Thoughts on Pain, Physical Activity, and Body in Patients With Recurrent Low Back Pain and Fear: An Interview Study

Machine Learning Identifies Chronic Low Back Pain Patients from an Instrumented Trunk Bending and Return Test

Nowadays, the better assessment of low back pain (LBP) is an important challenge, as it is the leading musculoskeletal condition worldwide in terms of years of disability. The objective of this study was to evaluate the relevance of various machine learning (ML) algorithms and Sample Entropy (SampEn), which assesses the complexity of motion variability in identifying the condition of low back pain. Twenty chronic low-back pain (CLBP) patients and 20 healthy non-LBP participants performed 1-min repetitive bending (flexion) and return (extension) trunk movements. Analysis was performed using the time series recorded by three inertial sensors attached to the participants. It was found that SampEn was significantly lower in CLBP patients, indicating a loss of movement complexity due to LBP. Gaussian Naive Bayes ML proved to be the best of the various tested algorithms, achieving 79% accuracy in identifying CLBP patients. Angular velocity of flexion movement was the most discriminative feature in the ML analysis. This study demonstrated that: supervised ML and a complexity assessment of trunk movement variability are useful in the identification of CLBP condition, and that simple kinematic indicators are sensitive to this condition. Therefore, ML could be progressively adopted by clinicians in the assessment of CLBP patients.

"I don't opt out of things because I think I will get a sore knee, but I don't expose myself to stupid risks either": patients' experiences of a second ACL injury-an interview study

PURPOSE

The purpose of this qualitative study was to describe women's experiences with anterior cruciate ligament reconstruction (ACLR) and a subsequent ACL rupture, and to identify potential facilitators and barriers for coping with rehabilitation after the second injury.

METHODS

Eight women between 17 and 36 years (mean 26, SD 6.5) who had experienced ACLR, followed by another ACL rupture, participated in the study. Semi-structured interviews were conducted, and data were analyzed using qualitative content analysis.

RESULTS

One overarching theme, "Rehabilitation after a second ACL injury-A lifelong adaptive coping process", emerged from analyses. Undergoing a second rehabilitation is described as a process of adaptation, beginning with the first injury and still ongoing, more than 5 years later. Participants applied different coping strategies to adapt to these life-altering injuries, but the common denominator was of major life adjustments with no return to previous activity levels. Initially, after the reinjury, it was about coping with the catastrophe of the dreaded second injury. Over time, they accepted their "new" life and reset their recovery/rehabilitation goal not just as "return to sport" but rather as a "personal life goal".

CONCLUSION

Undergoing a second ACL injury is a long process that challenges the patient's coping skills. Given these results, rehabilitation programs need to be more person centred according to the patients-adjusted life goals.