| The efficacy of systematic active conservative treatment for patients with severe sciatica.: A single-blind randomized clinical controlled trial. | |
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MedLine Citation:
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PMID: 21494193 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT: Study design: Prospective single-blind randomized clinical controlled trial.Objective: To evaluate the efficacy of active conservative treatment, and to compare two active conservative treatment programs for patients with severe sciatica.Summary of Background Data: Reviews have demonstrated little or no efficacy for passive conservative treatment modalities in patients suffering from sciatica. The results for surgery are conflicting. Cohort studies have shown excellent results for active treatment modalities in patients with sciatica.Methods: 181 consecutive patients with radicular pain below the knee were examined at baseline, at 8 weeks, and one year after treatment. Participants were randomized into two groups (1) symptom-guided exercises + information + advice to stay active, or (2) sham exercises + information + advice to stay active.Symptom-guided exercises consisted of a variety of back related exercises given in accordance with a written algorithm, where symptoms or response to exercises determined the exercises given, http://http://www.sygehuslillebaelt.dk/wm345075, click exercises. Sham exercises were optional, designed to increase general blood circulation and had no targeted effect on the back.The information was comprehensive and included anatomy, pathogenesis and how discs heal without surgery. The advice included encouragement to stay as active as possible but to reduce activity if leg pain increased. The use of medication was optional but only Paracetamol and NSAIDs were recommended.Results: Mean of 4.8 treatment sessions were provided. All patients experienced statistically significant and clinically important improvements in global assessment, functional status, pain, vocational status and clinical findings. The symptom-guided exercises group improved significantly more than the sham exercises group in most outcomes.Conclusion: Active conservative treatment was effective for patients who had symptoms and clinical findings that would normally qualify them for surgery. Although participating patients had greater faith in the sham exercises before treatment, the symptom-guided exercises were superior for most outcomes. |
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Authors:
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Hanne B Albert; Claus Manniche |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-7 |
Journal Detail:
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Title: Spine Volume: - ISSN: 1528-1159 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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The Back Research Centre, Funen, University of Southern Denmark, Denmark. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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