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NeuRA Magazine #20

SLEEP AND BACK PAIN

A new study that seeks to find improved ways to deal with back pain seeks participants.

Edel O’Hagan with a volunteer

Back pain researchers at NeuRA know that there is a shared relationship between sleep and pain. Typically, the higher the pain intensity the worse a person sleeps. Conversely, after a few bad nights’ sleep a person with lower back pain may perceive their pain to be even worse.

PhD student and physiotherapist Edel O’Hagan is currently working on a study that investigates whether using a medication, usually used for sleep disturbances can help people with acute back pain – that is, pain that has lasted less than three months.

“In this trial we are investigating whether improving sleep has a knock-on effect on improving lower back pain intensity,” she explains.

The medication used in the study acts on a neurotransmitter called GABA, which has a number of roles in the brain, but is primarily involved in calming overexcited neurons, such as those involved in transmitting pain.

The procedure involves a visit to NeuRA, where participants are reviewed by a physician and given the intervention tablets – either a sleep medication or a sugar pill. They take one tablet a night for 14 nights. Over this time participants keep a sleep diary and wear a monitor on their back to measure movements during sleep. They will also fill out questionnaires, online on day one, at two weeks and at six weeks.

“Participants don’t need to change anything they are currently doing to manage their back pain,” Edel assures.

It is hoped that this research will identify a new way to stop low back pain from developing into a long-term chronic condition.

Edel, who is part of the McAuley group, is looking to recruit more patients for the study. To get involved, email pain@neura.edu.au or call 02 9399 1618.

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Own Your Balance

Research investigating the impacts of cognitive behavioural therapy and balance programs on fear of falling, funded by Mindgardens. Falls and fear of falling affect many older people and can impose limitations upon daily activities. Over one third of community dwelling older people fall each year with about 15% of falls being injurious. However, two thirds of older people express a fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities, and subsequent deterioration of health and wellbeing. Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy (CBT) and balance exercise programs. However, these face-to-face treatments are resource intensive and not readily accessible to people. Furthermore, the effects of these treatments on fear of falling are small and often do not last beyond the duration of the program. By utilising technology and providing tailored physical activity guidance we are aiming to reduce a fear of falling in an accessible, efficient and lasting way. A thee-arm randomised clinical trial will be conducted in 189 community-dwelling older adults with a substantial concern of falling. Participants will be randomly allocated into one of three groups in order to test whether a self-managed CBT intervention, alone or in combination with a graded balance activity program, can reduce concerns about falling in older adults when compared to usual care. We are collaborating with the Black Dog institute to provide a home-based cognitive behavioural therapy program that addresses a fear of falling. We will also be utilising our cutting-edge balance program StandingTall to provide a graded balance program.   Related studies: https://www.neura.edu.au/project/reducing-fear-of-falling-and-activity-avoidance-in-older-adults-with-disproportionate-levels-of-fear-of-falling/ https://www.neura.edu.au/project/standingtall-plus-a-multifactorial-program-to-prevent-falls-in-older-people/ https://www.neura.edu.au/project/standing-tall/
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