Lumbar Lordosis Rehabilitation for Pain and Lumbar Segmental Motion in Chronic Mechanical Low Back Pain: A Randomized Trial

Diab, Aliaa A.; Moustafa, Ibrahim M.

doi:10.1016/j.jmpt.2012.04.021

Cited by 46 publications

(80 citation statements)

References 18 publications

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“…These results mirror the outcomes as found from the trials on the cervical spine by CBP extension traction methods [24,[28][29][30][31][32][33][34][35]. Table 2 summarizes the two lumbar trials [25][26][27].…”

Section: Restoration Of Lumbar Lordosissupporting

confidence: 71%

“…Since the original trial outlining the CBP extension traction approach for lumbar hypolordosis, two more randomized controlled trials have documented that superior outcomes occur in mechanical LBP and sciatic patients receiving lumbar extension traction as part of comprehensive physiotherapeutic programs versus those who receive the physiotherapy without the extension traction (Figures 9 and 10) [25][26][27]. These results mirror the outcomes as found from the trials on the cervical spine by CBP extension traction methods [24,[28][29][30][31][32][33][34][35].…”

Section: Restoration Of Lumbar Lordosismentioning

confidence: 99%

“…The demonstration of paralleled spine alignment improvements with reductions in pain and disability, versus no change in untreated control groups in pre-post clinical trials have been performed [18][19][20][21][22][23]. The demonstration in randomized clinical trials that only patient groups achieving lordosis and sagittal posture improvement (lumbar or cervical) achieve long-term improvements in various outcome measures versus comparative treatment groups not getting spine alignment improvement who experience regression in multiple outcome measures at follow-up have also been done [24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

“…Today the evidence supporting the CBP approach to the correction of cervical lordosis and lumbar lordosis is substantial. There are now many randomized controlled clinical trials (RCT) documenting the reduction of anterior head translation [24,[28][29][30][31][32][33][34][35], as well as the increase in cervical lordosis [24,[28][29][30][31][32][33][34][35], and the increase in lumbar lordosis [25][26][27] in patients presenting with hypolordosis in each of these spinal areas. These trials have also demonstrated that the postural and spinal improvements are associated with improvements in various patient outcomes, including: pain, disability, quality of life, range of motion as well as specific physiological measures such as improved neurological central conduction times-the ability of the brain to communicate with the body.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Oakley¹,

Moustafa²,

Harrison³

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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Low back and neck pain disorders are among the leading causes for work loss, suffering, and health care expenditures throughout the industrialized world. It has been extensively demonstrated that sagittal plane alignment of the cervical and lumbar spines impacts human health and well-being. Today there are reliable and predictable means through the application of extension spinal traction as part of comprehensive rehabilitation programs to restore the natural curvatures of the spine. High-quality evidence points to Chiropractic BioPhysics® (CBP®) methods offering superior long-term outcomes for treating patients with various craniocervical and lumbosacral disorders. CBP technique is a full spine and posture rehabilitation approach that incorporates mirror image® exercises, spinal and postural adjustments, and unique traction applications in the restoration of normal/ideal spinal alignment. Recent randomized controlled trials using CBP's unique extension traction methods in conjunction with various conventional physiotherapeutic methods have demonstrated those who restore normal lordosis (cervical or lumbar) get symptomatic relief that lasts up to 2 years after treatment. Comparative groups receiving various 'cookie-cutter' conventional treatments experience only temporary symptomatic relief that regresses as early as 3 months after treatment. The economic impact/benefit of CBPs newer sagittal spine rehabilitation treatments demand continued attention from clinicians and researchers alike.systematically as the Harrison group [4][5][6][7][8][9][10][11]. Elliptical shape modeling of the path of the posterior longitudinal ligament along the posterior vertebral body margins was chosen due to the ease of clear identification of these spine landmark points and for the ability to easily make measurements of spine segmental and total angle of curvature on patient radiographs to compare patient measurements to model predictions. Modeling was performed on radiographic samples of asymptomatic participants. Computer iterations of spinal shape modeling was applied to determine best-fit geometric spine shapes by fitting various ellipses of altering minor-to-major axes ratios to digitized posterior vertebral body corners on samples of radiographs of the cervical [4-6], thoracic [7,8], and lumbar spinal regions [9][10][11] (Figure 3).The Harrison normal spinal model (Figure 3) features a circular cervical lordosis, and portions of an elliptical curve for both the thoracic kyphosis (more curvature cephalad), and lumbar lordosis (more curvature caudad). Consequently, features of the normal human spine reveal that the opposite thoracic and lumbar curves meet together at the thoraco-lumbar junction being essentially straight; the upper, deeper curve of the upper thoracic spine reflects oppositely at the cervico-thoracic junction (between T1 and T2) and continues into the cervical lordosis; the lower lumbar spine increases its lordotic alignment having two-thirds of its curve between L4-S1 as it meets the forward tilted sacral base. T...

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Section: Restoration Of Lumbar Lordosissupporting

confidence: 71%

Section: Restoration Of Lumbar Lordosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Oakley¹,

Moustafa²,

Harrison³

2021

Spinal Deformities in Adolescents, Adults and Older Adults

View full text Add to dashboard Cite

show abstract

“…22 The positive 51 Several other related studies, while pertaining to lumbar area, have also highlighted the role of extension traction in improving the nerve root function and reducing pain. 52,53 The biomechanics of vascular system may be another possible explanation for the favorable results of extension position. It is postulated that the blood vessels of the dorsal and ventral roots will deform with postural changes.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Treatment Program Comparing 2 Different Traction Approaches for Patients With Discogenic Cervical Radiculopathy: A Randomized Controlled Trial

Moustafa

Diab

2014

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to investigate the immediate and long-term effects of a 1-year multimodal program with the addition of 2 different traction approaches on the pain, function, disability, and nerve root function in patients with discogenic cervical radiculopathy (CR). This study also attempted to identify the optimal traction angle based on the maximum recovery of the peak-to-peak amplitude of the flexor carpi radialis (FCR) H-reflex. Methods: This randomized clinical trial with one-year follow-up included a total of 216 (101 female) patients with unilateral lower discogenic CR were randomly assigned to 1 of 3 groups. The standard care group (C) received the multimodal program (pain relief methods, muscle strengthening, and thoracic spine manipulation). The ventroflexion traction group (A) received the same multimodal program as group C, with added traditional ventroflexion traction. The novel traction group (B) received the same multimodal program as group C in addition to a flexor carpi radialis (FCR) H-reflex-based traction method. Primary outcomes were the Neck Disability Index (NDI) and secondary outcomes included neck pain, arm pain, and the amplitude and latency of the H-reflex. Patients were assessed at 3 intervals (pre-treatment, 4 weeks post-treatment, and the 1-year follow-up). Results: The mixed linear model with repeated measures indicated a significant group × time effect in favor of the novel cervical traction group (B) for measures of NDI (F = 412.6, P b .0005), neck pain (F = 108.9, P b .0005), arm pain (F = 91.3, P b .0005), H-reflex amplitude (F = 207.7, P b .0005), and H-reflex latency (F = 58.9 P b .0005). We found that the extension position of cervical spine (5°extension) was the position that achieved the maximum improvement in the novel cervical traction method. Conclusions: This preliminary study showed that a multimodal program with a novel cervical traction method added improved NDI, neck pain, arm pain, and the amplitude and latency of FCR H-reflex for a group of patients with chronic discogenic CR.

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Efficacy of Therapeutic Aquatic Exercise vs Physical Therapy Modalities for Patients With Chronic Low Back Pain

Peng

Wang

et al. 2022

JAMA Netw Open

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IMPORTANCE Therapeutic aquatic exercise is frequently offered to patients with chronic low back pain, but its long-term benefits are unclear.OBJECTIVE To assess the long-term effects of therapeutic aquatic exercise on people with chronic low back pain. DESIGN, SETTING, AND PARTICIPANTSThis 3-month, single-blind randomized clinical trial with a 12-month follow-up period was performed from September 10, 2018, to March 12, 2019, and the trial follow-up was completed March 17, 2020. A total of 113 people with chronic low back pain were included in the experiment. INTERVENTIONS Participants were randomized to either the therapeutic aquatic exercise or the physical therapy modalities group. The therapeutic aquatic exercise group received aquatic exercise, whereas the physical therapy modalities group received transcutaneous electrical nerve stimulation and infrared ray thermal therapy. Both interventions were performed for 60 minutes twice a week for 3 months. MAIN OUTCOMES AND MEASURESThe primary outcome was disability level, which was measured using the Roland-Morris Disability Questionnaire; scores range from 0 to 24, with higher scores indicating more severe disability. Secondary outcomes included pain intensity, quality of life, sleep quality, recommendation of intervention, and minimal clinically important difference. Intention-totreat and per-protocol analyses were performed. RESULTSOf the 113 participants, 59 were women (52.2%) (mean [SD] age, 31.0 [11.5] years).Participants were randomly allocated into the therapeutic aquatic exercise group (n = 56) or the physical therapy modalities group (n = 57), and 98 patients (86.7%) completed the 12-month follow-up. Compared with the physical therapy modalities group, the therapeutic aquatic exercise group showed greater alleviation of disability, with adjusted mean group differences of −1.77 (95% CI, −3.02 to −0.51; P = .006) after the 3-month intervention, −2.42 (95% CI, −4.13 to −0.70; P = .006) at the 6-month follow-up, and −3.61 (95% CI, −5.63 to −1.58; P = .001) at the 12-month follow-up (P < .001 for overall group × time interaction). At the 12-month follow-up point, improvements were significantly greater in the therapeutic aquatic exercise group vs the physical therapy modalities group in the number of participants who met the minimal clinically important difference in pain (at least a 2-point improvement on the numeric rating scale) (most severe pain, 30 [53.57%] vs 12 [21.05%]; average pain, 14 [25%] vs 11 [19.30%]; and current pain, 22 [39.29%] vs 10 [17.54%]) and disability (at least a 5-point improvement on the Roland-Morris Disability Questionnaire) (26 (continued) Key Points Question Is therapeutic aquatic exercise as effective as physical therapy modalities in the management of adults with chronic low back pain? Findings In this randomized clinical trial of 113 individuals with chronic low back pain, therapeutic aquatic exercise had a greater influence on pain, function, quality of life, sleep quality, and mental state than physical therapy modalities a...

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Lumbar Lordosis Rehabilitation for Pain and Lumbar Segmental Motion in Chronic Mechanical Low Back Pain: A Randomized Trial

Cited by 46 publications

References 18 publications

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Multimodal Treatment Program Comparing 2 Different Traction Approaches for Patients With Discogenic Cervical Radiculopathy: A Randomized Controlled Trial

Efficacy of Therapeutic Aquatic Exercise vs Physical Therapy Modalities for Patients With Chronic Low Back Pain

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