DOI QR코드

DOI QR Code

A Preliminary Study of the Objective Measurement of Compliance Rates for Semirigid Lumbar-Support Use in Patients with Chronic Nonspecific Low Back Pain: How Important Is the Compliance Rate?

  • Hekmatfard, Maryam (Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences) ;
  • Sanjari, Mohammad Ali (Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, and Biomechanics Lab., Rehabilitation Research Center, Iran University of Medical Sciences) ;
  • Maroufi, Nader (Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences) ;
  • Saeedi, Hassan (Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences) ;
  • Ebrahimi, Esmail (Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences) ;
  • Behtash, Hamid (Department of Orthopedic and Spinal Surgery, School of Medicine, Iran University of Medical Sciences)
  • Received : 2016.09.26
  • Accepted : 2017.03.08
  • Published : 2017.10.31

Abstract

Study Design: Clinical pilot study. Purpose: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. Overview of Literature: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. Methods: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects' disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. Results: The mean compliance rate of the subjects was $78.16%{\pm}13.9%$. Pain intensity was significantly lower in patients with a higher compliance rate (p=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p<0.001, p=0.02, respectively). Conclusions: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.