Chronic Low Back Pain
Conditions
Keywords
Chronic low back pain, Back School, Walking, Physical activity
Brief summary
Do Back School and/or supervised walking improve reported pain and spine flexibility in sedentary women with chronic low back pain (LBP)?
Detailed description
From August 2002 to March 2004, one hundred nineteen volunteers sedentary women with chronic LBP and age ranging from 32 to 60 years old, randomly allocated to four groups of participants assigned as Back School (BS; N=28), Supervised Walking (W; N=32), Back School and Supervised Walking (BS+W; N=29), and Control Group (CG; N=30) were submitted to interventions once a week for 5 consecutive weeks and followed for up to 6 months. The groups BS, W, and BS+W received LBP-targeted lectures and on-place practical sessions of each respective intervention. CG received print information about LBP and 5 different lectures unrelated to LBP.
Interventions
BEHAVIORALBack School Intervention
Patients were submitted once a week for 5 consecutive weeks to sessions of 45 minutes including: 15-minute lectures about basics of spine's anatomy, ergonomics, techniques of lifting and transportation of weights and volumes, body posture in several daily tasks and situations, and spine preventive care; 30 minutes of on-place supervised exercises for posture and spine flexibility (muscle stretching, relaxation, strengthening)
BEHAVIORALSupervised Walking Intervention
Patients were submitted once a week for 5 consecutive weeks to sessions of 45 minutes including: 15-minute lectures about basics of physical activity, its advantages and benefits, barriers and facilitators, types and opportunities; 30 minutes of on-place supervised walking in group.
BEHAVIORALBack School and Walking
Weekly sessions of 90 minutes including: 30-minute lectures about basics of spine's anatomy, ergonomics, techniques of lifting and transportation of weights and volumes, body posture in several daily tasks and situations, spine preventive care, and about physical activity, its advantages and benefits, barriers and facilitators, types and opportunities
BEHAVIORALControl Group
Weekly sessions of 45 minutes including lectures about: stress control, healthy nutrition (2 lectures), sleep hygiene and injury prevention.; beside the 2-page folder content this group received no other information about LBP, BS or walking all along the follow-up.
Sponsors
University of Sao Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
30 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age range 30 to 60 years old * LBP without any known organic cause for at least 3 months of duration * Less than 90 minutes per week of regular physical activity of any intensity
Exclusion criteria
* Any known organic cause of LBP
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intensity of Low Back Pain (LBP) Self-Estimated by Visual Analogical Scale (VAS) | 6 months | Patients were asked to indicate their perception about their LBP intensity with a cross on a line without marks, ranging from 1 (very light pain) through 10 (very strong pain) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Spine Flexibility (3rd Fingertip to Floor - 3FF). | 6 months | Patients in up-right position with joined feet and stretched out arms were asked to bend the spine as much as possible without bending the knees; the least achieved distance between the 3rd fingertip and the floor was measured in centimeters with a proper rule. |
Countries
Brazil
Participant flow
Recruitment details
Between August 2002 and March 2004, 351 women that attended 4 community centers located in the city of São Paulo, Brazil, responding to invitations by folders and voice announcements, filled a form with basic questions about physical activity and low back pain (LBP). After a clinical evaluation, 119 patients fulfilled the study criteria.
Participants by arm
| Arm | Count |
|---|---|
| Back School | 28 |
| Supervised Walking | 32 |
| Backschool and Supervised Walking Once a week for 5 consecitive weeks participants attended of 90 minutes including: 30-minute lectures about basics of spine's anatomy, ergonomics, techniques of lifting and transportation of weights and volumes, body posture in several daily tasks and situations, spine preventive care, and about physical activity, its advantages and benefits, barriers and facilitators, types and opportunities; 30 minutes of on-place supervised exercises for posture and spine flexibility (muscle stretching, relaxation, strengthening); 30 minutes of on-place supervised walking in group. | 29 |
| Control Group Once a week for 5 consecutive weeks participants attended sessions of 45 minutes including lectures about: stress control, healthy nutrition (2 lectures), sleep hygiene and injury prevention. This group also received a 2-page folder with print information about LBP prevention and control. | 30 |
| Total | 119 |
Baseline characteristics
| Characteristic | Control Group | Backschool and Supervised Walking | Supervised Walking | Back School | Total |
|---|---|---|---|---|---|
| Age Categorical <=18 years | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants |
| Age Categorical >=65 years | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants |
| Age Categorical Between 18 and 65 years | 30 participants | 32 participants | 29 participants | 28 participants | 119 participants |
| Age Continuous | 46.8 years STANDARD_DEVIATION 7.2 | 46.5 years STANDARD_DEVIATION 7.5 | 47.2 years STANDARD_DEVIATION 7.1 | 44.8 years STANDARD_DEVIATION 7.3 | 46.6 years STANDARD_DEVIATION 7.4 |
| Gender Female | 30 participants | 32 participants | 29 participants | 28 participants | 119 participants |
| Gender Male | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants |
| Region of Enrollment Brazil | 30 participants | 32 participants | 29 participants | 28 participants | 119 participants |
Outcome results
Primary
Intensity of Low Back Pain (LBP) Self-Estimated by Visual Analogical Scale (VAS)
Patients were asked to indicate their perception about their LBP intensity with a cross on a line without marks, ranging from 1 (very light pain) through 10 (very strong pain)
Time frame: 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Back School | Intensity of Low Back Pain (LBP) Self-Estimated by Visual Analogical Scale (VAS) | 4.5 milimeters | Standard Deviation 3.3 |
| Supervised Walking | Intensity of Low Back Pain (LBP) Self-Estimated by Visual Analogical Scale (VAS) | 4.2 milimeters | Standard Deviation 3 |
| Backschool and Supervised Walking | Intensity of Low Back Pain (LBP) Self-Estimated by Visual Analogical Scale (VAS) | 5.4 milimeters | Standard Deviation 2.7 |
| Control Group | Intensity of Low Back Pain (LBP) Self-Estimated by Visual Analogical Scale (VAS) | 3.9 milimeters | Standard Deviation 2.8 |
Secondary
Spine Flexibility (3rd Fingertip to Floor - 3FF).
Patients in up-right position with joined feet and stretched out arms were asked to bend the spine as much as possible without bending the knees; the least achieved distance between the 3rd fingertip and the floor was measured in centimeters with a proper rule.
Time frame: 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Back School | Spine Flexibility (3rd Fingertip to Floor - 3FF). | 20.8 centimeters | Standard Deviation 8.4 |
| Supervised Walking | Spine Flexibility (3rd Fingertip to Floor - 3FF). | 20.3 centimeters | Standard Deviation 8.1 |
| Backschool and Supervised Walking | Spine Flexibility (3rd Fingertip to Floor - 3FF). | 20.4 centimeters | Standard Deviation 8.4 |
| Control Group | Spine Flexibility (3rd Fingertip to Floor - 3FF). | 17.1 centimeters | Standard Deviation 13 |