Treating Children and Teens for low back pain with self training methods: A Study

Low Back Pain is common ailment in adults, but is also among children and adolescents. Exercise increases strength and endurance with positive benefits for Low back pain relief.

A new study released by Spine on September 29 by Dr. Laurie Barclay and Dr. Desiree Lie compared the effects of a self exercise program for low back pain in children and adolescents . This study found that lower back pain improved with treatment.

"LBP among children and adolescents has increased," write Anna Ahlqwist, MSc, RPT, from the Sahlgrenska Academy at Göteborg University, Friskrehab, Göteborg, Sweden, and colleagues. "The literature shows that children with LBP also suffer from this condition as adults. Thus, it is important to prevent and treat LBP in children and adolescents."

It was the goal of the study to show how 2 different treatments administered to children and adolescents with Low back pain affect perception of health, pain, and physical function over time. For twelve weeks 45 children and adolescents were put into 2 groups:

• Group 1: received individual physical therapy and exercise and a standard self-training program and back education
  
• Group 2:a self-training program and back education but no individual therapy.
  

To measure how the children and adolescents did, outcome measures that were used:

• Child Health Questionnaire Child Form 87- this measures quality of life
  
• Children completed self-assessment scales on health-related quality of life and back function and questions about daily function, leisure time activity, and perceived pain.
  
• Roland & Morris Disability Questionnaire
  
• Painometer – a handheld pain measurement instrument, was used to measure pain intensity, quality, location, and duration.
  
• Back Saver Sit and Reach
  
• test of trunk muscle endurance administered before and after the treatment period (Hamstring flexibility and trunk muscle endurance were assessed )

Over time, both groups had statistically significant improvements in most outcome measures. Compared with group 2, group 1 had statistically significant improvements in physical function, measured by the Roland & Morris Disability Questionnaire, and in the duration of pain, measured by the Painometer

• The authors concluded that all assessments in back pain and function and quality of life showed improvement in both groups, but the Roland & Morris Disability Questionnaire score and duration of back pain showed greater improvement in the group with individualized education.
  
• The authors recommended that combining physical activity and exercise was a useful strategy to address LBP in children and adolescents.

According to the study authors: "An individual assessment by a knowledgeable physiotherapist and an active treatment model improve how children and adolescents experience their back problems with respect to health and physical function, pain, strength, and mobility, regardless of whether treatment consists of a home exercise program with follow-up or home exercise combined with exercise and treatment supervised by a physiotherapist,"
"A cost-effective treatment model that includes careful individual back examination and analysis of appropriate home exercise with follow-up and evaluation will help the majority," the study authors conclude.

A self-training program of exercise with individualized therapy is associated with greater improvements in the Roland & Morris Disability Questionnaire disability score and pain duration compared with a similar program without individualized therapy. Both exercise programs improve all pain, function, and quality-of-life outcomes in children and adolescents with Low Back Pain.


Additional Sources: Spine 2008;33:E721–E727
Picture: Gamercize on Flickr


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