Article

OBJECTIVE: To determine the feasibility of a randomized controlled trial
investigating the effectiveness of physiotherapy for sleep disturbance in chronic
low back pain (CLBP) (>/=12wks). DESIGN: Randomized controlled trial with
evaluations at baseline, 3 months, and 6 months.
SETTING: Outpatient
physiotherapy department in an academic teaching hospital. PARTICIPANTS:
Participants with CLBP were randomly assigned to a walking program (n=20; mean
age +/- SD, 46.4+/-13.8y), supervised exercise class (n=20; mean age +/- SD,
41.3+/-11.9y), or usual physiotherapy (n=20; mean age +/- SD, 47.1+/-14.3y). The
3-month evaluation was completed by 44 participants (73%), and 42 (70%)
participants completed the 6-month evaluation. INTERVENTIONS: Participants
received a physiotherapy-delivered 8-week walking program, an 8-week group
supervised exercise class (1 class/wk), or 1-to-1 usual physiotherapy (advice,
manual therapy, and exercise). MAIN OUTCOME MEASURES: Sleep was assessed by the
self-reported Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index
(ISI), Pittsburgh Sleep Diary, and objective actigraphy. RESULTS: Groups were
comparable at baseline. Most (95%, n=57) of the participants had sleep
disturbance. The acceptability of actigraphy was excellent at baseline (58 of 60
participants), but dropped at 3 months (26 of 44 participants). There were
improvements on the PSQI and ISI in all groups at 3 and 6 months, with
predominantly medium effect sizes (Cohen d=0.2-0.5).
CONCLUSIONS: The high
prevalence of sleep disturbance indicated the feasibility of good recruitment in
future trials. The PSQI would be a suitable screening tool and outcome measure
alongside an objective nonobtrusive sleep outcome measure.
The effectiveness of
physiotherapy for sleep disturbance in CLBP warrants investigation in a fully
powered randomized controlled trial.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS