AUTHOR=Ali Mohammad , Uddin Zakir , Hossain Ahmed 

TITLE=Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial

JOURNAL=Frontiers in Nutrition

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.717473

DOI=10.3389/fnut.2021.717473

ISSN=2296-861X

ABSTRACT=<p><bold>Background:</bold> The prevalence of musculoskeletal disorders (MSD) and vitamin D insufficiency is high. Past research indicating vitamin D supplementation and physiotherapy are useful for the treatment of MSDs. However, to the best of our knowledge, the combined benefits of vitamin D and physiotherapy are not yet evaluated in MSD. We hypothesized that combined intervention of vitamin D supplementation and physiotherapy would be more effective in relieving the pain of MSD compared to only physiotherapy intervention.</p><p><bold>Objective:</bold> This study aimed to examine whether combined effect of vitamin D supplementation and physiotherapy was better than physiotherapy alone in reducing pain-related outcomes (e.g., pain severity, affective interference, and physical interference) in patients with MSD.</p><p><bold>Methods:</bold> A quasi-clinical experiment was conducted between May 2020 and April 2021. Vitamin D level in the blood was measured at the start of the study. Patients with vitamin D levels &lt;20 ng/mL were assigned to the combined physiotherapy and vitamin D group. The physiotherapy group consisted of the patients with vitamin D levels more than 20 ng/mL. The Brief Pain Inventory scale was utilized to measure pain at baseline and after 12 weeks of interventions. We used the paired <italic>t</italic>-tests for unadjusted analysis. Further, a linear regression model was used to identify the combined effect of physiotherapy and vitamin D on reducing pain scores after adjusting potential confounders.</p><p><bold>Results:</bold> Combined intervention of vitamin D and physiotherapy showed significantly better results than only physiotherapy intervention in the reduction of three pain-related outcomes (<italic>p</italic> &lt; 0.001). The multivariable analysis indicated that the combination of physiotherapy and vitamin D treatment reduced pain score by 1.126 (slope = −1.126, <italic>p</italic> = 0.035) compared to physiotherapy alone.</p><p><bold>Conclusion:</bold> Combined intervention (vitamin D with physiotherapy) had a better pain-relieving effect than physiotherapy alone. To confirm these findings, more research is needed with randomized control trials.</p><p><bold>Clinical Trial Registration:</bold> [<ext-link ext-link-type="uri" xlink:href="http://ctri.nic.in/Clinicaltrials/advancesearchmain.php" xmlns:xlink="http://www.w3.org/1999/xlink">http://ctri.nic.in/Clinicaltrials/advancesearchmain.php</ext-link>], identifier [CTRI/2020/04/024845].</p>