INTRODUCTION:

Pain in the low back can be a result of conditions affecting the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen and the skin covering the lumbar area (Henschke N, Ostelo RW, Van Tulder MW, et al. 2010). Patients are often unsatisfied with conventional medical care and seek alternative or complementary therapies such as massage, chiropractic and mind-body techniques (Deyo RA, Diehl AK. 1986).

Eutony is one of the Mind-body technique and help patients with low back pain by enhancing body awareness. The essence of eutony lies in an attitude of awareness of oneself, in contact with others and with all manifestations of life.

The feeling of unity and integrity liberate the creative forces and develop the capacity to have contact with others without losing the own personality. By the eutony method, the involuntary tonus regulation and autonomic balance can be consciously influenced. Tonus is the level of tension of smooth and striated muscle fibers. Tonus is controlled by the peripheral nervous system and other physiological regulators and can be affected by psychological conditions. (Alicia B. Souto 2000).

METHODS:

After obtaining written informed consent, in-patients with chronic low back pain, who fulfilled the inclusion criteria like 30 to 60 years with continuous chronic low back pain for three to twelve months duration were recruited based on simple random sampling technique and enrolled in the study in Seventh day Adventist Hospital at Thanjavur. Patients with prior spinal surgery, psychoactive substance use, cognitive impairment and other pain related disorders were excluded from the study. The research was operated based on basic true experimental pretest –posttest design. Participants were randomly allocated in which 30 in experimental arm and 30 in control arm based on one to one session for 30-45 minutes thrice in a week for one month. 60 subjects were interviewed by using demographic variables such as gender, occupation, work pattern, history of medical problems and history of bad habits. The level of pain was observed and assessed by using visual analog scale (VAS).

After the pretest the experimental group received eutony as the treatment and control group received standard methods of care. Eutony steps includes touching and contact. In touching the boundaries of the body were experienced, while contact gives essential information about the external world and sensations coming from the outside. Eutonic contact also includes the surrounding space in awareness. Thus without touching the subjects were able to make real contact with other human beings and objects. It permits reestablishment of the equilibrium of the autonomic system. With eutonic movement which includes total body awareness presence through space is widened by means of contact. Posttest was conducted at the end of one month by using the same tool.

RESULTS:

Demographic distribution of patients according to their gender in experimental arm depicts that the highest (70%) were female and however least (30%) of them were male. Control arm showed that the majority (60%) were female and the least (40%) were male.

Their occupation in experimental arm showed that (50%) were employed and the remaining (50%) were unemployed. Control arm depicts that the highest (60%) were unemployed; however the least (40%) were employed.

Distribution of patients according to their work pattern in experimental arm depicts that the highest (60%) of them were heavy workers and (30%) of them were moderate workers, however (10%) of the patients were sedentary workers. Control arm depicts that the highest (60%) of the patients were moderate workers and (30%) of them were heavy workers, however only (10%) of the patients were sedentary workers.

According to their history of medical problems in experimental arm showed that the majority (70%) had no history of medical problems and only (30%) of them had the history of medical problems. Control arm showed that the majority (90%) had no history of medical problems and only (10%) of them had the history of medical problems.

According to their history of bad habits in experimental arm showed that the majority (60%) had no history of bad habit and only (40%) of them had the history of bad habits. Control arm showed that the majority (70%) had no history of bad habit and only (30%) of them had the history of bad habits.

Table 1: Comparison of mean and standard deviation of pretest and posttest pain scores between experimental arm and control arm

Arm	Pretest		Posttest
Arm	Mean	Standard deviation	Mean	Standard deviation
Experimental arm	16.9	12.1	12.2	10.6
Control arm	15.1	11	14.5	10.8

Comparison of mean and standard deviation of pretest and posttest pain scores in experimental arm showed 16.9(+ 12.1) and 12.2(+ 10.6) respectively. Likewise comparison of mean and standard deviation of pretest and posttest pain scores in control arm showed 15.1(+ 11) and 14.5(+ 10.8) respectively.

Table 2: Comparison of Paired t test value of pre and posttest pain scores between experimental arm and control arm

Arm	Paired t test value	Table value	Level of significance
Experimental arm	4.79	2.0452	P<0.05 Significant
Control arm	1.57	2.0452	P>0.05 Not Significant

Comparison of Paired t test value of pre and posttest pain scores between experimental arm and control arm showed 4.79 and 1.57 respectively which indicates the significance of Eutony on chronic back pain in experimental arm.

In experimental arm it was found that there was an association between the posttest pain scores and occupation (4.58), work pattern (5.75) with df=1 p< 0.05, whereas no association was found between other demographic variables such as gender (1.52), history of medical problems (1.35), history of bad habits (2.55) and the posttest pain scores with df=1, p> 0.05. In control arm it was found that there was no association between gender (2.74), occupation (2.33), work pattern (1.50), history of medical problems (2.01), history of bad habits (1.09) and the posttest pain scores with df=1, p> 0.05.

DISCUSSION:

The lack of statistically significant research studies with eutony for chronic low back pain in India and moreover this intervention has not been well defined in clinical research which in turn a wide research gap exists. It is extremely important for the nurses to take an active role in the development and implementation of eutony for the betterment of chronic low back pain. Patients had clinically significant improvement with eutony in experimental arm and the statistical non significance was found with control arm.

REFERENCES:

1. Alicia B. Souto, (2000) “The Eutony Method” The Yoga Research Society.

2. Clarke JA, Van Tulder MW, Blomberg SE, et al., (2010) “Traction for low-back pain with or without sciatica” Cochrane Database Systematic Reviews ,Oct;(5):CD003010.

3. Henschke N, Ostelo RW, Van Tulder MW, et al., (2010) “Behavioural treatment for chronic low-back pain” Cochrane Database Systematic Reviews; (7):CD002014.

4. Chou R, Huffman LH, (2007) “Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline” Annals of Internal Medicine; 147: 505-514.

5. Chou R, Huffman LH, (2007) “Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline” Annals of Internal Medicine; 147:492-504.

6. Deyo RA, Diehl AK, (1986) “Patient satisfaction with medical care for low -back pain” Spine; 11(1): 28-3 0.

7. Dixit R, Firestein GS, Budd RC, Gabriel SE, et al., (2012) “Low back pain” Kelly's Textbook of Rheumotology. 9th ed. Philadelphia, PA: Elsevier Saunders; Chap 47.

8. Manchikanti L, Abdi S, Atluri S, et al., (2013) “An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain” Pain Physician; 16(2):49-283.

Received on 27.08.2014 Modified on 15.09.2014

Asian J. Nur. Edu. and Research 5(1): Jan.-March 2015; Page121-123

DOI: 10.5958/2349-2996.2015.00026.9

Eutony on Chronic Low Back Pain