TY - GEN A1 - Niederer, Daniel A1 - Vogt, Lutz A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Pfeifer, Ann-Christin A1 - Schiltenwolf, Marcus A1 - Banzer, Winfried A1 - Mayer, Frank T1 - Medicine in spine exercise (MiSpEx) for nonspecific low back pain patients BT - study protocol for a multicentre, single-blind randomized controlled trial T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background: Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain. Methods and study design: A multicentre, single-blind two-armed randomized controlled trial to evaluate the effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires – clinical examination – biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing. Discussion: The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain. Trial registration: Identification number DRKS00010129. German Clinical Trial registered on 3 March 2016. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 444 KW - sensorimotor training KW - motor control KW - exercise KW - low back painExercise KW - functional capacity KW - individualized intervention Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-407308 IS - 444 ER - TY - JOUR A1 - Niederer, Daniel A1 - Vogt, Lutz A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Pfeifer, Ann-Christin A1 - Schiltenwolf, Marcus A1 - Banzer, Winfried A1 - Mayer, Frank T1 - Medicine in spine exercise (MiSpEx) for nonspecific low back pain patients: study protocol for a multicentre, single-blind randomized controlled trial JF - Trials N2 - Background: Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain. Methods and study design: A multicentre, single-blind two-armed randomized controlled trial to evaluate the effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires - clinical examination biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing. Discussion: The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain. KW - Sensorimotor training KW - Motor control KW - Low back pain KW - Exercise KW - Functional capacity KW - Individualized intervention Y1 - 2016 U6 - https://doi.org/10.1186/s13063-016-1645-1 SN - 1745-6215 VL - 17 PB - BioMed Central CY - London ER - TY - GEN A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Arampatzis, Adamantios A1 - Banzer, Winfried A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Schmidt, Hendrik A1 - Schneider, Christian A1 - Mayer, Frank T1 - Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network) N2 - Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 351 KW - Back pain prognosis KW - Back pain diagnosis KW - Pain screening KW - PROGRESS/TRIPOD KW - Prediction of disability/intensity KW - Yellow flags KW - Exercise Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-403424 ER - TY - JOUR A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Arampatzis, Adamantios A1 - Banzer, Winfried A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Schmidt, Hendrik A1 - Schneider, Christian A1 - Mayer, Frank T1 - Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network) JF - Pain reports N2 - Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments. KW - Back pain prognosis KW - Back pain diagnosis KW - Pain screening KW - PROGRESS/TRIPOD KW - Prediction of disability/intensity KW - Yellow flags KW - Exercise Y1 - 2017 U6 - https://doi.org/10.1097/PR9.0000000000000623 VL - 9 SP - 1 EP - 11 PB - Wolters Kluwer Health CY - Riverwoods, IL ER - TY - GEN A1 - Wippert, Pia-Maria A1 - Drießlein, David A1 - Beck, Heidrun A1 - Schneider, Christian A1 - Puschmann, Anne-Katrin A1 - Banzer, Winfried A1 - Schiltenwolf, Marcus T1 - The Feasibility and Effectiveness of a New Practical Multidisciplinary Treatment for Low-Back Pain BT - A Randomized Controlled Trial T2 - Postprints der Universität Potsdam : Mathematisch Naturwissenschaftliche Reihe N2 - Low-back pain is a major health problem exacerbated by the fact that most treatments are not suitable for self-management in everyday life. Particularly, interdisciplinary programs consist of intensive therapy lasting several weeks. Additionally, therapy components are rarely coordinated regarding reinforcing effects, which would improve complaints in persons with higher pain. This study assesses the effectiveness of a self-management program, firstly for persons suffering from higher pain and secondly compared to regular routines. Study objectives were treated in a single-blind multicenter controlled trial. A total of n = 439 volunteers (age 18–65 years) were randomly assigned to a twelve-week multidisciplinary sensorimotor training (3-weeks-center- and 9-weeks-homebased) or control group. The primary outcome pain (Chronic-Pain-Grade) as well as mental health were assessed by questionnaires at baseline and follow-up (3/6/12/24 weeks, M2-M5). For statistical analysis, multiple linear regression models were used. N = 291 (age 39.7 ± 12.7 years, female = 61.1%, 77% CPG = 1) completed training (M1/M4/M5), showing a significantly stronger reduction of mental health complaints (anxiety, vital exhaustion) in people with higher than those with lower pain in multidisciplinary treatment. Compared to regular routines, the self-management–multidisciplinary treatment led to a clinically relevant reduction of pain–disability and significant mental health improvements. Low-cost exercise programs may provide enormous relief for therapeutic processes, rehabilitation aftercare, and thus, cost savings for the health system T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 840 KW - low-back pain KW - multidisciplinary pain treatment KW - sensorimotor exercise training KW - classical conditioning KW - executive function KW - MiSpEx Network Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-445814 SN - 1866-8372 IS - 840 ER - TY - GEN A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Banzer, Winfried A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Schneider, Christian A1 - Mayer, Frank T1 - Personalized treatment suggestions BT - the validity and applicability of the risk-prevention-index social in low back pain exercise treatments T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background: The back pain screening tool Risk-Prevention-Index Social (RPI-S) identifies the individual psychosocial risk for low back pain chronification and supports the allocation of patients at risk in additional multidisciplinary treatments. The study objectives were to evaluate (1) the prognostic validity of the RPI-S for a 6-month time frame and (2) the clinical benefit of the RPI-S. Methods: In a multicenter single-blind 3-armed randomized controlled trial, n = 660 persons (age 18–65 years) were randomly assigned to a twelve-week uni- or multidisciplinary exercise intervention or control group. Psychosocial risk was assessed by the RPI-S domain social environment (RPI-SSE) and the outcome pain by the Chronic Pain Grade Questionnaire (baseline M1, 12-weeks M4, 24-weeks M5). Prognostic validity was quantified by the root mean squared error (RMSE) within the control group. The clinical benefit of RPI-SSE was calculated by repeated measures ANOVA in intervention groups. Results: A subsample of n = 274 participants (mean = 38.0 years, SD 13.1) was analyzed, of which 30% were classified at risk in their psychosocial profile. The half-year prognostic validity was good (RMSE for disability of 9.04 at M4 and of 9.73 at M5; RMSE for pain intensity of 12.45 at M4 and of 14.49 at M5). People at risk showed significantly stronger reduction in pain disability and intensity at M4/M5, if participating in a multidisciplinary exercise treatment. Subjects at no risk showed a smaller reduction in pain disability in both interventions and no group differences for pain intensity. Regarding disability due to pain, around 41% of the sample would gain an unfitted treatment without the back pain screening. Conclusion: The RPI-SSE prognostic validity demonstrated good applicability and a clinical benefit confirmed by a clear advantage of an individualized treatment possibility. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 690 KW - back pain diagnosis KW - pain screening KW - exercise treatment KW - yellow flags Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-471993 SN - 1866-8364 IS - 690 ER - TY - JOUR A1 - Wippert, Pia-Maria A1 - Drießlein, David A1 - Beck, Heidrun A1 - Schneider, Christian A1 - Puschmann, Anne-Katrin A1 - Banzer, Winfried A1 - Schiltenwolf, Marcus T1 - The Feasibility and Effectiveness of a New Practical Multidisciplinary Treatment for Low-Back Pain BT - A Randomized Controlled Trial JF - Journal of Clinical Medicine N2 - Low-back pain is a major health problem exacerbated by the fact that most treatments are not suitable for self-management in everyday life. Particularly, interdisciplinary programs consist of intensive therapy lasting several weeks. Additionally, therapy components are rarely coordinated regarding reinforcing effects, which would improve complaints in persons with higher pain. This study assesses the effectiveness of a self-management program, firstly for persons suffering from higher pain and secondly compared to regular routines. Study objectives were treated in a single-blind multicenter controlled trial. A total of n = 439 volunteers (age 18–65 years) were randomly assigned to a twelve-week multidisciplinary sensorimotor training (3-weeks-center- and 9-weeks-homebased) or control group. The primary outcome pain (Chronic-Pain-Grade) as well as mental health were assessed by questionnaires at baseline and follow-up (3/6/12/24 weeks, M2-M5). For statistical analysis, multiple linear regression models were used. N = 291 (age 39.7 ± 12.7 years, female = 61.1%, 77% CPG = 1) completed training (M1/M4/M5), showing a significantly stronger reduction of mental health complaints (anxiety, vital exhaustion) in people with higher than those with lower pain in multidisciplinary treatment. Compared to regular routines, the self-management–multidisciplinary treatment led to a clinically relevant reduction of pain–disability and significant mental health improvements. Low-cost exercise programs may provide enormous relief for therapeutic processes, rehabilitation aftercare, and thus, cost savings for the health system KW - low-back pain KW - multidisciplinary pain treatment KW - sensorimotor exercise training KW - classical conditioning KW - executive function KW - MiSpEx Network Y1 - 2019 U6 - https://doi.org/10.3390/jcm9010115 SN - 2077-0383 VL - 9 IS - 115 PB - MDPI CY - Basel ER -