title: Managing chronic nonspecific low back pain with a sensorimotor retraining approach: exploratory multiple-baseline study of 3 participants.
abstract: BACKGROUND
  Current approaches to the management of chronic nonspecific low back pain (CNSLBP) have shown limited effectiveness. It appears that disruption of cortical structure and function is a feature of CNSLBP and that these changes may contribute to current treatment failures. Sensorimotor retraining approaches have been shown to be effective in the management of other long-standing pain problems that are characterized by cortical dysfunction. Similar treatments may be an option for people with CNSLBP.
  
  
  OBJECTIVE
  The objectives of this study were to describe the effects of participation in a graded sensorimotor retraining program on pain intensity, interference of pain with daily life (pain interference), and self-reported disability and to evaluate the safety of the program.
  
  
  METHODS
  A multiple-baseline, replicated, single-case design was used for this study.
  
  
  METHODS
  Three people with disabling CNSLBP were assessed weekly during a no-treatment baseline period. Each person then participated in a graded sensorimotor retraining program for a minimum of 10 weeks, during which clinical status was assessed weekly. Data collection continued weekly for 1 month after the end of formal treatment.
  
  
  RESULTS
  Pain intensity, pain interference, and disability all were reduced, and the improvements were maintained throughout the follow-up period. No adverse reactions to treatment were reported.
  
  
  CONCLUSIONS
  The findings are preliminary and were based on a single-case design. The observed improvements in clinical status may have been attributable to the effects of factors other than treatment, such as the effect of time and other, nonspecific effects.
  
  
  CONCLUSIONS
  Positive outcomes were reported for 3 participants with CNSLBP after the completion of a graded sensorimotor retraining program. However, the findings are only preliminary and require replication with more-robust study designs.
authors.affiliation: School of Physiotherapy, The University of Notre Dame Australia, PO Box 1225, 19 Mouat St, Fremantle, Western Australia 6959, Australia. bwand@nd.edu.au
authors.forename: Benedict M
authors.initials: BM
authors.lastname: Wand
authors.forename: Neil E
authors.initials: NE
authors.lastname: O'Connell
authors.forename: Flavia
authors.initials: F
authors.lastname: Di Pietro
authors.forename: Max
authors.initials: M
authors.lastname: Bulsara
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000503:physiopathology; D002908:Chronic Disease; D056228:Feedback, Sensory; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities