Executive Summary: device based exercise treatment for CLBP

Quantifying a device based rehabilitation with isolated, targeted and specific, progressive strength development intervention for patients with Chronic Low Back Pain (CLBP): a clinical observational analysis with a 12 month follow up. Overview The recently published National Strategic Action Plan for Pain Management (2019), and a recent Lancet article (2018) called for the use of active strategies such as exercise in the treatment of Chronic Low Back Pain (CLBP). Despite the evidence and international recommendations endorsing ‘strengthening exercise’ as the desired therapy intervention, there has been considerable discussion about the optimal type of ‘exercise’ intervention for CLBP treatment. Furthermore, the prestigious Cochrane Review call for ‘best practice’ in strength rehabilitation for CLBP by providing an intervention which can be quantified, replicated and effective in addressing low back pain. Extensive review of various exercise interventions for the treatment of chronic back pain identifies that strength training focused on specific and targeted muscles of the spine was associated with the greatest improvement in pain and increased daily function. More recently it has been noted that device based intervention may provide the greatest benefit for effective treatment, as recent development in research design and technology ensures the isolated and targeted movement required to increase specific spinal musculature strength. Executive Summary * These Clinical Results are presented from the treatment of a sample of 479 patients who presented with CLBP at getback Rehabilitation Clinics. These patients were followed up 12 months after their initial treatment for re-assessment. * 253 Females and 226 males gave informed consent to examine their clinical treatment results. * The mean significant change in The Owestry Disability Index [ODI] over the getback rehabilitation programme was from 32.8% to 10.8% scores for Initial [T1] to post Rehabilitation [T2], respectively. A 20% change in ODI is considered clinically significant. * The 12 month follow up [T3] in the ODI revealed that the ODI Post rehabilitation score [T2] was maintained over the 12 months follow up, at 10.8 and 7.9%, respectively. * A mean change in strength score presented as an average across tests (T1 & T2) for Lumbar Thoracic Flexion, Extension, Rotation and Lateral Flexion revealed a significant increase of 62.5% with a range of 46-82% increase from T1 to T2 measures. * 12 Follow up data [T3] demonstrated that strength gains were maintained when assessed 12 months later. No significant difference from T2 toT3 reveals a mean change of 1.78% overall in these measures. * getback clinic-by-clinic analysis showed remarkable consistency in the trends in the strength changes over the three measurement periods [T1, T2,T3]. * The within-clinic changes for all getback clinics and across all of the functional measures for both ROM and Strength demonstrated consistently similar results with similar significant trends for the total group and the gender measures across the T1, T2 and T3 conditions. These clinical data demonstrate the effectiveness of device based exercise rehabilitation which focuses on isolated, targeted and specific progressive strengthening of the spinal muscle of patients with CLBP.
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