Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70039-X
Gina L. Fanucchi , Aimee Stewart , Ronél Jordaan , Piet Becker
Question
Does an eight-week exercise program reduce the intensity and prevalence of low back pain in 12–13 year old children? Does it decrease the childhood physical risk factors for low back pain and promote a sense of well-being?
Design
Randomised trial with concealed allocation and assessor blinding.
Participants
Seventy-two 12–13 year old children, who had complained of low back pain in the past three months.
Intervention
The experimental group completed eight exercise classes of 40–45 minutes duration over eight weeks conducted by a physiotherapist, whilst the control group received no intervention.
Outcome measures
The primary outcome was pain intensity measured on a 10-cm visual analogue scale. Secondary outcomes included 3-month prevalence of pain, childhood physical risk factors for low back pain, and sense of well-being. Measures were taken at baseline (Month 0), post-intervention (Month 3), and three months later (Month 6).
Results
Pain intensity over the past month had decreased by 2.2 cm (95% CI 1.0 to 3.5) more for the experimental group than the control group at Month 3 and was still 2.0 cm (95% CI 0.5 to 3.5) less than the control group at Month 6. The absolute risk reduction for 3-month prevalence in low back pain in the experimental group was 24% (95% CI 4 to 41) compared with the control group at Month 3, and 40% (95% CI 18 to 57) at Month 6. There were also statistically-significant between-group differences in neural mobility.
Conclusion
Exercise is effective in reducing the intensity and prevalence of low back pain in children.
Trial registration
Clinical trials NCT00786864
一个为期八周的运动项目是否能降低12-13岁儿童腰痛的强度和发病率?它是否减少了儿童时期腰痛的生理风险因素并促进了幸福感?设计随机试验，隐蔽分配和评估盲法。参与者:72名12-13岁的儿童，在过去的三个月里抱怨过腰痛。干预:实验组在八周内完成由物理治疗师指导的8节每次40-45分钟的运动课程，而对照组则没有接受任何干预。主要结局是用10厘米视觉模拟量表测量疼痛强度。次要结局包括3个月的疼痛发生率、儿童期腰痛的生理危险因素和幸福感。在基线(第0个月)、干预后(第3个月)和3个月后(第6个月)分别采取措施。结果实验组在过去一个月的西班牙强度比对照组在第3个月时下降了2.2 cm (95% CI 1.0 ~ 3.5)，在第6个月时仍比对照组低2.0 cm (95% CI 0.5 ~ 3.5)。与对照组相比，实验组腰痛3个月患病率的绝对风险在第3个月时降低24% (95% CI 4至41)，在第6个月时降低40% (95% CI 18至57)。神经活动能力组间差异也有统计学意义。结论运动能有效降低儿童腰痛的发生率和强度。临床试验NCT00786864
{"title":"Exercise reduces the intensity and prevalence of low back pain in 12–13 year old children: a randomised trial","authors":"Gina L. Fanucchi , Aimee Stewart , Ronél Jordaan , Piet Becker","doi":"10.1016/S0004-9514(09)70039-X","DOIUrl":"10.1016/S0004-9514(09)70039-X","url":null,"abstract":"<div><h3>Question</h3><p>Does an eight-week exercise program reduce the intensity and prevalence of low back pain in 12–13 year old children? Does it decrease the childhood physical risk factors for low back pain and promote a sense of well-being?</p></div><div><h3>Design</h3><p>Randomised trial with concealed allocation and assessor blinding.</p></div><div><h3>Participants</h3><p>Seventy-two 12–13 year old children, who had complained of low back pain in the past three months.</p></div><div><h3>Intervention</h3><p>The experimental group completed eight exercise classes of 40–45 minutes duration over eight weeks conducted by a physiotherapist, whilst the control group received no intervention.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was pain intensity measured on a 10-cm visual analogue scale. Secondary outcomes included 3-month prevalence of pain, childhood physical risk factors for low back pain, and sense of well-being. Measures were taken at baseline (Month 0), post-intervention (Month 3), and three months later (Month 6).</p></div><div><h3>Results</h3><p>Pain intensity over the past month had decreased by 2.2 cm (95% CI 1.0 to 3.5) more for the experimental group than the control group at Month 3 and was still 2.0 cm (95% CI 0.5 to 3.5) less than the control group at Month 6. The absolute risk reduction for 3-month prevalence in low back pain in the experimental group was 24% (95% CI 4 to 41) compared with the control group at Month 3, and 40% (95% CI 18 to 57) at Month 6. There were also statistically-significant between-group differences in neural mobility.</p></div><div><h3>Conclusion</h3><p>Exercise is effective in reducing the intensity and prevalence of low back pain in children.</p></div><div><h3>Trial registration</h3><p>Clinical trials NCT00786864</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 97-104"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70039-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28191273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70004-2
Daniela Aires Lemes, Walter Araújo Zin, Fernando Silva Guimarães
Question
Is ventilator-induced hyperinflation in sidelying more effective than sidelying alone in removing secretions and improving respiratory mechanics in ventilated patients with pulmonary infection?
Design
Randomised crossover trial with concealed allocation and intention-to-treat analysis.
Participants
30 mechanically ventilated patients with pulmonary infection in an adult intensive care unit.
Intervention
The experimental intervention was 30 minutes of ventilator-induced hyperinflation using pressure support ventilation in sidelying; the control intervention was 30 minutes of sidelying. Participants received both interventions on the same day, with a five-hour washout period between them.
Outcome measures
Secretion clearance was measured as sputum volume retrieved during the intervention. Respiratory mechanics were measured as static compliance and total resistance of the respiratory system before and after the intervention.
Results
The experimental intervention cleared 1.3 ml (95% CI 0.5 to 2.2) more secretions than the control. After ventilator-induced hyperinflation in sidelying, respiratory compliance had increased 4.7 ml/cmH2O (95% CI 2.6 to 6.8) more than in sidelying alone. There was no difference in total resistance of the respiratory system between the interventions (mean difference 0.3 cmH2O/l/s, 95% CI –0.8 to 1.3).
Conclusion
The application of hyperinflation using pressure support ventilation in mechanically ventilated patients with pulmonary infection improves secretion clearance and increases static compliance of the respiratory system.
对肺部感染的通气患者，在清除分泌物和改善呼吸力学方面，呼吸机诱导的恶性充气辅助通气是否比单独辅助通气更有效?设计随机交叉试验，采用隐蔽分配和意向治疗分析。研究对象为30例在成人重症监护病房接受机械通气的肺部感染患者。干预:实验干预为30分钟的呼吸机诱导恶性充气，采用压力支持通气辅助通气;对照组干预为30分钟的旁听。参与者在同一天接受了两种干预，中间有5个小时的洗脱期。结果测量:在干预期间以痰量来测量分泌物清除率。呼吸力学测量为干预前后呼吸系统的静态顺应性和总阻力。结果实验组比对照组多清除1.3 ml (95% CI 0.5 ~ 2.2)分泌物。在呼吸机诱导的侧化过度充气后，呼吸顺应性比单独侧化组增加4.7 ml/cmH2O (95% CI 2.6 - 6.8)。两种干预措施之间呼吸系统总阻力无差异(平均差异0.3 cmH2O/l/s, 95% CI -0.8 ~ 1.3)。结论在机械通气的肺部感染患者中应用高压通气可改善分泌物清除率，增加呼吸系统的静态顺应性。
{"title":"Hyperinflation using pressure support ventilation improves secretion clearance and respiratory mechanics in ventilated patients with pulmonary infection: a randomised crossover trial","authors":"Daniela Aires Lemes, Walter Araújo Zin, Fernando Silva Guimarães","doi":"10.1016/S0004-9514(09)70004-2","DOIUrl":"10.1016/S0004-9514(09)70004-2","url":null,"abstract":"<div><h3>Question</h3><p>Is ventilator-induced hyperinflation in sidelying more effective than sidelying alone in removing secretions and improving respiratory mechanics in ventilated patients with pulmonary infection?</p></div><div><h3>Design</h3><p>Randomised crossover trial with concealed allocation and intention-to-treat analysis.</p></div><div><h3>Participants</h3><p>30 mechanically ventilated patients with pulmonary infection in an adult intensive care unit.</p></div><div><h3>Intervention</h3><p>The experimental intervention was 30 minutes of ventilator-induced hyperinflation using pressure support ventilation in sidelying; the control intervention was 30 minutes of sidelying. Participants received both interventions on the same day, with a five-hour washout period between them.</p></div><div><h3>Outcome measures</h3><p>Secretion clearance was measured as sputum volume retrieved during the intervention. Respiratory mechanics were measured as static compliance and total resistance of the respiratory system before and after the intervention.</p></div><div><h3>Results</h3><p>The experimental intervention cleared 1.3 ml (95% CI 0.5 to 2.2) more secretions than the control. After ventilator-induced hyperinflation in sidelying, respiratory compliance had increased 4.7 ml/cmH<sub>2</sub>O (95% CI 2.6 to 6.8) more than in sidelying alone. There was no difference in total resistance of the respiratory system between the interventions (mean difference 0.3 cmH<sub>2</sub>O/l/s, 95% CI –0.8 to 1.3).</p></div><div><h3>Conclusion</h3><p>The application of hyperinflation using pressure support ventilation in mechanically ventilated patients with pulmonary infection improves secretion clearance and increases static compliance of the respiratory system.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Pages 249-254"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70004-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28521044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70046-7
Rob J.E.M. Smeets
Question
Does a graded exercise program emphasising lumbar stabilising exercises reduce pain and disability at 12 months, compared with a walking program, for patients with recurrent low back pain?
Design
Randomised controlled trial.
Setting
A single private physiotherapy clinic in Sweden.
Participants
71 patients with recurrent mechanical low back pain (> 8 weeks duration, with at least 1 pain-free period during the past year) and without leg pain were allocated to one of two groups, using a concealed allocation process. The groups were comparable at baseline with respect to age, sex, proportion of participants who had sought care for back pain, and pain duration (approximately 10 years).
Interventions
The graded exercise program and the walking program were both 8 weeks’ duration. The exercise program was individually supervised by a physiotherapist weekly for 45 minutes. In the walking program, patients met with a physiotherapist for 45 minutes in week 1 and again in week 8. The exercise program consisted primarily of stabilising exercises for the lumbar spine, commencing with re-learning activation of the transversus abdominis and multifidus muscles, with assistance of a pressure biofeedfack cuff. Exercises were progressed according to clinical judgement, pain levels, and movement control and quality. Progression entailed incorporation of muscle activation in upright positions and during functional activities. Continued implementation of the exercises in daily life was encouraged. The reference group were instructed to walk for 30 minutes daily at the fastest pace that did not aggravate pain. Walking compliance was monitored with a self-completed daily diary.
Outcomes
The primary outcomes were perceived pain and disability at 12 months, measured by self-completed questionnaires returned by post. Disability was measured with the Oswestry Disability Questionnaire (scale 0–100, where 100 = maximum disability). Pain was measured with 100-mm visual analogue scale (where 100 = worst pain imaginable).
Results
At 12 months 86% of patients were followed up. At this time there was no clinically-important difference between the groups with respect to median (IQR) change in pain: exercise group –12 (–34 to –3); walking group –12 (–22 to 0). For disability at 12 months, the between-group difference in median scores was 8 on the Oswestry score: exercise group –10 (–20 to –2); walking group –2 (–12 to 2).
Conclusion
Lumbar stabilising exercises appear to have a similar effect on pain and disability for patients with recurrent low back pain as a daily walking program.
{"title":"Do lumbar stabilising exercises reduce pain and disability in patients with recurrent low back pain?","authors":"Rob J.E.M. Smeets","doi":"10.1016/S0004-9514(09)70046-7","DOIUrl":"10.1016/S0004-9514(09)70046-7","url":null,"abstract":"<div><h3>Question</h3><p>Does a graded exercise program emphasising lumbar stabilising exercises reduce pain and disability at 12 months, compared with a walking program, for patients with recurrent low back pain?</p></div><div><h3>Design</h3><p>Randomised controlled trial.</p></div><div><h3>Setting</h3><p>A single private physiotherapy clinic in Sweden.</p></div><div><h3>Participants</h3><p>71 patients with recurrent mechanical low back pain (> 8 weeks duration, with at least 1 pain-free period during the past year) and without leg pain were allocated to one of two groups, using a concealed allocation process. The groups were comparable at baseline with respect to age, sex, proportion of participants who had sought care for back pain, and pain duration (approximately 10 years).</p></div><div><h3>Interventions</h3><p>The graded exercise program and the walking program were both 8 weeks’ duration. The exercise program was individually supervised by a physiotherapist weekly for 45 minutes. In the walking program, patients met with a physiotherapist for 45 minutes in week 1 and again in week 8. The exercise program consisted primarily of stabilising exercises for the lumbar spine, commencing with re-learning activation of the transversus abdominis and multifidus muscles, with assistance of a pressure biofeedfack cuff. Exercises were progressed according to clinical judgement, pain levels, and movement control and quality. Progression entailed incorporation of muscle activation in upright positions and during functional activities. Continued implementation of the exercises in daily life was encouraged. The reference group were instructed to walk for 30 minutes daily at the fastest pace that did not aggravate pain. Walking compliance was monitored with a self-completed daily diary.</p></div><div><h3>Outcomes</h3><p>The primary outcomes were perceived pain and disability at 12 months, measured by self-completed questionnaires returned by post. Disability was measured with the Oswestry Disability Questionnaire (scale 0–100, where 100 = maximum disability). Pain was measured with 100-mm visual analogue scale (where 100 = worst pain imaginable).</p></div><div><h3>Results</h3><p>At 12 months 86% of patients were followed up. At this time there was no clinically-important difference between the groups with respect to median (IQR) change in pain: exercise group –12 (–34 to –3); walking group –12 (–22 to 0). For disability at 12 months, the between-group difference in median scores was 8 on the Oswestry score: exercise group –10 (–20 to –2); walking group –2 (–12 to 2).</p></div><div><h3>Conclusion</h3><p>Lumbar stabilising exercises appear to have a similar effect on pain and disability for patients with recurrent low back pain as a daily walking program.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 138"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70046-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28249609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70090-X
Sandra Brauer
{"title":"Physical activity and public health","authors":"Sandra Brauer","doi":"10.1016/S0004-9514(09)70090-X","DOIUrl":"https://doi.org/10.1016/S0004-9514(09)70090-X","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 215"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70090-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91670506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1016/S0004-9514(09)70098-4
Keith D. Hill , Susan B. Williams
{"title":"Balance exercises in arthritis need to be targeted to the individual","authors":"Keith D. Hill , Susan B. Williams","doi":"10.1016/S0004-9514(09)70098-4","DOIUrl":"10.1016/S0004-9514(09)70098-4","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 224"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70098-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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