196 Jamnik / Rehabilitacija - letn. VII, supl. 3 (2008) THE EFFECTIVENESS OF LUMBOSACRAL ORTHOSIS IN PATIENTS WITH CHRONIC DISCOGENIC LOW BACK PAIN H. Jamnik Institute for rehabilitation, Ljubljana, Slovenia Institute for rehabilitation, Ljubljana, Slovenia discogenic low back pain were randomized into 3 groups (wearing an elastic lumbosacral orthosis for 1 week at least 8 hours a day, receiving standard physiotherapy or no treatment). They were evaluated at the level of pain (visual analogue scale), activities (Oswestry disability questionnaire and Rolland Morris questionnaire) and quality of life (SF-36). According to the first results (first 15 consecutive patients) no significant difference in any of our groups was observed. Abstract Lumbosacral orthosis is widely used for patients suf- fering from low back pain due to various conditions. The aim of this study was to evaluate the effectiveness of the elastic lumbosacral orthosis in patients with chronic discogenic low back pain. 30 consecutive patients presenting to physical medicine and reha- bilitation outpatient clinic with chronic (>3 months), INTRODUCTION Lumbosacral orthosis is widely used for patients suffering from low back pain due to various conditions. There are many proposed mechanisms of action alleviating low back pain, like restriction of trunk motion, reduction in required back muscle forces, increase in abdominal pressure, prop- rioceptive stimuli and even local temperature elevation. The existing evidence regarding effectiveness of lumbosacral orthosis is conflicting. The objective of this study was to evaluate the effectiveness of the elastic lumbosacral orthosis in patients with chronic discogenic low back pain. METHODS AND SUBJECTS Methods Subjects were randomized into 3 groups: wearing an elastic lumbosacral orthosis for 1 week at least 8 hours a day, receiv- ing standard physiotherapy one week or no treatment. They were evaluated at the level of pain (visual analogue scale), activities (Oswestry disability questionnaire and Rolland Morris questionnaire) and quality of life (SF-36) three times: before treatment, immediately after treatment and 2 weeks after prescription of orthosis or therapy. Subjects Subjects 30 consecutive patients presenting to physical medicine and rehabilitation outpatient clinic with chronic (>3 months) low back pain with discogenic characteristics were included in the study. RESULTS The study is still in progress, but according to the first results (first 15 consecutive patients) no significant dif- ference between the first and the second evaluation or the first and the last evaluation in any of our groups was observed, except in the group wearing a lumbosacral orthosis in respect of average pain intensity (between the first and the second evaluation), which got even worse (p=0.043). DISCUSSION The study is still in progress, so the results are inconclusive. The fact that none of the chosen outcome measures has not detected any significant improvement so far, supports the idea, that it is very difficult to improve the status of chronic pain patients with orthotic or physical therapy interventions only. CONCLUSION Results of the first analysis do not support any of the cho- sen interventions to be effective for patients with chronic discogenic low back pain. 197 R References eferences: 1. Oakley JC. An update on treatment of chronic low back pain. Critical Review in Physical and Rehabilitation Medicine 2003; 15(2):113-140. 2. Solomon J, Lutz G, Cooke P, Gage T. Discogenic low back pain. Critical Review in Physical and Rehabilitation Medicine 2004; 16(3):177-210. 3. Kawaguchi Y, Gejo R, Kanamori M, Kimura T. Quanti- tative analysis of the effect of lumbar orthosis on trunk muscle strength and muscle activity in normal subjects. J Orthop Sci 2002; 7:483-489. 4. Pengel HM, Maher CG, Refshauge KM. Systematic review of conservative interventions for subacute low back pain. Clin Rehab 2002;16:811-820. 5. Alaranta H, Hurri H. Complaince and subjective relief by corset treatment in chronic low back pain. Scand J Rehab Med 1988;20:133-136. Jamnik / Rehabilitacija - letn. VII, supl. 3 (2008)