Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021

George, Steven Z.; Fritz, Julie M.; Silfies, Sheri P.; Schneider, Michael J.; Beneciuk, Jason M.; Lentz, Trevor A.; Gilliam, John R; Hendren, Stephanie; Norman, Katherine

doi:10.2519/jospt.2021.0304

Cited by 227 publications

(142 citation statements)

References 167 publications

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“…The increased provision of active and manual treatments indicates that therapists were providing more ‘hands-on’ treatments with the active interventions following their PNE training, and this may be seen as a greater emphasis on high-value interventions and meeting the patients’ needs. The most recent clinical practice guidelines for interventions for the management of LBP gave a grade of A (strong evidence) for manual therapy (thrust and non-thrust joint mobilization) in the management of both acute and chronic LBP [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

The clinical impact of pain neuroscience continuing education on physical therapy outcomes for patients with low back and neck pain

et al. 2022

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Objectives Research suggests that attendance by physical therapists at continuing education (CE) targeting the management of low back pain (LBP) and neck pain does not result in positive impacts on clinical outcomes. The aim of this study was to determine if therapists attending a self-paced 3-hour online Pain Neuroscience Education (PNE) program was associated with any observed changes to patient outcomes and also clinical practice. Methods Participants were 25 different physical therapists who treated 3,705 patients with low back pain (LBP) or neck pain before and after they had completed an online PNE CE course. Change in outcomes measures of pain and disability at discharge were compared for the patients treated before and after the therapist training. Clinical practice patterns of the therapists, including total treatment visits, duration of care, total units billed, average units billed per visit, percentage of ‘active’ billing units and percentage of ‘active and manual’ billing units, were also compared for the patient care episodes before and after the therapist training. Results There was no significant difference for change in pain scores at discharge for patients treated after therapist CE training compared to those treated before regardless of the condition (LBP or neck pain). However, patients with LBP who were treated after therapist CE training did report greater improvement in their disability scores. Also after CE training, for each episode of care, therapists tended to use less total visits, billed fewer units per visit, and billed a greater percentage of more ‘active’ and ‘active and manual’ billing units. Discussion Attending an online 3-hour CE course on PNE resulted in improved disability scores for patients with LBP, but not for those with neck pain. Changes in clinical behavior by the therapists included using less visits, billing fewer total units, and shifting to more active and manual therapy interventions. Further prospective studies with control groups should investigate the effect of therapist CE on patient outcomes and clinical practice.

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Section: Discussionmentioning

confidence: 99%

The clinical impact of pain neuroscience continuing education on physical therapy outcomes for patients with low back and neck pain

et al. 2022

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“…Implementation of the home back extension exercise device appears to be appropriate for this purpose. Lumbar strengthening exercises and other exercises are recommended for the management of chronic low back pain [ 3 , 29 ]. However, subclassification of specific individuals for the management of low back pain to receive lumbar strengthening exercises or other exercises (e.g., motor control) has not been validated through research and is beyond the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

Electromyographic Analysis of the Lumbar Extensor Muscles during Dynamic Exercise on a Home Exercise Device

Mayer

Udermann

Verna

2022

JFMK

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Resistance exercise with devices offering mechanisms to isolate the lumbar spine is effective to improve muscle strength and clinical outcomes. However, previously assessed devices with these mechanisms are not conducive for home exercise programs. The purpose of this study was to assess the surface electromyographic (EMG) activity of the lumbar extensor muscles during dynamic exercise on a home back extension exercise device. Ten adults (5 F, 5 M) performed dynamic lumbar extension exercise on a home device at three loads: 1.00 × body weight (BW), 1.25 × BW and 1.50 × BW. Surface EMG activity from the L3/4 paraspinal region was collected. The effect of exercise load, phase of movement, and position in the range of motion on lumbar extensor EMG activity (normalized to % maximum voluntary isometric contraction) was assessed. Lumbar extensor EMG activity significantly increased from 1.00 BW to 1.50 BW loads (p = 0.0006), eccentric to concentric phases (p < 0.0001), and flexion to extension positions (p < 0.0001). Exercise using a home back extension exercise device progressively activates the lumbar extensor muscles. This device can be used for home-based resistance exercise programs in community-dwelling adults without contraindications.

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“…First-Line-Treatment Die aktive Trainingstherapie gilt als zentrale Behandlungskomponente beim Management von Patient*innen mit persistierenden Rückenschmerzen 2 – 4 . Gemäß der jüngst erschienenen Leitlinien von George et al sollte hierzu ein moderates bis hoch-intensives Kraft- und individuelles Ausdauertraining absolviert werden 27 . Das Training muss – dies gilt sicher für alle Krankheitsentitäten und nicht allein für chronische Rückenschmerzen – alle Beanspruchungsformen, d. h. Kraft, Ausdauer und Koordination, beinhalten 28 .…”

Section: Behandlungsinhalteunclassified

“…Die Einzeltherapie wird dem betreuten Training vorangestellt, um damit das Durchführen von Interventionen in einem persönlicheren und individuelleren Rahmen zu ermöglichen. Als flankierende Maßnahme kann eine Patientenedukation eingesetzt werden 27 .…”

Section: Behandlungsinhalteunclassified

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Trainingsorganisation im ambulanten Setting

Szep¹

2022

Schmerz.Therapie

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Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021

Cited by 227 publications

References 167 publications

The clinical impact of pain neuroscience continuing education on physical therapy outcomes for patients with low back and neck pain

The clinical impact of pain neuroscience continuing education on physical therapy outcomes for patients with low back and neck pain

Electromyographic Analysis of the Lumbar Extensor Muscles during Dynamic Exercise on a Home Exercise Device

Trainingsorganisation im ambulanten Setting

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