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Shoe Orthotics for the Treatment of Chronic Low Back Pain

CAMBRON JA; DEXHEIMER JM; DUARTE M; FREELS S
ARCH PHYS MED REHABIL , 2017, vol. 98, n° 9, p. 1752-1762
Doc n°: 186038
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.apmr.2017.03.028
Descripteurs : CE51 - LOMBALGIE, EC25 -ORTHESES DE MEMBRE INFERIEUR

OBJECTIVES: To investigate the efficacy of shoe orthotics with and without
chiropractic treatment for chronic low back pain compared with no treatment.
DESIGN: Randomized controlled trial. SETTING: Integrative medicine teaching
clinic at a university. PARTICIPANTS: Adult subjects (N=225) with symptomatic low
back pain of >/=3 months were recruited from a volunteer sample. INTERVENTIONS:
Subjects were randomized into 1 of 3 treatment groups (shoe orthotic, plus, and
waitlist groups). The shoe orthotic group received custom-made shoe orthotics.
The plus group received custom-made orthotics plus chiropractic manipulation, hot
or cold packs, and manual soft tissue massage. The waitlist group received no
care. MAIN OUTCOME MEASURES: The primary outcome measures were change in
perceived back pain (numerical pain rating scale) and functional health status
(Oswestry Disability Index) after 6 weeks of study participation. Outcomes were
also assessed after 12 weeks and then after an additional 3, 6, and 12 months.
RESULTS: After 6 weeks, all 3 groups demonstrated significant within-group
improvement in average back pain, but only the shoe orthotic and plus groups had
significant within-group improvement in function. When compared with the waitlist
group, the shoe orthotic group demonstrated significantly greater improvements in
pain (P<.0001) and function (P=.0068). The addition of chiropractic to orthotics
treatment demonstrated significantly greater improvements in function (P=.0278)
when compared with orthotics alone, but no significant difference in pain
(P=.3431). Group differences at 12 weeks and later were not significant.
CONCLUSIONS: Six weeks of prescription shoe orthotics significantly improved back
pain and dysfunction compared with no treatment. The addition of chiropractic
care led to higher improvements in function.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS

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