Publications by authors named "Martin B Weigl"

3 Publications

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Is multidisciplinary rehabilitation for low back pain effective in patients above 65 years? An observational cohort study with 12-month follow-up.

Eur J Phys Rehabil Med 2021 Jun 15. Epub 2021 Jun 15.

Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany -

Background: In contrast to the broad evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) in chronic low back pain (CLBP) patients of working age, little is known about the benefit in patients aged ≥ 65 years.

Aim: To quantify the short-term and 12-month effects of a 3-week CLBP specific MBR program in patients ≥ 65 years of age; to compare the effects in patients ≥ 65 years of age to the effects in younger patients.

Design: Observational prospective cohort study.

Setting: Outpatient clinic at a tertiary physical medicine and rehabilitation centre.

Population: Consecutive patients with CLBP who participated in a CLBP a specific MBR program.

Methods: The 3-week MBR program included 44 hours of treatment. The primary outcomes pain and disability were measured by the North American Spine Society Questionnaire (NASS). Secondary outcome measures were the Short-Form 36 (SF-36) and the numerical rating scale for pain. Effects were quantified using effect sizes (ES).

Results: From 203 included patients, 104 patients older than 65 years (mean: 70.7; SD: 4.0) were compared to 99 patients younger than 65 years (mean: 56.4; SD: 6.7). The older patients had more comorbidities (two or more comorbidities: 49.5% versus 23.5%; p < 0.001). Both groups showed significant improvements in pain and disability at discharge (both groups: p<0.001) and at the 12 months' follow-up (old: p < 0.001; young: 0.039) with slightly higher effects for the older patients compared to the younger patients (discharge: ES = 0.67 versus ES = 0.53; 12 months: ES = 0.42 versus ES = 0.29). Both groups also improved in the SF-36 Physical Component Summary with slightly lower effects for the older patients (discharge: ES =0.31, p<0.001 versus ES=0.43, p<0.001; 12 months: ES=0.27, p=0.025 versus ES=0.39, p=0.001). The group differences of the change scores were not significant in any of the outcome measures.

Conclusions: MBR shows similar improvements in pain and disability in patients aged ≥ 65 compared to younger patients for at least 12 months.

Clinical Rehabilitation Impact: The findings support the concept of MBR in the growing population of CLBP patients older than 65 years of age.
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http://dx.doi.org/10.23736/S1973-9087.21.06553-9DOI Listing
June 2021

Microcurrent therapy in the treatment of knee osteoarthritis: could it be more than a placebo effect? A randomized controlled trial.

Eur J Phys Rehabil Med 2020 Aug 15;56(4):459-468. Epub 2020 Apr 15.

Department of Orthopedics, Physical Medicine, and Rehabilitation, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.

Background: Microcurrent therapy (MCT) is a novel electrotherapy modality with very low current-levels that may reduce pain especially in joints and muscles.

Aim: The aim of this study is to explore potential effects of MCT on pain in patients with knee osteoarthritis, to explore effects of different treatment parameters and to distinguish them from placebo-effects.

Design: Randomized four arms controlled clinical trial.

Setting: Outpatient tertiary medical care center.

Population: Fifty-six patients with knee OA (Kellgren-Lawrence Score II or III, 14 male and 38 female, mean age: 71.7±7.3 years, pain intensity higher than Numeric Rating Scale [NRS] score 3 from 10).

Methods: Patients were randomized into four groups: MCT with 100 µA (group A), MCT with 25 µA (group B), sham-treatment (group C) and a control-group without intervention. Treatment groups received 10 sessions of MCT for 30 minutes each over a period of 22 days. The primary outcome was daily pain intensity throughout the treatment period measured by a NRS from 0-10. Second outcome measurements were the Knee Osteoarthritis Outcome Score (KOOS), the SF-36 Questionnaire, the Six-Minute Walking Test and the Get-Up-and-Go Test.

Results: Evening pain was reduced significantly in the verum-groups compared to sham group (Group A vs. Group C: P<0.001, Group B vs. Group C: P=0.006) and to no intervention (Group A vs. Group D: P<0.001, Group B vs. Group D: P=0.002). The difference between sham-therapy and no therapy was not significant. In the pre-post analysis of the KOOS group A improved significantly in the subscale Symptoms. Group A and B and D improved in the Activities of Daily Living subscale.

Conclusions: The results of this RCT suggest that MCT has beneficial effects on pain in patients with knee osteoarthritis that are not explained by a placebo effect. Due to the explorative, pilot character of the study, further confirmation is needed before clear recommendations can be given.

Clinical Rehabilitation Impact: More high-quality RCTs with transparent parameters should be investigated to elucidate potential effects of MCT in the field of physical medicine and rehabilitation. At the present time MCT is a treatment option that could be helpful, in particular for patients who are afraid of unpleasant sensations from electrotherapy with stronger currents.
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http://dx.doi.org/10.23736/S1973-9087.20.05921-3DOI Listing
August 2020

Multidisciplinary biopsychosocial rehabilitation in chronic neck pain: a naturalistic prospective cohort study with intraindividual control of effects and 12-month follow-up.

Eur J Phys Rehabil Med 2019 Oct 21;55(5):665-675. Epub 2018 Nov 21.

Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany -

Background: In contrast to the large evidence of the effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) in chronic low back pain, little is known about the effects of MBR in chronic neck pain (CNP).

Aim: To quantify short-term and 12-month effects of a 3-week CNP-specific MBR program.

Design: Naturalistic prospective observational cohort study with intraindividual control of effects.

Setting: Outpatient clinic at a tertiary physical medicine and rehabilitation center.

Population: Consecutive patients with CNP (N.=81) who participated in a CNP-specific MBR.

Methods: The intervention was a MBR outpatient clinic program. Primary Outcome was the North American Spine Society (NASS) questionnaire pain/function scale. Secondary outcomes included the NASS scale neurogenic symptoms, Short-Form 36 Health Survey (SF-36) and numerical rating scales (NRS) for maximum and average pain. Short-term changes of health were quantified using effect sizes (ES), which were corrected by the change during waiting time before MBR.

Results: At the end of treatment, the NASS pain/function scale showed significant improvement (P<0.001) by a moderate corrected ES (ES=0.59). Moderate significant improvements were also found for the NASS scale neurogenic symptoms (ES=0.65), the SF-36 scales bodily pain (ES=0.56) and mental health (ES=0.54), and the NRS maximum pain (ES=0.59). Significant small corrected ES were found for the SF-36 scales physical functioning (ES=0.32), physical role (ES=0.41), vitality (ES=0.42), social functioning (ES=0.41), emotional role (ES=0.41) and the NRS average pain (ES=0.48). The improvement on the SF-36 scale general health was not significant (ES=0.19). At the follow-up after 12 months, the NASS pain/function scale remained its moderate ES (ES=0.52, P value <0.001). Also, the NASS Scale neurogenic symptoms, the SF-36 scales bodily pain, general health, social functioning and mental health and both NRS pain scales showed significant benefits.

Conclusions: This study showed that MBR may be effective in patients with CNP. Maintenance of moderate benefits in pain and function seems possible for at least 12 months.

Clinical Rehabilitation Impact: The findings support the concept of CNP-specific MBR.
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http://dx.doi.org/10.23736/S1973-9087.18.05348-0DOI Listing
October 2019