Short-term effect of superficial heat treatment on paraspinal muscle activity, stature recovery, and psychological factors in patients with chronic low back pain

Lewis, Sandra E., Holmes, Paul S., Woby, Steve R., Hindle, Jackie and Fowler, Neil E. (2012) Short-term effect of superficial heat treatment on paraspinal muscle activity, stature recovery, and psychological factors in patients with chronic low back pain. Archives of Physical Medicine and Rehabilitation, 93 (2). pp. 367-372. ISSN 1532-821X

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Abstract

Objective : To test the hypothesis that patients with chronic low back pain (CLBP) would have reduced paraspinal muscle activity when wearing a heat wrap and that this would be associated with increased stature recovery and short-term improvements in psychological factors. Design : A within-subject repeated-measures design. Muscle activity and stature recovery were assessed before and after a 40-minute unloading period, both without a heat wrap and after 2 hours of wear. Questionnaires were completed after both sessions. Setting : Hospital physiotherapy department. Participants : Patients with CLBP (n=24; age, 48.0±9.0y; height, 166.6±7.3cm; body mass, 80.2±12.9kg) and asymptomatic participants (n=11; age, 47.9±15.4y; height, 168.7±11.6cm; body mass, 69.3±13.1kg) took part in the investigation. Patients on the waiting list for 2 physiotherapist-led rehabilitation programs, and those who had attended the programs during the previous 2 years, were invited to participate. Intervention : Superficial heat wrap. Main Outcome Measures : Paraspinal muscle activity, stature recovery over a 40-minute unloading period, pain, disability, and psychological factors. Results : For the CLBP patients only, the heat wrap was associated with a reduction in nonnormalized muscle activity and a positive short-term effect on self-report of disability, pain-related anxiety, catastrophizing, and self-efficacy. Changes in muscle activity were correlated with changes in stature recovery, and both were also correlated to changes in psychological factors. Conclusions : Use of the heat wrap was associated with a decrease in muscle activity and a short-term improvement in certain aspects of well-being for the CLBP patients. The results confirm the link between the biomechanical and psychological outcome measures.