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Physical therapy boosts back pain care

  • ASSOCIATED PRESS / 2007
                                Anah McMahon, L. Ac. adjusts one inch seirin acupuncture needles in the muscles around the spine of Mariah VanHorn to relieve lower back pain at the Pacific College of Oriental Medicine in Chicago.

    ASSOCIATED PRESS / 2007

    Anah McMahon, L. Ac. adjusts one inch seirin acupuncture needles in the muscles around the spine of Mariah VanHorn to relieve lower back pain at the Pacific College of Oriental Medicine in Chicago.

People with back pain are often referred for physical therapy, though studies on its effectiveness have been mixed. A randomized trial suggests that, despite some limitations, physical therapy may have real benefits.

Researchers studied 220 adults, ages 18 to 60, with back pain and sciatica (pain radiating down the leg) of less than three months’ duration. They assigned half to usual care — one session of education about back care — and half to four weeks of physical therapy, including a specified program of exercise and hands-on therapy. All patients completed eight well-validated questionnaires covering back and leg pain, disability, physical activity and quality of life.

At four weeks, six months and one year, the therapy group showed less disability and decreased back pain intensity compared with the controls. There was no difference between the treatment group and controls in how much additional health care they used or how many days of work they missed, but the therapy group was more likely to rate their treatment as successful at one month and one year. The study is in the Annals of Internal Medicine.

“We know that with back pain and sciatica, being active and exercising within your limits is a good thing to do,” said the lead author, Julie M. Fritz, a professor of physical therapy at the University of Utah. “But there’s an additive benefit in the care provided by a physical therapist. With added physical therapy, you’re less likely to have a prolonged case of disability.”

Dancing seniors reduce risk of falls

Dancing may help prevent falls in seniors, a review of studies suggests. And the more older people danced, the better.

Researchers combined data from 29 controlled trials in healthy people over 65 of “dance-based mind-motor activities” involving coordinated upright movements, structured through music or rhythm, with distinctive choreography and interactions with other people — in other words, dancing. The studies tested ballroom dancing, folk dancing, line dancing, eurythmics, tai chi and other styles.

Compared with their peers who engaged in walking, seated exercise, general aerobics and other types of exercise, those who engaged in dance-based activities had a 37% reduced risk of falling in eight trials, and a 31% reduced number of falls in seven other studies. Several trials showed significant advantage over controls in balance and lower body strength, but not upper body strength.

The review, in JAMA Network Open, found that dancing three or more sessions a week, and continuing to do so for 12 to 24 weeks, was associated with greater benefits than shorter interventions.

The lead author, Michele Mattle, a doctoral student at the University of Zurich, pointed out that most trials reported at least 80% adherence, which is probably higher than for most other types of exercise programs.

“Participants liked the interventions, and thus they had fun doing them,” she said. “The most important thing for physical activity to have a beneficial effect is that you stick with it — lifelong.”

Weighted blankets, better sleep

Weighted blankets, which have long been popular aids to induce calm, could help reduce insomnia, a new study suggests.

Swedish researchers studied 121 patients with depression, bipolar disorder and other psychiatric diagnoses, all of whom had sleep problems. They randomly assigned them to two groups. The first slept with an 18-pound blanket weighted with metal chains, and the second with an identical-looking 3-pound plastic chain blanket.

The study, in the Journal of Clinical Sleep Medicine, used the Insomnia Severity Index, a 28-point questionnaire that measures sleep quality, and participants wore activity sensors on their wrists to measure sleep time, awakenings and daytime activity.

More than 42% of those using the heavy blanket scored low enough on the Insomnia Severity Index to be considered in remission from their sleep troubles, compared with 3.6% of the controls. The likelihood of having a 50% reduction on the scale was nearly 26 times greater in the weighted-blanket group.

The weighted blankets did not have a significant effect on total sleep time, but compared with the controls, the users had a significant decrease in wakenings after sleep onset, less daytime sleepiness and fewer symptoms of depression and anxiety.

The senior author, Dr. Mats Adler of the Karolinska Institute in Stockholm, acknowledged that this is only one study and doesn’t provide scientific proof that the blankets work.

“I have colleagues using it and they love it,” he said, “but that’s not proof. This study is an indication that they may work, but more studies should be done.”

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