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Utilizing Clinical Practice Guidelines for Treatment of Low Back Pain: Summary
Acute LBP: • Education and advice: Moderate evidence/B: ○ Use of active education strategies
Key Points for Client Education: • Acute LBP : ○ There is evidence that active client education strategies reduce pain and disability • Chronic LBP : ○ Education should not be used as a stand-alone treatment; beneficial when combined with other interventions such as manual and exercise • Postoperative LBP : ○ Most research on general education in the postoperative LBP category is with lumbar decompression and discectomy surgery ○ No specific recommendation is provided for other surgical procedures such as spinal fusion due to lack of evidence HEALTHCARE CONSIDERATIONS Occupational Interventions for the Prevention of Low Back Pain: • LBP can affect one's participation in ADL and IADL such as rest, sleep, toileting, dressing, functional mobility, personal hygiene and sexual activity, caregiving tasks, care of pets, driving/community mobility, home management, meal preparation, work, and shopping. The nature of these activities may limit an individual from participating or exacerbate their symptoms (AOTA, 2014) • By encouraging clients to identify a supportive exercise activity that they find meaningful (e.g., Pilates, yoga, strength training), there is a higher chance of accountability. By evaluating which functional activities are most difficult and which exercise activities are most enjoyable, the interventionist can provide the client with an individualized plan that will address their goals and improve their participation in daily living Conclusion The ICF model assists clinicians in classifying clients on a more individualized and personal level. CPGs have been created based on high-quality and up-to- date research. CPGs assist clinicians in providing the best quality of care by recommending interventions for different classifications of a disease or disorder.
■ One-on-one communication ■ Self-management techniques ■ Advice to remain active ■ Self-pacing strategies ■ Back protection techniques
○ Avoidance of passive education strategies: ■ Providing access to educational materials ■ Directing clients to sources through which they may self-educate Chronic LBP: • Pain neuroscience education (PNE): Strong evidence/A: ○ When used alongside other treatments (manual therapy, exercise) and not as stand-alone treatment • PNE involves: ○ Teaching clients to reshape their perception of pain ○ Helping clients have a better understanding of their condition ○ Encouraging clients to be active participants in their condition • Education and advice: Moderate evidence/B: ○ Education effective in conjunction with treatment ○ Not recommended as a stand-alone treatment ○ Standard education strategies encouraged: ■ Advice to stay active ■ Advice related to exercise • Use of the following “other active treatments”: Strong evidence/A: ○ Yoga ○ Stretching ○ Pilates ○ Strength training ○ Recommendation: Use of these “other active treatments” rather than education as a stand- alone intervention Postoperative LBP: • Postoperative “general education”: Moderate evidence/B: ○ Safe resumption of physical activity ○ Postsurgical precautions ○ Proper exercise • This recommendation applies specifically to discectomy or decompression surgery only
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