisciplinaire l'aidera à définir ses objectifs fonctionnels et à gérer, via le psychologue, certains aspects émotionnels en lien avec la douleur. Le programme comprend des séances d'éducation thérapeutique et de reconditionnement physique, incluant un entraînement aérobie progressif, une gymnastique collective de tonification et un renforcement individualisé et graduel des muscles du tronc. L'instauration d'une activité physique à domicile sera encouragée de manière à pérenniser les changements de comportement du patient.
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Dolor Crónico , Dolor de la Región Lumbar , Medicina , Humanos , Masculino , Femenino , Dolor de la Región Lumbar/terapia , Modalidades de Fisioterapia , Atención Ambulatoria , Ejercicio Físico , Resultado del Tratamiento , Dolor Crónico/terapiaRESUMEN
BACKGROUND: While pain is influenced by multiple factors including psychosocial factors, previous research has shown that physiotherapists still favour a biomedical approach. PURPOSE: To evaluate: (1) how physiotherapists explain the patient's chronic non-specific low back pain (LBP); (2) whether physiotherapists use one or multiple influencing factors, and (3) whether these factors are framed in a biopsychosocial or biomedical approach. MATERIALS AND METHODS: This exploratory qualitative study uses a vignette depicting chronic non-specific LBP and employs a flexible framework analysis. Physiotherapists were asked to mention contributing factors to the pain based on this vignette. Five themes were predefined ("Beliefs", "Previous experiences", "Emotions", "Patients behaviour", "Contextual factors") and explored. RESULTS: Physiotherapists use very brief explanations when reporting contributing factors to chronic pain (median 13 words). Out of 670 physiotherapists, only 40% mentioned more than two different themes and 2/3rds did not see any link between the patients' misbeliefs and pain. Only a quarter of the participants mentioned the patient's worries about pain and movement, which is considered to be an important influencing factor. CONCLUSION: The lack of a multifactorial approach and the persistent biomedical beliefs suggest that it remains a challenge for physiotherapists to fully integrate the biopsychosocial framework into their management of chronic LBP.
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Dolor Crónico , Dolor de la Región Lumbar , Fisioterapeutas , Humanos , Fisioterapeutas/psicología , Dolor de la Región Lumbar/etiología , Dolor de la Región Lumbar/psicología , Conocimientos, Actitudes y Práctica en Salud , Actitud del Personal de Salud , Dolor Crónico/psicologíaRESUMEN
BACKGROUND: Clinical practice guidelines promote bio-psychosocial management of patients suffering from low back pain (LBP). The objective of this study was to examine the current knowledge, attitudes and beliefs of physiotherapists about a guideline-adherent approach to LBP and to assess the ability of physiotherapists to recognise signs of a specific LBP in a clinical vignette. METHODS: Physiotherapists were recruited to participate in an online study. They were asked to indicate whether they were familiar with evidence-based guidelines and then to fill in the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), Back Pain Attitudes Questionnaire (Back-PAQ), Neurophysiology of Pain Questionnaire (NPQ), as well as questions related to two clinical vignettes. RESULTS: In total, 527 physiotherapists participated in this study. Only 38% reported being familiar with guidelines for the management of LBP. Sixty-three percent of the physiotherapists gave guideline-inconsistent recommendations regarding work. Only half of the physiotherapists recognised the signs of a specific LBP. CONCLUSIONS: The high proportion of physiotherapists unfamiliar with guidelines and demonstrating attitudes and beliefs not in line with evidence-based management of LBP is concerning. It is crucial to develop efficient strategies to enhance knowledge of guidelines among physiotherapists and increase their implementation in clinical practice.
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Dolor de la Región Lumbar , Fisioterapeutas , Humanos , Dolor de la Región Lumbar/diagnóstico , Fisioterapeutas/psicología , Conocimientos, Actitudes y Práctica en Salud , Actitud del Personal de Salud , Encuestas y CuestionariosRESUMEN
BACKGROUND: Resisted training of the trunk muscles improves outcomes in chronic low back pain (CLBP). The Itensic b-effect machine was designed to provide resisted training through posterior translation of the pelvis in a seated, forward-tilted position, in contrast with traditional machines that involve extension of the trunk. OBJECTIVE: To study the effectiveness of lumbopelvic training on the Itensic b-effect machine in individuals with CLBP. METHODS: Participants were allocated to 4 weeks of either progressive Itensic (I) training in addition to an education/exercise (EE) program (I+EE group, n= 23) or the education/exercise program alone (EE group, n= 22). PRIMARY OUTCOME: Roland Morris Disability Questionnaire (RMDQ). SECONDARY OUTCOMES: pain (0-10 numeric rating scale), trunk extensor endurance (Sorensen test), motor control (thoraco-lumbar dissociation test) and mobility (finger-to-floor test). RESULTS: RMDQ score improved more in the I+EE group than in the EE group (with a between-group difference at the pos-test). Pain and mobility improved in the I+EE group only, motor control improved in both groups with no between-group difference and the Sorensen test did not improve significantly in either group. CONCLUSIONS: Resisted posterior pelvic translation using the Itensic machine in addition to an education/exercise program improved disability, pain and mobility more than the education/exercise program alone.
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Dolor Crónico , Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Evaluación de la Discapacidad , Torso , Pelvis , Modalidades de Fisioterapia , Terapia por Ejercicio , Dolor Crónico/terapia , Resultado del TratamientoRESUMEN
Objective: The primary aim of this pilot study was to test the feasibility and acceptability of a prototype of a novel digital system enabling somatosensory training at home by means of a gamified mobile application in patients with chronic pain. The secondary aims were to test the effect size of the intervention on clinical outcomes to power a subsequent randomized controlled trial. Materials and Methods: We conducted a pilot randomized controlled trial in patients with fibromyalgia. This was an 8-week crossover study, which included a 4-week somatosensory training phase (daily use with the novel digital system) and a 4-week control phase (no use of this new system) in a random order. Feasibility was tested by objectively measuring the adherence and retention rates. Acceptability and changes in pain and disability were measured through data from subjective questionnaires. Results: Thirty-five patients completed the study. The satisfaction questionnaire indicated high training enjoyment, ease of use for daily training and interest to continue to use the intervention after the study. The adherence (93%) and retention (94%) rates were high. The effect sizes were moderate for pain intensity (0.57). Conclusion: The novel gamified technology for remotely delivered somatosensory training is feasible in a group of patients with fibromyalgia, and results in high engagement, satisfaction, and adherence. A subsequent clinical trial with the final version of the technology platform, including a longer training with more sensory training tasks and a bigger sample size is necessary.
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Fibromialgia , Humanos , Fibromialgia/terapia , Proyectos Piloto , Estudios de Factibilidad , Estudios Cruzados , PercepciónRESUMEN
BACKGROUND: A common misconception about low back pain (LBP) is that the spine is weak and that lumbar flexion should be avoided. Because the beliefs of health-care professionals (HCPs) influence patients, it is important to understand the attitudes of health care professionals towards LBP and lifting. OBJECTIVES: To assess and compare the perceptions of different categories of HCPs regarding the safety of specific movement strategies used to lift a light load, and their beliefs regarding back pain. The secondary aim was to determine whether certain factors influenced the beliefs of HCPs. METHODS: Data were collected via an electronic survey. Student and qualified physical therapists (PTs), medical students, and general practitioner (GP) trainees were included. The questionnaire included eight photographs, depicting eight different strategies to lift a light load. Respondents were requested to select the strategy(s) they considered as "unsafe" to use for asymptomatic people with a previous history of LBP and people with chronic LBP. Beliefs and attitudes towards LBP were evaluated using the Back Pain Attitudes Questionnaire (Back-PAQ). RESULTS: Questionnaires from 1005 participants were included. Seventy percent of qualified PTs considered none of the strategies as harmful (versus 32% of PT students, 9% of GP trainees and 1% of medical students). Qualified PTs had higher Back-PAQ scores (mean ± SD: 13.6 ± 5.5) than PT students (8.7 ± 5.7), GP trainees (5.9 ± 5.9) and medical students (4.1 ± 5.2), indicating less misconceptions regarding LBP. Having LBP negatively influenced beliefs while taking a pain education course positively influenced beliefs. CONCLUSION: Misconceptions regarding LBP and the harmfulness of lifting a light load with a rounded back remain common among HCPs, particularly medical doctors.
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Dolor de la Región Lumbar , Fisioterapeutas , Dolor de Espalda , Humanos , Elevación , Encuestas y CuestionariosRESUMEN
PURPOSE: To translate and validate the Identification of Functional Ankle Instability (IdFAI) into French. METHODS: The IdFAI was translated according to international recommendations. Discriminative power, floor and ceiling effects, construct validity (including confirmatory factorial analysis (CFA)), internal consistency and test-retest reliability were measured. Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC) were also calculated. RESULTS: 160 participants were included. The IdFAI-F showed a very good test-retest reliability (ICC = 0.95). The SEM was 1.37 and the MDC was 3.79. The internal consistency was moderate (Cronbach's alpha coefficient = 0.68). The correlation between the IdFAI and the Cumberland Ankle Instability Tool (CAIT) was high (r = -0.75, p < 0.001). No floor, nor ceiling effects were observed. The CFA analyses did not confirm the factor structure proposed by the authors of the original English version. CONCLUSIONS: The IdFAI-F is a valid and reliable tool to accurately identify and measure chronic ankle instability in research and clinical settings for French-speaking individuals.
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Articulación del Tobillo , Inestabilidad de la Articulación , Tobillo , Comparación Transcultural , Humanos , Inestabilidad de la Articulación/diagnóstico , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND AND PURPOSE: Low back pain (LBP)-related misbeliefs are known to be among risk factors for LBP chronification and for persistence of chronic pain. The main objective of this study was to investigate the current LBP-related beliefs in the general population in Belgium, considering the fact that the last survey in Belgium about the topic was conducted more than 15 years ago. METHODS: A cross-sectional study design was used. Belgian adults (>17 years old) were recruited in the three regions of the country by means of non-probabilistic recruitment methods. Participants were invited to fill in a battery of questionnaires including demographic questions as well as questions about their LBP history and the LBP Beliefs Questionnaire (LBPBQ). RESULTS: A total of 3724 individuals participated in the study. The LBPBQ scores indicated several LBP-related misbeliefs. About 15%-25% of participants still think that imaging tests can always identify the cause of pain and that bed rest is the mainstay of therapy. The majority of the participants think that "unnecessary" movements should be avoided when having LBP (58% of the respondents), and that they should "take it easy" until the pain goes away (69%). Most respondents also had maladaptive/wrong expectations, for example, a systematic worsening with time (65%) and a need for surgery in case of disc herniation (54%). CONCLUSIONS: The present study suggests that in 2020 several LBP-related misbeliefs are still current in Belgium, particularly regarding the vulnerability of the spine. Therefore, further efforts to improve LBP-related beliefs/knowledge in the general population are necessary.
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Dolor Crónico , Dolor de la Región Lumbar , Adolescente , Adulto , Bélgica/epidemiología , Dolor Crónico/epidemiología , Estudios Transversales , Humanos , Dolor de la Región Lumbar/epidemiología , Encuestas y CuestionariosRESUMEN
Previous research indicates that high intensity training (HIT) is a more effective exercise modality, as opposed to moderate intensity training (MIT), to improve disability and physical performance in persons with chronic nonspecific low back pain (CNSLBP). However, it is unclear how well benefits are maintained after intervention cessation. This study aimed to evaluate the long-term effectiveness of HIT on disability, pain intensity, patient-specific functioning, exercise capacity, and trunk muscle strength, and to compare the long-term effectiveness of HIT with MIT in persons with CNSLBP. Persons with CNSLBP (n = 35) who participated in a randomized controlled trial comparing effects of an HIT versus MIT intervention (24 sessions/12 weeks) were included for evaluation at baseline (PRE), directly after (POST), and six months after program finalization (FU) on disability, pain intensity, exercise capacity, patient-specific functioning, and trunk muscle strength. A general linear model was used to evaluate PRE-FU and POST-FU deltas of these outcome measures in each group (time effects) and differences between HIT and MIT (interaction effects). Ultimately, twenty-nine participants (mean age = 44.1 year) were analysed (HIT:16; MIT:13). Six participants were lost to follow-up. At FU, pain intensity, disability, and patient-specific functioning were maintained at the level of POST (which was significant from PRE, p < 0.05) in both groups. However, HIT led to a greater conservation of lowered disability and improved exercise capacity when compared with MIT (p < 0.05). HIT leads to a greater maintenance of lowered disability and improved exercise capacity when compared to MIT six months after cessation of a 12-week supervised exercise therapy intervention, in persons with CNSLBP.