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- Title
Footwear-Generated Dynamic Biomechanical Manipulation and Perturbation Training for Chronic Nonspecific Low Back Pain.
- Authors
Lee, Se Won; Veeramachaneni, Ratnakar; Saleh, Ibrahim Abou; Morice, Karen; Tiu, Timothy; Lo, Yungtai; Frison, Kevin; Bartels, Matthew N.; Bartels, Matthew
- Abstract
<bold>Background: </bold>Home-based therapy optimizing biomechanics and neuromuscular control is increasingly recognized as a treatment option for chronic nonspecific low back pain (CNSLBP). However, its impact on pain, function, and gait is limited among patients in a metropolitan area.<bold>Objective: </bold>To evaluate the change of pain, function, and gait parameters with home-based therapy with the use of footwear-generated biomechanical manipulation and perturbation training in a population with CNSLBP in a metropolitan area.<bold>Design: </bold>Prospective observational study.<bold>Setting: </bold>Outpatient rehabilitation clinic at an academic teaching hospital.<bold>Participants: </bold>One hundred sixteen patients with CNSLBP for more than 6 months.<bold>Intervention: </bold>Six months of home-based therapy with a biomechanical device using 4 modular elements attached to a foot-worn platform.<bold>Main Outcome Measures: </bold>Instrumental gait analysis (gait velocity, step length, single limb support phase % of gait cycle), Numeric Rating Scale for pain, and Oswestry Disability Questionnaire Index for pain and function.<bold>Results: </bold>Only 43 patients (37.1%) completed the study. Among 43 patients, mean gait velocity increased from 86.6 ± 20.7 to 99.7 ± 22.1 cm/s (P < .0001) in 6 months. Mean left step length increased from 51.1 ± 8.4 to 54.8 ± 9.8 cm (P < .0001). Mean right step length increased from 51.0 ± 7.9 to 55.4 ± 9.0 cm (P < .0001). Mean single limb support increased from 36.4 ± 2.8 to 37.2 ± 2.5%, (P = .208) in the right side and from 36.6 ± 3.0 to 37.8 ± 4.4%, (P = .019) in the left side. Median Oswestry Disability Questionnaire Index score improved from 28 (18-44; interquartile range) to 17 (10-35) (P = .045). Mean Numeric Rating Scale for back pain improved from 7.7 ± 1.8 to 3.3 ± 3.1 (P < .0001).<bold>Conclusion: </bold>At 6 months, patients with CNSLBP undergoing home-based therapy with footwear-generated biomechanical manipulation and perturbation training demonstrated significant improvement of objective gait parameters, pain, and function.<bold>Level Of Evidence: </bold>IV.
- Subjects
PHYSICAL therapy equipment; CHRONIC pain; FUNCTIONAL assessment; LONGITUDINAL method; SHOES; PAIN measurement; LUMBAR pain
- Publication
PM & R: Journal of Injury, Function & Rehabilitation, 2018, Vol 10, Issue 8, p836
- ISSN
1934-1482
- Publication type
journal article
- DOI
10.1016/j.pmrj.2018.02.005