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Findings A total of 1928 participants with a median age of 44 years ( 71.6 % female ) were included and followed-up for a median of 39 days , although only 1650 ( 85.6 %) opted to receive the booster dose .
During the follow-up period , a total of 44 COVID-19 infections occurred ( incidence rate , 60.2 per 100,000 person-days ). Of these , 70.5 % were symptomatic but only five occurred in those who had been given a booster dose of BNT162b2 , of which three were symptomatic . The calculated hazard ratio for COVID-19 infection for booster-immunised ( that is , those with a third dose ) compared with booster-nonimmunised ( two doses ) was 0.07 ( 95 % CI 0.02 – 0.20 , p < 0.001 ), that is , a 93 % reduced risk of infection . There was also a noticeable increase in IgG antibody levels within five days of the third vaccine dose .
The authors concluded that a third dose significantly reduced the chance of becoming infected compared with only having two doses and suggested that ongoing surveillance was needed to assess the durability of these findings .
References 1 Polack FP et al . Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine . N Engl J Med 2021 ; 383:2603 – 15 . 2 Haas EJ et al . Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases , hospitalisations , and deaths following a nationwide vaccination campaign in Israel : an observational study using national surveillance data . Lancet 2021 ; 397:1819 – 29 . 3 Goldberg Y et al . Waning immunity after the BNT162b2 vaccine in Israel . N Engl J Med 2021 ; 385 : e85 . 4 Bar-On YM et al . Protection of BNT162b2 vaccine booster against COVID-19 in Israel . N Engl J Med 2021 ; 385:1393 – 400 . 5 Spitzer A et al . Association of a Third Dose of BNT162b2 Vaccine with Incidence of SARS-CoV-2 Infection Among Health Care Workers in Israel . JAMA 2022 . Doi 10.1001 / jama . 2021.23641
Therapeutic aquatic exercise superior to physical modality therapies in chronic low back pain
A 12-month therapeutic aquatic exercise programme for patients with chronic low back pain has been found to produce significantly greater relief of disability than the combination of two physical modality therapies . This was the conclusion of a randomised trial by researchers from the Department of Sport Rehabilitation , Shanghai University of Sport , Shanghai , China .
Non-specific low back pain can affect individuals at any
age and is a leading contributor to disease burden worldwide . 1 According to the International Association for the Study of Pain , low back pain is the leading cause of years lived with disability and in 2017 , was estimated to affect 577 million people , or around 7.5 % of the global population . 2 Various forms of exercise such as Pilates have been shown to provide better pain and disability outcomes for patients with non-specific chronic low back pain compared to advice alone . 3 In addition , physical therapies such as transcutaneous electrical nerve stimulation ( TENS ) for chronic low back pain has also been associated with a significant reduction in pain . 4
One form of water-based exercise , or therapeutic aquatic exercise , has been shown to be more effective than land-based methods in patients with low back pain . 5 In fact , a systematic review of eight trials involving therapeutic aquatic exercise concluded that it can produce statistically significant reductions in pain and increase physical function in patients with low back pain . 6 However , no studies have directly compared therapeutic aquatic exercise regimes with physical modalities .
For the present study , 7 the Chinese team conducted a single-blind , randomised trial to compare therapeutic aquatic exercise with two forms of physical modality therapy among those with chronic low back pain over a 12-month period . They recruited adults aged between 18 and 65 years and with chronic low back pain lasting for at least 3 months . Both interventions lasted for 60 minutes twice a week and the two physical therapy modalities used were TENS and infrared thermal therapy . Both techniques were focused on pain points , and each used for 30 minutes .
The primary outcome of interest was the Roland-Morris Disability questionnaire ( RMDQ ), which has 24 items and is scored between 0 and 24 with higher scores reflecting more severe disability . The study included a number of secondary outcomes , one of which was a numeric rating scale ( NRS ) from 0 ( no pain ) to 10 ( strong and unbearable pain ).
Findings A total of 113 individuals with a mean age of 31 years ( 47.8 % men ) were included in the study and randomised to therapeutic aquatic exercise ( 56 ) or physical therapy . The baseline RMDQ scores were 8.82 ( aquatic group ) and 8.37 ( physical modalities ) and this difference was not significantly different . At 12 months , the RMDQ had reduced to a mean of 3.52 and 6.67 ( aquatic vs physical modalities , mean difference = – 3.61 , p = 0.001 ).
For the NRS , the 12-month mean difference was – 2.04 ( aquatic vs physical modalities , p < 0.001 ).
The authors concluded that a therapeutic
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