A Comparison between Different Types and Frequency of Physiotherapy Treatment for Children and Adolescents with Postural Problems and Low Back Pain

Abstract

Aim

To examine the effect of a once-a-week group physiotherapy session in addition to a once-a-month individual physiotherapy treatment, in comparison to a monthly individual physiotherapy treatment.

Methods

Fifty children and adolescents aged 10-18 years with poor back posture, some of whom had LBP, met individually with a physiotherapist once a month. The intervention group received an additional once-a-week group physiotherapy session for 12 weeks. Thorax curve angle, postural behavior, and low back pain (LBP) were measured before and after intervention.

Results

The thorax curve angle decreased from 39.2 ± 9.3 to 28.2 ± 6.8 (p < 0.001) in the group + individual therapy group and from 38.9 ± 9.3 to 27.9 ± 7.8 in the individual therapy only group (p < 0.001). LBP decreased from 5.6 ± 2.2 to 1.6 ± 1.9 (p < 0.001) and from 5.5 ± 2.1 to 2.8 ± 2.0 (p < 0.001). A significantly greater improvement in postural behavior was found in the group + individual therapy group (p = 0.04). Moreover, attrition rates were lower in the experimental group.

Conclusion

A lower-frequency individual physiotherapy treatment for 12 weeks proved as beneficial as the same program with an additional higher-frequency group physiotherapy in improving thorax curve angle and LBP. However, the higher-frequency group physiotherapy in addition to the lower-frequency individual treatment was significantly more effective in improving postural behavior and adherence to treatment.

KEYWORDS:

• Adolescents
• children
• low back pain (LBP)
• physiotherapy
• posture

Acknowledgements

The authors would like to thank Dinah Olswang for her editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Neta Vitman

Mrs. Neta Vitman is a registered Physiotherapist in Israel (BPT MPE). She practices in multiple clinics at the health maintenance organization Maccabi Health Services, mainly with children and adolescents. She is certified in two international methods, the Schrot Method for diagnosis and treatment of spinal disorders such as scoliosis and kyphosis, and the McKenzie Method for Mechanical Diagnosis and Therapy (MDT). Her interest is in preventive healthcare at a young age. The current study was part of her master thesis.

Devora Hellerstein

Dr. Devora Hellerstein (PhD) is a staff member of the School of Physical Education Teacher Education at the Academic College at Wingate, Israel. She is the Coordinator of English Studies and Head of the International Relations Department at the College. She is also a member of the Steering Committee of H-INET, Higher Education in Israel Network of English Teachers. Her courses and research focus on the preparation of students for academic purposes and intercultural competence.

Aviva Zeev

Mrs. Aviva Zeev is a statistician (MSc). She has taken part and assisted research projects in sports, education and physiology since 1975. She worked at the Academic College at Wingate, Tel-Hashomer and Meir Hospital, Israel, before her retirement.

Yael Gilo

Mrs. Yael Gilo is a registered Physiotherapist in Israel (BPT). She practices in a clinic at the health maintenance organization Maccabi Health Services. She is certified by the international organization as a Casey-Smith Manual Lymphatic Drainage therapist. She is also an orthopedic rehabilitation therapist.

Oren Nakdimon

Mr. Oren Nakdimon is a registered Physiotherapist in Israel (BPT) and a clinical instructor. He practices in a clinic at the health maintenance organization Maccabi Health Services. He is certified in the McKenzie Method for Mechanical Diagnosis and Therapy (MDT). He has published research on the assessment of the lower extremity with focus on the knee, and lectures on this subject.

Asaf Peretz

Dr. Asaf Peretz (MD, MBA). Israeli is Board certified in internal medicine. He is the Head of the internal medicine COVID-19 ward at Assuta Ashdod University Hospital, and Deputy Director of the hospital. He holds managerial responsibility over the physiotherapy department and other health-allied professions. He has interest in clinical and research collaboration with health-allied professions.

Sigal Eilat-Adar

Dr. Sigal Eilat-Adar is a registered nutritionist and an epidemiologist. She is the director of a second-degree program in Physical Activity and Healthy Lifestyle Education at The Academic College at Wingate, and a lecturer at Tel- Aviv University, both in Israel. She is the head of several health-related committees that published position papers on behlf of the Israeli Ministry of Health. Dr. Eilat-Adar is interested in subjects related to children's health including children with disabilities and therefore mentors students interested in this field.