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Controlled Clinical Trial
. 2010 Dec 16:11:285.
doi: 10.1186/1471-2474-11-285.

Effectiveness of a 'Global Postural Reeducation' program for persistent low back pain: a non-randomized controlled trial

Francesca Bonetti  1 , Stefania Curti, Stefano Mattioli, Raffaele Mugnai, Carla Vanti, Francesco S Violante, Paolo Pillastrini
Affiliations
Controlled Clinical Trial

Effectiveness of a 'Global Postural Reeducation' program for persistent low back pain: a non-randomized controlled trial

Francesca Bonetti et al. BMC Musculoskelet Disord. .

Abstract

Background: The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months).

Methods: According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned.

Results: Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group.The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7).

Conclusions: Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects.

Trial registration: NCT00789204.

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Figures

Figure 1
Figure 1
Positions. Lying posture with legs extension progression: anterior muscle chain stretching.
Figure 2
Figure 2
Positions. Lying posture with hip joints flexion progression: posterior muscle chain stretching.
Figure 3
Figure 3
Positions. Standing posture with trunk flexion progression: posterior muscle chain loading stretching.
Figure 4
Figure 4
Flow-chart of participants through the trial. GPR Group: Global Postural Reeducation Group. SE Group: Stabilization Exercise Group.
Figure 5
Figure 5
Distribution of definitely improved, possibly improved and not improved subjects in the GPR and SE group. Definitely improved: reduction of at least 30% on RMDQ and VAS scores from baseline. Possibly improved: reduction of at least 30% on RMDQ score from baseline.
See this image and copyright information in PMC

References

    1. Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004;107(1-2):176–90. doi: 10.1016/j.pain.2003.10.017. - DOI - PubMed
    1. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. COST B13 Working Group on Guidelines for Chronic Low Back Pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–300. doi: 10.1007/s00586-006-1072-1. - DOI - PMC - PubMed
    1. Merskey H, Bogduk N. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definition of Pain Terms. 2. Seattle: IASP Press; 1994.
    1. Andersson HI. The epidemiology of chronic pain in a Swedish rural area. Qual Life Res. 1994;3(Suppl 1):S19–26. doi: 10.1007/BF00433371. - DOI - PubMed
    1. Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008;8(1):8–20. doi: 10.1016/j.spinee.2007.10.005. - DOI - PubMed

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