Background Low back pain (LBP) is a major cause of physical limitations and absenteeism at work throughout the world1. A number of studies have demonstrated the effectiveness of therapeutic exercises on reducing pain symptoms and improving function in patients with chronic LBP.2-4 Global Postural Reeducation (GPR) technique, theoretically consists of a reestablishment of the balance in the myofascial tension of different chains of muscles. GPR is based on the notion that a shortened muscle creates compensations in other proximal or distal muscles.5 One systematic review assessed the use of GPR for different conditions of the musculoskeletal system and found only one RCT that demonstrated a significant improvement in functional capacity in patients with ankylosing spondylitis.5 However, there are no previous randomized, controlled, clinical trials assessing the effectiveness of GPR on chronic LBP.
Objectives To assess the effectiveness of global postural reeducation (GPR) on pain, function, quality of life and depressive symptoms in patients with chronic LBP.
Methods Sixty-one patients with chronic LBP were randomly allocated to either the GPR group or a control group. Patients in the GPR group underwent one weekly 60-minute session of GPR for a period of 12 weeks. The control group remained on the waiting list under clinical treatment, with no physical intervention. Pain, function capacity, quality of life and depressive symptoms were assessed using a visual analog scale (VAS), the Roland-Morris questionnaire (RMQ), the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Beck Inventory, respectively. The evaluations were performed by a blinded examiner at baseline, three months and six months after the initial evaluation and the data were analysis using an intention to treat approach.
Results The GPR group demonstrated significant improvements in pain (p<0.001) and function (p<0.001) as well as the domains: pain (p=0.047), emotional aspects (p=0.008), limitation in physical functioning (p=0.040), vitality (p=0.003) and mental health (p=0.034) of the SF-36.
Conclusions Based on the findings, GPR proved to be effective regarding pain, function and some domains of quality of life in chronic LBP patients.
Lidgren L. The bone and joint decade 2000-2010. Bulletin of the World Health Organization 2003;81(9):629.
Snook SH, Webster BS, McGorry RW, Fogleman MT, McCann KB. The Reduction of Chronic Nonspecific Low Back Pain through the Control of Early Lumbar Flexion. Spine 1998;23(23):2601-2607.
Hsieh CYJ, Adams AH, Tobis J, Hong CZ, Danielson C, Platt K, Hoehler Fred, Reinsch S, Rubel A. Effectiveness of four conservative treatments for subacute Low Back Pain. Spine 2002;27(11):1142-1148.
Mannion AF, Mutineer M, Taimela S, et al. A Randomized Clinical Trial of three active therapies for chronic low back pain. Spine 1999;24:2435-2448.
Vanti C, Generali A, Ferrari S, Nava T, Tosarelli D, Pillastrini P. La Reeducation Posturale Globale in musculoskeletal diseases: scientific evidence and clinical practice. Reumatismo, 2007;59(3):192-201.
Disclosure of Interest None Declared