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Physiotherapist-delivered cognitive-behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review.

CONCLUSIONS: With additional training, physiotherapists can deliver effective CB interventions. However, without training or resources, successful translation and implementation remains unlikely. Researchers should improve reporting of procedural information, provide relevant materials, and offer accessible provider training. Implications for Rehabilitation Previous reviews have established that traditional biomedical-based treatments (e.g., acupuncture, manual therapy, massage, and specific exercise programmes) that focus only on physical symptoms do provide short-term benefits but the sustained effect is questionable. A cognitive-behavioural (CB) approach includes techniques to target both physical and psychosocial symptoms related to pain and provides patients with long-lasting skills to manage these symptoms on their own. This combined method has been used in a variety of settings delivered by different health care professionals and has been shown to produce long-term effects on patient outcomes. What has been unclear is if these programmes are effective when delivered by physiotherapists in routine physiotherapy settings. Our study synthesises the evidence for this context. We have confirmed with high-quality evidence that with additional training, physiotherapists can deliver CB interventions that are effective for patients with back pain. Physiotherapists who are considering enhancing their treatment for patients with low back pain should consider undertaking some addi...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research

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Study Design. A systematic review and single-arm meta-analysis of clinical trials. Objective. To assess the efficacy of mesenchymal stem cells or chondrocyte in patients with discogenic low back pain. Summary of Background Data. There is no previous review evaluated the efficacy of mesenchymal stem cell or chondrocyte therapy in adults with discogenic low back pain. Methods. A comprehensive literature search was conducted on PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO, and Web of Science from database inception through on September 10th, 2015. We included clinical trials that evaluated stem cells or chondrocyte-bas...
Source: Spine - Category: Orthopaedics Tags: Literature Review Source Type: research
Abstract Low back pain (LBP) is a common presentation to the ED, and a frequent cause of disability globally. The ED management is often associated with high rates of imaging, misuse and overuse of pharmacology and subsequent financial implications. Given this, improved quality of care for patients with LBP in ED is essential. This rapid review investigated best practice for the assessment and management of LBP in the ED. PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2015. Primary studies, systematic reviews and guidelines were considered for inclusion. E...
Source: Emergency Medicine Australasia - Category: Emergency Medicine Authors: Tags: Review Article Source Type: research
The aim of this meta-analysis of randomized controlled trials was to gain insight into the effectiveness of walking intervention on pain, disability, and quality of life in patients with chronic low back pain (LBP) at post intervention and follow ups.
Source: Manual Therapy - Category: Physiotherapy Authors: Tags: Review article Source Type: research
It has been established that Hyper-pronation of the foot may lead to postural changes in the lower limbs, with a resultant pelvic ante-version, and a subsequent risk of development of low back pain. However, the association between the presence of a hyper-pronated foot and the severity of disability in low back pain is currently not known.
Source: Journal of Bodywork and Movement Therapies - Category: Physiotherapy Authors: Tags: Observational Study Source Type: research
Introduction: Respiratory muscle strength (RMS) in patients with low back pain (LBP) has been a topic of recent investigation, but data comparing measured RMS to age-gender predicted values (AGPV) is limited in this population.Aim: To examine RMS and perceived disability (PD) in a LBP population with a wide range of PD and age seeking physical therapy for LBP.Methods: Thirty-one LBP patients (13 men, 18 women) underwent measurement of RMS via maximal inspiratory and expiratory pressure (MIP and MEP, respectively) using ATS/ERS guidelines which were compared to AGPV (Harik-Khan 1998, Black &Hyatt 1969). The Oswestry Dis...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Conclusions: Baseline SMIP predicts change in PD after 1 month of PT. Lower baseline SMIP scores were associated with greater improvements in PD. Thus, PD in subjects with CLBP, and concurrent low SMIP, may be associated with deconditioning rather than structural pathology and therefore be more responsive to PT. PT targeted at improving SMIP may improve PD in CLBP.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and Chronic Care Source Type: research
CONCLUSIONS: Pain, disability, quality of life and fear-avoidance similarly improve by walking or exercise in chronic low back pain. Walking may be considered as an alternative to other physical activity. Further studies with larger samples, different walking dosages, and different walking types should be conducted. Implications for Rehabilitation Walking is commonly recommended as an activity in chronic low back pain. Pain, disability, and fear-avoidance similarly improve by walking or exercise. Adding walking to exercise does not induce greater improvement in the short-term. Walking may be a less-expensive alternative to...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Study Design. Multicenter, prospective, cohort study. Objective. To estimate the Minimal Clinically Important Difference (MCID) for the physical (PCS) and mental (MCS) component summaries of Short Form SF-12 (SF-12), in patients with low back pain (LBP). Summary of Background Data. Quality of life is one of the core domains recommended to be assessed in patients with LBP. SF-12 is the most widely used instrument for this purpose, but its MCID was unknown. Methods. A total of 458 patients with subacute and chronic LBP were consecutively recruited across 21 practices. LBP, referred pain, disability, PCS, and MCS w...
Source: Spine - Category: Orthopaedics Tags: Health Services Research Source Type: research
Conclusion Lumbar spine arthrodesis was effective in improving pain, low back pain, functional capacity, limitation due to physical aspects, vitality, and social and emotional aspects. Patients without anxiety and depression symptoms had better results on the scales compared to those with such symptoms.
Source: Revista Brasileira de Ortopedia - Category: Orthopaedics Source Type: research
Conclusions: The finding that small indirect effects of the COPE intervention via changes in illness perceptions and pain catastrophizing on posttreatment disability could be estimated indicates that these variables may be viable treatment targets for biopsychosocial interventions; however, this finding must be viewed in light of the adjusted analyses, which showed that the indirect effects were significantly reduced through the inclusion of a treatment-mediator interaction term. PMID: 29186635 [PubMed - in process]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
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