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Gomes SRA, Mendes PRF, Costa LDO, Bulhões LCC, Borges DT, Macedo LB, Brasileiro J. Factors associated with low back pain in air force fighter pilots: a cross-sectional study. BMJ Mil Health 2021; 168:299-302. [PMID: 34266971 DOI: 10.1136/bmjmilitary-2021-001851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/23/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Low back pain in military pilots is a frequent condition which constantly leads to absences from work, decreased concentration and performance during flight, as well as changes in work functions. METHODS This is a cross-sectional analytical study including 28 fighter pilots who underwent an evaluation comprising muscle strength and fatigue resistance, trunk mobility and application of questionnaires to identify associated clinical factors. RESULTS It was observed that 68% of the pilots reported low back pain with an average pain intensity of 3.7 at numerical pain scale in the last week. No significant differences were observed regarding the range of motion and trunk muscle strength when pilots with low back pain were compared with asymptomatic pilots. However, lateral right trunk muscle (mean difference=16, 95% CI 0.6 to 33.0]) and lateral left trunk muscle (mean difference=22, 95% CI 1 to 44) fatigue sooner in pilots with low back pain when the two groups were compared (p=0.04 for both). CONCLUSION There was a high rate of low back pain complaints among fighter pilots. There was also a significant reduction in fatigue resistance of the lateral trunk muscles in symptomatic pilots when compared with asymptomatic pilots. These factors must be considered in the physical training of this population.
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Affiliation(s)
| | - P R F Mendes
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - L D O Costa
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - L C C Bulhões
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - D T Borges
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ld B Macedo
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - J Brasileiro
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Comparison of clinical and functional outcomes of vertebral body tethering to posterior spinal fusion in patients with adolescent idiopathic scoliosis and evaluation of quality of life: preliminary results. Spine Deform 2021; 9:1175-1182. [PMID: 33683642 DOI: 10.1007/s43390-021-00323-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/01/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE This preliminary study was aimed to present the results of the comparison of clinical and functional outcomes of vertebral body tethering (VBT) and posterior spinal fusion (PSF) for the first time in the literature. METHODS 21 thoracolumbar (T5-L3) VBT patients (VBT group); and 22 age-gender-fusion level and minimum follow-up duration matched thoracolumbar (T3-L3) PSF patients (PSF group) were enrolled. Average FU duration of group 1 and 2 were 37.1/37.8 months (p = 0.33). Patients clinical data together with SRS-22 scores and SF-36 scores were compared. A retrospective, comparative study was undertaken. RESULTS VBT group was detected to have superior lumbar range of motion; superior anterior-lateral lumbar bending flexibility; superior flexor and extensor endurances of trunk, and superior average motor strength of trunk muscles with high statistical significance. VBT group was also detected to have superior scores regarding life quality, including better average total SRS-22 and better average SF-36 MCS/PCS scores with also high statistical significance. CONCLUSION This study for the first time in the literature concluded, that in skeletally immature patients with AIS, VBT as a result of the utilization of growth modulation was able to yield significantly superior lumbar range of motion, lumbar anterior and lateral flexibility, trunk flexor-extensor endurance and trunk motor strength as compared to patients who underwent fusion. By yielding significantly superior SRS-22 and SF-36 scores, VBT was detected to provide better life quality and patient satisfaction than fusion. This study concluded hereby, that by applying VBT, spinal motion could be preserved and complications of fusion could be avoided.
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Ris I, Broholm D, Hartvigsen J, Andersen TE, Kongsted A. Adherence and characteristics of participants enrolled in a standardised programme of patient education and exercises for low back pain, GLA:D® Back - a prospective observational study. BMC Musculoskelet Disord 2021; 22:473. [PMID: 34022826 PMCID: PMC8141215 DOI: 10.1186/s12891-021-04329-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 05/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low back pain is often long-lasting, and implementation of low-cost interventions to improve care and minimise its burden is needed. GLA:D® Back is an evidence-based programme consisting of patient education and supervised exercises for people with low back pain, which was implemented nationwide in primary care clinics in Denmark. To assess how the intervention was received and factors influencing adherence to the program, we aimed to evaluate participants' adherence to the intervention and identified characteristics related to the completion of GLA:D® Back. Specifically, we investigated: 1) level of attendance of participants enrolled in the programme, and 2) participant-related factors associated with low attendance. METHODS Primary care clinicians delivered GLA:D® Back, a standardised 10-week programme of 2 educational and 16 supervised exercise sessions, to patients with low back pain. Attendance was defined as low, medium or high based on self-reported number of attended sessions. Additional participant-reported data included demographic characteristics, pain, prognostic risk profiles, self-efficacy, illness-beliefs, function and clinician-reported physical performance tests. Results for high, medium, low, and unknown attendance were reported descriptively. Odds ratios for low attendance compared to medium/high attendance were calculated by including all baseline factors in a mixed-model logistic regression model. RESULTS Of 1730 participants, 52% had high, 23% medium, and 25% low levels of attendance. Level of attendance was not strongly associated with participants' individual factors, but in combination, prediction of low attendance was fair (AUC 0.77; 95% CI 0.74-0.79). The strongest indicator of low attendance was not completing the baseline questionnaire. CONCLUSIONS Most participants of a 10-week low back pain programme attended almost all session. Non-response to the baseline questionnaire was strongly associated with low attendance, whereas individual patient characteristics were weakly related to attendance. Not completing baseline questionnaires might be an early indicator of poor adherence in programs for people with persistent low back pain. TRIAL REGISTRATION The Health Research Ethics for Southern Denmark decided there was no need for ethical approval (S-20172000-93). The Danish data collection has obtained authorisation from the Danish Data Protection Agency as part of the University of Southern Denmark's institutional authorisation (DPA no. 2015-57-0008 SDU no. 17/30591). The trial was registred at ClinicalTrials.gov NCT03570463 .
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Affiliation(s)
- Inge Ris
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Daniel Broholm
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Department of Anaesthesiology, Multidisciplinary Pain Centre, Vejle and Middelfart Hospitals, Østre Hougvej 55, 5500 Middelfart, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Chiropractic Knowledge Hub, Campusvej 55, 5230 Odense M, Denmark
| | - Tonny Elmose Andersen
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Chiropractic Knowledge Hub, Campusvej 55, 5230 Odense M, Denmark
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Rausch AK, Baltisberger P, Meichtry A, Topalidis B, Ciurea A, Vliet Vlieland TPM, Niedermann K. Reliability of an adapted core strength endurance test battery in individuals with axial spondylarthritis. Clin Rheumatol 2021; 40:1353-1360. [PMID: 32959189 PMCID: PMC7943491 DOI: 10.1007/s10067-020-05408-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/02/2020] [Accepted: 09/15/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To adapt the core strength endurance test battery (aCSE), previously used for testing athletes, to a target group of patients with axial spondylarthritis (axSpA), to evaluate its intra-tester reliability and its associations with disease-specific factors. METHODS A cross-sectional study was conducted at axSpA exercise therapy groups, including both axSpA patients and the physiotherapist group leaders (PTs). The aCSE was used to measure the isometric strength endurance of the ventral, lateral, and dorsal core muscle chains (measured in seconds), as well as to assess the disease-specific factors of functional status, self-reported pain, and perceived strength performance. The aCSE was repeated after 7-14 days to measure intra-tester reliability for the same rater (PT group leader). Reliability was calculated as an intra-class correlation coefficient (ICC) using a nested design. The associations between ventral, lateral, and dorsal strength endurance and the disease-specific factors were calculated using Pearson correlation coefficients. RESULTS Study participants were 13 PT group leaders and 62 axSpA patients. The latter were all capable of performing the aCSE, with the exception of one individual. A moderate to substantial intra-rater reliability (ICCs (95%CI)) was found for the ventral (0.54 (0.35, 0.74)), lateral (0.52 (0.33, 0.70)), and dorsal (0.71 (0.58, 0.86)) core muscle chains. None of the aCSE measures correlated with the disease-specific factors. CONCLUSION The aCSE was found to be a reliable test battery for assessing core strength endurance in axSpA patients. Interestingly, aCSE performance was not associated with any disease-specific factors. Key Points • The adapted core strength endurance test battery measures the isometric strength of the ventral, lateral and dorsal core muscle chains. • The adapted core strength endurance test battery showed a moderate to substantial intra-rater reliability for all three muscle chains tested in axSpA patients. • No correlations were found between the adapted core strength endurance test battery and the disease-specific factors of self-reported pain, functional status and perceived strength performance.
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Affiliation(s)
- Anne-Kathrin Rausch
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, 8401, Winterthur, Switzerland.
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands.
| | - Philipp Baltisberger
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, 8401, Winterthur, Switzerland
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, 8401, Winterthur, Switzerland
| | - Beatrice Topalidis
- Ankylosing Spondylitis Association of Switzerland, 8050, Zurich, Switzerland
| | - Adrian Ciurea
- Department of Rheumatology, Zurich University Hospital, 8091, Zurich, Switzerland
| | - Theodora P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands
| | - Karin Niedermann
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, 8401, Winterthur, Switzerland
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Martínez-Romero MT, Ayala F, Aparicio-Sarmiento A, De Ste Croix M, Sainz De Baranda P. Reliability of five trunk flexion and extension endurance field-based tests in high school-aged adolescents: ISQUIOS programme. J Sports Sci 2021; 39:1860-1872. [PMID: 33775212 DOI: 10.1080/02640414.2021.1903706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to explore the inter-session reliability of the measures obtained from 2 trunk extension (Biering-Sorensen and Dynamic Extensor Endurance (DEE) tests) and 3 trunk flexion (Ito, Side Bridge and Bench Trunk Curl-Up (BTC) tests) endurance field-based tests in adolescents. A total of 208 (males, n = 100; females, n = 108) adolescents performed all the field-based tests on 2 separate testing sessions, 7-days apart. The inter-session reliability scores were explored through relative reliability, inter-session differences and precision of measurements. Most of the trunk endurance measures demonstrated acceptable relative reliability (the intraclass correlation coefficients (ICC) ranged from 0.75 to 0.94). However, significant inter-session differences were identified for measures from the DEE and BTC tests. Likewise, the precision of the measurement of each field-based test was poor (the the standard error of measurement expressed as a percentage of the mean score (CVTE) ranged from 11.3 to 24.4%) with the minimal detectable change (MDC95) revealing that changes higher than 42% for trunk extension endurance tests and 31.4% for trunk flexion endurance tests after an intervention are required to indicate a significant change above measurement error. Therefore, the findings from this study indicate that only the BTC test demonstrates acceptable inter-session reliability (ICC > 0.9, CVTE ~ 10%, MDC95 ~ 30%) to monitor the changes in trunk endurance scores that may be expected in adolescents after performing an intervention programme.
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Affiliation(s)
- María Teresa Martínez-Romero
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Francisco Ayala
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain.,Ramon y Cajal post doctoral fellow (RYC2019-028383-I/AEI/10.13039/501100011033)
| | - Alba Aparicio-Sarmiento
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Mark De Ste Croix
- Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain.,School of Sport and Exercise, Exercise and Sport Research Centre, University of Gloucestershire, Gloucester, UK
| | - Pilar Sainz De Baranda
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
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Sitges C, Velasco-Roldán O, Crespí J, García-Dopico N, Segur-Ferrer J, González-Roldán AM, Montoya P. Acute Effects of a Brief Physical Exercise Intervention on Somatosensory Perception, Lumbar Strength, and Flexibility in Patients with Nonspecific Chronic Low-Back Pain. J Pain Res 2021; 14:487-500. [PMID: 33633462 PMCID: PMC7901430 DOI: 10.2147/jpr.s274134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/14/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Evidence-based clinical guidelines consider physical exercise one of the best nonpharmacological interventions for low-back pain (LBP), but it is necessary to clarify the exercise-induced hypoalgesia effect of different modalities of exercise in chronic pain populations. PURPOSE This study focused on exploring acute changes in tactile and pressure-pain perception and lumbar strength and flexibility in patients with nonspecific chronic LBP (NSCLBP) after performing one of three 20-minute physical exercise modalities. METHODS A total of 81 patients with NSCLBP were pseudorandomly distributed into three groups of 20-minute physical exercise - 1) aerobic (n=21, mean age 42±9.72 years, nine men), 2) stretching (n=21, mean age 40±11.37 years, ten men), and 3) strengthening (n=20, mean age 35.80±11.56 years, ten men) - and 4) a control group (n=19, mean age 38.64±10.24 years, eight men), and completed self-reported questionnaires during the same period. Tactile and pressure-pain thresholds and isometric lumbar muscle endurance and flexibility were assessed before and after this brief exercise-based intervention. RESULTS All groups were comparable in terms of sociodemographic and clinical data, cardiovascular capacity, and self-reported data onphysical disability, mood, motivation, psychological response to stimulus properties of physical exercise, and physical activity enjoyment. Our analyses revealed higher tactile sensitivity (p<0.001) and pressure-pain thresholds (p<0.001) at the forefinger than other body locations. We also found lower pain sensitivity (p=0.010) and pressure pain-intensity ratings (p=0.001) and higher lumbar flexibility (p<0.001) after intervention. After calculation of absolute pre-post differences, higher tactile sensitivity was observed at the gluteus medius muscle than the erector spinal muscle only after aerobic intervention (p=0.046). CONCLUSION These results add some evidence about different modalities of exercise-induced hypoalgesia in NSCLBP. However, the fact that we also found improvements in the control group limits our conclusions.
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Affiliation(s)
- Carolina Sitges
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Psychology, UIB, Palma, Spain
| | - Olga Velasco-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Nursing and Physiotherapy, UIB, Palma, Spain
| | - Jaume Crespí
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Nuria García-Dopico
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Joan Segur-Ferrer
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Ana María González-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Psychology, UIB, Palma, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Psychology, UIB, Palma, Spain
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Best N, Nisser M, Loudovici-Krug D. [The Jena standing stability (JESS) score : Development, standard value generation and clinical applicability of a score for evaluation of standing stability]. Z Rheumatol 2021; 80:85-95. [PMID: 32157383 PMCID: PMC7873111 DOI: 10.1007/s00393-020-00765-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Hintergrund Der Stand bzw. das Stehen kann neben den von Janda beschriebenen Bewegungsstereotypen ebenfalls als motorischer Prozess begriffen werden. Atypische Belastungen während des Stehens führen zur Überbeanspruchung myofaszialer Strukturen und zu Schmerz. Die Suche nach einer dezidierten Untersuchungsmöglichkeit mit der Aussicht auf individuelle Therapieempfehlungen, war Anlass für die Erarbeitung dieses Scores. Methodik Es wurden 80 gesunde Probanden mittels etablierter sowie anteilig neu beschriebener Testverfahren auf ihre Standstabilität hin untersucht. Die gleichgewichteten Ergebnisse wurden zu einem Score zusammengefasst und dessen Normwerte bestimmt. Ergebnisse Für die Altersklasse der 18- bis 44-Jährigen ist die Norm das Erfüllen von 10 der insgesamt 13 Einzelaufgaben. Für die 45- bis 59-Jährigen sind nach aktuellen Messungen 8 von 13 erreichten Punkten die Norm. In der Altersgruppe ab dem 60. Lebensjahr können bisher keine belastbaren Aussagen getroffen werden. Diskussion Belastbare Daten liefert die Altersgruppe bis 44 Jahre. Die Altersgruppe darüber zeigt zumindest einen deutlichen Trend. Die existierenden Tests bzw. Scores setzten sich verstärkt mit dem Sturzrisiko und der Geschicklichkeit bei Bewegungen und komplexen Aufgaben auseinander. Der Stand als motorischer Stereotyp wurde bisher noch nicht beschrieben. Nach einer Untersuchung mittels Jenaer-Stand-Stabilitäts-Score (JESS-Score) ist es möglich, Aussagen zu individuellen Therapieschwerpunkten zu treffen. Schlussfolgerungen Der JESS-Score stellt einen praktikablen Test zur Verifizierung des Standstereotyps dar. Die Erweiterung der Normgruppe durch Einschluss weiterer Studienteilnehmer wird über eine Verstetigung oder Modifikation der aktuellen Ergebnisse entscheiden. Die Testung weiterer Kohorten wird zeigen, inwieweit diese Items sensitiv für Veränderungen durch Trainingsmethoden sind und ob mit dem Score auch klinische Änderungen kongruent abgebildet werden können.
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Affiliation(s)
- N Best
- Institut für Physiotherapie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. .,Institut für Physiotherapie, Posture and Motion Group, Universitätsklinikum Jena, Jena, Deutschland.
| | - M Nisser
- Institut für Physiotherapie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - D Loudovici-Krug
- Institut für Physiotherapie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.,Forschungsberatungsstelle der Ärztevereinigung für Manuelle Medizin (ÄMM), Am Klinikum 1, 07747, Jena, Deutschland
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Lemieux J, Kawchuk G, Kongsted A, Hartvigsen J, Abdollah V, Jones A. The feasibility of implementing an English language version of GLA:D Back. Pilot Feasibility Stud 2021; 7:38. [PMID: 33522956 PMCID: PMC7849100 DOI: 10.1186/s40814-020-00758-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidenced-based clinical guidelines for the treatment of low back pain (LBP) consistently suggest educating patients about their back pain, its natural course, and providing advice to keep active and continue working. Despite this evidence, clinicians routinely do not follow these recommendations resulting in ineffective and fragmented care. GLA:D® Back, a standardized care package, was originally developed in Denmark to assist clinicians in implementing evidence-based care. This study will evaluate the feasibility of implementing the English version of the Danish GLA:D® Back program in Alberta, Canada. METHODS Thirty-five clinicians from nineteen clinics in Alberta, Canada, participated. Feasibility of program implementation, our primary objective, was evaluated within 3 months. Feasibility success was defined as 50% clinician/clinic adoption in addition to 66-88 enrolled participants registered in the database. Our secondary objectives included collecting data pertaining to clinician confidence, attitudes and behaviour of treating patients, perceived barriers and facilitators of program in addition to collecting patient-data regarding pain, function, general health and self-efficacy. RESULTS The majority of the clinics (15/19, 79%) offered GLA:D® Back to their patients within the study period. Of the participating clinicians, GLA:D® Back was delivered by (25/35, 71%) of clinicians. In total, 78 patients were enrolled in the program and (69/78, 88%) participants attended the final assessment. Secondarily, clinicians demonstrated a biomedical and behavioural orientation along with high confidence when treating LBP patients while patient outcomes trended toward improvement. CONCLUSION The English translation of the Danish GLA:D Back program was feasible for Albertan clinicians to implement into practice in both urban and rural settings.
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Affiliation(s)
- J Lemieux
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - G Kawchuk
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
| | - A Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - J Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - V Abdollah
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - A Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Madruga M, Carlos-Vivas J, Mendoza-Muñoz M, Adsuar JC, Mariano-Juárez L, Conde-Caballero D. Family Orchards and Health-Related Quality of Life in the Elderly. A Protocol for a Study in Las Hurdes (Spain) Based on an Ethnographic Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031059. [PMID: 33504078 PMCID: PMC7908362 DOI: 10.3390/ijerph18031059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/06/2021] [Accepted: 01/20/2021] [Indexed: 01/07/2023]
Abstract
Demographic evolution is resulting on an aged population increment in Spain. This growth has been more relevant in rural areas, where the population has traditionally lived under hard socio-economic conditions and leveraging the natural resources such as food from family orchards to survive. Studies that have investigated the possibilities and uses of these traditional family orchards today in relation to health-related quality of life in the elderly are scarce. Based on a previous ethnography, this mixed research aims to describe a protocol that will evaluate the effects of the use of traditional family orchards as a daily resource on fitness and quality of life of the elderly population in Las Hurdes (Spain). Body composition, fitness, mental health, health-related quality of life, and activity-related behaviors of participants will be assessed. The outcomes of this study might enable us to design further tailored physical exercise-based interventions using family orchards as an adequate resource to improve the health-related quality of life and fitness of the elderly in rural areas. In addition, the study detailed here might also be applied to other similar rural areas in Spain and worldwide.
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Affiliation(s)
- Miguel Madruga
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Sport Sciences, University of Extremadura, 10071 Cáceres, Spain
- Correspondence: ; Tel.: +34-927257000-57628
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society (PHeSo) Research Group, Faculty of Sport Sciences, University of Extremadura, 10071 Cáceres, Spain; (J.C.-V.); (M.M.-M.); (J.C.A.)
| | - María Mendoza-Muñoz
- Promoting a Healthy Society (PHeSo) Research Group, Faculty of Sport Sciences, University of Extremadura, 10071 Cáceres, Spain; (J.C.-V.); (M.M.-M.); (J.C.A.)
| | - José Carmelo Adsuar
- Promoting a Healthy Society (PHeSo) Research Group, Faculty of Sport Sciences, University of Extremadura, 10071 Cáceres, Spain; (J.C.-V.); (M.M.-M.); (J.C.A.)
| | - Lorenzo Mariano-Juárez
- Department of Nursing, School of Nursing and Occupational Therapy, Interdisciplinary Study Group on Society, Culture and Health (GISCSA), University of Extremadura, 10003 Cáceres, Spain; (L.M.-J.); (D.C.-C.)
| | - David Conde-Caballero
- Department of Nursing, School of Nursing and Occupational Therapy, Interdisciplinary Study Group on Society, Culture and Health (GISCSA), University of Extremadura, 10003 Cáceres, Spain; (L.M.-J.); (D.C.-C.)
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Rezai V, Mahdavi-Nejad R, Zolaktaf V. Comparing the Effects of Different Types of Aquatic Walking on Endurance and Electrical Activities of Spine Extensor Muscles in Men with Nonspecific Chronic Back Pain. Int J Prev Med 2020; 11:168. [PMID: 33312477 PMCID: PMC7716608 DOI: 10.4103/ijpvm.ijpvm_403_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 06/10/2020] [Indexed: 11/04/2022] Open
Abstract
Background Chronic back pain is one of the most challenging medical problems worldwide that results in disability, physical problems, and high costs for the family and society. Therefore, it can be very beneficial to find an appropriate treatment with minimum side-effects for this disease. The present study attempted to compare the effects of different water gait protocols on the endurance and electrical activity of spine extensor muscles in men with nonspecific chronic back pain. Methods The study adopted an experimental design in which 30 men with non-specific chronic back pain were selected through convenience sampling and using simple randomization method assigned into three groups of forward walking, backward walking, and sideways walking. Walking exercises were performed for 8 weeks, three sessions per week for 30 min. Twenty-four hours before and 48 h after the intervention, the endurance of spine extensor muscles and electrical activities were measured using the Ito test and electromyography, respectively. Data were analyzed in SPSS 23 using paired sample t-test and analysis of variance. Results The results showed that backward walking in water significantly increases endurance and electromyography activities of spine extensor muscles (P < 0.05), while forward and sideways walking had no significant effect on these variables (P > 0.05). The results obtained from Bonferroni post-hoc test showed a significant difference between the strength of trunk extensor muscles and EMG of spinal cord extensor muscles in forward and backward water gait groups (P = 0.001, 0.006). Conclusions According to the findings of this study, it seems that walking backward can be an effective therapeutic method for patients with chronic back pain.
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Affiliation(s)
- Vahid Rezai
- Department of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran
| | - Reza Mahdavi-Nejad
- Department of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran
| | - Vahid Zolaktaf
- Department of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran
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王 伟, 李 危, 陈 仲. [Progress on the evaluation method of paraspinal muscle and its correlation with lumbar diseases]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:1462-1467. [PMID: 33191707 PMCID: PMC8171695 DOI: 10.7507/1002-1892.201912120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/21/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review the evaluation method of paraspinal muscle and its role in lumbar spine diseases, and offer reference for further research on paraspinal muscles. METHODS The related literature of paraspinal muscle measurement and its role in lumbar spine diseases was reviewed. The evaluation methods of paraspinal muscle were analyzed from the advantages and disadvantages and the role of paraspinal muscle in lumbar spine diseases was summarized. RESULTS Radiographic methods are often used to evaluate the atrophy of paraspinal muscle, mainly including CT and MRI. The cross-sectional area and fatty infiltration of paraspinal muscle are two key parameters. Radiographic methods are reproducible and widely applied, but CT has the disadvantage of radiation exposure, while the cost of MRI is high. Besides, more and more researchers focus on the functional evaluation of paraspinal muscle, which mainly includes surface electromyogram analysis and back muscle strength test. The surface electromyogram analysis can quantitatively measure neuromuscular function, but the results could be affected by many influencing factors. The back muscle strength test is simple, but it lacks standardized posture. The atrophy of paraspinal muscle is related to many lumbar spine diseases, while the results of different researches are different. CONCLUSION There are many methods to evaluate paraspinal muscles, but there is no unified standard. The role of paraspinal muscle in lumbar spine diseases need to be further studied.
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Affiliation(s)
- 伟 王
- 北京大学第三医院骨科(北京 100191)Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P.R.China
- 北京大学医学部(北京 100191)Peking University Health Science Center, Beijing, 100191, P.R.China
| | - 危石 李
- 北京大学第三医院骨科(北京 100191)Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P.R.China
| | - 仲强 陈
- 北京大学第三医院骨科(北京 100191)Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P.R.China
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Mizoguchi Y, Akasaka K, Otsudo T, Hall T. Physical function characteristics in Japanese high school volleyball players with low back pain: A case-controlled study. Medicine (Baltimore) 2020; 99:e23178. [PMID: 33181694 PMCID: PMC7668454 DOI: 10.1097/md.0000000000023178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Low back pain (LBP) is a typical symptom in volleyball players, yet associated physical function factors have not been identified. This study purpose is to determine the relationship between LBP and physical function factors in order to identify potential factors for the management of LBP.Participants were 123 male and female volleyball players of 15- to 17-year-olds who, completed a questionnaire regarding demographic details, presence of LBP, and years of volleyball experience. Participants were divided into 2 groups based on the presence of current LBP and evaluated on physical function tests. The results of the questionnaire response and physical function test were compared between the 2 groups. Data were analyzed using a multivariate logistic regression analysis with presence and absence of current LBP as the explanatory variable.11.4% of all participants reported current LBP. Physical function factors associated with current LBP were a positive modified Thomas test, years of volleyball experience and reduced range of motion of shoulder horizontal abduction on the dominant hand side.The associations between physical function factors and LBP found in this survey suggest that attention should be given to more experienced players with decreased flexibility of hip and shoulder flexors on the dominant side in order to manage LBP in high school volleyball players.
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Affiliation(s)
- Yasuaki Mizoguchi
- Department of Rehabilitation, Saitama Medical University Hospital, 38 Morohongo
| | - Kiyokazu Akasaka
- Saitama Medical University Graduate School of Medicine
- School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981 Kawakado, Moroyama, Iruma, Saitama, Japan
| | - Takahiro Otsudo
- Saitama Medical University Graduate School of Medicine
- School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981 Kawakado, Moroyama, Iruma, Saitama, Japan
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Kent Street, Bentley, Perth, Western Australia, Australia
- Manual Concept, PO Box 1236, Booragoon, Western Australia, Australia
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Cejudo A, Ginés-Díaz A, Rodríguez-Ferrán O, Santonja-Medina F, Sainz de Baranda P. Trunk Lateral Flexor Endurance and Body Fat: Predictive Risk Factors for Low Back Pain in Child Equestrian Athletes. CHILDREN-BASEL 2020; 7:children7100172. [PMID: 33050134 PMCID: PMC7600765 DOI: 10.3390/children7100172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/16/2022]
Abstract
Low back pain (LBP) is the most common overuse musculoskeletal injury suffered by child equestrian athletes (CEA). Despite this, little is known about the risk factors related to LBP in these athletes, and very limited research has been conducted on this topic. This study was designed to investigate predictive risk factors for LBP in CEA. The purposes of this research were to determine whether anthropometric, range of motion (ROM), core endurance and sagittal spinal morphotype measures are risk factors for LBP and to establish a diagnostic cutoff value for those factors associated with LBP. Nineteen CEA between the ages of 12 and 17 years were voluntarily recruited. Potential risk factors evaluated included corporal composition, lower limb ROM, core endurance and sagittal spinal measures. Associations and predictions were calculated between these risk factors and the LBP during the last 12 months. Almost half of the CEA have suffered at least one episode of LBP. Two risk factors and cutoff values were identified as predictors of LBP in CEA: having a high body fat higher than 23% (p = 0.01) and trunk lateral flexor endurance lower to 65 s (p = 0.021), body fat being the strongest predictor.
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Affiliation(s)
- Antonio Cejudo
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30720 Murcia, Spain; (A.C.); (P.S.d.B.)
- Sports and Musculoskeletal System Research Group (RAQUIS), Campus de San Javier, University of Murcia, 30720 Murcia, Spain;
| | - Angélica Ginés-Díaz
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30720 Murcia, Spain; (A.C.); (P.S.d.B.)
- Sports and Musculoskeletal System Research Group (RAQUIS), Campus de San Javier, University of Murcia, 30720 Murcia, Spain;
- Correspondence: (A.G.-D.); (O.R.-F.); Tel.: +34-868-88-8824; Fax: +34-868-88-8672
| | - Olga Rodríguez-Ferrán
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30720 Murcia, Spain; (A.C.); (P.S.d.B.)
- Sports and Musculoskeletal System Research Group (RAQUIS), Campus de San Javier, University of Murcia, 30720 Murcia, Spain;
- Correspondence: (A.G.-D.); (O.R.-F.); Tel.: +34-868-88-8824; Fax: +34-868-88-8672
| | - Fernando Santonja-Medina
- Sports and Musculoskeletal System Research Group (RAQUIS), Campus de San Javier, University of Murcia, 30720 Murcia, Spain;
- Department of Surgery, Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30100 Murcia, Spain
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30720 Murcia, Spain; (A.C.); (P.S.d.B.)
- Sports and Musculoskeletal System Research Group (RAQUIS), Campus de San Javier, University of Murcia, 30720 Murcia, Spain;
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Denteneer L, van Daele U, Truijen S, de Hertogh W, Maldoy M, Leysen M, Stassijns G. Convergent validity of clinical tests which are hypothesized to be associated with physical functioning in patients with nonspecific chronic low back pain. J Back Musculoskelet Rehabil 2020; 33:313-322. [PMID: 31450488 DOI: 10.3233/bmr-181318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Up until now, assessment of physical functioning in patients with low back pain is mostly completed with the use of patient reported outcome measurements (PROMs). There are however limitations to the use of these measurements such as inaccuracies due to recall bias, social desirability bias and errors in self-observation. A recent review indicated seven clinical tests as having good test retest reliability. These tests can now be further investigated for their validity. OBJECTIVES To investigate the convergent validity of seven clinical tests (extensor endurance, flexor endurance, 5 minute walking, 50 foot walking, shuttle walk, sit to stand and the loaded forward reach test) in patients with nonspecific chronic low back pain (CLBP). METHODS Patients filled in a series of PROMs and performed all included clinical tests during a specific test moment. Convergent validity was firstly investigated by assessing Pearson correlations between the seven included clinical tests and secondly by assessing the correlations between the predefined PROMs and the clinical tests. RESULTS Twenty-five patients were included in this study representing a power of 84%. The best overall evidence for convergent validity could be identified for the extensor endurance, sit to stand and the loaded forward reach test. However, when all study results were combined, evidence for convergent validity was found for all included clinical tests except for the shuttle walk test. CONCLUSION The current study was able to provide evidence that multimethod and multidimensional approaches should be used as a more comprehensive assessment of physical function in patients with nonspecific CLBP.
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Affiliation(s)
- Lenie Denteneer
- Antwerp University Hospital, Physical Medicine and Rehabilitation, 2650 Edegem, Belgium.,Faculty of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Wilrijk, Belgium
| | - Ulrike van Daele
- Faculty of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Wilrijk, Belgium
| | - Steven Truijen
- Faculty of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Wilrijk, Belgium
| | - Willem de Hertogh
- Faculty of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Wilrijk, Belgium
| | - Marjan Maldoy
- Faculty of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Wilrijk, Belgium
| | - Marijke Leysen
- Faculty of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Wilrijk, Belgium
| | - Gaetane Stassijns
- Antwerp University Hospital, Physical Medicine and Rehabilitation, 2650 Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
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Baker P, Coole C, Drummond A, Khan S, McDaid C, Hewitt C, Kottam L, Ronaldson S, Coleman E, McDonald DA, Nouri F, Narayanasamy M, McNamara I, Fitch J, Thomson L, Richardson G, Rangan A. Occupational advice to help people return to work following lower limb arthroplasty: the OPAL intervention mapping study. Health Technol Assess 2020; 24:1-408. [PMID: 32930659 PMCID: PMC7520717 DOI: 10.3310/hta24450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hip and knee replacements are regularly carried out for patients who work. There is little evidence about these patients' needs and the factors influencing their return to work. There is a paucity of guidance to help patients return to work after surgery and a need for structured occupational advice to enable them to return to work safely and effectively. OBJECTIVES To develop an occupational advice intervention to support early recovery to usual activities including work that is tailored to the requirements of patients undergoing hip or knee replacements. To test the acceptability, practicality and feasibility of this intervention within current care frameworks. DESIGN An intervention mapping approach was used to develop the intervention. The research methods employed were rapid evidence synthesis, qualitative interviews with patients and stakeholders, a prospective cohort study, a survey of clinical practice and a modified Delphi consensus process. The developed intervention was implemented and assessed during the final feasibility stage of the intervention mapping process. SETTING Orthopaedic departments in NHS secondary care. PARTICIPANTS Patients who were in work and intending to return to work following primary elective hip or knee replacement surgery, health-care professionals and employers. INTERVENTIONS Occupational advice intervention. MAIN OUTCOME MEASURES Development of an occupational advice intervention, fidelity of the developed intervention when delivered in a clinical setting, patient and clinician perspectives of the intervention and preliminary assessments of intervention effectiveness and cost. RESULTS A cohort study (154 patients), 110 stakeholder interviews, a survey of practice (152 respondents) and evidence synthesis provided the necessary information to develop the intervention. The intervention included information resources, a personalised return-to-work plan and co-ordination from the health-care team to support the delivery of 13 patient and 20 staff performance objectives. To support delivery, a range of tools (e.g. occupational checklists, patient workbooks and employer information), roles (e.g. return-to-work co-ordinator) and training resources were created. Feasibility was assessed for 21 of the 26 patients recruited from three NHS trusts. Adherence to the defined performance objectives was 75% for patient performance objectives and 74% for staff performance objectives. The intervention was generally well received, although the short time frame available for implementation and concurrent research evaluation led to some confusion among patients and those delivering the intervention regarding its purpose and the roles and responsibilities of key staff. LIMITATIONS Implementation and uptake of the intervention was not standardised and was limited by the study time frame. Evaluation of the intervention involved a small number of patients, which limited the ability to assess it. CONCLUSIONS The developed occupational advice intervention supports best practice. Evaluation demonstrated good rates of adherence against defined performance objectives. However, a number of operational and implementation issues require further attention. FUTURE WORK The intervention warrants a randomised controlled trial to assess its clinical effectiveness and cost-effectiveness to improve rates and timing of sustained return to work after surgery. This research should include the development of a robust implementation strategy to ensure that adoption is sustained. STUDY REGISTRATION Current Controlled Trials ISRCTN27426982 and PROSPERO CRD42016045235. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 45. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Paul Baker
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Carol Coole
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Sayeed Khan
- Make UK, The Manufacturers' Organisation, London, UK
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Lucksy Kottam
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Sarah Ronaldson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Elizabeth Coleman
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - David A McDonald
- Whole System Patient Flow Programme, Scottish Government, Edinburgh, UK
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Fiona Nouri
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Melanie Narayanasamy
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Iain McNamara
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Judith Fitch
- British Orthopaedic Association Patient Liaison Group, Royal College of Surgeons of England, London, UK
| | - Louise Thomson
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Amar Rangan
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
- York Trials Unit, Department of Health Sciences, University of York, York, UK
- Faculty of Medical Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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Gusi N, Madruga M, González-González MDLÁ, Pérez-Gómez J, Prieto-Prieto J. Health-related quality of life and multidimensional fitness profile in polio survivors. Disabil Rehabil 2020; 44:1374-1379. [PMID: 32790481 DOI: 10.1080/09638288.2020.1804629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess and compare the HRQoL and physical fitness of polio survivors with healthy individuals. METHODS Thirty-seven polio survivors and 40 healthy individuals were recruited in this cross-sectional study. The Fatigue Severity Scale (FSS) was used to evaluate participant's level of fatigue; Short Form 36 (SF-36) was used for evaluating HRQoL, and hand-grip strength, lumbar trunk muscle endurance, flexibility, balance, and aerobic endurance were used as measures for physical fitness. RESULTS Polio survivors had lower HRQoL in most of the dimensions of the SF-36, and they showed a lower level of physical fitness than controls. In particular, mobility-related variables were 20-40% lower in people with PP. CONCLUSIONS Subjects with PP had lower scores for the physical component of the HRQoL questionnaire, reduced physical fitness, increased fatigue, less mobility, and a higher fall risk than controls. The outcomes of the study can be useful to the design of future programs tailored specifically to improve the assessment of the physical fitness of subjects with paralytic polio and to facilitate interventions based on appropriate physical exercise regimens.Implications for rehabilitationPost-polio syndrome is a disabling disease that impacts in fitness, physical and psychological health-related quality of life of polio survivors.Polio survivors should undergo physical activity programs that focus on improving mainly their mobility and physical functioning (walking, self-care, and climbing stairs), thereby reducing fall risk and fatigue.Individual tailored physical exercise programs should be promoted in order to improve HRQoL in this population.
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Affiliation(s)
- Narcís Gusi
- Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
| | - Miguel Madruga
- Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
| | | | - Jorge Pérez-Gómez
- Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
| | - Josué Prieto-Prieto
- University School of Education and Tourism of Avila, University of Salamanca, Salamanca, Spain
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Hosseinabadi M, Kamyab M, Azadinia F, Sarrafzadeh J. Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture: A randomized controlled trial. Prosthet Orthot Int 2020; 44:234-244. [PMID: 32507057 DOI: 10.1177/0309364620923816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Hyperkyphosis may cause balance impairment in elderly people. Although the effectiveness of orthoses for improving balance in hyperkyphotic elderly people has received much attention, the mechanisms by which devices affect balance remain unknown. OBJECTIVES The objective of this study was to evaluate changes in balance performance, thoracic kyphosis angle, craniovertebral angle, back muscle endurance and joint position sense after 3 months of wearing a Spinomed orthosis. The study also included a secondary exploratory analysis to determine whether changes in any of the above-mentioned outcome measures can predict balance performance improvement in elderly people with hyperkyphosis. STUDY DESIGN Parallel group randomized controlled trial. METHODS In total, 44 hyperkyphotic elderly people were randomly allocated to an experimental group, who wore a Spinomed orthosis and a control group, who did not. No other treatment or change in physical activity was permitted during the study. A blinded assessor evaluated thoracic kyphosis angle, joint position sense, craniovertebral angle, back muscle endurance, Timed Up and Go Test time and Berg Balance Scale score at baseline and after 5, 9 and 13 weeks. All dependent variables were measured without the orthosis and analyzed separately using a 2 × 4 (time × group) mixed model analysis of variance. Based on the results of correlation analysis, thoracic kyphosis angle, back muscle endurance and joint position sense were selected as independent variables in a stepwise multiple regression model. RESULTS The two-way (group × time) interactions were significant in terms of Berg Balance Scale (F = 11.6, P ⩽ 0.001, ηp2=0.59), Timed Up and Go Test (F = 3.74, P = 0.013, ηp2=0.46), thoracic kyphosis angle (F = 43.39, P ⩽ 0.001, ηp2=0.96), craniovertebral angle (F = 5.245, P = 0.002, ηp2=0.59) and joint position sense (F = 4.44, P = 0.005, [Formula: see text]). The two-way interaction was not significant in terms of back muscle endurance; however, the main effect of group was significant for this variable (F = 3.85, P = 0.025). Stepwise multiple regression showed that thoracic kyphosis angle and joint position sense were significant determinants of Timed Up and Go Test time (R2 = 0.155, P = 0.037 and R2 = 0.292, P = 0.012, respectively). CONCLUSION Wearing a Spinomed orthosis for 3 months improved the posture, position sense and muscle performance of hyperkyphotic elderly people. Orthoses may improve balance performance by correcting spinal alignment and increasing proprioceptive information.
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Affiliation(s)
- Mostafa Hosseinabadi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Azadinia
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Sarrafzadeh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Spencer L, McKenna L, Fary R, Ho R, Briffa K. Is Breast Size Related to Prevalent Thoracic Vertebral Fracture? A Cross-Sectional Study. JBMR Plus 2020; 4:e10371. [PMID: 32666022 PMCID: PMC7340439 DOI: 10.1002/jbm4.10371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/06/2020] [Accepted: 04/19/2020] [Indexed: 11/08/2022] Open
Abstract
Large breasts may increase the likelihood of thoracic vertebral fractures by increasing the mechanical loading of the spine. We examined breast size as a factor associated with prevalent thoracic vertebral fractures, also considering its relationship with thoracic kyphosis and upper back extensor muscle endurance. Using a cross-sectional study, the design measurements collected were thoracic vertebral fractures (≥20% loss in vertebral body height on lateral radiograph), breast size (bra size converted to an ordinal breast size score), BMD (g/cm2 averaged femoral neck, DXA), upper back extensor muscle endurance (isometric chest raise test), body composition (DXA), thoracic kyphosis (radiograph), and upper back pain (numerical rating scale). Correlations and multivariable logistic regression examined relationships between characteristics and their association with vertebral fracture. Participants were 117 healthy postmenopausal women. The 17 (15%) women with ≥1 thoracic vertebral fracture had larger breast size (mean difference [MD]: 2.2 sizes; 95% CI, 0.6 to 3.8 sizes), less upper back extensor muscle endurance (MD: -38.6 s; 95% CI, -62.9 to -14.3 s), and greater thoracic kyphosis (MD: 7.3°; 95% CI, 1.7° to 12.8°) than those without vertebral fracture. There were no between group differences in age, height, weight, and BMD. Breast size (r = -0.233, p = 0.012) and thoracic kyphosis (r = -0.241, p = 0.009) correlated negatively with upper back extensor muscle endurance. Breast size was unrelated to thoracic kyphosis (r = 0.057, p = 0.542). A (final) multivariable model containing breast size (OR 1.85; 95% CI, 1.10 to 3.10) and thoracic kyphosis (OR 2.04; 95%CI, 1.12 to 3.70) explained 18% of the variance in vertebral fracture. Breast size had a significant, but weak relationship with vertebral fracture (R 2 = 0.10), which was independent of BMD and unrelated to thoracic kyphosis. Further work is needed to confirm larger breast size as a risk factor for vertebral fracture. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Robyn Fary
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Richard Ho
- Perth Radiological Clinic Perth Western Australia Australia
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
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Ilves O, Neva MH, Häkkinen K, Dekker J, Järvenpää S, Kyrölä K, Häkkinen A. Effectiveness of a 12-month home-based exercise program on trunk muscle strength and spine function after lumbar spine fusion surgery: a randomized controlled trial. Disabil Rehabil 2020; 44:549-557. [PMID: 32525413 DOI: 10.1080/09638288.2020.1772383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: The effectiveness of a 12-month home-exercise program on trunk muscle strength after lumbar spine fusion surgery was evaluated. Materials and methods: Three months postoperatively, 98 patients were randomized either to the exercise group (EG), with a progressive 12-month home-based exercise program, or to usual care group (UCG), with one guidance session for light home-exercises. Maximal trunk muscle strength was measured by a strain-gauge dynamometer and trunk extensor endurance was measured by Biering-Sørensen's test at baseline and after the intervention. Results: The mean change in extension strength during the intervention was 75 N in EG and 58 N in UCG. Flexion strength improved 50 N in UCG and 45 N in EG. Trunk extension/flexion strength ratio changed from 0.90 to 1.02 in EG and from 0.98 to 1.00 in UCG. In EG, Biering-Sørensen's test improved by 17 s, and in UCG, it improved by 24 s. No statistically significant between-group differences were found in any variables. Median exercise frequency in EG decreased from 2.5×/week during the first two intervention months to 1.7×/week during the last two intervention months. Conclusions: Twelve-month progressive exercise program was equally effective as usual care in improving trunk muscle strength. Home exercise adherence decreased, which may have influenced the strength changes.Implications for rehabilitationThe 12-month home-based exercise program was equally as effective as usual care after lumbar spine fusion (LSF) in improving trunk muscle strength, however, the back-specific exercises led to better trunk muscle strength balance in exercise group only.The adherence to the home based exercise program is a challenge; therefore, different techniques could be implemented to provide purposeful support for each individual in their long-term exercising.It is important to recognize those who need more individualized rehabilitation in recovery of the spine function, while others may manage with subtle intervention after LSF.
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Affiliation(s)
- Outi Ilves
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marko H Neva
- Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - Keijo Häkkinen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Joost Dekker
- Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Salme Järvenpää
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
| | - Kati Kyrölä
- Department of Orthopaedics and Trauma, Central Finland Health Care District, Jyväskylä, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
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Randomized Trial of General Strength and Conditioning Versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes. J Clin Med 2020; 9:jcm9061726. [PMID: 32503243 PMCID: PMC7355598 DOI: 10.3390/jcm9061726] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 12/29/2022] Open
Abstract
Exercise and spinal manipulative therapy are commonly used for the treatment of chronic low back pain (CLBP) in Australia. Reduction in pain intensity is a common outcome; however, it is only one measure of intervention efficacy in clinical practice. Therefore, we evaluated the effectiveness of two common clinical interventions on physical and self-report measures in CLBP. Participants were randomized to a 6-month intervention of general strength and conditioning (GSC; n = 20; up to 52 sessions) or motor control exercise plus manual therapy (MCMT; n = 20; up to 12 sessions). Pain intensity was measured at baseline and fortnightly throughout the intervention. Trunk extension and flexion endurance, leg muscle strength and endurance, paraspinal muscle volume, cardio-respiratory fitness and self-report measures of kinesiophobia, disability and quality of life were assessed at baseline and 3- and 6-month follow-up. Pain intensity differed favoring MCMT between-groups at week 14 and 16 of treatment (both, p = 0.003), but not at 6-month follow-up. Both GSC (mean change (95%CI): −10.7 (−18.7, −2.8) mm; p = 0.008) and MCMT (−19.2 (−28.1, −10.3) mm; p < 0.001) had within-group reductions in pain intensity at six months, but did not achieve clinically meaningful thresholds (20mm) within- or between-group. At 6-month follow-up, GSC increased trunk extension (mean difference (95% CI): 81.8 (34.8, 128.8) s; p = 0.004) and flexion endurance (51.5 (20.5, 82.6) s; p = 0.004), as well as leg muscle strength (24.7 (3.4, 46.0) kg; p = 0.001) and endurance (9.1 (1.7, 16.4) reps; p = 0.015) compared to MCMT. GSC reduced disability (−5.7 (−11.2, −0.2) pts; p = 0.041) and kinesiophobia (−6.6 (−9.9, −3.2) pts; p < 0.001) compared to MCMT at 6-month follow-up. Multifidus volume increased within-group for GSC (p = 0.003), but not MCMT or between-groups. No other between-group changes were observed at six months. Overall, GSC improved trunk endurance, leg muscle strength and endurance, self-report disability and kinesiophobia compared to MCMT at six months. These results show that GSC may provide a more diverse range of treatment effects compared to MCMT.
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71
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Martínez-Romero MT, Ayala F, De Ste Croix M, Vera-Garcia FJ, Sainz de Baranda P, Santonja-Medina F, Sánchez-Meca J. A Meta-Analysis of the Reliability of Four Field-Based Trunk Extension Endurance Tests. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3088. [PMID: 32365490 PMCID: PMC7246735 DOI: 10.3390/ijerph17093088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/26/2020] [Indexed: 12/30/2022]
Abstract
This meta-analysis aimed to estimate the inter- and intra-tester reliability of endurance measures obtained through trunk extension field-based tests and to explore the influence of the moderators on the reliability estimates. The reliability induction rate of trunk extension endurance measures was also calculated. A systematic search was conducted using various databases, and subsequently 28 studies were selected that reported intraclass correlation coefficients for trunk extension endurance measures. Separate meta-analyses were conducted using a random-effects model. When possible, analyses of potential moderator variables were carried out. The inter-tester average reliability of the endurance measure obtained from the Biering-Sorensen test was intraclass correlation coefficient (ICC) = 0.94. The intra-session reliability estimates of the endurance measures recorded using the Biering-Sorensen test, the prone isometric chest raise test, and the prone double straight-leg test were ICC = 0.88, 0.90, and 0.86, respectively. The inter-session average reliability of the endurance measures from the Biering-Sorensen test, the prone isometric chest raise test, and the dynamic extensor endurance test were ICC = 0.88, 0.95, and 0.99, respectively. However, due to the limited evidence available, the reliability estimates of the measures obtained through the prone isometric chest raise, prone double straight-leg, and dynamic extensor endurance tests should be considered with a degree of caution. Position control instruments, tools, and familiarization session demonstrated a statistical association with the inter-session reliability of the Biering-Sorensen test. The reliability induction rate was 72.8%. Only the trunk extension endurance measure obtained through the Biering-Sorensen test presented sufficient scientific evidence in terms of reliability to justify its use for research and practical purposes.
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Affiliation(s)
- María Teresa Martínez-Romero
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, 30720 San Javier (Murcia), Spain
| | - Francisco Ayala
- Department of Sport Science, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche (Alicante), Spain
| | - Mark De Ste Croix
- School of Sport and Exercise, Exercise and Sport Research Centre, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - Francisco J. Vera-Garcia
- Department of Sport Science, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche (Alicante), Spain
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, 30720 San Javier (Murcia), Spain
| | - Fernando Santonja-Medina
- Department of Surgery, Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Traumatology and Orthopedic Surgery Service, Virgen de la Arrixaca University Clinical Hospital, 30120 Murcia, Spain
| | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain
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Ekström L, Zhang Q, Abrahamson J, Beck J, Johansson C, Westin O, Todd C, Baranto A. A model for evaluation of the electric activity and oxygenation in the erector spinae muscle during isometric loading adapted for spine patients. J Orthop Surg Res 2020; 15:155. [PMID: 32303232 PMCID: PMC7165389 DOI: 10.1186/s13018-020-01652-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Simultaneous measurement of electromyography (EMG) and local muscle oxygenation is proposed in an isometric loading model adjusted for patients that have undergone spinal surgery. METHODS Twelve patients with degenerative lumbar spinal stenosis (DLSS) were included. They were subjected to a test protocol before and after surgery. The protocol consisted of two parts, a dynamic and an isometric Ito loading with a time frame of 60 s and accompanying rest of 120 s. The Ito test was repeated three times. EMG was measured bilaterally at the L4 level and L2 and was recorded using surface electrodes and collected (Biopac Systems Inc.). EMG signal was expressed as RMS and median frequency (MF). Muscle tissue oxygen saturation (MrSO2) was monitored using a near-infrared spectroscopy (NIRS) device (INVOS® 5100C Oxymeter). Two NIRS sensors were positioned bilaterally at the L4 level. The intensity of the leg and back pain and perceived exertion before, during, and after the test was evaluated with a visual analogue scale (VAS) and Borg RPE-scale, respectively. RESULTS All patients were able to perform and complete the test protocol pre- and postoperatively. A consistency of lower median and range values was noted in the sensors of EMG1 (15.3 μV, range 4.5-30.7 μV) and EMG2 (13.6 μV, range 4.0-46.5 μV) that were positioned lateral to NIRS sensors at L4 compared with EMG3 (18.9 μV, range 6.5-50.0 μV) and EMG4 (20.4 μV, range 7.5-49.0 μV) at L2. Right and left side of the erector spinae exhibited a similar electrical activity behaviour over time during Ito test (60 s). Regional MrSO2 decreased over time during loading and returned to the baseline level during recovery on both left and right side. Both low back and leg pain was significantly reduced postoperatively. CONCLUSION Simultaneous measurement of surface EMG and NIRS seems to be a promising tool for objective assessment of paraspinal muscle function in terms of muscular activity and local muscle oxygenation changes in response to isometric trunk extension in patients that have undergone laminectomy for spinal stenosis.
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Affiliation(s)
- Lars Ekström
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden.
| | - Qiuxia Zhang
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Josefin Abrahamson
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Joel Beck
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Christer Johansson
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Olof Westin
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Carl Todd
- The Carl Todd Clinic, 5 Pickwick Park, Park Lane, Corsham, SN13 0HN, UK
| | - Adad Baranto
- Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden
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73
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Task-Specific Sensitivity in Physical Function Testing Predicts Outcome in Patients With Low Back Pain. J Orthop Sports Phys Ther 2020; 50:206-213. [PMID: 31663814 DOI: 10.2519/jospt.2020.8953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the prognostic value of task-specific sensitivity in patients with low back pain by exploring whether task-specific sensitivity during physical function testing was associated with self-reported change in pain and disability. DESIGN Prospective cohort study nested in a randomized controlled trial. METHODS The study included 260 patients with low back pain, referred for evaluation in a secondary care setting. All patients completed questionnaires and underwent clinical examination by a physical therapist. Patients rated their pain intensity before and after completing a test battery measuring physical function and were classified into 4 categories-worse, unchanged, better, or no pain-depending on their pain response. At 3-month follow-up, outcomes were obtained by a postal questionnaire. RESULTS Task-specific sensitivity significantly predicted pain, after adjusting for known prognostic factors. Patients in the no pain, better, and unchanged groups improved their pain score significantly more than patients in the worse pain group. Patients in the no pain group also improved their disability score significantly more compared to patients in the worse pain group, after adjusting for known prognostic factors. CONCLUSION Task-specific sensitivity predicted pain intensity after 3 months in patients with low back pain. The prognostic value appears limited with respect to disability. J Orthop Sports Phys Ther 2020;50(4):206-213. Epub 30 Oct 2019. doi:10.2519/jospt.2020.8953.
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Cost-Effectiveness and Effects of a Home-Based Exercise Intervention for Female Caregivers of Relatives with Dementia: Study Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2020; 8:healthcare8010054. [PMID: 32155761 PMCID: PMC7151160 DOI: 10.3390/healthcare8010054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022] Open
Abstract
Previous research has proposed a range of support interventions to mitigate the adverse impact of caregiving on the daily life of caregivers of relatives with dementia. However, the effectiveness of these interventions shows a high variability. Informal caregivers usually lack the time and/or live too far from conventional facilities to do physical exercise, especially those who live in rural areas. Thus, home-based interventions may be more efficacious due to their greater convenience for this population. The present work proposes and describes a study protocol for a randomized control trial that will analyze the efficacy and cost-effectiveness of a home-based, structured individual physical exercise intervention to improve the health-related quality of life and the mental health of female informal caregivers of relatives with dementia. The nine-month-long intervention will comprise participation in two supervised physical exercise sessions per week at the caregiver’s home. The proposed study outcomes will be: (1) feasibility of and adherence to the home-based provision of the intervention; (2) improvement in physical fitness and quality of life; and (3) reduction in subjective burden, psychological symptomatology and depression. Analyses will also be performed to determine the cost-effectiveness after the intervention. In conclusion, this intervention might thus represent a tailored and feasible strategy to help caregivers cope with the physical and psychological stress resulting from caregiving-related responsibilities, and it could represent a novel cost-effective support home-based intervention for caregivers.
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Carlos-Vivas J, Pérez-Gómez J, Delgado-Gil S, Campos-López JC, Granado-Sánchez M, Rojo-Ramos J, Muñoz-Bermejo L, Barrios-Fernandez S, Mendoza-Muñoz M, Prado-Solano A, Garcia-Gordillo MÁ, Adsuar JC. Cost-Effectiveness of "Tele-Square Step Exercise" for Falls Prevention in Fibromyalgia Patients: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030695. [PMID: 31973115 PMCID: PMC7037096 DOI: 10.3390/ijerph17030695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 01/07/2023]
Abstract
Background: Women with fibromyalgia (FM) have 2.5 falls per year compared to the 0.5 falls in people without FM. This fact poses a significant health expense. Square Stepping Exercise (SSE) is a balance training system that has been shown to be effective in preventing falls in the elderly. However, there are neither studies in people with FM nor studies that apply SSE through video-conferencing (Tele-SSE). The objectives of this project are 1) to investigate the applicability, safety, decrease in the number of falls, and incremental cost-effectiveness ratio of prevention of falls program through Tele-SSE in women with FM, and 2) to study the transfer of obtained results to the public and private socio-health economy of Extremadura. Methods/Design: A randomized controlled trial with experimental (Tele-SSE) and control (usual treatment) groups will be carried out. The application of Tele-SSE will be performed for 12 months (three times per week) and one additional follow-up month after the intervention. A focus group including agents to identify key points to transfer the findings to the public and private sectors in Extremadura. One-hundred and eighteen women with FM will be recruited and randomly distributed into the two groups: Experimental (Tele-SSE; n = 59) and control group (Usual care; n = 59). Primary outcome measures will be: 1) Applicability; 2) safety; 3) annual number of falls; and 4) incremental cost-effectiveness ratio. Secondary outcomes will be: 1) Balance; 2) fear of falling; 3) socio-demographic and clinical information; 4) body composition; 5) physical fitness; 6) physical activity and sedentary behavior; 7) quality of life-related to health, mental health, and positive health; 8) pain; 9) disability level; 10) cognitive aspects; and 11) depressive symptoms. Regarding the focus group, the acceptability of the Tele-SSE will be evaluated in social-sanitary agents and will include Tele-SSE in their services offer. A statistical analysis will be carried out by treatment intention and protocol. In addition, a cost-effectiveness analysis from the perspective of the health system will be performed. Discussion: This project aims to improve the efficiency and equity of physical therapy services based on tele-exercise in preventing falls in people with FM. Furthermore, orientations will be given in order to transfer the obtained findings into the social-sanitary system and market.
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Affiliation(s)
- Jorge Carlos-Vivas
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, Cáceres 10003, Spain; (M.M.-M.); (A.P.-S.); (J.C.A.)
- Correspondence: (J.C.-V.); (J. P.-G.)
| | - Jorge Pérez-Gómez
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, Cáceres 10003, Spain; (M.M.-M.); (A.P.-S.); (J.C.A.)
- Correspondence: (J.C.-V.); (J. P.-G.)
| | - Serafín Delgado-Gil
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, Cáceres 10003, Spain; (S.D.-G.); (J.C.C.-L.); (M.G.-S.); (J.R.-R.); (L.M.-B.); (S.B.-F.)
| | - José Carlos Campos-López
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, Cáceres 10003, Spain; (S.D.-G.); (J.C.C.-L.); (M.G.-S.); (J.R.-R.); (L.M.-B.); (S.B.-F.)
| | - Manuel Granado-Sánchez
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, Cáceres 10003, Spain; (S.D.-G.); (J.C.C.-L.); (M.G.-S.); (J.R.-R.); (L.M.-B.); (S.B.-F.)
| | - Jorge Rojo-Ramos
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, Cáceres 10003, Spain; (S.D.-G.); (J.C.C.-L.); (M.G.-S.); (J.R.-R.); (L.M.-B.); (S.B.-F.)
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, Cáceres 10003, Spain; (S.D.-G.); (J.C.C.-L.); (M.G.-S.); (J.R.-R.); (L.M.-B.); (S.B.-F.)
| | - Sabina Barrios-Fernandez
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, Cáceres 10003, Spain; (S.D.-G.); (J.C.C.-L.); (M.G.-S.); (J.R.-R.); (L.M.-B.); (S.B.-F.)
- Department of Terapéutica Médico-Quirúgica, Faculty of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain
| | - María Mendoza-Muñoz
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, Cáceres 10003, Spain; (M.M.-M.); (A.P.-S.); (J.C.A.)
| | - Angelina Prado-Solano
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, Cáceres 10003, Spain; (M.M.-M.); (A.P.-S.); (J.C.A.)
| | | | - José Carmelo Adsuar
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, Cáceres 10003, Spain; (M.M.-M.); (A.P.-S.); (J.C.A.)
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Tagliaferri SD, Miller CT, Owen PJ, Mitchell UH, Brisby H, Fitzgibbon B, Masse-Alarie H, Van Oosterwijck J, Belavy DL. Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective. Pain Pract 2019; 20:211-225. [PMID: 31610090 DOI: 10.1111/papr.12846] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/26/2019] [Accepted: 10/09/2019] [Indexed: 12/25/2022]
Abstract
Nonspecific chronic low back pain (CLBP) is a common clinical condition that has impacts at both the individual and societal level. Pain intensity is a primary outcome used in clinical practice to quantify the severity of CLBP and the efficacy of its treatment; however, pain is a subjective experience that is impacted by a multitude of factors. Moreover, differences in effect sizes for pain intensity are not observed between common conservative treatments, such as spinal manipulative therapy, cognitive behavioral therapy, acupuncture, and exercise training. As pain science evolves, the biopsychosocial model is gaining interest in its application for CLBP management. The aim of this article is to discuss our current scientific understanding of pain and present why additional factors should be considered in conservative CLBP management. In addition to pain intensity, we recommend that clinicians should consider assessing the multidimensional nature of CLBP by including physical (disability, muscular strength and endurance, performance in activities of daily living, and body composition), psychological (kinesiophobia, fear-avoidance, pain catastrophizing, pain self-efficacy, depression, anxiety, and sleep quality), social (social functioning and work absenteeism), and health-related quality-of-life measures, depending on what is deemed relevant for each individual. This review also provides practical recommendations to clinicians for the assessment of outcomes beyond pain intensity, including information on how large a change must be for it to be considered "real" in an individual patient. This information can guide treatment selection when working with an individual with CLBP.
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Affiliation(s)
- Scott D Tagliaferri
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Clint T Miller
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Patrick J Owen
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, U.S.A
| | - Helena Brisby
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Bernadette Fitzgibbon
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Epworth Centre for Innovation in Mental Health, Epworth HealthCare, Melbourne, Victoria, Australia
| | - Hugo Masse-Alarie
- Centre Interdisciplinaire de Recherche en Réadaptation et Integration Sociale (CIRRIS), Université Laval, Québec City, Québec, Canada
| | - Jessica Van Oosterwijck
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium.,Research Foundation - Flanders (FWO), Brussels, Belgium.,Pain in Motion International Research Group
| | - Daniel L Belavy
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
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Colgrove YM, Gravino-Dunn NS, Dinyer SC, Sis EA, Heier AC, Sharma NK. Physical and Physiological Effects of Yoga for an Underserved Population with Chronic Low Back Pain. Int J Yoga 2019; 12:252-264. [PMID: 31543635 PMCID: PMC6746048 DOI: 10.4103/ijoy.ijoy_78_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Yoga has been shown useful in reducing chronic low back pain (CLBP) through largely unknown mechanisms. The aim of this pilot study is to investigate the feasibility of providing yoga intervention to a predominantly underserved population and explore the potential mechanisms underlying yoga intervention in improving CLBP pain. Methods The quasi-experimental within-subject wait-listed crossover design targeted the recruitment of low-income participants who received twice-weekly group yoga for 12 weeks, following 6-12 weeks of no intervention. Outcome measures were taken at baseline, preintervention (6-12 weeks following baseline), and then postintervention. Outcome measures included pain, disability, core strength, flexibility, and plasma tumor necrosis factor (TNF)-α protein levels. Outcomes measures were analyzed by one-way ANOVA and paired one-tailed t-tests. Results Eight patients completed the intervention. Significant improvements in pain scores measured over time were supported by the significant improvement in pre- and post-yoga session pain scores. Significant improvements were also seen in the Oswestry Disability Questionnaire scores, spinal and hip flexor flexibility, and strength of core muscles following yoga. Six participants saw a 28.6%-100% reduction of TNF-α plasma protein levels after yoga, while one showed an 82.4% increase. Two participants had no detectable levels to begin with. Brain imaging analysis shows interesting increases in N-acetylaspartate in the dorsolateral prefrontal cortex and thalamus. Conclusion Yoga appears effective in reducing pain and disability in a low-income CLBP population and in part works by increasing flexibility and core strength. Changes in TNF-α protein levels should be further investigated for its influence on pain pathways.
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Affiliation(s)
- Yvonne M Colgrove
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Nicole S Gravino-Dunn
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Sarah C Dinyer
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Emily A Sis
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Alexa C Heier
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Neena K Sharma
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA
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Upper back pain in postmenopausal women and associated physical characteristics. PLoS One 2019; 14:e0220452. [PMID: 31365548 PMCID: PMC6668906 DOI: 10.1371/journal.pone.0220452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/16/2019] [Indexed: 11/19/2022] Open
Abstract
The physical characteristics of postmenopausal women that are associated with upper back pain are not well-understood. The aim of this cross-sectional study was to identify the physical characteristics associated with presence and severity of upper back pain in healthy postmenopausal women. Self-reported upper back pain presence (within the previous month) and severity (numerical rating scale) were examined against the physical characteristics: height; weight; body mass index; breast size; breast ptosis; upper back extensor muscle endurance (isometric chest raise test); head, shoulder and upper back posture (photogrammetry); thoracic extension mobility (photogrammetry); bone mineral density (dual-energy x-ray absorptiometry (DXA)); body composition (DXA); and thoracic kyphosis, thoracic osteoarthritis and thoracic vertebral fracture (all radiography). A multivariable logistic regression model, adjusted for age, was built using physical characteristics with a significant univariate association with upper back pain. Censored Tobit regression, adjusted for age, was used to examine each physical characteristic against upper back pain severity. Postmenopausal women (n = 119) with a mean (SD) age of 61.4 (7.0) years participated in the study. After adjusting for age, the physical characteristics independently associated with upper back pain were: height (OR: 0.50, 95% CI: 0.31–0.79); and upper back extensor muscle endurance (OR: 0.46, 95%CI: 0.28–0.75). This model explained 31% of the variance in upper back pain (p<0.001). After adjusting for age, being taller and having better upper back extensor muscle endurance were associated with lower odds for upper back pain. After adjusting for age, differences in upper back pain severity were explained by upper back extensor muscle endurance (p = <0.001) and lean mass (p = 0.01). Conclusion: As a modifiable physical characteristic of postmenopausal women with upper back pain, upper back extensor muscle endurance is worth considering clinically.
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Kongsted A, Hartvigsen J, Boyle E, Ris I, Kjaer P, Thomassen L, Vach W. GLA:D® Back: group-based patient education integrated with exercises to support self-management of persistent back pain - feasibility of implementing standardised care by a course for clinicians. Pilot Feasibility Stud 2019; 5:65. [PMID: 31086676 PMCID: PMC6507160 DOI: 10.1186/s40814-019-0448-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/12/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Clinical guidelines for management of low back pain (LBP) are not routinely implemented in practice, and guidelines rarely offer tools for implementation. Therefore, we developed GLA:D® Back, a standardised intervention of patient education and supervised exercises. This pilot study tested the feasibility of implementing GLA:D Back in clinical practice in Denmark by delivering a course for physiotherapists and chiropractors. It should further inform the planning of an implementation-effectiveness study using a pre-post group design alongside nation-wide implementation. METHODS Thirty-one clinicians from nine clinics participated. Feasibility of implementation was evaluated in terms of adoption and through focus group interviews and a feedback meeting. Patient-level data, including pain, disability, and pain enablement, were collected from (1) LBP patients visiting the clinics during a pre-specified 2-week period 2 months prior to clinicians attending the GLA:D Back course (n = 84), (2) LBP patients consulting during a 2-week period 2 months after the course (n = 77), and (3) those enrolled in GLA:D Back during 4 months after implementation (n = 89). Patient data were collected at baseline and at 4 months. RESULTS Clinicians' evaluations of the course were positive and resulted in several modifications. The clinical intervention was adopted by all test sites. Most patient characteristics were similar across groups. Patients mainly had persistent LBP (73% > 3 months) and most had been treated for more than 4 weeks at inclusion. Patients in GLA:D Back were more often retired (30% vs. 16% before implementation) and at high risk of poor prognosis (25% vs. 13%). Procedures for data collection were feasible, and outcomes after implementation, especially with GLA:D Back, were as good as or better than before implementation. Recruiting patients and achieving comparable pre- and post-groups was difficult. CONCLUSIONS Implementation of the GLA:D Back clinical intervention in Danish primary care physiotherapy and chiropractic clinics was feasible through a 2-day clinician course. Both clinicians and patients were satisfied with the programme, and patient-reported outcomes were slightly better than outcomes in patients registered before implementation. It was not deemed possible to conduct an implementation-effectiveness trial as part of a nation-wide implementation.
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Affiliation(s)
- Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Inge Ris
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Kjaer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Health Sciences Research Centre, University College Lillebaelt, Odense, Denmark
| | - Line Thomassen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Werner Vach
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
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Grande-Alonso M, Suso-Martí L, Cuenca-Martínez F, Pardo-Montero J, Gil-Martínez A, La Touche R. Physiotherapy Based on a Biobehavioral Approach with or Without Orthopedic Manual Physical Therapy in the Treatment of Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial. PAIN MEDICINE 2019; 20:2571-2587. [DOI: 10.1093/pm/pnz093] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Objective
To compare the effectiveness of a biobehavioral approach with and without orthopedic manual physical therapy on the intensity and frequency of pain in patients diagnosed with nonspecific chronic low back pain.
Methods
A single-blind randomized controlled trial. Fifty patients were randomly allocated into two groups: one group received biobehavioral therapy with orthopedic manual physical therapy, and the other group received only biobehavioral therapy. Both groups completed a total of eight sessions, with a frequency of two sessions per week. The somatosensory, physical, and psychological variables were recorded at baseline and during the first and third month after initiation of treatment.
Results
In both groups, the treatment was effective, presenting significant differences for all the variables in the time factor. There were no significant differences between groups in intensity or frequency of pain, with a large effect size (>0.80), but there were intragroup differences for both intervention groups at one- and three-month follow-up. There were also no significant differences between groups in the secondary variables during the same follow-up period.
Conclusions
The results of this study suggest that orthopedic manual physical therapy does not increase the effects of a treatment based on biobehavioral therapy in the short or medium term, but these results should be interpreted with caution.
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Affiliation(s)
- Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Joaquín Pardo-Montero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
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Murillo C, Falla D, Rushton A, Sanderson A, Heneghan NR. Shear wave elastography investigation of multifidus stiffness in individuals with low back pain. J Electromyogr Kinesiol 2019; 47:19-24. [PMID: 31077992 DOI: 10.1016/j.jelekin.2019.05.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 12/26/2022] Open
Abstract
The purpose of this study was to investigate differences in passive muscular stiffness between the superficial multifidus (SM) and deep multifidus (DM), and to compare their passive and active stiffness in individuals with low back pain (LBP) and asymptomatic individuals. Fifteen LBP individuals and 15 asymptomatic individuals were recruited. Passive stiffness of the SM and DM was measured bilaterally using shear wave elastography (SWE) with participants lying prone. Active stiffness was measured for the SM during trunk extension, and the contraction ratio was calculated. DM displayed higher passive muscular stiffness than SM in both the asymptomatic and LBP groups (14.41 ± 2.62 and 15.40 ± 2.77 kPa respectively; p < 0.001). Individuals with LBP exhibited higher passive muscular stiffness of SM (LBP: 10.15 ± 4.21, asymptomatic: 6.84 ± 1.69 kPa; p < 0.005) and a lower contraction ratio (LBP: 1.54 ± 0.47, asymptomatic: 2.65 ± 1.36 kPa; p < 0.003) compared to the asymptomatic group. The findings support a differentiation in passive muscular stiffness between SM and DM and provide evidence for an alteration in muscular stiffness at rest in individuals with LBP. The lower increase of muscular stiffness with contraction observed for those with LBP may reflect a deficit in activation of the multifidus.
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Affiliation(s)
- Carlos Murillo
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, UK
| | - Andy Sanderson
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, UK.
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Jørgensen MB, Gupta N, Korshøj M, Lagersted-Olsen J, Villumsen M, Mortensen OS, Skotte J, Søgaard K, Madeleine P, Samani A, Ørberg A, Rasmussen CL, Holtermann A. The DPhacto cohort: An overview of technically measured physical activity at work and leisure in blue-collar sectors for practitioners and researchers. APPLIED ERGONOMICS 2019; 77:29-39. [PMID: 30832776 DOI: 10.1016/j.apergo.2019.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 01/14/2019] [Accepted: 01/17/2019] [Indexed: 05/27/2023]
Abstract
For improved prevention of health issues among blue-collar workers, there is a need for an overview of the physical activity at work and leisure using technical long-term measurements in blue-collar sectors investigation of differences between the sectors. Thus, the objective of this paper was to provide an overview and investigate differences in physical activities and body postures at work and leisure among blue-collar sectors. The Dphacto cohort consists of 1087 workers from manufacturing, transportation and cleaning sectors (901 blue-collar and 186 white-collar workers) in Denmark. Eligible workers provided physical activity and heart rate measurements over several days with follow-up on health-related outcomes by self-report and registers. Considerable differences in sitting, standing, time on feet (walking, shuffling and standing combined) and forward bending of the back were found between work and leisure, and between the sectors. This overview of physical activity at work and leisure can be useful for better prevention of work-related health issues among blue-collar workers.
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Affiliation(s)
- Marie Birk Jørgensen
- Department of Forensic Medicine, University of Copenhagen, 2100, Copenhagen, Denmark.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Morten Villumsen
- National Research Centre for the Working Environment, Copenhagen, Denmark; Sport Sciences, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg East, Denmark; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Denmark; Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
| | - Jørgen Skotte
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Pascal Madeleine
- Sport Sciences, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg East, Denmark
| | - Afshin Samani
- Sport Sciences, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg East, Denmark
| | - Anders Ørberg
- Department of Epidemiology and Biostatistics, Central Region, Denmark
| | - Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Kongsted A, Ris I, Kjaer P, Vach W, Morsø L, Hartvigsen J. GLA:D ® Back: implementation of group-based patient education integrated with exercises to support self-management of back pain - protocol for a hybrid effectiveness-implementation study. BMC Musculoskelet Disord 2019; 20:85. [PMID: 30777049 PMCID: PMC6380042 DOI: 10.1186/s12891-019-2443-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 01/30/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Reassuring patient education and exercise therapy are widely recommended interventions for back pain in clinical guidelines. However, many patients are offered non-guideline endorsed options, and strategies for effective implementation of guideline-based care have not yet been developed. This protocol outlines the evaluation of a strategy for nationwide implementation of standardised patient education and exercise therapy for people with persistent or recurrent back pain in a hybrid implementation-effectiveness design. The strategy and the evaluation were planned using the framework of the Behaviour Change Wheel. METHODS The main activity of the implementation strategy is a two-days course for physiotherapists and chiropractors in delivering patient education and exercise therapy that is aimed at supporting patient self-management. This comes with ready-to-use patient education materials and exercise programs. The clinical intervention is a group-based program consisting of two sessions of patient education and 8 weeks of supervised exercises. The program uses a cognitive-behavioural approach and the aim of the exercise component is to restore the patient's ability and confidence to move freely. The implementation process is evaluated in a dynamic process monitoring the penetration, adoption and fidelity of the clinical intervention. The clinical intervention and potential effect mechanisms will be evaluated at the patient-level using measures of knowledge, skills, beliefs, performance, self-efficacy and success in self-management. The education of clinicians will be evaluated via clinician-level outcomes, including the Pain Attitudes and Beliefs Scale, the Practitioner Confidence Scale, and the Determinants of Implementation Behaviour Questionnaire. Effects at a national level will be investigated via data from national registries of health care utilisation and sick-leave. DISCUSSION This implementation-effectiveness study is designed to evaluate the process of implementing an evidence-based intervention for back pain. It will inform the development of strategies for implementing evidence-based care for musculoskeletal pain conditions, it will enhance the understanding of mechanisms for developing patient self-management skills, and it will demonstrate the outcomes that are achievable in everyday clinical practice. TRIAL REGISTRATION ClinicalTrials.gov NCT03570463 . Registered 27 June 2018.
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Affiliation(s)
- Alice Kongsted
- The Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Inge Ris
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Kjaer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Applied Health Science, University College Lillebaelt, Odense, Denmark
| | - Werner Vach
- The Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Lars Morsø
- Centre for Quality, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Sanderson A, Martinez-Valdes E, Heneghan NR, Murillo C, Rushton A, Falla D. Variation in the spatial distribution of erector spinae activity during a lumbar endurance task in people with low back pain. J Anat 2019; 234:532-542. [PMID: 30663783 DOI: 10.1111/joa.12935] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2018] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate the spatial distribution and redistribution of lumbar erector spinae (ES) activity during a lumbar extension endurance task in pain-free participants and how this is modified in people with low back pain (LBP). High density surface electromyography (HDEMG) was recorded using 13 × 5 electrode grids placed over the lumbar ES in 13 LBP and 13 control participants while completing an Ito test to task failure. The root mean square of the HDEMG signals was computed, a topographical map of the EMG amplitude generated and the centre of the activity (centroid) determined throughout the task. The centroid of the EMG amplitude map was systematically more cranial (F = 6.09, P = 0.022) for the LBP participants compared with the control subjects. Regression analysis showed that the extent of redistribution of ES activity was associated with longer endurance. These results show that LBP participants utilised a different motor strategy to perform the endurance task, characterised by greater activation of more cranial regions of the ES and less redistribution of ES activity throughout the task. This study provides new insight into the functional activation of the lumbar ES and how it is modified when people have pain.
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Affiliation(s)
- Andy Sanderson
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Carlos Murillo
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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BELAVY DANIELL, QUITTNER MATTHEW, RIDGERS NICOLAD, LING YUAN, CONNELL DAVID, TRUDEL GUY, RANTALAINEN TIMO. Beneficial Intervertebral Disc and Muscle Adaptations in High-Volume Road Cyclists. Med Sci Sports Exerc 2019; 51:211-217. [DOI: 10.1249/mss.0000000000001770] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kjaer P, Kongsted A, Ris I, Abbott A, Rasmussen CDN, Roos EM, Skou ST, Andersen TE, Hartvigsen J. GLA:D ® Back group-based patient education integrated with exercises to support self-management of back pain - development, theories and scientific evidence. BMC Musculoskelet Disord 2018; 19:418. [PMID: 30497440 PMCID: PMC6267880 DOI: 10.1186/s12891-018-2334-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/31/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Clinical guidelines recommend that people with back pain be given information and education about their back pain, advice to remain active and at work, and exercises to improve mobility and physical activity. Guidelines, however, rarely describe how this is best delivered. The aim of this paper is to present the development, theories, and underlying evidence for 'GLA:D Back' - a group education and exercise program that translates guideline recommendations into a clinician-delivered program for the promotion of self-management in people with persistent/recurrent back pain. METHODS GLA:D Back, which included a rationale and objectives for the program, theory and evidence for the interventions, and program materials, was developed using an iterative process. The content of patient education and exercise programs tested in randomised trials was extracted and a multidisciplinary team of expert researchers and clinicians prioritised common elements hypothesised to improve back pain beliefs and management skills. The program was tested on eight people with persistent back pain in a university clinic and 152 patients from nine primary care physiotherapy and chiropractic clinics. Following feedback from the clinicians and patients involved, the working version of the program was created. RESULTS Educational components included pain mechanisms, pain modulation, active coping strategies, imaging, physical activity, and exercise that emphasised a balance between the sum of demands and the individual's capacity. These were operationalised in PowerPoint presentations with supporting text to aid clinicians in delivering two one-hour patient education lectures. The exercise program included 16 supervised one-hour sessions over 8 weeks, each comprising a warm-up section and eight types of exercises for general flexibility and strengthening of six different muscle groups at four levels of difficulty. The aims of the exercises were to improve overall back fitness and, at the same time, encourage patients to explore variations in movement by incorporating education content into the exercise sessions. CONCLUSION From current best evidence about prognostic factors in back pain and effective treatments for back pain, research and clinical experts developed a ready-to-use structured program - GLA:D® Back - to support self-management for people with persistent/recurrent back pain.
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Affiliation(s)
- Per Kjaer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Department of Applied Health Services, University College Lillebaelt, Niels Bohrs Alle 1, 5230 Odense M, Denmark
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
| | - Inge Ris
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Allan Abbott
- Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Sandbäcksgatan 7/3, University Hospital Campus, Linköping University, 581 83 Linköping, Sweden
| | | | - Ewa M. Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Søren T. Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
| | - Tonny Elmose Andersen
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
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Chiang SL, Lin CH, Hsu YD, Wei SH, Sung WH, Lu LH, Chang ST, Ho TY, Shen YP, Chen LC, Lin CH. Analysis of trunk rolling in Parkinson's disease patients using a mattress mobility detection system. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 162:157-163. [PMID: 29903482 DOI: 10.1016/j.cmpb.2018.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 03/30/2018] [Accepted: 04/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Parkinson's disease (PD) is a neurodegenerative condition characterized by motor dysfunction and various types of non-motor impairments. The reaction time and movement time are reported to become more severe delayed in worse PD patients. Most tools for evaluating motor impairment are limited by relying on subjective observations and being qualitative in design. The aim of this study was to investigate trunk rolling performance in PD patients by using a recently developed system to detect turning in bed. METHODS The study included 20 PD patients and 42 healthy controls. A mattress mobility detection system was employed for quantitative measurements. Each test session consisted of subjects starting by lying in a supine position on a bed and rolling 10 times onto their left side and 10 times onto their right side. Strain gauges mounted under the feet of the bed recorded changes in the center of pressure (CoP). RESULTS For turning back, the patients compared with the controls had significantly longer movement time (P = 0.017), longer time to peak counteraction (P = 0.001), larger ratio of peak counteraction to movement time (P = 0.006), shorter CoP displacement (P < 0.0001), slower turning speed (P = 0.000), weaker peak counteraction (P = 0.013), and smaller ratio of peak counteraction to weight (P = 0.032). Results for turning over were similar except there was no significant difference in the ratio of peak counteraction to weight. CONCLUSIONS The mattress mobility detection system was useful for objectively assessing trunk rolling performance of PD patients. Improved assessment of trunk function in PD patients could lead to better treatments and improved rehabilitation procedures.
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Affiliation(s)
- Shang-Lin Chiang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chueh-Ho Lin
- School of Gerontology Health Management & Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taiwan
| | - Yaw-Don Hsu
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shun-Hwa Wei
- Department of Physical Therapy and Assistive Technology, National Yang Ming University, Taipei, Taiwan
| | - Wen-Hsu Sung
- Department of Physical Therapy and Assistive Technology, National Yang Ming University, Taipei, Taiwan
| | - Liang-Hsuan Lu
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shin-Tsu Chang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsung-Yen Ho
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ping Shen
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Liang-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Huei Lin
- School of Nursing & School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Nursing, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan.
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Rose-Dulcina K, Vuillerme N, Tabard-Fougère A, Dayer R, Dominguez DE, Armand S, Genevay S. Identifying Subgroups of Patients With Chronic Nonspecific Low Back Pain Based on a Multifactorial Approach: Protocol For a Prospective Study. JMIR Res Protoc 2018; 7:e104. [PMID: 29685875 PMCID: PMC5938595 DOI: 10.2196/resprot.9224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023] Open
Abstract
Background Low back pain, especially nonspecific chronic low back pain (LBP), the leading cause of disability worldwide, represents both social and economic problems. Different therapeutic management techniques can be used, but their effects vary. Clinicians and researchers attribute the variation in the efficacy of therapeutic and management techniques to the heterogeneity of the nonspecific chronic low back pain population, and they agree that nonspecific chronic LBP must be subgrouped. Objective This study aims to identify nonspecific chronic LBP subgroups based on a multifactorial approach, including biomechanical, physical, and psychosocial data. Methods A total of 100 nonspecific chronic LBP patients and 30 healthy participants aged between 18 and 60 years will be recruited for this prospective study. A psychosocial profile will be established using questionnaires on anxiety, depression, functional disability, pain, fear of pain, avoidance belief, and physical activity. A physical capacity evaluation will be conducted. It will evaluate flexibility of the hips, lumbar spine, and lateral thoracolumbar segment, as well as trunk (extensor and flexor) muscle endurance. The subjects will perform functional daily life activities, such as walking, object lifting, forward bending, sit-to-stand, stand-to-sit, balance, and usual postures. Full body kinematics, kinetics, and surface electromyography of the trunk and hip muscles will be assessed during these tasks. The clustering classification methods for the statistical analysis will be determined according to the data and will be used to identify the subgroups of nonspecific chronic LBP patients. Results Data collection started in September 2017 and will be completed with the inclusion of all the participants (100 nonspecific chronic LBP and 30 control). The study results will be published in peer-reviewed journals and presented at relevant international conferences. Conclusions Numerous studies have showed that the therapeutic management of nonspecific chronic LBP is difficult and has inconstant effects caused by the complexity and heterogeneity of nonspecific chronic LBP. Identifying subgroups with a multifactorial approach is more comprehensive and closer to the pathophysiology of nonspecific chronic LBP. It also represents benefit interests and a challenge both clinically and socially. The perspective of this study is expected to support clinicians for a more adapted therapeutic management for each subgroup.
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Affiliation(s)
- Kevin Rose-Dulcina
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Nicolas Vuillerme
- Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Anne Tabard-Fougère
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Romain Dayer
- Division of Paediatric Orthopaedics, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dennis E Dominguez
- Division of Orthopaedic and Trauma Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Armand
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Stéphane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Intervertebral disc status is associated with vertebral marrow adipose tissue and muscular endurance. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:1704-1711. [PMID: 29626268 DOI: 10.1007/s00586-018-5567-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/26/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Low back pain is a major public health issue. Identifying factors associated with better intervertebral disc (IVD) characteristics gives insight into IVD metabolism and highlights intervention targets for improvement of IVD health. This cross-sectional study investigates whether IVD T2-relaxation time on magnetic resonance imaging (MRI) is associated with vertebral fat fraction (VFF; to quantify marrow adipose tissue), trunk muscle cross-sectional area (CSA), muscle function and physical activity (PA). METHODS Seventy-nine healthy subjects (35 males, 44 females) without history of spinal disease were included. Lumbar IVDs T2-relaxation time, lumbar VFF and CSA of multifidus, erector spinae, quadratus lumborum, and psoas muscles were quantified via MRI. Isometric trunk flexion and extension endurance times as well as habitual PA levels and exposure to occupational spine risk factors were documented. Pearson-partial correlations adjusted for anthropometric differences by controlling for vertebral body height. RESULTS Higher IVD T2-time correlated with: (a) lower VFF (r = - 0.27, p < 0.05), (b) greater trunk extensor muscle endurance (r = 0.37, p < 0.01), and (c) greater trunk flexor muscle endurance (r = 0.30, p < 0.01) but not with muscle CSA. Lower VFF also correlated with greater extensor muscle endurance (r = - 0.26, p < 0.05) and habitual PA (MET-mins per week) (r = - 0.24, p < 0.05). CONCLUSION This is the first study to show that better IVD hydration is associated with lower VFF and that greater physical activity is associated with favourable levels of vertebral marrow adipose tissue in young healthy individuals. Reduced vertebral marrow adipose tissue may specifically improve IVD hydration via improved nutrient supply. These slides can be retrieved under Electronic Supplementary Material.
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[Inpatient multimodal pain therapy : Additive value of neuromuscular core stability exercises for chronic back pain]. Schmerz 2018; 31:115-122. [PMID: 27913929 DOI: 10.1007/s00482-016-0178-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The medical and healthcare economic burden caused by chronic lumbar back pain (CLBP) requires the use of interdisciplinary treatment approaches. The present study aimed to evaluate whether the effectiveness of inpatient multimodal pain therapy (MPT, operations and procedures (OPS) coding 8-918.02), can be increased by implementing additional neuromuscular core stability exercises (NCSE). MATERIAL AND METHODS As part of a prospective controlled study, subjects with CLBP (n = 48, 17 males, 58.2 ± 11.7 years) were allocated to one of two groups. One group received standard care (SC, n =23) encompassing manual, pharmacological and psychological therapy in addition to passive physiotherapeutic applications. The intervention group (IG, n =25) additionally completed NCSE. On the day of admission and on discharge as well as 1 and 6 weeks after inpatient care, pain intensity (numeric rating scale), pain-related routine daily functions (Oswestry disability index), well-being (SF-12 Health Survey) and motor function parameters (trunk strength, endurance and postural control) were assessed. Data analysis was performed using statistical inference methods. In addition, effect sizes (Cohen's d) of intergroup differences were calculated. RESULTS Both groups showed significant reductions in pain intensity (p < 0.05, d > 0.6) at all measurement points (MP). Physical well-being and disability (p < 0.05, d > 0.6) were improved 1 week after discharge in the intervention group only. Overall, no systematic differences between groups were detected (p > 0.05). In relation to the motor outcomes, no significant changes over time nor between groups were verified (p > 0.05). DISCUSSION Despite the use of an additional NCSE, no significant added value in individuals with CLBP could be detected, although a systematic pre-post effect in daily functions and physical well-being (one week after discharge) was observed for the IG only. Therefore, on the basis of the study results, the implementation of additional NCSE into the inpatient MPT cannot be clearly recommended. To further delineate the therapeutic relevance, studies with larger sample sizes are needed.
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ShahAli S, Arab AM, Ebrahimi E, ShahAli S, Rahmani N, Negahban H, Kazemnejad A, Bahmani A. Ultrasound measurement of abdominal muscles during clinical isometric endurance tests in women with and without low back pain. Physiother Theory Pract 2018; 35:130-138. [DOI: 10.1080/09593985.2018.1441345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Shabnam ShahAli
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Massoud Arab
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Esmaeil Ebrahimi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva ShahAli
- Medical Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Rahmani
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Andia Bahmani
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Moya-Ramón M, Juan-Recio C, Lopez-Plaza D, Vera-Garcia FJ. Dynamic trunk muscle endurance profile in adolescents aged 14-18: Normative values for age and gender differences. J Back Musculoskelet Rehabil 2018; 31:155-162. [PMID: 28800307 DOI: 10.3233/bmr-169760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The selection and validation of age- and gender-specific criterion-referenced cut-points for abdominal endurance are still unclear. OBJECTIVE To stablish normative values for abdominal endurance in adolescents by age and gender using the Bench Trunk Curl-up Test (BTC). Additionally, the reliability of the BTC was analyzed. METHODS Two hundred and sixteen untrained high school students (104 males - 112 females) were grouped into five age strata. Participants performed the BTC twice with a rest period of 72 h. Descriptive statistics and percentile scores were determined for each gender/age strata. RESULTS Males showed higher BTC scores than females (males: 90.07 ± 32.65 repetitions; females: 73.43 ± 27.74 repetitions), but no significant differences between age strata nor age * gender interaction were found. Significant differences for the BTC scores between sessions were found (T1 = 72.06 ± 26.28 repetitions; T2 = 81.44 ± 31.27 repetitions). The ICC was 0.82, whereas the typical error was 17.2%. CONCLUSIONS Gender, but not age, is an important factor when abdominal endurance is compared between adolescents. Finally, the BTC is a reliable test, supporting the findings of this study. However, an extensive familiarization period to reduce the learning effect is necessary.
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Berenshteyn Y, Gibson K, Hackett GC, Trem AB, Wilhelm M. Is standing balance altered in individuals with chronic low back pain? A systematic review. Disabil Rehabil 2018; 41:1514-1523. [PMID: 29382241 DOI: 10.1080/09638288.2018.1433240] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To examine the static standing balance of individuals with chronic low back pain when compared to a healthy control group. METHODS A search of available literature was done using PubMed, SPORTDiscus, CINAHL, and Scopus databases. Studies were included if they contained the following: (1) individuals with chronic low back pain 3 months or longer; (2) healthy control group; (3) quantified pain measurement; and (4) center of pressure measurement using a force plate. Two authors independently reviewed articles for inclusion, and assessed for quality using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross Sectional Studies. Cohen's d effect size was calculated to demonstrate the magnitude of differences between groups. RESULTS Nine articles were included in this review. Quality scores ranged from 5/8 to 8/8. Although center of pressure measures were nonhomogeneous, subjects with chronic low back pain had poorer performance overall compared to healthy controls. Despite inconsistencies in statistical significance, effect sizes were frequently large, indicating a lack of sufficient power in the included studies. Data were insufficiently reported among certain studies, limiting the ability of direct study comparison. CONCLUSIONS Results suggest that balance is impaired in individuals with chronic low back pain when compared to healthy individuals. Implications for rehabilitation Static balance is affected in individuals with chronic low back pain. Balance assessments should be completed for individuals with chronic low back pain. Results from balance assessments should be used to indicate areas of improvement and help guide the course of treatment, as well as reassess as treatment progresses.
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Affiliation(s)
| | - Kelsey Gibson
- a Department of Physical Therapy , Walsh University , North Canton , OH , USA
| | - Gavin C Hackett
- a Department of Physical Therapy , Walsh University , North Canton , OH , USA
| | - Andrew B Trem
- a Department of Physical Therapy , Walsh University , North Canton , OH , USA
| | - Mark Wilhelm
- a Department of Physical Therapy , Walsh University , North Canton , OH , USA
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Denteneer L, Van Daele U, Truijen S, De Hertogh W, Meirte J, Stassijns G. Reliability of physical functioning tests in patients with low back pain: a systematic review. Spine J 2018; 18:190-207. [PMID: 28882521 DOI: 10.1016/j.spinee.2017.08.257] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/21/2017] [Accepted: 08/29/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to provide a comprehensive overview of physical functioning tests in patients with low back pain (LBP) and to investigate their reliability. DATA SOURCES A systematic computerized search was finalized in four different databases on June 24, 2017: PubMed, Web of Science, Embase, and MEDLINE. STUDY SELECTION Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed during all stages of this review. Clinical studies that investigate the reliability of physical functioning tests in patients with LBP were eligible. The methodological quality of the included studies was assessed with the use of the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. To come to final conclusions on the reliability of the identified clinical tests, the current review assessed three factors, namely, outcome assessment, methodological quality, and consistency of description. DATA SYNTHESIS A total of 20 studies were found eligible and 38 clinical tests were identified. Good overall test-retest reliability was concluded for the extensor endurance test (intraclass correlation coefficient [ICC]=0.93-0.97), the flexor endurance test (ICC=0.90-0.97), the 5-minute walking test (ICC=0.89-0.99), the 50-ft walking test (ICC=0.76-0.96), the shuttle walk test (ICC=0.92-0.99), the sit-to-stand test (ICC=0.91-0.99), and the loaded forward reach test (ICC=0.74-0.98). For inter-rater reliability, only one test, namely, the Biering-Sörensen test (ICC=0.88-0.99), could be concluded to have an overall good inter-rater reliability. None of the identified clinical tests could be concluded to have a good intrarater reliability. CONCLUSIONS Further investigation should focus on a better overall study methodology and the use of identical protocols for the description of clinical tests. The assessment of reliability is only a first step in the recommendation process for the use of clinical tests. In future research, the identified clinical tests in the current review should be further investigated for validity. Only when these clinimetric properties of a clinical test have been thoroughly investigated can a final conclusion regarding the clinical and scientific use of the identified tests be made.
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Affiliation(s)
- Lenie Denteneer
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Ulrike Van Daele
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Steven Truijen
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Willem De Hertogh
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Jill Meirte
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Gaetane Stassijns
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Physical Medicine and Rehabilitation, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
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García-Vaquero MP, Ruiz-Pérez I, Barbado D, Vera-Garcia FJ. Electromyographic and Kinematic Analysis of the Flexion-Rotation Trunk Test. J Strength Cond Res 2017; 34:3386-3394. [PMID: 28796125 DOI: 10.1519/jsc.0000000000002168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
García-Vaquero, MP, Ruiz-Pérez, I, Barbado, D, and Vera-Garcia, FJ. Electromyographic and kinematic analysis of the flexion-rotation trunk test. J Strength Cond Res 34(12): 3386-3394, 2020-Although most trunk endurance field protocols are performed in the sagittal or frontal planes, the flexion-rotation trunk (FRT) test combines trunk flexion with rotation, which may be relevant to rotation-related sports. The aim of this study was to describe the trunk and hip muscle activation and fatigue and the range of hip flexion of this test. Twenty-seven physically active males and females performed the FRT test after a period of practice. Electromyographic (EMG) signals were bilaterally collected from the rectus abdominis (RA), internal oblique (IO), and rectus femoris (RF), and hip flexion amplitude was measured using a biaxial electrogoniometer. Because the fast Fourier transform algorithm requires stationary EMG signals, subjects performed a 6-second isometric trunk flexion-rotation repetition just before and just after the test execution (preexecution and postexecution repetitions, respectively). Rectus abdominis showed the highest mean activation levels (approximately 30% maximal voluntary isometric contractions [MVC]) in the preexecution repetition, followed by IO (approximately 20% MVC). Also, the mean power frequency (MPF) significantly decreased from the pre-execution to the postexecution repetition for RA and IO, which shows abdominal muscle fatigue. Although each trunk flexion-rotation repetition involved an average 8-14° hip flexion, the RF activation was lower than 10% MVC, and no significant MPF reduction (i.e., no muscle fatigue) was observed for this muscle. In addition, significant negative correlations were found between the FRT test scores and the normalized EMG amplitudes of RF. Based on these results, the FRT test seems a valid field protocol to assess abdominal muscle endurance in trunk flexion-rotation exertions.
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Reliability and Practicality of the Core Score: Four Dynamic Core Stability Tests Performed in a Physician Office Setting. Clin J Sport Med 2017; 27:409-414. [PMID: 28653966 DOI: 10.1097/jsm.0000000000000366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Pilot study to determine the practicality and inter-rater reliability of the "Core Score," a composite measure of 4 clinical core stability tests. DESIGN Repeated measures. SETTING Academic hospital physician clinic. PARTICIPANTS 23 healthy volunteers with mean age of 32 years (12 females, 11 males). ASSESSMENT OF VARIABLES All subjects performed 4 core stability maneuvers under direct observation from 3 independent physicians in sequence. MAIN OUTCOME MEASURES Inter-rater reliability and time necessary to perform examination. RESULTS The Core Score scale is 0 to 12, with 12 reflecting the best core stability. The mean composite score of all 4 tests for all subjects was 9.54 (SD, 1.897; range, 4-12). The intraclass correlation coefficients (ICC 1,1) for inter-rater reliability for the composite Core Score and 4 individual tests were 0.68 (Core Score), 0.14 (single-leg squat), 0.40 (supine bridge), 0.69 (side bridge), and 0.46 (prone bridge). The time required for a single examiner to assess a given subject's core stability in all 4 maneuvers averaged 4 minutes (range, 2-6 minutes). CONCLUSIONS Even without specialized equipment, a clinically practical and moderately reliable measure of core stability may be possible. Further research is necessary to optimize this measure for clinical application. CLINICAL RELEVANCE Despite the known value of core stability to athletes and patients with low back pain, there is currently no reliable and practical means for rating core stability in a typical office-based practice. This pilot study provides a starting point for future reliability research on clinical core stability assessments.
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Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial. Trials 2017; 18:184. [PMID: 28427472 PMCID: PMC5399383 DOI: 10.1186/s13063-017-1913-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/22/2017] [Indexed: 12/19/2022] Open
Abstract
Background Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain. Methods/design Forty participants, 25–45 years old with chronic (>3 months), non-specific low back pain will be recruited. Participants will be randomised to receive either motor control and manual therapy (n = 20) or general strength and conditioning (n = 20) exercise treatments for 6 months. The motor control/manual therapy group will receive twelve 30-min sessions, ten in the first 3 months (one or two per week) and two in the last 3 months. The general exercise group will attend two 1-hour sessions weekly for 3 months, and one or two a week for the following 3 months. Primary outcome measures are average lumbar spine intervertebral disc T2 relaxation time and changes in thickness of the transversus abdominis muscle on a leg lift using magnetic resonance imaging (MRI). Secondary outcomes include muscle size and fat content, vertebral body fat content, intervertebral disc morphology and water diffusion measured by MRI, body composition using dual energy X-ray absorptiometry, physical function through functional tests, changes in corticospinal excitability and cortical motor representation of the spinal muscles using transcranial magnetic stimulation and self-reported measure of pain symptoms, health and disability. Outcome measures will be conducted at baseline, at the 3-month follow-up and at 6 months at the end of intervention. Pain, depressive symptomology and emotions will be captured fortnightly by questionnaires. Discussion Chronic low back pain is ranked the highest disabling disorder in Australia. The findings of this study will inform clinical practice guidelines to assist with decision-making approaches where outcomes beyond pain are sought for adults with chronic low back pain. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12615001270505. Registered on 20 November 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1913-8) contains supplementary material, which is available to authorized users.
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Harding AT, Weeks BK, Horan SA, Little A, Watson SL, Beck BR. Validity and test-retest reliability of a novel simple back extensor muscle strength test. SAGE Open Med 2017; 5:2050312116688842. [PMID: 28255442 PMCID: PMC5315361 DOI: 10.1177/2050312116688842] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/20/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To develop and determine convergent validity and reliability of a simple and inexpensive clinical test to quantify back extensor muscle strength. METHODS Two testing sessions were conducted, 7 days apart. Each session involved three trials of standing maximal isometric back extensor muscle strength using both the novel test and isokinetic dynamometry. Lumbar spine bone mineral density was examined by dual-energy X-ray absorptiometry. Validation was examined with Pearson correlations (r). Test-retest reliability was examined with intraclass correlation coefficients and limits of agreement. Pearson correlations and intraclass correlation coefficients are presented with corresponding 95% confidence intervals. Linear regression was used to examine the ability of peak back extensor muscle strength to predict indices of lumbar spine bone mineral density and strength. RESULTS A total of 52 healthy adults (26 men, 26 women) aged 46.4 ± 20.4 years were recruited from the community. A strong positive relationship was observed between peak back extensor strength from hand-held and isokinetic dynamometry (r = 0.824, p < 0.001). For the novel back extensor strength test, short- and long-term reliability was excellent (intraclass correlation coefficient = 0.983 (95% confidence interval, 0.971-0.990), p < 0.001 and intraclass correlation coefficient = 0.901 (95% confidence interval, 0.833-0.943), p < 0.001, respectively). Limits of agreement for short-term repeated back extensor strength measures with the novel back extensor strength protocol were -6.63 to 7.70 kg, with a mean bias of +0.71 kg. Back extensor strength predicted 11% of variance in lumbar spine bone mineral density (p < 0.05) and 9% of lumbar spine index of bone structural strength (p < 0.05). CONCLUSION Our novel hand-held dynamometer method to determine back extensor muscle strength is quick, relatively inexpensive, and reliable; demonstrates initial convergent validity in a healthy population; and is associated with bone mass at a clinically important site.
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Affiliation(s)
- Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, QLD, Australia
| | - Benjamin Kurt Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, QLD, Australia
| | - Sean A Horan
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, QLD, Australia
| | - Andrew Little
- School of Medicine, Griffith University, Gold Coast campus, QLD, Australia
| | - Steven L Watson
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, QLD, Australia
| | - Belinda Ruth Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, QLD, Australia; The Bone Clinic, Brisbane, QLD, Australia
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Strøyer J, Essendrop M, Jensen LD, Warming S, Avlund K, Schibye B. Validity and Reliability of Self-Assessed Physical Fitness Using Visual Analogue Scales. Percept Mot Skills 2016; 104:519-33. [PMID: 17566442 DOI: 10.2466/pms.104.2.519-533] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To test the validity and reliability of self-assessed physical fitness samples included healthcare assistants working at a hospital (women = 170, men = 17), persons working with physically and mentally handicapped patients (women = 530, men = 123), and two separate groups of healthcare students (a) women = 91 and men = 5 and (b) women = 159 and men =10. Five components of physical fitness were self-assessed by Visual Analogue Scales with illustrations and verbal anchors for the extremes: aerobic fitness, muscle strength, endurance, flexibility, and balance. Convergent and divergent validity were evaluated by age-adjusted correlations stratified by sex with performance-based measures of physical fitness. Self-assessed aerobic fitness ( r = .36–.64) (women/men), muscle strength ( r = .30–.51), and flexibility ( r = .36–.31) showed moderate convergent validity. The divergent validity was satisfactory except for flexibility among men. The reliability was moderate to good ( ICC = .62–.80). Self-assessed aerobic fitness, muscle strength, and flexibility showed moderate construct validity and moderate to good reliability using visual analogues.
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Affiliation(s)
- Jesper Strøyer
- National Research Center for the Working Environment, Denmark, Lerso Parkalle 105, DK-2100 Copenhagen, Denmark.
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