DATAPOINT – Improving motion improves pain and wellbeing, and targeting additional contracting (active subsystem) and connecting (passive subsystem) in more different ways to improve motion increased the effect. In other words…MORE IS MORE.
One of the problems with science is that it can take a lot of people in a study to see an effect (e.g. doing X makes A better). Intuitively, it seems like doing X and Y is better than doing X alone, and adding a third treatment Z and a 4th treatment even more people! However, science deals in facts, not intuition, so it takes a lot of people (which means an expensive study) to test the idea that combining therapies works better.
DATAPOINT – Studies comparing more treatment options require WAY more people.
Keeping people active is a good thing…but is there an incremental benefit to combining activity with muscle stretching, manual therapy and steroid injections. A new study says there is, A 10 week study conducted in nine primary health care and one outpatient orthopaedic hospital department compared 4 groups:
‘Stay active’ advice only
‘Stay active’ + muscle stretching
‘Stay active’ + muscle stretching + manual therapy
‘Stay active’ + muscle stretching + manual therapy + steroid injections
The study found more care meant responses were better….finding significant effects on pain as well as on well-being (patience, energy, mood and family situation). In other words, telling people to stay active helped (actively engaging their CONTRACTING subsystem), but adding focused active to stretch (actively engaging their ACTIVE and PASSIVE subsystems) helped more.
Then, adding passive care (manual therapy targeting connecting as well as contracting subsystems) helped even more.The next therapy, adding an external drug to reduce inflammation and facilitate motion, would not be my default choice, but even that helped even more. I have strong feeling about the dangers of steroids and the longer term damage and residual clinical problems they create, but the principle of motion improving health and wellbeing is demonstrated again.
HYPOTHESIS – StrongPosture® exercise focusing conscious motion to incremental arcs of motion will improve the results seen with any motion based treatment.
Clin Rehabil. 2011 Aug 12. [Epub ahead of print]
A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to ‘stay active’ care on health-related quality of life in acute or sub-acute low back pain.
Grunnesjö MI, Bogefeldt JP, Blomberg SI, Strender LE, Svärdsudd KF.