The influence of therapeutic exercise on subsequent occurrence of lower extremity musculoskeletal dysfunction within one year of a low back pain diagnosis in the military health system

Date

2024-05

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Abstract

The primary purpose of this study was to determine the impact of receiving therapeutic exercise (TE) to manage low back pain (LBP), adjusted for demographic factors, on the time-to-occurrence of subsequent lower extremity (LE) dysfunction within 1 year of LBP diagnosis in beneficiaries of the Military Health System (MHS). The secondary purpose was to examine the impact of the number of TE sessions adjusted for associated demographic factors on the time-to-occurrence of subsequent LE dysfunction within 1 year of LBP diagnosis in the beneficiaries who received TE. In this secondary analysis, a total of 452,668 individuals diagnosed with LBP in the MHS between January 2015 and December 2019 were identified to be eligible participants who were followed for 1 year during which a hip, knee, or ankle/foot dysfunction occurred. Participants were placed into one of two groups: those receiving TE or those not receiving TE. Cox proportional hazards regression models were used to examine the utilization of TE and the number of TE sessions adjusted for demographic factors of interest on the time-to-occurrence of subsequent hip, knee, and ankle injury, respectively. Patients who received TE demonstrated a significantly decreased risk in time-to-occurrence for subsequent LE injuries that decreased further with each additional appointment, in the year following LBP diagnosis. In addition, several demographic factors significantly increased the risk of subsequent hip, knee, or ankle/foot injury including age, being on active duty, seeking care in the emergency room or urgent care, and being in the Army, whereas other factors such as being in the navy, being in the Coast Guard, or being an officer significantly reduced the risk of time-to-occurrence of LE dysfunction in the year following LBP diagnosis. In conclusion, individuals who did not receive TE for their LBP had an increased risk of subsequent LE injury or dysfunction in the year following the episode of LBP. Further, in individuals who did receive TE, the risk of subsequent LE dysfunction significantly decreased with each additional session. The results of the study can inform decisions related to treatment and return to work and sport after LBP.

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Keywords

Health Sciences, Rehabilitation and Therapy

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