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Rajkumar RP. The influence of cultural and religious factors on cross-national variations in the prevalence of chronic back and neck pain: an analysis of data from the global burden of disease 2019 study. FRONTIERS IN PAIN RESEARCH 2023; 4:1189432. [PMID: 37305205 PMCID: PMC10248050 DOI: 10.3389/fpain.2023.1189432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Low back pain and neck pain are among the most commonly reported forms of chronic pain worldwide, and are associated with significant distress, disability and impairment in quality of life. Though these categories of pain can be analyzed and treated from a biomedical perspective, there is evidence that they are both related to psychological variables such as depression and anxiety. The experience of pain can be significantly influenced by cultural values. For example, cultural beliefs and attitudes can influence the meaning attached to the experience of pain, the responses of others to a sufferer's pain, and the likelihood of seeking medical care for particular symptoms. Likewise, religious beliefs and practices can influence the both experience of pain and the responses to it. These factors have also been associated with variations in the severity of depression and anxiety. Methods In the current study, data on the estimated national prevalence of both low back pain and neck pain, obtained from the 2019 Global Burden of Disease Study (GBD 2019), is analyzed in relation to cross-national variations in cultural values, as measured using Hofstede's model (n =115 countries) and in religious belief and practice, based on the most recent Pew Research Center survey (n = 105 countries). To address possible confounding factors, these analyses were adjusted for variables known to be associated with chronic low back or neck pain, namely smoking, alcohol use, obesity, anxiety, depression and insufficient physical activity. Results It was found that the cultural dimensions of Power Distance and Collectivism were inversely correlated with the prevalence of chronic low back pain, and Uncertainty Avoidance was inversely correlated with the prevalence of chronic neck pain, even after adjustment for potential confounders. Measures of religious affiliation and practice were negatively correlated with the prevalence of both conditions, but these associations were not significant after adjusting for cultural values and confounders. Discussion These results highlight the existence of meaningful cross-cultural variations in the occurrence of common forms of chronic musculoskeletal pain. Psychological and social factors that could account for these variations are reviewed, along with their implications for the holistic management of patients with these disorders.
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Yihunie M, Abich Y, Demissie SF, Kassa T, Ranganathan P, Janakiraman B. Fear-Avoidance Beliefs for Physical Activity Among Chronic Low Back Pain: A Multicenter Cross-Sectional Study. J Pain Res 2023; 16:233-243. [PMID: 36726857 PMCID: PMC9885961 DOI: 10.2147/jpr.s388002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Background Among different psychological predictors of outcome in low back pain (LBP) adults, the negative influence of fear-avoidance beliefs in physical activity is an area of research attention. However, there is a lack of evidence on the burden of fear avoidance about physical activity among chronic LBP adults in Ethiopia. Objective To describe fear-avoidance beliefs about physical activity and explore its association with socio-demographic and clinical factors among low back pain patients attending physiotherapy treatment in 3 Amhara regional comprehensive hospitals. Methods A multi-center cross-sectional study was conducted and adults with chronic LBP (n = 263) participated. Data were collected by face-to-face interview using the modified Fear-Avoidance Belief Questionnaire about Physical Activity (mFABQ-PA) tool. Multivariable logistic regression at a p-value <0.05 significance level was used to identify predictors of fear-avoidance beliefs about physical activity. Results Among the 263 participants, 113 subjects (43%, 95% CI (36.9-49.0)) reported a higher cut-off (>15) mFABQ-PA. The logistic regression model demonstrated that LBP adults with a higher mFABQ-PA score were more likely to be urban residents (AOR 2.75, 95% CI (1.32, 5.88)), and ADL-related LBP (AOR 1.97 95% CI (1.18, 3.29)). The clinical-specific factor indicative of a higher cut-off score of mFABQ-PA was using analgesic medications (AOR 2.00, 95% CI (1.19, 3.37)). The model fit was 0.21 and 0.11 (R2 = Nagelkerke's, Cox & snell respectively). Conclusion High fear avoidance beliefs about physical activity in adults with low back pain were found and associated with residence, work, and medication intake. These findings might urge the researchers to explore further associations and assist clinicians in choosing subgroups to use behavioral therapy and graded exposure to physical activity.
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Affiliation(s)
- Mulualem Yihunie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Yohannes Abich, Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, PO Box: 196, Gondar, Ethiopia, Email
| | - Solomon Fasika Demissie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Kassa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Parthasarathy Ranganathan
- Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India
| | - Balamurugan Janakiraman
- Department of Research and Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India
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Maiers MJ. The John A. Sweaney Lecture: Virtual, September 2021, Given by Dr Michele Maiers. A Time to Lead: Reflections During a Pandemic. JOURNAL OF CHIROPRACTIC HUMANITIES 2022; 29:7-14. [PMID: 35899149 PMCID: PMC9307899 DOI: 10.1016/j.echu.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
The following is The John A. Sweaney Lecture delivered by Dr Michele Maiers at the biannual Congress of the World Federation of Chiropractic that was held virtually on September 25, 2021.
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Affiliation(s)
- Michele J. Maiers
- American Chiropractic Association, Arlington, Virginia
- Northwestern Health Sciences University, Bloomington, Minnesota
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Salik E, Ozden AV, Alptekin HK. Chiropractic Care and Quality of Life Among Office Workers With Nonspecific Pain: A Cross-Sectional Study. J Chiropr Med 2022; 21:157-167. [PMID: 36118107 PMCID: PMC9479198 DOI: 10.1016/j.jcm.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to evaluate the quality of life by a self-administered World Health Organization Quality of Life short version survey (WHOQoL-BREF) among office workers with nonspecific pain receiving chiropractic care in Istanbul, Turkey. Methods This cross-sectional study included 77 office workers (age interval, 18-65) with nonspecific neck, thoracic, back and/or extremity pain who underwent chiropractic care. Two weeks later, the quality of life was evaluated by a self-administered WHOQoL-BREF. The Numeric Pain Scale to evaluate the perceived pain was administered to all of the participants in the beginning and at the end of the study. Group-level changes on WHOQoL-BREF total score and subdimensions were compared according to descriptive data of office workers. The significance level was set at P ≤ .05. Results WHOQoL-BREF scale scores after chiropractic care (mean ± standard deviation) were 71.21% ± 7.91% (total score), 81.49% ± 14.43% (general health), 80.38% ± 10.49% (physical health), 73.16% ± 11.68% (psychological), 70.41% ± 12.43% (social), and 65.58% ± 10.91% (environment). Numeric Pain Scale scores decreased in a statistically significant way when compared with baseline (P ≤ .05). The descriptive statistical analysis of WHOQoL-BREF dimensions revealed that women had significantly higher scores than men, the 18-to-35 age group had higher scores compared with the 50-to-65 age group, and those married had significantly higher scores than those who were not married (P ≤ .05). Conclusion The findings of our study suggest that chiropractic care had positive effects on the quality of life of office workers.
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Affiliation(s)
- Emsal Salik
- Corresponding author: Emsal Salik, MD, PhD, DC, Faculty of Health Sciences, Bahcesehir University, Abbasaga, Ihlamur Yildiz Cd. No:8, 34353 Besiktas, Istanbul, Turkey
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Fear-Avoidance Beliefs, Kinesiophobia, and Disability Risk Among Indians with Spine Pain. Indian J Orthop 2022; 56:1782-1788. [PMID: 36187595 PMCID: PMC9485369 DOI: 10.1007/s43465-022-00692-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 06/17/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To determine the burden of fear-avoidance beliefs (FAB), kinesiophobia, and risk of persistent disability among Indians with spine pain. METHODS Demographic and clinical data collected from 139 patients who attended a spine rehabilitation clinic for assessment and treatment of their spine pain were analyzed. Fear-avoidance beliefs, kinesiophobia, and risk of persistent disability were measured using the Fear-avoidance Beliefs Questionnaire (FABQ), Tampa Scale for Kinesiophobia (TSK), and the STarT Back Tool (SBT). A multivariate analysis was performed to determine the effect of pain, disability, age, gender, BMI, lifestyle, pain duration, and pain location on FAB, TSK, and SBT scores. RESULTS A majority of patients had medium to high-risk FAB-physical activities (FAB-P) (50.5%) and SBT (54%) scores. The percentage of patients with medium or high-risk FAB-P (p = 0.03), FAB-work (FAB-W) (p = 0.03), and SBT (p = 0.03) scores were significantly higher in patients with pain score > 7, and the percentage of patients with medium or high-risk with FAB-P (p < 0.0001), TSK (p = 0.0003), and SBT (p < 0.0001) scores were significantly higher in patients with severe, crippled or bed-ridden disability. Disability was the only significant predictor for FAB-W, FAB-P, and SBT scores. CONCLUSION The prevalence of fear-avoidance beliefs and risk of persistent disability was significant among Indians and should be taken into account while planning treatment for their spine pain.
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Corrêa LA, Mathieson S, Meziat-Filho NADM, Reis FJ, Ferreira ADS, Nogueira LAC. Which psychosocial factors are related to severe pain and functional limitation in patients with low back pain?: Psychosocial factors related to severe low back pain. Braz J Phys Ther 2022; 26:100413. [PMID: 35489300 PMCID: PMC9062419 DOI: 10.1016/j.bjpt.2022.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a global public health issue. Psychosocial factors are linked to LBP. However, there is a lack of knowledge about the relation of psychosocial factors to clinical outcomes of patients with severe LBP. OBJECTIVE To investigate the relationship between specific psychosocial factors with severe pain and functional limitation of patients with LBP. METHODS A cross-sectional study of 472 participants with LBP was conducted. Participants completed self-reported questionnaires, including psychosocial factors, characteristics of pain, and functional limitations. Two multivariable logistic regression models were performed with severe pain intensity (≥ 7 out of 10) and functional limitation (≥ 7 out of 10) (dependent variables) and 15 psychosocial factors (independent variables). RESULTS One hundred twenty-five (26.5%) participants had severe LBP. Patients with catastrophising symptoms were 2.21 [95%Confidence Interval (CI): 1.30, 3.77] times more likely to have severe pain and 2.72 (95%CI: 1.75, 4.23) times more likely to have severe functional limitation than patients without catastrophising symptoms. Patients with maladaptive beliefs about rest were 2.75 (95%CI: 1.37, 5.52) times more likely to present with severe pain and 1.72 (95%CI: 1.04, 2.83) times more likely to have severe functional limitation. Patients with kinesiophobia were 3.34 (95%CI: 1.36, 8.24) times more likely to present with severe pain, and patients with social isolation were 1.98 (95%CI: 1.25, 3.14) times more likely to have severe functional limitation. CONCLUSION Catastrophising, kinesiophobia, maladaptive beliefs about rest, and social isolation are related to unfavourable clinical outcomes of patients with LBP.
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Affiliation(s)
- Leticia Amaral Corrêa
- Rehabilitation Science Postgraduation Program, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Stephanie Mathieson
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | | | - Felipe José Reis
- Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
| | - Arthur de Sá Ferreira
- Rehabilitation Science Postgraduation Program, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduation Program, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil; Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil.
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Matamalas A, Figueras C, Pizones J, Moreno-Manzanaro L, Betegón J, Esteban M, Pellisé F, Sanchez-Raya J, Sanchez-Marquez JM, Bagó J. How back pain intensity relates to clinical and psychosocial factors in patients with idiopathic scoliosis. 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 2022; 31:1006-1012. [PMID: 35128586 DOI: 10.1007/s00586-022-07117-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A pain intensity of 3 can reliably distinguish idiopathic scoliosis (IS) patients with acceptable pain or not. This research aims to analyze psychosocial, family and quality of life differences in patients according to their pain status. MATERIAL AND METHODS Patients with IS, without previous surgery, Cobb ≥ 30° and age (12-40) were included in the study. They completed the questionnaires Numerical Rate Scale (NRS), Tampa Scale for Kinesiophobia (TSK)-11, SRS22r, Hospital Anxiety-Depression Scale (HADS), COMI item 7 (work/school absenteeism) and family APGAR. Comorbidities and family health history were collected. Analysis of covariance was performed to compare means between the PAIN (NRS > 3), (NRS < = 3) groups controlling for the effect of age and the magnitude of the curve. RESULTS In total, 272 patients were included. 37.1% belonged to the PAIN group (PG). The PG showed a significantly higher Cobb grade and age than the NO-PAIN group. After controlling for these variables, the PG had worse pain, mental health and SRS22-subtotal values. However, they did not differ in function or self-image. PG showed higher levels of kinesiophobia, anxiety, depression, absenteeism from work/school and impact on social/family environment. PG patients reported a higher prevalence of comorbidities and family history of nonspecific spinal pain. CONCLUSIONS Patients with IS and unacceptable pain constitute a group with a different incidence of psychological, social, family and comorbidities factors than those with acceptable pain. In contrast, the severity of IS was not substantially different between the groups. This profile is similar to that observed in patients with nonspecific spinal pain.
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Affiliation(s)
- Antonia Matamalas
- Orthopaedic Surgery Department, Spine Unit, Hospital Vall D'Hebrón, Passeig de la Vall d'Hebron 119- 129, 08035, Barcelona, Spain
| | - Clara Figueras
- Fundacio Institut de Recerca Vall Hebron, Vall D'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
- Departament de Cirurgia, Universitat Autonoma de Barcelona, Barcelona, Spain.
| | - Javier Pizones
- Orthopaedic Surgery Department, Spine Unit, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Lucia Moreno-Manzanaro
- Orthopaedic Surgery Department, Spine Unit, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Jesús Betegón
- Orthopaedic Surgery Department, Spine Unit, Complejo Asistencial Universitario de León (CAULE), Calle Altos de nava, s/n, 24001, León, Spain
| | - Marta Esteban
- Orthopaedic Surgery Department, Spine Unit, Complejo Asistencial Universitario de León (CAULE), Calle Altos de nava, s/n, 24001, León, Spain
| | - Ferran Pellisé
- Orthopaedic Surgery Department, Spine Unit, Hospital Vall D'Hebrón, Passeig de la Vall d'Hebron 119- 129, 08035, Barcelona, Spain
| | - Judith Sanchez-Raya
- Physical Medicine and Rehabilitation Department, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Jose Miguel Sanchez-Marquez
- Orthopaedic Surgery Department, Spine Unit, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Juan Bagó
- Orthopaedic Surgery Department, Spine Unit, Hospital Vall D'Hebrón, Passeig de la Vall d'Hebron 119- 129, 08035, Barcelona, Spain
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Jain S, Jha S, Shetty G, Ram CS. Patient Expectations From Consultation and Treatment of Spine Pain in a Private Spine Rehabilitation Clinic in Urban India. J Patient Exp 2021; 8:23743735211034076. [PMID: 34377771 PMCID: PMC8326608 DOI: 10.1177/23743735211034076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Despite high prevalence of spine pain among the Indian population, patient expectations regarding consultation and its treatment are unknown. We aimed to determine consultation and treatment expectations among patients visiting a spine rehabilitation clinic in urban India. We included 194 consecutive patients who completed a consultation expectation (CE) and treatment outcome expectation (OE) questionnaires and the Patient-Centered Outcome Questionnaire (PCOQ). To learn about the most suitable treatment for their problem (98%), and to know what kind of activities they could do and should avoid (96%) were the most important CEs, and to achieve complete relief of symptoms (96%), and prevent recurrence of pain (95%) were the most important OEs. For successful treatment, patients expected PCOQ pain levels of 2.0 (96.5% reduction) and interference levels of 1.5 (96% reduction). Patients expected to know the most suitable treatment, activities they could do and avoid after consultation, and to achieve complete relief of symptoms and prevent recurrence after treatment. Incorporating and addressing these expectations may help improve outcomes and satisfaction with the consultation and treatment of spine pain.
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Affiliation(s)
| | | | | | - C S Ram
- I.T.S College of Physiotherapy, Ghaziabad, Uttar Pradesh, India
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Haldeman S, Nordin M, Tavares P, Mullerpatan R, Kopansky-Giles D, Setlhare V, Chou R, Hurwitz E, Treanor C, Hartvigsen J, Schneider M, Gay R, Moss J, Haldeman J, Gryfe D, Wilkey A, Brown R, Outerbridge G, Eberspaecher S, Carroll L, Engelbrecht R, Graham K, Cashion N, Ince S, Moon E. Distance Management of Spinal Disorders During the COVID-19 Pandemic and Beyond: Evidence-Based Patient and Clinician Guides From the Global Spine Care Initiative. JMIR Public Health Surveill 2021; 7:e25484. [PMID: 33471778 PMCID: PMC7891494 DOI: 10.2196/25484] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has greatly limited patients' access to care for spine-related symptoms and disorders. However, physical distancing between clinicians and patients with spine-related symptoms is not solely limited to restrictions imposed by pandemic-related lockdowns. In most low- and middle-income countries, as well as many underserved marginalized communities in high-income countries, there is little to no access to clinicians trained in evidence-based care for people experiencing spinal pain. OBJECTIVE The aim of this study is to describe the development and present the components of evidence-based patient and clinician guides for the management of spinal disorders where in-person care is not available. METHODS Ultimately, two sets of guides were developed (one for patients and one for clinicians) by extracting information from the published Global Spine Care Initiative (GSCI) papers. An international, interprofessional team of 29 participants from 10 countries on 4 continents participated. The team included practitioners in family medicine, neurology, physiatry, rheumatology, psychology, chiropractic, physical therapy, and yoga, as well as epidemiologists, research methodologists, and laypeople. The participants were invited to review, edit, and comment on the guides in an open iterative consensus process. RESULTS The Patient Guide is a simple 2-step process. The first step describes the nature of the symptoms or concerns. The second step provides information that a patient can use when considering self-care, determining whether to contact a clinician, or considering seeking emergency care. The Clinician Guide is a 5-step process: (1) Obtain and document patient demographics, location of primary clinical symptoms, and psychosocial information. (2) Review the symptoms noted in the patient guide. (3) Determine the GSCI classification of the patient's spine-related complaints. (4) Ask additional questions to determine the GSCI subclassification of the symptom pattern. (5) Consider appropriate treatment interventions. CONCLUSIONS The Patient and Clinician Guides are designed to be sufficiently clear to be useful to all patients and clinicians, irrespective of their location, education, professional qualifications, and experience. However, they are comprehensive enough to provide guidance on the management of all spine-related symptoms or disorders, including triage for serious and specific diseases. They are consistent with widely accepted evidence-based clinical practice guidelines. They also allow for adequate documentation and medical record keeping. These guides should be of value during periods of government-mandated physical or social distancing due to infectious diseases, such as during the COVID-19 pandemic. They should also be of value in underserved communities in high-, middle-, and low-income countries where there is a dearth of accessible trained spine care clinicians. These guides have the potential to reduce the overutilization of unnecessary and expensive interventions while empowering patients to self-manage uncomplicated spinal pain with the assistance of their clinician, either through direct in-person consultation or via telehealth communication.
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Affiliation(s)
- Scott Haldeman
- World Spine Care, Santa Ana, CA, United States
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
- Department of Neurology, University of California, Irvine, CA, United States
| | - Margareta Nordin
- Department of Orthopedic Surgery, New York University, New York, NY, United States
- Department of Environmental Medicine, New York University, New York, NY, United States
| | - Patricia Tavares
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi, Mumbai, India
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Vincent Setlhare
- Department of Family Medicine and Public Health Medicine, University of Botswana, Gaborone, Botswana
| | - Roger Chou
- Department of Medicine, Oregon Health & Science University, Portland, OR, United States
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
| | - Eric Hurwitz
- Office of Public Health Studies, University of Hawaii, Manoa, HI, United States
| | - Caroline Treanor
- Department of Physiotherapy, Beaumont Hospital, Dublin, Ireland
- Department of Neurosurgery, National Neurosurgical Spinal Service, Beaumont Hospital, Dublin, Ireland
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Norway
| | - Michael Schneider
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ralph Gay
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Alix School of Medicine, Rochester, MN, United States
| | - Jean Moss
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | | | - David Gryfe
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Adam Wilkey
- World Spine Care Europe, Holmfirth, United Kingdom
| | - Richard Brown
- World Federation of Chiropractic, Toronto, ON, Canada
| | | | | | - Linda Carroll
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | | | - Kait Graham
- Volunteer Programs and Operations, World Spine Care, Ottawa, ON, Canada
| | - Nathan Cashion
- Digital Communications, World Spine Care, Oregon City, OR, United States
| | | | - Erin Moon
- World Spine Care Yoga Project, Vancouver, BC, Canada
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Reliability and Validity of the Turkish Short-Form McGill Pain Questionnaire-2 (TR-SF-MPQ-2) in patients with chronic low back pain. Turk J Phys Med Rehabil 2020; 66:343-350. [PMID: 33089091 PMCID: PMC7557621 DOI: 10.5606/tftrd.2020.3689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/03/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives
The aim of this study was to assess validity and reliability of the Turkish version of the expanded and revised version of the Short-Form McGill Pain Questionnaire (TR-SF-MPQ-2) in patients with chronic low back pain (CLBP) and to investigate the relationship between TR-SF-MPQ-2 and etiology, pain scales, and disability index. Patients and methods
Between October 2014 and December 2014, a total of 194 patients with CLBP (66 males, 128 females; mean age 50±14.3 years; range, 35 to 65 years) attending to our outpatient clinic were included. To assess reliability, Cronbach alpha (α) and intraclass correlation coefficient (ICC) were estimated for participants who completed the questionnaire in the morning and afternoon. The validity of the questionnaire was evaluated by analyzing the confirmatory factor analysis. The Visual Analog Scale and Oswestry Disability Index were also used to test concurrent validity of the questionnaire. Results
For total score, Cronbach α was 0.912 and ICC was 0.973, ranging from 0.72 to 0.84 for Cronbach α and from 0.960 to 0.989 for ICC in subgroups. The confirmatory factor analysis showed a good model fit for each subgroup (χ2/Df <3, GFI >0.95, CFI >0.90, NFI >0.90, and RMSEA <0.10). The correlation coefficient between the mean VAS and the mean total score was 0.648. Conclusion Our study results indicate that the Turkish version of the SF-MPQ-2 is a reliable and valid tool to assess pain in the Turkish patients with CLBP.
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Ahmadi H, Adib H, Selk-Ghaffari M, Shafizad M, Moradi S, Madani Z, Partovi G, Mahmoodi A. Comparison of the effects of the Feldenkrais method versus core stability exercise in the management of chronic low back pain: a randomised control trial. Clin Rehabil 2020; 34:1449-1457. [DOI: 10.1177/0269215520947069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective: To investigate the effect of the Feldenkrais method versus core stability exercises on pain, disability, quality of life and interoceptive awareness in patients with chronic non-specific low back pain. Design: A single-blinded, randomised, controlled trial. Setting: Outpatient, sports medicine clinic of Mazandaran medical university. Participants: Sixty patients with chronic non-specific low back pain randomised equally into the Feldenkrais method versus core stability exercises groups. Intervention: Intervention group received Feldenkrais method consisting of training theoretical content and supervised exercise therapy two sessions per week for five weeks. Control group received educational programme and home-based core stability exercises for five weeks. Outcome measures: All patients were examined by World Health Organization’s Quality of life Questionnaire, McGill Pain Questionnaire, Oswestry Disability Questionnaire and Multidimensional Assessment of Interoceptive Awareness Questionnaire. All outcomes were measured at baseline and the end of the intervention Results: There were statistically significant differences between groups for quality of life ( P = 0.006, from 45.51 to 60.49), interoceptive awareness ( P > 0.001, from 2.74 to 4.06) and disability ( P = 0.021, from 27.17 to 14.5) in favour of the Feldenkrais method. McGill pain score significantly decreased in both the Feldenkrais (from 15.33 to 3.63) and control groups (from 13.17 to 4.17), but there were no between-groups differences ( P = 0.16). Conclusion: Feldenkrais method intervention gave increased benefits in improving quality of life, improving interoceptive awareness and reducing disability index.
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Affiliation(s)
- Hanieh Ahmadi
- Department of Sports and Exercise Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hanieh Adib
- Department of Sports and Exercise Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Selk-Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Misagh Shafizad
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Moradi
- Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Madani
- Department of Sports and Exercise Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gholamreza Partovi
- Department of Sports and Exercise Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Aliakbar Mahmoodi
- Department of Sports and Exercise Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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12
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Johnson SM, Hutchins T, Peckham M, Anzai Y, Ryals E, Davidson HC, Shah L. Effects of implementing evidence-based appropriateness guidelines for epidural steroid injection in chronic low back pain: the EAGER (Esi Appropriateness GuidElines pRotocol) study. BMJ Open Qual 2020; 8:e000772. [PMID: 31909212 PMCID: PMC6937044 DOI: 10.1136/bmjoq-2019-000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/19/2019] [Accepted: 11/28/2019] [Indexed: 11/18/2022] Open
Abstract
Objective Chronic low back pain is very common and often treated with epidural steroid injections (ESIs). As ESI referrals had been rapidly increasing at our Veterans’ Administration hospital, we were concerned that they were supplanting more comprehensive care. The objective was to determine how referral patterns and multidisciplinary care might change with the implementation of evidence-based guidelines. Methods In this retrospective observational study, multidisciplinary evidence-based guidelines were implemented in 2014 (EAGER: Esi Appropriateness GuidElines pRotocol) as part of the ordering process for an ESI. Time series analysis was performed to assess the primary outcome of subspecialty referral pattern, that is, the number of patients receiving referrals to ancillary services which might serve to provide a more comprehensive approach to their back pain. Secondary outcomes included patient-level changes (ie, body mass index, number of injections, opioid use), which were compared before and after protocol implementation. Results Comparing preimplementation and postimplementation protocol periods, referrals to physical medicine/rehabilitation increased 11.7% (p=0.003) per year and integrative health increased 2.1% (p<0.001) per year among the 2294 individual patients who received ESI through the neurointerventional radiology service. Of 100 randomly selected patients for patient-level analysis, the median body mass index decreased from 31.57 to 30.22 (p=<0.001) and the mean number of injections decreased from 1.76 to 0.73 (p<0.001). The percentage of patients using oral opioid analgesics decreased from 72% to 49% (p=<0.001). Conclusion Implementation of evidence-based guidelines for ESI referral helps guide patients into a more comprehensive care pathway for chronic low back pain and is correlated with patient-level changes such as decreased body mass index and decreased opioid usage.
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Affiliation(s)
- Scott M Johnson
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Troy Hutchins
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Miriam Peckham
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Yoshimi Anzai
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Elizabeth Ryals
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - H Christian Davidson
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.,Radiology, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Lubdha Shah
- Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
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13
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Garcia AN, Costa LOP, Costa LDCM, Hancock M, Cook C. Do prognostic variables predict a set of outcomes for patients with chronic low back pain: a long-term follow-up secondary analysis of a randomized control trial. J Man Manip Ther 2019; 27:197-207. [PMID: 30946005 DOI: 10.1080/10669817.2019.1597435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022] Open
Abstract
Objective: The objective was to explore for universal prognostic variables, or predictors, across three different outcome measures in patients with chronic low back pain (LBP). We hypothesized that selected prognostic variables would be 'universal' prognostic variables, regardless of the outcome measures used. Methods: This study was a secondary analysis of data from a previous randomized controlled trial comparing the McKenzie treatment approach with placebo in patients with chronic LBP. Ten baseline prognostic variables were explored in predictive models for three outcomes: pain intensity, disability, and global perceived effect, at 6 and 12 months. Predictive models were created using backward stepwise logistic and linear multivariate regression analyses. Results: Several predictors were present including age, expectancy of improvement, global perceived effect; however, we only identified baseline disability as a universal predictor of outcomes at 6 months. The second most represented universal predictor was baseline pain intensity for outcomes at 12 months. Discussion: Only two predictors demonstrated an association with more than one outcome measure. High baseline disability predicts multidimensional outcome measures at 6 months in patients with chronic LBP while baseline pain intensity can best predict the outcome at 12 months. Nevertheless, other predictors seem to be unique to the outcome used. Level of evidence: 2c.
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Affiliation(s)
- Alessandra Narciso Garcia
- a Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University , Durham , NC , USA
| | - Leonardo O P Costa
- b Physical Therapy, University Cidade de Sao Paulo , Sao Paulo , Brazil.,c School of Public Health, Sydney Medical School, The University of Sydney, Ashleigh Provest , Sydney , Australia
| | | | - Mark Hancock
- e Discipline of Physiotherapy, Faculty of Human Sciences, Macquarie University , Sydney , Australia
| | - Chad Cook
- f Doctor of Physical Therapy Division, Duke Clinical Research Institute, Duke University , Durham , NC , USA
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14
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Controlling the burden of spinal disorders in low- and middle-income countries. 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; 27:773-775. [PMID: 30151806 DOI: 10.1007/s00586-018-5731-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
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15
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Haldeman S, Nordin M, Chou R, Côté P, Hurwitz EL, Johnson CD, Randhawa K, Green BN, Kopansky-Giles D, Acaroğlu E, Ameis A, Cedraschi C, Aartun E, Adjei-Kwayisi A, Ayhan S, Aziz A, Bas T, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dudler J, Dunn R, Eberspaecher S, Emmerich J, Farcy JP, Fisher-Jeffes N, Goertz C, Grevitt M, Griffith EA, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Kane EJ, Laplante J, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Rajasekaran S, Shearer H, Smuck M, Sönmez E, Tavares P, Taylor-Vaisey A, Torres C, Torres P, van der Horst A, Verville L, Vialle E, Kumar GV, Vlok A, Watters W, Wong CC, Wong JJ, Yu H, Yüksel S. The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability 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; 27:776-785. [PMID: 30151809 DOI: 10.1007/s00586-018-5722-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. METHODS Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. RESULTS Literature reviews on the burden of spinal disorders and six categories of evidence-based interventions for spinal disorders (assessment, public health, psychosocial, noninvasive, invasive, and the management of osteoporosis) were completed. In addition, participants developed a stratification system for surgical intervention, a classification system for spinal disorders, an evidence-based care pathway, and lists of resources and recommendations to implement the GSCI model of care. CONCLUSION The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders. The model requires testing to determine feasibility. If it proves to be implementable, this model holds great promise to reduce the tremendous global burden of spinal disorders. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - 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, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Arthur Ameis
- Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of Medicine, University of Montreal, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Afua Adjei-Kwayisi
- Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Amer Aziz
- Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital Lahore Pakistan, Lahore, Punjab, Pakistan
| | - Teresa Bas
- Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health, Madrid, Spain.,Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Jean Dudler
- Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, Western Cape, South Africa.,Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | | | - Juan Emmerich
- University of La Plata, La Plata, Buenos Aires, Argentina
| | - Jean Pierre Farcy
- Department of Orthopedic Surgery (retired), New York University, Piermont, NY, USA
| | - Norman Fisher-Jeffes
- Groote Schuur Hospital, Cape Town, Western Cape, South Africa.,Panorama Medi Clinic, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA.,The Spine Institute for Quality, Davenport, IA, USA
| | | | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | - Julie Laplante
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | | | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | | | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Alexander van der Horst
- Department of Surgery, University of Namibia, Windhoek, Namibia.,Central Hospital, Windhoek, Namibia
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | | | | | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
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Kopansky-Giles D, Johnson CD, Haldeman S, Chou R, Côté P, Green BN, Nordin M, Acaroğlu E, Ameis A, Cedraschi C, Hurwitz EL, Ayhan S, Borenstein D, Brady O, Brooks P, Davatchi F, Dunn R, Goertz C, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Lemeunier N, Mayer J, Mior S, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Torres C, Torres P, Vlok A, Wong CC. The Global Spine Care Initiative: resources to implement a spine care program. 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; 27:915-924. [PMID: 30151804 DOI: 10.1007/s00586-018-5725-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries. METHODS Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.g., back and neck pain, deformity, spine injury, neurological conditions, pathology and spinal diseases). An iterative expert consensus process was used using electronic surveys. RESULTS Thirty-five experts completed the process. An iterative consensus process was used through an electronic survey. A consensus was reached after two rounds. The checklist of resources included the following categories: healthcare provider knowledge and skills, materials and equipment, human resources, facilities and infrastructure. The list identifies resources needed to implement a spine care program in any community, which are based upon spine care needs. CONCLUSION To our knowledge, this is the first international and interprofessional attempt to develop a list of resources needed to deliver care in an evidence-based care pathway for the management of people presenting with spine-related concerns. This resource list needs to be field tested in a variety of communities with different resource capacities to verify its utility. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA.
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
- World Spine Care, Santa Ana, CA, USA
| | - 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
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | | | - Arthur Ameis
- Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal Faculty of Medicine, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'I, Mānoa, Honolulu, HI, USA
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, Western Cape, South Africa
- Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA
- The Spine Institute for Quality, Davenport, IA, USA
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Carlos Torres
- University of Ottawa, Ottawa, ON, Canada
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
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17
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Haldeman S, Johnson CD, Chou R, Nordin M, Côté P, Hurwitz EL, Green BN, Kopansky-Giles D, Cedraschi C, Aartun E, Acaroğlu E, Ameis A, Ayhan S, Blyth F, Borenstein D, Brady O, Davatchi F, Goertz C, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Mullerpatan R, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Sönmez E, Torres C, Torres P, Watters W, Yu H. The Global Spine Care Initiative: classification system for spine-related concerns. 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; 27:889-900. [PMID: 30151807 DOI: 10.1007/s00586-018-5724-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway. METHODS Existing classification systems for spinal disorders were assembled. A seed document was developed through round-table discussions followed by a modified Delphi process. International and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. RESULTS Thirty-six experts from 15 countries participated. After the second round, there was 95% agreement of the proposed classification system. The six major classifications included: no or minimal symptoms (class 0); mild symptoms (i.e., neck or back pain) but no interference with activities (class I); moderate or severe symptoms with interference of activities (class II); spine-related neurological signs or symptoms (class III); severe bony spine deformity, trauma or pathology (class IV); and spine-related symptoms or destructive lesions associated with systemic pathology (class V). Subclasses for each major class included chronicity and severity when different interventions were anticipated or recommended. CONCLUSIONS An international and interprofessional group developed a comprehensive classification system for all potential presentations of people who may seek care or advice at a spine care program. This classification can be used in the development of a spine care pathway, in clinical practice, and for research purposes. This classification needs to be tested for validity, reliability, and consistency among clinicians from different specialties and in different communities and cultures. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - 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
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | | | - Arthur Ameis
- Faculty of Medicine, Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA.,The Spine Institute for Quality, Davenport, IA, USA
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Rajani Mullerpatan
- Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Erkin Sönmez
- Department of Neurological Surgery, School of Medicine, Başkent University, Ankara, Turkey
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
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18
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The Global Spine Care Initiative: model of care and implementation. 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; 27:925-945. [PMID: 30151805 DOI: 10.1007/s00586-018-5720-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions. METHODS The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps. RESULTS Sixty-six experts representing 24 countries participated. The GSCI model of care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining. The model of care includes a classification system and care pathway, levels of care, and a focus on the patient's journey. The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up. CONCLUSION The GSCI proposes an evidence-based, practical, sustainable, and scalable model of care representing eight core principles with a six-step implementation plan. The aim of this model is to help transform spine care globally, especially in low- and middle-income countries and underserved communities. These slides can be retrieved under Electronic Supplementary Material.
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19
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Johnson CD, Haldeman S, Nordin M, Chou R, Côté P, Hurwitz EL, Green BN, Kopansky-Giles D, Randhawa K, Cedraschi C, Ameis A, Acaroğlu E, Aartun E, Adjei-Kwayisi A, Ayhan S, Aziz A, Bas T, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dudler J, Dunn R, Eberspaecher S, Emmerich J, Farcy JP, Fisher-Jeffes N, Goertz C, Grevitt M, Griffith EA, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Kane EJ, Laplante J, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Rajasekaran S, Shearer H, Smuck M, Sönmez E, Tavares P, Taylor-Vaisey A, Torres C, Torres P, van der Horst A, Verville L, Vialle E, Kumar GV, Vlok A, Watters W, Wong CC, Wong JJ, Yu H, Yüksel S. The Global Spine Care Initiative: methodology, contributors, and disclosures. 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; 27:786-795. [PMID: 30151808 DOI: 10.1007/s00586-018-5723-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. METHODS World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiative aims to improve the management, prevention, and public health for spine-related disorders worldwide; thus, global representation was essential. A series of meetings established the initiative's mission and goals. Electronic surveys collected contributorship and demographic information, and experiences with spinal conditions to better understand perceptions and potential biases that were contributing to the model of care. RESULTS Sixty-eight clinicians and scientists participated in the deliberations and are authors of one or more of the GSCI articles. Of these experts, 57 reported providing spine care in 34 countries, (i.e., low-, middle-, and high-income countries, as well as underserved communities in high-income countries.) The majority reported personally experiencing or having a close family member with one or more spinal concerns including: spine-related trauma or injury, spinal problems that required emergency or surgical intervention, spinal pain referred from non-spine sources, spinal deformity, spinal pathology or disease, neurological problems, and/or mild, moderate, or severe back or neck pain. There were no substantial reported conflicts of interest. CONCLUSION The GSCI participants have broad professional experience and wide international distribution with no discipline dominating the deliberations. The GSCI believes this set of papers has the potential to inform and improve spine care globally. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - 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
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawaii, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, North York, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Arthur Ameis
- University of Montreal Faculty of Medicine Certification Program in Insurance Medicine and MedicoLegal Expertise, Toronto, ON, Canada
| | | | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Afua Adjei-Kwayisi
- Ghana World Spine Care, Ridge Regional Hospital, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Amer Aziz
- Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital Lahore Pakistan, Lahore, Punjab, Pakistan
| | - Teresa Bas
- Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Jean Dudler
- Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | | | - Juan Emmerich
- University of La Plata, La Plata, Buenos Aires, Argentina
| | | | - Norman Fisher-Jeffes
- Panorama Medi Clinic, Cape Town, Western Cape, South Africa.,Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic and The Spine Institute for Quality, Davenport, IA, USA
| | | | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | - Julie Laplante
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | | | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | | | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Carlos Torres
- Department of Medical Imaging, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Alexander van der Horst
- Department of Surgery, University of Namibia, Windhoek, Namibia.,Central Hospital, Windhoek, Namibia
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | | | - Gomatam Vijay Kumar
- Head of Neurosurgery, AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
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20
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Haldeman S, Johnson CD, Chou R, Nordin M, Côté P, Hurwitz EL, Green BN, Cedraschi C, Acaroğlu E, Kopansky-Giles D, Ameis A, Adjei-Kwayisi A, Ayhan S, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dunn R, Goertz C, Griffith EA, Hondras M, Kane EJ, Lemeunier N, Mayer J, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Shearer H, Sönmez E, Torres C, Torres P, Verville L, Vlok A, Watters W, Wong CC, Yu H. The Global Spine Care Initiative: care pathway for people with spine-related concerns. 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; 27:901-914. [PMID: 30151811 DOI: 10.1007/s00586-018-5721-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. METHODS The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. An iterative consensus process was used. RESULTS After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (e.g., non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes. The care pathway can be used to guide the management of patients with any spine-related concern (e.g., back and neck pain, deformity, spinal injury, neurological conditions, pathology, spinal diseases). The pathway is simple and can be incorporated into educational tools, decision-making trees, and electronic medical records. CONCLUSION A care pathway for the management of individuals presenting with spine-related concerns includes evidence-based recommendations to guide health care providers in the management of common spinal disorders. The proposed pathway is person-centered and evidence-based. The acceptability and utility of this care pathway will need to be evaluated in various communities, especially in low- and middle-income countries, with different cultural background and resources. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
- World Spine Care, Santa Ana, CA, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA.
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology and Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Christine Cedraschi
- Division of General Medical Rehabilitation and Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | | | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, North York, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Arthur Ameis
- Faculty of Medicine Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
| | - Afua Adjei-Kwayisi
- Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation, University of Complutense, Madrid, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA
- The Spine Institute for Quality, Davenport, IA, USA
| | | | - Maria Hondras
- Department of Anesthesiology, University of Kansas, Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | | | - John Mayer
- U.S. Spine & Sport Foundation, San Diego, CA, USA
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching & Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
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21
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Nordin M, Randhawa K, Torres P, Yu H, Haldeman S, Brady O, Côté P, Torres C, Modic M, Mullerpatan R, Cedraschi C, Chou R, Acaroğlu E, Hurwitz EL, Lemeunier N, Dudler J, Taylor-Vaisey A, Sönmez E. The Global Spine Care Initiative: a systematic review for the assessment of spine-related complaints in populations with limited resources and 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; 27:816-827. [DOI: 10.1007/s00586-017-5446-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 10/17/2022]
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