The Effect of Combined Treatment with Passive Therapy, Physical Exercises, Lumbar Traction, and Walking Program on Chronic Low Back Pain

Abstract

Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders worldwide with far-reaching implications for social, economic, and public health. The study aimed to compare the effect of combined physiotherapy treatment in patients with CLBP. This observational retrospective randomized controlled study involved reviewing medical records of patients who were treated during a period of 6 weeks in the physiotherapy department of the Special Hospital for General Rehabilitation “Banja e Kllokotit,” Kllokot, Republic of Kosovo. The observational research was conducted for 60 patients, divided into two groups: Group 1: experimental group (n=30), with mean age of 41.7 years, average height of 1.68 cm, and average body mass index (BMI) of 71.7 for both sexes; Group 2: control group (n=30) with mean age of 43.1 years, average height of 1.66 cm, and average body mass index (BMI) of 71.5 for both sexes. In Group 1, combined treatment with passive therapy [thermotherapy and transcutaneous electrical nerve stimulation (TENS)], physical exercises, lumbar traction, and walking program was applied, while in Group 2, passive therapy like thermotherapy and TENS was applied. Outcome measurements included pain intensity, lumbar flexibility, revised Oswestry disability index (ODI), and self-confidence, which were assessed pre-treatment, at 3 weeks, and after 6 weeks of clinical treatment. The results showed significant improvement in both groups. However, the improvement was greater and with a significant difference only after 6 weeks in Group 1 compared to Group 2. The differences were observed in various outcome measures, including the visual analog scale for pain (VAS; p<0.0001), fingertip-to-floor distance (FTF; p<0.0001), ODI (p<0.0001), and Rosenberg self-esteem scale (RSE; p=0.0002). According to our data, combined treatment with thermotherapy, therapeutic exercises, lumbar traction, TENS, and walking program was more effective and can be considered as a treatment protocol for patients with CLBP. However, further research is recommended on the efficacy of combined physiotherapy treatment, especially lumbar traction for longer periods.