Gina L. Fanucchi , Aimee Stewart , Ronél Jordaan , Piet Becker
{"title":"Exercise reduces the intensity and prevalence of low back pain in 12–13 year old children: a randomised trial","authors":"Gina L. Fanucchi , Aimee Stewart , Ronél Jordaan , Piet Becker","doi":"10.1016/S0004-9514(09)70039-X","DOIUrl":"10.1016/S0004-9514(09)70039-X","url":null,"abstract":"<div><h3>Question</h3><p>Does an eight-week exercise program reduce the intensity and prevalence of low back pain in 12–13 year old children? Does it decrease the childhood physical risk factors for low back pain and promote a sense of well-being?</p></div><div><h3>Design</h3><p>Randomised trial with concealed allocation and assessor blinding.</p></div><div><h3>Participants</h3><p>Seventy-two 12–13 year old children, who had complained of low back pain in the past three months.</p></div><div><h3>Intervention</h3><p>The experimental group completed eight exercise classes of 40–45 minutes duration over eight weeks conducted by a physiotherapist, whilst the control group received no intervention.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was pain intensity measured on a 10-cm visual analogue scale. Secondary outcomes included 3-month prevalence of pain, childhood physical risk factors for low back pain, and sense of well-being. Measures were taken at baseline (Month 0), post-intervention (Month 3), and three months later (Month 6).</p></div><div><h3>Results</h3><p>Pain intensity over the past month had decreased by 2.2 cm (95% CI 1.0 to 3.5) more for the experimental group than the control group at Month 3 and was still 2.0 cm (95% CI 0.5 to 3.5) less than the control group at Month 6. The absolute risk reduction for 3-month prevalence in low back pain in the experimental group was 24% (95% CI 4 to 41) compared with the control group at Month 3, and 40% (95% CI 18 to 57) at Month 6. There were also statistically-significant between-group differences in neural mobility.</p></div><div><h3>Conclusion</h3><p>Exercise is effective in reducing the intensity and prevalence of low back pain in children.</p></div><div><h3>Trial registration</h3><p>Clinical trials NCT00786864</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Pages 97-104"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70039-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28191273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Aires Lemes, Walter Araújo Zin, Fernando Silva Guimarães
{"title":"Hyperinflation using pressure support ventilation improves secretion clearance and respiratory mechanics in ventilated patients with pulmonary infection: a randomised crossover trial","authors":"Daniela Aires Lemes, Walter Araújo Zin, Fernando Silva Guimarães","doi":"10.1016/S0004-9514(09)70004-2","DOIUrl":"10.1016/S0004-9514(09)70004-2","url":null,"abstract":"<div><h3>Question</h3><p>Is ventilator-induced hyperinflation in sidelying more effective than sidelying alone in removing secretions and improving respiratory mechanics in ventilated patients with pulmonary infection?</p></div><div><h3>Design</h3><p>Randomised crossover trial with concealed allocation and intention-to-treat analysis.</p></div><div><h3>Participants</h3><p>30 mechanically ventilated patients with pulmonary infection in an adult intensive care unit.</p></div><div><h3>Intervention</h3><p>The experimental intervention was 30 minutes of ventilator-induced hyperinflation using pressure support ventilation in sidelying; the control intervention was 30 minutes of sidelying. Participants received both interventions on the same day, with a five-hour washout period between them.</p></div><div><h3>Outcome measures</h3><p>Secretion clearance was measured as sputum volume retrieved during the intervention. Respiratory mechanics were measured as static compliance and total resistance of the respiratory system before and after the intervention.</p></div><div><h3>Results</h3><p>The experimental intervention cleared 1.3 ml (95% CI 0.5 to 2.2) more secretions than the control. After ventilator-induced hyperinflation in sidelying, respiratory compliance had increased 4.7 ml/cmH<sub>2</sub>O (95% CI 2.6 to 6.8) more than in sidelying alone. There was no difference in total resistance of the respiratory system between the interventions (mean difference 0.3 cmH<sub>2</sub>O/l/s, 95% CI –0.8 to 1.3).</p></div><div><h3>Conclusion</h3><p>The application of hyperinflation using pressure support ventilation in mechanically ventilated patients with pulmonary infection improves secretion clearance and increases static compliance of the respiratory system.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 4","pages":"Pages 249-254"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70004-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28521044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do lumbar stabilising exercises reduce pain and disability in patients with recurrent low back pain?","authors":"Rob J.E.M. Smeets","doi":"10.1016/S0004-9514(09)70046-7","DOIUrl":"10.1016/S0004-9514(09)70046-7","url":null,"abstract":"<div><h3>Question</h3><p>Does a graded exercise program emphasising lumbar stabilising exercises reduce pain and disability at 12 months, compared with a walking program, for patients with recurrent low back pain?</p></div><div><h3>Design</h3><p>Randomised controlled trial.</p></div><div><h3>Setting</h3><p>A single private physiotherapy clinic in Sweden.</p></div><div><h3>Participants</h3><p>71 patients with recurrent mechanical low back pain (> 8 weeks duration, with at least 1 pain-free period during the past year) and without leg pain were allocated to one of two groups, using a concealed allocation process. The groups were comparable at baseline with respect to age, sex, proportion of participants who had sought care for back pain, and pain duration (approximately 10 years).</p></div><div><h3>Interventions</h3><p>The graded exercise program and the walking program were both 8 weeks’ duration. The exercise program was individually supervised by a physiotherapist weekly for 45 minutes. In the walking program, patients met with a physiotherapist for 45 minutes in week 1 and again in week 8. The exercise program consisted primarily of stabilising exercises for the lumbar spine, commencing with re-learning activation of the transversus abdominis and multifidus muscles, with assistance of a pressure biofeedfack cuff. Exercises were progressed according to clinical judgement, pain levels, and movement control and quality. Progression entailed incorporation of muscle activation in upright positions and during functional activities. Continued implementation of the exercises in daily life was encouraged. The reference group were instructed to walk for 30 minutes daily at the fastest pace that did not aggravate pain. Walking compliance was monitored with a self-completed daily diary.</p></div><div><h3>Outcomes</h3><p>The primary outcomes were perceived pain and disability at 12 months, measured by self-completed questionnaires returned by post. Disability was measured with the Oswestry Disability Questionnaire (scale 0–100, where 100 = maximum disability). Pain was measured with 100-mm visual analogue scale (where 100 = worst pain imaginable).</p></div><div><h3>Results</h3><p>At 12 months 86% of patients were followed up. At this time there was no clinically-important difference between the groups with respect to median (IQR) change in pain: exercise group –12 (–34 to –3); walking group –12 (–22 to 0). For disability at 12 months, the between-group difference in median scores was 8 on the Oswestry score: exercise group –10 (–20 to –2); walking group –2 (–12 to 2).</p></div><div><h3>Conclusion</h3><p>Lumbar stabilising exercises appear to have a similar effect on pain and disability for patients with recurrent low back pain as a daily walking program.</p></div>","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 2","pages":"Page 138"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70046-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28249609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physical activity and public health","authors":"Sandra Brauer","doi":"10.1016/S0004-9514(09)70090-X","DOIUrl":"https://doi.org/10.1016/S0004-9514(09)70090-X","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 215"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70090-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91670506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Balance exercises in arthritis need to be targeted to the individual","authors":"Keith D. Hill , Susan B. Williams","doi":"10.1016/S0004-9514(09)70098-4","DOIUrl":"10.1016/S0004-9514(09)70098-4","url":null,"abstract":"","PeriodicalId":50086,"journal":{"name":"Australian Journal of Physiotherapy","volume":"55 3","pages":"Page 224"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0004-9514(09)70098-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28340608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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