scholarly journals 1365Does pain self-efficacy influence initial bending following exercise in adults with chronic low back pain?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Fiona McManus ◽  
Adrian Pranata ◽  
Julie A. Simpson ◽  
Joshua Farragher ◽  
Samuel Crofts ◽  
...  

Abstract Background Differences in pain self-efficacy between individuals with chronic low back pain (CLBP) may partly explain why response to exercise varies. The aim of this study was to determine if pain self-efficacy influences initial forward bending following an exercise intervention in adults with CLBP. Methods A total of 69 adults (18-65 years old) with moderate-severe CLBP-related disability who presented to a primary care physiotherapy clinic in Melbourne, Australia underwent baseline assessment of pain self-efficacy, pain intensity and kinesiophobia, prior to participation in one of two 12-week exercise interventions. Two outcome measures (lumbar and hip flexion range of motion (ROM) over the first quarter of forward bending from stance), were assessed at baseline, 6 and 12-weeks. Multiple linear mixed-effects modelling was performed for each outcome measure. Results For every 10-point increase in baseline pain self-efficacy, lumbar flexion ROM during initial bending decreased by an estimated mean 0.51 (95% CI: -1.41, 0.39) and 0.94 (95% CI: -1.75, -0.13) degrees at 6 and 12-weeks, respectively. Similarly, hip flexion ROM during initial bending decreased by an estimated mean 1.64 (95% CI: -3.70, 0.41) and 1.43 (95% CI: -3.34, 0.48) degrees at 6 and 12-weeks, respectively, per 10-point increase in baseline pain self-efficacy. Conclusions Pain self-efficacy did not influence initial forward bending following a 12-week exercise intervention. As the exercises were not targeted to improve bending, further research is required to verify these findings. Key message Pain self-efficacy may not explain variations in initial forward bending following an exercise intervention in adults with CLBP.

2009 ◽  
Vol 89 (12) ◽  
pp. 1275-1286 ◽  
Author(s):  
Leonardo O.P. Costa ◽  
Christopher G. Maher ◽  
Jane Latimer ◽  
Paul W. Hodges ◽  
Robert D. Herbert ◽  
...  

BackgroundThe evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.ObjectiveThe purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.DesignThis was a randomized, placebo-controlled trial.SettingThe study was conducted in an outpatient physical therapy department in Australia.PatientsThe participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.InterventionTwelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.MeasurementsPrimary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.ResultsThe exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=−0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.LimitationClinicians could not be blinded to the intervention they provided.ConclusionsMotor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.


Biology ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1096
Author(s):  
Boon Chong Kwok ◽  
Justin Xuan Li Lim ◽  
Pui Wah Kong

Exercise plays an important role in rehabilitating people with chronic low back pain. Aerobic exercise and resistance training are general exercise strategies to manage chronic low back pain, but these strategies require longer intervention period to achieve clinical outcomes in pain reduction and functional improvements. Directional preference is recognised as an important exercise strategy in managing low back pain. The Clinical Pilates exercise method leverages on the directional preference of an individual to achieve clinical outcomes faster. Clinical Pilates is a hybrid of two of the best exercise interventions for low back pain, which are general Pilates and the McKenzie method. Due to the scarcity of Clinical Pilates literature, a review of its theory and studies was undertaken to provide a structured guide to the technique in managing people with chronic low back pain. Hypothetical algorithms are developed to support translation into clinical practice and future research studies. These algorithms are useful in the management of complex cases involving multiple directional trauma. Although limited, current evidence suggests that the Clinical Pilates exercise method is safe and provides faster functional recovery in the early stage of rehabilitation and similar longer term outcomes as general exercises.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028259
Author(s):  
Joshua Brodie Farragher ◽  
Adrian Pranata ◽  
Gavin Williams ◽  
Doa El-Ansary ◽  
Selina M Parry ◽  
...  

IntroductionChronic low back pain (CLBP) is the leading cause of disability worldwide. However, there is no consensus in the literature regarding optimal management. Exercise intervention is the most widely used treatment as it likely influences contributing factors such as physical and psychological. Literature evaluating the effects of exercise on CLBP is often generalised, non-specific and employs inconsistent outcome measures. Moreover, the mechanisms behind exercise-related improvements are poorly understood. Recently, research has emerged identifying associations between neuromuscular-biomechanical impairments and CLBP-related disability. This information can be used as the basis for more specific and, potentially more efficacious exercise interventions for CLBP patients.Methods and analysisNinety-four participants (including both males and females) with CLBP aged 18–65 who present for treatment to a Melbourne-based private physiotherapy practice will be recruited and randomised into one of two treatment groups. Following baseline assessment, participants will be randomly allocated to receive either: (i) strengthening exercises in combination with lumbar force accuracy training exercises or (ii) strengthening exercises alone. Participants will attend exercise sessions twice a week for 12 weeks, with assessments conducted at baseline, midway (ie, 6 weeks into the trial) and at trial completion. All exercise interventions will be supervised by a qualified physiotherapist trained in the intervention protocol. The primary outcome will be functional disability measured using the Oswestry Disability Index. Other psychosocial and mechanistic parameters will also be measured.Ethics and disseminationThis study was given approval by the University of Melbourne Behavioural and Social Sciences Human Ethics Sub-Committee on 8 August 2017, reference number 1 749 845. Results of the randomised controlled trial will be published in peer-reviewed journals.Trial registration numberACTRN12618000894291.


2011 ◽  
Vol 15 (2) ◽  
pp. 213-219 ◽  
Author(s):  
Luciola da C. Menezes Costal ◽  
Christopher G. Maherl ◽  
James H. McAuleyl ◽  
Mark J. Hancockl ◽  
Rob J.E.M. Smeetsl

1996 ◽  
Vol 2 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Jennifer B. Levin ◽  
Kenneth R. Lofland ◽  
Jeffrey E. Cassisi ◽  
Amir M. Poreh ◽  
E. Richard Blonsky

2021 ◽  
Vol 44 (6) ◽  
pp. 433-444
Author(s):  
Margaret D. Whitley ◽  
Patricia M. Herman ◽  
Gursel R. Aliyev ◽  
Cathy D. Sherbourne ◽  
Gery W. Ryan ◽  
...  

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