Low back pain oswestry disability index changes following 8-week movement proficiency exercise program – A retrospective cohort study

Abstract

Chronic low back pain (CLBP) is a worldwide epidemic, with a prevalence rate of 75–84% in developed countries. With the prevalence increasing, health-care professionals must question current best practice guidelines. In 2014, spinal neurosurgeon and back pain rehabilitation specialist Dr. David Johnson developed a unique back pain rehabilitation program referred to as NearoHAB®. The program’s uniqueness is founded on the principle that effective rehabilitation must eliminate the root cause of pain symptoms. The NeuroHAB® 8-week Movement therapy program aims to reverse movement dysfunction by restoring central nervous system-derived motor patterns based on proficient spinopelvic biomechanics for bending activities of daily living. To date, no other rehabilitation methodology adopts a movement dysfunction cause-based clinical model for back pain symptoms or includes a framework for what healthy lumbar pelvic movement should resemble. Over the course of the 8-week program, each participant is gradually upskilled, developing new default movement proficiency and improved biomechanics, in efforts to downregulate pain, improve disability, and increase functional movement capacity, creating a positive feedback loop for further progress. The leading question of this study is “How does functional movement-based therapy impact chronic low back pain?” Ten sets of participant details were selected at random and retrieved from the NeuroHAB® 8-week program database of 2020. All participants presented with CLBP, and two oswestry disability index (ODI) scores were documented – the first at the beginning of the 8-week program, and the second after the NeuroHAB® intervention. ODI scores were collated and the pre- and post-program results were measured and compared quantitatively through a paired t-test to determine the statistical significance of improvement. Results showed a two-tailed P=0.05 indicating that there was a significant difference between the pre- and post-data (0.0024). The pre- and post-group intervention ODI means were 25.80 and 13.30, respectively, resulting in a difference of 12.50 (95% CI: 5.73–19.27); determining the mean data between the pre- and post-intervention decreased by 48.4496%. The results from this study support the alternative hypothesis, concluding an 8-week intervention of functional movement therapy represented by NeuroHAB® results in a significant reduction of LBP ODI scores. 

References

1. Thiese MS, Hegmann KT, Wood EM, Garg A, Moore JS, Kapellusch J, et al. Prevalence of low back pain by anatomic location and intensity in an occupational population. BMC Musculoskeletal Disord 2014;15:283.
2. Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: Estimates from the Global Burden of Disease Study 2017. Ann Transl Med 2020;8:299.
3. Gatchel RJ. The continuing and growing epidemic of chronic low back pain. Healthcare (Basel) 2015;3:838-45.
4. Traeger AC, Buchbinder R, Elshaug AG, Croft PR, Maher CG. Care for low back pain: Can health systems deliver? Bull World Health Organ 2019;97:423-33.
5. Lopez-Jaramillo P, Lopez-Lopez JP, Tole MC, Cohen DD. Muscular strength in risk factors for cardiovascular disease and mortality: A narrative review. Anatol J Cardiol 2022;26:598-607.
6. Aman JE, Elangovan N, Yeh IL, Konczake. the effectiveness of proprioceptive training for improving motor function: A systematic review. Front Hum Neurosci 2015;8:1075.
7. Behm DG, Sanchez JC. Instability resistance training across the exercise continuum. Sports Health 2013;5:500-3.
8. Freeman M, Woodham M, Woodham A, Skeate JG. Long-term lumbar multifidus muscle atrophy changes documented with magnetic resonance imaging: A case series. J Radiol Case Rep 2014;8:27-34.
9. Myrtos CD. Low back disorders. Evidence-based prevention and rehabilitation. J Can Chiropr Assoc 2012;56:76.
10. Arnau JM, Vallano A, Lopez A, Pellisé F, Delgado MJ, Prat N. A critical review of guidelines for low back pain treatment. Eur Spine J 2006;15:543-53.
11. Johnson D, Hanna J. Why we fail, the long-term outcome of lumbar fusion in the Swedish Lumbar Spine Study. Spine J 2017;17:754.
12. Radcliff KE, Kepler CK, Jakoi A, Sidhu GS, Rihn J, Vaccaro AR, et al. Adjacent segment disease in the lumbar spine following different treatment interventions. Spine J 2013;13:1339-49.
13. Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 1992;5:390-6; discussion 397.
14. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine (Phila Pa 1976) 1996;21:2640-50.
15. Freeman MD, Woodham MA, Woodham AW. The role of the lumbar multifidus in chronic low back pain: A review. PM R 2010;2:142-6; quiz 1 p following 167.
16. Naghdi N, Mohseni-Bandpei MA, Taghipour M, Rahmani N. Lumbar multifidus muscle morphology changes in patient with different degrees of lumbar disc herniation: An ultrasonographic study. Medicina (Kaunas) 2021;57:699.
17. Admin. Movement Disorder Functional Movement Training Centre FMTC. Back Pain Functional Movement. Available from: https://www.fmtc.com.au/movement-disorder [Last accessed on 2022 Nov 27].

Comments & Peer Review