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Orenius TI, Ristolainen L, Silén E, Hurri H. The Efficacy and Feasibility of an Interoceptive Exposure Technique for Preventing the Transition From Subacute to Chronic Back Pain by Altering the Emotional Response to Pain: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e45701. [PMID: 37856182 PMCID: PMC10623225 DOI: 10.2196/45701] [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: 03/17/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Psychological factors such as stress, anxiety, mood, emotions, cognitive functioning, and pain behavior are relevant to the onset of pain and its continuation in the transition to chronic conditions. Subacute low back pain (LBP), a precursor to chronic LBP, is particularly poorly understood, and its relationships with psychological factors are understudied. OBJECTIVE We will conduct a study aiming to prevent the chronicity of subacute LBP by altering the emotional response to pain using an interoceptive exposure technique (IET). Considering the recent increase in knowledge about psychological risk factors, as well as recent findings in cognitive neuroscience regarding emotional and cognitive background factors in the LBP chronicity process, efforts should be made to discover effective preventive methods. METHODS We present a novel method aiming to prevent the transition from subacute to chronic back pain by altering the emotional response to pain using an IET. In this pilot randomized controlled trial, participants who are at a higher risk of LBP chronification due to the presence of a biomarker (ie, functional connectivity between the medial prefrontal cortex and nucleus accumbens) will be randomly assigned to the IET intervention group or control group A (treatment as usual). Participants who do not present with the biomarker will be assigned to control group B (treatment as usual) to assess how well this biomarker predicts the chronification of subacute LBP in this study population. Questionnaires measuring the pain experience and psychological distress will be used before the intervention, after the intervention (at 3 months), and at the 12-month follow-up. RESULTS This research project will combine 2 novel methods: a biomarker as the inclusion criterion and an IET as the intervention. The comparative study design enables evaluation of the efficacy of the IET, as well as replication of the biomarker's validity as a possible clinical screening method. CONCLUSIONS If found to be useful, the IET would offer a cost-effective and reasonable way to develop treatment for acute and subacute back pain conditions. Potential benefits include increased pain management and quality of life for the individual patient with the addition of a potentially useful functional pain management method at the societal level. TRIAL REGISTRATION ClinicalTrials.gov NCT05450263; https://clinicaltrials.gov/ct2/show/NCT05450263. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45701.
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Affiliation(s)
| | | | - Esko Silén
- Research Institute Orton, Helsinki, Finland
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Liew S. Is elective spinal surgery overused in private health care in Australia? Med J Aust 2023; 219:299-300. [PMID: 37670472 DOI: 10.5694/mja2.52094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
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Malik KN, Giberson C, Ballard M, Camp N, Chan J. Pain Management Interventions in Lumbar Spinal Stenosis: A Literature Review. Cureus 2023; 15:e44116. [PMID: 37753034 PMCID: PMC10518428 DOI: 10.7759/cureus.44116] [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: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Lumbar spinal stenosis (LSS) occurs due to the narrowing of the space within the vertebral canal and or intervertebral foramina. This results in the compression of the spinal cord and possibly the roots of the spinal nerves. Lower back pain and neurogenic claudication (NC) are major symptoms of spinal stenosis. This is a literature review that summarizes the important findings pertaining to pain management of spinal stenosis. Twenty-four original articles were assessed. Pain can be treated through non-invasive or surgical methods. Conservative techniques include physical exercises, epidural corticosteroid injection, local anesthetic injection therapy, and oral analgesics. Surgical intervention deals with the decompression of the affected spinal region, with or without vertebral fusion surgery. Other novel surgical techniques include implantation of specific equipment, known as interspinous spacer devices and minimally invasive lumbar decompression (MILD). Most studies offering a comparative analysis have demonstrated that surgical intervention is more efficacious than non-surgical interventions to manage pain associated with spinal stenosis.
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Affiliation(s)
- Kashif N Malik
- Physical Medicine and Rehabilitation, Casa Colina Hospital, Pomona, USA
| | - Curren Giberson
- Physical Medicine and Rehabilitation, Casa Colina Hospital, Pomona, USA
| | - Matthew Ballard
- Physical Medicine and Rehabilitation, Casa Colina Hospital, Pomona, USA
| | - Nathan Camp
- Physical Medicine and Rehabilitation, Casa Colina Hospital, Pomona, USA
| | - Justin Chan
- Physical Medicine and Rehabilitation, Western University of Health Sciences, Pomona, USA
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Tesfaye AH, Abere G, Mekonnen TH, Jara AG, Aragaw FM. A systematic review and meta-analysis of low back pain and its associated factors among school teachers in Africa. BMC Musculoskelet Disord 2023; 24:499. [PMID: 37330490 DOI: 10.1186/s12891-023-06633-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023] Open
Abstract
INTRODUCTION Low back pain (LBP) is a key social, economic, and public health problem in the world. The impact of LBP is given less priority and is empirically unrepresented in low- and middle-income countries as a result of the focus on more pressing and life-threatening health issues, including infectious diseases. In Africa, the prevalence of LBP is irregular and increasing among schoolteachers on account of teaching activities performed under suboptimal working conditions. Therefore, the objective of this review was to estimate the pooled prevalence and associated factors of LBP among school teachers in Africa. METHODS This systematic review and meta-analysis was designed based on the PRISMA guidelines. A comprehensive systematic literature search focused on LBP in African school teachers was conducted using the PubMed/MEDLINE, CINAHL, and CABI databases, regardless of publication timelines, from October 20 to December 3, 2022. In addition, gray literature was searched using Google Scholar and Google Search. Data were extracted in Microsoft Excel by using the JBI data extraction checklist. The overall effect of LBP was estimated using a random effect model via DerSimonian-Laird weights. The pooled prevalence and odds ratio of associated factors with 95% CI were computed using STATA 14/SE software. The I2 test and Egger's regression test were used to assess heterogeneity and publication bias, respectively. RESULTS A total of 585 articles were retrieved, and 11 eligible studies involving a total of 5,805 school teachers were included in this systematic review and meta-analysis. The overall estimated pooled prevalence of LBP in African school teachers was found to be 59.0% (95% CI: 52.0%-65.0%). Being female [POR: 1.53; 95% CI (1.19, 1.98)], being older [POR: 1.58; 95% CI (1.04, 2.40)], being physically inactive [POR: 1.92; 95% CI (1.04, 3.52)], having sleep problems [POR: 2.03; 95% CI (1.19, 3.44)] and having a history of injury [POR: 1.92; 95% CI (1.67, 2.21)] were factors significantly associated with LBP. CONCLUSIONS The pooled prevalence of LBP was high among school teachers in Africa compared to developed nations. Sex (female), older age, physical inactivity, sleep problems, and a history of previous injury were predictors of LBP. It is suggested that policymakers and administrators ought to gain awareness of LBP and its risk factors to put existing LBP preventive and control measures into action. Prophylactic management and therapeutic strategies for people with LBP should also be endorsed.
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Affiliation(s)
- Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Giziew Abere
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Tesfaye Hambisa Mekonnen
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Abdisa Gemedi Jara
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Yabe Y, Hagiwara Y, Sugawara Y, Tsuji I. Association between low back pain and functional disability in the elderly people: a 4-year longitudinal study after the great East Japan earthquake. BMC Geriatr 2022; 22:930. [PMID: 36460950 PMCID: PMC9716857 DOI: 10.1186/s12877-022-03655-7] [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: 09/16/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Functional disability is a major health issue in an aging population. Low back pain (LBP) is a common health concern that can lead to functional disability in the elderly; nonetheless, their association has not yet been clarified. This study aimed to examine the association between LBP and functional disability in the elderly, with a focus on its dose-dependent effects. METHODS This study used the 4-year longitudinal data of people living in disaster-affected areas after the Great East Japan Earthquake (aged ≧65, n = 914). LBP and physical function were assessed at 2, 4, and 6 years after the disaster. Multivariate logistic regression analyses were performed to assess the association between LBP and low physical function, as well as the effect of preceding LBP on the onset of low physical function. RESULTS LBP was significantly associated with low physical function, and the association became stronger as the duration of LBP increased. Adjusted odds ratios (95% confidence intervals) were 1.27 (0.79-2.06) in "< 2 years," 1.95 (1.01-3.77) in "≥2 years and <4 years," and 2.34 (1.35-4.06) in "≥4 years" (p for trend = 0.009). Additionally, preceding LBP was significantly associated with the onset of low physical function, and the effect became prominent as the duration of LBP increased. Adjusted odds ratios (95% confidence intervals) were 2.28 (1.19-4.37) in "< 2 years" and 2.82 (1.35-5.90) in "≥2 years" (p for trend = 0.003). CONCLUSIONS LBP is associated with physical disability among the elderly in a dose-dependent manner. Therefore, prevention and treatment of LBP are important for preventing functional disability.
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Affiliation(s)
- Yutaka Yabe
- Department of Orthopedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Yoshihiro Hagiwara
- grid.69566.3a0000 0001 2248 6943Department of Orthopedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574 Japan
| | - Yumi Sugawara
- grid.69566.3a0000 0001 2248 6943Department of Health Informatics and Public Health, Division of Epidemiology, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Ichiro Tsuji
- grid.69566.3a0000 0001 2248 6943Department of Health Informatics and Public Health, Division of Epidemiology, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
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Orenius T, Silén E, Nuortimo A, Ristolainen L. Psychological interventions in preventing chronicity of sub-acute back pain: a systematic review. Scand J Pain 2022; 22:211-217. [PMID: 35073473 DOI: 10.1515/sjpain-2021-0063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/22/2021] [Indexed: 02/28/2024]
Abstract
OBJECTIVES There is scarce information on preventive psychological and behavioural methods applicable to sub-acute (4-12 weeks) back pain, a precursor to chronic back pain. We conducted a systematic literature review of the efficacy of psychological interventions in preventing chronicity of sub-acute back pain. METHODS A systematic literature search in CINAHL, CENTRAL, MEDLINE, PubMed®, PsychINFO, Scopus and Web of Science databases. RESULTS From a total of 271 records, only three studies met the eligibility criteria. In two of the reviewed studies, the interventions had an insignificant preventive impact on the chronification of back pain. In one study the CBT intervention proved promising in preventing back pain related disability. None of the studies reported a significant impact on pain intensity at follow-up. CONCLUSIONS The psychological interventions did not impact pain outcomes. There is a disproportion between novel knowledge on psychological factors involved in the transition to chronic pain and corresponding preventive treatments. Additional studies on psychological interventions on sub-acute back pain prevention are highly warranted due to the enormous burden that back pain creates when it becomes chronic. The research project has the ethical approval of the Research Ethical Committee at Helsinki University Hospital, HUS/2435/2017.
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Affiliation(s)
- Tage Orenius
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland
| | - Esko Silén
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland
- Terveystalo, Helsinki, Finland
- Pohjola Hospital, Helsinki, Finland
| | - Antti Nuortimo
- Department of Mathematics and Statistics, Faculty of Science, University of Helsinki, Helsinki, Finland
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Li T, Wang S, Cheng K, Sun L, Jin D, Zhang S, Yang Z, Huang Z. Comparing the efficacy of two different temperature stimulation in warm acupuncture on acute low back pain: A randomized controlled trial. Integr Med Res 2022; 11:100748. [PMID: 34189032 PMCID: PMC8217681 DOI: 10.1016/j.imr.2021.100748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Warm acupuncture, a combination of the mechanical stimulation of acupuncture and thermal stimulation of moxibustion, is commonly used in treating acute low back pain (LBP). This trial aimed to compare the efficacy of stronger (above 43°C) and weaker (above 40°C) heat stimulation in warm acupuncture on the function and pain in patients with acute LBP due to lumbosacral disc degeneration (LDD). METHODS One hundred and fifty-nine adults were randomly assigned to receive warm acupuncture treatment with silver needle (SvN) or with stainless steel needle (SSN) (1:1). Both groups received a 3-week therapy with 3 sessions per week. The primary outcome was the modified Oswestry Disability Index at week 4. The secondary outcomes included average pain, three physical sign tests and adverse events. Participants were followed up at week 16 and week 28 after randomization. RESULTS The LBP related disability and pain intensity significantly relieved more in the SvN warm acupuncture group than in the SSN group, in both the short and long term (p<0.001). The between-groups difference in physical signs showed statistical significance only in the short term (p = 0.024), but not in long term (p = 0.081; p = 0.069). CONCLUSION Compared with warm acupuncture with stainless-steel needle at above 40°C, warm acupuncture with silver needle at above 43°C relieved more disability and pain in patients with acute LBP due to LDD. STUDY REGISTRATION Chinese Clinical Trial Registry (ChiCTR1800019051).
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Affiliation(s)
- Tian Li
- Shanghai Pudong Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Siyao Wang
- Shanghai Pudong Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Ke Cheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lu Sun
- Shanghai Jing'an District Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Daopeng Jin
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shen Zhang
- Shanghai Pudong Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Zhen Yang
- Shanghai Pudong Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Zouqin Huang
- Shanghai Pudong Hospital of Traditional Chinese Medicine, Shanghai, China
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Ahmed UA, Maharaj SS, Van Oosterwijck J. Effects of dynamic stabilization exercises and muscle energy technique on selected biopsychosocial outcomes for patients with chronic non-specific low back pain: a double-blind randomized controlled trial. Scand J Pain 2021; 21:495-511. [PMID: 33641272 DOI: 10.1515/sjpain-2020-0133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/12/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Low back pain is the most prevalent musculoskeletal condition, and causes activity limitations which result in reduced work productivity and high medical expenditure. The management of this condition has been challenging to both clinicians and researchers. While the use of Muscle Energy Technique (MET) as a potentially effective treatment strategy seems promising, studies examining MET combined with exercise therapy are scarce and studies with strong methodology are lacking. Therefore, this study aims to determine the effects of a combination of Dynamic Stabilization Exercises (DSE) and MET on selected biopsychosocial outcomes compared to DSE alone or conventional physiotherapy in the management of chronic non-specific low back pain (NSLBP). METHODS A total of 125 (80 male and 45 female) patients with chronic NSLBP were involved in this study, they were recruited from Rasheed Shekoni Teaching hospital and Federal Medical centre Birnin-Kudu, Jigawa State, Nigeria. A random number generator method was used to allocate patients to either DSE + MET (n=41), DSE alone (n=39) or conventional physiotherapy (n=45). Interventions were administered twice a week over 12 weeks. Outcome measures included pain intensity, lumbar (flexion and extension) range of motion, functional-disability, self-perceived health status, limitations in activities and participation restrictions. These were assessed at baseline, mid-intervention at six weeks, post-intervention at 12 weeks and long term follow-up at 24 weeks. Data was analyzed using repeated-measures ANOVA to determine significance difference within groups and between groups. RESULTS All intervention groups showed within-groups changes of the study outcomes over time (p<0.001). However, between-group comparisons showed greater improvements in pain intensity (F=7.91, p<0.001), lumbar ROM (flexion F=1.51, p<0.001; extension F=3.25, p<0.001), activity limitations/participation restrictions (F=3.7, p<0.001) and health status (F=10.9, p<0.001) for the intervention in which MET and DSE were combined. The MET plus DSE interventions were superior to DSE and convention physiotherapy for all outcome measures, except for functional disability (F=0.53, p=0.590). CONCLUSIONS The data from this study showed MET combined with DSE had greater therapeutic benefits compared to DSE or conventional physiotherapy on selected biopsychosocial outcomes in patients with chronic NSLBP. The findings from the study show that the combination of MET with DSE is safe and has beneficial effects in the management of patients with chronic NSLBP. CLINICAL TRIAL REGISTRATION The study protocol has been registered with www.ClinicalTrial.gov with the registration number NCT3449810.
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Affiliation(s)
- Usman Abba Ahmed
- Department of Physiotherapy, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sonill Sooknunan Maharaj
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Jessica Van Oosterwijck
- Department of Rehabilitation Sciences, SPINE Research Unit Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Research Foundation - Flanders (FWO), Brussels, Belgium
- Pain in Motion, International Research Group, Brussels, Belgium
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Ahmed UA, Nadasan T, Van Oosterwijck J, Maharaj SS. The effect of muscles energy technique in the management of chronic mechanical low back pain: A scoping review. J Back Musculoskelet Rehabil 2021; 34:179-193. [PMID: 33164923 DOI: 10.3233/bmr-200011] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Muscle Energy Technique (MET) is one of the treatments of choice for the management of chronic mechanical low back pain (MLBP); however, there is a paucity of evidence to justify its effectiveness. OBJECTIVES The objectives of this review are to explore, analyze and summarize the available evidence related to the effectiveness of MET in the management of chronic MLBP. METHOD The scoping review methodology was adopted based on a recommendation from the work of Arksey and O'Malley, to systematically appraise literature and map the existing evidence on the effectiveness of MET in the management of chronic MLBP. A systematic search was performed comprising of an electronic search of online databases using key search terms and subsided by a hand search to identify the existing literature on the topic which was summarized and discussed. RESULT Initially 25,195 hits were identified which were screened to examine their eligibility based on predetermined inclusion criteria after removing duplicate articles. Eleven articles met the inclusion criteria and were discussed. CONCLUSIONS Generally there exists a scarcity of published articles on the effect of MET in chronic MLBP. However, the analysis of the retrieved articles showed that the MET procedure is a favourable intervention that is safe (i.e. no adverse effects) and can be effective as a standalone treatment or in combination with other treatment strategies for patients with chronic MLBP with the potential to provide numerous physical and psychosocial benefits.
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Affiliation(s)
- Usman Abba Ahmed
- Department of Physiotherapy, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria.,Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thayananthee Nadasan
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Jessica Van Oosterwijck
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Research Foundation - Flanders (FWO), Brussels, Belgium.,Pain in Motion, International Research Group, Belgium
| | - Sonill Sooknunan Maharaj
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Abstract
STUDY DESIGN A longitudinal panel study. OBJECTIVE The aim of this study was to examine the occurrence of low back pain (LBP), especially the association of previous LBP with further episodes of LBP, in survivors of the Great East Japan Earthquake (GEJE) during the course of 5 years. SUMMARY OF BACKGROUND DATA LBP is common among survivors of natural disasters, but its long-term course is not clear. METHODS A 5-year longitudinal study was conducted among survivors of the GEJE (n = 1821). The presence of LBP was assessed using a self-reported questionnaire at 2, 4, and 7 years after the disaster (termed the first, second, and third time points, respectively). Multiple logistic regression analysis was performed to assess a potential association between LBP at the first and second time points with LBP at the third time point, and the odds ratios (ORs) and 95% confidence intervals (CI) were calculated. RESULTS The prevalence of LBP was 25.3%, 27.3%, and 27.2% at the first, second, and third time points, respectively. The occurrence of LBP at the first time point was significantly associated with LBP at the third time point, and the adjusted odds ratio (OR) (95% confidence interval [CI]) was 5.47 (4.28-6.98). Furthermore, LBP at the first and second time points was significantly associated with LBP at the third time point. Compared to no LBP at the first and second time points, the adjusted OR (95% CIs) for LBP at the third time point was 4.12 (3.14-5.41) in the case of LBP at either of the first or second time points and 10.73 (7.80-14.76) for LBP at both time points (P for trend < 0.001). CONCLUSION Previous LBP was associated with LBP 5 years later among survivors of the GEJE. Furthermore, the effect on subsequent LBP was stronger with a higher frequency of previous LBP episodes.Level of Evidence: 3.
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Rajasekaran S, Dilip Chand Raja S, Pushpa BT, Ananda KB, Ajoy Prasad S, Rishi MK. The catastrophization effects of an MRI report on the patient and surgeon and the benefits of 'clinical reporting': results from an RCT and blinded trials. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2069-2081. [PMID: 33748882 DOI: 10.1007/s00586-021-06809-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/05/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Inappropriate use of MRI leads to increasing interventions and surgeries for low back pain (LBP). We probed the potential effects of a routine MRI report on the patient's perception of his spine and functional outcome of treatment. An alternate 'clinical reporting' was developed and tested for benefits on LBP perception. METHODS In Phase-I, 44 LBP patients were randomized to Group A who had a factual explanation of their MRI report or Group B, who were reassured that the MRI findings showed normal changes. The outcome was compared at 6 weeks by VAS, PSEQ-2, and SF-12. In Phase-II, clinical reporting was developed, avoiding potential catastrophizing terminologies. In Phase-III, 20 MRIs were reported by both routine and clinical methods. The effects of the two methods were tested on four categories of health care professionals (HCP) who read them blinded on their assessment of severity of disease, possible treatment required, and the probability of surgery. RESULTS Both groups were comparable initial by demographics and pain. After 6 weeks of treatment, Group A had a more negative perception of their spinal condition, increased catastrophization, decreased pain improvement, and poorer functional status(p = significant for all). The alternate method of clinical reporting had significant benefits in assessment of lesser severity of the disease, shift to lesser severity of intervention and surgery in three groups of HCPs. CONCLUSION Routine MRI reports produce a negative perception and poor functional outcomes in LBP. Focussed clinical reporting had significant benefits, which calls for the need for 'clinical reporting' rather than 'Image reporting'.
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Affiliation(s)
- S Rajasekaran
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India.
| | - S Dilip Chand Raja
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India
| | | | - Kumar Behera Ananda
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India
| | - Shetty Ajoy Prasad
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India
| | - Mugesh Kanna Rishi
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India
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Ahmed UA, Maharaj SS, Nadasan T, Kaka B. Cross-cultural adaptation and psychometric validation of the Hausa version of Örebro Musculoskeletal Pain Screening Questionnaire in patients with non-specific low back pain. Scand J Pain 2021; 21:103-111. [PMID: 32892191 DOI: 10.1515/sjpain-2020-0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) is widely used in clinical practice and for research purpose to screen the risk of chronicity in patients with Non-specific low back pain (NSLBP). The questionnaire has been cross-culturally adapted into different languages, but to date, there has not been Hausa version of the questionnaire. This study is important as the Hausa language is widely spoken across sub-Saharan Africa. The study aims to cross-culturally translate the English version of the (OMPSQ) into Hausa language (OMPSQ-H) and to test its psychometric properties in Hausa patients with NSLBP. METHODS This observational study involved the use of forward-backwards translation method for the English version of OMPSQ. Thus, 124 male and female participants with subacute NSLBP were recruited using convenient sampling techniques. The psychometric properties statistically tested included reliability, internal-consistency, ceiling and floor effects, acceptability and construct validity. RESULTS The Hausa version of OMPSQ has demonstrated good reliability (ICC=0.82) and internal consistency (Cronbach's alpha=0.72) with good acceptability as all questions were answered in 5 min. Responsiveness was adequate as OMPSQ-H retest scores demonstrated good correlation with the global rating of change scale scores (r=0.67, p=0.01). Construct validity was evaluated using principal component analysis and it reveals six components structure for the OMPSQ-H. CONCLUSIONS The OMPSQ-H was successfully translated and cross-culturally adapted with no problem of comprehension. Moreover, it has shown adequate psychometric properties in terms of internal consistency, reliability, responsiveness and constructs validity. Consequently, the OMPSQ-H can be considered as a valid tool for identifying and screening both psychosocial risk factors and risk of chronicity of NSLBP in Hausa population.
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Affiliation(s)
- Usman Abba Ahmed
- Department of Physiotherapy, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria.,Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sonill S Maharaj
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thayananthee Nadasan
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Bashir Kaka
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
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Lan T, Shiyu-Hu, Shen Z, Yan B, Chen J. New insights into the interplay between miRNAs and autophagy in the aging of intervertebral discs. Ageing Res Rev 2021; 65:101227. [PMID: 33238206 DOI: 10.1016/j.arr.2020.101227] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023]
Abstract
Intervertebral disc degeneration (IDD) has been widely known as a main contributor to low back pain which has a negative socioeconomic impact worldwide. However, the underlying mechanism remains unclear. MicroRNAs (miRNAs) are a class of small noncoding RNAs that post-transcriptionally regulate gene expression and serve key roles in the ageing process of intervertebral disc. Autophagy is an evolutionarily conserved process that maintains cellular homeostasis through recycling of nutrients and degradation of damaged or aged cytoplasmic organelles. Autophagy has been proposed as a "double-edged sword" and autophagy dysfunction of IVD cells is considered as a crucial reason of IDD. A rapidly growing number of recent studies demonstrate that both miRNAs and autophagy play important roles in the progression of IDD. Furthermore, accumulated research has indicated that miRNAs target autophagy-related genes and influence the onset and development of IDD. Hence, this review focuses mainly on the current findings regarding the correlations between miRNA, autophagy, and IDD and provides new insights into the role of miRNA-autophagy pathway involved in IDD pathophysiology.
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Sturion LA, Nowotny AH, Barillec F, Barette G, Santos GK, Teixeira FA, Fernandes KP, da Silva R. Comparison between high-velocity low-amplitude manipulation and muscle energy technique on pain and trunk neuromuscular postural control in male workers with chronic low back pain: A randomised crossover trial. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2020; 76:1420. [PMID: 33241157 PMCID: PMC7669951 DOI: 10.4102/sajp.v76i1.1420] [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: 12/13/2019] [Accepted: 07/14/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A therapeutic recommendation for restoring function in individuals with chronic low back pain (CLBP) is manual therapy through manipulative spinal or muscle energy techniques. OBJECTIVES To compare the effectiveness of two osteopathic manipulative techniques on clinical low back symptoms and trunk neuromuscular postural control in male workers with CLBP. METHOD Ten male workers with CLBP were randomly allocated to two groups: high-velocity low-amplitude (HVLA) manipulation or muscle energy techniques (MET). Each group received one therapy per week for both techniques during 7 weeks of treatment. Pain and function were measured by using the Numeric Pain-Rating Scale, the McGill Pain Questionnaire and the Roland Morris Disability Questionnaire. The lumbar flexibility was assessed by Modified Schober Test. Electromyography (EMG) and force platform measurements were used for evaluation of trunk muscular activation and postural balance, respectively at three different times: baseline, post intervention, and 15 days later. RESULTS Both techniques were effective (p < 0.01) in reducing pain with large clinical differences (-1.8 to -2.8) across immediate and after 15 days. However, no significant effect between groups and times was found for other variables, namely neuromuscular activation and postural balance measures. CONCLUSION Both techniques (HVLA thrust manipulation and MET) were effective in reducing back pain immediately and 15 days later. Neither technique changed the trunk neuromuscular activation patterns nor postural balance in male workers with LBP. CLINICAL IMPLICATIONS These results may facilitate clinical decision-making for CLBP management in physiotherapy programs.
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Affiliation(s)
- Leandro A. Sturion
- Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
| | - Alexandre H. Nowotny
- Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
| | - Fabrice Barillec
- Département des Thérapie Manuelle, Gilles Barette Formations, Saint Cyr du Ronceray, Valorbiquet, France
| | - Gilles Barette
- Département des Cadre de santé-kinésithérapeute, Thérapie Manuelle, Gilles Barette Formations, Valorbiquet, France
| | - Gabriela K. Santos
- Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
| | | | - Karen P. Fernandes
- Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
| | - Rubens da Silva
- Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
- Département des sciences de la santé, Lab BioNR, CUpht, Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
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Sanchis-Sánchez E, Lluch-Girbés E, Guillart-Castells P, Georgieva S, García-Molina P, Blasco JM. Effectiveness of mechanical diagnosis and therapy in patients with non-specific chronic low back pain: a literature review with meta-analysis. Braz J Phys Ther 2020; 25:117-134. [PMID: 32773288 DOI: 10.1016/j.bjpt.2020.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/06/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of mechanical diagnosis and therapy (MDT) in patients with chronic low back pain (CLBP) compared to other traditional physical therapy interventions. METHODS Randomized controlled trials investigating the effect of MDT compared to other traditional physical therapy interventions in individuals with CLBP were considered eligible. For the purpose of this review, MDT was compared to active and passive physical therapy interventions. Independent reviewers assessed the eligibility of studies, extracted data, and assessed the risk of bias. The primary outcomes investigated were pain and disability. RESULTS Fourteen studies were included in the review. Of these, 11 provided data to be included in the meta-analyses. Our findings showed that MDT was no more effective in decreasing pain (standardized mean difference [SMD]=0.01, 95% confidence interval [CI]: -0.44, 0.46) and disability (SMD=0.08, 95% CI: -0.53, 0.68) than other active treatments. Similar results were found when comparing MDT to other passive treatments for pain (SMD=-0.39, 95% CI: -0.90, 0.11) and disability (SMD=-0.13, 95% CI: -0.29, 0.03). CONCLUSION There is low to moderate quality evidence that MDT is not superior than other traditional physical therapy interventions in improving pain and disability in people with CLBP.
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Affiliation(s)
- Enrique Sanchis-Sánchez
- Department of Physical Therapy, University of Valencia, Valencia, Spain; IRIMED Joint Research Unit (La Fe - UV), Valencia, Spain
| | - Enrique Lluch-Girbés
- Department of Physical Therapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group, Department of Human Physiology (Chropiver), Vrije Universiteit, Brussels, Belgium.
| | | | - Sylvia Georgieva
- Department of Methodology and Behavioral Sciences, University of Valencia, Valencia, Spain
| | | | - Jose-María Blasco
- Department of Physical Therapy, University of Valencia, Valencia, Spain; Group of Physiotherapy in the Ageing Processes: Socio-sanitary and Healthcare Strategies, Valencia, Spain; IRIMED Joint Research Unit (La Fe - UV), Valencia, Spain
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Ahmed UA, Nadasan T, Van Oosterwijck J, Maharaj SS. Effect of dynamic stabilisation exercise therapy enhanced with muscles energy technique on some selected patients outcomes and trunk muscles function in patients with chronic non-specific low back pain: a study protocol. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1748710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Usman Abba Ahmed
- Department of Physiotherapy, Rasheed Shekoni Specialist Hospital, Dutse, Nigeria
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thaya Nadasan
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Jessica Van Oosterwijck
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Research Foundation – Flanders (FWO), Brussels, Belgium
- Pain in Motion, International Research Group
| | - Sonill Sooknunan Maharaj
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Mukasa D, Sung J. A prediction model of low back pain risk: a population based cohort study in Korea. Korean J Pain 2020; 33:153-165. [PMID: 32235016 PMCID: PMC7136293 DOI: 10.3344/kjp.2020.33.2.153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/19/2019] [Accepted: 01/01/2020] [Indexed: 12/27/2022] Open
Abstract
Background Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service–National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell’s C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.
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Affiliation(s)
- David Mukasa
- Complex Diseases & Genome Epidemiology Branch, Division of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
| | - Joohon Sung
- Complex Diseases & Genome Epidemiology Branch, Division of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea.,Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea
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Kahere M, Ginindza T. Mapping evidence on the prevalence, incidence, risk factors and cost associated with chronic low back pain among adults in Sub-Saharan Africa: a systematic scoping review protocol. Syst Rev 2020; 9:57. [PMID: 32183868 PMCID: PMC7077148 DOI: 10.1186/s13643-020-01321-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 03/06/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Globally, low back pain (LBP) is a major public health problem affecting mainly adults of the working class and is the leading cause of disability. The estimated lifetime prevalence of LBP is 50 to 80%. From 1990 to 2015, the years lived with disability caused by LBP have scaled up by 54% with the greatest increase observed in low-middle-income countries (LMICs). LBP poses a significant socio-economic burden to the society regardless of all the technological advancement in diagnosis and intervention approaches in recent years. Despite an increase in the literature of LBP in LMICs, chronic low back pain (CLBP) is poorly investigated yet it is responsible for the largest amount of burden. The purpose of this scoping review is to map the existing evidence on the prevalence, incidence, mortality, risk factors, and cost associated with CLBP among adults in Sub-Saharan Africa (SSA). METHODS We will conduct a scoping review to explore, describe, and map literature on the prevalence, incidence, mortality, risk factors, and costs associated with CLBP among adults in SSA. The search will be performed using the EBSCOhost platform by searching the following databases within the platform: Academic search complete, health source: nursing/academic edition, CINAHL with full text, Embase, PubMed, MEDLINE, Science Direct databases, Google Scholar, and the World Health Organization library databases. The search will include peer-reviewed, review articles, and gray literature. The first (title and abstract) and the second (full text) screening phases will be performed by two independent reviewers, with the third reviewer employed to adjudicate discrepancies. The reference list of all included articles will also be searched for eligible articles. This scoping review will be reported in accordance to the MOOSE and PRISMA-ScR guidelines. The NVivo 12 data analysis software will be used to generate themes, and a thematic content analysis will be used to give the narrative account of the review. DISCUSSION The study anticipates finding relevant literature on the prevalence, incidence, risk factors, mortality, and cost associated with CLBP among adults in SSA. The study outcomes will aid in identifying research gaps, planning, informing policy, commissioning of future research, and funding prioritization.
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Affiliation(s)
- Morris Kahere
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, Durban, 4041, South Africa.
| | - Themba Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, Durban, 4041, South Africa
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Truumees E, Macadaeg K, Pena E, Arbuckle J, Gentile J, Funk R, Singh D, Vinayek S. A prospective, open-label, single-arm, multi-center study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:1594-1602. [DOI: 10.1007/s00586-019-05995-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/28/2019] [Accepted: 05/01/2019] [Indexed: 12/21/2022]
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Locks F, Gupta N, Hallman D, Birk Jørgensen M, Oliveira AB, Holtermann A. Association between objectively measured static standing and low back pain - a cross-sectional study among blue-collar workers. ERGONOMICS 2018; 61:1196-1207. [PMID: 29560812 DOI: 10.1080/00140139.2018.1455900] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/14/2018] [Indexed: 06/08/2023]
Abstract
This study aims to investigate the cross-sectional association between objectively measured total time and temporal patterns of static standing (short bouts: 0-5 min; moderate bouts: >5-10 min; and long bouts: >10 min) during work and leisure and low back pain (LBP) among 698 blue-collar workers. Workers reported LBP on a 0-10 scale. The association between time spent on static standing and LBP was tested with linear regression. A positive association with LBP intensity was found for long bouts of static standing (β = 0.27) during total day (work + leisure), and total static standing time at leisure (β = 0.12). No significant associations were found for static standing during work and LBP intensity. These findings indicate that particularly long bouts of static standing over the entire day contribute to LBP in blue-collar workers. Practitioner Summary: The association between LBP and static standing time was investigated. This study indicates that prolonged time standing during total day and standing during leisure are positively associated with LBP among blue-collar workers. Therefore, practitioners should consider long periods of standing as a potential risk factor for LBP.
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Affiliation(s)
- Francisco Locks
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Nidhi Gupta
- b National Research Centre for the Working Environment , Copenhagen , Denmark
| | - David Hallman
- c Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research , University of Gävle , Gävle , Sweden
| | | | - Ana Beatriz Oliveira
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Andreas Holtermann
- b National Research Centre for the Working Environment , Copenhagen , Denmark
- d Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark
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Morris LD, Daniels KJ, Ganguli B, Louw QA. An update on the prevalence of low back pain in Africa: a systematic review and meta-analyses. BMC Musculoskelet Disord 2018; 19:196. [PMID: 30037323 PMCID: PMC6055346 DOI: 10.1186/s12891-018-2075-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 05/04/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Low back pain (LBP) remains a common health problem and one of the most prevalent musculoskeletal conditions found among developed and developing nations. The following paper reports on an updated search of the current literature into the prevalence of LBP among African nations and highlights the specific challenges faced in retrieving epidemiological information in Africa. METHODS A comprehensive search of all accessible bibliographic databases was conducted. Population-based studies into the prevalence of LBP among children/adolescents and adults living in Africa were included. Methodological quality of included studies was appraised using an adapted tool. Meta-analyses, subgroup analyses, sensitivity analyses and publication bias were also conducted. RESULTS Sixty-five studies were included in this review. The majority of the studies were conducted in Nigeria (n = 31;47%) and South Africa (n = 16;25%). Forty-three included studies (66.2%) were found to be of higher methodological quality. The pooled lifetime, annual and point prevalence of LBP in Africa was 47% (95% CI 37;58); 57% (95% CI 51;63) and 39% (95% CI 30;47), respectively. CONCLUSION This review found that the lifetime, annual and point prevalence of LBP among African nations was considerably higher than or comparable to global LBP prevalence estimates reported. Due to the poor methodological quality found among many of the included studies, the over-representation of affluent countries and the difficulty in sourcing and retrieving potential African studies, it is recommended that future African LBP researchers conduct methodologically robust studies and report their findings in accessible resources. TRIAL REGISTRATION The original protocol of this systematic review was initially registered on PROSPERO with registration number CRD42014010417 on 09 July 2014.
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Affiliation(s)
- Linzette Deidrè Morris
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO BOX 241, Cape Town, 8000 South Africa
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Kurt John Daniels
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO BOX 241, Cape Town, 8000 South Africa
| | - Bhaswati Ganguli
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Quinette Abegail Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO BOX 241, Cape Town, 8000 South Africa
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Isa ILM, Srivastava A, Tiernan D, Owens P, Rooney P, Dockery P, Pandit A. Hyaluronic Acid Based Hydrogels Attenuate Inflammatory Receptors and Neurotrophins in Interleukin-1β Induced Inflammation Model of Nucleus Pulposus Cells. Biomacromolecules 2015; 16:1714-25. [DOI: 10.1021/acs.biomac.5b00168] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Isma Liza Mohd Isa
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
| | - Akshay Srivastava
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
| | - David Tiernan
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
| | - Peter Owens
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
| | - Peadar Rooney
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
| | - Peter Dockery
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
| | - Abhay Pandit
- Centre for Research in Medical Devices (CÚRAM) and ‡Centre for Microscopy and Imaging, National University of Ireland, Galway, Ireland
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Acute low back pain information online: An evaluation of quality, content accuracy and readability of related websites. ACTA ACUST UNITED AC 2012; 17:318-24. [DOI: 10.1016/j.math.2012.02.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 02/20/2012] [Accepted: 02/24/2012] [Indexed: 11/19/2022]
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The relationship between low back pain and leisure time physical activity in a working population of cleaners--a study with weekly follow-ups for 1 year. BMC Musculoskelet Disord 2012; 13:28. [PMID: 22356733 PMCID: PMC3306730 DOI: 10.1186/1471-2474-13-28] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 02/22/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low back pain (LBP) and leisure time physical activity (LTPA) are considered to be closely related, and clinical guidelines for the treatment of acute LBP recommend patients stay physically active. However, the documentation for this recommendation is sparse and based on studies involving patient populations. The purpose of the study was (1) to investigate the correlation between LBP and LTPA on a weekly basis over the course of a year in a high-risk group of cleaners; and (2) to investigate if maintaining LTPA during an episode of acute LBP has a positive effect on LBP intensity in the subsequent 4 weeks. METHODS 188 cleaners consented to participate in a 52-week text message survey about hours of LTPA and intensity of LBP (from 0 to 9) over the previous 7 days. The correlation between LBP and LTPA was calculated by Pearson correlation coefficient. During an episode of acute LBP, a mixed effect logistic regression model was used to investigate whether cleaners who maintain LTPA have a lower pain intensity and higher probability of returning to initial pain intensity within the following four weeks compared with cleaners who decrease LTPA during acute LBP. RESULTS The correlation between weekly LTPA and LBP data was negative, but numerically low (r = -0.069) and statistically insignificant (p = 0.08). Among the 82 cleaners experiencing at least one episode of acute LBP, those maintaining LTPA during an episode of acute LBP did not have a lower pain intensity (average LBP intensity difference between groups of 0.06; 95% confidence interval (95% CI) of -0.417 to 0.539) or higher probability of returning to initial pain level (Odds ratio 1,02; 95% CI of 0.50 to 2.09) in the following four weeks compared with cleaners decreasing LTPA during acute LBP. CONCLUSIONS Hours of LTPA and intensity of LBP measured on a weekly basis throughout a year showed no close correlation. Maintaining LTPA during an episode of acute LBP did not result in a positive effect on LBP in the following 4 weeks. Documentation of LTPA recommendations for acute LBP in working populations is still needed.
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Hendrick P, Milosavljevic S, Hale L, Hurley DA, McDonough S, Ryan B, Baxter GD. The relationship between physical activity and low back pain outcomes: a systematic review of observational studies. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2010; 20:464-74. [PMID: 21053026 DOI: 10.1007/s00586-010-1616-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 10/01/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
Abstract
Although clinical guidelines advocate exercise and activity in the management of non-specific low back pain (NSLBP), the link between levels of physical activity and outcomes is unclear. This systematic review investigated the relationships between free living activity levels after onset of low back pain (LBP) and measures of pain, and disability in patients with NSLBP. Cohort and cross-sectional studies were located using OVID, CINAHL, Medline, AMED, Embase, Biomed, PubMed-National Library of Medicine, Proquest and Cochrane Databases, and hand searches of reference lists. Studies were included if a statistical relationship was investigated between measures of free living physical activity (PA) in subjects with LBP and LBP outcome measures. Twelve studies (seven cohort and five cross-sectional) were included. One prospective study reported a statistically significant relationship between increased leisure time activity and improved LBP outcomes, and one cross-sectional study found that lower levels of sporting activity were associated with higher levels of pain and disability. All other studies (n = 10) found no relationship between measures of activity levels and either pain or disability. Heterogeneity of study designs, particularly in terms of activity measurement, made comparisons between studies difficult. These data suggest that the activity levels of patients with NSLBP are neither associated with, nor predictive of, disability or pain levels. Validated activity measurement in prospective research is required to better evaluate the relationships between PA and LBP.
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Affiliation(s)
- Paul Hendrick
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin, New Zealand.
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Hendrick P, Milosavljevic S, Bell ML, Hale L, Hurley DA, McDonough SM, Melloh M, Baxter DG. Does physical activity change predict functional recovery in low back pain? Protocol for a prospective cohort study. BMC Musculoskelet Disord 2009; 10:136. [PMID: 19895697 PMCID: PMC2777147 DOI: 10.1186/1471-2474-10-136] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 11/06/2009] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Activity advice and prescription are commonly used in the management of low back pain (LBP). Although there is evidence for advising patients with LBP to remain active, facilitating both recovery and return to work, to date no research has assessed whether objective measurements of free living physical activity (PA) can predict outcome, recovery and course of LBP. METHODS An observational longitudinal study will investigate PA levels in a cohort of community-dwelling working age adults with acute and sub-acute LBP. Each participant's PA level, functional status, mood, fear avoidance behaviours, and levels of pain, psychological distress and occupational activity will be measured on three occasions during for 1 week periods at baseline, 3 months, and 1 year. Physical activity levels will be measured by self report, RT3 triaxial accelerometer, and activity recall questionnaires. The primary outcome measure of functional recovery will be the Roland Morris Disability Questionnaire (RMDQ). Free living PA levels and changes in functional status will be quantified in order to look at predictive relationships between levels and changes in free living PA and functional recovery in a LBP population. DISCUSSION This research will investigate levels and changes in activity levels of an acute LBP cohort and the predictive relationship to LBP recovery. The results will assess whether occupational, psychological and behavioural factors affect the relationship between free living PA and LBP recovery. Results from this research will help to determine the strength of evidence supporting international guidelines that recommend restoration of normal activity in managing LBP. TRIAL REGISTRATION [Clinical Trial Registration Number, ACTRN12609000282280].
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Affiliation(s)
- Paul Hendrick
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Stephan Milosavljevic
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Melanie L Bell
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Leigh Hale
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Deirdre A Hurley
- School of Physiotherapy and Performance Science, College of Life Sciences, University College Dublin, Ireland
| | - Suzanne M McDonough
- Health & Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Northern Ireland
| | - Markus Melloh
- Section of Orthopaedic Surgery, Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - David G Baxter
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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