Back pain treating mindfulness and epidural stimulation recognised as 2016 research highlights by National Institutes of Health

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Back pain treating mindfulness and epidural stimulation recognised as 2016 research highlights by National Institutes of Health

Two spine-related studies have been recognised as the research highlights for 2016 by US National Institutes of Health (NIH). Research into the effects of meditation and cognitive behavioural therapy on low back pain has been regarded as “Clinical Breakthrough”, while a study investigating the ability of electrical epidural stimulation to help move the hands of paralysed individuals was regarded as“Promising Medical Advance”.

The mindfulness study revealed that meditation and cognitive-behavioural therapy can reduce chronic low back pain in adults , and it was published online in the Journal of the American Medical Association. Daniel Cherkin (Cherkin Health Research Institute, Seattle, USA) and colleagues enrolled 342 people, aged 20 to 70 years, who had back pain for more than three months that could not be attributed to a specific cause.  Participants were randomly assigned to one of three treatments groups: cognitive behavioural therapy, mindfulness-based stress reduction, or usual care. The individuals in the cognitive behavioural therapy and mindfulness groups who got exercise books and compact discs (CDs) to supplement weekly two-hour sessions, attended the program for eight weeks. The article states, "The usual care group could seek whatever treatment, if any, they wanted”.

At six months, functional improvement was found to be higher by 61% in the mindfulness group and 58% higer in the cognitive behavioural therapy group. As compared to baseline, only 44% of the usual care group experienced higher functional improvement. When compared to the usual care group, the amount of individuals reporting ameliorated back pain was significantly higher for the mindfulness and cognitive behavioural therapy groups. Moderate advantages were sustained for one year.

Cherkin in the NIH article said," training the brain to respond differently to pain signals may be more effective—and last longer—than traditional physical therapy and medications". The NCCIH director Josephine Briggs mentioned"The results from this research affirm that non-drug/non-opioid therapies, such as meditation, can help manage chronic low-back pain. Physicians and their patients can use this information to inform treatment decisions".

The proof-of concept study was the second piece of research recognised by the NIH testing the possibility of improving hand function in patients suffering from cervical spinal cord injury. It was used on upper limbs of people with severe spinal cord injuries for the first time, although this approach has been used to treat lower limbs before. The study was published in the Neurorehabilitation and Neural Repair.

Daniel Lu (University of California, Los Angeles, USA) and colleagues installed an array of 16 electrodes across the injury sites of two quadriplegic people with severe cervical spinal injury, who had been paralysed for over 18 months. As per a NIH report on the study, “The participants practiced grasping and moving a handgrip while receiving varying levels of electrical pulses from the devices. One person was tested daily for over 7 days and had weekly sessions for 8 weeks”.

Individuals  noticed an improvement in stregnth of their hands over the course of just one session, and the strength consistently improved over further sessions. Improvement in the control of their hands was also observed. It was interesting to note that the participants were able to sustain these results beyond the duration of stimulation. Patients made large gains in feeding, dressing, bathing, and grooming. Their mobility in bed and ability to get themselves in and out of bed improved as well. One participant regained the ability to pick up and drink as well.

According to Lu, through cervical epidural stimulation, hand and upper extremity function can be substantially improved, imparting the ability to participate in activities of daily living, self-care, transfer, and to live independently. The co-author V Reggie Edgerton (University of California, Los Angeles, USA) further added that even relatively minor gains in function of the upper limb can make huge differences in the quality of life for a person who can’t grasp anything. As per the report, the team plans to study the approach in more patients, with a longer follow-up.

Source:

NIH

Link to the source:

http://https://spinalnewsinternational.com/nih-recognises-back-pain-treating-mindfulness-and-epidural-stimulation-as-2016-research-highlights/

Original title of article:

NIH recognises back-pain treating mindfulness and epidural stimulation as 2016 research highlights

NIH
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