SPINE
Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(9):59 BMC Musculoskelet Disord. 2010 Feb 10;11:30.136 patients with chronic low back pain were randomized into 3 groups that received a supervised nordic training, unsupervised training or a general advice on management of pain and functionality. At 8 weeks, there was no statistically significant effect of supervised Nordic Walking on the Low Back Pain Rating Scale (LBPRS) or the Patient Specific Function Scale (PSFS) when compared to non-supervised Nordic Walking group or group given advice to remain active.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
3/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Nordic walking involves walking with ski poles, aiding improvement of cardiovascular metabolism. It is yet unknown whether specific or unspecific exercise provides the most benefit for patients with chronic low back pain. This is the first study to investigate whether Nordic walking has a beneficial effects for patients with chronic low back pain.
主な研究課題は何ですか？
Does supervised Nordic walking improve the pain and pain-related disability compared to non-supervised Nordic walking or advice to stay active in patients with chronic low back pain?
重要な知見は？
- Within the supervised NW group, the improvement in the pain scale of the LBPRS was significant at 11 weeks, 26 weeks, and 52 weeks (P=0.009, 0.01, and 0.03, respectively), and was consistently the largest average improvement among the three groups. Despite this, the improvements were not significantly different, at any time point, from the unsupervised NW group, who had a significant improvement at 26 weeks, nor the control group, whose improvement was significant at 11 and 26 weeks.
- Similar to the pain scale, while the average improvement on the disability scale of the LBPRS was greatest and significant at all time points in the supervised NW group, the differences compared to the unsupervised group and control group were not significant. Effect in the unsupervised group was borderline significant at 52 weeks (P=0.06), and in the control group at 11 and 26 weeks (P=0.01 and 0.03, respectively).
- On the PSFS, improvement within each group was significant at all time points (Supervised NW group: P= 0.009, 0.001, and 0.02, respectively) (Unsupervised NW group: P < 0.001, 0.004, and 0.001, respectively) (Control group: P=0.01, 0.01, and 0.004, respectively). The differences between groups were not significant at any time point.
- Minimum clinically important difference (MCID) on LBPRS pain subscale was achieved by 10 participants of the supervised NW group, 10 of the unsupervised NW group, and 8 in the control group by the end of 52 weeks. MCID on the disability scale of the LBPRS was attained by 7, 4, and 4, respectively. The difference between groups for either scale was not significant.
- There was no significant difference observed between groups at any point for outcome on the EQ5D.
最も覚えておくべきことは？
8 weeks of bi-weekly supervised Nordic Walking resulted in small clinical effects but the results were not statistically different when compared to the unsupervised Nordic Walking group or the group only given advice to remain active.
それが私の患者ケアにどのように影響するか？
Nordic Walking, although it offers a safe and cheap rehabilitation modality for various conditions including Lower Back Pain, has not been proven superior to conventional advice when assessed for improvement in pain and pain-related loss of function.
免責事項
このページに記載されている内容は、情報提供のみを目的としたものであり、専門的な医療アドバイス、診断、治療の代わりとなるものではありません。治療が必要な場合は、必ず医師の診断を仰ぐか、最寄りの救急外来を受診してください。このページに記載されている内容に関して個人が表明した意見、信念、見解は、OrthoEvidenceの意見、信念、見解を反映するものではありません。
0の4 月間無料記事のロック解除
