Physiotherapy Advantage by cmlang


                                                                            of Milton
Fall Newsletter
At Advantage Physiotherapy we are committed to providing treatment based on the highest quality of research that is
available. The fall newsletter is a compilation of current studies that look at the influence of rehabilitation approaches, advice
and exercise on patients with low back pain. This is an overview of current randomized controlled trials available via Pub Med.
At our clinic we try to view each client in a comprehensive manner.

There are different specialists that work at Advantage Physiotherapy to allow for a more global approach to client care if need
be. We have three Physiotherapists, a Chiropractor, an Osteopath (Currently in Study), a Pedorthist, and a Personal Training

                                                                     Is osteopathic manual treatment effective for
                                                                              patients with low back pain

                                                                Osteopathic manipulative treatment for low back pain: a
                                                          systematic review and meta-analysis of randomized controlled trials.
                                                              John C Licciardone*1, Angela K Brimhall2 and Linda N King3
                                                         BMC Musculoskeletal Disorders 2005, 6:43 doi:10.1186/1471-2474-6-43

                                                         Background: Osteopathic manipulative treatment (OMT) is a distinctive
                                                         modality commonly used by osteopathic physicians/ [osteopaths] to
                                                         complement their conventional treatment of musculoskeletal disorders. The
                                                         purpose of this study was to assess the efficacy of OMT as a complementary
                                                         treatment for low back pain.
                                                         Methods: Six trials, involving eight OMT (Osteopathic Manipulative Treatment)
                                                         vs control treatment comparisons, were included because they were
                                                         randomized controlled trials of OMT that involved blinded assessment of low
                                                         back pain in ambulatory settings.
                                                         Results: Overall, OMT significantly reduced low back pain. Stratified analyses
                                                         demonstrated significant pain reductions in trials of OMT vs active treatment or
                                                         placebo control and OMT vs no treatment control. Significant pain reductions
                                                         were also observed during short-, intermediate-, and long-term follow-up.
                                                         Conclusion: OMT significantly reduces low back pain. The level of pain
                                                         reduction is greater than expected from placebo effects alone and persists for
                                                         at least three months. Additional research is warranted to elucidate
                                                         mechanistically how OMT exerts its effects, to determine if OMT benefits are
       Meredith Craigie, an Osteopath                    long lasting, and to assess the cost-effectiveness of OMT as a complementary
         in current study, is new to our                 treatment for low back pain.
        clinic team. Meredith has been
       trained in techniques which may
        approach back pain differently                          Does the focus of the rehabilitation approach effect
       than conventional interventions.                         return to work days in patients with low back pain?
          Techniques such as: cranial
      osteopathy, fascial release, osteo-                    Function-centered rehabilitation increases work days in
           articular manipulation and                        patients with nonacute nonspecific low back pain: 1-year
      visceral manipulation. She treats                             results from a randomized controlled trial.
        a client holistically in which she                     (Kool J et al. Arch Phys Med Rehabil. 2007, Sep 88;9
         addresses issues that may be
       physical, mental and emotional.                   Methods: 174 patients with previous sick leave of 6 weeks or more were
        Meredith, along with the whole                   randomly assigned to one of two groups. Group 1: function-centered
                                                         treatment (FCT) which emphasized activity despite pain, or Group 2: pain-
          Advantage Team, has a very
                                                         centered treatment (PCT) which emphasized pain reduction.
         hands-on approach to care as                    Measures: Work days, return to work, rate of patients receiving financial
         well as substantial one on one                  compensation for permanent disability, and unemployment rate.
         time. At Advantage we pride                     Results: After 1 year, the FCT group had significantly more work days than the
      ourselves on offering quality care                 PCT group. The odds ratio of returning to work in the FCT group to the PCT
              that is client focused.                    group was 2.1%. The differences of the other measures were not statistically
                                                         Conclusion: FCT is more effective than PCT for increasing work days.
                                                     Can education alone in patients with fear-avoidance
                                                          beliefs reduce number of days off work?

                                                Effects of education on return-to-work status for people with
                                                       fear-avoidance beliefs and acute low back pain.
                                                         (Godges JJ et al. Phys Ther. 2008 Feb 88;2)

                                              Methods: 34 people who were unable to return to work following a work-
                                              related episode of low back pain and who exhibited fear-avoidance beliefs
                                              participated in this study. Participants were assigned to one of two groups, an
                                              education group or a comparison group. Both groups received conventional
                                              physical therapy, but the education group also received education on pain
                                              management and the value of physical activity and exercise.
                                              Measures: The number of days before people returned to work without
                                              Results: Everyone in the education group returned to their regular work duties
                                              within 45 days. One third of the comparison group had not returned to work
                                              within 45 days.
                                              Conclusion: Education and counseling regarding pain management, physical
                                              activity, and exercise can reduce the number of days off work in people with
                                              fear-avoidance beliefs and acute low back pain.

                                                                What has been proven to help
                                                           adolescents with recurrent low back pain?

                                                The efficacy of exercise as an intervention to treat recurrent
                                                          nonspecific low back pain in adolescents.
                                                     (Jones M et al. Pediatr Exerc Sci. 2007, Aug 19;3)

                                              Methods: 54 adolescents who suffered from recurrent nonspecific low back
                                              pain were randomized into either the exercise rehabilitation program or a
                                              control condition.
                                              Measures: Perceived severity of pain, number of occasions missing physical
                                              activity, sit-and-reach performance, hip range of motion, lumbar sagittal
                                              mobility, and number of sit-ups.
                                              Conclusion: All measures were shown to have significant improvement.
                                              Therefore, the specific exercise program appeared to provide positive benefits
                                              for adolescents suffering from recurrent nonspecific low back pain.

                                                                  Do extension exercises really
                                                             help people with back pain get better?

                                                             Effectiveness of an extension-oriented
      The Physiotherapists at Advantage                 treatment approach in a subgroup of subjects
     Physiotherapy have had training in a
                                                        with low back pain: a randomized clinical trial.
     technique called Myofascial Release.
       This technique is used to release                          (Phys Ther. 2007 Dec 87; 12)
    tension along plains of fascia that run
      throughout the body, and that can       Method: Subjects with LBP and symptoms distal to the buttocks that
     become adhered to adjacent tissue if     centralized with extension movements were included. 48 subjects
         trauma has occurred. This is         were randomly assigned to two groups. Group one received an
      potentially the case in patients that   extension-oriented treatment approach (EOTA). Group two received a
    have undergone surgery or treatment       lumbar spine strengthening exercise program. Each group attended 8
            related to breast cancer.
       Active Release Therapy (ART), a        Measures: Disability and pain at 1 week, 4 weeks, and 6 months.
       technique that Valerie Brouwers        Results: Subjects in the EOTA group had greater improvements in
      practices also can be beneficial in     disability compared with the strengthening group at 1 week, 4 weeks,
     releasing scarred or adhered tissue.     and 6 months. The EOTA group showed greater improvements in pain
         ART lengthens soft tissues, in       only a 1 week.
         particular contractile tissue.       Conclusions: An EOTA was more effective than trunk strengthening
                                              exercise in a subgroup of subjects hypothesized to benefit from this
                                              treatment approach.

| | 550 Ontario St S, Unit 7, Milton. | Tel. 905-693 8043 |

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