Motion Sensor Biofeedback Improves Low Back Pain
Written by Editor   
Thursday, June 25, 2015 08:21 AM
Quick Brief: The use of motion-sensor biofeedback has a positive effect in reducing pain and limitations in activity in patients with low back pain and suggests that movement retraining using biofeedback is capable of resulting in sustained improvements, even after treatment finishes.


Changing a person's posture and movement using motion-sensor biofeedback reduces pain and reduces limitations in activity in patients with low back pain (LBP) compared with guidelines-based management, Danish researchers have found in a comparative effectiveness study.

"Our results suggest that where a relationship between movement and pain can be identified, movement retraining using biofeedback is capable of resulting in sustained improvements in pain and activity limitation, even after treatment finishes, and indicate that a fully powered trial is warranted," the authors wrote.

Relative improvements on these outcomes in the movement biofeedback group compared with the guidelines-based group ranged from 15% to 27% at 3 months to 35% to 47% at 12 months, which were all above the threshold for clinically important difference.

Treatment effects were "moderate to large" at the end of the 10-week treatment period, and they "remained or increased at the 12 month follow-up. 

Patients seeking primary care for subacute and chronic back pain were randomized to an intervention group, consisting of modification of movement patterns augmented by motion-sensor movement biofeedback, or a control group that received guidelines-based medical or physiotherapy care while wearing motion sensors without biofeedback.  Participants in both groups were assessed at baseline and attended six to eight consultations over a 10-week treatment period and also received advice on staying active and self-management of back pain. Usual medical and physiotherapy care were permitted.

Subjects wore a motion-sensor system for 4 to 10 hours during the day, and during and after each treatment session over the 10 weeks. The system consists of wireless motion-sensors that measured movement, movement velocity, and acceleration, and orientation to gravity; wireless surface electromyography sensors; a wireless recording device to capture sensor data; and a charging dock for the wireless devices. Clinicians had the ability to observe movement characteristics in real time, to download movement data from the recording device, and to compare movement patterns with previous assessments or with reference values.

Across 1 year, differences between groups on all of the primary outcome measures favored the motion sensor intervention. On 0 to 100 scales (0=unable to perform activity, 100=able to perform activity at the same level as before injury or problem), there was a 7.1-point difference on the Roland Morris Disability Questionnaire (RMDQ), a 10.3-point difference on the Patient Specific Functional Scale (PSFS), and a 7.7-point difference on the self-reported Quadruple Pain Visual Analogue Scale (QVAS).

The average difference between the groups in the rate of change over time also significantly favored the biofeedback group on all the primary outcomes, by 3.5 points on the RMDQ points, 4.7 points on the PSFS, and 4.8 points on the QVAS, for every 100 days since the baseline consult.

"These results are unusual and encouraging because they show moderate to large effects at the end of the 10-week treatment period that remained or increased at the 12-month follow-up, in a health condition where interventions typically show small to moderate effects that are not sustained 12 months later," authors state.