Abstract:

Treatment preferences utilized by most physical therapists on adults with LBP in Nigeria often do not adhere to global clinical practice guidelines, which include aerobic exercise. This case report describes the utilization of aerobic exercise within a conventional multimodal treatment approach in the management of chronic LBP for an older adult living in Nigeria. Baseline measures of NPRS, ODI, RPE, and lumbar range of movement were taken at the initial visit. Subsequently, the intervention combined a walking aerobic exercise both overground and, on the treadmill, with other therapies (e.g., directional preference exercises, strengthening exercises) for 16 sessions over four weeks. Following 16 sessions, clinically meaningful improvements in pain, disability, lumbar range of motion, and rate of perceived exertion were observed. The patient complied, reported no side effects, and had positive feedback regarding the intervention. The utilization of aerobic exercises within a conventional multimodal treatment approach is safe and could be useful for the management of chronic LBP in older adults.

References:

[1] World Health Organization Scientific Group, 2003, The burden of musculoskeletal conditions at the start of the new millennium. Geneva, Switzerland: World Health Organization, https://apps.who.int/iris/handle/10665/42721.

[2] Ries J. D., 2018, Rehabilitation for individuals with dementia: Facilitating success. Curr Geriatr Rep, 7(11):59–70. doi:10.1007/s13670-018-0237-1.

[3] Awosan K. J., Yikawe S.S., Oche O.M., Oboirien M., 2017, Prevalence, perception, and correlates of low back pain among healthcare workers in tertiary health institutions in Sokoto, Nigeria. Ghana Med J, 51(4):164-174 doi:10.4314/GMJ.V51I4.4.

[4] Ogden C.L., Carroll M.D., Curtin L.R., McDowell M.A., Tabak C.J., Flegal K.M., 2006, Prevalence of overweight and obesity in the United States, 1999–2004. JAMA, 295(13):1549–1555. doi:10.1001/jama.295.13.1549.

[5] Patel H., Alkhawam H., Madanieh R., Shah N., Kosmas C.E., Vittorio T.J., 2017, Aerobic vs anaerobic exercise training effects on the cardiovascular system. World J Cardiol, 9(2):134. doi:10.4330/wjc.v9.i2.134.

[6] Ayanniyi O., Lasisi O.T., Adegoke B., Oni-Orisan M.O., 2007, Management of low back pain: Attitudes and treatment preferences of physiotherapists in Nigeria. Afri J Biomed Res, 10:41-49. doi:10.4314/ajbr.v10i1.48970.

[7] Dagenais S., Caro J., Haldeman S., 2008, A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J, 8:8–20. doi:10.1016/j.spinee.2007.10.005.

[8] Battie M.C., Cherkin D.C., Dunn R., Ciol M.A., Wheeler K.J., 1994, Managing low back pain. attitudes and treatment preferences of physical therapists. Phys Ther, 74(3):219- 226. doi:10.1093/ptj/74.3.219.

[9] Oppong-Yeboah B., May S., 2014, Management of low back pain in Ghana: A survey of self-reported practice. Physiother Res Intl, 19(4):222-230. doi:10.1002/pri.1586.

[10] Foster N.E., Thompson K.A., Baxter G.D., Allen J., 1999, Management of non-specific low back pain by physiotherapists in Britain and Ireland. A descriptive questionnaire of current clinical practice Spine, 24(13):1332-42. doi:10.1097/00007632-199907010-00011.

[11] George S.Z., Fritz J.M., Silfies S.P., et al., 2021, Interventions for the management of acute and chronic low back pain: Revision 2021. J Orthop Sports Phys Ther, 51(11): CPG1-CPG60. doi:10.2519/jospt.2021.0304.

[12] Finley C.R., Chan D.S., Garrison S., et al., 2018, What are the most common conditions in primary care? Systematic review. Can Fam Physician, 64:832-840. Published 2018. Accessed July 16, 2022

[13] Haldeman S., Nordin M., Chou R., et al., 2018, The global spine care initiative: World spine care executive summary on reducing spine‑related disability in low‑ and middle‑income communities. Eur Spine J, 27(Suppl 6);27:776–785. doi:10.1007/s00586-018-5722-x.

[14] Safiri S., Kolahi A.A., Cross M., et al., 2021, Prevalence, deaths, and disability-adjusted life years due to musculoskeletal disorders for 195 countries and territories 1990–2017. Arthritis Rheumatol, 73:702-714. doi:org/10.1002/art.41571.

[15] Cook C., Learman K., Showalter C., O’Halloran B., 2015, The relationship between chief complaint
and comparable sign in patients with spinal pain: An exploratory study. Man Ther, 20(3):451-5. doi:10.1016/j.math.2014.11.007.

[16] Egwu M.O., Ojeyinka A.A., Olaogun M.O., 2007, The effect of vertical oscillatory pressure (vop) on youths and elderly adult low back pain (lbp) intensity and lumbo-sacral mobility. J Jpn Phys Ther Assoc, 10(1):17-26. doi:10.1298/jjpta.10.17.

[17] Pesonen J., Shacklock M., Rantanen P., et al., 2021, Extending the straight leg raise test for improved clinical evaluation of sciatica: Reliability of hip internal rotation or ankle dorsiflexion. BMC Musculoskeletal Disord, 22(1):1-8. doi:10.21203/rs.3.rs-200428/v1.

[18] Fairbank J.C., Pynsent P.B., 2000, The Oswestry disability index. Spine. 25(22):2940-2952. doi:10.1097/00007632-200011150-00017.

[19] U.S. Department of Health and Human Services, 2018, Physical activity guidelines for Americans. 2nd edition. Washington, DC: U.S. Department of Health and Human Services.

[20] Morris J.N., Hardman A.E., 1997, Walking to health. Sports Med. 23(5):306-332. doi:10.2165/00007256-199723050-00004.

[21] Liu M.Q., Anderson F.C., Schwartz M.H., Delp S.L., 2008, Muscle contributions to support and progression over a range of walking speeds. J Biomech, 41(15):3243-52. doi:10.1016/j.jbiomech.2008.07.031.

[22] Uzawa H., Davis S., 2018, Outcome measures for adherence to home exercises among patients with chronic low back pain: A systematic review. J Phys Ther Sci, 30(4):649-653. doi:10.1589/jpts.30.649.

[23] Morris J.N., Hardman A.E., 1997, Walking to health. Sports Med, 23(5):306-332. doi:10.2165/00007256-199723050-00004.