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.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.