Evaluation of functional disability and pain in patients with chronic low back pain submitted to physiotherapy
Introduction: Chronic low back pain (CLBP) is one of the causes that usually result in mobility limitations in the economically active population due to musculo-skeletal disorders. It has, as main symptoms, pain and disability and should be seen as a public health problem. Objective: This study aimed to evaluate the Functional Disability (FD) and pain intensity in patients with CLBP, underwent to manipulative therapy and conventional physiotherapy at Getulio Vargas Hospital. Method: This was a randomized trial study with a control group, with a sample, participants with CLBP, who were divided into two groups: those who underwent manipulative physiotherapy (group 1) and those who underwent conventional therapy (group 2), and the both groups were subjected to two treatments at different times. The program lasted five weeks, and 2 weeks for each intervention, performing two weekly sessions, which average duration was 30 minutes and one week interval between treatments. There were collected sociodemographic data, data related to FD using the Disability questionnaire Roland-Morris (RMDQ) and data related to pain intensity using the Visual Analogue Scale (VAS). Results: The study included 14 patients with mean age of 51 + 9 years. They showed significant improvement in RMDQ (p <0.001) and VAS (p <0.001), after being subjected to manipulative group, also showing a significant treatment effect over conventional treatment in both RMDQ (p = 0.004) and EVA (p = 0.006). Conclusion: Through this study, it can be shown that patients with CLBP showed significant improvements in functional capacity, by reducing the FD and reduction of painful symptoms, after being subjected to a five-week-program of manipulative physiotherapy.
1. Nogueira HC, Navega MT. Influência da escola de postura na qualidade de vida, capacidade funcional e intensidade de dor e flexibilidade de trabalhadores administrativos. Fisio. e Pesq., São Paulo, 2011;18(4):353-8.
2. Mancin B, Bonvicine G, Gonçalves C, Barboza MAI. Análise da influência do sedentarismo sobre a qualidade de vida de pacientes portadores de dor lombar crônica. Conscientia e Saúde. 2008;7(4):441-7.
3. Adorno MLGR, Brasil-neto JP. Avaliação da qualidade de vida com o instrumento SF-36 em lombalgia crônica. Acta Ortop Bras. 2013;21(4):202-7.
4. Yang M et al. Effectiveness of Chinese massage therapy (Tui Na) for chronic low back pain: study protocol for a randomized controlled trial. Trials. 2014 Oct 29;15:418.
5. Ferreira S, Pereira MG. Preditores da qualidade de vida e incapacidade functional em doentes com lombalgia crônica em tratamento diferenciado. Rev. SBPH 2011;14(1).
6. Mascarenhas CHM, Santos LS. Avaliação da dor e da capacidade funcional em indivíduos com lombalgia crônica. J Health Sci Inst. 2011;29(3):205-8.
7. Zdrodowska B, Leszczyńska-Filus M, Leszczyński R, Błaszczyk J. Comparison of the effect of laser and magnetic therapy for pain level and the range of motion of the spine of people with osteoarthritis lower back. Pol Merkur Lekarski. 2015 Jan;38(223):26-31.
8. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet 2012;379:482–491.
9. Xia T et al. Study protocol for patient response to spinal manipulation - a prospective observationalclinical trial on physiological and patientcentered outcomes in patients with chronic low back pain. BMC Complement Altern Med. 2014 Aug 8;14:292.
10. Tozzi P, Bongiorno D, Vitturini C. Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility. Journal Bodyw Mov Ther. 2012 Jul;16(3):381-91.
11. Oliveira RF et al. Immediate Effects of Region Specific and Non Region Specific Spinal Manipulative Therapy in Randomized Patients With Chronic Low Back Pain: A Controlled Trial. PHYS THER. 2013;93:748-756.
12. Voogt L et al. Analgesic effects of manual therapy in patients with musculoskeletal pain: A systematic review. Manual Ther 2015;20:250-256.
13. Kuchera ML. Applying Osteopathic Principles for Treatment of Patients With Chronic Pain. Journal Am Osteopath Assoc. 2007;107(suppl 6):ES28-ES38.
14. Monteiro J, Faísca L, Nunes O, Hipólito J. Questionário de incapacidade de roland morris-adaptação e validação para os doentes de língua portuguesa com lombalgia. Acta Med Port 2010;23:761-766.
15. Toniolli ACS, Pagliuca LMF. Tecnologia tátil para a avaliação da dor em cegos. Rev Latinoam Enferm. 2003;11(2):220-6.
16. Cruser A et al. A randomized, controlled trial of osteopathic manipulative treatment for acute low back pain in active duty military personnel. J of Manual and Manipulative Ther 2012 VOL. 20 No. 1.
17. Hougt E, Stephenson R, Swift L. A comparison of manual therapy and active rehabilitation in the treatment of non specific low back pain with particular reference to a patient’s Linton & Hallden psychological screening score: a pilot study. BMC Musculoskeletal Disorders 2007, 8:106.
18. Clark BC et al. Muscle functional magnetic resonance imaging and acute low back pain: a pilot study to characterize lumbar muscle activity asymmetries and examine the effects of osteopathic manipulative treatment. Osteop Med and Primary Care 2009, 3:7.
19. Lehman GJ, Vernon H, and McGill SM. Effects of a Mechanical Pain Stimulus on Erector Spinae Activity Before and After a Spinal Manipulation in Patients With Back Pain: A Preliminary Investigation. Journal of Manipulation and Physio Ther July/August 2001 V 24 N 6.
20. Zhang W et al. Therapeutic Effects of Chinese Osteopathy in Patients with Lumbar Disc Herniation. The American J. of Chin. Med., 2013,Vol. 41, No. 5, 983–994.
21. Licciardone JC, Kearns CM, Hodge LM, Bergamini MV. Associations of cytokine concentrations with key osteopathic lesions and clinical outcomes in patients with nonspecific chronic low back pain: results from the OSTEOPATHIC Trial. J Am Osteopath Assoc 2012;112:596 e 605.
22. Licciardone JC, Aryal S. Clinical response and relapse in patients with chronic low back pain following osteopathic manual treatment: Results from the OSTEOPATHIC Trial . Manual Therapy xxx (2014) 1-8.
23. Licciardone JC et al. Osteopathic Manual Treatment and Ultrasound Therapy for Chronic Low Back Pain: A Randomized Controlled Trial. Ann Fam Med 2013;11:122-129.
24. Deyo RA, Mirza SK, Turner JA, Martin BI. Overtreating chronic back pain: time to back off? J Am Board Fam Med. 2009;22(1):62-68.
25. Licciardone JC, Brimhall AK, King LN: Osteopathic manipulative treatment for low back pain: a systematic review and metaanalysis of randomized controlled trials. BMC Musculoskelet Disord 2005, 6:43.