Middle-term effects of education programme in chronic low back pain patients to an adherence to physical activity: A randomized controlled trial.

OBJECTIVE: This study was to measure the impact of an education programme in Chronic Low Back Pain (CLBP) patients on their changing behaviour; particularly on the resumption or maintenance of physical activity (PA) at three and six months after care. METHODS: A two-group, randomised controlled clinical trial was conducted on 68 patients as the control group (CG) and 68 as the experimental group (EG). All patients benefited from a four-week multidisciplinary programme, with an educative programme for the EG. The dropouts of patients during the follow-up period and the PA level were measured at three and six months after the end of care. RESULTS: At 3-months, the EG presented a significant higher level of physical activity (91% of EG versus 77% of CG, p < 0.001) and at six months, this group presented a lower dropout rate than CG (60% of EG versus 73% of CG, p = 0.017). CONCLUSION: The educative programme, added to a multidisciplinary care plan, can improve adherence to the care programme and the continuum of PA. PRACTICE IMPLICATIONS: Add an educative programme focused on motivation, physical activity, stress management and daily activities seems necessary to accompany CLBP patient towards the maintenance of a regular PA.

Isometric Strength Database for Muscle Maximal Voluntary Endurance Field Tests: Normative Data.

BACKGROUND: Different field tests are used to evaluate muscle capacity, in particular maximal voluntary isometric endurance. However, although there are some normative values for a few muscle endurance tests, these do not consider the weight, height, gender, or age of individuals, which are well-known factors that influence muscle performance. HYPOTHESIS/PURPOSE: The purpose of this study was to investigate the test-retest reproducibility of eight field tests and establish muscle endurance norms, in a healthy population, based on their anthropometric characteristics, which could allow the optimal evaluation of the entire muscle function in a quick manner. DESIGN: Case series. METHODS: This study was conducted in two phases. The first phase was to check the reproducibility inter- and intra-assessor for eight isometric muscle field tests on 20 volunteer subjects aged 40.9 ± 11.6 years old (age range, 21-58 years). The second part was to establish muscle maximal voluntary isometric endurance norms according to these tests on a total of 400 healthy participants grouped by age (50 males and females in each of the age brackets, 20-29; 30-39; 40-49; 50-59 years old, for a total of 200 males and 200 females). RESULTS: The intra- and inter-assessor reproducibility tests are good for all muscle measurements (the intraclass correlation coefficients varied between 0.915 and 0.996 and the coefficient of variation between 3.6 and 11.8%). The area under the receiver operating characteristic curves demonstrates a good sensibility with values greater than 0.7 for each test. Each muscle belt presents same ratio regardless of the age and gender group. The simultaneous multiple regression analyses highlight that the anthropometric characteristics of subjects influence significantly the performance of isometric tests. CONCLUSION: This study has permitted establishing prediction equations in a healthy population according to their anthropometric characteristics as well as agonist/antagonist ratios for eight muscle isometric field tests after demonstrating a good reproducibility of all tests.

A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France.

STUDY DESIGN: A controlled and retrospective study of 144 chronic low back pain patients to evaluate the effectiveness of an intensive functional restoration program in France. OBJECTIVE: Evaluating the efficiency of an intensive, dynamic and multidisciplinary functional restoration program in patients with chronic low back pain (LBP), during 6 and 12 months follow up. SUMMARY OF BACKGROUND DATA: Chronic low back pain disease has a multifactor nature, involving physical, psychological professional and social factors. A functional restoration program (FRP) has been included in a multidisciplinary training program which provides an efficient therapeutic solution. However, the effectiveness of an FRP has not been yet established. METHODS: 144 subjects (71 males, 73 females) with chronic low back pain were included in a functional restoration program. The FRP includes physiotherapy and occupational therapy interventions together with psychological counselling. Patients participated as in- or outpatients 6 h per day, 5 days a week over 5 weeks. Pain intensity, trunk flexibility, trunk strength, lifting ability, quality of life and return to work were recorded before, immediately after, and at 6 months and 12 months after the treatment period. RESULTS: All outcome measures were significantly higher just after the FRP (144 patients) and at 6 and 12 months (from available data in 31 subjects) compared to pre-treatment values. This FRP for chronic low back pain maintained its benefits whatever the patient's activities. CONCLUSIONS: The effects reflected on all outcome measures, both on short and long term follow-up. The multidisciplinary FRP for chronic low back pain patients durably stopped the de-conditioning syndrome and involved new life-style habits for the patient, daily pain management and a return to work.