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Khan T, Rizvi MR, Sharma A, Ahmad F, Hasan S, Uddin S, Sidiq M, Ammari A, Iqbal A, Alghadir AH. Assessing muscle energy technique and foam roller self-myofascial release for low back pain management in two-wheeler riders. Sci Rep 2024; 14:12144. [PMID: 38802553 PMCID: PMC11130120 DOI: 10.1038/s41598-024-62881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
Pain in the lower back is a major concern in today's era due to prolonged sitting in two-wheeler riders, mainly due to hamstring tightness. It also creates physical disability and impairment in activities of daily living. The study aimed to compare the efficacy of muscle energy technique (MET) and self-myofascial release (SMFR) using the foam roller on hamstring flexibility, dynamic balance, and physical disability amongst two-wheeler riders with chronic low back pain (LBP). Participants were randomized into two intervention groups, MET and SMFR using the envelope method, with each group having 20 participants. Hamstring flexibility and range of motion for knee extension and the lower back were assessed using the active knee extension test (AKE-L and AKE-R) and sit and reach test (SRT), while the dynamic balance was assessed by the star excursion balance test (SEBT) and physical disability by Roland-Morris Disability Questionnaire, (RMDQ). Measurements were taken at baseline and after 4 weeks of intervention. This study demonstrated that both SMFR using a foam roller and MET are effective in enhancing hamstring muscle flexibility, (SRT-F(1, 38) = 299.5, p < 0.001; AKE-R-F(1, 38) = 99.53, p < 0.001; AKE-L-F(1, 38) = 89.67, p < 0.001). Additionally, these techniques significantly improved dynamic balance in various directions, including anterior (ANT), anteromedial (AMED), medial (MED), posteromedial (PMED), posterior (POST), posterolateral (PLAT), lateral (LAT), and anterolateral (ALAT) directions (p < 0.01). Furthermore, there was a significant reduction in physical disability (RMDQ-F(1, 38) = 1307, p < 0.001), among two-wheeler riders suffering from chronic LBP. Compared to MET, SMFR using foam rollers was found to be more effective in enhancing hamstring flexibility, improving balance, and decreasing disability level on the RMDQ after 4 weeks.
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Affiliation(s)
- Tabassum Khan
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, 121001, India
| | - Moattar Raza Rizvi
- School of Allied Health Sciences, Manav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, 121001, India
| | - Ankita Sharma
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, 121001, India
| | - Fuzail Ahmad
- Respiratory Care Department, College of Applied Sciences, AlMaarefa University, 13713, Riyadh, Saudi Arabia
| | - Shahnaz Hasan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, 15431, Al-Majmaah, Saudi Arabia
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mohammad Sidiq
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Areej Ammari
- Department of Medical Rehabilitation, Abu-Arish General Hospital, Jazan, Saudi Arabia
| | - Amir Iqbal
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, 11433, Riyadh, Saudi Arabia.
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, 11433, Riyadh, Saudi Arabia
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Labanca L, Berti L, Tedeschi R, D'Auria L, Platano D, Benedetti MG. Effects of MLS Laser on pain, function, and disability in chronic non-specific low back pain: A double-blind placebo randomized-controlled trial. J Back Musculoskelet Rehabil 2024:BMR230383. [PMID: 38820011 DOI: 10.3233/bmr-230383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
BACKGROUND Among non-pharmacological interventions, Multiwave Locked System (MLS) Laser therapy has been used in patients with several musculoskeletal pathologies and in combination with other therapeutical interventions. The effects of sole MLS therapy on pain and function in patients with chronic non-specific low-back pain are unknown. OBJECTIVE The objective of this study was to investigate the effects of MLS Laser therapy on pain, function, and disability in patients with chronic non-specific low back pain in comparison to a placebo treatment group. METHODS Forty-five patients were randomized into two groups: the MLS Laser group and the Sham Laser group, undergoing 8 sessions of either a MLS Laser therapy or a Sham Laser therapy, respectively. At the beginning of the therapy (T0), at the end of the therapy (T1), and 1 month after the end of therapy (T2) patients were assessed for low back pain (by means of a VAS scale), function (by means of kinematic and electromyographic assessment of a forward bending movement) and self-reported disability (by means of the Roland-Morris and Oswestry Disability questionnaires). RESULTS There was a significant reduction of pain and disability in both groups at T1 and T2 in comparison with T0. At T2 patients in the MLS group showed a significantly lower pain in comparison with patients in the Sham group (VAS = 2.2 ± 2 vs. 3.6 ± 2.4; p< 0.05). No differences between the two groups were found for function and disability. CONCLUSION Both MLS Laser and Sham Laser therapies lead to a significant and comparable reduction in pain and disability in patients with chronic non-specific low back pain. However, one month after treatment, MLS Laser therapy has been found to be significantly more effective in reducing pain as compared to sham treatment.
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Affiliation(s)
- Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Lisa Berti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Roberto Tedeschi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lucia D'Auria
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Daniela Platano
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Ampiah JA, Moffatt F, Diver CJ, Ampiah PK. 'Specialist before physiotherapist': physicians' and physiotherapists' beliefs and management of chronic low back pain in Ghana - A qualitative study. Disabil Rehabil 2024:1-11. [PMID: 38767467 DOI: 10.1080/09638288.2024.2356005] [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: 10/04/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE This study provides an understanding of the chronic low back pain (CLBP) beliefs and management practices of physicians/doctors and physiotherapists in Ghana, and the mechanisms underlying their beliefs and practices. MATERIALS/METHODS Thirty-three individual semi-structured interviews, involving eighteen physio-therapists and fifteen physicians involved with CLBP management, were carried out. Interviews were audio recorded, transcribed, and analysed using Straussian grounded theory principles and critical realist philosophy. RESULTS Five categories were derived: The predominance of bio-medical/mechanical beliefs, maladaptive beliefs, maladaptive practices, limited involvement of physiotherapists and other healthcare professionals (HCPs) and evidence-based beliefs and practices. The predominant mechanisms underlying the HCPs beliefs and practices were: the healthcare environment (professional roles/identity hinged around paternalistic and biomedical care, fragmented CLBP management, limited physiotherapy/HCPs' knowledge) and sociocultural environment (sociocultural/patients' expectations of passive therapy and paternalism). CONCLUSION The CLBP beliefs and practices of HCPs involved with CLBP in Ghana is modelled around a professional identity that is largely hinged on paternalism and bio-medical/mechanical understandings. Lack of collaboration and sociocultural expectations also play a significant role. There is the need for a reconstitution of Ghanaian HCPs' CLBP beliefs and management approaches to align with evidenced-based approaches (e.g., imaging should not be universally prescribed, biopsychosocial and patient-centred care).
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Affiliation(s)
- Josephine Ahenkorah Ampiah
- Division of Physiotherapy, Sports Rehabilitation and Chiropractic, Institute of Health and Social Care, London South Bank University, London, UK
| | - Fiona Moffatt
- Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Claire J Diver
- Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Paapa Kwesi Ampiah
- Department of Health Sciences, Division of Physiotherapy, College of Health, Medicine and Life Sciences, Brunel University, London, UK
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Kim TK, Gil HY. Effects of Paraspinal Intramuscular Injection of Atelocollagen in Patients with Chronic Low Back Pain: A Retrospective Observational Study. J Clin Med 2024; 13:2607. [PMID: 38731135 PMCID: PMC11084233 DOI: 10.3390/jcm13092607] [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: 03/12/2024] [Revised: 04/21/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: Atelocollagen is used for soft tissue repair and reconstruction by replacing defective or damaged muscles, membranes, ligaments, and tendons. This study aimed to evaluate the clinical efficacy and safety of additional paraspinal intramuscular injection of atelocollagen on lumbar epidural steroid injection for reducing pain and improving functional capacity of patients with chronic low back pain (CLBP). Methods: We retrospectively enrolled 608 consecutive patients with CLBP who received lumbar epidural steroid injection with or without additional paraspinal intramuscular injection of atelocollagen. The Numerical Rating Scale and the Oswestry Disability Index were used to assess pain and functional capacity, respectively, before the procedure, and three months after the injection. Also, we analyzed the relationship between the additional paraspinal intramuscular injection of atelocollagen and the success rate. Results: Both Numerical Rating Scale and the Oswestry Disability Index scores were significantly reduced in both groups at three months after injection. However, there was a significant difference between the two groups. Furthermore, the success rate was significantly higher in the additional paraspinal intramuscular injection of atelocollagen group. Conclusions: This study's results showed that additional paraspinal intramuscular injection of atelocollagen on lumbar epidural steroid injection reduced pain and improved functional capacity for patients with CLBP. Therefore, the paraspinal intramuscular injection of atelocollagen may be a promising option for the treatment of patients with CLBP.
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Affiliation(s)
- Tae Kwang Kim
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Republic of Korea;
| | - Ho Young Gil
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi 39371, Republic of Korea
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Silişteanu SC, Antonescu E, Duică L, Totan M, Cucu AI, Costea AI. Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities. Healthcare (Basel) 2024; 12:853. [PMID: 38667615 PMCID: PMC11050304 DOI: 10.3390/healthcare12080853] [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: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.
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Affiliation(s)
- Sînziana Călina Silişteanu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Elisabeta Antonescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Lavinia Duică
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Andrei Ionuţ Cucu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Andrei Ioan Costea
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
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Connolly ML, Pascoe MC, Bowden SC, Amorim AB, Goonewardena K, Van Dam NT. The mental health-related barriers and benefits to exercise in adults with and without chronic pain. Int J Clin Health Psychol 2024; 24:100471. [PMID: 38817976 PMCID: PMC11137543 DOI: 10.1016/j.ijchp.2024.100471] [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: 09/13/2023] [Accepted: 05/15/2024] [Indexed: 06/01/2024] Open
Abstract
Background Qualitative evidence points to the importance of both mental health-related barriers and benefits to exercise in chronic pain, yet this bidirectional relationship has not been established quantitatively. Methods 89 adults with chronic pain (75 female, Age: M = 34.7, SD=13.2), and 89 demographically-matched individuals without chronic pain (73 female, Age: M = 32.0, SD=13.3) self-reported demographic and health information, mental health-related barriers and benefits to exercise, and leisure-time exercise activity. Results Adults with chronic pain had significantly higher scores on mental health-related barriers to exercise, and lower leisure-time exercise participation than adults without chronic pain. The groups did not differ on mental health-related benefits of exercise scores. Benefits scores positively predicted exercise, yet there was a significant negative interaction between pain and benefit scores, indicating a weaker positive relationship between benefits and exercise for adults with chronic pain than for those without chronic pain. Barrier scores significantly negatively predicted exercise engagement, but did not interact significantly with chronic pain. Conclusion Mental health-related barriers and benefits to exercise are important considerations when prescribing exercise for adults with chronic pain. Adults with chronic pain may require individualised support to address mental health-related barriers to leisure-time exercise.
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Affiliation(s)
- Madeleine L. Connolly
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, 3010, Australia
| | - Michaela C. Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, 3011, Australia
| | - Stephen C. Bowden
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, 3010, Australia
- Centre for Clinical Neurosciences & Neurological Research, St Vincent's Hospital Melbourne, 3065, Australia
| | - Anita B. Amorim
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Kusal Goonewardena
- Elite Akademy Sports Medicine, University of Melbourne Campus, VIC 3010, Australia
| | - Nicholas T. Van Dam
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, 3010, Australia
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Wang J, Liu M, Tian C, Gu J, Chen S, Huang Q, Lv P, Zhang Y, Li W. Elaboration and validation of a novelty nomogram for the prognostication of anxiety susceptibility in individuals suffering from low back pain. J Clin Neurosci 2024; 122:35-43. [PMID: 38461740 DOI: 10.1016/j.jocn.2024.03.003] [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: 12/18/2023] [Revised: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
Low back pain (LBP) constitutes a distressing emotional ordeal and serves as a potent catalyst for adverse emotional states, notably anxiety. We dedicated to discerning methodologies for identifying patients who are predisposed to heightened levels of anxiety and pain. A self-assessment questionnaire was administered to patients afflicted with LBP. The pain scores were subjected to analysis in conjunction with anxiety scores, and a clustering procedure was executed using the scientific k-means methodology. Subsequently, six machine learning algorithms, including Logistics Regression (LR), K-Nearest Neighbor (KNN), Decision Tree (DT), Support Vector Machine (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGB), were employed. Next, five pertinent variables were identified, namely Age, Course, Body Mass Index (BMI), Education, and Marital status. Furthermore, a LR model was utilized to construct a nomogram, which was subsequently subjected to assessment for discrimination, calibration, and evaluation of its clinical utility. As a result, 599 questionnaires were valid (effective rate: 99 %). The correlation analysis revealed a significant association between anxiety and pain scores (r = 0.31, P < 0.001). LBP patients could be divided into two clusters, Cluster1 had higher pain scores (P < 0.05) and SAS scores (P < 0.001). The proposed nomogram demonstrated an area under the receiver operating characteristics curve (ROC) of 0.841 (95 %CI: 0.804-0.878) and 0.800 (95 %CI: 0.733-0.867) in the training and test groups, respectively. Briefly, the established nomogram has demonstrated remarkable proficiency in discerning individuals afflicted with LBP who are at a heightened risk of experiencing anxiety.
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Affiliation(s)
- Jian Wang
- Department of Neurosurgery, Tangdu Hospital, Affiliated Hospital of the Air Force Medical University, Xi'an, China
| | - Miaomiao Liu
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Affiliated Hospital of the Air Force Medical University, Xi'an, China
| | - Chao Tian
- Department of Rehabilitation, Southeast Hospital, Affiliated Hospital of Xiamen University, Xiamen, China
| | - Junxiang Gu
- Department of Neurosurgery, the Second Affiliated Hospital of the Xi'an Jiaotong University, Xi'an, China
| | - Sihai Chen
- Department of Psychiatry, Xiaogan Mental Health Center, Xiaogan, China
| | - Qiujuan Huang
- Department of Rehabilitation, Southeast Hospital, Affiliated Hospital of Xiamen University, Xiamen, China
| | - Peiyuan Lv
- Department of Neurosurgery, Tangdu Hospital, Affiliated Hospital of the Air Force Medical University, Xi'an, China
| | - Yuhai Zhang
- Department of Health Statistics and Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational, China.
| | - Weixin Li
- Department of Neurosurgery, Tangdu Hospital, Affiliated Hospital of the Air Force Medical University, Xi'an, China.
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Koszela K. A three-stage concept of spine pathology treatment - a different perspective. Reumatologia 2024; 62:58-63. [PMID: 38558895 PMCID: PMC10979373 DOI: 10.5114/reum/183911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/09/2024] [Indexed: 04/04/2024] Open
Abstract
Spinal pathologies develop in patients of all ages and may have various underlying factors. These factors include, among others, myofascial pain syndromes, disc herniation and spinal degeneration. Treatment alone, both causal and symptomatic, is not always sufficient in certain situations. The aim of this paper is to discuss the question of comprehensive treatment of spine pathologies focusing on a three-stage treatment concept. An important aspect is to determine the risk factors and their reduction, or at least modification, i.e. the first stage of the discussed treatment concept. Then, medical treatment aimed at a specific pathology, including both conservative and surgical methods, allows the cause of the pathology to be removed, i.e. the second stage of the discussed concept. And finally, timely and specialized, broadly understood rehabilitation allowing to maintain the effect of medical therapy. The implemented rehabilitation can be considered as the third stage of the discussed treatment concept.
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Affiliation(s)
- Kamil Koszela
- Department of Neuroorthopedics and Neurology Clinic and Polyclinic, National Institute of Geriatric, Rheumatology and Rehabilitation, Warsaw, Poland
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Marotta N, de Sire A, Lippi L, Moggio L, Tasselli A, Invernizzi M, Ammendolia A, Iona T. Impact of yoga asanas on flexion and relaxation phenomenon in women with chronic low back pain: Prophet model prospective study. J Orthop Res 2024. [PMID: 38379407 DOI: 10.1002/jor.25790] [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: 10/17/2023] [Revised: 12/18/2023] [Accepted: 01/04/2024] [Indexed: 02/22/2024]
Abstract
Chronic nonspecific low back pain (NSLBP) is a prevalent condition with socioeconomic and healthcare challenges. The flexion-relaxation phenomenon (FRP) evaluation is a valid clinical tool for low back pain (LBP) assessment. Yoga, a holistic mind-body practice, has been explored as an LBP intervention. This study aimed to evaluate the impact of yoga asanas on the FRP in women with NSLBP. The study included healthy and chronic NSLBP females who underwent an eight-session yoga asanas program, with the first session conducted in-clinic and the rest delivered with tele-approach. Outcome measures included pain intensity, flexion-relaxation ratio (FRR), and trough surface electromyography collected during trunk maximum voluntary flexion (MVF). The study included 11 healthy and 10 NSLBP women. Repeated measures test in chronic NSLBP group showed a significant decrease in pain intensity after the 4 weeks follow-up (visual analog scale [VAS]: 6.80 ± 1.48 vs. 3.30 ± 1.25; p < 0.001) and an FRR improvement after the intervention (5.12 ± 0.93 vs. 9.49 ± 0.92; p < 0.001). VAS and FRR effect sizes were 0.77 and 0.47, respectively. Therefore, we performed a Prophet evaluation to assess FRR trends, finding a growth rate (k) of 0.405 ± 0.448, with a forecast 1 month after the end of the intervention approaching the trend line of the control group. The findings suggested that tele-yoga asana might have a positive impact on pain intensity and the FRP in chronic LBP. Further research is warranted to confirm the long-term effects of yoga for managing LBP.
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Affiliation(s)
- Nicola Marotta
- Physical and Rehabilitative Medicine Division, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Alessandro de Sire
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Physical and Rehabilitative Medicine Division, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine Division, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
- Translational Medicine Division, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Lucrezia Moggio
- Physical and Rehabilitative Medicine Division, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Rehabilitation Unit, Ospedale degli Infermi, Biella, Italy
| | - Anna Tasselli
- Physical and Rehabilitative Medicine Division, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine Division, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
- Translational Medicine Division, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Antonio Ammendolia
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Physical and Rehabilitative Medicine Division, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Teresa Iona
- Motor Sciences Division, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Liu D, Li G, Wang S, Liu Z, Wang Y, Connolly L, Usevitch DE, Shen G, Cleary K, Iordachita I. A magnetic resonance conditional robot for lumbar spinal injection: Development and preliminary validation. Int J Med Robot 2024; 20:e2618. [PMID: 38536711 PMCID: PMC10982612 DOI: 10.1002/rcs.2618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/27/2023] [Accepted: 12/12/2023] [Indexed: 04/04/2024]
Abstract
PURPOSE This work presents the design and preliminary validation of a Magnetic Resonance (MR) conditional robot for lumbar injection for the treatment of lower back pain. METHODS This is a 4-degree-of-freedom (DOF) robot that is 200 × 230 × 130 mm3 in volume and has a mass of 0.8 kg. Its lightweight and compact features allow it to be directly affixed to patient's back, establishing a rigid connection, thus reducing positional errors caused by patient movements during treatment. RESULTS To validate the positioning accuracy of the needle by the robot, an electromagnetic (EM) tracking system and a needle with an EM sensor embedded in the tip were used for the free space evaluation with position accuracy of 0.88 ± 0.46 mm and phantom mock insertions using the Loop-X CBCT scanner with target position accuracy of 3.62 ± 0.92 mm. CONCLUSION Preliminary experiments demonstrated that the proposed robot showed improvements and benefits in its rotation range, flexible needle adjustment, and sensor protection compared with previous and existing systems, offering broader clinical applications.
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Affiliation(s)
- Depeng Liu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gang Li
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, District of Columbia, USA
| | - Shuyuan Wang
- Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zixuan Liu
- Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yanzhou Wang
- Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Laura Connolly
- The Department of Electrical and Computer Engineering, Queen's University, Kingston, Ontario, Canada
| | - David E Usevitch
- Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Guofeng Shen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Kevin Cleary
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, District of Columbia, USA
| | - Iulian Iordachita
- Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, USA
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Mudda S, Janardhan SK, Santenna C, Mooventhan A, Shetty P. Efficacy of Integrated Yoga and Naturopathy With Physiotherapy or Acupuncture for Low Back Pain: A Parallel, Two-Arm, Randomized Trial. Cureus 2024; 16:e55198. [PMID: 38558622 PMCID: PMC10980909 DOI: 10.7759/cureus.55198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Low back pain (LBP) is a musculoskeletal condition that affects many individuals. While physiotherapy and acupuncture are frequently used treatments, determining their specific contributions when used alongside integrated yoga and naturopathy (IYN) therapy for relieving chronic LBP symptoms and enhancing quality of life is important. METHODOLOGY In the present prospective randomized comparative trial, a total of 60 participants were divided into the following two groups: physiotherapy with IYN and acupuncture with IYN. The treatment duration was 10 days, and assessments were conducted both before (baseline) and after the intervention. Various assessment tools, such as the visual analog scale (VAS), Oswestry Disability Index (ODI), fingertip-to-floor test (FTF), State-Trait Anxiety Inventory (STAI), and Short Form 36 (SF-36), were utilized. The statistical analysis was performed using SPSS version 21.0 (Armonk, NY: IBM Corp). RESULTS The results revealed significant differences in VAS score, ODI, FTF score, STAI score, and SF-36 score between the physiotherapy and acupuncture groups (p<0.001). A t-test for the equality of means and a Mann-Whitney U test were used to compare the two groups; these tests revealed a significant difference in disability levels, range of motion, and state of anxiety. The acupuncture group showed a significant difference in the ODI (15.9 {12.6, 19.3}; p <0.001) and state anxiety (23.0 {20.0, 26.0}; p<0.001) compared to the physiotherapy ODI (22.4 {18.5, 26.4}) and state anxiety (27.5 {25.0, 30.0}). The physiotherapy group showed a significant difference in range of motion (7.7 {5.7, 9.7}; p<0.001) compared to the acupuncture group (11.6 {9.8, 13.5}). CONCLUSION The present study findings revealed that both physiotherapy and acupuncture, as interventions along with integrated yoga and naturopathy may be considered an effective treatment strategy for chronic LBP.
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Affiliation(s)
- Sofia Mudda
- Yoga and Naturopathy, Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy (AYUSH) All India Institute of Medical Sciences, Bhopal, IND
| | - Sujatha K Janardhan
- Natural Therapeutics, Sri Dharmasthala Manjunatheshwara (SDM) College of Naturopathy and Yogic Sciences, Mangalore, IND
| | | | - Aruchunan Mooventhan
- Research, Government Yoga and Naturopathy Medical College and Hospital, Chennai, IND
| | - Prashanth Shetty
- Yoga, Sri Dharmasthala Manjunatheshwara (SDM) College of Naturopathy and Yogic Sciences, Mangalore, IND
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Gnall KE, Sinnott SM, Laumann LE, Park CL, David A, Emrich M. Changes in Interoception in Mind-body Therapies for Chronic Pain: A Systematic Review and Meta-Analysis. Int J Behav Med 2024:10.1007/s12529-023-10249-z. [PMID: 38169051 DOI: 10.1007/s12529-023-10249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Emerging literature has demonstrated deficits in interoception (i.e., the perception of physical sensations from inside the body) in individuals with chronic pain conditions. Mind-body therapies (MBTs) are purported to improve chronic pain in part through improving or restoring interoceptive abilities. The present systematic review and meta-analysis aimed to examine changes in interoception in MBTs for chronic pain conditions. METHODS A systematic search of PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertation and Theses was conducted from database inception to February 2023. English language intervention studies evaluating the effect of MBTs on interoception in adults with chronic pain conditions were examined. Changes in pain (severity and interference) following treatment were examined as secondary outcomes. RESULTS A total of 11 studies (10 unique samples) were identified. Meta-analytic results reveal significant improvements in total interoceptive awareness (Becker's d = 1.168, p < .01) as well as improvements in seven of eight subdomains of interoceptive awareness (ds = 0.28 to 0.81). MBTs were also associated with reductions in both pain intensity (d = -1.46, p = .01) and pain interference (d = -1.07, p < .001). CONCLUSIONS Preliminary research suggests that MBTs demonstrate improvements in interoceptive awareness and reduce pain in adults with chronic pain. Literature on changes in other domains of interoception, such as interoceptive accuracy, following MBTs is severely lacking. Although more rigorous studies are needed to corroborate results, the present findings lay an important foundation for future research to examine interoception as a possible underlying mechanism of MBTs to improve pain outcomes.
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Affiliation(s)
- Katherine E Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Sinead M Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Laura E Laumann
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Adam David
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Mariel Emrich
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
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Wang HS, Lin S, Yu HM. Exosome-mediated Repair of Intervertebral Disc Degeneration: The Potential Role of miRNAs. Curr Stem Cell Res Ther 2024; 19:798-808. [PMID: 37150986 DOI: 10.2174/1574888x18666230504094233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 05/09/2023]
Abstract
Intervertebral disc degeneration (IVDD) is a serious condition that manifests as low back pain, intervertebral disc protrusion, and spinal canal stenosis. At present, the main treatment methods for IVDD are surgical interventions such as discectomy, total disc replacement, and spinal fusion. However, these interventions have shown limitations, such as recurrent lumbar disc herniation after discectomy, lesions in adjacent segments, and failure of fixation. To overcome these shortcomings, researchers have been exploring stem cell transplantation therapy, such as mesenchymal stem cell (MSC) transplantation, but the treatment results are still controversial. Therefore, researchers are in search of new methods that are more efficient and have better outcomes. The exosomes from stem cells contain a variety of bioactive molecules that mediate cell interactions, and these components have been investigated for their potential therapeutic role in the repair of various tissue injuries. Recent studies have shown that MSC-derived miRNAs in exosomes and vesicles have therapeutic effects on nucleus pulposus cells, annulus fibrosus, and cartilage endplate. miRNAs play a role in many cell activities, such as cell proliferation, apoptosis, and cytokine release, by acting on mRNA translation, and they may have immense therapeutic potential, especially when combined with stem cell therapy. This article reviews the current status of research on intervertebral disc repair, especially with regard to the latest research findings on the molecular biological mechanisms of miRNAs in MSC-derived exosomes in intervertebral disc repair.
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Affiliation(s)
- Han-Shi Wang
- Department of Orthopaedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
- Group of Neuroendocrinology, Garvan Institute of Medical Research, Sydney, Australia
| | - Hai-Ming Yu
- Department of Orthopaedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
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Mao S, Xiao K, Zhou W, Xu H, Zhang S. The Impact of Hot Spring Hydrotherapy on Pain Perception and Dysfunction Severity in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. J Pain Res 2023; 16:3925-3944. [PMID: 38026467 PMCID: PMC10658949 DOI: 10.2147/jpr.s438744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Chronic Low Back Pain (CLBP) is a prevalent global health issue, leading to prolonged discomfort and functional limitations. Hot spring hydrotherapy, which utilizes mineral-rich, warm spring water, offers a unique physical therapy that holds promise in alleviating CLBP symptoms. Objective This meta-analysis aims to assess the effectiveness of hot spring hydrotherapy in improving CLBP symptoms, encompassing pain intensity, functional disability, quality of life, and medication usage. Methods A systematic review and meta-analysis were conducted by searching relevant literature in multiple databases. Included studies compared hot spring hydrotherapy with control interventions or other treatments. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated for pain intensity, functional disability, medication usage, and quality of life. Results A total of 16 studies met the inclusion criteria, involving 1656 participants with chronic low back pain across various countries. The meta-analysis demonstrated that hot spring hydrotherapy was effective in reducing pain intensity (SMD = -0.901, 95% CI [-1.777, -0.025], P < 0.05) and improving functional disability (SMD = -3.236, 95% CI [-4.898, -1.575], P < 0.0001) in CLBP patients. Hot spring hydrotherapy also resulted in a significant reduction in medication usage (P < 0.05). Subgroup analysis showed that the effects of hot spring hydrotherapy were more pronounced in patients aged 60 and above, while no significant differences were observed in patients below 60 years of age, single hot Spring Hydrotherapy help improve patients' quality of life. Conclusion Hot spring hydrotherapy is an effective intervention for improving CLBP symptoms, including pain intensity, functional disability, and medication usage. It is particularly beneficial for CLBP patients aged 60 and above. These findings support the integration of hot spring hydrotherapy into the treatment approach for CLBP, although further research is needed to determine its efficacy in younger patients and to explore the underlying mechanisms of its therapeutic effects. Prospero Id CRD42023430860.
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Affiliation(s)
- Sujie Mao
- Discipline Construction Office, Nanjing Sport Institute, NanJing, Jiangsu, People’s Republic of China
| | - Kaiwen Xiao
- Discipline Construction Office, Nanjing Sport Institute, NanJing, Jiangsu, People’s Republic of China
| | - Wensheng Zhou
- Department of Physical Education, Jiangsu Second Normal University, Nanjing, JiangSu, People’s Republic of China
| | - Hong Xu
- Department of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, JiangSu, People’s Republic of China
| | - Shikun Zhang
- Department of Police Physical Education, Jiangsu Police Institute, Nanjing, JiangSu, People’s Republic of China
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15
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Greff Ballejos K, Calvetti PÜ, Schaab BL, Reppold CT. What are the benefits of cultivating self-compassion in adults with low back pain? A systematic review. Front Psychol 2023; 14:1270287. [PMID: 38022933 PMCID: PMC10657904 DOI: 10.3389/fpsyg.2023.1270287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Low back pain is one of the most prevalent public health problems in the world, generating psychosocial impacts on quality of life and a high demand for medical care. Self-compassion may be beneficial for low back pain control, however, studies in the area are scarce. Therefore, this systematic review aimed to investigate the benefits of self-compassion-related interventions on low back pain and mental health in adults. Methods The review protocol was registered in PROSPERO and the method was performed according to the PRISMA guidelines. Searches were conducted using the keywords "self-compassion" and "low back pain" in Portuguese, English, and Spanish in the following databases: PubMed, LILACS, SciELO, PePSIC, PsycInfo, Embase, Scopus, Web of Science, and Cochrane. Additional searches were also conducted through the references of the included studies. Results Thirty-three articles were identified and analyzed by two independent reviewers using Rayyan. Four of these studies were included. RoB 2 was used to assess the risk of bias of each study. The main findings suggest that self-compassion-related interventions demonstrate benefits in the treatment of low back pain, as well as reduction in pain intensity, psychological stress, and improvement of pain acceptance. Discussion However, these positive data must be analyzed carefully, as only two studies presented a low risk of bias. Despite growing interest in this field, more research self-compassion-related interventions for low back pain are suggested, since biopsychosocial aspects associated with low back pain can impact the outcome of treatment. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier (CRD42022376341).
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Affiliation(s)
- Kellen Greff Ballejos
- Psychological Assessment Laboratory, Department of Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Prisla Ücker Calvetti
- Psychological Assessment Laboratory, Health Sciences Program, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Bruno Luis Schaab
- Psychological Assessment Laboratory, Health Sciences Program, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Caroline Tozzi Reppold
- Psychological Assessment Laboratory, Department of Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Mehendale P, Iyenagar M, Bhatt G, Manwadkar S. Virtually Administered Intervention Through Telerehabilitation for Chronic Non-specific Low Back Pain: A Review of Literature. Cureus 2023; 15:e42942. [PMID: 37667713 PMCID: PMC10475325 DOI: 10.7759/cureus.42942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
The most frequent reason for individuals to seek medical attention in both primary care settings and immediate care centers is low back pain (LBP). Over a duration of time, the disability caused by lower back pain has risen enough, particularly in countries with low or moderate incomes. In the coming years, there may be an increase in LBP-related impairment and expenses in countries with low or medium incomes, particularly when fragile medical systems are unable to handle this growing load. Hence, this review focuses on the effectiveness of telerehabilitation (TR) on LBP. The significant advantages of TR may include greater interaction and remote accessibility to medical treatments. The exchange of knowledge and health information is made possible through a more effective interaction, which benefits patients, families, carers, physicians, and researchers. People who live in distant places now have the opportunity to get medical attention assisting families in caring for patients with poor responsiveness. In addition, it provides the potential for prompt detection, the beginning of treatment in the midst of an emergency, a shorter stay in the hospital, ongoing monitoring of those at risk, and overall time and expense savings. Therefore, this study supports the application of TR in conditions of LBP for early management and relief of pain for patients in low-resource areas.
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Affiliation(s)
- Priti Mehendale
- Department of Physiotherapy, Parul Institute of Doctoral Studies, Parul University, Vadodara, IND
| | - Madhavan Iyenagar
- Department of Surgery, Parul Institute of Doctoral Studies, Parul University, Vadodara, IND
| | - Geeta Bhatt
- Department of Neurophysiotherapy, K.J. Somaiya College of Physiotherapy, Mumbai, IND
| | - Shweta Manwadkar
- Department of Cardiorespiratory Physiotherapy, K.J. Somaiya College of Physiotherapy, Mumbai, IND
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Kheirinejad S, Visuri A, Suryanarayana SA, Hosio S. Exploring mHealth applications for self-management of chronic low back pain: A survey of features and benefits. Heliyon 2023; 9:e16586. [PMID: 37346357 PMCID: PMC10279785 DOI: 10.1016/j.heliyon.2023.e16586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
The adoption of Mobile Health (mHealth) for self-management is growing. mHealth solutions are commonly used in public healthcare and health services, where they are appreciated for their ease of use, broad reach, and wide acceptance. Chronic Low Back Pain (CLBP) is one of the most common health problems and a leading cause of disability. As such, it imposes a tremendous burden on patients and society. Studies have proposed that mHealth self-management solutions, such as mobile applications, can supplement traditional care methods and benefit patients, particularly in self-managing CLBP easier. To this end, the number of available mobile applications for CLBP has increased. This paper i) provides an overview of scientific studies on mobile applications for CLBP management from three different viewpoints: researchers, health professionals, and patients, ii) uncovers the application features that were seen as beneficial in the studies, and iii) contrasts the currently available applications for CLBP in Google Play Store and Apple App Store against the discovered features. The findings show that "Personalization and customization" is the most significant feature as it is beneficial from stakeholders' viewpoint and is represented by most applications. In contrast, "Gamification" and "Artificial intelligence" are the least significant features, indicating a lack of attention from application creators and researchers in this area.
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Migliorini F, Vaishya R, Pappalardo G, Schneider M, Bell A, Maffulli N. Between guidelines and clinical trials: evidence-based advice on the pharmacological management of non-specific chronic low back pain. BMC Musculoskelet Disord 2023; 24:432. [PMID: 37254090 DOI: 10.1186/s12891-023-06537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 05/16/2023] [Indexed: 06/01/2023] Open
Abstract
The pharmacological management of nonspecific chronic low back pain (NCLBP) aims to restore patients' daily activities and improve their quality of life. The management of NCLBP is not well codified and extremely heterogeneous, and residual symptoms are common. Pharmacological management should be considered as co-adjuvant to non-pharmacological therapy, and should be guided by the symptoms reported by the patients. Depending on the individual severity of NCLPB, pharmacological management may range from nonopioid to opioid analgesics. It is important to identify patients with generalized sensory hypersensitivity, who may benefit from dedicated therapy. This article provides an evidence-based overview of the principles of pharmacological management of NCLPB.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital of Aachen, 52064, Aachen, Germany.
- Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Bolzano, 39100, Italy.
| | - Raju Vaishya
- Department of Orthopedics, Indraprastha Apollo Hospitals Institutes of Orthopaedics, New Delhi, India
| | | | - Marco Schneider
- Department of Medicine and Dentistry, University of Witten/Herdecke, 58455, Witten, Germany
- Department of Arthroscopy and Joint Replacement, MVZ Praxisklinik Orthopädie Aachen, RWTH University Hospital Aachen, 52074, Aachen, Germany
| | - Andreas Bell
- Department of Orthopedics, Eifelklinik St. Brigida, Simmerath, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, E1 4DG, England
- School of Pharmacy and Bioengineering, Stoke on Trent, Keele University Faculty of Medicine, Keele, England
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Naz S, Talha M, Nazir P, Talat S, Raza khan H, Shahid H. Frequency of Low Back Pain and Its Association with Functional Ability in Engineers. PAKISTAN JOURNAL OF HEALTH SCIENCES 2023:71-74. [DOI: 10.54393/pjhs.v4i04.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Low back pain (LBP) is the most common health problem among workers; most workers experience this issue during their lives. There are some psycho-social factors interlinked with LBP including hostile work environments, long working hours & overtime working hours. Objective: To determine the frequency of low back pain in engineers and to evaluate the association between functional ability and low back pain in engineers. Methods: A descriptive Cross-Sectional study was conducted, and the data were collected through a convenient sampling technique from Rawalpindi, Islamabad, and Malakand. The duration of the study was 6 months after synopsis approval. Data collection were done using a self-structured questionnaire containing demographic data and clinical characteristics. Visual analogue scale for pain (VAS pain) and Back pain functional scale (BPFS) were used to assess pain and functional abilities. Results: There were 85.9% Males and 24.1% females in this study. The point prevalence of LBP was 36.7% and the 12-month prevalence was 63.3%. There was a moderate association found between the severity of LBP and functional ability [(r= -0.59), p < 0.001]. Conclusions: The study concluded that the prevalence of LBP is found in engineers. A moderately significant association was found between the severity of LBP and functional ability in engineers.
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Alizadeh R, Anastasio AT, Shariat A, Bethell M, Hassanzadeh G. Teleexercise for geriatric patients with failed back surgery syndrome. Front Public Health 2023; 11:1140506. [PMID: 37081949 PMCID: PMC10111615 DOI: 10.3389/fpubh.2023.1140506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/28/2023] [Indexed: 04/07/2023] Open
Abstract
IntroductionFailed back surgery syndrome (FBSS) is defined as back pain which either persists after attempted surgical intervention or originates after a spine surgery. There is a high risk of perioperative morbidity and a high likelihood of extensive revision surgery in geriatric patients with FBSS or post-laminectomy foraminal stenosis.MethodsThere is a need for less invasive methodologies for the treatment of FBSS, such as patient-tailored exercise training, with attention to the cost and special needs of the geriatric patients with FBSS. This commentary will provide some background regarding teleexercise (utilizing an internet-based platform for the provision of exercise-related care) for FBSS and will propose three exercises which are easy to administer over online-based platforms and can be the subject of future investigation.ResultsGiven the documented benefits of regular rehabilitative exercises for patients with FBSS, the high cost of face-to-face services, and the need for infection mitigation in the wake of the COVID-19 Pandemic, teleexercise may be a practical and cost-beneficial method of exercise delivery, especially for geriatric patients with limitations in mobility and access to care. It should be noted that, prescription of these exercises should be done after face-to-face evaluation by the physician and careful evaluation for any “red flag” symptoms.ConclusionIn this commentary, we will suggest three practical exercise training methodologies and discuss the benefits of teleexercise for geriatric patients with FBSS. Future research should aim to assess the efficacy of these exercises, especially when administered through telehealth platforms.
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Affiliation(s)
- Reza Alizadeh
- Department of Anesthesiology and Pain, AJA University of Medical Sciences, Tehran, Iran
| | | | - Ardalan Shariat
- Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Ardalan Shariat,
| | - Mikhail Bethell
- Department of Orthopaedic Surgery, Duke University, Durham, NC, United States
| | - Gholamreza Hassanzadeh
- Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Shi T, Chen Z, Hu D, Li W, Wang Z, Liu W. Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? BMC Musculoskelet Disord 2023; 24:198. [PMID: 36927410 PMCID: PMC10018869 DOI: 10.1186/s12891-023-06305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
DESIGN Propensity-matched retrospective study. OBJECTIVES To determine whether type 2 diabetes mellitus (T2D) would affect prognosis in patients with degenerative lumbar spinal stenosis (DLSS) who underwent therapeutic exercises. METHODS This study included consecutive patients with or without T2D who underwent therapeutic exercises for symptomatic DLSS from December 2018 to January 2020. Baseline demographics and clinical and radiological data were collected. The 2 groups of patients were further matched in a 1:1 fashion based on the propensity score, balancing the groups on pre-treatment factors including age, sex, leg and back pain, and low back disability. The primary outcomes included self-reported leg pain intensity (Numerical Rating Scale, NRS) and low back disability (Oswestry Disability Index, ODI) and the secondary outcomes included low back pain intensity and walking capacity (self-paced walking test, SPWT) were compared at baseline, 6 weeks, and 12 weeks. RESULTS Forty-one pairs of patients were selected by propensity matching. After 6-week therapeutic exercises, patients with T2D achieved a lower improvement in leg pain at 6 weeks (NRS leg change, 1.21 ± 0.40 vs. 1.78 ± 0.52, P = 0.021) and 12 weeks (NRS leg change, 1.52 ± 0.92 vs. 2.18 ± 0.96, P = 0.007) above minimal clinically important difference (MCID), with a significant Group × Time interactions (F1,80 = 16.32, p < 0.001, ηp2 = 0.053). However, the two groups showed no difference in the improvement of ODI, although the sample had significant improvements at 6 weeks (ODI change 3.02 [95% CI, 2.08 to 2.77], P < 0.001) and 12 weeks ([ODI change 3.82 [95% CI, 4.03 to 4.90], P < 0.001), 46% of the patients achieved an MCID. CONCLUSION Six-week therapeutic exercises have an inferior effect on DLSS patients with T2D. Findings from this study will provide an increased understanding of exercise treatment in patients with DLSS.
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Affiliation(s)
- Tengbin Shi
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhi Chen
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Dingxiang Hu
- School of Health, Fujian Medical University, 350108, Fuzhou, Fujian, China
| | - Wenwen Li
- School of Health, Fujian Medical University, 350108, Fuzhou, Fujian, China
| | - Zhenyu Wang
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenge Liu
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, China. .,School of Health, Fujian Medical University, 350108, Fuzhou, Fujian, China.
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Ahmad I, Sharma A, Zaidi S, Alshahrani MS, Gautam AP, Raizah A, Reddy RS, Verma S, Tanwar T, Hussain ME, Malhotra D, Uddin S, Mukhtar EM. Establishing Responsiveness and Minimal Clinically Important Difference of Quebec Back Pain Disability Scale (Hindi Version) in Chronic Low Back Pain Patients Undergoing Multimodal Physical Therapy. Healthcare (Basel) 2023; 11:healthcare11040621. [PMID: 36833155 PMCID: PMC9957059 DOI: 10.3390/healthcare11040621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Increasing emphasis is placed on physical functional measures to examine treatments for chronic low back pain (CLBP). The Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) has never been evaluated for responsiveness. The objectives of this study were to (1) examine the internal and external responsiveness of the Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) and (2) find out the minimal clinically important difference (MCID) and minimal detectable change (MDC) in the functional ability of patients with chronic low back pain (CLBP) undergoing multimodal physical therapy treatment. In this prospective cohort study, QBPDS-H responses were recorded at the baseline and after eight weeks from 156 CLBP patients undergoing multimodal physiotherapy treatment. To differentiate between the clinically unimproved (n = 65, age: 44.16 ± 11.8 years) and clinically improved (n = 91, age: 43.28 ± 10.7 years) scores of patients from the initial assessment to the last follow-up, the Hindi version of the Patient's Global Impression of Change (H-PGIC) scale was utilized. Internal responsiveness was large (E.S. (pooled S.D.) (n = 91): 0.98 (95% CI = 1.14-0.85) and Standardized Response Mean (S.R.M.) (n = 91): 2.57 (95% CI = 3.05-2.17)). In addition, the correlation coefficient and receiver operative characteristics (R.O.C.) curve were used to assess the QBPDS-H external responsiveness. MCID and MDC were detected by the R.O.C. curve and standard error of measurements (S.E.M.), respectively. The H-PGIC scale showed moderate responsiveness (ρ = 0.514 and area under the curve (A.U.C.) = 0.658; 95% CI, 0.596-0.874), while the MDC achieved 13.68 points, and the MCID was found have 6 points (A.U.C. = 0.82; 95% CI: 0.74-0.88, sensitivity = 90%, specificity = 61%). This study shows that QBPDS-H has moderate levels of responsiveness in CLBP patients receiving multimodal physical therapy treatment, so it can be used to measure the changes in disability scores. MCID and MDC changes were also reported with QBPDS-H.
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Affiliation(s)
- Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Akhil Sharma
- St. Stephens Hospital, Tis Hazari, New Delhi 110054, India
| | - Sahar Zaidi
- Department of Physiotherapy, Jamia Hamdard, New Delhi 110062, India
- Correspondence: ; Tel.: +91-97-3986-4312
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Abdullah Raizah
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Shalini Verma
- Department of Physiotherapy, Jamia Hamdard, New Delhi 110062, India
| | - Tarushi Tanwar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mohammad Ejaz Hussain
- Faculty of Allied Health Sciences and Physiotherapy, SGT University, Gurugram 122505, India
| | - Deepak Malhotra
- Department of Physiotherapy, Jamia Hamdard, New Delhi 110062, India
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 82911, Saudi Arabia
| | - Emadeldin Mohammed Mukhtar
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
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Raizah A, Alzahrani F, Albarqi B, Abusaq I, Alqarni H, Alyami I, Ahmad I, Reddy RS. Treatment Beliefs and Practices towards Low Back Pain among Teachers in Asir Region, Saudi Arabia-A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11030383. [PMID: 36766958 PMCID: PMC9914584 DOI: 10.3390/healthcare11030383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
The prevalence of low back pain (LBP) is increasing exponentially, with this public health issue affecting over 70% of the population. However, sedentary careers exacerbate the problem further, with professions such as teaching disproportionately affected. In addition, the general population does not seek interventions from medical professionals for LBP; instead, they opt to manage their pain with over-the-counter medications, such as sedatives. The purpose of this study was to explore practices and beliefs related to back pain treatment among schoolteachers in the Asir region. This cross-sectional study included a sample of 312 teachers from the Asir region, with data collected regarding the prevalence of back pain, management approaches, and beliefs surrounding medical interventions. Chi-square or exact tests defined the association between variables, with significance determined at p < 0.05. Our results revealed that 67.3% of Saudi Arabian teachers experienced LBP within the last two months, with a continuous condition representing 36.7% of cases. This study identified several different treatment modalities the participants use to manage their pain, including sedatives, best rest, kaiy (traditional cautery), and local adhesives, with sedatives being the most employed method. It also highlighted that increased daily working hours and total days worked significantly increased the prevalence of LBP (p < 0.05). Although a considerable number of the included teachers were highly educated, with some teaching experience, they had a poor level of awareness and an incorrect attitude towards pain management. Enhanced efforts should be made to improve teachers' awareness regarding back pain causes and management methods.
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Affiliation(s)
- Abdullah Raizah
- Department of Orthopaedic Surgery, King Khalid University, Abha 61413, Saudi Arabia
| | - Faris Alzahrani
- The Joint Program of Public Health and Preventive Medicine, Abha 62527, Saudi Arabia
| | - Bandar Albarqi
- The Joint Program of Public Health and Preventive Medicine, Abha 62527, Saudi Arabia
| | - Ibrahim Abusaq
- Department of Pediatric Surgery, University Hospital Estaing, 63000 Clermont Ferrand, France
| | | | | | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
- Correspondence:
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
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Saleh NEH, Hamdan Y, Shabaanieh A, Housseiny N, Ramadan A, Diab AH, Sadek Z. Global perceived improvement and health-related quality of life after physical therapy in Lebanese patients with chronic non-specific low back pain. J Back Musculoskelet Rehabil 2023; 36:1421-1428. [PMID: 37482984 DOI: 10.3233/bmr-220423] [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] [Indexed: 07/25/2023]
Abstract
BACKGROUND The effectiveness of physical therapy (PT) in patients with chronic non-specific low back pain (CNSLBP) is mainly evaluated through pain, disability, and health-related quality of life (HRQOL). However, recent studies have recommended the consideration of improvement from patients' perspectives. OBJECTIVE This study aimed to investigate the relationship between the global perception of improvement in Lebanese patients with CNSLBP who have undergone PT, the HRQOL levels, as well as pain intensity. METHODS 132 patients with CNSLBP who have undergone PT completed a questionnaire consisting of sociodemographic and CNSLBP characteristics questions, pain intensity numeric scale (NRS), 12-Item Short-Form Health Survey (SF-12), and the Global Perceived Effect scale (GPE). Binary logistic regressions and Pearson correlation coefficient were used for analyses. RESULTS Global perceived improvement of PT varies according to HRQOL levels. A significant correlation was found between pain intensity after PT, perceived improvement from PT, and HRQOL. Educational level and pain irradiation have been shown to be predictive factors of perceived improvement after PT. CONCLUSION Pain and HRQOL are interrelated and contributed to elucidating the global perception of improvement after PT in patients with CNSLBP. The findings suggest that patients' global perception of improvement should be considered in evaluating the benefits of physical therapy in addition to pain and HRQOL.
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Affiliation(s)
- Nour El Hoda Saleh
- Department of Research, Health, Rehabilitation, Integration, and Research Center (HRIR), Beirut, Lebanon
- Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon
| | - Yara Hamdan
- Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon
| | - Abdullah Shabaanieh
- Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon
| | - Nourhan Housseiny
- Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon
| | - Ahmad Ramadan
- Department of Research, Health, Rehabilitation, Integration, and Research Center (HRIR), Beirut, Lebanon
| | - Aly Haj Diab
- Department of Research, Health, Rehabilitation, Integration, and Research Center (HRIR), Beirut, Lebanon
| | - Zahra Sadek
- Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon
- Physical Therapy Department, Faculty of Public Health, Lebanese University, Beirut, Lebanon
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Tekmyster G, Jonely H, Lee DW, Myerson J, Avery M, Moradian M, Desai MJ. Physical Therapy Considerations and Recommendations for Patients Following Spinal Cord Stimulator Implant Surgery. Neuromodulation 2023; 26:260-269. [PMID: 33819381 DOI: 10.1111/ner.13391] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Spinal cord stimulation (SCS) is an established therapy option in interventional pain medicine. Recent advances in technology have allowed for greater compliance with treatment and improved efficacy in pain control. This article was proposed to fill the gap in the literature addressing this specific patient population and to facilitate further research. Even though there is a lack of consensus among societies and experts on exact parameters of physical therapy (PT) considerations and postoperative limitations in patients with SCS, we propose rehabilitative care for this population should be standardized. As the number of patients with SCS implants grow, it is vital to understand how to appropriately approach patients with implantable devices when additional treatments such as PT are prescribed. MATERIALS AND METHODS A literature search was performed on the use of PT following SCS implantation. Presently, there is no literature to date which addresses the use of PT in this patient population. The lack of data is the largest hurdle in the creation of formal SCS therapy guidelines. The authors therefore proposed recommendations for rehabilitation based upon a detailed understanding of SCS hardware alongside well-studied physiotherapy concepts. RESULTS Considerations when initiating PT in the SCS patient population should include: 1) biomechanics and quality of SCS output; 2) therapeutic exercise and spinal manipulation in association with risk for lead migration and fracture; 3) the application of therapeutic modalities and risk for injury to the patient and/or damage to the SCS componentry; and 4) integration of a biopsychosocial, person-centered approach. CONCLUSIONS PT treatment protocol in patients with a recently implanted SCS device should be person-centered addressing individual needs, values, and goals. Further research is needed to fully appreciate the impact of an interprofessional approach to management of SCS patients, particularly following stimulator implantation.
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Affiliation(s)
- Gene Tekmyster
- Keck Medicine of USC, Orthopaedic Surgery, Los Angeles, CA, USA
| | - Holly Jonely
- International Spine Pain & Performance Center, Washington, DC, USA
| | - David W Lee
- Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA.
| | - Jason Myerson
- Performance Physical Therapy & Wellness, Westport, CT, USA
| | - Melinda Avery
- International Spine Pain & Performance Center, Washington, DC, USA
| | | | - Mehul J Desai
- International Spine Pain & Performance Center, Washington, DC, USA
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van Amstel RN, Jaspers RT, Pool-Goudzwaard AL. Skin Displacement as fascia tissue manipulation at the lower back affects instantaneously the flexion-and extension spine, pelvis, and hip range of motion. Front Physiol 2022; 13:1067816. [PMID: 36505071 PMCID: PMC9727291 DOI: 10.3389/fphys.2022.1067816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Low back pain (LBP), associated with spine, pelvis, and hip mobility impairments can be caused by tight muscle contractions, to protect sensitized lumbar fasciae. Fascia tissue manipulations are used to treat lumbar fascia in LBP. The effect of fascia tissue manipulations through lumbodorsal skin displacement (SKD) on mobility is inconclusive likely depending on the location and displacement direction of the manipulation. This study aimed to assess whether lumbodorsal SKD affects the flexion -and extension range of motion (ROM), in healthy subjects. Furthermore, we aimed to test the effect of SKD at different locations and directions. Finally, to assess intertester and intratester reliability of SKD. Effects of SKD were tested in a motion capture, single-blinded, longitudinal, experimental study. Sixty-three subjects were randomly assigned to SKD- or sham group. SKD group was subjected to either mediolateral directed SKD during flexion or extension movement, versus a sham. The thoracic, lumbar, and hip angles and finger floor distance were measured to assess the change in ROM. Statistics indicated that the effect size in instantaneously change of flexion -and extension ROM by SKD was large (Effect size: flexion η2 p = 0.12-0.90; extension η2 p = 0.29-0.42). No significant effect was present in the sham condition. Flexion ROM decreased whereas the extension ROM increased, depending on SKD location- and displacement direction (p < 0.05). The ICC indicates a good intertester and intratester reliability (resp. ICC3,k = 0.81-0.93; ICC3,1 = 0.70-0.84). Lumbodorsal SKD affects the flexion- and extension spine, pelvis, and hip range of motion. The effects of SKD are direction- and location dependent as well as movement (flexion/extension) specific. Lumbodorsal SKD during flexion and extension may be useful to determine whether or not a patient would benefit from fascia tissue manipulations. Further research is required to obtain insight into the mechanisms via which the SKD affects ROM and muscle activation, in healthy, asymptomatic-LBP, and LBP subjects.
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Affiliation(s)
- Robbert N. van Amstel
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Fysio Science Department, Fysio Physics Group, IJsselstein, Netherlands,*Correspondence: Robbert N. van Amstel, ; Annelies L. Pool-Goudzwaard,
| | - Richard T. Jaspers
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Annelies L. Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,SOMT, University of Physiotherapy, Amersfoort, Netherlands,*Correspondence: Robbert N. van Amstel, ; Annelies L. Pool-Goudzwaard,
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Talbot LA, Ramirez VJ, Webb L, Morrell C, Metter EJ. Home therapies to improve disability, activity, and quality of life in military personnel with subacute low back pain: Secondary outcome analysis of a randomized controlled trial. Nurs Outlook 2022; 70:S136-S145. [PMID: 36585060 DOI: 10.1016/j.outlook.2022.08.007] [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: 03/31/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Low back pain (LBP) is an urgent military health concern with implications for fitness, quality of life (QoL) and disability. PURPOSE This secondary outcome analysis from a randomized controlled trial (RCT) was to determine if the addition of neuromuscular electrical stimulation core strength training (NMES) or progressive exercise (PEP)in conjunction with primary care management (PCM) was more effective than PCM alone. METHODS This randomized controlled trial (RCT assigned 128 service members to the three intervention groups. The outcomes included changes in perceived disability (Oswestry Disability Index), health-related quality of life (SF-12v2), pain during activity (Clinical Back Pain Questionnaire), and daily steps walked in service members with subacute LBP. FINDINGS Over a 9-week intervention, perceived disability, SF-12v2 physical component summary, and activity associated with pain improved in all groups. Home therapies were helpful to reduce perceived disability, QoL and pain during activity in service members with subacute LBP. DISCUSSION These non-pharmacological options provide other home-managed approaches for those in the subacute LBP phase.
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Affiliation(s)
- Laura A Talbot
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN.
| | | | - Lee Webb
- La Pointe Health Clinic, Physical Therapy, Fort Campbell, KY
| | - Christopher Morrell
- Department of Mathematics and Statistics, Loyola University Maryland, Baltimore, MD
| | - Earl J Metter
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN
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Impact of Active Physiotherapy Rehabilitation on Pain and Global and Functional Improvement 1-2 Months after Lumbar Disk Surgery: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10101943. [PMID: 36292390 PMCID: PMC9601491 DOI: 10.3390/healthcare10101943] [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: 08/10/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction: Lumbar disc surgery is a common procedure for patients with lower back pain associated with lumbar disc herniation. This study aims to evaluate the impact of active physiotherapeutic rehabilitation on global/functional improvement and subjective pain score reduction among patients 1–2 months following lumbar disc surgery. The outcomes of this study are to assess the impact of active physiotherapeutic rehabilitation on functional improvement and subjective improvement in pain behavior post active rehabilitation. The outcomes are measured as pain assessed using the visual analog scale, global measurement of improvement, back pain functional status, and return to work. Methods: Databases, including MEDLINE/PubMed (10 June 1996, 2022), Web of Science (10 June 1997, 2022), Scopus (15 March, 10 June 2004, 2022), CINAHL Plus (10 June 1961, 2022), and Cochrane (10 June 1993, 2022) were reviewed without any language restrictions. All studies were systematically screened; however, only randomized controlled trials were eligible against the inclusion/exclusion criteria. All statistical tests were conducted in Review Manager (RevMan) 5.4. The quality of studies was appraised using the grading of recommendations assessment, development, and evaluation (GRADE) approach and the risk-of-bias 2 (RoB 2) tool. Results: Fifteen articles were identified, enrolling a total of 2188 patients, where the majority of active rehabilitation interventions continued for 3 months. All these interventions began 1–2 months postoperatively, and quantitative findings were presented as mean scores. The subjective pain scores were significantly lower in the interventional group, with a mean difference (MD) of −7.01 (p = 0.004). The pain disability score was considerably lower in the interventional group, with an MD of −3.94 (p = 0.002). Global improvement was higher in the interventional group (OR = 1.94, p = 0.0001). Conclusions: This study presents significant improvement in all parameters concerning pain and functionality. Postoperative rehabilitation requires optimization concerning timing, duration, intensity, and associated components to benefit patients post lumbar disc surgery.
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Tseng MC, Lim J, Chu YC, Chen CW, Feng CK, Wang JL. Dynamic Pressure Stimulation Upregulates Collagen II and Aggrecan in Nucleus Pulposus Cells Through Calcium Signaling. Spine (Phila Pa 1976) 2022; 47:1111-1119. [PMID: 34812197 DOI: 10.1097/brs.0000000000004286] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/25/2021] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An in vitro study to investigate the effect of pressure stimulation on nucleus pulposus (NP) cells. OBJECTIVE The aim of this study was to investigate the question whether physical stimulation can be leveraged to enhance extracellular matrix (ECM) synthesis as a preventive measure for intervertebral disc (IVD) degeneration. SUMMARY OF BACKGROUND DATA ECM plays an important role in regulating hydration and pressure balance of the IVD. METHODS Cellular stimulation devices with different pressurizing protocols were used to create a pressurized environment to cells cultures. The setup was used to mimic the pressurized conditions within IVD to investigate the effect of pressure stimulation on NP cells. RESULTS Pressure stimulation at 300 kPa can enhance the synthesis of ECM proteins Collagen II and aggrecan in NP cells and the effect of dynamic pressure stimulation outperformed the static one. The difference between static and dynamic pressure stimulation was due primarily to calcium signaling activated by pressure fluctuation. The superior effect of dynamic pressure holds for a wide range of stimulation durations, relating to the range of spontaneous calcium oscillations in NP cells. CONCLUSION The results link mechanotransduction to the downstream ECM protein synthesis and suggest slow exercises that correspond with spontaneous calcium oscillations in NP cells can be effective to stimulate ECM synthesis in IVD.
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Affiliation(s)
- Mu-Cyun Tseng
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC
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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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Lena O, Todri J, Todri A, Papajorgji P, Martínez-Fuentes J. A randomized controlled trial concerning the implementation of the postural Mézières treatment in elite athletes with low back pain. Postgrad Med 2022; 134:559-572. [PMID: 35708481 DOI: 10.1080/00325481.2022.2089464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aimed to evaluate the impact of adding the Mézières Method (MM) to the standard rehabilitation protocol for the elite athletes with low back pain (LBP) in reducing lumbar pain than only using the traditional rehabilitation protocol treatment. The disciplines considered in this study were soccer, rhythmic gymnastics, and basketball. DESIGN Randomized controlled trial. SETTING Training Camp. PARTICIPANTS One hundred thirty-nine elite athletes with low back pain of whom 69 were assigned to the experimental group. INTERVENTION The intervention consists of treatment with three lying postures in a 40-minutes long session twice a week. The session goal was to focus on breathing exercises, spine mobility, and stretching of the back muscles, with particular attention to the diaphragmatic, paravertebral, and latissimus dorsi muscles. OUTCOME MEASURES Assessments as Visual Analogue Scale (VAS), Sit and Reach flexibility test, Roland-Morris Questionnaire, and health status questionnaire (SF12) were used. RESULTS The evaluation of all outcomes in 4 measurement periods of the study (baseline, 4, 12, and 24 weeks) showed a significant difference between groups. Also, at the 6-month of the intervention, a significant difference in the means (SD) was observed in pain (VAS), back flexibility (Sit & Reach) and back disability (QRM) outcomes in favor of the experimental group with a medium-large effect size comparing with the control group. CONCLUSION The MM approach can also be applied in established conventional protocols to alleviate pain and functionality. The obtained results include improving the quality of life of the athletes and their physical and emotional states. Clinical trial registration number ID: NCT03849053.
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Affiliation(s)
- Orges Lena
- Health Sciences Department, Universidad Catolica de Murcia UCAM, Spain
| | - Jasemin Todri
- Health Sciences Department, Universidad Catolica de Murcia UCAM, Spain
| | - Ardita Todri
- Statistics Specialist Area. Economics Department, Universiteti "Aleksander Xhuvani", Elbasan, Albania
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Acharya M, Chopra D, Smith AM, Fritz JM, Martin BC. Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas. J Chiropr Med 2022; 21:67-76. [PMID: 35774633 PMCID: PMC9237579 DOI: 10.1016/j.jcm.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022] Open
Abstract
Objective The objective of this study was to estimate the association between early use of physical therapy (PT) or chiropractic care and incident opioid use and long-term opioid use in individuals with a low back pain (LBP) diagnosis. Methods A retrospective cohort study was conducted using data from Arkansas All Payers' Claims Database. Adults with incident LBP diagnosed in primary care or emergency departments between July 1, 2013, and June 30, 2017, were identified. Participants were required to be opioid naïve in the 6-month baseline period and without cancer, cauda equina syndrome, osteomyelitis, lumbar fracture, and paraplegia/quadriplegia in the entire study period. PT and chiropractic treatment were documented over the ensuing 30 days starting on the date of LBP. Any opioid use and long-term opioid use (LTOU) in 1-year follow-up were assessed. Multivariable logistic regressions controlling for covariates were estimated. Results A total of 40 929 individuals were included in the final sample, with an average age of 41 years and 65% being women. Only 5% and 6% received PT and chiropractic service, respectively, within the first 30 days. Sixty-four percent had incident opioid use, and 4% had LTOU in the follow-up period. PT was not associated with incident opioid use (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.98-1.18) or LTOU (OR, 1.19; 95% CI, 0.97-1.45). Chiropractic care decreased the odds of opioid use (OR, 0.88; 95% CI, 0.80-0.97) and LTOU (OR, 0.56; 95% CI, 0.40-0.77). Conclusion In this study we found that receipt of chiropractic care, though not PT, may have disrupted the need for opioids and, in particular, LTOU in newly diagnosed LBP.
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Affiliation(s)
- Mahip Acharya
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Divyan Chopra
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Allen M. Smith
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Julie M. Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah
| | - Bradley C. Martin
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, Arkansas,Corresponding author: Bradley C. Martin, PharmD, PhD, 4301 West Markham Street, Slot 522, Little Rock, AR 72205
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Hu Y, Yang Z, Li Y, Xu Y, Zhou X, Guo N. Anxiety Symptoms and Associated Factors Among Chronic Low Back Pain Patients in China: A Cross-Sectional Study. Front Public Health 2022; 10:878865. [PMID: 35602156 PMCID: PMC9114483 DOI: 10.3389/fpubh.2022.878865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed to investigate the prevalence of anxiety symptoms among patients with chronic low back pain and explore its related factors. Methods A cross-sectional study was conducted on patients with chronic low back pain from two general hospitals in China. Anxiety symptoms were assessed by the Generalized Anxiety Disorder-7. Binary logistic regression was used to examine the association between demographic characteristics, pain severity, pain self-efficacy, family functioning and anxiety symptoms. Results This study involved 1,172 chronic low back pain patients, with an effective rate of 94.67%. The prevalence of anxiety symptoms among patients with chronic low back pain in China was 23.89%. In the binary logistic regression, patients with more severe pain (OR = 1.15, 95%CI: 1.11–1.18) and pain duration between 1~5 years (1~3 years: OR = 2.45, 95%CI: 1.38–4.36; 3~5 years: OR = 2.99, 95%CI: 1.49–6.00) had a higher risk to anxiety symptoms. In contrast, patients with higher monthly income (OR = 0.62, 95%CI: 0.39–0.98), better family functioning (highly functional family: OR = 0.22, 95% CI: 0.13–0.37; moderately dysfunctional family: OR = 0.44, 95% CI: 0.27–0.72) and higher pain self-efficacy (OR = 0.95, 95%CI: 0.94–0.96) had a lower risk to anxiety symptoms. Conclusion The prevalence of anxiety symptoms among chronic low back pain patients was high in China. Targeted intervention measures should be taken to reduce anxiety symptoms levels of chronic low back pain patients.
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Affiliation(s)
- Yueming Hu
- Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Zechuan Yang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Xu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ningfeng Guo
- Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
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Chen X, Deng Q, Wang Q, Liu X, Chen L, Liu J, Li S, Wang M, Cao G. Image Quality Control in Lumbar Spine Radiography Using Enhanced U-Net Neural Networks. Front Public Health 2022; 10:891766. [PMID: 35558524 PMCID: PMC9087032 DOI: 10.3389/fpubh.2022.891766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To standardize the radiography imaging procedure, an image quality control framework using the deep learning technique was developed to segment and evaluate lumbar spine x-ray images according to a defined quality control standard. Materials and Methods A dataset comprising anteroposterior, lateral, and oblique position lumbar spine x-ray images from 1,389 patients was analyzed in this study. The training set consisted of digital radiography images of 1,070 patients (800, 798, and 623 images of the anteroposterior, lateral, and oblique position, respectively) and the validation set included 319 patients (200, 205, and 156 images of the anteroposterior, lateral, and oblique position, respectively). The quality control standard for lumbar spine x-ray radiography in this study was defined using textbook guidelines of as a reference. An enhanced encoder-decoder fully convolutional network with U-net as the backbone was implemented to segment the anatomical structures in the x-ray images. The segmentations were used to build an automatic assessment method to detect unqualified images. The dice similarity coefficient was used to evaluate segmentation performance. Results The dice similarity coefficient of the anteroposterior position images ranged from 0.82 to 0.96 (mean 0.91 ± 0.06); the dice similarity coefficient of the lateral position images ranged from 0.71 to 0.95 (mean 0.87 ± 0.10); the dice similarity coefficient of the oblique position images ranged from 0.66 to 0.93 (mean 0.80 ± 0.14). The accuracy, sensitivity, and specificity of the assessment method on the validation set were 0.971-0.990 (mean 0.98 ± 0.10), 0.714-0.933 (mean 0.86 ± 0.13), and 0.995-1.000 (mean 0.99 ± 0.12) for the three positions, respectively. Conclusion This deep learning-based algorithm achieves accurate segmentation of lumbar spine x-ray images. It provides a reliable and efficient method to identify the shape of the lumbar spine while automatically determining the radiographic image quality.
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Affiliation(s)
- Xiao Chen
- Department of Radiology, Key Laboratory of Intelligent Medical Imaging of Wenzhou, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qingshan Deng
- Department of Radiology, Key Laboratory of Intelligent Medical Imaging of Wenzhou, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qiang Wang
- Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China
| | - Xinmiao Liu
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Lei Chen
- Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China
| | - Jinjin Liu
- Department of Radiology, Key Laboratory of Intelligent Medical Imaging of Wenzhou, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuangquan Li
- Department of Radiology, Key Laboratory of Intelligent Medical Imaging of Wenzhou, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meihao Wang
- Department of Radiology, Key Laboratory of Intelligent Medical Imaging of Wenzhou, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guoquan Cao
- Department of Radiology, Key Laboratory of Intelligent Medical Imaging of Wenzhou, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Yao C, Guo G, Huang R, Tang C, Zhu Q, Cheng Y, Kong L, Ren J, Fang M. Manual therapy regulates oxidative stress in aging rat lumbar intervertebral discs through the SIRT1/FOXO1 pathway. Aging (Albany NY) 2022; 14:2400-2417. [PMID: 35289767 PMCID: PMC8954973 DOI: 10.18632/aging.203949] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/01/2022] [Indexed: 11/25/2022]
Abstract
With the increasing burden of a globally aging population, low back pain has become one of the most common musculoskeletal disorders, caused mainly by intervertebral disc (IVD) degeneration. There are currently several clinical methods to alleviate back pain, but there is scarce attention paid as to whether they can improve age-related IVD degeneration. It is therefore difficult to conduct an in-depth evaluation of these methods. A large number of clinical studies have shown that manual therapy (MT), a widely used comprehensive alternative method, has effects on pain, the mechanisms of which require further study. In this study, MT was performed on aging rats for 6 months, and their behaviors were compared with those of a non-intervention group of aging and young rats. After the intervention, all rats were examined by X-ray to observe lumbar spine degeneration, and the IVD tissues were dissected for detection, including pathological staining, immunofluorescence, Western bolt, etc. This study demonstrated the possibility that MT intervention delay the lumbar IVD degeneration in aging rats, specifically improving the motor function and regulating senescence-associated β-galactosidase, p53, p21, p16, and telomerase activity to retard the senescence of cells in IVDs. Moreover, MT intervention can modify oxidative stress, increase the expression of SIRT1 and FOXO1 in IVDs and decrease ac-FOXO1 expression, suggesting that MT can reduce oxidative stress through the SIRT1/FOXO1 pathway, thereby playing a role in delaying the aging of IVDs. This study shows that drug-free, non-invasive mechanical interventions could be of major significance in improving the physical function of the elderly.
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Affiliation(s)
- Chongjie Yao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China.,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Guangxin Guo
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China.,Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Ruixin Huang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Cheng Tang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Qingguang Zhu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China.,Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Yanbin Cheng
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China.,Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Lingjun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China.,Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Jun Ren
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China
| | - Min Fang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China.,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, P.R. China.,Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai 200437, P.R. China
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Bolton R, Ritter G, Highland K, Larson MJ. The relationship between capacity and utilization of nonpharmacologic therapies in the US Military Health System. BMC Health Serv Res 2022; 22:312. [PMID: 35255912 PMCID: PMC8900315 DOI: 10.1186/s12913-022-07700-4] [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: 06/01/2021] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nonpharmacologic therapies (NPTs) are recommended as first-line treatments for pain, however the impact of expanding professional capacity to deliver these therapies on use has not been extensively studied. We sought to examine whether an effort by the US Military Health System (MHS) to improve access to NPTs by expanding professional capacity increased NPT utilization in a cohort at higher risk for pain – Army soldiers returning from deployment. Methods Our study involved secondary analysis of MHS workforce data derived from the Defense Medical Human Resources System Internet (DMHRSi), and healthcare utilization data obtained from two ambulatory record systems of the Military Health System (MHS) for a sample of 863,855 Army soldiers previously deployed to Iraq or Afghanistan over a 10-year period (2008–2017). We measured clinical provider capacity in three occupational groups responsible for pain management at 130 military treatment facilities (MTFs): physical therapy, chiropractic, and behavioral health, measured annually as full-time equivalence per 100,000 patients served at each MTF. Utilization in both direct and purchased care settings was measured as annual mean NPT users per 1000 sample members and mean encounters per NPT user. Generalized estimating equation models estimated the associations of facility-level occupational capacity measures and facility-level utilization NPT measures. Results In 2008, nearly all MTFs had some physical therapist and behavioral health provider capacity, but less than half had any chiropractor capacity. The largest increase in capacity from 2008 to 2017 was for chiropractors (89%) followed by behavioral health providers (77%) and physical therapists (37%). Models indicated that increased capacity of physical therapists and chiropractors were associated with significantly increased utilization of six out of seven NPTs. Acupuncture initiation was associated with capacity increases in each occupation. Increased professional capacity in MTFs was associated with limited but positive effects on NPT utilization in purchased care. Conclusions Increasing occupational capacity in three professions responsible for delivering NPTs at MTFs were associated with growing utilization of seven NPTs in this Army sample. Despite increasing capacity in MTFs, some positive associations between MTF capacity and purchased care utilization suggest an unmet need for NPTs. Future research should examine if these changes lead to greater receipt of guideline-concordant pain management. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07700-4.
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Affiliation(s)
- Rendelle Bolton
- The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MA, 02453, Waltham, USA. .,US Department of Veterans Affairs, VA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, 200 Springs Road, Bedford, MA, 01730, USA.
| | - Grant Ritter
- The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MA, 02453, Waltham, USA
| | - Krista Highland
- Department of Anesthesiology, Defense and Veterans Center for Integrative Pain Management, Uniformed Services University, 11300 Rockville Pike, Suite 709, Rockville, MD, 20852, USA.,Henry M. Jackson Foundation, 11300 Rockville Pike, Suite 709, Rockville, MD, 20852, USA
| | - Mary Jo Larson
- The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MA, 02453, Waltham, USA
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Zhang F, Zhao J, Jiang N, Zhai Q, Hu J, Zhang J. Meta-Analysis of Tai Chi Chuan in Treating Lumbar Spondylosis and Back Pain. Appl Bionics Biomech 2022; 2022:2759977. [PMID: 35178121 PMCID: PMC8843943 DOI: 10.1155/2022/2759977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The effectiveness of Tai Chi Chuan in treating various ailments has been well reported; however, its effect on back pain and lumbar spondylosis remains unclear. METHODS We performed this meta-analysis under the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the research-associated search was performed over the provided databases: Embase, Cochrane Library, Web of Science, PubMed, Scopus, and CINAHL in the period of 2008 to 2016, to recognize the related studies. We used the Physiotherapy Evidence Database (PEDro) scale to measure the standard of the involved randomized control trials (RCTs). The accumulated outcomes with parameters of weighted mean difference (WMD) and confidence level (CI) of 95% were evaluated to discover the influence of Tai Chi over pain as well as dysfunction among the patients suffering from pain depending on the outcome model. RESULTS Seven eligible studies with a total of 296 participants were identified that met inclusion criteria for the systematic review; in the forest plot analysis, it was noted that for 95% CI, the standardized mean difference found to be -1.58 (-1.79, -1.38) with the heterogeneity of 87%, thereby favoring Tai Chi over the control group; a comparison was drawn for Tai Chi with routine therapy against the routine therapy alone, where 95% CI for -1.22 [-1.47, -0.97] is observed for I 2 = 0% for the overall effect Z = 9.42 (P < 0.00001); pain intensity of Tai Chi was compared with the control group, where 95% CI for -1.62 [-2.09, -1.14] was observed for Z = 6.69 (P < 0.00001). The forest plot subgroup analysis of Tai Chi was compared with the control group for an unchanged lifestyle, where 95% CI for -2.26 [-2.61, -1.91] was observed for Z = 12.76 (P < 0.00001). CONCLUSION Our results indicate that Tai Chi individually or with additional treatment along with routine physical exercises might reduce the pain and functional disorders for the patients suffering from back pain.
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Affiliation(s)
- Fushun Zhang
- Department of Health Management Centre in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China
| | - Junfang Zhao
- Department of Laboratory Medicine in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China
| | - Nan Jiang
- Department of Health Management Centre in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China
| | - Qiao Zhai
- Department of Health Management Centre in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China
| | - Juanjuan Hu
- Department of Health Management Centre in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China
| | - Jing Zhang
- Department of Health Management Centre in Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China
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Etemadifar S, Dehghan M, Jazayeri T, Javanbakhtian R, Rabiei L, Masoudi R. A comparative study into the effects of topical hot salt and hot sand on patients' perception of low back pain. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:27. [PMID: 35281384 PMCID: PMC8893094 DOI: 10.4103/jehp.jehp_296_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/10/2021] [Indexed: 06/14/2023]
Abstract
BACGROUND Low back pain (LBP) has been regarded as one of the musculoskeletal problems which is affecting more than three-quarters of individuals in their lifetime. Nowadays, various pharmacological and nonpharmacological therapies are employed for relieving and treating LBP. This study was conducted to compare the effects of topical hot salt and hot sand on patients' perception of LBP. MATERIALS AND METHODS In this, quasi-experimental study patients with LBP referring to the orthopedic clinic of Shahrekord educational hospital were divided randomly into two interventions and one control group in 2020. All three groups were received naproxen cream and daily physiotherapy in the same manner, the interventional groups in addition either topical hot salt or topical hot sand. Data gathering tool for measuring patients' perception of LBP was the McGill Pain Short Form Questionnaire to be completed at the beginning, immediately at the end, and 2 months after the intervention. The data were analyzed using SPSS statistical software (version 21.0). RESULTS Totally, 90 patients were randomized based on the table of random numbers (mean age 51.1 + 11.1), and finally, 87 patients completed the study. Patients' perception of LBP before the intervention was homogenous in hot salt, hot sand, and the control group The mean score of total pain experience before the intervention was 14.1 ± 11.3 for hot sand, 13.9 ± 10.7 for hot salt and 13.7 ± 10.1 for control group The mean scores of these three groups were not significant before the intervention (P > 0.05). The mean score of total pain experience immediately after the intervention was 6.7 ± 4.2 for hot sand, 5.2 ± 3.1 for hot salt and 13.9 ± 9.8 for control group. The mean scores of the hot sand group and the hot salt group were significantly decreased compared with control group (P > 0.05). The mean score of total pain experience two months after the intervention was 5.6 ± 3.27 for hot sand, 4.21 ± 2.14 for hot salt and 13.8 ± 10.4 for control group. Mean score of total pain experience in both intervention groups had significantly reduced two months after the intervention compared to control group (P ≤ 0.001); so that the effect of hot salt treatment on reducing total pain experience was larger than hot sand (P ≤ 0.001). The same trend was observed for VAS and Present pain intensity variables. CONCLUSIONS The findings have revealed that the topical treatments with hot salt and hot sand could have a significant effect on the perception of LBP compared to those in the control group; whereas hot salt might be stronger effects than hot sand on reducing LBP.
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Affiliation(s)
- Shahram Etemadifar
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Morteza Dehghan
- Department of Orthopedy, Kashani Hospital and Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Tahereh Jazayeri
- Nurse of Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Raheleh Javanbakhtian
- Department of Operating Room, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Leili Rabiei
- Social Determinants of Health Research Center, School of Health, Shahrekord University of Medical Sciences, Shahrekord , Iran
| | - Reza Masoudi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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The effect of the Alexander Technique on pain intensity in patients with chronic low back pain: A randomized controlled trial. J Bodyw Mov Ther 2022; 29:54-59. [DOI: 10.1016/j.jbmt.2021.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/19/2021] [Accepted: 09/24/2021] [Indexed: 11/21/2022]
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40
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Salemi MDM, Gomes VMDSA, Bezerra LMR, Melo TMDS, Alencar GGD, Montenegro IHPDM, Calado APDM, Montenegro EJN, Siqueira GRD. Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial. J Acupunct Meridian Stud 2021; 14:219-230. [DOI: 10.51507/j.jams.2021.14.6.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/10/2021] [Accepted: 09/07/2021] [Indexed: 11/03/2022] Open
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Zhang SK, Yang Y, Gu ML, Mao SJ, Zhou WS. Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis. Percept Mot Skills 2021; 129:63-89. [PMID: 34911404 DOI: 10.1177/00315125211059407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our objective in this paper was to systematically review evaluations of the effects of exercises on pain symptoms and activities of daily living (ADL) in middle-aged and elderly patients with low back pain (LBP). We searched Web of Science, PubMed, EBSCO, and China National Knowledge Internet (CNKI) databases for randomized controlled trials (RCTs) on this topic. We evaluated the methodological quality of included articles using the Physiotherapy Evidence Database (PEDro) scale, and we statistically analyzed these studies using RevMan software. We reviewed 18 RCTs (23 comparison groups) with a total of 910 participants, and our meta-analysis confirmed that exercises significantly improved both pain and ADLs measured on visual analog scales (VAS) (SMD = -0.91, 95% CI: [-1.3, -0.52], p < 0.00001) and on the Oswestry Disability Index (ODI) (SMD = -2.07, 95% CI: [-3.19, -0.96], p < 0.00001). We conclude that exercises can reduce pain severity and improve ADL capacity in middle-aged and elderly persons with LBP, confirming that exercise can serve as a medical intervention for these indivdiuals. However, given the high heterogeneity of responses among individual participants, there remains a need for further study.
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Affiliation(s)
- Shi-Kun Zhang
- Department of Police Physical Education, 164369Jiangsu Police Institute, Nanjing, China
| | - Yong Yang
- Institute of Sport, Henan University, Kai Feng, China
| | - Mei-Ling Gu
- Nanjing Tian-zheng Primary School, Nanjing, China
| | - Su-Jie Mao
- 71198Graduate School of Nanjing University of Physical Education, Nanjing, China
| | - Wen-Sheng Zhou
- Department of Physical Education, 74587Nanjing Xiao-Zhuang University, Nanjing, China
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Comparison of two manual therapy approaches combined with exercise on pain, strength and electromyographic muscle activity in athletes with subacute mechanical low back pain. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00750-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Giusti EM, Varallo G, Abenavoli A, Manzoni GM, Aletti L, Capodaglio P, Castelnuovo G, Maggiani A. Factor Structure, Validity, and Reliability of the STarT Back Screening Tool in Italian Obese and Non-obese Patients With Low Back Pain. Front Psychol 2021; 12:740851. [PMID: 34744912 PMCID: PMC8563832 DOI: 10.3389/fpsyg.2021.740851] [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: 07/13/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The STarT Back Screening Tool (SBST) is a self-report questionnaire developed for prognostic purposes which evaluates risk factors for disability outcomes in patients with chronic low back pain. Previous studies found that its use enables to provide a cost-effective stratified care. However, its dimensionality has been assessed only using exploratory approaches, and reports on its psychometric properties are conflicting. Objective: The objective of this study was to assess the factorial structure and the psychometric properties of the Italian version of the STarT Back Screening Tool (SBST). Materials and Methods: Patients with medical diagnosis of low back pain were enrolled from a rehabilitation unit of a tertiary care hospital specialized in obesity care (Sample 1) and from a clinical internship center of an osteopathic training institute (Sample 2). At baseline and after 7 days patients were asked to fill a battery of self-report questionnaires. The factorial structure, internal consistency, test-retest reliability, and construct validity of the SBST were assessed. Results: One hundred forty-six patients were enrolled (62 from Sample 1 and 84 from Sample 2). The confirmatory factor analysis showed that the fit of the original two-correlated factors model was adequate (CFI = 0.98, TLI = 0.99, RMSEA = 0.03). Cronbach's α of the total scale (α = 0.64) and of the subscales (physical subscale α = 0.55; psychological subscale α = 0.61) was below the cutoffs, partly because of the low correlation of item 2 with the other items. Test-retest reliability was adequate (ICC = 0.84). The SBST had moderate correlations with comparisons questionnaires, except for the Roland-Morris Disability Questionnaire, which had a high correlation (r = 0.65). Discussion: The SBST has adequate psychometric properties and can be used to assess prognostic factors for disability in low back pain patients.
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Affiliation(s)
- Emanuele Maria Giusti
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Giorgia Varallo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Alessandra Abenavoli
- Research Department, Accademia Italiana di Medicina Osteopatica (AIMO), Saronno, Italy
| | - Gian Mauro Manzoni
- Faculty of Psychology, eCampus University, Novedrate, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Luca Aletti
- Research Department, Accademia Italiana di Medicina Osteopatica (AIMO), Saronno, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy.,Department Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, Turin, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Alberto Maggiani
- Research Department, Accademia Italiana di Medicina Osteopatica (AIMO), Saronno, Italy
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Salik Sengul Y, Yilmaz A, Kirmizi M, Kahraman T, Kalemci O. Effects of stabilization exercises on disability, pain, and core stability in patients with non-specific low back pain: A randomized controlled trial. Work 2021; 70:99-107. [PMID: 34487008 DOI: 10.3233/wor-213557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Many studies have emphasized the importance of stabilization exercises (SE) for the management of non-specific low back pain (NSLBP), yet there is no study assessing all aspects of core stability in comparing SE and other exercises. OBJECTIVE To investigate the effects of SE on pain and core stability by using core stability tests that focus on all aspects of core stability in patients with NSLBP. METHODS Thirty-seven individuals with chronic NSLBP were randomly divided into two groups as SE and conventional exercises (CE). Both groups underwent the progressive exercise program three days per week for six weeks. The assessments were conducted before and after the exercise programs. The outcome measures included pain, disability, trunk strength, trunk flexor, extensor and lateral flexor endurance, function, flexibility, and motor control during eyes open/closed. RESULTS All assessment parameters except motor control during eyes open improved after SE (p < 0.05). Also, all assessment parameters except motor control during eyes open/closed and lateral trunk endurance improved after CE (p < 0.05). When comparing groups for gain scores, there were more significant improvements in pain during activity, endurance and function after SE (p < 0.05). CONCLUSIONS SE is more effective than CE in reducing pain during activity and improving core stability regarding functionality and endurance.
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Affiliation(s)
- Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Alev Yilmaz
- Graduate School of Health Sciences, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Muge Kirmizi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
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AlSaeed MJ, Elmaghraby DA. Assessing the Knowledge of Analgesic Drugs Utilization during Pregnancy among Women in Saudi Arabia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7440. [PMID: 34299890 PMCID: PMC8305415 DOI: 10.3390/ijerph18147440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/10/2021] [Accepted: 07/11/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pain is a common compensation mechanism in pregnant women that they may face during gestation due to physiological changes. Paracetamol and non-steroidal anti-inflammatory drugs are the most administered analgesic drugs worldwide. Therefore, safety and efficacy are important measures for the use of analgesics during pregnancy. OBJECTIVE Assess the knowledge of analgesic drug utilization among Saudi pregnant women. METHOD We conducted a self-administered survey with an electronic questionnaire via Google Drive among a sample of 406 Saudi women. RESULTS About half of the respondents took analgesics during the first trimester, and 52.5% of women have used analgesics at least once without any medical advice during their gestation. Most participants agreed that paracetamol is the safest and effective analgesic drug during pregnancy, yet 61.8% of women are not aware that analgesics could be detrimental to the fetus if inappropriately administered in the third trimester. CONCLUSION Participants have a good perception of the safest and most effective analgesic drug during pregnancy, but they have poor knowledge about analgesics' side effects.
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Affiliation(s)
- Maryam Jamal AlSaeed
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf 31982, Saudi Arabia;
- Titus Family Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Los Angeles, CA 90089, USA
| | - Dalia Ahmed Elmaghraby
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf 31982, Saudi Arabia;
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Widerström B, Elvén M, Rasmussen-Barr E, Boström C. "How does physical examination findings influence physiotherapists' decision-making when matching treatment to patients with low back pain?". Musculoskelet Sci Pract 2021; 53:102374. [PMID: 33798815 DOI: 10.1016/j.msksp.2021.102374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/10/2021] [Accepted: 03/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Further clinical data how low-back pain (LBP) symptoms and signs manifests in physiotherapy clinical reasoning and treatment decision-making is needed. OBJECTIVE The aim was to explore and describe how symptoms and signs portrayed in three case descriptions of LBP influences physiotherapy treatment decision-making. DESIGN This was an exploratory interview study using inductive content analysis. METHOD Fifteen semi-structured individual interviews were used to collect data of physiotherapists' treatment decision-making regrading three diverse LBP case descriptions. The participants were men, women, experienced and novice, working in primary healthcare settings in one sparsely populated region and in one larger city in Sweden. FINDINGS Two overarching themes were identified influencing decision-making for the treatment of LBP:1) Explicit assessment features distinguish treatment approaches; with categories describing how symptoms and signs were used to target treatment (nature of pain induce reflections on plausible cause; narrative details trigger attention and establishes knowledge-enhancing foci; pain-movement-relationship is essential; diverse emphasis of pain modulation and targeted treatment approaches): and 2) Preconceived notion of treatment, with categories describing personal treatment rationales, unrelated to the presented symptoms and signs (passive treatment avoidance and motor control exercise ambiguity). CONCLUSION This study identifies how assessment details lead to decisions on diverse treatment approaches for LBP, but also that treatment decisions can be based on preconceived beliefs unrelated to the clinical presentation. The results underpin the mix of knowledge sources that clinicians need to balance and the necessity of self-awareness of preconceptions for informed and meaningful clinical decision-making.
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Affiliation(s)
| | - Maria Elvén
- Mälardalen University, School of Health, Care and Social Welfare, Division of Physiotherapy, Västerås, Sweden
| | | | - Carina Boström
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden
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Polaski AM, Phelps AL, Smith TJ, Helm ER, Morone NE, Szucs KA, Kostek MC, Kolber BJ. Integrated Meditation and Exercise Therapy: A Randomized Controlled Pilot of a Combined Nonpharmacological Intervention Focused on Reducing Disability and Pain in Patients with Chronic Low Back Pain. PAIN MEDICINE 2021; 22:444-458. [PMID: 33621332 DOI: 10.1093/pm/pnaa403] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This pilot trial examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise compared with a control condition in chronic low back pain patients. We hypothesized that meditation before exercise would reduce disability, pain, and anxiety by increasing mindfulness prior to physical activity compared with an audiobook control group. PARTICIPANTS Thirty-eight adults completed either meditation and exercise treatment (MedExT) (n=18) or an audiobook control condition (n=20). SETTING Duquesne University Exercise Physiology Laboratory. DESIGN A pilot, assessor-blinded, randomized controlled trial. METHODS Over a 4-week period, participants in the MedExT group performed 12-17 minutes of guided meditation followed by 30 minutes of moderate-intensity walking exercise 5 days per week. Measures of disability, pain, mindfulness, and anxiety were taken at baseline and postintervention. Pain perception measurements were taken daily. RESULTS Compared with the control group, we observed larger improvements in disability in the MedExT intervention, although the changes were modest and not statistically significant (mean between-group difference, -1.24; 95% confidence interval [CI], -3.1 to 0.6). For secondary outcome measures, MedExT increased mindfulness (within-group) from pre-intervention to postintervention (P=0.0141). Additionally, mean ratings of low back pain intensity and unpleasantness significantly improved with time for the MedExT group compared with that of the control group, respectively (intensity P=0.0008; unpleasantness P=0.0022). CONCLUSION . Overall, 4 weeks of MedExT produced suggestive between-group trends for disability, significant between-group differences for measures of pain, and significant within-group increases in mindfulness.
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Affiliation(s)
- Anna M Polaski
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Amy L Phelps
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, USA.,Palumbo-Donahue School of Business, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Thomas J Smith
- Counseling and Wellbeing Center, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Eric R Helm
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Natalia E Morone
- Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Kimberly A Szucs
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, USA.,Department of Occupational Therapy, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Matthew C Kostek
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, USA.,Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Benedict J Kolber
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, USA.,Department of Neuroscience and Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, Texas, USA
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Xu C, Fu Z, Wang X. Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain. BMC Sports Sci Med Rehabil 2021; 13:35. [PMID: 33794983 PMCID: PMC8017650 DOI: 10.1186/s13102-021-00262-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/23/2021] [Indexed: 12/29/2022]
Abstract
Background Therapeutic training is the most commonly used treatment methods for chronic low back pain (CLBP), and the use of a pressure biofeedback unit for transversus abdominis muscle (TrA) training is one of the core muscle training methods. The study aim of this research is to explore the effects of different intensities (sham training, low-intensity and high-intensity) of TrA muscle training on people with CLBP in pressure-pain threshold (PPT). Methods A total of 45 patients with CLBP were recruited, of whom 44 were included in the analysis. Fifteen, 14, and 15 were included in the sham training group, the low-intensity group, and the high-intensity group, respectively. A pressure biofeedback unit was used in performing a one-time TrA training intervention involving 30 times of 180 mmHg TrA contraction training at high intensity for 10 min and 15 times of 100 mmHg TrA contraction training at low intensity for 5 min. The sham training group completed comfort exercises and did not undergo training. The evaluation indicators were as follows: PPT, short-form McGill pain questionnaire, and body surface pain radiation. Results High-intensity training could activate more waist core muscles than low-intensity training. Significant changes on PPT (units: kgf) were observed in the following four muscles immediately after high-intensity training: iliopsoas [0.69 (0.13–1.25) 95% CI, p = 0.020]; quadratus lumborum [0.84 (0.23–1.45) 95% CI, p = 0.012]; erector spinae [0.66 (0.18–1.15) 95% CI, p = 0.011]; transversus abdominis [0.70 (0.26–1.14) 95% CI, p = 0.004], and in three muscles after low-intensity training: quadratus lumborum [0.61 (0.17–1.05) 95% CI, p = 0.009]; transversus abdominis [0.14 (from − 0.15 to 0.43) 95% CI, p = 0.022]; piriformis [0.55 (0.13–0.98) 95% CI, p = 0.014]. The change in body surface pain radiation immediately after exercise was [− 10.87 (from − 17.51 to − 4.22) 95% CI, p = 0.003] for high-intensity training and [− 5.21 (from − 9.40 to − 1.03) 95% CI, p = 0.019] for low-intensity training. Conclusions TrA training could increase the PPT of the waist core muscles and reduce the radiation range of waist pain. The benefits of high-intensity training are higher than those of low-intensity training. Trial registration ChiCTR-TRC-13003701. Registered 18 October 2013. Code of ethical approval: 2018069.
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Affiliation(s)
- Changming Xu
- Department of Rehabilitation, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zhiwei Fu
- Department of Bone and Joint Surgery, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China. .,Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospitai, Shanghai, China.
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Pharmacological and non-pharmacological treatment approaches to chronic lumbar back pain. Turk J Phys Med Rehabil 2021; 67:1-10. [PMID: 33948537 PMCID: PMC8088811 DOI: 10.5606/tftrd.2021.8216] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/01/2021] [Indexed: 12/14/2022] Open
Abstract
Low back pain is a common and important cause of disability. Chronic pain increases disability and cost. In this review, we discuss pharmacological and non-pharmacological treatment approaches for chronic low back pain in the light of current data and guidelines.
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Postural Stability in Individuals with and without Sacroiliac Joint Dysfunction Before and After Pelvic Belt Application. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.106242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Sacroiliac Joint Dysfunction (SIJD) is considered an origin of low-back pain. It can change the motor control strategy and postural control (PC). Objectives: We aimed to find any probable differences in PC between subjects with and without SIJD and determine the effects of the pelvic belt (PB) on PC. Methods: Thirty-eight subjects were assigned into two equal groups with and without SIJD. They started to walk from the place marked on a force plate for 10 seconds after hearing an auditory signal and performed three attempts for each foot. They repeated six more ones with PB. Raw data were imported to an excel software (version 2007) spreadsheet to calculate the reaction time (RT) and anticipatory postural adjustment (APA) as the components of PC. Results: Our results showed a significant difference in RT between the SIJD-affected and non-affected sides (P = 0.035), but there was no significant difference in APA (P = 0.057). There were significant differences in RT and APAs between the control and SIJD-affected side groups (P = 0.001 and P = 0.010, respectively). The PB application showed a significant difference in RT and APAs of the SIJD-affected side (P = 0.001 and P = 0.047, respectively). Conclusions: It seems pain could lead to the postural sway into instability and change the motor control strategy. The proprioception signals from the neuromuscular system of SIJ improved after PB. Therefore, PB, as a feasible tool, can be recommended for PC improvement.
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