Novel continuous passive motion device for self-treatment of chronic lower back pain: a randomised controlled study. Issue 1 (March 2015)

• Record Type: Journal Article
• Authors: Gavish, L.; Barzilay, Y.; Koren, C.; Stern, A.; Weinrauch, L.; Friedman, D.J.
• Is Part Of: Physiotherapy. Volume 101:Issue 1(2015)
• Page Start: 75
• Page End: 81
• Publication Date: 2015-03
• Subjects: Physical therapy -- Periodicals; Therapeutics, Physiological -- Periodicals; 615.8205
• DOI: 10.1016/j.physio.2014.06.003
• Languages: English
• ISSNs: 0031-9406

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Objective</title> <p id="spar0005">To evaluate the efficacy of a novel, angular, continuous passive motion device for self-treatment at home in patients with mild-to-moderate, non-specific, chronic low back pain (LBP).</p> </sec> <sec> <title id="sect0015">Design</title> <p id="spar0010">Prospective, randomised, waiting-list-controlled (WLC) trial.</p> </sec> <sec> <title id="sect0020">Setting</title> <p id="spar0015">Recruitment and assessment were conducted at the Koren Centre for Physical Therapy. Self-treatment was performed at home.</p> </sec> <sec> <title id="sect0025">Participants</title> <p id="spar0020">Thirty-six patients with a score ≤6 on the numeric rating scale (NRS) for pain were enrolled. Twenty-eight patients completed treatment.</p> </sec> <sec> <title id="sect0030">Interventions</title> <p id="spar0025">Participants were randomised to receive the Kyrobak (Radiancy, Hod-hasharon, Israel) at enrolment [immediate treatment (IT) group] or 3 weeks later (WLC group). Self-treatment was prescribed for 10 minutes, one to three times per day, for 3 weeks. The treatment period was followed by a 3-week follow-up period.</p> </sec> <sec> <title id="sect0035">Main outcome measures</title> <p id="spar0030">Primary outcome was self-reported pain level (NRS).</p> </sec> <sec> <title id="sect0040">Results</title> <p id="spar0035">Three weeks of self-treatment with the Kyrobak reduced pain levels significantly in the IT group compared with the WLC group {mean [standard deviation (SD)] ΔNRS score from baseline to post-treatment: IT group, 1.4 (1.5), 95% confidence interval (CI) 0.5 to 2.3; WLC group, −0.1 (2.2), 95% CI −1.1 to 1.2; effect mean difference 1.5}. This benefit was maintained over the follow-up period [from baseline to end of follow-up, mean (SD) ΔNRS score 1.1 (1.8), 95% CI 0.4 to 1.8]. Multi-linear regression analysis found that higher baseline pain resulted in greater pain reduction (<italic>P</italic> = 0.003). Eighty-three percent of participants with a baseline NRS score >4.35 (threshold determined by logistic regression, <italic>P</italic> = 0.01) achieved the minimal important change criterion of ΔNRS score ≥2. Daily NRS score reduced gradually over the treatment period [regression slope −0.052 (0.01), 95% CI −0.07 to −0.03].</p> </sec> <sec> <title id="sect0045">Conclusions</title> <p id="spar0040">Preliminary evidence suggests that the Kyrobak may be beneficial for short-term relief of non-specific, chronic LBP, particularly in participants with a moderate level of pain. A longer treatment period may lead to a further reduction in pain.</p> </sec> </abstract>