ORIGINAL PAPER
Real-world effectiveness and costs of vertical oscillatory pressure manipulation for low back pain
 
More details
Hide details
1
Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, United Kingdom
 
2
Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
 
3
Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
 
4
Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
 
5
Department of Physiotherapy, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
 
 
Submission date: 2020-11-05
 
 
Acceptance date: 2021-06-08
 
 
Publication date: 2023-06-01
 
 
Physiother Quart. 2023;31(2):71-78
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Real-world evidence studies using routinely collected data, such as patient clinical records, are innovative ways of generating insight into the effectiveness of healthcare interventions. This study examined the effectiveness of vertical oscillatory pressure (VOP) on selected clinical outcomes for patients with low back pain (LBP) using routinely collected data.

Methods:
Retrospective analysis was carried out on the medical records of patients diagnosed with LBP in a tertiary hospital in south-west Nigeria over a 10-year period. Clinical outcomes (pain intensity and functional disability) in patients who received VOP (n = 201) for their LBP were compared with controls that had traditional physiotherapy (TP) (n = 138) in a routine clinical setting. Total costs of intervention were estimated in terms of direct and indirect costs.

Results:
There were significant differences within group (from baseline to 4th and 8th week of intervention) for the VOP group in pain intensity (p = 0.001) and functional disability (p = 0.001). However, TP group showed no significant differences in pain intensity and functional disability across baseline and week 8 of the study. There was a significant difference in pain intensity (2.95 ± 1.38 vs. 4.16 ± 2.48; p = 0.013) between VOP and TP at week eight. A higher direct and indirect costs associated with VOP compared with TP (both p = 0.042).

Conclusions:
The findings of this study suggest that VOP is an effective intervention for LBP in the ‘real-world’. VOP is more effective compared to TP on its effect on pain intensity over time.

REFERENCES (55)
1.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–1259; doi: 10.1016/S0140-6736(17)32154-2.
 
2.
May SJ. Patient satisfaction with management of back pain main. Physiotherapy. 2001;87(1):4–20; doi: 10.1016/S0031-9406(05)61186-8.
 
3.
Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. Edinburgh: Churchill Livingstone; 2000.
 
4.
Gilgil E, Kaçar C, Bütün B, Tuncer T, Urhan S, Yildirim C, et al. Prevalence of low back pain in a developing urban setting. Spine. 2005;30(9):1093–1098; doi: 10.1097/01.brs.0000161007.46849.4c.
 
5.
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–974; doi: 10.1136/annrheumdis-2013-204428.
 
6.
Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84(1):95–103; doi: 10.1016/s0304-3959(99)00187-6.
 
7.
Ehrlich GE. Low back pain. Bull World Health Organ. 2003;81(9):671–676.
 
8.
van den Bosch MAAJ, Hollingworth W, Kinmonth AL, Dixon AK. Evidence against the use of lumbar spine radiography for low back pain. Clin Radiol. 2004;59(1):69–76; doi: 10.1016/j.crad.2003.08.012.
 
9.
Mielenz TJ, Carey TS, Dyrek DA, Harris BA, Garrett JM, Darter JD. Physical therapy utilization by patients with acute low back pain. Phys Ther. 1997;77(10):1040–1051; doi:10.1093/ptj/77.10.1040.
 
10.
Byrne K, Doody C, Hurley DA. Exercise therapy for low back pain: a small-scale exploratory survey of current physiotherapy practice in the Republic of Ireland acute hospital setting. Man Ther. 2006;11(4):272–278; doi: 10.1016/j.math.2005.06.002.
 
11.
Casserley-Feeney SN, Bury G, Daly L, Hurley DA. Physiotherapy for low back pain: differences between public and private healthcare sectors in Ireland – a retrospective survey. Man Ther. 2008;13(5):441–449; doi: 10.1016/j.math.2007.05.017.
 
12.
Liddle SD, Baxter GD, Gracey JH. Physiotherapists’ use of advice and exercise for the management of chronic low back pain: a national survey. Man Ther. 2009;14(2):189–196; doi: 10.1016/j.math.2008.01.012.
 
13.
Schmidt CO, Raspe H, Pfingsten M, Hasenbring M, Basler HD, Eich W, et al. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine. 2007;32(18):2005–2011; doi: 10.1097/BRS.0b013e318133fad8.
 
14.
French SD, Cameron M, Walker BF, Reggars JW, Ester­man AJ. Superficial heat or cold for low back pain. Cochrane Database Syst Rev. 2006;(1):CD004750; doi: 10.1002/14651858.CD004750.pub2.
 
15.
Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M. Massage for low-back pain. Cochrane Database Syst Rev. 2015;(9):CD001929; doi: 10.1002/14651858.CD001929.pub3.
 
16.
Koes B, van Tulder M. Low back pain (acute). Clin Evid. 2006;15:1619–1633.
 
17.
Koura G, Hamada AH, Mohamed YE, Balbaa AA, El-Nassag BA, Baghdadi ARZ. Impact of strain counter strain on treatment of acute nonspecific low back pain: a single blind randomized controlled trial. Hum Mov. 2021;22(1):42–49; doi: 10.5114/hm.2021.98463.
 
18.
Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142(9):776–785; doi: 10.7326/0003-4819-142-9-200505030-00014.
 
19.
Kuczynski JJ, Schwieterman B, Columber K, Knupp D, Shaub L, Cook CE. Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain: a systematic review of the literature. Int J Sports Phys Ther. 2012;7(6):647–662.
 
20.
van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine. 1997;22(18):2128–2156; doi: 10.1097/00007632-199709150-00012.
 
21.
Wong JJ, Côté P, Sutton DA, Randhawa K, Yu H, Varatharajan S, et al. Clinical practice guidelines for the noninvasive management of low back pain: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain. 2017;21(2):201–216; doi: 10.1002/ejp.931.
 
22.
Nallamothu BK, Hayward RA, Bates ER. Beyond the randomized clinical trial: the role of effectiveness studies in evaluating cardiovascular therapies. Circulation. 2008;118(12):1294–1303; doi: 10.1161/CIRCULATIONAHA.107.703579.
 
23.
Riegelman RK. Studying a Study and Testing a Test: How to Read the Medical Evidence. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2005.
 
24.
Compher C. Efficacy vs effectiveness. J Parenter Enteral Nutr. 2010;34(6):598–599; doi: 10.1177/0148607110381906.
 
25.
Roland M, Torgerson DJ. What are pragmatic trials? BMJ. 1998;316(7127):285; doi: 10.1136/bmj.316.7127.285.
 
26.
Saturni S, Bellini F, Braido F, Paggiaro P, Sanduzzi A, Scichilone N, et al. Randomized Controlled Trials and real-life studies. Approaches and methodologies: a clinical point of view. Pulm Pharmacol Ther. 2014;27(2):129–138; doi: 10.1016/j.pupt.2014.01.005.
 
27.
Price D, Hillyer EV, van der Molen T. Efficacy versus effectiveness trials: informing guidelines for asthma management. Curr Opin Allergy Clin Immunol. 2013;13(1):50–57; doi: 10.1097/ACI.0b013e32835ad059.
 
28.
Price D, Chisholm A, van der Molen T, Roche N, Hillyer EV, Bousquet J. Reassessing the evidence hierarchy in asthma: evaluating comparative effectiveness. Curr Allergy Asthma Rep. 2011;11(6):526–538; doi: 10.1007/s11882-011-0222-7.
 
29.
Center for Devices and Radiological Health. Use of Real-World Evidence to Support Regulatory Decision-Making for Medical Devices. Guidance for Industry and Food and Drug Administration Staff. U.S. Food and Drug Administration. 2019. Available 3.07.2020 from: https://www.fda.gov/regulatory....
 
30.
Sherman RE, Davies KM, Robb MA, Hunter NL, Califf RM. Accelerating development of scientific evidence for medical products within the existing US regulatory framework. Nat Rev Drug Discov. 2017;16(5):297–298; doi: 10.1038/nrd.2017.25.
 
31.
Annemans L, Aristides M, Kubin M. Real-Life Data: A Growing Need. 2016. Available 3.07.2020 from: https://web.archive.org/web/20....
 
32.
Berger ML, Lipset C, Gutteridge A, Axelsen K, Subedi P, Madigan D. Optimizing the leveraging of real-world data to improve the development and use of medicines. Value Health. 2015;18(1):127–130; doi: 10.1016/j.jval.2014.10.009.
 
33.
Epstein RS, Sidorov J, Lehner J-P, Salimi T. Integrating scientific and real-world evidence within and beyond the drug development process. J Comp Eff Res. 2012;1(Suppl 1):9–13; doi: 10.2217/cer.11.3.
 
34.
Tannock IF, Amir E, Booth CM, Niraula S, Ocana A, Se­ruga B, et al. Relevance of randomised controlled trials in oncology. Lancet Oncol. 2016;17(12):e560–e567; doi: 10.1016/S1470-2045(16)30572-1.
 
35.
Akhras KS, Alsheikh-Ali AA, Kabbani S. Use of real-world evidence for healthcare decision-making in the Middle East: practical considerations and future directions. Expert Rev Pharmacoecon Outcomes Res. 2019;19(3):245–250; doi: 10.1080/14737167.2019.1568243.
 
36.
Makady A, Ham RT, de Boer A, Hillege H, Klungel O, Goettsch W, et al. Policies for use of real-world data in Health Technology Assessment (HTA): a comparative study of six HTA agencies. Value Health. 2017;20(4):520–532; doi: 10.1016/j.jval.2016.12.003.
 
37.
Kaushik P, Sehgal M, Sharma S, Pal Kaur V, Vadlamudi NK. Real-world evidence of treatment pattern and associated costs of fibromyalgia in the United States. Value Health. 2016;19(3):A238; doi: 10.1016/j.jval.2016.03.1107.
 
38.
Nwuga VCB, Egwu MO. Back Pain: Causes Treatment and Prevention. Ile-Ife: Obafemi Awolowo University Press; 1999.
 
39.
Nwuga VCB. Manual Treatment of Back Pain. Ibadan: Shaneson C.I.; 1990.
 
40.
Egwu MO, Adeoshun IO, Olaogun MOB, Ikem IC, Ukpon­mwan OE. Cortical electrophysiological changes during vertical oscillatory pressure therapy in patients with low back pain. Intercont J Med Intermont Sci. 2012;2:1–7.
 
41.
Ojoawo AO, Olaogun MO, Odejide SA, Badru AA. Effect of vertical oscillatory pressure on disability of patients with chronic mechanical low back pain using Roland Morris Disability questionnaire. Tanzan J Health Res. 2013;15(1):58–63; doi: 10.4314/thrb.v15i1.9.
 
42.
Johnston KM, Lakzadeh P, Donato BMK, Szabo SM. Methods of sample size calculation in descriptive retrospective burden of illness studies. BMC Med Res Methodol. 2019;19(1):9; doi: 10.1186/s12874-018-0657-9.
 
43.
Heinrich HW, Petersen D, Roos N. Industrial Accident Prevention. A Safety Management Approach. New York: McGraw-Hill Comp.; 1980.
 
44.
Muhammad MS, Kasim R, Martin D, Mohammed MI, Adamu D. Housing quality in segregated residential neighborhoods in Bauchi metropolis. Int J Sci Res Publ. 2015;5(11):432–440.
 
45.
Meucci RD, Fassa AG, Faria NMX. Prevalence of chronic Low Back Pain: systematic review. Rev Saude Publica. 2015;49:1; doi: 10.1590/S0034-8910.2015049005874.
 
46.
Egwu MO, Ojeyinka AA, Olaogun MOB. 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. 2007;10(1):17–26; doi: 10.1298/jjpta.10.17.
 
47.
Onuwe HEK. Relative therapeutic efficacy of vertical oscillatory pressure and transcutaneous electrical nerve stimulation in low back pain management. J Nigeria Med Rehabil. 1998;3:26–31.
 
48.
Nwuga VCB. An insight into back pain and manual therapy 2. The Health Team. 1993;1:8–11.
 
49.
Bartgis J, Bigfoot D. Evidence-based Practices and Practice-based Evidence. National Council Urban Indian Health (NCUIH). 2010. Available 3.07.2020 from: https://www.ncuih.org/krc/D_bi....
 
50.
Freiman A, Bouganim N. History of cryotherapy. Dermatol Online J. 2005;11(2):9.
 
51.
Janwantanakul P. Cold pack/skin interface temperature during ice treatment with various levels of compression. Physiotherapy. 2006;92(4):254–259; doi: 10.1016/j.physio.2006.05.006.
 
52.
Cramer GD, Cambron J, Cantu JA, Dexheimer JM, Po­cius JD, Gregerson D, et al. Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding. J Manipulative Physiol Ther. 2013;36(4):203–217; doi: 10.1016/j.jmpt.2013.04.003.
 
53.
Tsung BYS, Evans J, Tong P, Lee RYW. Measurement of lumbar spine loads and motions during rotational mobilization. J Manipulative Physiol Ther. 2005;28(4):238–244; doi: 10.1016/j.jmpt.2005.03.014.
 
54.
Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Ann Intern Med. 2003;138(11):898–906; doi: 10.7326/0003-4819-138-11-200306030-00011.
 
55.
Williams NH, Hendry M, Lewis R, Russell I, Westmoreland A, Wilkinson C. Psychological response in spinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled trials. Complement Ther Med. 2007;15(4):271–283; doi: 10.1016/j.ctim.2007.01.008.
 
eISSN:2544-4395
Journals System - logo
Scroll to top