[The role of an information booklet or oral information about back pain in reducing disability and fear-avoidance beliefs among patients with subacute and chronic low back pain. A randomized controlled trial in a rehabilitation unit]. / Un simple livret d'information peut contribuer à réduire l'incapacité fonctionnelle de patients lombalgiques subaigus et chroniques. Etude contrôlée randomisée en milieu de rééducation.

OBJECTIVES: To compare the efficacy of an information booklet or oral information about back pain in reducing disability and fear-avoidance beliefs among patients with subacute and chronic low back pain referred to a rehabilitation department. METHODS: An alternate-month design was used for 142 patients with subacute or chronic low back pain who were hospitalized for treatment. Seventy-two patients received written standardized information about back pain (the "back book") and usual physical therapy (intervention group), and 70 received usual physical therapy only along with nonstandardized oral information (control group). The main outcome measure was disability (measured on the Quebec back-pain disability scale), and secondary outcome measures were pain intensity (measured on a visual analog scale), fear-avoidance beliefs (measured on the Fear-Avoidance Beliefs Questionnaire [FABQ] Physical component), and knowledge of the relation of back pain to physical activity assessed at baseline, just before discharge from the hospital and 3 months after discharge. Satisfaction related to the information received was assessed on the day of discharge. RESULTS: Receiving the "back book" had a significant impact on disability at 3 months, from 48.40+/-14.55 to 34.57+/-18.42 in the intervention group and from 52.17+/-16.88 to 42.40+/-14.95 in the control group (p=0.03). Receipt of the book also had a significant impact on patients' knowledge and satisfaction about information but a nonsignificant effect on fear-avoidance beliefs. CONCLUSIONS: Providing an information booklet about back pain to patients with subacute and chronic low back pain referred to a rehabilitation unit contributes to reduced disability in these patients.

[Effect of music therapy among hospitalized patients with chronic low back pain: a controlled, randomized trial]. / Intérêt de la musicothérapie dans la prise en charge de la lombalgie chronique en milieu hospitalier (Etude contrôlée, randomisée sur 65 patients).

OBJECTIVE: To evaluate the influence of music therapy in hospitalized patients with chronic low back pain. METHODS: A controlled, randomized study (N = 65). During a stationary rehabilitation stay of 12 days, 65 patients with low back pain were randomized to receive on alternate months standardized physical therapy plus 4 music therapy sessions between day 1 and day 5 (intervention group; N = 33) or standardized physical therapy alone (control group; N =32). Scores for pain (as measured on a visual analogue scale [VAS]), disability (Oswestry index) and anxiety and depression (as measured on the hospital anxiety and depression scale [HAD]) were collected on day 1, 5 and 12. Pain intensity was also evaluated on a VAS just before and after music therapy sessions. RESULTS: Introduced music therapy sessions during a stationary rehabilitation stay in patients with chronic low back pain reduce pain (-2.0+/-2.7 vs -1.8+/-2.6) but not significantly. However, music therapy significantly (p < 0.01) reduced disability as measured on the Owestry index between day 1 and day 5 (-11.8+/-17.8 vs -2.5+/-9.4), anxiety (-3.5+/-3.7 vs -0.9+/-2.7) and depression (-2.1+/-3.0 vs 0.6+/-2.4). The immediate effect on pain intensity (VAS score) was confirmed (p < 0.001). CONCLUSION: Our results confirmed the effectiveness of music therapy for hospitalized patients with chronic low back pain. Music therapy can be a useful complementary treatment in chronic pain and associated anxiety-depression and behavioural consequences.

[Strength training with elastic bands: measure of its effects in cardiac rehabilitation after coronary diseases]. / Le renforcement musculaire par bandes élastiques : évaluation de ses effets dans le réentraînement à l'effort du coronarien.

OBJECTIVES: To compare high intensity strength training with weightlifting exercises or with elastic bands. SETTING: Outpatient unit of cardiac rehabilitation. TYPE: Prospective randomised clinical trial. POPULATION: Inclusion of coronary patients in phase II after medical or surgical treatment of a myocardiac infarction, without cardiac insufficiency; beta-blockers were accepted. METHOD: Evaluation of coronary patients at beginning and at the end of a 4 week cardiac rehabilitation program. It included progressive aerobic training according to Karvonen method for all the patients, associated with weightlifting exercises (Koch press) in the control group, or use of elastic bands in the experimental group. Cardiac rate, oxygen consumption at rest and at maximum power were the main criteria with also muscle strength of quadriceps, hamstrings, biceps brachii, latissimus dorsi and triceps brachii, body mass indexes, quality of life with SF-36, anxiety (stay T test) and perceived exertion with the Borg 10-point category-ratio scale, myotendinous injuries (Shaw scale). RESULTS: Twenty-six coronary patients, all male from 45 to 65 years old, all receiving beta-blockers, were included, 13 in each group. Control and experimental groups were initially similar. At the end of the 4 week program, all the two groups improved significantly their strength and power and there were no differences between the two groups. Perceived exertion was lower in the group using elastic bands and there were no myotendinous lesions. CONCLUSION: Strength training with elastic bands is a low-cost, attractive, playful technique, proposed to a group of coronary patients, which appears as effective in cardiac rehabilitation as individual weightlifting training.