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Efficacy of Graded Activity with and without Daily-Monitored-Walking on Pain and Back Endurance among Patients with Concomitant Low-Back Pain and Type-2 Diabetes: A Randomized Trial.

Ethiopian journal of health sciences
March 1, 2020
Opeyemi Ayodiipo Idowu et al. (2 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether Graded Activity (GA) alone or combined with daily-monitored walking (GAMW) was more effective in managing clinical attributes in patients with both Low-Back Pain (LBP) and Type-2 Diabetes (T2D).

Results Summary

The study found that GAMW significantly improved glycaemic control (GC) and yielded better improvements in static back and abdominal endurance compared to GA alone, though no differences were observed in pain intensity between the two groups.

Population

58 patients (mean age 48.3±9.4 years, 64.7% female) with concomitant LBP and T2D.

Effective Dosage

Treatment was administered twice weekly for GA, with additional daily-monitored walking for GAMW.

Duration

12 weeks

Interactions

None mentioned

Extracted Claims (15)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Graded Activity (GA)
decrease
Pain Intensity (PI)
patients with concomitant LBP and T2D
-
significant differences
#1
Graded Activity (GA)
increase
Static Abdominal Muscular Endurance (SAME)
patients with concomitant LBP and T2D
-
significant differences
#2
Graded Activity (GA)
increase
Static Back Extensors Endurance (SBEE)
patients with concomitant LBP and T2D
-
significant differences
#3
Graded Activity with daily-monitored-walking (GAMW)
decrease
Pain Intensity (PI)
patients with concomitant LBP and T2D
-
significant differences
#4
Graded Activity with daily-monitored-walking (GAMW)
increase
Static Abdominal Muscular Endurance (SAME)
patients with concomitant LBP and T2D
-
significant differences
#5
Graded Activity with daily-monitored-walking (GAMW)
increase
Static Back Extensors Endurance (SBEE)
patients with concomitant LBP and T2D
-
significant differences
#6
Graded Activity with daily-monitored-walking (GAMW)
decrease
Glycaemic Control (GC)
patients with concomitant LBP and T2D
6.3±0.9% to 5.7±0.7%
significant within-group difference
#7
Graded Activity (GA)
no change
Glycaemic Control (GC)
patients with concomitant LBP and T2D
6.3±0.9% to 6.3±0.9%
no significant within-group difference
#8
Graded Activity with daily-monitored-walking (GAMW)
increase
Static Back Extensors Endurance (SBEE)
patients with concomitant LBP and T2D
7.3±0.1 sec vs 7.2±0.1 sec
significant difference compared to GA
#9
Graded Activity with daily-monitored-walking (GAMW)
decrease
Glycaemic Control (GC)
patients with concomitant LBP and T2D
-0.6±0.5% vs -0.5±0.2%
significant difference compared to GA
#10
Graded Activity with daily-monitored-walking (GAMW)
no change
Pain Intensity (PI)
patients with concomitant LBP and T2D
-
no differences compared to GA
#11
Graded Activity with daily-monitored-walking (GAMW)
no change
Static Abdominal Muscular Endurance (SAME)
patients with concomitant LBP and T2D
-
no differences compared to GA
#12
Graded Activity with daily-monitored-walking (GAMW)
increase
Glycaemic Control (GC)
patients with concomitant LBP and T2D
-
produced positive effects
#13
Graded Activity with daily-monitored-walking (GAMW)
increase
Static Abdominal Muscular Endurance (SAME)
patients with concomitant LBP and T2D
-
yielded a better improvement
#14
Graded Activity with daily-monitored-walking (GAMW)
increase
Static Back Extensors Endurance (SBEE)
patients with concomitant LBP and T2D
-
yielded a better improvement
#15
Abstract

BACKGROUND: There is evidence supporting the efficacy of Graded Activity (GA) in managing clinical attributes of patients with Low-Back Pain (LBP) in the general population. However, it is unknown whether GA alone is efficacious in managing these clinical attributes in patients with concomitant LBP and Type-2 Diabetes (T2D) or additional daily-monitored walking will be required. METHODS: A single-blind controlled trial involving 58 patients (mean age: 48.3±9.4 years, 64.7% females) with concomitant LBP and T2D who received treatment twice weekly for twelve weeks was conducted. Participants were randomized into GA or GA with daily-monitored-walking (GAMW) groups. Pain Intensity (PI), Static Back Extensors Endurance (SBEE), Static Abdominal Muscular Endurance (SAME) and Glycaemic Control (GC) were assessed using Visual Analogue Scale, Biering-Sorensen test, flexor endurance test, and in2itTM device respectively at baseline, 4th, 8th and 12th week. Data were analysed using repeated measures ANOVA and Unpaired t-tests at α = 0.05. RESULTS: There were significant differences in PI, SAME and SBEE among participants in each of GA and GAMW groups respectively (p<0.05). Within-group difference on GC was significant for GAMW (6.3±0.9%, 5.7±0.7%) but not GA (6.3±0.9%, 6.3±0.9%). There was significant difference (p<0.05) between GA and GAMW group participants for SBEE (7.2±0.1 sec, 7.3±0.1 sec) at week 8 of the study and GC (-0.5±0.2%, -0.6±0.5%) at the end of the study. No differences were found between GA and GAMW groups for PI and SAME. CONCLUSION: Graded activity with daily-monitored-walking produced positive effects on GC and yielded a better improvement on SAME and SBEE.

Medical Subject Headings (MeSH)
Diabetes Mellitus, Type 2Exercise TherapyFemaleHumansLow Back PainMaleMiddle AgedPhysical EnduranceSingle-Blind MethodTreatment OutcomeWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations8
Citations/Year1.6
Relative Citation Ratio0.82
NIH Percentile42.8%
Research Impact Scores
APT Score0.50
Weight Score2.27
Normalized Score0.66
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