INTRODUCTION: Low back pain is one of the most frequent health problems. The aim of the study was to investigate clinical effects of complex rehabilitation programs on quality of life of patients with subacute lumbar pain, and also to investigate the relationship between quality of life and the intensity of pain and local functional status of the lumbar spine. MATERIAL AND METHODS: The prospective study included 60 patients suffering from subacute low back pain with radiculopathy caused by lumbar disc syndrome, without any previous treatment, and who did not need surgery. In a single blind trial patients were divided into two groups. The first group (A group, n=30) was treated by low level laser therapy (wavelength 904 nm, frequency 4000 Hz, at dose 2J per point); the whole dose of 12J, then with TENS (frequency 80 Hz, 30 minutes, pulse duration 200 micros), with exercise, and simultaneously with conventional therapy with NSAIDs which inhibit COX-2 (meloxicam, 15 mg per day). Patients were treated 5 times a week, a total of 15 treatments. The second group (B group, n =30), was treated only by meloxicam (15 mg per day). The subjects were evaluated before the first treatment and three days after the last treatment (21st to 24th day). Data were analyzed using Student's t test and with analytic statistical methods. RESULTS: The mean Oswestry scores before and after therapy for group A have reduced from 25+/-2 to 16+/-3, with statistical significance (t= 8.84 p<0.001) and in group B from 24+/-2.5 to 22+/-2.5 (t=2.56 p<0.05). Statistical analysis has shown an increase of mean values for the 12-item health survey (SF-12) from 22.33+/-4.66 to 36.33+/-3.66 (t=9.12 p<0.001), in group A and from 23.66+/-3.66 to 30.33+/-4.66 (t=3.15 p <0.001) in group B. Mean values of intensity of pain in group A have been reduced from 82+/-6.50 to 46+/-5.50, (t=7.85, p<0.001) and from 80+/-5.50 to 62+/-6.50 in group B (t=5.65; p<0.001). No significant changes have been recorded in Schober measurement. The intensity of pain was in positive correlation with Oswestry score (Ft=7.84; p<0.001) in group A and also in group B (Ft=5.25: p<0.05), as for the 12-item health survey (SF-12) (Ft=8.34: p<0.001) in group A and in group B (Ft=5.98; p<0.05). Two measurements of quality of life have shown close relationship (Ft=5.45; p<0.05) in group A and group B (Ft=6.45: p<0.05). CONCLUSION: Results of this study showed that better results were achieved in group treated with complex rehabilitation methods in comparison with patients treated only with anti-inflammatory drugs. Also, the 12-item health survey (SF-12) has shown positive correlation with intensity of pain reduction and with Oswestry disability score and so it is valid for measuring the effectiveness of therapeutic modalities in subacute lumbar pain.
RCT Entities:
INTRODUCTION:Low back pain is one of the most frequent health problems. The aim of the study was to investigate clinical effects of complex rehabilitation programs on quality of life of patients with subacute lumbar pain, and also to investigate the relationship between quality of life and the intensity of pain and local functional status of the lumbar spine. MATERIAL AND METHODS: The prospective study included 60 patients suffering from subacute low back pain with radiculopathy caused by lumbar disc syndrome, without any previous treatment, and who did not need surgery. In a single blind trial patients were divided into two groups. The first group (A group, n=30) was treated by low level laser therapy (wavelength 904 nm, frequency 4000 Hz, at dose 2J per point); the whole dose of 12J, then with TENS (frequency 80 Hz, 30 minutes, pulse duration 200 micros), with exercise, and simultaneously with conventional therapy with NSAIDs which inhibit COX-2 (meloxicam, 15 mg per day). Patients were treated 5 times a week, a total of 15 treatments. The second group (B group, n =30), was treated only by meloxicam (15 mg per day). The subjects were evaluated before the first treatment and three days after the last treatment (21st to 24th day). Data were analyzed using Student's t test and with analytic statistical methods. RESULTS: The mean Oswestry scores before and after therapy for group A have reduced from 25+/-2 to 16+/-3, with statistical significance (t= 8.84 p<0.001) and in group B from 24+/-2.5 to 22+/-2.5 (t=2.56 p<0.05). Statistical analysis has shown an increase of mean values for the 12-item health survey (SF-12) from 22.33+/-4.66 to 36.33+/-3.66 (t=9.12 p<0.001), in group A and from 23.66+/-3.66 to 30.33+/-4.66 (t=3.15 p <0.001) in group B. Mean values of intensity of pain in group A have been reduced from 82+/-6.50 to 46+/-5.50, (t=7.85, p<0.001) and from 80+/-5.50 to 62+/-6.50 in group B (t=5.65; p<0.001). No significant changes have been recorded in Schober measurement. The intensity of pain was in positive correlation with Oswestry score (Ft=7.84; p<0.001) in group A and also in group B (Ft=5.25: p<0.05), as for the 12-item health survey (SF-12) (Ft=8.34: p<0.001) in group A and in group B (Ft=5.98; p<0.05). Two measurements of quality of life have shown close relationship (Ft=5.45; p<0.05) in group A and group B (Ft=6.45: p<0.05). CONCLUSION: Results of this study showed that better results were achieved in group treated with complex rehabilitation methods in comparison with patients treated only with anti-inflammatory drugs. Also, the 12-item health survey (SF-12) has shown positive correlation with intensity of pain reduction and with Oswestry disability score and so it is valid for measuring the effectiveness of therapeutic modalities in subacute lumbar pain.
Authors: R Yousefi-Nooraie; E Schonstein; K Heidari; A Rashidian; V Pennick; M Akbari-Kamrani; S Irani; B Shakiba; S A Mortaz Hejri; S O Mortaz Hejri; A Jonaidi Journal: Cochrane Database Syst Rev Date: 2008-04-16