Dose optimisation and effectiveness of vertical oscillatory pressure on some clinical and psychosocial variables of patients with chronic lowback pain
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Date
2022
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Department of Medical Rehabilitation, Faculty Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Abstract
This study was aimed to assess the feasibility and validation of a Digital Pressure Sensor Machine (DPSM) for pressure magnitude detection during Vertical Oscillatory Pressure (VOP), predicted and characterised the optimal dosage for VOP based on the Digital Pressure Magnitude (DPM), number of oscillation and frequency of treatment, somatotype and pain intensity. Also, the study evaluated the dose-response of VOP on clinical variables (Pain Intensity (PI), spinal range of motion (SROM) and Disability Level (DL)) and psychosocial variables (fear avoidance belief (FABQ) and Health-Related Quality of life (HQol)) domains of patients with Low Back Pain (LBP). Furthermore, the effects of dose-specific (dVOP) and non-dose specific VOP (ndVOP) based on clinical and psychosocial variables of the patients with LBP were compared..
These were with a view to determining the usability and validity of DPSM and optimising dose of VOP required for effective treatment of patient with LBP. Eighty-seven participants (Physiotherapist (n=14), patient with chronic LBP (n=63)) were purposively recruited for this three-stage research which involved feasibility, validation and implementation of DPSM. In stage 1, 14 Physiotherapists tested the feasibility and validity of DPSM using System Usability Scale (SUS) and Pain Pressure Threshold Scale. For stage 2, predicting the optimal dose of VOP based on DPM, number of oscillation, frequency of treatment among patient with chronic LBP (n=24) was carried out. In stage 3, Implementing the DPSM for VOP application was by a randomized control trial involving group I ( dVOP;n=24) and group 2 (ndVOP; n= 25).Relative effectiveness of both dVOP and ndVOP were tested in term of PI, SROM, FAB, DL and HRQol domains using QVAS, Finger to Floor method, FABQ, ODI and HSQ (SF-12) respectively at baseline, week 3 and 6 respectively of the study. Alpha level was set at p< 0.05. The study showed that DPSM had a usability rating of 50% and 14.3% of good and excellent respectively. The mean SUS score was 74% out of 100% . also, DPSM has 50% sensitivity, 33% specificity, 20% positive prediction and 67% negative prediction values . PI (β= 0.288, p= 0.181), somatotype (β = -112, p=0.624), weight (β= 0.379, p=0.102), height (β=- 017, p=0.935) were not significant predictors of DPM. Within group comparison across week indicated that there dVOP has significant effect on PI (F= 561.44, p=0.000), SROM (FF (F=27.02,p=0.000; BB(F=528.19,p=0.000), HRQol (PH (F= 1309, p= 0.000; MH(F=1309,p= 0.000), FAB (F=522.27, p=0.000), DL (F= 320.64, p=0.000). Between group comparison showed that dVOP had more effect on PI (p<0.05) and FAB (p< 0.05) compared to ndVOP. This study concluded that DPSM had good to excellent usability during VOP. Also it was 50% sensitive and 33% specific rating in application. Both dVOP and ndVOP were effective on clinical and psychosocial variables. Moreover, dVOP has superior effect on PI and FAB.
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AFOLABI T .O (2022) Dose optimisation and effectiveness of vertical oscillatory pressure on some clinical and psychosocial variables of patients with chronic lowback pain, Department of Medical Rehabilitation, Faculty Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.