Article

Home-based therapy optimizing biomechanics and neuromuscular control
is increasingly recognized as a treatment option for chronic nonspecific low back
pain (CNSLBP). However, its impact on pain, function, and gait is limited among
patients in a metropolitan area. OBJECTIVE: To evaluate the change of pain,
function, and gait parameters with home-based therapy with the use of
footwear-generated biomechanical manipulation and perturbation training in a
population with CNSLBP in a metropolitan area. DESIGN: Prospective observational
study. SETTING: Outpatient rehabilitation clinic at an academic teaching
hospital. PARTICIPANTS: One hundred sixteen patients with CNSLBP for more than 6
months. INTERVENTION: Six months of home-based therapy with a biomechanical
device using 4 modular elements attached to a foot-worn platform. MAIN OUTCOME MEASURES: Instrumental gait analysis (gait velocity, step length, single limb
support phase % of gait cycle), Numeric Rating Scale for pain, and Oswestry
Disability Questionnaire Index for pain and function. RESULTS: Only 43 patients
(37.1%) completed the study. Among 43 patients, mean gait velocity increased from
86.6 +/- 20.7 to 99.7 +/- 22.1 cm/s (P < .0001) in 6 months. Mean left step
length increased from 51.1 +/- 8.4 to 54.8 +/- 9.8 cm (P < .0001). Mean right
step length increased from 51.0 +/- 7.9 to 55.4 +/- 9.0 cm (P < .0001). Mean
single limb support increased from 36.4 +/- 2.8 to 37.2 +/- 2.5%, (P = .208) in
the right side and from 36.6 +/- 3.0 to 37.8 +/- 4.4%, (P = .019) in the left
side. Median Oswestry Disability Questionnaire Index score improved from 28
(18-44; interquartile range) to 17 (10-35) (P = .045). Mean Numeric Rating Scale
for back pain improved from 7.7 +/- 1.8 to 3.3 +/- 3.1 (P < .0001). CONCLUSION:
At 6 months, patients with CNSLBP undergoing home-based therapy with
footwear-generated biomechanical manipulation and perturbation training
demonstrated significant improvement of objective gait parameters, pain, and
function.
LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS