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Edgar MC, Lambert C, Abbas A, Young JJ, McIsaac W, Monteiro R, Girdhari R, Schofield L, Miller L, Kopansky-Giles D. Development of a low resource exercise rehabilitation application for musculoskeletal disorders to help underserved patients in a primary care setting. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2022; 66:130-145. [PMID: 36275080 PMCID: PMC9512304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE We set out to create a Family Medicine EHR (electronic health record) embedded exercise application. This was done to evaluate the utility of the exercise app for providers and to understand the usefulness of the exercise app from the perspective of patients. METHODS This exercise application was developed through an iterative process with repeated pre-testing and feedback from an interprofessional team and embedded into the EHR at an academic family medicine clinic. Anecdotal feedback from patients was used to inform pre-testing adaptations. RESULTS The application required six iterations prior to clinical utility. It had several features that clinicians and patients felt were beneficial. These features involved a customizable exercise directory with pre-made templated plans which could be further modified. To overcome accessibility barriers, the application was developed to include digital and printable copies with an integrated direct email option for ease of remote sharing with patients. CONCLUSION A customizable, open-source exercise application was developed to facilitate provider exercise prescription and support patient self-management. This project may be useful for other providers interested in developing similar programs to address musculoskeletal conditions in their patients. Next steps are to undertake pilot testing of the app with broader provider and patient feedback.
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Affiliation(s)
- Michael C Edgar
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto
- Canadian Memorial Chiropractic College
| | | | - Anser Abbas
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto
- Canadian Memorial Chiropractic College
| | - James J Young
- Canadian Memorial Chiropractic College
- Centre for Muscle and Joint Health, University of Southern Denmark
| | - Willem McIsaac
- Department of Family and Community Medicine, University of Toronto
| | - Rhea Monteiro
- Department of Family and Community Medicine, University of Toronto
| | - Rajesh Girdhari
- Unity Health-St. Michael's Hospital Academic Family Health Team
- University of Toronto Department of Family & Community Medicine
| | - Lee Schofield
- Unity Health-St. Michael's Hospital Academic Family Health Team
- University of Toronto Department of Family & Community Medicine
| | - Lisa Miller
- Unity Health-St. Michael's Hospital Academic Family Health Team
| | - Deborah Kopansky-Giles
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto
- Canadian Memorial Chiropractic College
- Department of Family and Community Medicine, University of Toronto
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de Zoete RMJ, Stanwell P, Weber KA, Snodgrass SJ. Differences in Structural Brain Characteristics Between Individuals with Chronic Nonspecific Neck Pain and Asymptomatic Controls: A Case–Control Study. J Pain Res 2022; 15:521-531. [PMID: 35210851 PMCID: PMC8863323 DOI: 10.2147/jpr.s345365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background Neck pain is a prevalent and costly problem, but its underlying mechanisms are poorly understood. Neuroimaging studies show alterations in brain morphometry in chronic musculoskeletal pain, but reports on neck pain are scarce. Objective This study investigates (1) differences in brain morphometry between individuals with chronic nonspecific neck pain and asymptomatic individuals and (2) associations between brain morphometry and patient-reported outcomes. Methods Sixty-three participants (33 pain, 11 female, mean [SD] age 35 [10] years; 30 control, 12 female, age 35 [11] years) underwent magnetic resonance imaging. Brain regions of interest (ROIs) were determined a priori, outcomes included cortical thickness and volume. Between-group differences were determined using cluster-wise correction for multiple comparisons and analyses of pain-related ROIs. Results Between-group differences in volume were identified in the precentral, frontal, occipital, parietal, temporal, and paracentral cortices. ROI analyses showed that parahippocampal cortical thickness was larger in the neck pain group (p=0.015, 95% CI: −0.27 to −0.03). Moderate to strong associations between volume and thickness of the cingulate cortex, prefrontal cortex, and temporal lobe and neck pain duration, pain intensity, and neck disability were identified (p-values 0.006 to 0.048). Conclusion Alterations in brain morphology that are associated with clinical characteristics inform the mechanisms underlying chronic nonspecific neck pain and may guide the development of more effective treatment approaches.
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Affiliation(s)
- Rutger M J de Zoete
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA, Australia
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia
- Correspondence: Rutger MJ de Zoete, School of Allied Health Science and Practice, The University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia, Email
| | - Peter Stanwell
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia
| | - Kenneth A Weber
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | - Suzanne J Snodgrass
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia
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Mansell G, Corp N, Wynne-Jones G, Hill J, Stynes S, van der Windt D. Self-reported prognostic factors in adults reporting neck or low back pain: An umbrella review. Eur J Pain 2021; 25:1627-1643. [PMID: 33864327 DOI: 10.1002/ejp.1782] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/09/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Numerous systematic reviews have attempted to synthesize evidence on prognostic factors for predicting future outcomes such as pain, disability and return-to-work/work absence in neck and low back pain populations. DATABASES AND DATATREATMENT An umbrella review of systematic reviews was conducted to summarize the magnitude and quality of the evidence for each prognostic factor investigated. Searches were limited to the last 10 years (2008-11th April 2018, updated 28th September 2020). A two-stage approach was undertaken: in stage one, data on prognostic factors was extracted from systematic reviews identified from the systematic search that met the inclusion criteria. Where a prognostic factor was investigated in ≥1 systematic review and where 50% or more of those reviews found an association between the prognostic factor and one of the outcomes of interest, it was taken forward to stage two. In stage two, additional information extracted included the strength of association found, consistency of effects and risk of bias. The GRADE approach was used to grade confidence in the evidence. RESULTS Stage one identified 41 reviews (90 prognostic factors), with 35 reviews (25 prognostic factors) taken forward to stage two. Seven prognostic factors (disability/activity limitation, mental health; pain intensity; pain severity; coping; expectation of outcome/recovery and fear-avoidance) were judged as having moderate confidence for robust findings. CONCLUSIONS Although there was conflicting evidence for the strength of association with outcome, these factors may be used for identifying vulnerable subgroups or people able to self-manage. Further research can investigate the impact of using such prognostic information on treatment/referral decisions and patient outcomes.
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Affiliation(s)
- Gemma Mansell
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Nadia Corp
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Gwenllian Wynne-Jones
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Jonathan Hill
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Siobhán Stynes
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Daniëlle van der Windt
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
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de Zoete RM, Armfield NR, McAuley JH, Chen K, Sterling M. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. Br J Sports Med 2020; 55:bjsports-2020-102664. [PMID: 33139256 DOI: 10.1136/bjsports-2020-102664] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the effectiveness of different physical exercise interventions for chronic non-specific neck pain. DESIGN Systematic review and network meta-analysis. DATA SOURCES Electronic databases: AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus. ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) describing the effects of any physical exercise intervention in adults with chronic non-specific neck pain. RESULTS The search returned 6549 records, 40 studies were included. Two networks of pairwise comparisons were constructed, one for pain intensity (n=38 RCTs, n=3151 participants) and one for disability (n=29 RCTs, n=2336 participants), and direct and indirect evidence was obtained. Compared with no treatment, three exercise interventions were found to be effective for pain and disability: motor control (Hedges' g, pain -1.32, 95% CI: -1.99 to -0.65; disability -0.87, 95% CI: -1.45 o -0.29), yoga/Pilates/Tai Chi/Qigong (pain -1.25, 95% CI: -1.85 to -0.65; disability -1.16, 95% CI: -1.75 to -0.57) and strengthening (pain -1.21, 95% CI: -1.63 to -0.78; disability -0.75, 95% CI: -1.28 to -0.22). Other interventions, including range of motion (pain -0.98 CI: -2.51 to 0.56), balance (pain -0.38, 95% CI: -2.10 to 1.33) and multimodal (three or more exercises types combined) (pain -0.08, 95% CI: -1.70 to 1.53) exercises showed uncertain or negligible effects. The quality of evidence was very low according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. CONCLUSION There is not one superior type of physical exercise for people with chronic non-specific neck pain. Rather, there is very low quality evidence that motor control, yoga/Pilates/Tai Chi/Qigong and strengthening exercises are equally effective. These findings may assist clinicians to select exercises for people with chronic non-specific neck pain. PROSPERO REGISTRATION NUMBER CRD42019126523.
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Affiliation(s)
- Rutger Mj de Zoete
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nigel R Armfield
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
| | - James H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Kenneth Chen
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
- Geriatric Education and Research Institute, Singapore
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
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Farrell SF, Zoete RMJ, Cabot PJ, Sterling M. Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis. Eur J Pain 2020; 24:1666-1686. [DOI: 10.1002/ejp.1630] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/28/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Scott F. Farrell
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Gold Coast Queensland Australia
| | - Rutger M. J. Zoete
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
- School of Allied Health Science and Practice The University of Adelaide Adelaide South Australia Australia
| | - Peter J. Cabot
- School of Pharmacy The University of Queensland Brisbane Queensland Australia
| | - Michele Sterling
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
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Areerak K, van der Beek AJ, Janwantanakul P. Recovery from nonspecific neck pain in office workers. J Back Musculoskelet Rehabil 2018; 31:727-734. [PMID: 29578475 DOI: 10.3233/bmr-170958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Neck pain has an episodic course with varying time for recovery and identification of individuals likely to recover is important. OBJECTIVE The aim of this study was twofold: 1a) to explore the duration of recovery from nonspecific neck pain, and 1b) to investigate the relation between recovery duration and age, and 2) to evaluate whether the NHBOW can predict duration of recovery from non-specific neck pain. METHODS One hundred and three from 342 office workers reported non-specific neck pain, with information collected on pain intensity and disability every month for 12 months. The time to recovery was measured from the onset of neck pain to full recovery. The 103 office workers were divided into two groups using the NHBOW score. Kaplan-Meier survival curves were used to describe the median time to recovery. The survival curves of the two NHBOW groups were compared using Cox regression analysis. RESULTS The median time to recovery from neck pain was 2 months. The duration of recovery was not significantly related with age of participants. There was no significant difference in time to recovery from neck pain between the NHBOW low-score group and the high-score group. CONCLUSION This study showed that the NHBOW was unable to predict duration of recovery from nonspecific neck pain in office workers.
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Affiliation(s)
- Kantheera Areerak
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Acaroğlu E, Nordin M, Randhawa K, Chou R, Côté P, Mmopelwa T, Haldeman S. The Global Spine Care Initiative: a summary of guidelines on invasive interventions for the management of persistent and disabling spinal pain in low- and middle-income communities. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:870-878. [PMID: 29322309 DOI: 10.1007/s00586-017-5392-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/03/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain. RESULTS Lower priority surgery/conditions include fusion for lumbar/non-radicular neck pain and higher priority surgery/conditions include discectomy/decompressive surgery for cervical or lumbar radiculopathy, cervical myelopathy, and lumbar spinal stenosis. Epidural steroid injections are less expensive than most surgeries with fewer harms; however, benefits are small and short lived. Vertebroplasty should be considered over kyphoplasty as an option for patients with severe pain and disability due to osteoporotic vertebral compression fracture. CONCLUSION Elective surgery and interventional procedures could be limited in medically underserved areas and low- and middle-income countries due to a lack of resources and surgeons and thus surgical and interventional procedures should be prioritized within these settings. There are non-invasive alternatives that produce similar outcomes and are a recommended option where surgical procedures are not available. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, USA
- Department of Neurology, University of California, Irvine, Irvine, USA
- World Spine Care, Santa Ana, CA, USA
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Gardiner P, Lestoquoy AS, Gergen-Barnett K, Penti B, White LF, Saper R, Fredman L, Stillman S, Lily Negash N, Adelstein P, Brackup I, Farrell-Riley C, Kabbara K, Laird L, Mitchell S, Bickmore T, Shamekhi A, Liebschutz JM. Design of the integrative medical group visits randomized control trial for underserved patients with chronic pain and depression. Contemp Clin Trials 2016; 54:25-35. [PMID: 27979754 DOI: 10.1016/j.cct.2016.12.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/07/2016] [Accepted: 12/10/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Given the public health crisis of opioid overprescribing for pain, there is a need for evidence-based non pharmacological treatment options that effectively reduce pain and depression. We aim to examine the effectiveness of the Integrative Medical Group Visits (IMGV) model in reducing chronic pain and depressive symptoms, as well as increasing pain self-management. METHODS This paper details the study design and implementation of an ongoing randomized controlled trial of the IMGV model as compared to primary care visits. The research aims to determine if the IMGV model is effective in achieving: a) a reduction in self-reported pain and depressive symptoms and 2) an improvement in the self-management of pain, through increasing pain self-efficacy and reducing use of self-reported pain medication. We intend to recruit 154 participants to be randomized in our intervention, the IMGV model (n=77) and to usual care (n=77). CONCLUSIONS Usual care of chronic pain through pharmacological treatment has mixed evidence of efficacy and may not improve quality of life or functional status. We aim to conduct a randomized controlled trial to evaluate the effectiveness of the IMGV model as compared to usual care in reducing self-reported pain and depressive symptoms as well as increasing pain management skills.
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Affiliation(s)
- Paula Gardiner
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States.
| | - Anna Sophia Lestoquoy
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - Katherine Gergen-Barnett
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - Brian Penti
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - Laura F White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States
| | - Robert Saper
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - Lisa Fredman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Sarah Stillman
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - N Lily Negash
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | | | - Ivy Brackup
- DotHouse Health Center, Dorchester, MA, United States
| | | | - Karim Kabbara
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - Lance Laird
- Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, United States
| | - Suzanne Mitchell
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States
| | - Timothy Bickmore
- College of Computer & Information Science, Northeastern University, Boston, MA, United States
| | - Ameneh Shamekhi
- College of Computer & Information Science, Northeastern University, Boston, MA, United States
| | - Jane M Liebschutz
- Clinical Addictions Research and Education Unit, Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine and Public Health, Boston, MA, United States
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Van Niekerk SM, Fourie SM, Louw QA. Postural dynamism during computer mouse and keyboard use: A pilot study. APPLIED ERGONOMICS 2015; 50:170-176. [PMID: 25959332 DOI: 10.1016/j.apergo.2015.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 02/11/2015] [Accepted: 03/10/2015] [Indexed: 06/04/2023]
Abstract
Prolonged sedentary computer use is a risk factor for musculoskeletal pain. The aim of this study was to explore postural dynamism during two common computer tasks, namely mouse use and keyboard typing. Postural dynamism was described as the total number of postural changes that occurred during the data capture period. Twelve participants were recruited to perform a mouse and a typing task. The data of only eight participants could be analysed. A 3D motion analysis system measured the number of cervical and thoracic postural changes as well as, the range in which the postural changes occurred. The study findings illustrate that there is less postural dynamism of the cervical and thoracic spinal regions during computer mouse use, when compared to keyboard typing.
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Affiliation(s)
- S M Van Niekerk
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa.
| | - S M Fourie
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa
| | - Q A Louw
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, South Africa
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Misterska E, Jankowski R, Głowacki J, Shadi M, Walczak M, Głowacki M. Kinesiophobia in pre-operative patients with cervical discopathy and coexisting degenerative changes in relation to pain-related variables, psychological state and sports activity. Med Sci Monit 2015; 21:181-94. [PMID: 25598197 PMCID: PMC4548700 DOI: 10.12659/msm.891045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/02/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND No research group has ever investigated the level of kinesiophobia in a well defined group of preoperative patients treated due to cervical discopathy and degenerative spine disease, confirmed by X-ray and magnetic resonance imaging (MRI) examinations. We aimed to investigate the degree of kinesiophobia and the differences in pain-related and psychosocial characteristics between patients with high and low levels of kinesiophobia, in relation to factors commonly associated with neck pain. MATERIAL/METHODS Sixty-five consecutive patients with cervical discopathy and coexisting degenerative changes were assessed pre-surgically. The mean pain duration was 31.7 SD 34.0 months. Patients completed the Polish versions of the Tampa Scale for Kinesiophobia (TSK-PL) on 2 occasions, and the following once: Neck Disability Index (NDI-PL), State-Trait Anxiety Inventory (STAI-PL), Coping Strategies Questionnaire (CSQ-PL), and the Visual Analogue Scale (VAS-PL). RESULTS A high level of kinesiophobia was indicated in 81.5% and 87.7% of patients in first and second completion, respectively. Patients with high and low kinesiophobia differ in regards to the recreation section of NDI-PL (p=0.012), gender (p=0.043), and sports activity (p=0.024). Correlations were identified between TSK-PL and marital status (p=0.023) and sports activity (p=0.024). CONCLUSIONS Kinesiophobia levels are higher in patients with chronic cervical pain before surgical treatment. Fear of movement tends to be higher in women and among patients avoiding sports recreation before surgical treatment. Although sports activity and socio-demographic data are predictors of kinesiophobia, psychological, pain-related, and clinical data are not. These findings should be considered when planning rehabilitation after surgical treatment of cervical discopathy and coexisting degenerative changes.
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Affiliation(s)
- Ewa Misterska
- Department of Social Sciences, Higher School of Safety in Poznań, Poznań, Poland
| | - Roman Jankowski
- Department of Neurosurgery and Neurotraumatology, Poznań University of Medical Sciences, Poznań, Poland
| | | | - Milud Shadi
- Department of Pediatric Orthopaedics, Poznań University of Medical Sciences, Poznań, Poland
| | - Michał Walczak
- Department of Pediatric Orthopaedics, Poznań University of Medical Sciences, Poznań, Poland
| | - Maciej Głowacki
- Department of Pediatric Orthopaedics, Poznań University of Medical Sciences, Poznań, Poland
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Dropkin J, Kim H, Punnett L, Wegman DH, Warren N, Buchholz B. Effect of an office ergonomic randomised controlled trial among workers with neck and upper extremity pain. Occup Environ Med 2014; 72:6-14. [PMID: 25227570 DOI: 10.1136/oemed-2014-102160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Office computer workers are at increased risk for neck/upper extremity (UE) musculoskeletal pain. METHODS A seven-month office ergonomic intervention study evaluated the effect of two engineering controls plus training on neck/UE pain and mechanical exposures in 113 computer workers, including a 3-month follow-up period. Participants were randomised into an intervention group, who received a keyboard/mouse tray (KBT), touch pad (TP) for the non-dominant hand and keyboard shortcuts, and a control group who received keyboard shortcuts. Participants continued to have available a mouse at the dominant hand. Outcomes were pain severity, computer rapid upper limb assessment (RULA), and hand activity level. Prevalence ratios (PRs) evaluated intervention effects using dichotomised pain and exposure scores. RESULTS In the intervention group, the dominnt proximal UE pain PR=0.9, 95% CI 0.7 to 1.2 and the dominant distal UE PR=0.8, 95% CI 0.5 to 1.3, postintervention. The non-dominant proximal UE pain PR=1.0, 95% CI 0.8 to 1.4, while the non-dominant distal UE PR=1.2, 95% CI 0.6 to 2.2, postintervention. Decreases in non-neutral postures were found in two RULA elements (non-dominant UE PR=0.9, 95% CI 0.8 to 0.9 and full non-dominant RULA PR=0.8, 95% CI 0.8 to 0.9) of the intervention group. Hand activity increased on the non-dominant side (PR=1.4, 95% CI 1.2 to 1.6) in this group. CONCLUSIONS While the intervention reduced non-neutral postures in the non-dominant UE, it increased hand activity in the distal region of this extremity. To achieve lower hand activity, a KBT and TP used in the non-dominant hand may not be the best devices to use.
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Affiliation(s)
- Jonathan Dropkin
- Department of Population Health, North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA
| | - Hyun Kim
- Department of Population Health, North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA
| | - Laura Punnett
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - David H Wegman
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Nicholas Warren
- Ergonomic Technology Center, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Bryan Buchholz
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Abstract
UNLABELLED In a three-year follow-up study, the occurrence of neck and shoulder pain (NSP) in terms of frequency, duration and intensity was investigated in a population of 537 male professional drivers. Over the follow-up period, the cumulative incidences for neck and shoulder pain were 31.9% and 21.4%, respectively. After adjustment for potential confounders, a measure of cumulative whole-body vibration exposure was significantly associated with all NSP outcomes. Lifting loads and work with hands above shoulder level were significantly related to shoulder outcomes, while driving with trunk bent or twisted was associated with neck pain. Limited job decision, low social support and job dissatisfaction were significant predictors of neck outcomes. Psychological distress was associated with all NSP outcomes. The findings of this cohort study suggest that NSP outcomes are of multifactorial origin in driving occupations. PRACTITIONER SUMMARY This prospective cohort study highlighted the multifactorial nature of neck and shoulder pain (NSP) outcomes in a population of professional drivers. Cumulative whole-body vibration exposure, physical load factors and adverse psychosocial environment at the workplace, as well as individual-related psychological distress, were significant predictors of the occurrence of NSP in the professional drivers.
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Affiliation(s)
- Massimo Bovenzi
- a Department of Medical Sciences , Clinical Unit of Occupational Medicine, University of Trieste , Trieste , Italy
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Kesiktas N, Ozcan E, Vernon H. Clinimetric properties of the Turkish translation of a modified neck disability index. BMC Musculoskelet Disord 2012; 13:25. [PMID: 22353546 PMCID: PMC3305639 DOI: 10.1186/1471-2474-13-25] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 02/21/2012] [Indexed: 01/08/2023] Open
Abstract
Background Neck pain is a common problem that can greatly affect a person's activities of daily living. Functional status questionnaires are important in assessing this effect, and are used to follow up neck pain management programs. The Neck Disability Index (NDI) is the first-created scale for neck pain-related disability and is widely translated and in common used in many countries. Our aim is investigate to clinometric properties of a Turkish version of modified NDI and to give a choice in daily practise of versions to be used. Methods The modified NDI was applied to 30 patients for reliability. 185 patients participated in the validity study. All patients were recruited from the outpatient clinic of our department. The scale was translated by the forward and backward translation procedure according to the COSMIN criteria. The test was repeated at 48 hours interval for reliability study. SPSS-10.0, software was used for statistical analyses. The Intraclass correlation coefficient was used for the test- retest reliability of the modified NDI. Cronbach α was used for internal consistency. Factor analysis was used for construct validity. The validity of the modified NDI with respect to the SF-36, HAD, VAS pain, VAS disability was assessed using Spearman correlations. Results The Intraclass correlation coefficient between first and second (within 48 hours) evaluation of test (rs) was 0.92. Questions 1,4,6,8,10 were shown to have excellent reliability. (rs > 0.9). Question 10 was the most frequently challenged question because "recreational and social activities" do not have not the same meanings in Turkey than in western countries. This required that detailed explanations be provided by the investigators. Cronbach's alpha for the total index was 0.88. A single factor accounting for 80.2% of the variance was obtained. Validity studies demonstrated good and moderate correlations (rs) among NDI, HAD, VAS, physical function subtitle of SF 36 (0.62, 0.76, 0.68). Conclusions The modified NDI-Turkish version is a reliable and valid test and is suitable for daily practise.
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Affiliation(s)
- Nur Kesiktas
- IMAE Education and Research Hospital, I, Avrupa Konutları 8, Blok 27 no Atakent mahallesi Kucukcekmece Halkalı, Istanbul, Turkey.
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Carroll LJ, Jones DC, Ozegovic D, Cassidy JD. How well are you recovering? The association between a simple question about recovery and patient reports of pain intensity and pain disability in whiplash-associated disorders. Disabil Rehabil 2011; 34:45-52. [DOI: 10.3109/09638288.2011.587085] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Aas RW, Tuntland H, Holte KA, Røe C, Lund T, Marklund S, Moller A. Workplace interventions for neck pain in workers. Cochrane Database Syst Rev 2011; 2011:CD008160. [PMID: 21491405 PMCID: PMC6485986 DOI: 10.1002/14651858.cd008160.pub2] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Musculoskeletal disorders are the most common cause of disability in many industrial countries. Recurrent and chronic pain accounts for a substantial portion of workers' absenteeism. Neck pain seems to be more prominent in the general population than previously known. OBJECTIVES To determine the effectiveness of workplace interventions (WIs) in adult workers with neck pain. SEARCH STRATEGY We searched: CENTRAL (The Cochrane Library 2009, issue 3), and MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, OTseeker, PEDro to July 2009, with no language limitations;screened reference lists; and contacted experts in the field. SELECTION CRITERIA We included randomised controlled trials (RCT), in which at least 50% of the participants had neck pain at baseline and received interventions conducted at the workplace. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias. Authors were contacted for missing information. Since the interventions varied to a large extend, International Classification of Functioning, Disability and Health (ICF) terminology was used to classify the intervention components. This heterogeneity restricted pooling of data to only one meta-analysis of two studies. MAIN RESULTS We identified 1995 references and included10 RCTs (2745 workers). Two studies were assessed with low risk of bias. Most trials (N = 8) examined office workers. Few workers were sick-listed. Thus, WIs were seldom designed to improve return-to-work. Overall, there was low quality evidence that showed no significant differences between WIs and no intervention for pain prevalence or severity. If present, significant results in favour of WIs were not sustained across follow-up times. There was moderate quality evidence (1 study, 415 workers) that a four-component WI was significantly more effective in reducing sick leave in the intermediate-term (OR 0.56, 95% CI 0.33 to 0.95), but not in the short- (OR 0.83, 95% CI 0.52 to 1.34) or long-term (OR 1.28, 95% CI 0.73 to 2.26). These findings might be because only a small proportion of the workers were sick-listed. AUTHORS' CONCLUSIONS Overall, this review found low quality evidence that neither supported nor refuted the benefits of any specific WI for pain relief and moderate quality evidence that a multiple-component intervention reduced sickness absence in the intermediate-term, which was not sustained over time. Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There is an urgent need for high quality RCTs with well designed WIs.
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Affiliation(s)
- Randi Wågø Aas
- International Research Institute of Stavanger (IRIS)Box 8046StavangerNorway4068
| | - Hanne Tuntland
- Bergen University CollegeFaculty of Health and Social SciencesHaugeveien 28BergenNorway5005
| | - Kari Anne Holte
- International Research Institute of Stavanger (IRIS)Box 8046StavangerNorway4068
| | - Cecilie Røe
- Oslo University Hospital UllevålPhysical Medicine and RehabilitationKirkevn 166OsloNorway0407
| | - Thomas Lund
- International Research Institute of Stavanger (IRIS)Box 8046StavangerNorway4068
| | - Staffan Marklund
- Karolinska InstitutetDepartment of Clinical Neuroscience and Division of Insurance MedicineBerzelius väg 3StockholmSweden171 77
| | - Anders Moller
- Nordic School of Public HealthGothenburgSwedenSE‐40242
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Spearing NM, Connelly LB. Is compensation "bad for health"? A systematic meta-review. Injury 2011; 42:15-24. [PMID: 20060524 DOI: 10.1016/j.injury.2009.12.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is a common perception that injury compensation has a negative impact on health status, and systematic reviews supporting this thesis have been used to influence policy and practice decisions. This study evaluates the quality of the empirical evidence of a negative correlation between injury compensation and health outcomes, based on systematic reviews involving both verifiable and non-verifiable injuries. DESIGN Systematic meta-review (a "review of reviews"). DATA SOURCES PubMED, CINAHL, EMBASE, PEDro, PsycInfo, EconLit, Lexis, ABI/INFORM, The Cochrane Library, and the AHRQ EPC were searched from the date of their inception to August 2008, and hand searches were conducted. REVIEW METHODS Selection criteria were established a priori. Included systematic reviews examined the impact of compensation on health, involved adults, were published in English and used a range of outcome measures. Two investigators independently applied standard instruments to evaluate the methodological quality of the included reviews. Data on compensation scheme design (i.e., the intervention) and outcome measures were also extracted. RESULTS Eleven systematic reviews involving verifiable and non-verifiable injuries met the inclusion criteria. Nine reviews reported an association between compensation and poor health outcomes. All of them were affected by the generally low quality of the primary (observational) research in this field, the heterogeneous nature of compensation laws (schemes) and legal processes for seeking compensation, and the difficulties in measuring compensation in relation to health. CONCLUSION Notwithstanding the limitations of the research in this field, one higher quality review examining a single compensation process and relying on primary studies using health outcome (rather than proxy) measures found strong evidence of no association between litigation and poor health following whiplash, challenging the general belief that legal processes have a negative impact on health status. Moves to alter scheme design and limit access to compensation on the basis that it is "bad for health" are therefore premature, as evidence of such an association is unclear.
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Affiliation(s)
- Natalie M Spearing
- Australian Centre for Economic Research on Health, The University of Queensland, Level 3 Mayne Medical School, Herston Road, Herston, Queensland, Australia 4006.
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Walton DM, Macdermid JC, Nielson W. Recovery from acute injury: Clinical, methodological and philosophical considerations. Disabil Rehabil 2009; 32:864-74. [DOI: 10.3109/09638280903349511] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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