The Mézières Method as a Novel Treatment for Elite Spanish Second-Division Soccer League Players With Low Back Pain: A Randomized Controlled Trial.

OBJECTIVES: To evaluate the efficacy of 24 weeks of treatment with Mézières method in a Spanish elite second-division soccer team with low back pain (LBP), analyzing their state of back health, flexibility, pain, and steps speed. DESIGN: Double-blind randomized controlled trial. METHODS: A total of 20 players with LBP from the second soccer division league were allocated equally to the experimental and control groups (n = 10) as per selection criteria and participated in 2 different rehabilitation programs. The postural Mézières method was implemented in the experimental group, whereas the standard European treatment protocol for LBP was implemented in the control group. Both treatments had a twice weekly session of 40 minutes duration for 24 weeks consecutively with a follow-up in the fourth, 12th, and 24th weeks. RESULTS: Multivariate analysis of covariance with the baseline assessment as a covariance showed a significant difference between groups at the 12th and 24th weeks of the treatment for pain and back functionality. A relevant difference between the experimental and control groups was shown only at the 24th week of the treatment (P < .05) for back flexibility. A significant difference between groups was reported for the quality of life scale and steps speed at the 24th week of the treatment (P > .05). CONCLUSION: The Mézières method showed a positive effect in the elite soccer athletes with nonspecific chronic LBP and can be used as an alternative treatment.

Short- and medium-term effects of a single session of pain neuroscience education on pain and psychological factors in patients with chronic low back pain. A single-blind randomized clinical trial.

INTRODUCTION: Biopsychosocial approach in patients suffering chronic low back pain (CLBP) promotes pain self-management strategies. Current evidence recommends high dose of Pain Neuroscience Education (PNE) for clinically significant differences. However, the workload and time constraints experienced by healthcare providers impede the application of the recommended treatment regimen. In fact, Back School with a biomechanical model is the main approach to manage CLBP in public systems. OBJECTIVE: The objective of this study is to explore the effect of a 60 min single session of PNE as an adjunct to back school on pain intensity and psychological variables patients with CLBP. METHODS: A double-blind, two-arm randomized controlled clinical trial was conducted in patients with CLBP who attended back school sessions held in a Spanish public hospital. A total of 121 patients were randomized into control group, who received the Back School program during 5 weeks, and intervention group, who additionally received a single session of PNE. Patient-reported outcomes were the Numerical Pain Rating Scale, Central Sensitization Inventory, Pain Catastrophizing Scale, and Tampa Scale of Kinesiophobia, with a 12-week follow-up. RESULTS: A total of 113 patients were analysed. Intervention and control group presented similar effects on pain and kinesiophobia. At follow-up, intervention group exhibited reduced sensitization and catastrophism scores compared with control, including the subscales. Additionally, PNE reduced the percentage of participants classified as having central sensitization compared with control. CONCLUSIONS: Adding a single PNE session in the back school program did not reduce pain but improved psychological factors as central sensitization and pain catastrophizing at medium-term. This study highlights the potential of PNE to optimize treatment strategies for CLBP, especially in public health centres where time resources are scarce. SIGNIFICANCE STATEMENT: Adding a single PNE session in the back school program did not reduce pain but improved psychological factors as central sensitization and pain catastrophism at medium-term.