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Movement System Impairment-Based Classification Treatment Versus General Exercises for Chronic Low Back Pain

AZEVEDO DC; FERREIRA PH; SANTOS HO; OLIVEIRA D; DE SOUZA JVL; COSTA LOP
PHYS THER , 2018, vol. 98, n° 1, p. 28-39
Doc n°: 186353
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1093/ptj/pzx094
Descripteurs : CE51 - LOMBALGIE

Treatment for chronic low back pain (LBP) includes different forms of
exercises, that to date have resulted in only small to moderate treatment
effects. To enhance the treatment effects, different classification systems have
been developed to classify people with LBP into more homogeneous subgroups
leading to specific treatments for each subgroup. Objective: The purpose of this
study was to compare the efficacy of a treatment based on the Movement System
Impairment (MSI) model with a treatment consisting of symptom-guided stretching
and strengthening exercises in people with chronic LBP. Design: The study was a
2-arm, prospectively registered, randomized controlled trial with a blinded
assessor. Setting: The study setting was a university physical therapy clinic in
Brazil. Patients: A total of 148 participants with chronic LBP participated in
the study. Interventions: Participants were randomly allocated to an 8-week
treatment of either treatment based on the MSI-based classification system or
symptom-guided stretching and strengthening exercises. Measurements: Measures of
pain intensity, disability, and global impression of recovery were obtained by a
blinded assessor at baseline and at follow-up appointments at 2, 4, and 6 months
after randomization. Results: There were no significant between-group differences
for the primary outcomes of pain intensity at 2 months (mean difference = 0.05,
95% CI = -0.90 to 0.80) and disability at 2 months (mean difference = 0.00, 95%
CI = -1.55 to 1.56). There also were no statistically significant differences
between treatment groups for any of the secondary outcome measures. Limitations:
Participants and physical therapists were not masked. Conclusions: People with
chronic LBP had similar improvements in pain, disability, and global impression
of recovery with treatment consisting of symptom-guided stretching and
strengthening exercises and treatment based on the MSI model.
CI - (c) 2017 American Physical Therapy Association

Langue : ANGLAIS

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