Abstract
Background and Objective: Low back pain (LBP) is a frequent symptom. Among the causes that can determine it, lumbar osteoarthritis plays an important role. Therapeutic exercise, according to McKenzie method, has been shown to be effective in the treatment of LBP. Oral supplementation with collagen peptides represents a new therapeutic possibility in osteoarthritis. The aim of this study is to evaluate the combined efficacy of therapeutic exercise and oral administered viscosupplements in the treatment of osteoarthritis-related chronic LBP.
Methods: Sixty patients were recruited and randomly divided into two groups (Group A and B). Group A performed only kinesitherapy, Group B carried out the same kinesitherapy combined with the daily administration of food supplements such as Fortigel®, Vitamin C, sodium hyaluronate, manganese and copper, during the whole treatment period. Patients were evaluated at the time of recruitment (T0), at the end of the treatment (T1 - 3 weeks after T0) and 6 weeks after T1 (T2). The outcome measures used were: Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and Short Form-12 (SF-12).
Results: All the outcomes improved significantly at T1 in both groups, but more markedly in group B. Furthermore, in group A at T2, there was a statistically significant worsening in the scores of VAS, ODI and physical component of the SF-12, while in group B, this variation has not been detected.
Conclusion: The combination of rehabilitation based on McKenzie back exercises and oral viscosupplementation with Fortigel®, Vitamin C, sodium hyaluronate, manganese and copper represents a valid option in patients with chronic LBP, as it ensures pain relief and improvement in the quality of life and in lumbar spine functionality. These therapeutic benefits are more evident and long-lasting compared to those obtained with rehabilitation alone.
Keywords: Low back pain, osteoarthritis, rehabilitation, therapeutic exercise, McKenzie method, oral supplementation, hyaluronate sodium, collagen peptides, vitamine C.
Graphical Abstract
[http://dx.doi.org/10.1016/S0140-6736(18)30480-X] [PMID: 29573870]
[http://dx.doi.org/10.1016/S0140-6736(16)31678-6] [PMID: 27733282]
[http://dx.doi.org/10.1097/BRS.0b013e31815e7f94] [PMID: 18165754]
[http://dx.doi.org/10.1056/NEJM200102013440508] [PMID: 11172169]
[http://dx.doi.org/10.3174/ajnr.A4498] [PMID: 26359154]
[http://dx.doi.org/10.1016/S0140-6736(16)30970-9] [PMID: 27745712]
[http://dx.doi.org/10.1016/j.semarthrit.2007.01.007] [PMID: 17379279]
[http://dx.doi.org/10.1016/0005-2795(77)90211-2] [PMID: 577186]
[http://dx.doi.org/10.1520/JFS2003198] [PMID: 15171159]
[http://dx.doi.org/10.1007/s11926-012-0305-z] [PMID: 23307577]
[http://dx.doi.org/10.1097/BRS.0b013e3181aa5b33] [PMID: 20147869]
[http://dx.doi.org/10.1007/s11916-004-0075-z] [PMID: 15509467]
[http://dx.doi.org/10.1007/s00586-018-5673-2] [PMID: 29971708]
[http://dx.doi.org/10.1016/S0140-6736(18)30489-6] [PMID: 29573872]
[http://dx.doi.org/10.1016/S0004-9514(14)60110-0] [PMID: 15574109]
[http://dx.doi.org/10.1093/jn/129.10.1891] [PMID: 10498764]
[http://dx.doi.org/10.1080/09637480802498820] [PMID: 19212858]
[http://dx.doi.org/10.1016/j.ctim.2011.12.007] [PMID: 22500661]
[http://dx.doi.org/10.1007/s00441-003-0702-8] [PMID: 12658447]
[http://dx.doi.org/10.2147/JPR.S171729] [PMID: 30588084]
[http://dx.doi.org/10.1002/jsfa.6752] [PMID: 24852756]
[http://dx.doi.org/10.1074/jbc.M110.104950] [PMID: 20504769]
[http://dx.doi.org/10.1097/j.pain.0000000000000671] [PMID: 27434504]
[http://dx.doi.org/10.1016/j.mam.2005.07.015] [PMID: 16112185]
[http://dx.doi.org/10.1007/BF02563794] [PMID: 3117341]
[http://dx.doi.org/10.1016/j.joca.2011.01.001] [PMID: 21251991]
[http://dx.doi.org/10.1016/S1063-4584(07)61727-0]
[http://dx.doi.org/10.1185/030079908X291967] [PMID: 18416885]
[http://dx.doi.org/10.1021/jf8017029] [PMID: 18959406]
[http://dx.doi.org/10.1100/2012/167928] [PMID: 23226979]
[http://dx.doi.org/10.1186/1475-2891-7-3] [PMID: 18208600]
[PMID: 10555905]
[http://dx.doi.org/10.1016/j.fct.2004.11.006] [PMID: 15621331]
[http://dx.doi.org/10.1042/bj3080327] [PMID: 7755582]
[PMID: 2547540]
[http://dx.doi.org/10.1080/07315724.2013.875439] [PMID: 25387081]
[http://dx.doi.org/10.1080/10408690590956341] [PMID: 16048146]
[http://dx.doi.org/10.1016/S0021-9258(18)69232-4] [PMID: 3276690]
[http://dx.doi.org/10.1016/S0945-053X(01)00193-7] [PMID: 11852233]
[http://dx.doi.org/10.1002/jbmr.2709] [PMID: 26358868]
[http://dx.doi.org/10.1016/0304-4165(94)90145-7] [PMID: 7918577]
[http://dx.doi.org/10.1080/030097402760375179] [PMID: 12455818]
[http://dx.doi.org/10.1016/j.chembiol.2018.01.007] [PMID: 29398562]
[http://dx.doi.org/10.1053/joca.1999.0308] [PMID: 10966840]