Motor control exercise and patient education program for low resource rural community dwelling adults with chronic low back pain: a pilot randomized clinical trial

Abstract

This pilot randomized clinical trial assessed the feasibility of implementing motor control exercise (MCE) and patient education (PE) program for the management of chronic low back pain (CLBP) in a low resource rural Nigerian community. Thirty patients with CLBP were recruited and randomly assigned to MCE, PE, or MCE plus PE groups. The MCE program was provided twice a week while the PE program was provided once a week all for 6 weeks. Feasibility was assessed through recruitment rate, treatment compliance, retention/dropout rate, report of adverse events, perceived helpfulness, overall satisfaction, and clinical outcome of pain (numeric pain rating scale) and functional disability (Oswestry Disability Index). Many patients were willing to participate in the study and the recruitment rate was 77%. Treatment compliance in all the three groups were >65% for supervised treatment sessions and <50% for prescribed home program. Retention rate was high and greater overall satisfaction with the interventions was reported. Compared with the baseline, all the three groups improved significantly in pain and disability (P<0.05) after 6 weeks. Pairwise comparison revealed that the MCE plus PE group was superior to the PE group for pain and to the MCE for disability (P<0.05), with large effect size. It was concluded that the designed interventions are promising and conducting a full-scale randomized clinical trial in the future is feasible to confirm the effectiveness of the interventions for the management CLBP in rural Nigeria. (Trial registration: ClinicalTrials.gov, NCT03398174)

Operationalisation of a biopsychosocial approach for the non‐pharmacological management of patients with chronic musculoskeletal pain in low‐ and middle‐income countries: A systematic review

“…Percentage level for inter-rater reliability was 87.5%, while Cohen's kappa statistic was K = 0.63 signifying a moderate level of agreement (McHugh, 2012). Four studies required further information regarding their intervention protocol and the roles of healthcare professionals (HCPs) involved in the conduct of the studies (Castro, Daltro, Kraychete, & Lopes, 2012;Ibrahim, Akindele, & Ganiyu, 2018;Nazari, Ebrahimi, Naseh, & Sahebi, 2018;Saedi, Hatami, Asgari, Ahadi, & Poursharifi, 2016). Two authors responded: both independent reviewers (PKA and JA) came to a consensus to include the responses (Castro et al, 2012;Ibrahim et al, 2018).…”

“…Four studies required further information regarding their intervention protocol and the roles of healthcare professionals (HCPs) involved in the conduct of the studies (Castro, Daltro, Kraychete, & Lopes, 2012;Ibrahim, Akindele, & Ganiyu, 2018;Nazari, Ebrahimi, Naseh, & Sahebi, 2018;Saedi, Hatami, Asgari, Ahadi, & Poursharifi, 2016). Two authors responded: both independent reviewers (PKA and JA) came to a consensus to include the responses (Castro et al, 2012;Ibrahim et al, 2018). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis group (PRISMA) checklist was utilized in the reporting of studies (Moher, Liberati, Tetzlaff, & Altman, 2009).…”

“…186 full-text articles were screened for eligibility; 170 were subsequently excluded. This resulted in 16 articles being included in the final review (Aliyu et al, 2018;Babai, Sepavand, Nokani, Aghamohammadi, & Sheybani, 2016;Bello, Quartey, & Lartey, 2015;Castro et al, 2012;Elshiwi, Hamada, Zakaria, & Ragab, 2016;Ghadyani, Tavafian, Kazemnejad, & Wagner, 2017;Ibrahim et al, 2018;Igna et al, 2014;Khan, Akhter, Soomro, & Ali, 2014;Lopes, Vannucchi, Demarzo, Cunha, & Nunes, 2019;Magalhaes et al, 2015;Nazari et al, 2018;Nochit, Kaewthummanukul, Srisuphan, & Senaratana, 2014;Ogunlana, Odole, Adejumo, Olagbegi, & Williams, 2018;Onac et al, 2012;Saedi et al, 2016). All included articles were published in English.…”

“…The main findings and characteristics of the 16 included studies are summarised in Table 1. Nine studies were RCTs (Aliyu et al, 2018;Bello et al, 2015;Castro et al, 2012;Elshiwi et al, 2016;Ibrahim et al, 2018;Igna et al, 2014;Khan et al, 2014;Magalhaes et al, 2015;Onac et al, 2012); of the seven remaining, five were quasiexperimental studies (Babai et al, 2016;Nazari et al, 2018;Nochit et al, 2014;Ogunlana et al, 2018;Saedi et al, 2016), and two cohort studies (Ghadyani et al, 2017;Lopes et al, 2019).…”

“…Two out of the nine RCTs were feasibility RCTs investigating the feasibility of implementing a BPS approach for the management of patients with CLBP in African settings (Ghana, Nigeria) (Bello et al, 2015;Ibrahim et al, 2018). The country distribution of all 16 studies included in this review are as follows:…”