Improving self-management of lower back pain with a core activity detecting belt

使用核心活动检测带改善腰痛的自我管理

• 批准号: MR/X013464/1
• 负责人: Paul Bentley
• 金额: $ 191.71万
• 依托单位: Imperial College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FX013464%2F1
• 关键词: Improving; self; management; lower; back

Lower back pain is one of the commonest ailments seen by the NHS, and a leading cause of sick leave and disability. The UK Government recommends that first line treatment should be exercise, which is often more effective, safer and cheaper, than painkillers or back surgery. However exercise is only effective if performed regularly and appropriately. This may explain why prescribing exercise for the back often does not work - because people tire of exercises, or perform manoeuvres incorrectly. While physiotherapy can help with back exercises - by offering one-to-one personal training - this is a limited resource. Typically the NHS offers a small number of personalised exercise sessions, or a training class. But beyond this, back pain sufferers are merely provided with an exercise sheet, and expected to "get on with it" themselves.This project will develop a simple device that can encourage people to perform back exercises by themselves. The device is a belt that detects activity of "core" muscles in the trunk; and then displays this activity back to the user via a smartphone or smartwatch. This enables users to "see" their muscles contract; track their exercise performance, and strive to reach daily workout goals. Not only can this incentivize - in the same way that step-counters motivate walking - but the belt will also indicate to people if they are performing exercises correctly or not.The core muscles targeted are those that are worked on with back exercises. One set of muscles are the "Abs" (or "6-pack") that fitness fanatics know only too well; but others are a deeper thinner tummy muscle, and another one that runs down either side of the spine. When these other muscles are engaged with regular exercise, they can reduce or prevent back pain. However often people don't know how to engage them, even when they are shown by a physiotherapist. Hence the belt can show patients how to perform suitable exercises by enabling them to visualise the correct muscles that need to be contracted.In our earlier research we showed that our belt device is a reliable way of measuring core muscles contracting, by comparison with a gold standard method, that is a sophisticated instrument called EMG, used only in laboratories. We also showed that when people used our device, in combination with a feedback App during back exercises, they increased the amount of effort and time they put into exercise, whether prompted or unprompted. We also found that subjects using the device with muscle feedback performed back exercises more appropriately, activating the right set of muscles. These effects were found in people with or without back pain.Research participants felt more engaged and motivated to exercise when they used our invention; felt the belt was comfortable and the App easy to understand, and many wanted to use it again or purchase it.Given encouraging results from our early studies, we now wish to develop the device further to ensure that the belt design is sufficiently comfortable, and simple to apply, for people to want to use it at home, repeatedly for weeks, months or even years. We also want the App to be easily understood, so it can be used without professional assistance. We shall test the belt and App out on people who have back pain, who have attended their GP or seen a therapist to help with this. Our device will supplement standard treatment. After 2 months of use, we shall see what effect the device has had on their level of exercise, and back pain.We expect that patients with lower back pain will exercise more effectively and more often when provided with the muscle feedback belt, which is likely to reduce pain and disability. Given the expected cost of our device is low, and simple enough that anyone could put it on and use it, we expect our invention could be rolled out across the NHS, enabling effective self-care. This will reduce disability, dependency and reduce costs.

下背痛是NHS最常见的疾病之一，也是病假和残疾的主要原因。英国政府建议，一线治疗应该是运动，这通常比止痛药或背部手术更有效，更安全，更便宜。然而，只有定期和适当地进行锻炼才有效。这也许可以解释为什么给背部开运动处方通常不起作用--因为人们厌倦了运动，或者不正确地执行动作。虽然物理治疗可以帮助背部锻炼-通过提供一对一的个人训练-这是一个有限的资源。通常，NHS提供少量的个性化锻炼课程或培训课程。但除此之外，背痛患者只是得到一张运动单，并希望自己“继续下去”。本项目将开发一种简单的设备，可以鼓励人们自己进行背部锻炼。该设备是一条腰带，可以检测躯干中“核心”肌肉的活动;然后通过智能手机或智能手表将此活动显示给用户。这使用户能够“看到”他们的肌肉收缩;跟踪他们的运动表现，并努力达到日常锻炼目标。这不仅可以激励-以同样的方式，步计数器激励步行-但带也将指示人们，如果他们正在进行正确的运动或不。目标的核心肌肉是那些与背部练习工作。一组肌肉是健身狂热者非常熟悉的“腹肌”（或“6块肌”）;但其他肌肉是更深更薄的腹部肌肉，另一组肌肉则沿着脊柱两侧延伸。当这些其他肌肉进行定期锻炼时，它们可以减少或预防背痛。然而，人们往往不知道如何吸引他们，即使他们是由物理治疗师显示。因此，腰带可以向患者展示如何进行适当的锻炼，使他们能够可视化需要收缩的正确肌肉。在我们早期的研究中，我们证明了我们的腰带设备是一种可靠的测量核心肌肉收缩的方法，与金标准方法相比，金标准方法是一种称为EMG的复杂仪器，仅在实验室中使用。我们还表明，当人们在背部锻炼期间使用我们的设备与反馈应用程序相结合时，他们增加了他们投入锻炼的努力和时间，无论是提示还是自发的。我们还发现，使用带有肌肉反馈的设备的受试者更恰当地进行背部锻炼，激活了正确的肌肉。这些效果在有或没有背痛的人身上都有发现。研究参与者在使用我们的发明时感到更投入和更有动力去锻炼;感觉腰带很舒适，应用程序很容易理解，许多人想再次使用或购买它。鉴于我们早期研究的令人鼓舞的结果，我们现在希望进一步开发该设备，以确保腰带设计足够舒适，并且易于应用，让人们想在家里反复使用它几周、几个月甚至几年。我们还希望应用程序易于理解，因此无需专业人员协助即可使用。我们将测试腰带和应用程序的人谁有背部疼痛，谁参加了他们的家庭医生或看到治疗师，以帮助这一点。我们的设备将补充标准治疗。使用2个月后，我们将观察该设备对患者运动水平和背痛的影响。我们预计，当为下背痛患者提供肌肉反馈带时，他们将更有效地进行更频繁的运动，这可能会减少疼痛和残疾。考虑到我们的设备的预期成本很低，而且足够简单，任何人都可以戴上并使用它，我们希望我们的发明可以在NHS中推广，从而实现有效的自我护理。这将减少残疾、依赖和降低成本。