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Erschienen in: Clinical Rheumatology 7/2008

01.07.2008 | Original Article

Comparison of three different approaches in the treatment of chronic low back pain

verfasst von: Şebnem Koldaş Doğan, Birkan Sonel Tur, Yeşim Kurtaiş, Mesut Birol Atay

Erschienen in: Clinical Rheumatology | Ausgabe 7/2008

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Abstract

Our aim is to investigate the effects of three therapeutic approaches in the chronic low back pain on pain, spinal mobility, disability, psychological state, and aerobic capacity. Sixty patients with chronic low back pain were randomized to three groups: group 1, aerobic exercise + home exercise; group 2, physical therapy (hot pack, ultrasound, TENS) + home exercise; group 3, home exercise only. Spinal mobility, pain severity, disability, and psychological disturbance of the patients were assessed before and after the treatment and at 1-month follow-up. Aerobic capacities of the patients were measured before and after treatment. All of the groups showed similar decrease in pain after the treatment and at 1-month follow-up, and there was no significant difference between the groups. In group 2, a significant decrease in Beck Depression Inventory scores was observed with treatment. At 1-month follow-up, group 1 and 2 showed significant decreases in General Health Assessment Questionnaire scores. In group 2, there was also a significant improvement in Roland Morris Disability scores. There were similar improvements in exercise test duration and the MET levels in all the three groups. All of the three therapeutic approaches were found to be effective in diminishing pain and thus increasing aerobic capacity in patients with chronic low back pain. On the other hand, physical therapy + home exercise was found to be more effective regarding disability and psychological disturbance.
Literatur
1.
Zurück zum Zitat Sinaki M, Mokri B (2000) Low back pain and disorders of the lumbar spine. In: Braddom RL (ed) Physical Medicine and Rehabilitation. WB Saunders Comp, Philadelphia, pp 853–893 Sinaki M, Mokri B (2000) Low back pain and disorders of the lumbar spine. In: Braddom RL (ed) Physical Medicine and Rehabilitation. WB Saunders Comp, Philadelphia, pp 853–893
2.
Zurück zum Zitat Weinstein SM, Herring SA (1993) Rehabilitation of the patient with low back pain. In: Delisa JA, Gans BM (eds) Rehabilitation Medicine Principles and Practice. J.B. Lippincott Company, Philadelphia, pp 996–1017. Weinstein SM, Herring SA (1993) Rehabilitation of the patient with low back pain. In: Delisa JA, Gans BM (eds) Rehabilitation Medicine Principles and Practice. J.B. Lippincott Company, Philadelphia, pp 996–1017.
3.
Zurück zum Zitat Descarreaux M, Normand MC, Laurencelle L et al (2002) Evaluation of a specific home exercise program for low back pain. J Manipulative Physiol Ther 25:497–503PubMedCrossRef Descarreaux M, Normand MC, Laurencelle L et al (2002) Evaluation of a specific home exercise program for low back pain. J Manipulative Physiol Ther 25:497–503PubMedCrossRef
4.
Zurück zum Zitat Wheeler AH (1995) Diagnosis and management of low back pain and sciatica. Am. fam. phys 52(5):1333–1341 Wheeler AH (1995) Diagnosis and management of low back pain and sciatica. Am. fam. phys 52(5):1333–1341
5.
Zurück zum Zitat Phillips K, Ch’ien APY, Norwood BR et al (2003) Chronic low back pain management in primary care. The Nurse Practitioner 28(8):26–31PubMedCrossRef Phillips K, Ch’ien APY, Norwood BR et al (2003) Chronic low back pain management in primary care. The Nurse Practitioner 28(8):26–31PubMedCrossRef
6.
Zurück zum Zitat Lahad A, Malter AD, Berg AO et al (1994) The effectiveness of four interventions for the prevention of low back pain. JAMA 272(16):1286–1291PubMedCrossRef Lahad A, Malter AD, Berg AO et al (1994) The effectiveness of four interventions for the prevention of low back pain. JAMA 272(16):1286–1291PubMedCrossRef
7.
Zurück zum Zitat Helewa A, Goldsmith CH, Lee P et al (1999) Does strengthening the abdominal muscles prevent low back pain – a randomized controlled trial. J Rheumatol 26:1808–1815PubMed Helewa A, Goldsmith CH, Lee P et al (1999) Does strengthening the abdominal muscles prevent low back pain – a randomized controlled trial. J Rheumatol 26:1808–1815PubMed
8.
Zurück zum Zitat Frank AO, Souza LD (2001) Conservative management of low back pain. Int J Clin Pract 55(1):21–31PubMed Frank AO, Souza LD (2001) Conservative management of low back pain. Int J Clin Pract 55(1):21–31PubMed
9.
Zurück zum Zitat Liddle SD, Baxter GD, Gracey JH (2004) Exercise and chronic low back pain: what works? Pain 107:176–190PubMedCrossRef Liddle SD, Baxter GD, Gracey JH (2004) Exercise and chronic low back pain: what works? Pain 107:176–190PubMedCrossRef
10.
Zurück zum Zitat Bayramoğlu M, Akman MN, Kılınç Ş et al (2001) Isokinetic measurement of trunk muscle strength in women with chronic low back pain. Am J Phys Med Rehabil 80:650–655PubMedCrossRef Bayramoğlu M, Akman MN, Kılınç Ş et al (2001) Isokinetic measurement of trunk muscle strength in women with chronic low back pain. Am J Phys Med Rehabil 80:650–655PubMedCrossRef
11.
Zurück zum Zitat Mannion AF, Müntener M, Taimela S et al (2001) Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up. Rheumatol 40:772–778CrossRef Mannion AF, Müntener M, Taimela S et al (2001) Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up. Rheumatol 40:772–778CrossRef
12.
Zurück zum Zitat Taimela S, Diederich C, Hubsch M (2000) The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain. Spine 25:1809–1816PubMedCrossRef Taimela S, Diederich C, Hubsch M (2000) The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain. Spine 25:1809–1816PubMedCrossRef
13.
Zurück zum Zitat Tulder MV, Malmivaara A, Esmail R et al (2000) Exercise therapy for low back pain. Spine 25:2784–2796PubMedCrossRef Tulder MV, Malmivaara A, Esmail R et al (2000) Exercise therapy for low back pain. Spine 25:2784–2796PubMedCrossRef
14.
Zurück zum Zitat Saridoğan ME (2000) Bel ağrısı nedenleri ve epidemiyolojisi. In: Kutsal YG (ed) Modern Tıp Seminerleri. Ankara pp 19–29 Saridoğan ME (2000) Bel ağrısı nedenleri ve epidemiyolojisi. In: Kutsal YG (ed) Modern Tıp Seminerleri. Ankara pp 19–29
15.
Zurück zum Zitat Özcan E (2002) Bel ağrılı hastaların konservatif tedavisi. In: Özcan E, Ketenci A (eds) Bel Ağrısı Tanı ve Tedavi. Nobel Kitabevi, İstanbul, pp 187–219 Özcan E (2002) Bel ağrılı hastaların konservatif tedavisi. In: Özcan E, Ketenci A (eds) Bel Ağrısı Tanı ve Tedavi. Nobel Kitabevi, İstanbul, pp 187–219
16.
Zurück zum Zitat Rainville J, Hartigan C, Martinez E et al (2004) Exercise as a treatment for chronic low back pain. Spine J 4:106–115PubMedCrossRef Rainville J, Hartigan C, Martinez E et al (2004) Exercise as a treatment for chronic low back pain. Spine J 4:106–115PubMedCrossRef
17.
Zurück zum Zitat Kankaanpaa M, Taimela S, Airaksinen O et al (1999) The efficacy of active rehabilitation in chronic low back pain. Spine 24:1034–1042PubMedCrossRef Kankaanpaa M, Taimela S, Airaksinen O et al (1999) The efficacy of active rehabilitation in chronic low back pain. Spine 24:1034–1042PubMedCrossRef
18.
Zurück zum Zitat Van der Velde G, Mierau D (2000) The effect of exercise on percentile rank aerobic capacity, pain, and self-rated disability in patients with chronic low-back pain: a retrospective chart review. Arch Phys Med Rehabil 81:1457–1463PubMedCrossRef Van der Velde G, Mierau D (2000) The effect of exercise on percentile rank aerobic capacity, pain, and self-rated disability in patients with chronic low-back pain: a retrospective chart review. Arch Phys Med Rehabil 81:1457–1463PubMedCrossRef
19.
Zurück zum Zitat Chatzitheodorou D, Kabitsis C, Malliou P et al (2007) A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psycgological strain, and serum cortisol concentrations in people with chronic low back pain. Phys Ther 87(3):304–312PubMedCrossRef Chatzitheodorou D, Kabitsis C, Malliou P et al (2007) A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psycgological strain, and serum cortisol concentrations in people with chronic low back pain. Phys Ther 87(3):304–312PubMedCrossRef
20.
Zurück zum Zitat Bensten H, Lindgarde F, Manthorpe R (1997) The effect of dynamic strength back exercise and/or a home training program in 57 year old women with chronic low back pain. Spine 22:1494–1500CrossRef Bensten H, Lindgarde F, Manthorpe R (1997) The effect of dynamic strength back exercise and/or a home training program in 57 year old women with chronic low back pain. Spine 22:1494–1500CrossRef
21.
Zurück zum Zitat Ross MD (2002) Physical therapy and changes in disability for patients with low back pain. Military Medicine 167:662–665PubMed Ross MD (2002) Physical therapy and changes in disability for patients with low back pain. Military Medicine 167:662–665PubMed
22.
Zurück zum Zitat Brosseau L, Milne S, Robinson V et al (2002) Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain. Spine 27:596–603PubMedCrossRef Brosseau L, Milne S, Robinson V et al (2002) Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain. Spine 27:596–603PubMedCrossRef
23.
Zurück zum Zitat Oldervoll LM, Ro M, Zwart JA (2001) Comparison of two physical exercise programs for the early intervention of pain in the neck, shoulders and lower back in female hospital staff. J Rehabil Med 33:156–161PubMedCrossRef Oldervoll LM, Ro M, Zwart JA (2001) Comparison of two physical exercise programs for the early intervention of pain in the neck, shoulders and lower back in female hospital staff. J Rehabil Med 33:156–161PubMedCrossRef
24.
Zurück zum Zitat Carpenter DM, Nelson BW (1999) Low back strengthening for the prevention and treatment of low back pain. Medicine and science in sports and exercise 31(1):18–24PubMedCrossRef Carpenter DM, Nelson BW (1999) Low back strengthening for the prevention and treatment of low back pain. Medicine and science in sports and exercise 31(1):18–24PubMedCrossRef
25.
Zurück zum Zitat Macrael IF, Wright V (1969) Measurement of back movement. Ann Rheum Dis 28:584CrossRef Macrael IF, Wright V (1969) Measurement of back movement. Ann Rheum Dis 28:584CrossRef
26.
Zurück zum Zitat Gatchel RJ, Mayer TG, Capra P et al (1986) Quantification of lumbar function. Part 6: the use of psychological measures in guiding physical functional restoration. Spine 11:36–42PubMedCrossRef Gatchel RJ, Mayer TG, Capra P et al (1986) Quantification of lumbar function. Part 6: the use of psychological measures in guiding physical functional restoration. Spine 11:36–42PubMedCrossRef
27.
28.
Zurück zum Zitat Kucukdeveci AA, Tennant A, Elhan AH et al (2001) Validation of the Turkish version of the Roland Morris Disability Questionnaire for use in low back pain. Spine 26(24):2738–2743PubMedCrossRef Kucukdeveci AA, Tennant A, Elhan AH et al (2001) Validation of the Turkish version of the Roland Morris Disability Questionnaire for use in low back pain. Spine 26(24):2738–2743PubMedCrossRef
29.
Zurück zum Zitat Goldberg DP, Williams P (1988) A user’s guide to the General Health Questionnaire. NFER/Nelson, Windsor, CA Goldberg DP, Williams P (1988) A user’s guide to the General Health Questionnaire. NFER/Nelson, Windsor, CA
30.
Zurück zum Zitat Kılıc C (1996) Genel Sağlık Anketi; güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi 7:3–9 Kılıc C (1996) Genel Sağlık Anketi; güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi 7:3–9
31.
Zurück zum Zitat Beck AT (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed Beck AT (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed
32.
Zurück zum Zitat Hisli N (1989) Beck Depresyon Envanterinin üniversite öğrencileri içi geçerliği, güvenirliği. Psikoloji Dergisi 7:3–13 Hisli N (1989) Beck Depresyon Envanterinin üniversite öğrencileri içi geçerliği, güvenirliği. Psikoloji Dergisi 7:3–13
33.
Zurück zum Zitat Siegel S, Castellan NJ (1988) The case of k related samples, section 7,2: The Friedman two-way analysis of variance by Ranks. In: Siegel S, Castellan NJ (eds) Nonparametric Statistics for the Behavioral Sciences. Mc Graw Hill Inc, New York, pp 174–183 Siegel S, Castellan NJ (1988) The case of k related samples, section 7,2: The Friedman two-way analysis of variance by Ranks. In: Siegel S, Castellan NJ (eds) Nonparametric Statistics for the Behavioral Sciences. Mc Graw Hill Inc, New York, pp 174–183
34.
Zurück zum Zitat Conover WJ (1980) Some methods based on Ranks, section 5,2 several independent samples. In: Conover WJ (ed) Practical Non-parametric İstatistics. John Wiley and sons, pp 229–239 Conover WJ (1980) Some methods based on Ranks, section 5,2 several independent samples. In: Conover WJ (ed) Practical Non-parametric İstatistics. John Wiley and sons, pp 229–239
35.
Zurück zum Zitat Jacobsson L, Lindgarde F, Monthorpe R (1989) The commonest rheumatic complaints of over six weeks’ duration in a twelve month period in a defined Swedish population: prevalences and relationships. Scand J Rheumatol 18:353–360PubMedCrossRef Jacobsson L, Lindgarde F, Monthorpe R (1989) The commonest rheumatic complaints of over six weeks’ duration in a twelve month period in a defined Swedish population: prevalences and relationships. Scand J Rheumatol 18:353–360PubMedCrossRef
36.
Zurück zum Zitat Hartigan C, Rainville J, Sobel JB et al (2000) Long term exercise adherence after intensive rehabilitation for chronic low back pain. Medicine and science in sports and exercise 32(3):551–557PubMedCrossRef Hartigan C, Rainville J, Sobel JB et al (2000) Long term exercise adherence after intensive rehabilitation for chronic low back pain. Medicine and science in sports and exercise 32(3):551–557PubMedCrossRef
37.
Zurück zum Zitat Rainville J, Jouve CA, Hartigan C et al (2002) Comparison of short and long term outcomes for aggressive spine rehabilitation delivered two versus three times per week. The Spine Journal 2:402–407PubMedCrossRef Rainville J, Jouve CA, Hartigan C et al (2002) Comparison of short and long term outcomes for aggressive spine rehabilitation delivered two versus three times per week. The Spine Journal 2:402–407PubMedCrossRef
38.
Zurück zum Zitat Handa N, Yamamoto H, Tani T et al (2000) The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain. J Orthop Sci 5:210–216PubMedCrossRef Handa N, Yamamoto H, Tani T et al (2000) The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain. J Orthop Sci 5:210–216PubMedCrossRef
39.
Zurück zum Zitat Goldstein MS, Morgenstern H, Hurwitz EL et al (2002) The impact of treatment confidence on pain and related disability among patients with low back pain: results from the University of California, Los Angeles, low back pain study. The Spine Journal 2:391–401PubMedCrossRef Goldstein MS, Morgenstern H, Hurwitz EL et al (2002) The impact of treatment confidence on pain and related disability among patients with low back pain: results from the University of California, Los Angeles, low back pain study. The Spine Journal 2:391–401PubMedCrossRef
40.
Zurück zum Zitat Wittink H, Michel TH, Wagner A et al (2000) Deconditioning in patients with chronic low back pain. Spine 25:2221–2228PubMedCrossRef Wittink H, Michel TH, Wagner A et al (2000) Deconditioning in patients with chronic low back pain. Spine 25:2221–2228PubMedCrossRef
41.
Zurück zum Zitat Hoch AZ, Young J, Press J (2006) Aerobic fitness in women with chronic discogenic nonradicular low back pain. Am J Phys Med Rehabil 85(7):607–613PubMedCrossRef Hoch AZ, Young J, Press J (2006) Aerobic fitness in women with chronic discogenic nonradicular low back pain. Am J Phys Med Rehabil 85(7):607–613PubMedCrossRef
42.
Zurück zum Zitat Smeets RJ, Wittink H, Hidding A et al (2006) Do patients with chronic low back pain have a lower level of aerobic fitness than healthy controls?: are pain, disability, fear of injury, working status, or level of leisure time activity associated with the difference in aerobic fitness level. Spine 31(1):90–97PubMedCrossRef Smeets RJ, Wittink H, Hidding A et al (2006) Do patients with chronic low back pain have a lower level of aerobic fitness than healthy controls?: are pain, disability, fear of injury, working status, or level of leisure time activity associated with the difference in aerobic fitness level. Spine 31(1):90–97PubMedCrossRef
43.
Zurück zum Zitat Cunha IT, Simmonds MJ, Protas EJ et al (2002) Back pain, physical function and estimates of aerobic capacity. Am J Phys Med Rehabil 81:913–920CrossRef Cunha IT, Simmonds MJ, Protas EJ et al (2002) Back pain, physical function and estimates of aerobic capacity. Am J Phys Med Rehabil 81:913–920CrossRef
44.
Zurück zum Zitat Sculco AD, Paup DC, Fernhall B et al (2001) Effects of aerobic exercise on low back pain patients in treatment. The Spine Journal 1:95–101PubMedCrossRef Sculco AD, Paup DC, Fernhall B et al (2001) Effects of aerobic exercise on low back pain patients in treatment. The Spine Journal 1:95–101PubMedCrossRef
Metadaten
Titel
Comparison of three different approaches in the treatment of chronic low back pain
verfasst von
Şebnem Koldaş Doğan
Birkan Sonel Tur
Yeşim Kurtaiş
Mesut Birol Atay
Publikationsdatum
01.07.2008
Verlag
Springer-Verlag
Erschienen in
Clinical Rheumatology / Ausgabe 7/2008
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-007-0815-7

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