López Díaz JV1, Campoy Gerrero C1, Solé Cases S1
1Lleida University, Physiotherapy, Lleida, Spain
Background: This clinical research, registered in "ClinicalTrials.gov" (NTC01591824), explores a novel approach in the treatment of non-specific chronic low back pain.
Purpose: This study focuses on analysing the effectiveness of oscillatory POLD manual therapy in non-specific, chronic low back pain, and compares it with the treatment protocol indicated by the clinical practice guidelines based on the most current evidence.
Methods: Analytic single-blind randomized controlled clinical trial study. A sample size of 50 patients divided into two homogeneous groups that received 10 sessions of treatment, either the usual treatment (Control group) or POLD intervention (POLD group). We analysed pain intensity by Visual Analogy Scale (VAS), health status using the SF12 test, and disability by the Oswestry test. Data was collected during the study, at the end of the study, and as a follow-up at 3 and 6 months.
Results: Regarding the pain, patients treated with POLD showed statistically significant reduced low back pain (VAS) at all time points (p 0.001). Importantly, the POLD group shows lower VAS than the Control group not only at completion of the study (p 0.001), but also 3 months (p=0.001) and 6 months after cessation the treatment (p 0.05).
On the SF12 test for physical health assessment, POLD group presented a significant improvement at completion of treatment (p 0.001), as well as at 3 months (p 0.001) and 6 months (p 0.05) post-cessation of treatment. In comparison with the Control group, the POLD group was shown more effective at all time point during treatment (p=0.001) and the effect was maintained at 3 months after treatment (p 0.05). Despite the significance between the two groups was not maintained at 6 months (p=0.126), SF12 values on physical health for the POLD group were still higher than those of the Control group.
On the SF12 test for mental health assessment, the POLD treatment did not present statistically significant compared to the control group. Nevertheless, SF12 values on mental health for the POLD group were higher than the standards registered for the Catalonian population.
In the assessment of disability (Oswestry test), POLD treatment was shown effective at the completion of treatment (p 0.001) and at the 3- and 6- months follow-up (p 0.05). Interestingly Oswestry test values for the POLD group were significantly lower than those of the Control group after treatment (p 0.001), and at the 3- and 6- months follow-up (p 0.05).
Conclusion(s): In conclusion, the application of POLD oscillatory mobilization for the treatment of non-specific chronic low back pain was effective in decreasing pain intensity and disability and in improving physical health. Moreover, it was more efficient than the usual treatment advised by the current evidence for the same pathology.
Implications: These data imply a possible change in the way of treating these pathologies, where the application of oscillatory mobilization would improve the effectiveness of current treatments. Furthermore, given its effectiveness in the short, medium and long-term, this novel treatment may also have a positive impact on social costs.
Keywords: lumbar pain, manual therapy, POLD oscillation
Funding acknowledgements: The research was sponsored by the research service of Omphis Foundation, with the collaboration of the "Hospital de la Esperanza"
Purpose: This study focuses on analysing the effectiveness of oscillatory POLD manual therapy in non-specific, chronic low back pain, and compares it with the treatment protocol indicated by the clinical practice guidelines based on the most current evidence.
Methods: Analytic single-blind randomized controlled clinical trial study. A sample size of 50 patients divided into two homogeneous groups that received 10 sessions of treatment, either the usual treatment (Control group) or POLD intervention (POLD group). We analysed pain intensity by Visual Analogy Scale (VAS), health status using the SF12 test, and disability by the Oswestry test. Data was collected during the study, at the end of the study, and as a follow-up at 3 and 6 months.
Results: Regarding the pain, patients treated with POLD showed statistically significant reduced low back pain (VAS) at all time points (p 0.001). Importantly, the POLD group shows lower VAS than the Control group not only at completion of the study (p 0.001), but also 3 months (p=0.001) and 6 months after cessation the treatment (p 0.05).
On the SF12 test for physical health assessment, POLD group presented a significant improvement at completion of treatment (p 0.001), as well as at 3 months (p 0.001) and 6 months (p 0.05) post-cessation of treatment. In comparison with the Control group, the POLD group was shown more effective at all time point during treatment (p=0.001) and the effect was maintained at 3 months after treatment (p 0.05). Despite the significance between the two groups was not maintained at 6 months (p=0.126), SF12 values on physical health for the POLD group were still higher than those of the Control group.
On the SF12 test for mental health assessment, the POLD treatment did not present statistically significant compared to the control group. Nevertheless, SF12 values on mental health for the POLD group were higher than the standards registered for the Catalonian population.
In the assessment of disability (Oswestry test), POLD treatment was shown effective at the completion of treatment (p 0.001) and at the 3- and 6- months follow-up (p 0.05). Interestingly Oswestry test values for the POLD group were significantly lower than those of the Control group after treatment (p 0.001), and at the 3- and 6- months follow-up (p 0.05).
Conclusion(s): In conclusion, the application of POLD oscillatory mobilization for the treatment of non-specific chronic low back pain was effective in decreasing pain intensity and disability and in improving physical health. Moreover, it was more efficient than the usual treatment advised by the current evidence for the same pathology.
Implications: These data imply a possible change in the way of treating these pathologies, where the application of oscillatory mobilization would improve the effectiveness of current treatments. Furthermore, given its effectiveness in the short, medium and long-term, this novel treatment may also have a positive impact on social costs.
Keywords: lumbar pain, manual therapy, POLD oscillation
Funding acknowledgements: The research was sponsored by the research service of Omphis Foundation, with the collaboration of the "Hospital de la Esperanza"
Topic: Musculoskeletal: spine; Pain & pain management; Disability & rehabilitation
Ethics approval required: Yes
Institution: CEIC - Parc Salut Mar (Barcelona) Spain
Ethics committee: Comité Etic D''Investigacio Clinica (Ethical Committee for Clinical Research)
Ethics number: 2011/4150/I
All authors, affiliations and abstracts have been published as submitted.
