Physical therapy on low back pain and sciatica. An attempt at evaluation

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    • "Coxhead et al. compared four methods of PT (traction, exercises, manipulation and corset therapy) in 322 participating patients with sciatica [3]; the authors concluded that although active PT appeared to be of short-term value, it did not seem to confer any long-term benefit [3]. Lidström and Zachrisson compared three methods of PT (massage/exercises, traction and hot packs) in 62 patients with sciatica [11]; after treatment (1 month after randomisation) they concluded that the traction group showed better results than the other two groups [11]. The results of our study are not in concordance with the earlier studies, because we found that in the long-term PT care added to GP care is effective. "
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    ABSTRACT: A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in patients with acute sciatica. There is a lack of knowledge concerning the effectiveness of PT in patients with sciatica. The primary outcome was patients' global perceived effect (GPE). Secondary outcomes were severity of leg and back pain, severity of disability, general health and absence from work. The outcomes were measured at 3, 6, 12 and 52 weeks after randomisation. At 3 months follow-up, 70% of the intervention group and 62% of the control group reported improvement (RR 1.1; 95% CI 0.9-1.5). At 12 months follow-up, 79% of the intervention group and 56% of the control group reported improvement (RR 1.4; 95% CI 1.1; 1.8). No significant differences regarding leg pain, functional status, fear of movement and health status were found at short-term or long-term follow-up. At 12 months follow-up, evidence was found that PT added to general practitioners' care is only more effective regarding GPE, and not more cost-effective in the treatment of patients with acute sciatica than general practitioners' care alone. There are indications that PT is especially effective regarding GPE in patients reporting severe disability at presentation.
    European Spine Journal 05/2008; 17(4):509-17. DOI:10.1007/s00586-007-0569-6 · 2.07 Impact Factor
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    • "In two controlled studies in patients with lumbagosciatica and disc herniation, conventional traction (Tru Trac) was not found to be superior to placebo treatment (Lidstrom & Zachrisson 1970, Weber 1973). These studies have either shown poor results of treatment or positive effects that were of limited or marginal significance in most cases. "
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    ABSTRACT: In this controlled prospective study of the Auto-traction method for the treatment of lumbago-sciatica, 82 patients were randomly allocated to either treatment with Auto-traction for up to three 1-hour sessions in 1 week, or they were given a corset and advised to rest. The orthopaedic surgeons participating in the study worked at six different hospitals and all had limited experience of the Auto-traction method obtained during a 1-week course. All patients were clinically evaluated by an independent observer who also performed the follow-up examinations 1 and 3 weeks after the treatment sessions. In addition a 3-month follow-up was performed by letter. The Auto-traction method gave prompt relief of pain and a normalizing of the SLR test more often than treatment with only a corset and rest. The difference between the two treatment groups was statistically significant. The immediate difference noted between the treatment groups had decreased slightly at 3 weeks but was still statistically significant at this time.
    Acta Orthopaedica Scandinavica 11/1980; 51(5):791-8. DOI:10.3109/17453678008990875 · 2.77 Impact Factor

  • Physiotherapy 01/2005; 91. DOI:10.1016/ · 1.91 Impact Factor
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