PMID- 25054648
OWN - NLM
STAT- MEDLINE
DCOM- 20151008
LR  - 20240323
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Print)
IS  - 0362-2436 (Linking)
VI  - 39
IP  - 21
DP  - 2014 Oct 1
TI  - A randomized clinical trial comparing extensible and inextensible lumbosacral 
      orthoses and standard care alone in the management of lower back pain.
PG  - 1733-42
LID - 10.1097/BRS.0000000000000521 [doi]
AB  - STUDY DESIGN: Single blinded, randomized clinical trial for the evaluation of 
      lumbosacral orthoses (LSOs) in the management of lower back pain (LBP). 
      OBJECTIVE: To evaluate the effects of two types of LSOs on self-rated disability 
      in patients with LBP. SUMMARY OF BACKGROUND DATA: LSOs are commonly used for the 
      management of LBP, but their effectiveness may vary because of design. An 
      inextensible LSO (iLSO) reduces trunk motion and increases trunk stiffness, 
      whereas an extensible LSO (eLSO) does not. METHODS: A total of 98 participants 
      with LBP were randomized to 3 groups: (1) standard care (SC) group, which 
      included medication and physical therapy (n = 29), (2) SC with eLSO (eLSO group) 
      (n = 32), and (3) SC with iLSO (iLSO group) (n = 37). Outcome measures were 
      evaluated before and after 2 weeks of treatment: modified Oswestry Disability 
      Index (ODI), Patient Specific Activity Scale, pain ratings, and Fear Avoidance 
      Beliefs Questionnaire. RESULTS: There were no statistically significant 
      differences between groups at baseline. Compared with the SC alone, iLSO group 
      showed greater improvement on the ODI scores (P = 0.01) but not the eLSO group. 
      The ODI scores improved by a mean of 2.4 (95% confidence interval [CI], 2.2-7.1), 
      8.1 (95% CI, 2.8-13.4), and 14.0 (95% CI, 8.2-19.8) points for SC, eLSO, and iLSO 
      groups, respectively. Individuals wearing the iLSO had 4.7 times higher odds of 
      achieving 50% or greater improvement in the ODI scores than those assigned to SC 
      (95% CI, 1.2-18.5, P = 0.03). Both the eLSO and iLSO groups had a greater 
      improvement in the Patient Specific Activity Scale scores than the SC group (P = 
      .05 and P = 0.01, respectively), but the change did not meet the minimal 
      clinically important difference. Pain ratings improved for all 3 groups, with no 
      statistical difference between them. Finally, no significant differences across 
      groups were found for the Fear Avoidance Beliefs Questionnaire. CONCLUSION: An 
      iLSO led to greater improvement in ODI scores than SC and an eLSO. We surmise 
      that the likely mechanism responsible for this difference in outcome was the 
      added trunk stiffness and motion restriction by the iLSO. LEVEL OF EVIDENCE: 2.
FAU - Morrisette, David C
AU  - Morrisette DC
AD  - *Division of Physical Therapy, College of Health Professions, Medical University 
      of South Carolina, Charleston daggerCenter for Orthopedic Research, Osteopathic 
      Surgical Specialties, College of Osteopathic Medicine, Michigan State University, 
      East Lancing double daggerFamily Services Research Center, Medical University of South 
      Carolina, Charleston  section signDivision of Physical Therapy, College of Health 
      Professions, Medical University of South Carolina, Charleston; and  paragraph signDepartment of 
      Physical Therapy, Medical University of South Carolina Hospital Authority, 
      Charleston.
FAU - Cholewicki, Jacek
AU  - Cholewicki J
FAU - Logan, Sarah
AU  - Logan S
FAU - Seif, Gretchen
AU  - Seif G
FAU - McGowan, Stephanie
AU  - McGowan S
LA  - eng
GR  - UL1 TR000062/TR/NCATS NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Biomechanical Phenomena
MH  - Disability Evaluation
MH  - Equipment Design
MH  - Female
MH  - Humans
MH  - Low Back Pain/diagnosis/physiopathology/*therapy
MH  - Lumbar Vertebrae/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Numbers Needed To Treat
MH  - Orthopedic Procedures/*instrumentation
MH  - *Orthotic Devices
MH  - Pain Measurement
MH  - Sacrum/*physiopathology
MH  - Single-Blind Method
MH  - Surveys and Questionnaires
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC4521401
MID - NIHMS702747
EDAT- 2014/07/24 06:00
MHDA- 2015/10/09 06:00
PMCR- 2015/10/01
CRDT- 2014/07/24 06:00
PHST- 2014/07/24 06:00 [entrez]
PHST- 2014/07/24 06:00 [pubmed]
PHST- 2015/10/09 06:00 [medline]
PHST- 2015/10/01 00:00 [pmc-release]
AID - 10.1097/BRS.0000000000000521 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2014 Oct 1;39(21):1733-42. doi: 
      10.1097/BRS.0000000000000521.