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Igwesi-Chidobe CN, Amarachukwu C, Sorinola IO, Godfrey EL. Translation, cultural adaptation and psychometric testing of Igbo fear avoidance beliefs questionnaire in mixed rural and urban Nigerian populations with chronic low back pain. PLoS One 2019; 14:e0216482. [PMID: 31086408 PMCID: PMC6516646 DOI: 10.1371/journal.pone.0216482] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/22/2019] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Low back pain (LBP) is highly prevalent in Nigeria and is more devastating in rural Nigeria due to adverse living and working conditions, reinforced by maladaptive illness beliefs. There is a need to develop measures for assessing such beliefs in this population. This study aimed to cross-culturally adapt the Fear Avoidance Beliefs Questionnaire (FABQ) and test its psychometric properties in mixed rural and urban Nigerian populations with chronic LBP. METHODS Translation, cultural adaptation, test-retest, and cross-sectional psychometric testing. FABQ was forward and back translated by clinical/non-clinical translators. A review committee evaluated the translations. Twelve people with chronic LBP in a rural Nigerian community pre-tested the questionnaire. Cronbach's alpha assessing internal consistency; intra-class correlation coefficient and Bland-Altman plots assessing test-retest reliability; and minimal detectable change were investigated in a convenient sample of 50 chronic low back pain sufferers in rural and urban Nigeria. Construct validity was examined using Pearson's correlation analyses with the eleven-point box scale and Igbo Roland Morris Disability Questionnaire (Igbo-RMDQ), and exploratory factor analysis in a random sample of 200 adults with chronic low back pain in rural Nigeria. Ceiling and floor effects were investigated in all samples. RESULTS Amendments allowed interviewer-administration. Item 8 was modified to 'I have a compensation or gains I get from having my pain' as there is no benefit system in Nigeria. Igbo phrase for 'physical activity' could also mean 'being active', 'moving the body' or 'moving about' and was used in the items with 'physical activity'. The Igbo-FABQ had good internal consistency (α = 0.80-0.86); intra class correlation coefficients (ICC = 0.71-0.72); standard error of measurements (3.21-7.40) and minimal detectable change (8.90-20.51). It correlated moderately with pain intensity and disability, with a two-factor structure and no floor and ceiling effects. CONCLUSIONS Igbo-FABQ is valid, reliable, and can be used clinically and for research.
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Affiliation(s)
- Chinonso Nwamaka Igwesi-Chidobe
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria (Enugu Campus), Nigeria
- Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
- * E-mail:
| | - Charity Amarachukwu
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Isaac Olubunmi Sorinola
- Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Emma Louise Godfrey
- Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King′s College London, United Kingdom
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102
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Goubert D, Meeus M, Willems T, De Pauw R, Coppieters I, Crombez G, Danneels L. The association between back muscle characteristics and pressure pain sensitivity in low back pain patients. Scand J Pain 2019; 18:281-293. [PMID: 29794309 DOI: 10.1515/sjpain-2017-0142] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/24/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Some low back pain (LBP) patients recover after every pain episode whereas others develop chronicity. Research indicates that the amount of atrophy and fat infiltration differs between patients with LBP. Also enhanced pain sensitivity is present only in a subgroup of LBP patients. The relationship between pain sensitivity and muscular deformations in LBP, is however unexplored. This study examined the association between pressure pain sensitivity and the structural characteristics of the lumbar muscles in three different groups of non-specific LBP patients. METHODS This cross-sectional study examined the total cross-sectional area (CSA), fat CSA, muscle CSA and muscle fat index (MFI) of the lumbar multifidus (MF) and erector spinae (ES) at level L4 by magnetic resonance imaging in 54 patients with non-specific LBP (23 recurrent LBP, 15 non-continuous chronic LBP and 16 continuous chronic LBP). Pressure pain thresholds were measured at four locations (lower back, neck, hand and leg) by a manual pressure algometer and combined into one "pain sensitivity" variable. As a primary outcome measure, the association between pain sensitivity and muscle structure characteristics was investigated by multiple independent general linear regression models. Secondly, the influence of body mass index (BMI) and age on muscle characteristics was examined. RESULTS A positive association was found between pain sensitivity and the total CSA of the MF (p=0.006) and ES (p=0.001), and the muscle CSA of the MF (p=0.003) and ES (p=0.001), irrespective of the LBP group. No association was found between pain sensitivity and fat CSA or MFI (p>0.01). Furthermore, a positive association was found between BMI and the fat CSA of the MF (p=0.004) and ES (p=0.006), and the MFI of the MF (p<0.01) and ES (p=0.003). Finally, a positive association was found between age with the fat CSA of the MF (p=0.008) but not with the fat CSA of the ES (p>0.01), nor the MFI of the MF (p>0.01) and ES (p>0.01). CONCLUSIONS A higher pain sensitivity is associated with a smaller total and muscle CSA in the lumbar MF and ES, and vice versa, but results are independent from the LBP subgroup. On the other hand, the amount of fat infiltration in the lumbar muscles is not associated with pain sensitivity. Instead, a higher BMI is associated with more lumbar fat infiltration. Finally, older patients with LBP are associated with higher fat infiltration in the MF but not in the ES muscle. IMPLICATIONS These results imply that reconditioning muscular tissues might possibly decrease the pain sensitivity of LBP patients. Vice versa, therapy focusing on enhancement of pain sensitivity might also positively influence the CSA and that way contribute to the recovery of LBP. Furthermore, the amount of lumbar muscle fat seems not susceptible to pain sensitivity or vice versa, but instead a decrease in BMI might decrease the fat infiltration in the lumbar muscles and therefore improve the muscle structure quality in LBP. These hypothesis apply for all non-specific LBP patients, despite the type of LBP.
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Affiliation(s)
- Dorien Goubert
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent Campus Heymans (UZ) 3 B3, Corneel Heymanslaan 10, Ghent, Belgium, Phone: +3293325374, Fax: +32 9 332 38 11; andPain in Motion International Research Group
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium;Pain in Motion International Research Group.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tine Willems
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Robby De Pauw
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Iris Coppieters
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; andPain in Motion International Research Group
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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103
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Pakbaz M, Hosseini MA, Aemmi SZ, Gholami S. Effectiveness of the back school program on the low back pain and functional disability of Iranian nurse. J Exerc Rehabil 2019; 15:134-138. [PMID: 30899749 PMCID: PMC6416510 DOI: 10.12965/jer.1836542.271] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 01/06/2019] [Indexed: 11/22/2022] Open
Abstract
Low back pain (LBP) as a recurrent and costly health problem and one of the leading causes of disability, is common in nurses. It can have adverse effects on the quality of life of nurses and quality of care of patients. The aim of the study was to evaluate the effectiveness of Back School program on the LBP and functional disability of Iranian nurses. A quasi-experimental methodological design was utilized for this study. Participants were nurses with back pain who participated in the Back School program workshop and completed a self-report visual analogue scales and Roland–Morris Disability questionnaire that measuring LBP and functional disability. Data were analyzed descriptively and comparisons in LBP and functional disability made between groups with t-test for pre-intervention and analysis of covariance for after intervention. Sixty-four participants (16 males, 48 females) completed this survey. The study participants’ mean age was 38.9 ± 8.1 years in intervention group and 38.1 ± 8.2 in control group. There were no significant differences in terms of pain (P = 0.575) and disability scores (P = 0.844) before intervention. Although, the intervention led to a decrease in the functional ability and LBP scores of the nurses (P<0.001) in the intervention group compared with that in the control group. Overall, Back School program as an educational strategy can reduce the LBP and functional disability in nurses. This program can be suitable for preventing of pain and functional disability among nurses working in hospital settings.
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Affiliation(s)
- Mehdi Pakbaz
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Ali Hosseini
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyedeh Zahra Aemmi
- Department of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Center of Psychiatry and Behavioral Science Research, Ibn-e-Sina Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Gholami
- Department of Operating Room, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
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104
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Doualla M, Aminde J, Aminde LN, Lekpa FK, Kwedi FM, Yenshu EV, Chichom AM. Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC Musculoskelet Disord 2019; 20:25. [PMID: 30646894 PMCID: PMC6334448 DOI: 10.1186/s12891-019-2403-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 01/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very little is known about the burden of chronic low back pain in Africa. This study aimed at assessing disability and associated factors in chronic low back patients in Cameroon. METHODS We carried a hospital-based cross-sectional study including patients suffering from low back pain (LBP) of at least 12 weeks' duration. Disability was assessed using the Roland Morris Disability Questionnaire (RMDQ). RMDQ > 4 described persons with dysfunctional levels of disability. Multivariable linear regression was used to investigate factors associated with higher RMDQ scores hence greater disability. Variables investigated included; gender, age, marital status, employment status and type, smoking history, alcohol consumption, income, pain intensity, LBP duration, psychological wellbeing, sleep satisfaction, leg pain, numbness/paresthesia, bowel/bladder dysfunction symptoms (BBDS), body mass index (BMI), and days of work absence. RESULTS A sample of 136 adults (64% female) with a mean age of 50.6 ± 12.2 years participated in the study. Median duration of LBP was 33 (25th - 75th percentile: 12-81) months. Mean RMDQ score was 12.8 ± 6. In multivariable linear regression, pain intensity (β = 0.07, p = 0.002), longer days of work absence (β = 0.15, p = 0.003) and BBDS (β =2.33, p = 0.029) were associated with greater disability. Factors such as consumption of alcohol (β = - 3.55, p = 0.005) and higher psychological wellbeing scores (β = - 0.10, p = 0.004) significantly contributed to less disability (lower RMDQ scores). Dysfunctional levels of disability were present in 88.1% of patients. CONCLUSION CLBP is associated with significant disability and this relationship is driven by several factors. Multidisciplinary management strategies especially those targeted to improve pain control, manage BBDS and improve psychological wellbeing could reduce disability and improve quality of life.
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Affiliation(s)
- Marie Doualla
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Jeannine Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Leopold Ndemnge Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Fernando Kemta Lekpa
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Felix Mangan Kwedi
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Douala General Hospital, Douala, Cameroon
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105
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Andersen TE, Ellegaard H, Schiøttz-Christensen B, Manniche C. Somatic experiencing® for patients with low back pain and comorbid posttraumatic stress disorder - protocol of a randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:308. [PMID: 30466429 PMCID: PMC6251218 DOI: 10.1186/s12906-018-2370-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Research has almost exclusively focused on the neck in order to explain the mechanisms of persistent pain after motor vehicle collisions (MVC). However, studies have shown that low back pain after MVC is as common as neck pain. Also, posttraumatic stress disorder (PTSD) is common after MVCs, and evidence indicate that PTSD may be linked to the development of pain and disability. PTSD has even been proposed as "the missing link" for some in the development of chronic low back pain. Unfortunately, PTSD often goes unattended in low back pain rehabilitation and very few randomized controlled studies exists targeting both conditions. Hence, the aim of the present study is to investigate the potential additional effect of the trauma therapy "Somatic Experiencing®" (SE) in addition to physiotherapy (PT) compared to PT alone for patients with chronic low back pain and comorbid PTSD. METHODS The study is a two-group randomized controlled clinical trial in which participants (n = 140) are recruited consecutively from a large Danish spine center in the Region of Southern Denmark, between January 2016 and December 2017. Patients are randomly allocated to one of the two conditions: SE + PT or PT alone. Measurements of effect are carried out at baseline before randomization, post-intervention, 6 and 12 months post-randomization. The primary outcome is a 20% reduction in disability (Rolland Morris Disability Questionnaire) at 6 months post-randomization. Secondary outcomes are: PTSD symptoms, pain intensity, pain-catastrophizing, fear of movement, anxiety and depression. DISCUSSION Comorbid PTSD is currently not targeted in back pain rehabilitation although highly prevalent. If the SE intervention shows to have an additional effect on disability and pain, the study is likely to have a positive impact on the management of chronic low back pain and will have immediate clinical applicability. TRIAL REGISTRATION Current Controlled Trials Registration August 4, 2017: NCT03244046 . Retrospectively registered.
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Affiliation(s)
- Tonny Elmose Andersen
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Hanne Ellegaard
- Spine Centre of Southern Denmark and University of Southern Denmark, Middelfart, Denmark
| | | | - Claus Manniche
- Spine Centre of Southern Denmark and University of Southern Denmark, Middelfart, Denmark
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106
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Song L, Qiu P, Xu J, Lv J, Wang S, Xia C, Chen P, Fan S, Fang X, Lin X. The Effect of Combination Pharmacotherapy on Low Back Pain. Clin J Pain 2018; 34:1039-1046. [DOI: 10.1097/ajp.0000000000000622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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107
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Simplified Chinese Version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: Agreement, Responsiveness, and Minimal Important Change for Patients With Chronic Low Back Pain. Spine (Phila Pa 1976) 2018; 43:1438-1445. [PMID: 29659442 DOI: 10.1097/brs.0000000000002692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Psychometric test of the cross-cultural adaptation the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) in low back pain (LBP) patients. OBJECTIVE To investigate the agreement, responsiveness, and minimal important change (MIC) of the simplified Chinese version of the JOABPEQ in LBP patients. SUMMARY OF BACKGROUND DATA The factor structure, internal consistency, test-retest reliability, validity, floor and ceiling effect of simplified Chinese JOABPEQ have been tested, while the agreement, responsiveness, and MIC were required. METHODS The agreement, responsiveness, and MIC of the simplified Chinese version were assessed by completing the Chinese JOABPEQ twice. Agreement was tested with Bland-Altman plot. Responsiveness was operationalized using receiver operating characteristic analyses. The anchor-based method was used to calculate MIC. RESULTS One hundred sixty-two of 184 patients returned to finish the booklet twice were available for analysis (response rate: 88.0%). While the responsiveness, the area under the curves of each subscale were ranged from 0.746 to 0.875, which meant a good responsiveness. While the MIC (MIC%) of simplified Chinese JOABPEQ was 19.28 (44.98%) for Q1 Low back pain, 15.20 (24.13%) for Q2 Lumbar function, 15.79 (22.76%) for Q3 Walking ability, 9.58 (19.86%) for Q4 Social life function, 7.33 (17.28%) for Q5 Mental health. While compared with the MIC, only the Q3 Walking ability had a positive rating for agreement in the Bland-Altman plot. CONCLUSION The simplified Chinese JOABPEQ has positive agreement of Q3 Walk ability and acceptable to excellent responsiveness of all the subscales. The MICs for subscales of the simplified Chinese JOABPEQ ranged from 7.33 to 19.28 points. LEVEL OF EVIDENCE 3.
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108
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Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: Short-and long-term outcomes of pain and disability. Eur J Pain 2018; 23:234-249. [DOI: 10.1002/ejp.1314] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Lianne Wood
- Centre for Spinal Studies and Surgery; Nottingham University Hospitals NHS Trust; Nottingham UK
- Research Institute for Primary Care and Health Sciences; Keele University; Staffordshire, ST5 5PB
| | - Paul A. Hendrick
- Division of Physiotherapy and Rehabilitation Sciences; School of Health Sciences, University of Nottingham, Nottingham University Hospitals (City Campus); Nottingham UK
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109
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Hyun EH, Lee HY, Kim HW, Kim HM, Kim EJ, Kim SJ, Song YG, Kim YI, Nam WJ, Seo DH, Lee SH, Kim N. Clinical and cost-effectiveness of collaborative traditional Korean and Western medicine treatment for low back pain: A protocol for a prospective observational exploratory study. Medicine (Baltimore) 2018; 97:e12595. [PMID: 30278573 PMCID: PMC6181614 DOI: 10.1097/md.0000000000012595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 09/06/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In South Korea, a few patients with low back pain (LBP) are currently being treated with a combination of traditional Korean medicine (KM) and Western medicine (WM). Although a recent research has reported results regarding patient satisfaction and exploratory effectiveness, evidence of comparative effectiveness still needs to be reviewed. The aim of this study is to evaluate the clinical and cost-effectiveness of KM and WM collaborative treatment (CT) compared with that of sole treatment (ST) for patients with LBP in Korea. METHOD/DESIGN This multisite, prospective observational comparative effectiveness research study is part of a nationwide pilot project for KM and WM collaboration launched by the Korean Ministry of Health and Welfare. The duration of the study is 8 weeks, and the target number of inclusion is 360 patients. Participants receive treatment according to their treatment plan, and a researcher conducts investigations thrice, every 4 weeks. In the final analysis, the merged data from the participants' questionnaire responses, hospital medical records, and administrative data, and Health Insurance Review and Assessment service data will be compared between the CT and ST groups. DISCUSSION This study will provide clinical and economic information about CT for LBP, which might be a milestone for establishing future polices about this collaboration in Korea. TRIAL REGISTRATION The study protocol has been registered with the Clinical Research Information Service (KCT0002827).
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Affiliation(s)
- Eun Hye Hyun
- School of Korean Medicine, Pusan National University
- National Clinical Research Center for Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do
| | - Hye-Yoon Lee
- National Clinical Research Center for Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do
| | - Hye Won Kim
- National Clinical Research Center for Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do
| | - Hyun Min Kim
- School of Korean Medicine, Pusan National University
- National Clinical Research Center for Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do
| | - Eun Jung Kim
- Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do
| | - Seon Jong Kim
- Dongshin University Mokpo Oriental Hospital, Mokpo-si, Jeollanam-do
| | - Yoon Gyung Song
- Gachon University Gil Korean Medicine Hospital, Jung-gu, Incheon
| | - Young Il Kim
- Daejeon University, Dunsan Korean Medicine Hospital, Seo-gu, Daejeon
| | - Woo Jin Nam
- Samse Korean Medical Hospital, Geumjeong-gu, Busan
| | | | - Sang Ho Lee
- Mokhuri Neck and Back Hospital, Gangdong-gu, Seoul, Republic of Korea
| | - NamKwen Kim
- School of Korean Medicine, Pusan National University
- National Clinical Research Center for Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do
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A Comparison of Back Pain Functional Scale With Roland Morris Disability Questionnaire, Oswestry Disability Index, and Short Form 36-Health Survey. Spine (Phila Pa 1976) 2018; 43:877-882. [PMID: 28984734 DOI: 10.1097/brs.0000000000002431] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A comparison study of Back Pain Functional Scale (BPFS) with Roland Morris Questionnaire (RMQ), Oswestry Disability Index (ODI), and Short Form 36-Health Survey (SF-36). OBJECTIVE The aim of this study is to investigate the correlation of BPFS with RMQ, ODI, and SF-36. SUMMARY OF BACKGROUND DATA The primary goal in the treatment of patients with low back pain is to improve the patients' levels of activities and participation. Many questionnaires focusing on function have been developed in patients with low back pain. BPFS is one of these questionnaires. No studies have investigated the correlation of BPFS with ODI and SF-36. METHODS This study was conducted with 120 patients receiving outpatient and inpatient treatment in physiotherapy and rehabilitation units of a state hospital. BPFS, RMQ, ODI, and SF-36 questionnaires were used to assess the disability in low back pain. Spearman and Pearson Correlation were used to compare the data obtained in the study. RESULTS There was a good correlation among the 5 functional outcome measures (correlation r = -0.693 for BPFS/RMQ, r = -0.794 for BPFS/ODI, r = 0.697 for BPFS/SF-36 Physical function and r = 0.540 for BPFS/SF-36 Pain). CONCLUSION BPFS demonstrated good correlation with RMQ, ODI, SF-36 physical function, and SF-36 pain. LEVEL OF EVIDENCE 2.
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111
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Pool-Goudzwaard A, Groeneveld W, Coppieters MW, Waterink W. Changes in spontaneous overt motor execution immediately after observing others' painful action: two pilot studies. Exp Brain Res 2018; 236:2333-2345. [PMID: 29876631 PMCID: PMC6061486 DOI: 10.1007/s00221-018-5290-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 05/15/2018] [Indexed: 11/05/2022]
Abstract
Research has demonstrated that motor control is directly influenced by observation of others’ action, stimulating the mirror neuron system. In addition, there is evidence that both emotion and empathy after observing a painful stimulus affects motor cortical excitability and reaction times. Aim of the present two pilot studies is a) to test for significant influence of observing other’s painful bending of the trunk on execution of the same activity in a self-directed bending action (study 1) and to compare these results with a bending action according to a strict bending protocol (study 2). In addition to study 1, differences between Low Back Pain (LBP) patients versus healthy subjects are tested. Video footage of a (1) neutral, (2) painful, and (3) happy bending action was presented in random order. Changes in flexion–relaxation phenomenon (FRP) of back muscles were studied directly after watching the videos with surface EMG, in study 1 during a self-directed bending action in LBP patients and healthy subjects, in study 2 according to a strict bending protocol. FRP ratios were calculated by a custom-made analysis scheme tested for sufficient reliability prior to both studies. Evoked emotions were measured with an Emotional Questionnaire after each video. A Mixed Model ANOVA was used to test for the effect video and the difference between LBP and healthy subjects on the FRP-rs. Differences in evoked emotion will be tested with a Wilcoxon Signed Rank Test. In study 1, 24 healthy controls and 16 LBP patients FRP-rs were significantly influenced after observing a painful video in all subjects versus a happy and neutral video (p = 0.00). No differences were present between LBP and healthy controls. All subjects experienced more fear after observation of the painful video (p 0.05). In study 2, 6 healthy subjects followed the strict FRP bending protocol for three times after observing each video. No significant changes occurred in FRPs per video compared to FRPs of six healthy subjects carrying out the spontaneous bending activity. Observing a painful action in another person changes motor performance and increases fear in both people with and without back pain, during self-directed trunk flexion, but not during a protocolled trunk flexion.
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Affiliation(s)
- Annelies Pool-Goudzwaard
- Amsterdam Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands. .,Somt University of Physiotherapy, Amersfoort, The Netherlands.
| | - Wim Groeneveld
- Department of Neuroscience, Faculty of Health Sciences and Medicine, ErasmusMC University, Rotterdam, The Netherlands
| | - Michel W Coppieters
- Amsterdam Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Wim Waterink
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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112
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Papi E, Bull AM, McGregor AH. Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review. Clin Biomech (Bristol, Avon) 2018; 55:53-64. [PMID: 29684790 PMCID: PMC6161016 DOI: 10.1016/j.clinbiomech.2018.04.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures. METHODS PubMed, Embase and Scopus databases were searched for relevant studies. Reference lists of selected studies and hand searches were performed. Studies had to compare people with and without non-specific low back pain while performing functional tasks and report body segment/joint kinematic and/or kinetic data. Two reviewers independently identified relevant papers. FINDINGS Sixty-two studies were included. Common biases identified were lack of assessor blinding and sample size calculation, use of samples of convenience, and poor experimental protocol standardization. Studies had small sample sizes. Range of motion maneuvers were the main task performed (33/62). Kinematic/kinetic data of different individual or combination of body segments/joints were reported among the studies, commonest was to assess the hip joint and lumbar segment motion (13/62). Only one study described full body movement. The most commonly reported outcome was range of motion. Statistically significant differences between controls and low back pain groups were reported for different outcomes among the studies. Moreover, when the same outcome was reported disagreements were noted. INTERPRETATION The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinically.
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Affiliation(s)
- Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK,Department of Bioengineering, Imperial College London, London, UK,Corresponding author at: Department of Surgery and Cancer, Imperial College London, Room 7L16, Floor 7, Laboratory Block, Charing Cross Hospital, London, W6 8RF, UK.
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Goldsmith ES, Taylor BC, Greer N, Murdoch M, MacDonald R, McKenzie L, Rosebush CE, Wilt TJ. Focused Evidence Review: Psychometric Properties of Patient-Reported Outcome Measures for Chronic Musculoskeletal Pain. J Gen Intern Med 2018; 33:61-70. [PMID: 29633142 PMCID: PMC5902346 DOI: 10.1007/s11606-018-4327-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Developing successful interventions for chronic musculoskeletal pain requires valid, responsive, and reliable outcome measures. The Minneapolis VA Evidence-based Synthesis Program completed a focused evidence review on key psychometric properties of 17 self-report measures of pain severity and pain-related functional impairment suitable for clinical research on chronic musculoskeletal pain. METHODS Pain experts of the VA Pain Measurement Outcomes Workgroup identified 17 pain measures to undergo systematic review. In addition to a MEDLINE search on these 17 measures (1/2000-1/2017), we hand-searched (without publication date limits) the reference lists of all included studies, prior systematic reviews, and-when available-Web sites dedicated to each measure (PROSPERO registration CRD42017056610). Our primary outcome was the measure's minimal important difference (MID). Secondary outcomes included responsiveness, validity, and test-retest reliability. Outcomes were synthesized through evidence mapping and qualitative comparison. RESULTS Of 1635 abstracts identified, 331 articles underwent full-text review, and 43 met inclusion criteria. Five measures (Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), SF-36 Bodily Pain Scale (SF-36 BPS), Numeric Rating Scale (NRS), and Visual Analog Scale (VAS)) had data reported on MID, responsiveness, validity, and test-retest reliability. Seven measures had data reported on three of the four psychometric outcomes. Eight measures had reported MIDs, though estimation methods differed substantially and often were not clinically anchored. CONCLUSIONS In this focused evidence review, the most evidence on key psychometric properties in chronic musculoskeletal pain populations was found for the ODI, RMDQ, SF-36 BPS, NRS, and VAS. Key limitations in the field include substantial variation in methods of estimating psychometric properties, defining chronic musculoskeletal pain, and reporting patient demographics. TRIAL REGISTRATION Registered in the PROSPERO database: CRD42017056610.
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Affiliation(s)
- Elizabeth S Goldsmith
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA. .,Section General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA. .,University of Minnesota School of Public Health, Minneapolis, MN, USA.
| | - Brent C Taylor
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA.,University of Minnesota School of Public Health, Minneapolis, MN, USA.,University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nancy Greer
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Maureen Murdoch
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA.,Section General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.,University of Minnesota Medical School, Minneapolis, MN, USA
| | - Roderick MacDonald
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Lauren McKenzie
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Christina E Rosebush
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Timothy J Wilt
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA.,Section General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.,University of Minnesota Medical School, Minneapolis, MN, USA
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Simon CB, Hicks GE. Paradigm Shift in Geriatric Low Back Pain Management: Integrating Influences, Experiences, and Consequences. Phys Ther 2018; 98:434-446. [PMID: 29669088 PMCID: PMC6692842 DOI: 10.1093/ptj/pzy028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/09/2018] [Indexed: 12/19/2022]
Abstract
Geriatric low back pain (LBP) can have a profound impact on physical activity and can cause a decline in physical function, which is a major health risk for older adults. Within the last decade, physical therapist management of LBP has shifted from an emphasis on pathoanatomical mechanisms, such as spine degeneration, to addressing psychological distress factors. Although this approach is promising, the complexity of LBP in older adults (including biological, psychological, cognitive, and social influences), which may differ from that in younger adults, must be considered. Further, outcome assessment should represent not only the LBP experience (eg, pain intensity, pain with movement) but also LBP consequences, such as physical activity decline and physical function decline. This perspective discusses influences on geriatric LBP, experiences, and consequences with the goal of facilitating standardized and comprehensive physical therapist management.
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Affiliation(s)
- Corey B Simon
- Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University School of Medicine, PO Box 104002 DUMC, Durham, NC 27708 (USA); and Musculoskeletal Research Team, Duke Clinical Research Institute, Durham, NC,Address all correspondence to Dr Simon at:
| | - Gregory E Hicks
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark, Delaware
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Perron M, Gendron C, Langevin P, Leblond J, Roos M, Roy JS. Prognostic factors of a favorable outcome following a supervised exercise program for soldiers with sub-acute and chronic low back pain. BMC Musculoskelet Disord 2018; 19:95. [PMID: 29606114 PMCID: PMC5879551 DOI: 10.1186/s12891-018-2022-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 03/23/2018] [Indexed: 12/13/2022] Open
Abstract
Background Low back pain (LBP) encompasses heterogeneous patients unlikely to respond to a unique treatment. Identifying sub-groups of LBP may help to improve treatment outcomes. This is a hypothesis-setting study designed to create a clinical prediction rule (CPR) that will predict favorable outcomes in soldiers with sub-acute and chronic LBP participating in a multi-station exercise program. Methods Military members with LBP participated in a supervised program comprising 7 stations each consisting of exercises of increasing difficulty. Demographic, impairment and disability data were collected at baseline. The modified Oswestry Disability Index (ODI) was administered at baseline and following the 6-week program. An improvement of 50% in the initial ODI score was considered the reference standard to determine a favorable outcome. Univariate associations with favorable outcome were tested using chi-square or paired t-tests. Variables that showed between-group (favorable/unfavorable) differences were entered into a logistic regression after determining the sampling adequacy. Finally, continuous variables were dichotomized and the sensitivity, specificity and positive and negative likelihood ratios were determined for the model and for each variable. Results A sample of 85 participants was included in analyses. Five variables contributed to prediction of a favorable outcome: no pain in lying down (p = 0.017), no use of antidepressants (p = 0.061), FABQ work score < 22.5 (p = 0.061), fewer than 5 physiotherapy sessions before entering the program (p = 0.144) and less than 6 months’ work restriction (p = 0.161). This model yielded a sensitivity of 0.78, specificity of 0.80, LR+ of 3.88, and LR- of 0.28. A 77.5% probability of favorable outcome can be predicted by the presence of more than three of the five variables, while an 80% probability of unfavorable outcome can be expected if only three or fewer variables are present. Conclusion The use of prognostic factors may guide clinicians in identifying soldiers with LBP most likely to have a favorable outcome. Further validation studies are needed to determine if the variables identified in our study are treatment effect modifiers that can predict success following participation in the multi-station exercise program. Trial registration ClinicalTrials.gov Identifier: NCT03464877 registered retrospectively on 14 March 2018. Electronic supplementary material The online version of this article (10.1186/s12891-018-2022-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marc Perron
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Local 4445, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada.
| | - Chantal Gendron
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Local 4445, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada.,Canadian Forces Health Services Group, Valcartier Garison, Quebec City, Canada
| | - Pierre Langevin
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Local 4445, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada.,Physio Interactive, Quebec City, Canada
| | - Jean Leblond
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Canada
| | - Marianne Roos
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Local 4445, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Local 4445, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Canada
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Simplified Chinese Version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: Cross-cultural Adaptation, Reliability, and Validity for Patients With Low Back Pain. Spine (Phila Pa 1976) 2018; 43:E357-E364. [PMID: 28953707 DOI: 10.1097/brs.0000000000002424] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-cultural adaptation and cross-sectional psychometric testing in a convenience sample of patients with low back pain. OBJECTIVE The aim of this study was to translate and adapt the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) into a simplified Chinese version, and assess its reliability and validity. SUMMARY OF BACKGROUND DATA No simplified Chinese version of the JOABPEQ was previously available. METHODS We translated and culturally adapted the original English JOABPEQ to develop a Chinese version, based on cross-cultural adaptation guidelines. Principal component analysis with varimax rotation was used to confirm the factor structure of each subscale. Internal consistency was evaluated with Cronbach alpha. Test-retest reliability was examined in stable patients, who completed the questionnaire again at 4 days to 2 weeks from baseline. The validity of the translated Chinese version was assessed by examining the relationship between the JOABPEQ and Chinese versions of the Roland-Morris Disability Questionnaire (RMDQ), the Oswestry Disability Index (ODI), the Short Form Health Survey (SF-36), and the Numerical Pain Rating Scale. Ceiling and floor effects were considered present if more than 15% of respondents achieved the lowest or highest possible total score. RESULTS The JOABPEQ showed excellent internal consistency (α = 0.886). The test-retest reliability (intraclass correlation coefficients) ranged from 0.951 to 0.977. The convergent validity of the Chinese version was supported by its high correlation with other physical functional status measures (RMDQ, ODI, and SF-36 Physical Function; r values from -0.645 to -0.726), and moderate correlation with other measures (SF-36 Bodily pain and Social functioning subscales; r values 0.426-0.546). Q5 Mental health was highly correlated with SF-36 items (r values 0.337-0.640). There was a floor effect in Q1 low back pain (38, 20.65%). CONCLUSION The results indicate that the simplified Chinese version of the JOABPEQ is a reliable and valid instrument to measure the multidimensional status in patients with low back pain. LEVEL OF EVIDENCE 4.
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Chiarotto A, Boers M, Deyo RA, Buchbinder R, Corbin TP, Costa LO, Foster NE, Grotle M, Koes BW, Kovacs FM, Lin CWC, Maher CG, Pearson AM, Peul WC, Schoene ML, Turk DC, van Tulder MW, Terwee CB, Ostelo RW. Core outcome measurement instruments for clinical trials in nonspecific low back pain. Pain 2018; 159:481-495. [PMID: 29194127 PMCID: PMC5828378 DOI: 10.1097/j.pain.0000000000001117] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/09/2017] [Accepted: 11/15/2017] [Indexed: 01/09/2023]
Abstract
To standardize outcome reporting in clinical trials of patients with nonspecific low back pain, an international multidisciplinary panel recommended physical functioning, pain intensity, and health-related quality of life (HRQoL) as core outcome domains. Given the lack of a consensus on measurement instruments for these 3 domains in patients with low back pain, this study aimed to generate such consensus. The measurement properties of 17 patient-reported outcome measures for physical functioning, 3 for pain intensity, and 5 for HRQoL were appraised in 3 systematic reviews following the COSMIN methodology. Researchers, clinicians, and patients (n = 207) were invited in a 2-round Delphi survey to generate consensus (≥67% agreement among participants) on which instruments to endorse. Response rates were 44% and 41%, respectively. In round 1, consensus was achieved on the Oswestry Disability Index version 2.1a for physical functioning (78% agreement) and the Numeric Rating Scale (NRS) for pain intensity (75% agreement). No consensus was achieved on any HRQoL instrument, although the Short Form 12 (SF12) approached the consensus threshold (64% agreement). In round 2, a consensus was reached on an NRS version with a 1-week recall period (96% agreement). Various participants requested 1 free-to-use instrument per domain. Considering all issues together, recommendations on core instruments were formulated: Oswestry Disability Index version 2.1a or 24-item Roland-Morris Disability Questionnaire for physical functioning, NRS for pain intensity, and SF12 or 10-item PROMIS Global Health form for HRQoL. Further studies need to fill the evidence gaps on the measurement properties of these and other instruments.
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Affiliation(s)
- Alessandro Chiarotto
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
- Department of Health Sciences, Faculty of Science, Amsterdam Movement Sciences Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Maarten Boers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
- Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Richard A. Deyo
- Department of Family Medicine, Department of Internal Medicine, and Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, USA
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Australia
| | - Terry P. Corbin
- Cochrane Collaboration, Back and Neck Review Group, Maple Grove, MN, USA
| | - Leonardo O.P. Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
| | - Nadine E. Foster
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, United Kingdom
| | - Margreth Grotle
- Oslo and Akershus University College, Faculty of Health Science, Oslo, Norway
- Communication and Research Unit for Musculoskeletal Disorders (FORMI), Oslo University Hospital & University of Oslo, Oslo, Norway
| | - Bart W. Koes
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Francisco M. Kovacs
- Spanish Back Pain Research Network, Hospital Universitario HLA-Moncloa, Madrid, Spain
| | - C.-W. Christine Lin
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Chris G. Maher
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Adam M. Pearson
- Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, PA, USA
| | - Wilco C. Peul
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Mark L. Schoene
- Cochrane Collaboration, Back and Neck Review Group, Newbury, MA, USA
| | - Dennis C. Turk
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Maurits W. van Tulder
- Department of Health Sciences, Faculty of Science, Amsterdam Movement Sciences Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Caroline B. Terwee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Raymond W. Ostelo
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
- Department of Health Sciences, Faculty of Science, Amsterdam Movement Sciences Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
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Seiger A, Gadjradj PS, Harhangi BS, van Susante JL, Peul WC, van Tulder MW, de Boer MR, Rubinstein SM. PTED study: design of a non-inferiority, randomised controlled trial to compare the effectiveness and cost-effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) versus open microdiscectomy for patients with a symptomatic lumbar disc herniation. BMJ Open 2017; 7:e018230. [PMID: 29273659 PMCID: PMC5778332 DOI: 10.1136/bmjopen-2017-018230] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Lumbosacral radicular syndrome is often caused by a disc herniation. The standard surgical technique to remove a disc herniation is open microdiscectomy. An alternative technique is percutaneous transforaminal endoscopic discectomy (PTED), which is less invasive. In the Netherlands, PTED is not currently considered as standard care, and therefore not reimbursed within public health insurance. A pragmatic, multicentre, non-inferiority, randomised controlled trial has been designed to determine the effectiveness and cost-effectiveness of PTED versus open microdiscectomy for the treatment of lumbar disc herniation. METHOD AND ANALYSIS In total, 682 patients between 18 and 70 years of age with >10 weeks of radiating pain or with >6 weeks of excessive radiating pain are to be recruited from participating centres. Patients must have an indication for surgery based on an MRI demonstrating compression of the nerve root from a lumbar disc herniation. Patients are to be randomised to PTED or open microdiscectomy. The primary outcome is self-reported leg pain measured by the 0-100 mm Visual Analogue Scale. Secondary outcomes include self-reported health and functional status, back pain, self-perceived recovery and a physical examination. Outcomes will be measured the day following surgery, at 2, 4 and 6 weeks, and at 3, 6, 9, 12 and 24 months. Physical examination will be performed at 6 weeks, and 3 and 12 months. An economic evaluation will be performed from a societal perspective and cost questionnaires will be used (eg, EQ-5D-5L). The data will be analysed longitudinally; the non-inferiority margin for the primary outcome is 5. Bootstrapping techniques will be used for the economic evaluation. ETHICS AND DISSEMINATION This study has received approval of the Medical Ethical Committee of the VU Medical Centre Amsterdam: NL50951.029.14. The results will be published in an international peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER NCT02602093; Pre-results, recruiting stage.
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Affiliation(s)
- Ankie Seiger
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pravesh S Gadjradj
- Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Neurosurgery, Erasmus MC: University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Biswadjiet S Harhangi
- Department of Neurosurgery, Erasmus MC: University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | - Wilco C Peul
- Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Michiel R de Boer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Sidney M Rubinstein
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
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Igwesi-Chidobe CN, Obiekwe C, Sorinola IO, Godfrey EL. Assessing self-reported disability in a low-literate population with chronic low back pain: cross-cultural adaptation and psychometric testing of Igbo Roland Morris disability questionnaire. Disabil Rehabil 2017; 41:948-957. [DOI: 10.1080/09638288.2017.1416185] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chinonso N. Igwesi-Chidobe
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria (Enugu Campus), Enugu State, Nigeria
- Department of Physiotherapy, School of population health sciences, faculty of life sciences and medicine, King's College London, UK
| | - Chinwe Obiekwe
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Isaac O. Sorinola
- Department of Physiotherapy, School of population health sciences, faculty of life sciences and medicine, King's College London, UK
| | - Emma L Godfrey
- Department of Physiotherapy, School of population health sciences, faculty of life sciences and medicine, King's College London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Mansell G, Storheim K, Løchting I, Werner EL, Grotle M. Identification of Indirect Effects in a Cognitive Patient Education (COPE) Intervention for Low Back Pain. Phys Ther 2017; 97:1138-1146. [PMID: 29186635 PMCID: PMC5803786 DOI: 10.1093/ptj/pzx091] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 09/05/2017] [Indexed: 11/12/2022]
Abstract
BACKGROUND Many interventions for the treatment of low back pain exist, but the mechanisms through which such treatments work are not always clear. This situation is especially true for biopsychosocial interventions that incorporate several different components and methods of delivery. OBJECTIVE The study objective was to examine the indirect effects of the Cognitive Patient Education (COPE) intervention via illness perceptions, back pain myths, and pain catastrophizing on disability outcome. DESIGN This study was a secondary analysis of the COPE randomized controlled trial. METHODS Mediation analysis techniques were employed to examine the indirect effects of the COPE intervention via residualized change (baseline - posttreatment) in the 3 variables hypothesized to be targeted by the COPE intervention on posttreatment disability outcome. Pain intensity at baseline, pain duration, clinician type, and a treatment-mediator interaction term were controlled for in the analysis. RESULTS Preliminary analyses confirmed that changes in pain catastrophizing and illness perceptions (not back pain myths) were related to both allocation to the intervention arm and posttreatment disability score. The treatment exerted statistically significant indirect effects via changes in illness perceptions and pain catastrophizing on posttreatment disability score (illness perceptions standardized indirect effect = 0.09 [95% CI = 0.03 to 0.16]; pain catastrophizing standardized indirect effect = 0.05 [95% CI = 0.01 to 0.12]). However, the inclusion of an interaction term led to the indirect effects being significantly reduced, with the effects no longer being statistically significant. LIMITATIONS This study presents a secondary analysis of variables not identified a priori as being potentially important treatment targets; other, unmeasured factors could also be important in explaining treatment effects. CONCLUSIONS The finding that small indirect effects of the COPE intervention via changes in illness perceptions and pain catastrophizing on posttreatment disability could be estimated indicates that these variables may be viable treatment targets for biopsychosocial interventions; however, this finding must be viewed in light of the adjusted analyses, which showed that the indirect effects were significantly reduced through the inclusion of a treatment-mediator interaction term.
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Affiliation(s)
- Gemma Mansell
- G. Mansell, PhD, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire ST5 5BG, United Kingdom,Address all correspondence to Dr Mansell at:
| | - Kjersti Storheim
- K. Storheim, PT, PhD, Research and Communication Unit for Musculoskeletal Diseases (FORMI), Division for Surgery and Neurology, Oslo University Hospital, Ullevaal, Oslo, Norway
| | - Ida Løchting
- I. Løchting PhD, FORMI, Division for Surgery and Neurology, Oslo University Hospital, and Department of Clinical Medicine, University of Oslo, Ullevaal, Oslo, Norway
| | - Erik L. Werner
- E.L. Werner, MD, PhD, Department of General Practice, Institute of Health and Society, University of Oslo, and Research Unit for General Practice, Uni Health Research, Uni Research, Bergen, Norway
| | - Margreth Grotle
- M. Grotle, PT, PhD, FORMI, Division for Surgery and Neurology, Oslo University Hospital, and Institute of Physiotherapy, Oslo and Akershus University College for Applied Sciences, Oslo, Norway
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Dahlqvist JR, Vissing CR, Hedermann G, Thomsen C, Vissing J. Fat Replacement of Paraspinal Muscles with Aging in Healthy Adults. Med Sci Sports Exerc 2017; 49:595-601. [PMID: 27741218 DOI: 10.1249/mss.0000000000001119] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The aims of this study were to investigate the age-related changes in fatty replacement and cross-sectional area (CSA) of cervical, thoracic, and lumbar paraspinal muscles versus leg muscles in healthy adults and to test for association between muscle fat fraction and lifestyle factors. METHODS Fifty-three healthy adults (24-76 yr) were included. Dixon magnetic resonance imaging technique was used to determine CSA and to quantify the fat fraction of paraspinal and leg muscles. Muscle CSA and fat fractions were tested for association with age and muscle strength. The fat fractions were also tested for association with sex, body mass index (BMI), physical activity, and lower back pain. RESULTS Both paraspinal and leg fat fractions correlated directly with age (P < 0.0001). At all ages, fat fraction was higher in paraspinal than leg muscles. The age-related increase in fat fraction was higher in paraspinal muscles than leg muscles (P < 0.0001). The CSA of the muscles did not correlate with age. Knee extension strength correlated with fat fraction (P < 0.05), and the muscle strength of hip muscles, thigh muscles, and anterior calf muscles correlated with CSA (P < 0.05). Sex was associated with lumbar paraspinal fat fraction (P < 0.05) and BMI with thigh fat fraction (P < 0.001). There was no association between fat fraction and physical activity or lower back pain. CONCLUSION The paraspinal muscles were more susceptible to age-related changes than leg muscles. Further, men had significantly lower fat fractions in lumbar paraspinal muscles, and BMI was positively associated with thigh, but not paraspinal, fat fraction.
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Affiliation(s)
- Julia R Dahlqvist
- 1Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, DENMARK; and 2Department of Diagnostic Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, DENMARK
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Goosheh B, Ravanbakhsh M, Salavati M, Ebrahimi Takamjani I, Akhbari B, Kahlaee AH. Attention-demand effects on respiration in chronic low back pain patients. J Bodyw Mov Ther 2017; 21:788-793. [DOI: 10.1016/j.jbmt.2016.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/07/2016] [Accepted: 11/24/2016] [Indexed: 11/27/2022]
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Huang JC, Qian BP, Qiu Y, Wang B, Yu Y, Zhu ZZ, Hu J, Qu Z. Quality of life and correlation with clinical and radiographic variables in patients with ankylosing spondylitis: a retrospective case series study. BMC Musculoskelet Disord 2017; 18:352. [PMID: 28810915 PMCID: PMC5558739 DOI: 10.1186/s12891-017-1711-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 08/08/2017] [Indexed: 12/29/2022] Open
Abstract
Background Previously, many studies have evaluated quality of life (QoL) in patients with ankylosing spondylitis (AS), however, none of them specifically investigated the correlation between pain-related disability measured by Oswestry Disability Index (ODI) and QoL in AS patients. In addition, the correlation between global kyphosis (GK) in lateral plain radiographs and QoL in AS patients remains unclear up to now. Therefore, this study aimed to evaluate QoL and correlation with clinical and radiographic variables in AS patients, especially to figure out the relationship about the pain-specific disability measured by ODI, GK and QoL. Methods From January 2008 to November 2015, two hundred and forty-five consecutive patients with an average age of 36.2 ± 10.9 years (range, 17–66 years) satisfying the Modified New York Criteria for AS from a single institution were enrolled. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Global score (BAS-G) were applied to assess the disease activity, functional status, spinal mobility and overall feeling of AS patients, respectively. ODI was recorded to evaluate low back pain-related disability. QoL was evaluated by the Short Form-36 (SF-36). According to global kyphosis (GK) measured on standing lateral full-spine radiographs, the patients were divided into two groups: mild kyphotic group (GK < 70°,n = 176) and severe kyphotic group (GK ≥ 70°,n = 69). Results The scores of BASDAI, BASFI, BASMI and ODI had significant negative correlations with all SF-36 subscale scores (P < 0.01). BASFI and BASMI scores of severe kyphotic group were much higher than those of mild kyphotic group, respectively (P = 0.005 and P = 0.001, respectively) and the score of physical function (PF) subscale in severe kyphotic group was significantly higher than that in mild kyphotic group (P = 0.046) as well. Notably, the scores of ODI, BASFI and BASMI were the major predictors of PF subscale score of SF-36. Conclusions Poor QoL is significantly correlated with high disease activity, poor functional status and decreased spinal mobility in AS. GK is significantly associated with functional status, spinal mobility and QoL in AS patients. ODI, BASFI and BASMI are the major predictors of PF subscale of SF-36.
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Affiliation(s)
- Ji-Chen Huang
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.,Medical School of Southeast University, Nanjing, China
| | - Bang-Ping Qian
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
| | - Yong Qiu
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Bin Wang
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Yang Yu
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Ze-Zhang Zhu
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Jun Hu
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Zhe Qu
- Department of Spine Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
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Chiarotto A, Terwee CB, Ostelo RW. Choosing the right outcome measurement instruments for patients with low back pain. Best Pract Res Clin Rheumatol 2017; 30:1003-1020. [PMID: 29103546 DOI: 10.1016/j.berh.2017.07.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/01/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
Choosing the most fit-for-purpose outcome measurement instruments is fundamental because using inappropriate instruments can lead to detection bias and measurement inconsistency. Recent recommendations, consensus procedures and systematic reviews on existing patient-reported outcome measures (PROMs) informed this manuscript, which provides suggestions on which outcome domains and measurement instruments to use in patients with low back pain (LBP). Six domains are identified as highly relevant: (1) physical functioning, (2) pain intensity, (3) health-related quality of life, (4) work, (5) psychological functioning and (6) pain interference. For each domain, one or more PROMs are suggested for clinical research and practice, selecting among those that are most frequently used and recommended, and that have satisfactory measurement properties in patients with LBP. Further research on the measurement properties of these suggested PROMs is needed while also considering other emerging instruments, such as the PROMIS computerised adaptive testing and short forms.
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Affiliation(s)
- Alessandro Chiarotto
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Raymond W Ostelo
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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Nordeman L, Thorselius L, Gunnarsson R, Mannerkorpi K. Predictors for future activity limitation in women with chronic low back pain consulting primary care: a 2-year prospective longitudinal cohort study. BMJ Open 2017; 7:e013974. [PMID: 28674128 PMCID: PMC5734216 DOI: 10.1136/bmjopen-2016-013974] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To assess if body function, activity, participation, health-related quality of life and lifestyle behavioural factors can predict activity limitation in women with chronic low back pain (CLBP) in primary healthcare (PHC) 2 years later. DESIGN A 2-year prospective longitudinal cohort study within PHC. SETTINGS PHC in southwestern Sweden. PARTICIPANTS The cohort comprised 130 women with CLBP attending PHC at baseline 2004-2005 and were reassessed after 2 years. MEASURES The dependent outcome variable was self-reported activity limitation (Roland Morris disability questionnaire (RMDQ)) at 2-year follow-up. Independent predictors at baseline were age, body mass index, smoking, alcohol consumption, sleep quantity and quality, leisure time physical activity, a questionnaire of clinical manifestation of stress (Stress and Crises Inventory (SCI-93)), pain localisation, pain intensity, fatigue, anxiety, depression, RMDQ, work status, private social support, health-related quality of life and measures of physical performance specified as 6 min walk test (6MWT) and hand grip strength. Relation between baseline predictors and variation in later self-reported activity limitation (RMDQ) was analysed using multivariate linear regression. RESULTS Ninety-five per cent (n=123/130) were followed up after 2 years. The participants were middle-aged (mean 45 (SD 10) years), mostly educated >9 years (88%; 108/123), mainly living with another adult (76%; 93/122) and born in Sweden (90%; 111/123). Seventy-nine per cent (97/123) were categorised as having work ability at baseline. The final prognostic model including 6MWT, SCI-93 and RMDQ at baseline explained 54% of the variance in self-reported activity limitation (RMDQ) at the 2-year follow-up. CONCLUSIONS Lower physical performance, more severe clinical stress symptoms and more severe activity limitation predicted activity limitation after 2 years in women with CLBP within PHC. The results can give guidance for interventional trials aiming to improve physical capacity and decrease stress. The impact of the interaction between prognostic factors and interventions on activity limitation needs further investigation.
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Affiliation(s)
- Lena Nordeman
- Research and Development Center Södra Älvsborg, Närhälsan, Research and Development Primary Health Care Region Västra Götaland, Borås, Sweden
- Department of Health and Rehabilitation, Unit of Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden
| | - Lena Thorselius
- Närhälsan, Health Unit, Primary Health Care Region, Västra Götaland, Sweden
| | - Ronny Gunnarsson
- Research and Development Center Södra Älvsborg, Närhälsan, Research and Development Primary Health Care Region Västra Götaland, Borås, Sweden
- Department of Public Health and Community Medicine, University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, Gothenburg, Sweden
- Cairns clinical school, College of Medicine and Dentistry, James Cook University, Australia
| | - Kaisa Mannerkorpi
- Department of Health and Rehabilitation, Unit of Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden
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Haufe S, Wiechmann K, Stein L, Kück M, Smith A, Meineke S, Zirkelbach Y, Rodriguez Duarte S, Drupp M, Tegtbur U. Low-dose, non-supervised, health insurance initiated exercise for the treatment and prevention of chronic low back pain in employees. Results from a randomized controlled trial. PLoS One 2017; 12:e0178585. [PMID: 28662094 PMCID: PMC5490969 DOI: 10.1371/journal.pone.0178585] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 05/15/2017] [Indexed: 12/19/2022] Open
Abstract
Objective Back pain is a major problem requiring pragmatic interventions, low in costs for health care providers and feasible for individuals to perform. Our objective was to test the effectiveness of a low-dose 5-month exercise intervention with small personnel investment on low back strength and self-perceived pain. Methods Two hundred twenty-six employees (age: 42.7±10.2 years) from three mid-size companies were randomized to 5-month non-supervised training at home (3 times/week for 20 minutes) or wait-list-control. Health insurance professionals instructed the participants on trunk exercises at the start and then supervised participants once a month. Results Muscle strength for back extension increased after the 5-month intervention with a significant between-group difference (mean 27.4 Newton [95%CI 2.2; 60.3]) favoring the exercise group (p = 0.035). Low back pain was reduced more in subjects after exercise than control (mean difference –0.74 cm [95%CI –1.17; –0.27], p = 0.002). No between-group differences were observed for back pain related disability and work ability. After stratified analysis only subjects with preexisting chronic low back pain showed a between-group difference (exercise versus controls) after the intervention in their strength for back extension (mean 55.7 Newton [95%CI 2.8; 108.5], p = 0.039), self-perceived pain (mean –1.42 cm [95%CI –2.32; –0.51], p = 0.003) and work ability (mean 2.1 points [95%CI 0.2; 4.0], p = 0.032). Significant between-group differences were not observed in subjects without low back pain: strength for back extension (mean 23.4 Newton [95%CI –11.2; 58.1], p = 0.184), self-perceived pain (mean –0.48 cm [95%CI –0.99; 0.04], p = 0.067) and work ability (mean –0.1 points [95%CI –0.9; 0.9], p = 0.999). An interaction between low back pain subgroups and the study intervention (exercise versus control) was exclusively observed for the work ability index (p = 0.016). Conclusion In middle-aged employees a low-dose, non-supervised exercise program implemented over 20 weeks improved trunk muscle strength and low back pain, and in those with preexisting chronic low back pain improved work ability.
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Affiliation(s)
- Sven Haufe
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Klaus Wiechmann
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Lothar Stein
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Momme Kück
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Andrea Smith
- Institute of Biometry, Hannover Medical School, Hannover, Germany
| | | | | | | | | | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
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Splettstößer A, Khan MF, Zimmermann B, Vogl TJ, Ackermann H, Middendorp M, Maataoui A. Correlation of lumbar lateral recess stenosis in magnetic resonance imaging and clinical symptoms. World J Radiol 2017; 9:223-229. [PMID: 28634513 PMCID: PMC5441455 DOI: 10.4329/wjr.v9.i5.223] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/11/2017] [Accepted: 03/17/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the correlation of lateral recess stenosis (LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index (ODI).
METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study. On magnetic resonance images (MRI) the lateral recesses (LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale (Grade 0-3) as normal, not deviated, deviated or compressed. Patient symptoms and disability were assessed using ODI. The Spearman’s rank correlation coefficient was used for statistical analysis (P < 0.05).
RESULTS Approximately half of the LR revealed stenosis (grade 1-3; 52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression. The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%. We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1, each bilaterally (L4/5 left: rho < 0.105, P < 0.01; L4/5 right: rho < 0.111, P < 0.01; L5/S1 left: rho 0.128, P < 0.01; L5/S1 right: rho < 0.157, P < 0.001).
CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis, this study showed only a weak correlation of LRS on MRI and clinical findings. This can be attributed to a number of reasons outlined in this study, underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.
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128
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Kaeding TS, Karch A, Schwarz R, Flor T, Wittke TC, Kück M, Böselt G, Tegtbur U, Stein L. Whole-body vibration training as a workplace-based sports activity for employees with chronic low-back pain. Scand J Med Sci Sports 2017; 27:2027-2039. [PMID: 28185300 DOI: 10.1111/sms.12852] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2017] [Indexed: 11/26/2022]
Abstract
The goal of this randomized and controlled study was to examine whether whole-body vibration (WBV) training is able to reduce back pain and physical disability in seated working office employees with chronic low-back pain in a real-world setting. A total of 41 subjects (68.3% female/mean age 45.5±9.1 years/mean BMI 26.6±5.2) were randomly allocated to an intervention group (INT [n=21]) or a control group (CON [n=20]). The INT participated in WBV training 2.5 times per week for 3 months. The primary outcome was the change in the Roland and Morris disability questionnaire (RMQ) score over the study period. In addition, secondary outcomes included changes in the Oswestry Disability Index (ODI), the Work Ability Index Questionnaire, the quality of life questionnaire SF-36, the Freiburger activity questionnaire, and an isokinetic test of the musculature of the trunk. Compliance with the intervention in the INT reached a mean of 81.1%±31.2% with no long-lasting unwanted side effects. We found significant positive effects of 3 months of WBV training in the INT compared to the CON regarding the RMQ (P=.027), the ODI (P=.002), the SF-36 (P=.013), the Freiburger activity questionnaire (P=.022), the post-interventional sick-leave in the INT (P=.008), and trends regarding a positive effect of the intervention on the muscular capacity of the muscles of the trunk in flexion. WBV training seems to be an effective, safe, and suitable intervention for seated working employees with chronic low-back pain.
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Affiliation(s)
- T S Kaeding
- Institute of Sports Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - A Karch
- Institute for Biostatistics, Hannover Medical School (MHH), Hannover, Germany
| | - R Schwarz
- Institute of Sports Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - T Flor
- Institute for Biostatistics, Hannover Medical School (MHH), Hannover, Germany
| | - T-C Wittke
- Institute of Sports Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - M Kück
- Institute of Sports Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - G Böselt
- Deutsche Rentenversicherung Braunschweig-Hannover, Laatzen, Germany
| | - U Tegtbur
- Institute of Sports Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - L Stein
- Institute of Sports Medicine, Hannover Medical School (MHH), Hannover, Germany
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Eyvazov K, Samartzis D, Cheung JPY. The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study. BMC Musculoskelet Disord 2017; 18:51. [PMID: 28143455 PMCID: PMC5282845 DOI: 10.1186/s12891-017-1423-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background Spinal deformities affect the overall alignment of the spine and thus the vectors of loading on the lumbar region and intervertebral discs. Due to wedging of the disc or vertebrae of unbalanced spinal segments, alignment change may affect the range of motion (ROM) of individual spinal segments or the global spine. This is particularly important in adolescent idiopathic scoliosis (AIS) patients who may suffer from early degeneration, back stiffness and pain. Hence, this study aimed to determine the correlation between spine range of motion (ROM) and adolescent idiopathic scoliosis (AIS) curve magnitude. Methods Consecutive recruitment of all AIS patients with Lenke 5 (thoracolumbar/lumbar) curves within one month was performed with ROM assessments in the coronal, sagittal and axial planes using the change in C7-S1 distance on standing upright, active flexion and extension positions, change in finger-floor distance on forward bending position and lateral bending, lateral bending angles, modified Schober’s test, and trunk rotation in seating position. Patients were further stratified into two groups based on their lumbar spine curve magnitude: Group A with curves of 10 to 39 degrees and Group B with 40 degrees or greater. Univariate and multivariate analyses were conducted, with lumbar curve magnitude severity being the dependent variable. Results In total, 58 patients (n = 12 males, n = 46 females; mean age: 15.7 years) were recruited. The mean curve magnitudes were 25 ± 6.5 degrees in Group A and 48 ± 10.6 degrees in Group B. Mean axial rotation (Group A: 90 ± 21.7 degree; Group B: 76 ± 19.6 degrees; p = 0.038) and lateral bending ROM (Group A: 67 ± 13.4 degrees; Group B: 58 ± 14.3 degrees; p = 0.045) decreased in more severe curves. These two parameters continued to remain significant irrespective of the curve severity cut-off values. Conclusions This is the first study to determine associations between spinal ROM parameters with the lumbar curve magnitude in AIS patients. We found that the coronal curve severity is associated with reduced axial and coronal ROM. This is a platform for future studies assessing lumbar spine biomechanics in AIS and to determine the effects of altered spine motion in this context and its implication in patient management and outcomes.
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Affiliation(s)
- Kamil Eyvazov
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Dino Samartzis
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
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Andersen TE, Lahav Y, Ellegaard H, Manniche C. A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms. Eur J Psychotraumatol 2017; 8:1331108. [PMID: 28680540 PMCID: PMC5489867 DOI: 10.1080/20008198.2017.1331108] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/08/2017] [Indexed: 01/16/2023] Open
Abstract
Background: It is well documented that comorbid post-traumatic stress disorder (PTSD) in chronic pain is associated with a more severe symptom profile with respect to pain, disability and psychological distress. However, very few intervention studies exist targeting both PTSD and pain. The current study is the first randomized controlled trial evaluating the effect of the body-oriented trauma approach of Somatic Experiencing (SE) for comorbid PTSD and low back pain. Although the method is well recognized by clinicians and widely used, SE still needs to be tested in a randomized clinical trial in comparison with an active control group. Objective: The aim of the current study was to compare the effect of an SE intervention in addition to treatment-as-usual (TAU) for patients with chronic low back pain and comorbid PTSD compared to TAU alone. Method: The study was a two-group randomized controlled clinical trial. A cohort of patients (n = 1045) referred to a large Danish spine centre between February 2013 and October 2014 were screened for PTSD and randomized to either TAU (4-12 sessions of supervised exercises for low back pain) or TAU plus SE (6-12 sessions). In total, 91 patients fulfilled the inclusion criteria and volunteered to participate in the study. Treatment effects were evaluated by self-report questionnaires comparing baseline measures with 12-month follow-up measures. Results: The additional SE intervention significantly reduced the number of PTSD symptoms compared with TAU alone, corresponding to a large effect size. Also, fear of movement was significantly reduced (moderate effect size). Both groups achieved a large reduction in pain-catastrophizing, disability and pain. Conclusions: A brief additional SE intervention was found to have a significant effect on PTSD and fear of movement compared to TAU alone. However, the overall effect of SE was less than expected and the clinical importance of the effects can be questioned.
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Affiliation(s)
| | - Yael Lahav
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Center of Excellence for Mass Trauma, Tel Aviv University, Tel Aviv, Israel
| | - Hanne Ellegaard
- Spine Center and University of Southern Denmark, Middelfart, Denmark
| | - Claus Manniche
- Spine Center and University of Southern Denmark, Middelfart, Denmark
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Patient Priority Weighting of the Roland Morris Disability Questionnaire Does Not Change Results of the Lumbar Epidural Steroid Injections for Spinal Stenosis Trial. Spine (Phila Pa 1976) 2017; 42:42-48. [PMID: 27105466 PMCID: PMC5071103 DOI: 10.1097/brs.0000000000001647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Secondary analysis of lumbar epidural steroid injections for spinal stenosis randomized controlled trial data. OBJECTIVE To reevaluate whether outcomes for older adults receiving epidural steroid injections with or without corticosteroid improve after using patient-prioritized Roland-Morris Disability Questionnaire (RDQ) items. SUMMARY OF BACKGROUND DATA Epidural corticosteroid injections are commonly used to treat lumbar spinal stenosis symptoms, despite limited evidence for their effectiveness in clinical trials. It is unclear whether evaluating patient-prioritized outcomes would alter results of a large clinical trial. METHODS Outcomes from the trial of lumbar epidural corticosteroid injections for spinal stenosis (LESS) trial were reanalyzed using RDQ, Sickness Impact Profile (SIP) weights assigned to the RDQ items, and patient-prioritized RDQ items. Differences between corticosteroid + lidocaine versus lidocaine-alone groups and 95% confidence intervals (CI) were calculated using analysis of covariance with adjustment for baseline values of the RDQ and recruitment site. RESULTS At 6 weeks, both the corticosteroid + lidocaine group and the lidocaine-alone group had improvement in the RDQ scores (RDQ, RDQ using SIP weights, patient-prioritized RDQ) as compared with baseline scores (corticosteroid + lidocaine: -4.2 points, -4.1 points, -4.2; lidocaine-alone: -3.1 points, -2.9 points, and -3.1 points, respectively). However, there was no significant between-group difference in the RDQ or patient-prioritized RDQ (average treatment effect -1.0 points, 95% CI -2.1 to 0.1, P = 0.07; -1.0 points, 95% CI -2.0 to 0.1, P = 0.08, respectively). Although the between-group difference of RDQ using SIP weights was statistically significant (average treatment effect -1.1, 95% CI -2.2 to -0.1, P = 0.04), this was not clinically important. CONCLUSION Results of the LESS trial did not substantively differ based on reanalysis of data using RDQ with SIP weights or patient-prioritized RDQ outcomes. This provides additional evidence that epidural injection of corticosteroid + lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone for older adults with lumbar spinal stenosis. LEVEL OF EVIDENCE 2.
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Abstract
STUDY DESIGN Systematic review of cross-cultural adaptation of the Oswestry Disability Index (ODI). OBJECTIVE The aim of this study was to evaluate the translation procedures for and measurement properties of cross-cultural adaptations of the ODI. SUMMARY OF BACKGROUND DATA The ODI is the most commonly used questionnaire to determine the outcome of low back pain, and has been translated into many other languages, such as Danish, Greek, and Korean, and adapted for use in different countries. METHODS PubMed, the Cochrane Library, Medline, and EMBASE were searched from the time they were established to January 2015. Studies related to cross-cultural adaptation of the ODI in a specific language/culture were included. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Quality Criteria for Psychometric Properties of Health Status Questionnaire were used for assessment. RESULTS This study included 27 versions of ODI adaptations in 24 different languages/cultures. Only the Danish-Danish adaptation employed all six of the cross-cultural adaptation processes. Expert committee review (three of 27), back translation (eight of 27), and pretesting (nine of 27) were conducted in very few studies. The Polish-Polish (two) adaptation reported all (nine of nine) the measurement properties, whereas the Traditional Chinese-Taiwan and Hungarian-Hungarian adaptations reported six of them. Content validity (16/27), construct validity (17/27), and reliability (22/27) were determined in a relatively high number of studies, whereas agreement (three of 27), responsiveness (12/27), floor and ceiling effects (six of 27), and interpretability (one of 27) were only determined in some studies. CONCLUSION We recommend the Traditional Chinese-Taiwan, Simplified Chinese-Mandarin Chinese, Danish-Danish, German-Swiss, Hungarian-Hungarian, Italian-Italian, and Polish-Polish (two) versions for application, but Traditional Chinese-Hong Kong, French-Swiss, Japanese-Japanese (two), Polish-Polish (two), Tamil-Indian, and Thai-Thai versions may need more research. Furthermore, supplementary tests for the adaptations are necessary, especially for assessing agreement, responsiveness, and interpretability. LEVEL OF EVIDENCE 1.
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Measurement Properties of the Quebec Back Pain Disability Scale in Patients With Nonspecific Low Back Pain: Systematic Review. Phys Ther 2016; 96:1816-1831. [PMID: 27231271 DOI: 10.2522/ptj.20140478] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 05/03/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Quebec Back Pain Disability Scale (QBPDS) has been translated into different languages, and several studies on its measurement properties have been done. PURPOSE The purpose of this review was to critically appraise and compare the measurement properties, when possible, of all language versions of the QBPDS by systematically reviewing the methodological quality and results of the available studies. METHOD Bibliographic databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for articles with the key words "Quebec," "back," "pain," and "disability" in combination with a methodological search filter for finding studies on measurement properties concerning the development or evaluation of the measurement properties of the QBPDS in patients with nonspecific low back pain. Assessment of the methodological quality was carried out by the reviewers using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for both the original language version of the QBPDS in English and French and all translated versions. The results of the measurement properties were rated based on criteria proposed by Terwee et al. RESULTS The search strategy resulted in identification of 1,436 publications, and 27 articles were included in the systematic review. There was limited-to-moderate evidence of good reliability, validity, and responsiveness of the QBPDS for the different language versions, but for no language version was evidence available for all measurement properties. CONCLUSION For research and clinical practice, caution is advised when using the QBPDS to measure disability in patients with nonspecific low back pain. Strong evidence is lacking on all measurement properties for each language version of the QBPDS.
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Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis. Phys Ther 2016; 96:1620-1637. [PMID: 27081203 DOI: 10.2522/ptj.20150420] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 03/31/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physical functioning is a core outcome domain to be measured in nonspecific low back pain (NSLBP). A panel of experts recommended the Roland-Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) to measure this domain. The original 24-item RMDQ and ODI 2.1a are recommended by their developers. PURPOSE The purpose of this study was to evaluate whether the 24-item RMDQ or the ODI 2.1a has better measurement properties than the other to measure physical functioning in adult patients with NSLBP. DATA SOURCES Bibliographic databases (MEDLINE, Embase, CINAHL, SportDiscus, PsycINFO, and Google Scholar), references of existing reviews, and citation tracking were the data sources. STUDY SELECTION Two reviewers selected studies performing a head-to-head comparison of measurement properties (reliability, validity, and responsiveness) of the 2 questionnaires. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the methodological quality of these studies. DATA EXTRACTION The studies' characteristics and results were extracted by 2 reviewers. A meta-analysis was conducted when there was sufficient clinical and methodological homogeneity among studies. DATA SYNTHESIS Nine articles were included, for a total of 11 studies assessing 5 measurement properties. All studies were classified as having poor or fair methodological quality. The ODI displayed better test-retest reliability and smaller measurement error, whereas the RMDQ presented better construct validity as a measure of physical functioning. There was conflicting evidence for both instruments regarding responsiveness and inconclusive evidence for internal consistency. LIMITATIONS The results of this review are not generalizable to all available versions of these questionnaires or to patients with specific causes for their LBP. CONCLUSIONS Based on existing head-to-head comparison studies, there are no strong reasons to prefer 1 of these 2 instruments to measure physical functioning in patients with NSLBP, but studies of higher quality are needed to confirm this conclusion. Foremost, content, structural, and cross-cultural validity of these questionnaires in patients with NSLBP should be assessed and compared.
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Mansell G, Hill JC, Main C, Vowles KE, van der Windt D. Exploring What Factors Mediate Treatment Effect: Example of the STarT Back Study High-Risk Intervention. THE JOURNAL OF PAIN 2016; 17:1237-1245. [PMID: 27565304 PMCID: PMC5123895 DOI: 10.1016/j.jpain.2016.08.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/04/2016] [Accepted: 08/15/2016] [Indexed: 12/01/2022]
Abstract
Interventions developed to improve disability outcomes for low back pain (LBP) often show only small effects. Mediation analysis was used to investigate what led to the effectiveness of the Stratified Targeted Treatment (STarT) Back trial, a large primary care-based trial that treated patients consulting with LBP according to their risk of a poor outcome. The high-risk subgroup, randomized to receive either psychologically-informed physiotherapy (n = 93) or current best care (n = 45), was investigated to explore pain-related distress and pain intensity as potential mediators of the relationship between treatment allocation and change in disability. Structural equation modeling was used to generate latent variables of pain-related distress and pain intensity from measures used to identify patients at high risk (fear-avoidance beliefs, depression, anxiety, and catastrophizing thoughts). Outcome was measured using the Roland–Morris Disability Questionnaire. Change in pain-related distress and pain intensity were found to have a significant mediating effect of .25 (standardized estimate, bootstrapped 95% confidence interval, .09–.39) on the relationship between treatment group allocation and change in disability outcome. This study adds to the evidence base of treatment mediation studies in pain research and the role of distress in influencing disability outcome in those with complex LBP. Perspective Mediation analysis using structural equation modeling found that change in pain-related distress and pain intensity mediated treatment effect in the STarT Back trial. This type of analysis can be used to gain further insight into how interventions work, and lead to the design of more effective interventions in future. Identifying how treatments work is important in making them more effective in the future. Changes in psychological distress and pain intensity are mediators of treatment effect. This study adds to the evidence base for the role of mediators in pain research.
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Affiliation(s)
- Gemma Mansell
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, United Kingdom.
| | - Jonathan C Hill
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - Chris Main
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - Kevin E Vowles
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Daniëlle van der Windt
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
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Lotzke H, Jakobsson M, Brisby H, Gutke A, Hägg O, Smeets R, den Hollander M, Olsson LE, Lundberg M. Use of the PREPARE (PREhabilitation, Physical Activity and exeRcisE) program to improve outcomes after lumbar fusion surgery for severe low back pain: a study protocol of a person-centred randomised controlled trial. BMC Musculoskelet Disord 2016; 17:349. [PMID: 27538757 PMCID: PMC4991107 DOI: 10.1186/s12891-016-1203-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/04/2016] [Indexed: 11/21/2022] Open
Abstract
Background Following lumbar fusion surgery, a successful outcome is empirically linked to effective rehabilitation. While rehabilitation is typically postoperative, the phase before surgery – termed prehabilitation – is reportedly an ideal time to prepare the patient. There are presently no guidelines for prehabilitation before lumbar fusion surgery. Physical activity has well-known health benefits, and staying physically active despite pain is a major principle in non-pharmacological chronic low back pain treatment. Psychological factors such as fear of movement, pain catastrophizing and low self-efficacy are known to be barriers to staying active. No studies have investigated prehabilitation protocols that promote physical activity and target psychological risk factors before lumbar fusion surgery. The aim of our proposed randomised controlled trial is to investigate whether patients who undergo lumbar fusion surgery for degenerative disc disease experience better functioning with a physiotherapeutic prehabilitation program (PREPARE) based on a cognitive behavioural approach compared to conventional care. Methods/Design We will recruit 110 patients between 18–70 years of age with degenerative disc disease who are waiting for lumbar fusion surgery. These patients will be randomly assigned to receive either PREPARE or conventional care. PREPARE uses a person-centred perspective and focuses on promoting physical activity and targeting psychological risk factors before surgery. The primary outcome will be disability measured using the Oswestry Disability Index 2.0. Secondary outcomes will include functioning (patient-reported and performance-based), physical activity (accelerometer), health-related quality of life, back and leg pain intensity, pain catastrophizing, kinesiophobia, self-efficacy, depression, anxiety, satisfaction with treatment results and health economic factors. Data will be collected at baseline (preoperatively) after the intervention (preoperatively), 3 and 8 weeks, 3, 6, 12, 24 and 60 months postoperatively. Discussion We hypothesise that the focus on promoting physical activity and targeting psychological risk factors before surgery will decrease disability and help the patients to be more active despite pain both before and after surgery. We will use a combination of outcome measures both patient-reported and performance-based, as well as accelerometer data. This will provide a more comprehensive picture of the patient’s functioning than just patient-reported outcomes alone. Trial registration Current Controlled Trials ISCRTN17115599, Retrospectively Registered 18 May 2015.
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Affiliation(s)
- Hanna Lotzke
- Department of Orthopaedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Spine Center Göteborg, Västra Frölunda, Sweden. .,Physiotherapy Department Spine Center AB, 430 21, Västra Frölunda, Sweden.
| | - Max Jakobsson
- Department of Orthopaedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,District Department North, Division of Rehabilitation, Borås Stad, Borås, Sweden
| | - Helena Brisby
- Department of Orthopaedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Sociology, Karolinska Institutet, Stockholm, Sweden
| | - Annelie Gutke
- Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Olle Hägg
- Department of Orthopaedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Spine Center Göteborg, Västra Frölunda, Sweden
| | - Rob Smeets
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands.,Libra Rehabilitation and Audiology, Eindhoven/Weert, The Netherlands
| | - Marlies den Hollander
- Department of Rehabilitation Medicine, Maastricht University, Medical Centre, Maastricht, The Netherlands.,Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Lars-Eric Olsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Mari Lundberg
- Department of Orthopaedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Sociology, Karolinska Institutet, Stockholm, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Yuan WH, Hsu HC, Lai KL. Vertebroplasty and balloon kyphoplasty versus conservative treatment for osteoporotic vertebral compression fractures: A meta-analysis. Medicine (Baltimore) 2016; 95:e4491. [PMID: 27495096 PMCID: PMC4979850 DOI: 10.1097/md.0000000000004491] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Although the majority of available evidence suggests that vertebroplasty and kyphoplasty can relieve pain associated with vertebral compression fractures (VCFs) and improve function, some studies have suggested results are similar to those of placebo. The purpose of this meta-analysis was to compare the outcomes of vertebroplasty and kyphoplasty with conservative treatment in patients with osteoporotic VCFs. METHODS Medline, Cochrane, and Embase databases were searched until January 31, 2015 using the keywords: vertebroplasty, kyphoplasty, compression fracture, osteoporotic, and osteoporosis. Inclusion criteria were randomized controlled trials (RCTs) in which patients with osteoporosis, and VCFs were treated with vertebroplasty/kyphoplasty or conservative management. Outcome measures were pain, function, and quality of life. Standardized differences in means were calculated as a measure of effect size. MAIN RESULTS Ten RCTs were included. The total number of patients in the treatment and control groups was 626 and 628, respectively, the mean patient age ranged from 64 to 80 years, and the majority was female. Vertebroplasty/kyphoplasty was associated with greater pain relief (pooled standardized difference in means = 0.82, 95% confidence interval [CI]: 0.374-1.266, P < 0.001) and a significant improvement in daily function (pooled standardized difference in means = 1.273, 95% CI: 1.028-1.518, P < 0.001) as compared with conservative treatment. The pooled estimate indicated vertebroplasty/kyphoplasty was associated with higher quality of life (pooled standardized difference in means = 1.545, 95% CI: 1.293-1.798, P < 0.001). Subgroup analysis of 8 vertebroplasty studies and 2 kyphoplasty studies that reported pain data, however, indicated that vertebroplasty provided greater pain relief than conservative treatment but kyphoplasty did not. CONCLUSION Vertebroplasty may provide better pain relief than balloon kyphoplasty in patients with osteoporotic VCFs, both may improve function, and their effect on quality of life is less clear.
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Affiliation(s)
- Wei-Hsin Yuan
- Division of Radiology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital)
- School of Medicine, National Yang Ming University
- Department of Radiology, Taipei Veterans General Hospital
- Correspondence: Wei-Hsin Yuan, Division of Radiology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), No.12, 225 Lane, Zhi-Sing Road, Taipei 11260 Taiwan ROC (e-mail: )
| | - Hui-Chen Hsu
- Medical Imaging Department, Taipei Beitou Health Management Hospital
| | - Kaun-Lin Lai
- School of Medicine, National Yang Ming University
- Department of Neurology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan, ROC
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138
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Stevens ML, Lin CCW, Maher CG. The Roland Morris Disability Questionnaire. J Physiother 2016; 62:116. [PMID: 26687949 DOI: 10.1016/j.jphys.2015.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/16/2015] [Accepted: 10/22/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Matthew L Stevens
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | - Christine C-W Lin
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | - Chris G Maher
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
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139
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Sakalauskienė G, Obelienius V, Pilvinienė R, Jauniškienė D. Evaluation of daily outpatient multidisciplinary rehabilitative treatment of patients with musculoskeletal, neurological and traumatic disorders in a municipality outpatient setting. MEDICINA-LITHUANIA 2016; 52:61-8. [PMID: 26987502 DOI: 10.1016/j.medici.2015.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 10/22/2015] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Musculoskeletal, neurological, and traumatic injuries are a considerably increasing problem. There is a lack of studies evaluating the results of outpatient rehabilitative treatment of patients with the abovementioned diseases. The aim of this study was to determine the effectiveness of daily outpatient multidisciplinary rehabilitation. MATERIALS AND METHODS This observational study enrolled 223 adult people undergoing outpatient rehabilitation performed in a municipality outpatient clinic during 14 days. The functional assessment of disability was performed by using the Barthel index (BI), functional performance was estimated by the modified Keitel functional test (MKFT), and pain perception was evaluated by the visual analogue scale (VAS). The mean scores of the tests were compared before and after outpatient multidisciplinary rehabilitation. RESULTS Significantly reduced disability and pain perception as well as increased functional performance were documented after outpatient rehabilitation. The mean scores of BI, MKFT, and VAS before and after rehabilitation did not differ significantly among patients ranked to each cluster of diseases. Increased functional performance of patients had a moderate-to-weak association with decreased disability and pain perception. The positive changes in health status considering disability, functional performance, and pain perception were documented after 14-day rehabilitation. CONCLUSIONS Multidisciplinary outpatient rehabilitation can be considered as effective treatment. However, it is necessary to implement specific, well-adapted consuming assessment instruments in order to evaluate the outcomes of daily multidisciplinary outpatient rehabilitative treatment.
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Affiliation(s)
- Giedrė Sakalauskienė
- Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Kaunas Šilainiai Outpatient Clinic, Kaunas, Lithuania.
| | | | - Rugilė Pilvinienė
- Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Abstract
The rheumatology community began incorporating patient-reported outcomes in the early 1980s, helping shift the care of chronic diseases from a narrower biomedical model to a broader biopsychosocial model of health. Early efforts were focused primarily in clinical trials and clinical research, but over the last decade there has been increasing use in routine rheumatology clinical care. More than 250 valid and reliable scales to assess domains of importance to patients with rheumatic conditions have been developed. The approach to measurement continues to be refined. Rheumatology has much to be proud of in contributions to the important field of patient-reported outcomes.
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Affiliation(s)
- Leigh F Callahan
- Department of Medicine, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, 3330 Thurston Building, CB 7280, Chapel Hill, NC 27599, USA.
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Chiarotto A, Vanti C, Cedraschi C, Ferrari S, de Lima E Sà Resende F, Ostelo RW, Pillastrini P. Responsiveness and Minimal Important Change of the Pain Self-Efficacy Questionnaire and Short Forms in Patients With Chronic Low Back Pain. THE JOURNAL OF PAIN 2016; 17:707-18. [PMID: 26975193 DOI: 10.1016/j.jpain.2016.02.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/12/2016] [Accepted: 02/18/2016] [Indexed: 12/11/2022]
Abstract
UNLABELLED The Pain Self-Efficacy Questionnaire (PSEQ) is a valid and reliable patient-reported instrument used to assess pain self-efficacy in patients with chronic low back pain (CLBP). Recently, the 2-item (PSEQ-2) and the 4-item (PSEQ-4) short versions were developed showing satisfactory measurement properties in mixed populations with chronic pain. The aim of this study was to examine responsiveness and minimal important change (MIC) of PSEQ, PSEQ-2, and PSEQ-4 in patients with CLBP. We used a sample of 104 patients undergoing multimodal physical therapy designed to partly change pain self-efficacy beliefs. Responsiveness was assessed by testing 16 a priori formulated hypotheses regarding effect sizes, areas under the curve, and correlations with changes in other instruments measuring other constructs. The MIC was calculated using an external anchor specific for pain self-efficacy and the receiver operator characteristic (ROC) method. The PSEQ and the PSEQ-4 met all hypotheses, whereas the PSEQ-2 met all but 1. The MICs were 5.5 for the PSEQ (9% of the scale range) and 1.5 for PSEQ-2 (13% scale range) and PSEQ-4 (6% scale range). MIC values were different for patients with low or high baseline values for all 3 instruments. The PSEQ and its short versions are adequately responsive instruments in patients with CLBP. PERSPECTIVE This study suggests that the PSEQ and its short versions are responsive measures of pain self-efficacy in patients with CLBP, adding to previous literature on their validity and reliability. Considering their similar responsiveness, the 4-item PSEQ could replace the original 10-item version in busy clinical or research settings.
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Affiliation(s)
- Alessandro Chiarotto
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO(+) Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, EMGO(+) Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands.
| | - Carla Vanti
- Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland
| | - Silvano Ferrari
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | | | - Raymond W Ostelo
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO(+) Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, EMGO(+) Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands
| | - Paolo Pillastrini
- Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy
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Riecke J, Holzapfel S, Rief W, Lachnit H, Glombiewski JA. Cross-cultural adaption of the German Quebec Back Pain Disability Scale: an exposure-specific measurement for back pain patients. J Pain Res 2016; 9:9-15. [PMID: 26811693 PMCID: PMC4714739 DOI: 10.2147/jpr.s92615] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Study design Cross-cultural translation and psychometric testing. Objective The purpose of the present study was to examine reliability and validity of a cross-cultural adaption of the German Quebec Back Pain Disability Scale (QBPDS) in a context of a randomized controlled trial evaluating the effectiveness of graded in vivo exposure in chronic low back pain patients. Background The QBPDS is one of the most widely used disease-specific disability questionnaires. In particular, for cognitive behavioral treatments with a clear focus on behavioral aspects such as graded in vivo exposure, the QBPDS provides an ascertained strategy with a sound conceptual basis and excellent quality criteria. Nevertheless, there is conflicting evidence concerning factor structure and a German adaption is missing. Methods The cross-cultural adaption followed international guidelines. Psychometric testing was performed using data from 180 participants with chronic low back pain. The psychometric analyses included internal consistency, convergent, and divergent validity. Exploratory factor analysis was used to determine the underlying factor structure. Results The QBPDS showed strong psychometric properties, with high internal consistency for the full scale (α=0.94) and good convergent and divergent validity. The factor analysis revealed a four-factor solution (bending, ambulation, brief effortful movements, and long-lasting postures). Conclusion The translation and cross-cultural adaption of the QBPDS into German was successful. The German version proved to be a valid and reliable instrument and is well suited for use in the context of an exposure-based psychological treatment.
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Affiliation(s)
- Jenny Riecke
- Department for Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Sebastian Holzapfel
- Department for Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Winfried Rief
- Department for Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Harald Lachnit
- Department for Associative Learning, University of Marburg, Marburg, Germany
| | - Julia A Glombiewski
- Department for Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
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Van Koppen LH, Zandwijk PJJ, Van Mameren H, Mesters I, Winkens B, De Bie RA. Patients’ adherence to a walking programme for non-specific low back pain. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2016. [DOI: 10.3109/21679169.2015.1127419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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144
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Walton LM, Costa A, LaVanture D, McIlrath S, Stebbins B. The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI) and pelvic floor disability index scores (PFDI). ACTA ACUST UNITED AC 2016. [DOI: 10.7243/2055-2386-3-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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145
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Kritische Betrachtung einer Besprechung. MANUELLE MEDIZIN 2015. [DOI: 10.1007/s00337-015-1234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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146
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Han L, Zhao P, Guo W, Wei J, Wang F, Fan Y, Li Y, Min Y. Short-term study on risk-benefit outcomes of two spinal manipulative therapies in the treatment of acute radiculopathy caused by lumbar disc herniation: study protocol for a randomized controlled trial. Trials 2015; 16:122. [PMID: 25872929 PMCID: PMC4380109 DOI: 10.1186/s13063-015-0634-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND That patients with acute radiculopathy caused by lumbar disc herniation (LDH) will benefit from spinal manipulation (SM) treatment has been taken for granted, despite no solid evidence to support that claim. There is a demand for a win-win SM treatment that is both effective and less risky, and we attempt to use this trial to demonstrate such a treatment. In this study, Feng's Spinal Manipulative Therapy (FSM) is selected as the observational SM. FSM can be performed with either manipulation or mobilization, and also can be easily mimicked as a sham SM. METHODS/DESIGN Two hundred and sixteen qualified hospitalized participants will be randomly allocated to one of the three following groups: sham SM, mobilization, or manipulation, according to a ratio of 1:1:1. Participants in each group will receive specific FSM treatments four times, along with basic therapies over a course of 2 weeks. Two days after each SM appointment, risk outcomes will be assessed using a questionnaire developed to identify accompanying unpleasant reactions (AUR). The pain pressure threshold (PPT) will be measured paraspinally on the tender spot beside the involved joint before and immediately after each SM treatment. Relative risk (RR) of AUR, number needed to harm (NNH) and the 95% confidence intervals of each group will be calculated and compared. Benefit outcomes will be assessed by analyzing the following data recordings: the Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), and Global Perceived Effect (GPE) before enrollment and at the 7th, and 15th day after the treatment. Analyses will include comparisons of NRS, ODI and changes at the different visit times among the three groups by Repeated Measures Data ANOVA, an evaluation of reduced scores of NRS and ODI after the therapy to determine if they meet the minimum acceptable outcome (MAO), and the determination of the minimal clinically important difference (MCID) by the average improvement in NRS and ODI scores of all participants who have been allocated to the category 'improved' on the GPE assessment. TRIAL REGISTRATION This trial is registered in Chinese Clinical Trial Register (ChiCTR) on 19 August 2013 ( ChiCTR-TRC-13003496 ).
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Affiliation(s)
- Lei Han
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Ping Zhao
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Wei Guo
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Jie Wei
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Fei Wang
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Yu Fan
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Yi Li
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
| | - Yaqing Min
- PLA Spine Center of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, No. 30, Fu Cheng Street, Hai Dian District, Beijing, 100142, China.
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Abstract
Low-back pain is one of the most common painful conditions experienced by humans throughout their life. Some occupational risk factors (namely, heavy manual material handling) may also contribute to the development of low-back pain: due to the high prevalence of both low-back pain and manual material handling in the adult working population, it has been estimated that low-back pain is probably the most common occupational disorder worldwide. Lifetime prevalence of low-back pain has been reported to be as high as 84%, depending on the case definition used, and no age group is spared, even children. Although low-back pain is not a lethal condition, it was estimated at the third rank among all diseases by disability-adjusted life-years in 2010 in the USA, after ischemic heart disease and chronic obstructive pulmonary disease, and at the first rank by years lived with disability. It also ranked high (13th) globally for the same year, in disability-adjusted life-years. Low-back pain is currently classified as nonspecific/specific as to putative cause and as acute (lasting less than 6 weeks), subacute (6-12 weeks), or chronic (more than 12 weeks) according to duration of symptoms. The distinction between nonspecific/specific and acute/subacute/chronic low-back pain is useful not only for epidemiologic studies, but also (mainly) for choosing the appropriate strategy for the diagnosis and treatment of the disorder. Workplace risk factors for low-back pain include manual lifting and whole-body vibration exposure. This chapter will provide an overview of modern concepts of low-back pain (in general) and will then outline some distinctive features of work-related low-back pain.
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PainVision Apparatus Is Effective for Assessing Low Back Pain. Asian Spine J 2014; 8:793-8. [PMID: 25558322 PMCID: PMC4278985 DOI: 10.4184/asj.2014.8.6.793] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 02/02/2014] [Accepted: 02/26/2014] [Indexed: 12/19/2022] Open
Abstract
STUDY DESIGN Case series. PURPOSE To determine the utility of "PainVision" apparatus for the assessment of low back pain. OVERVIEW OF LITERATURE A newly developed device, the PainVision PS-2100 (Nipro, Osaka, Japan), has been used to assess the perception of pain in a quantitative manner. In the current study, we aimed to evaluate the efficacy of PainVision for the assessment of low back pain. METHODS We assessed 89 patients with low back pain. The numeric rating scale (NRS) score, McGill Pain Questionnaire (MPQ) score and the degree of pain calculated by PainVision were measured twice at 4-week intervals in each patient. An electrode was patched on the forearm surface of the patients and the degree of pain was automatically calculated (degree of pain=100×[current producing pain comparable with low back pain-current at perception threshold/current at perception threshold]). Correlations between NRS and MPQ scores and the degree of pain were determined using Spearman's rank correlation test. RESULTS There was a strong correlation between the NRS and MPQ scores at each time point (rs =0.60, p<0.0001). The degree of pain also showed a moderate correlation with NRS and MPQ scores at each time point (rs =0.40, p<0.03). The change in the degree of pain over 4 weeks showed a moderate correlation with changes in the NRS and MPQ scores (rs =0.40, p<0.01). CONCLUSIONS PainVision as self-reported questionnaires is a useful tool to assess low back pain.
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Bresnahan BW, Rundell SD. Including patient-reported outcomes and patient-reported resource-use questionnaires in studies. Acad Radiol 2014; 21:1129-37. [PMID: 25107865 DOI: 10.1016/j.acra.2014.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/24/2014] [Accepted: 05/27/2014] [Indexed: 11/30/2022]
Abstract
RATIONALE More efficient and better informed healthcare systems are expected to have improved knowledge of the impact of interventions on patient outcomes and resources used by patients and providers in specific health conditions. OBJECTIVES To describe trends related to putting patients at the center of healthcare decision making, regulatory trends and best practice recommendations for developing high-quality patient-reported outcomes (PROs), and strategic issues related to including PROs in studies. MATERIALS AND METHODS We summarize PRO concepts, definitions, and broadly-accepted scientific standards for developing, assessing, and interpreting PROs. Three conceptual models are presented as examples for assessing PROs in relation to other outcomes. We discuss different perspectives for stakeholders, including regulatory issues pertaining to formal guidance for PRO development and for use in trials. We provide examples of PROs used in studies for assessing health outcomes in oncology and resource-use outcomes in low back pain patients. RESULTS Psychometric scientists working closely with multi-disciplinary teams and regulatory authorities have greatly improved the science of collecting, assessing, and understanding patient-reported outcomes in clinical trials. A simplified framework is presented for strategic considerations for including PROs in studies, such as the appropriate timing for PRO endpoints. Asking patients about their health status and/or use of resources improves our understanding of how interventions and care processes may impact their lives and their budgets. We provide examples from a back pain trial of patient-reported resource-use questionnaires for medicines taken and other services or products used by patients. CONCLUSIONS Healthcare stakeholders are placing increased emphasis on resource use and the impact of interventions on patients, including effects associated with diagnostic tests. Patient-reported outcomes are being used in clinical practice and in clinical research, supported by formal best-practice guidelines. Radiology has a role as an engaged stakeholder in the design, conduct, and interpretation of patient-based evidence, and in its relevance to health policy implementation.
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Affiliation(s)
- Brian W Bresnahan
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195; Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, Washington.
| | - Sean D Rundell
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195; Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, Washington
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Park SW, Shin YS, Kim HJ, Lee JH, Shin JS, Ha IH. The dischargeable cut-off score of Oswestry disability index (ODI) in the inpatient care for low back pain with disability. 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 2014; 23:2090-6. [DOI: 10.1007/s00586-014-3503-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/29/2014] [Accepted: 07/30/2014] [Indexed: 01/10/2023]
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