Article

An experimental controlled study . Physical therapy influences chronic pain by means of the specific
ingredient of an intervention as well as contextual factors including the setting
and therapeutic alliance (TA) between provider and patient. OBJECTIVE: The
purpose of this study was to compare the effect of enhanced versus limited TA on
pain intensity and muscle pain sensitivity in patients with chronic low back pain
(CLBP) receiving either active or sham interferential current therapy (IFC).
DESIGN: An experimental controlled study with repeated measures was conducted.
Participants were randomly divided into 4 groups: (1) AL (n=30), which included
the application of active IFC combined with a limited TA; (2) SL (n=29), which
received sham IFC combined with a limited TA; (3) AE (n=29), which received
active IFC combined with an enhanced TA; and (4) SE (n=29), which received sham
IFC combined with an enhanced TA. METHODS: One hundred seventeen individuals with
CLBP received a single session of active or sham IFC. Measurements included pain
intensity as assessed with a numerical rating scale (PI-NRS) and muscle pain
sensitivity as assessed via pressure pain threshold (PPT). RESULTS: Mean
differences on the PI-NRS were 1.83 cm (95% CI=14.3-20.3), 1.03 cm (95%
CI=6.6-12.7), 3.13 cm (95% CI=27.2-33.3), and 2.22 cm (95% CI=18.9-25.0) for the
AL, SL, AE, and SE groups, respectively. Mean differences on PPTs were 1.2 kg
(95% CI=0.7-1.6), 0.3 kg (95% CI=0.2-0.8), 2.0 kg (95% CI=1.6-2.5), and 1.7 kg
(95% CI=1.3-2.1), for the AL, SL, AE, and SE groups, respectively. LIMITATIONS:
The study protocol aimed to test the immediate effect of the TA within a clinical
laboratory setting. CONCLUSIONS: The context in which physical therapy
interventions are offered has the potential to dramatically improve therapeutic
effects. Enhanced TA combined with active IFC appears to lead to clinically
meaningful improvements in outcomes when treating patients with CLBP.

Langue : ANGLAIS