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Hasenoehrl T, Steiner M, Ebenberger F, Kull P, Sternik J, Reissig L, Jordakieva G, Crevenna R. "Back Health 24/7/365"-A Novel, Comprehensive "One Size Fits All" Workplace Health Promotion Intervention for Occupational Back Health among Hospital Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:772. [PMID: 38929018 PMCID: PMC11203411 DOI: 10.3390/ijerph21060772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Projects for workplace health promotion (WHP) for back pain traditionally focus exclusively on work-related but not on leisure-time stress on the spine. We developed a comprehensive WHP project on the back health of hospital workers regardless of the physical characteristics of their work and compared its effects on sedentary and physically active hospital workers. METHODS Study assessments were carried out before and six months after participation in the WHP intervention. The primary outcome parameter was back pain (Oswestry Disability Index, ODI). Anxiety (Generalized Anxiety Disorder-7), work ability (Work Ability Index), depression (Patient Health Questionnaire-9), stress (Perceived Stress Scale-10), and quality of life (Short Form-36) were assessed via questionnaires as secondary outcome parameters. Physical performance was measured via the 30 seconds Sit-to-Stand test (30secSTS). RESULTS Sixty-eight healthcare workers with non-specific back pain were included in the evaluation study of the WHP project "Back Health 24/7/365". After six months, back pain, physical performance, and self-perceived physical functioning (SF-36 Physical Functioning subscale) improved significantly in both groups. Not a single parameter showed an interaction effect with the group allocation. CONCLUSIONS A comprehensive WHP-intervention showed significant positive effects on hospital workers regardless of the physical characteristics of their work.
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Affiliation(s)
- Timothy Hasenoehrl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Margarete Steiner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Felix Ebenberger
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Philipp Kull
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Julia Sternik
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Lukas Reissig
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Waehringer Straße 13, 1090 Vienna, Austria
| | - Galateja Jordakieva
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Yuan S, Li Y, Zhang L, Wang H. The Relationship Between the NSP and the Individual and Work Organizational Variables: A Cross-Sectional Study. Front Public Health 2022; 10:726826. [PMID: 35433581 PMCID: PMC9009827 DOI: 10.3389/fpubh.2022.726826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives To investigate the characteristics of neck–shoulder pain (NSP) and explore the potentional relationship between the NSP and the individual and work organizational variables. Methods A cross-sectional study was performed in the tertiary general hospitals in Hunan Province, China between May 2019 and July 2019. A total of 2,030 healthcare workers were enrolled randomly in this study based on a three-stage stratified sampling method. The Neck Disability Index (NDI) was used to measure disability in subjects with neck pain. A self-administered questionnaire was used to assess the characteristics of individual and work organizational variables. The Mann–Whitney U test and the Kruskal–Wallis H test were applied to analyze the prevalence of pain intensity among groups. Multivariate linear regression analysis was performed to explore the potentional relationship between NSP and individual and work organizational variables using the NDI score as the dependent variable. Results 2,008 of 2,030 healthcare workers filled out the survey questionnaires online. In the past 12 months, 1,489 participants (74.2%) complained of pain in the cervical–shoulder region. NDI score increased by 0.10 for each year of age, with healthcare workers working in Obstetrics and Gynecology, and the Operating Room less likely to have NSP than those working in other departments. In contrast, female healthcare workers with a history of pregnancy were more likely to have NSP. In terms of organizational factors, workers who received concern from their supervisor about their health, who had the choice to change their shift status to off duty when they were not feeling well, or who were informed about WMSDs were less likely to have NSP. Conclusion The prevalence of NSP within the previous year was high in this population. Individual factors including history of neck–shoulder diseases, age, and history of pregnancy and organizational factors including being adequately informed regarding WMSDs, concern from supervisors about workers' health, and the ability of workers to change their shift status to off duty when they were not feeling well were shown to induce significant effects to NSP.
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Affiliation(s)
- Sue Yuan
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yunxia Li
- Xiangya Nursing School, Central South University, Changsha, China
| | - Lihui Zhang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, China
- *Correspondence: Honghong Wang
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Effectiveness of Ergonomic Training to Decrease Awkward Postures during Dental Scaling Procedures: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111217. [PMID: 34769736 PMCID: PMC8583220 DOI: 10.3390/ijerph182111217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/11/2022]
Abstract
Studies demonstrate that there is a lack of effective ergonomic principles for adopting a neutral posture during the execution of dental procedures. ISO 11.226:2000 Standard, Corr. 1:2006 has been thoroughly evaluated and adapted to the way that dentists work by the European Society of Dental Ergonomics (ESDE). However, after 15 years, no studies that showed strong evidence of effectiveness in reducing the prevalence of awkward posture in applying its parameters within the scope of dental practice were found. The aim of this study was to verify the effectiveness of applying the ergonomic parameters proposed by the European Society of Dental Ergonomics (ESDE) and ISO 11226 in reducing the prevalence of the main awkward postures adopted by female dental surgeons during the execution of dental scaling on a dental mannequin. A randomized clinical trial was carried out with sixty dental surgeons randomly assigned to two groups: the intervention group, who received instructions and theoretical and practical ergonomic training; and the control group, who received the same training only at the end of the study. For data analysis, Software IBM SPSS 27 and RStudio was used. Descriptive statistics were performed to verify the effectiveness of the intervention, and generalized linear models (specifically, generalized estimated equation models) were used. Poisson distribution was carried out with log link function and network analyses. Sixty female dental surgeons participated in the study. Twenty-two were distributed in the intervention group and thirty-eight in the control group. It was found that ergonomic training enabled a 63% reduction in the prevalence of awkward postures and that there was a statistically significant difference (p < 0.001) only in the intervention group. The analyses showed that the estimated marginal means of postures not recommended in the groups’ initial control, final control, initial intervention, and final intervention were 8.6, 8.2, 9.0, and 3.4, respectively. The relationship of networks analyses of the variables is shown with different profiles in the control and intervention groups, but the same pattern between the groups only vary in the strength and direction of the correlations. It was concluded that the ergonomic training based on the parameters of ISO 11226 and DIN EN 1005-4, and its adaptations to the dental practice provided by the European Society of Dental Ergonomics, as well as recent studies, contributed significantly to reducing the prevalence of awkward postures adopted by female dentists during the simulation of the basic periodontal procedures; however, it was not effective enough to improve the posture of the head and neck.
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Price JW. Osteopathic model of the development and prevention of occupational musculoskeletal disorders. J Osteopath Med 2021; 121:287-305. [PMID: 33635956 DOI: 10.1515/jom-2020-0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Context The direct and indirect costs of work-related musculoskeletal disorders are significant. Prevention is the most effective way to control these costs. To do that, we must understand how these disorders develop. Objectives To use the five models of osteopathic care to illustrate how cellular processes and neural reflexes interact to create work-related musculoskeletal pathology and to provide evidence-informed musculoskeletal injury and disability prevention recommendations. Methods A literature review of electronic databases (Google Scholar, PubMed, OVID, Cochrane Central Register of Controlled Trials, PEDro, and OSTMED.DR) from inception to October 16, 2019 and hand-search of publication references was performed for systematic reviews, cohort studies, case-control studies, and randomized controlled trials. The search terms reflected topics related to occupational injury and injury prevention, and included supplementary laboratory studies and narrative reviews related to the biological aspects of musculoskeletal injury. The eligible studies contained the following criteria: (1) the population of working age; (2) exposures to known risk factors, musculoskeletal disorders, and psychosocial factors; (3) written in English; (4) full text papers published in peer-reviewed journals; and (5) systematic review, cohort study, case-control study, and randomized controlled trial methodology. Studies were excluded if they included outcomes of productivity and costs only or outcomes that were assessed through qualitative methods only. Results The literature search resulted in 1,074 citations; 26 clinical studies and 14 systematic reviews were used in this review. A comprehensive workplace musculoskeletal disorder prevention program should match demands to capacity, correct dysfunctional movement patterns, and limit tissue vulnerability (biomechanical-structural model); restore alpha-gamma balance, tonic-phasic synergistic function, and autonomic balance (neurological model); maximize physiologic reserve (metabolic-energy model) component of a prevention program; optimize respiration and circulation (respiratory-circulatory model); and address cognitive distortions (behavioral-biopsychosocial model). Conclusions The presented osteopathic model of the development and prevention of work-related musculoskeletal disorders suggests that a combination of preventive interventions will be more effective than any single preventive intervention.
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Affiliation(s)
- James William Price
- Ascension St. Vincent Occupational Medicine Clinic, Evansville, IN, USA.,College of Osteopathic Medicine, Marion University, Indianapolis, IN, USA
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Affiliation(s)
- Tarcisio F de Campos
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Mark R Elkins
- Editor, Journal of Physiotherapy; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
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Semrau J, Hentschke C, Peters S, Pfeifer K. Effects of behavioural exercise therapy on the effectiveness of multidisciplinary rehabilitation for chronic non-specific low back pain: a randomised controlled trial. BMC Musculoskelet Disord 2021; 22:500. [PMID: 34051780 PMCID: PMC8164753 DOI: 10.1186/s12891-021-04353-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022] Open
Abstract
Background The long-term effects of behavioural medical rehabilitation (BMR), as a type of multidisciplinary rehabilitation, in the treatment of chronic non-specific low back pain (CLBP) have been shown. However, the specific effects of behavioural exercise therapy (BET) compared to standard exercise therapy (SET) within BMR are not well understood. The aim of the study was to assess the effectiveness of BMR + BET compared to BMR + SET in individuals with CLBP in a two-armed, pre-registered, multicentre, parallel, randomised controlled trial (RCT). Methods A total of 351 adults with CLBP in two rehabilitation centres were online randomised based on an ‘urn randomisation’ algorithm to either BMR + SET (n = 175) or BMR + BET (n = 176). Participants in both study groups were non-blinded and received BMR, consisting of an multidisciplinary admission, a psychosocial assessment, multidisciplinary case management, psychological treatment, health education and social counselling. The intervention group (BMR + BET) received a manualised, biopsychosocial BET within BMR. The aim of BET was to develop self-management strategies in coping with CLBP. The control group (BMR + SET) received biomedical SET within BMR with the aim to improve mainly physical fitness. Therapists in both study groups were not blinded. The BMR lasted on average 27 days, and both exercise programmes had a mean duration of 26 h. The primary outcome was functional ability at 12 months. Secondary outcomes were e.g. pain, avoidance-endurance, pain management and physical activity. The analysis was by intention-to-treat, blinded to the study group, and used a linear mixed model. Results There were no between-group differences observed in function at the end of the BMR (mean difference, 0.08; 95% CI − 2.82 to 2.99; p = 0.955), at 6 months (mean difference, − 1.80; 95% CI; − 5.57 to 1.97; p = 0.349) and at 12 months (mean difference, − 1.33; 95% CI − 5.57 to 2.92; p = 0.540). Both study groups improved in the primary outcome and most secondary outcomes at 12 months with small to medium effect sizes. Conclusion BMR + BET was not more effective in improving function and other secondary outcomes in individuals with CLBP compared to BMR + SET. Trial registration Current controlled trials NCT01666639, 16/08/2012. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04353-y.
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Affiliation(s)
- Jana Semrau
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Gebbertstraße 123 b, 91056, Erlangen, Germany.
| | | | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie (DVGS) e.V, Vogelsanger Weg 48, 50354, Hürth-Efferen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Gebbertstraße 123 b, 91056, Erlangen, Germany
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Wu A, Dong W, Zeng X, Xu X, Xu T, Zhang K, Tian H, Zhao J, Wang X, Zhou M. Neck pain is the leading cause of disability burden in China: Findings from the Global Burden of Disease Study 2017. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:777. [PMID: 34268390 PMCID: PMC8246184 DOI: 10.21037/atm-20-6868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/29/2021] [Indexed: 11/06/2022]
Abstract
Background Neck pain (NP) is a common musculoskeletal problem; however, the prevalence and years lived with disability (YLD) of NP in China are still unclear. This study sought to estimate the age-, sex- and province-specific prevalence and YLD of NP in China. Methods Adopting the methodology framework and analytical strategies used in the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2017), the prevalence and YLD of NP in China were estimated by age, sex, year, and provinces/regions. Results In China, the age-standardized point prevalence rate of NP was 4,532.6 per 100,000 persons in 1990 and increased slightly to 4,634.4 per 100,000 persons in 2017. The prevalence of NP was 48.0 million in 1990 and rose dramatically to 87.3 million in 2017 (an increase of 82.0%). The age-standardized YLD rate of NP was 454.0 per 100,000 persons in 1990, and there was a slight increase to 465.6 per 100,000 persons in 2017. The all-age YLD of NP was 4.8 million in 1990 and rose to 8.8 million in 2017 (which represents an increase of 81.1%). In 1990, NP was the third leading cause of YLD in China, and in 2017, NP was the leading cause of disability burden. Conclusions This study estimated the prevalence and disability burden of NP in China. NP is currently the leading cause of disability burden in China; however, it is currently inadequately recognized and should receive further attention and be subject to further research.
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Affiliation(s)
- Aimin Wu
- Division of Spine Surgery, Department of Orthopedics, Zhejiang Spine Research Centre, Orthopedic Hospital, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopedics, Wenzhou, China
| | - Wenlan Dong
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Xinying Zeng
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Xiaohui Xu
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Tingling Xu
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Kai Zhang
- Department of Orthopedics, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haijun Tian
- Department of Orthopedics, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Zhao
- Department of Orthopedics, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiangyang Wang
- Division of Spine Surgery, Department of Orthopedics, Zhejiang Spine Research Centre, Orthopedic Hospital, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopedics, Wenzhou, China
| | - Maigeng Zhou
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
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Müller G, Lyssenko L, Giurgiu M, Pfinder M, Clement M, Kaiserauer A, Heinzel-Gutenbrunner M, Kohlmann T, BÖs K. How effective and efficient are different exercise patterns in reducing back pain? Eur J Phys Rehabil Med 2020; 56:585-593. [PMID: 32498492 DOI: 10.23736/s1973-9087.20.05975-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Exercise is considered an effective intervention to relieve chronic back pain. However, it is still unknown whether specific exercise patterns vary in terms of their efficiency and effectiveness. AIM To investigate the differential health and economic effects of intensity, specificity and degree of subjective perceived physical exertion across five exercise patterns (endurance, gymnastics, fitness, back gymnastics, multimodal back exercise) in adults with back pain. DESIGN Longitudinal observational cohort study over a period of 24 months. SETTING Various non-therapeutic exercise facilities (e.g. outdoor, fitness centers, health insurance programs, sports clubs) across one federal state of Germany (Baden-Wuerttemberg). POPULATION Adults with back pain (N.=2,542, Mean =46.9 years, 66% females, graded chronic back pain [GCPS] 1=40.5%, GCPS 2=27.3%, GCPS 3=20.7%, GCPS 4=11.5%). METHODS Self-reported back pain (functional restrictions and pain = back pain function score, [BPFS]) and characteristics of exercising behavior (frequency, duration, type, physical exertion) were assessed at baseline and at 6, 12, 18 and 24 months. Direct medical costs for back disorders (international classification of diseases, dorsopathies: M40-M54) were compiled from health insurance records. RESULTS Moderate- to high-intensity exercise patterns were effective in reducing back pain, particularly at lower levels of subjective perceived physical exertion. At these intensity levels, multimodal back exercise (i.e. exercising the spine-stabilizing muscles specifically, ergonomic training) was 14.5 times more effective than non-back specific fitness exercise in reducing BPFS. The beneficial effects of both exercise types increased with the initial severity of back pain. However, only multimodal back exercise (moderate- to high-intensity/high back specificity) was associated with a significant decrease in direct medical costs for back pain. CONCLUSIONS Targeted exercise of the spine-stabilizing musculature at moderate to high intensities without maximum perceived exertion is effective and efficient in reducing back pain. CLINICAL REHABILITATION IMPACT The combination of high-intensity and high-specificity exercises yielded a significant reduction in medical costs. However, the intensities in terms of muscular load in endurance training and gymnastics may not be sufficient to reduce back pain effectively.
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Kawasaki T, Tozawa R. Grit in Community-Dwelling Older Adults with Low Back Pain Is Related to Self-Physical Training Habits. PM R 2020; 12:984-989. [PMID: 31901016 DOI: 10.1002/pmrj.12318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/30/2019] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Self-management is an effective way to manage chronic low back pain (LBP) and is frequently recommended. However, the psychological aspects, including grit (ie, perseverance and passion for long-term goals), of the habit of self-management remain unclear. OBJECTIVE To investigate the relationship between grit and the self-directed exercise. DESIGN Cross-sectional observational study. SETTING Community-dwelling older adults. PARTICIPANTS Fifty-nine older adults with LBP (30 men, 29 women; mean age 72 ± 5 years, range 65-82 years). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Primary outcome measures included grit scores on the Short Grit Scale and the number of months performing self-directed exercise. Correlation and multiple regression analyses were performed to determine the relationship between participants' grit and duration of self-directed exercise. RESULTS A significant positive correlation between grit and the duration of self-directed exercise habits was observed (r = 0.49, P < .001). Furthermore, in multiple regression analysis, grit was a significant factor of the duration of self-directed exercise. CONCLUSION Low grit was associated with reduced self-directed exercise in individuals with LBP self-directed exercise.
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Affiliation(s)
- Tsubasa Kawasaki
- Institute of Sports Medicine and Science, School of Human and Social Sciences, Tokyo International University, Kawagoe-City, Japan
| | - Ryosuke Tozawa
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu-City, Japan
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Eğri Ö, Ökten ME, Deveci H. Lomber disk herniasyonlu hastalarda, transkutanöz elektriksel sinir stimülasyonu (TENS) ve ultrason uygulamalarının, serum oksidatif stres parametreleri ve idrar kollajen yıkım ürünleri üzerine etkilerinin değerlendirilmesi. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.664930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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[What influence do increased physical performance, age, sex and training frequency have on the effectiveness of back training?]. Schmerz 2019; 33:139-146. [PMID: 30649627 DOI: 10.1007/s00482-018-0353-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Active exercising can effectively reduce low back pain but the mechanisms of action are still unclear. OBJECTIVE What are the influences of training frequency, increased physical performance, age and gender on the effectiveness of a multimodal back training? MATERIAL AND METHODS A total of 1395 persons with back pain (mean age 46.9 ± 12.3 years, 65% female) took part in a multimodal back training over 24 months in the context of a multicenter study (39 locations). Back pain, physical capacity of strength, mobility and bilateral strength ratio of the spine stabilizing muscles were measured at the beginning of the training and after 6, 12 and 18 months. RESULTS AND DISCUSSION The participants trained on average for 41.0 (SD ± 17.8) 60-min training units. This resulted in an increase of strength (28.1%), mobility (14.7%) and strength ratio (6.5%) compared to an age and gender-matched cohort without back pain. Back pain was reduced by 37.5%. The reduction in back pain can be ascribed to the training frequency by 70% and to increased physical performance by 30%. Age only marginally influenced the effect of training, while gender had no significant effect. CONCLUSION Increases in physical performance have positive effects on the reduction of back pain but the number of training sessions was shown to be more relevant in the reduction of low back pain.
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Abstract
Low back pain affects individuals of all ages and is a leading contributor to disease burden worldwide. Despite advancements in assessment and treatment methods, the management of low back pain remains a challenge for researchers and clinicians alike. One reason for the limited success in identifying effective treatments is the large variation in the manifestations, possible causes, precipitating and maintaining factors, course, prognosis and consequences in terms of activity interference and quality of life. However, despite these challenges, steady progress has been achieved in the understanding of back pain, and important steps in the understanding of the psychological and social risk factors, genetics and brain mechanisms of low back pain have been made. These new findings have given impetus to the development of new diagnostic procedures, evidence-based screening methods and more targeted interventions, which underscore the need for a multidisciplinary approach to the management of low back pain that integrates biological, psychological and social aspects.
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Williams A, van Dongen JM, Kamper SJ, O'Brien KM, Wolfenden L, Yoong SL, Hodder RK, Lee H, Robson EK, Haskins R, Rissel C, Wiggers J, Williams CM. Economic evaluation of a healthy lifestyle intervention for chronic low back pain: A randomized controlled trial. Eur J Pain 2018; 23:621-634. [PMID: 30379386 DOI: 10.1002/ejp.1334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 10/03/2018] [Accepted: 10/27/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Economic evaluations which estimate cost-effectiveness of potential treatments can guide decisions about real-world healthcare services. We performed an economic evaluation of a healthy lifestyle intervention targeting weight loss, physical activity and diet for patients with chronic low back pain, who are overweight or obese. METHODS Eligible patients with chronic low back pain (n = 160) were randomized to an intervention or usual care control group. The intervention included brief advice, a clinical consultation and referral to a 6-month telephone-based healthy lifestyle coaching service. The primary outcome was quality-adjusted life years (QALYs). Secondary outcomes were pain intensity, disability, weight and body mass index. Costs included intervention costs, healthcare utilization costs and work absenteeism costs. An economic analysis was performed from the societal perspective. RESULTS Mean total costs were lower in the intervention group than the control group (-$614; 95%CI: -3133 to 255). The intervention group had significantly lower healthcare costs (-$292; 95%CI: -872 to -33), medication costs (-$30; 95%CI: -65 to -4) and absenteeism costs (-$1,000; 95%CI: -3573 to -210). For all outcomes, the intervention was on average less expensive and more effective than usual care, and the probability of the intervention being cost-effective compared to usual care was relatively high (i.e., 0.81) at a willingness-to-pay of $0/unit of effect. However, the probability of cost-effectiveness was not as favourable among sensitivity analyses. CONCLUSIONS The healthy lifestyle intervention seems to be cost-effective from the societal perspective. However, variability in the sensitivity analyses indicates caution is needed when interpreting these findings. SIGNIFICANCE This is an economic evaluation of a randomized controlled trial of a healthy lifestyle intervention for chronic low back pain. The findings suggest that a healthy lifestyle intervention may be cost-effective relative to usual care.
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Affiliation(s)
- Amanda Williams
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, MOVE research institute Amsterdam, Amsterdam, The Netherlands
| | - Steven J Kamper
- Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia.,School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Kate M O'Brien
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Sze L Yoong
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia
| | - Hopin Lee
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia.,Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia.,Centre for Statistics in Medicine, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Emma K Robson
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia
| | - Robin Haskins
- Outpatient Services, John Hunter Hospital, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - Chris Rissel
- NSW Office of Preventive Health, Liverpool Hospital, South West Sydney Local Health District, Liverpool, New South Wales, Australia
| | - John Wiggers
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Christopher M Williams
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter New England Population Health, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Ourimbah, New South Wales, Australia
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Amorim AB, Ferreira PH, Ferreira ML, Lier R, Simic M, Pappas E, Zadro JR, Mork PJ, Nilsen TI. Influence of family history on prognosis of spinal pain and the role of leisure time physical activity and body mass index: a prospective study using family-linkage data from the Norwegian HUNT study. BMJ Open 2018; 8:e022785. [PMID: 30341129 PMCID: PMC6196861 DOI: 10.1136/bmjopen-2018-022785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. DESIGN Prospective cohort study. SETTING We used family-linked longitudinal data from the Norwegian HUNT study collected in HUNT2 (1995-1997) and HUNT3 (2006-2008). PARTICIPANTS A total of 1529 offspring who reported spinal pain in HUNT2 were linked with parental data and followed up in HUNT3. OUTCOMES We estimated relative risk (RR) with 95% CI for recovery from chronic spinal pain, and also from activity limiting spinal pain, in offspring related to chronic spinal pain in parents. We also investigated whether offspring leisure time physical activity and BMI modified these intergenerational associations in spinal pain. RESULTS A total of 540 (35%) offspring were defined as recovered after approximately 11 years of follow-up. Offspring with both parents reporting chronic spinal pain were less likely to recover from chronic spinal pain (RR 0.83, 95% CI 0.69 to 0.99) and activity limiting spinal pain (RR 0.71, 95% CI 0.54 to 0.94), compared with offspring of parents without chronic spinal pain. Analyses stratified by BMI and physical activity showed no strong evidence of effect modification on these associations. However, offspring who were overweight/obese and with both parents reporting chronic spinal pain had particularly low probability of recovery from activity limiting spinal pain, compared with those who were normal weight and had parents without chronic spinal pain (RR 0.57, 95% CI 0.39 to 0.84). CONCLUSION Offspring with chronic spinal pain are less likely to recover if they have parents with chronic spinal pain, particularly if offspring are overweight/obese.
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Affiliation(s)
- Anita B Amorim
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Paulo H Ferreira
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, New South Wales, Australia
| | - Ragnhild Lier
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Milena Simic
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Joshua R Zadro
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tom Il Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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15
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Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: Short-and long-term outcomes of pain and disability. Eur J Pain 2018; 23:234-249. [DOI: 10.1002/ejp.1314] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Lianne Wood
- Centre for Spinal Studies and Surgery; Nottingham University Hospitals NHS Trust; Nottingham UK
- Research Institute for Primary Care and Health Sciences; Keele University; Staffordshire, ST5 5PB
| | - Paul A. Hendrick
- Division of Physiotherapy and Rehabilitation Sciences; School of Health Sciences, University of Nottingham, Nottingham University Hospitals (City Campus); Nottingham UK
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16
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Sowah D, Boyko R, Antle D, Miller L, Zakhary M, Straube S. Occupational interventions for the prevention of back pain: Overview of systematic reviews. JOURNAL OF SAFETY RESEARCH 2018; 66:39-59. [PMID: 30121110 DOI: 10.1016/j.jsr.2018.05.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 02/12/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION We conducted an overview of systematic reviews of interventions for the prevention of low back pain (LBP) that can be conducted in a workplace setting. METHODS An electronic literature search was performed in Medline, EMBASE, and the Cochrane Library. Published peer-reviewed systematic reviews and meta-analyses, which described interventions for the primary or secondary prevention of LBP applicable to a workplace setting, were eligible for inclusion. The methodological quality of the included systematic reviews was assessed with the AMSTAR tool. The primary outcome of interest was the incidence of LBP; secondary outcomes were LBP-associated absenteeism, activity interference, and costs related to LBP. RESULTS Twenty-eight eligible articles published between 1994 and 2016 were included in a qualitative synthesis following our screening of abstracts and full-text articles. The AMSTAR rating revealed 14 reviews of high, 10 of moderate, and 4 of low methodological quality. The identified interventions included workplace modifications (6 reviews, 10 studies, 6,751 subjects); shoe insoles (4 reviews, 6 studies, 2,356 subjects); and lumbar supports and other assistive devices (15 reviews, 18 studies, 60,678 subjects). Educational interventions investigated were back schools (10 reviews, 30 studies, 9,973 subjects); manual material handling techniques/advice (6 reviews, 24 studies, 10,505 subjects); and other forms of instruction including pamphlets, booklets, and other media (four reviews, 14 studies, 11,991 subjects). Exercise interventions, investigated in 12 reviews (35 studies, 19,330 subjects), showed moderate quality evidence of effectiveness for exercise interventions alone or in conjunction with educational interventions; no other type of intervention was consistently effective in the prevention of LBP or LBP-associated outcomes of interest. CONCLUSIONS Our overview provides evidence of effectiveness for exercise with or without educational interventions in the prevention of LBP. PRACTICAL APPLICATIONS Exercise interventions with or without educational interventions that can be applied in the workplace have the potential to prevent LBP.
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Affiliation(s)
- Daniel Sowah
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Robert Boyko
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - David Antle
- EWI Works International Inc., Edmonton, Alberta, Canada.
| | - Linda Miller
- EWI Works International Inc., Edmonton, Alberta, Canada.
| | - Michael Zakhary
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Sebastian Straube
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
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17
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de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ. Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. J Physiother 2018; 64:159-165. [PMID: 29908853 DOI: 10.1016/j.jphys.2018.05.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/03/2018] [Accepted: 05/15/2018] [Indexed: 02/04/2023] Open
Abstract
QUESTION What is the effectiveness of interventions that aim to prevent a new episode of neck pain? DESIGN Systematic review and meta-analysis of randomised, controlled trials. PARTICIPANTS People without neck pain at study entry. INTERVENTION Any intervention aiming to prevent a future episode of neck pain. OUTCOME MEASURES New episode of neck pain. RESULTS Five trials including a total of 3852 individuals met the inclusion criteria. The pooled results from two randomised, controlled trials (500 participants) found moderate-quality evidence that exercise reduces the risk of a new episode of neck pain (OR 0.32, 95% CI 0.12 to 0.86). One of the meta-analysed trials included some co-interventions with the exercise. There was low-quality evidence from three randomised, controlled trials (3352 participants) that ergonomic programs do not reduce the risk of a new neck pain episode (OR 1.00, 95% CI 0.74 to 1.35). CONCLUSION This review found moderate-quality evidence supporting the effectiveness of an exercise program for reducing the risk of a new episode of neck pain. There is a need for high-quality randomised, controlled trials evaluating interventions to prevent new episodes of neck pain. REGISTRATION PROSPERO CRD42017055174. [de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ (2018) Exercise programs may be effective in preventing a new episode of neck pain: a systematic review. Journal of Physiotherapy 64: 159-165].
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Affiliation(s)
| | - Chris G Maher
- The University of Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Sydney Medical School, The University of Sydney
| | - Joel T Fuller
- Department of Health Professions, Macquarie University
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18
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Shiri R, Coggon D, Falah-Hassani K. Exercise for the Prevention of Low Back Pain: Systematic Review and Meta-Analysis of Controlled Trials. Am J Epidemiol 2018; 187:1093-1101. [PMID: 29053873 DOI: 10.1093/aje/kwx337] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/05/2017] [Indexed: 12/21/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to assess the effect of exercise in population-based interventions to prevent low back pain (LBP) and associated disability. Comprehensive literature searches were conducted in multiple databases, including PubMed, Embase, and the Cochrane Library, from their inception through June 2017. Thirteen randomized controlled trials (RCTs) and 3 nonrandomized controlled trials (NRCTs) qualified for the meta-analysis. Exercise alone reduced the risk of LBP by 33% (risk ratio = 0.67, 95% confidence interval: 0.53, 0.85; I2 = 23%, 8 RCTs, n = 1,634), and exercise combined with education reduced it by 27% (risk ratio = 0.73, 95% confidence interval: 0.59, 0.91; I2 = 6%, 6 trials, n = 1,381). The severity of LBP and disability from LBP were also lower in exercise groups than in control groups. Moreover, results were not changed by excluding the NRCTs or adjusting for publication bias. Few trials assessed health-care consultation or sick leave for LBP, and meta-analyses did not show statistically significant protective effects of exercise on those outcomes. Exercise reduces the risk of LBP and associated disability, and a combination of strengthening with either stretching or aerobic exercises performed 2-3 times per week can reasonably be recommended for prevention of LBP in the general population.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - David Coggon
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
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19
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The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskelet Sci Pract 2018; 34:38-46. [PMID: 29257996 DOI: 10.1016/j.msksp.2017.12.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/02/2017] [Accepted: 12/08/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this meta-analysis of randomized controlled trials was to gain insight into the effectiveness of walking intervention on pain, disability, and quality of life in patients with chronic low back pain (LBP) at post intervention and follow ups. METHOD Six electronic databases (PubMed, Science Direct, Web of Science, Scopus, PEDro and The Cochrane library) were searched from 1980 to October 2017. The following keywords were used: Walk* or Pedometer* or Accelerometer* or Treadmill* paired with "Back pain", "Low back pain", "Chronic low back pain", "LBP", or "Backache". Randomized controlled trials in patients with chronic LBP were included if they compared the effects of walking intervention to non-pharmacological interventions. Pain, disability, and quality of life were the primary health outcomes. RESULTS Nine studies were suitable for meta-analysis. Data was analyzed according to the duration of follow-up (short-term, < 3 months; intermediate-term, between 3 and 12 months; long-term, > 12 months). Low- to moderate-quality evidence suggests that walking intervention in patients with chronic LBP was as effective as other non-pharmacological interventions on pain and disability reduction in both short- and intermediate-term follow ups. CONCLUSIONS Unless supplementary high-quality studies provide different evidence, walking, which is easy to perform and highly accessible, can be recommended in the management of chronic LBP to reduce pain and disability.
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20
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Balling M, Holmberg T, Petersen CB, Aadahl M, Meyrowitsch DW, Tolstrup JS. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain: The Danish Health Examination Survey cohort 2007–2008. Scand J Public Health 2018; 47:45-52. [DOI: 10.1177/1403494818758843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aims: This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. Methods: A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007–2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. Results: During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03–1.30 and HR = 1.45, 95% CI: 1.15–1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. Conclusions: The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.
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Affiliation(s)
- Mie Balling
- University of Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Teresa Holmberg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christina B. Petersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mette Aadahl
- Centre for Clinical Research and Prevention, Frederiksberg Hospital
- Department of Public Health, University of Copenhagen, Denmark
| | | | - Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Work-Related Musculoskeletal Injuries in Plastic Surgeons in the United States, Canada, and Norway. Plast Reconstr Surg 2018; 141:165e-175e. [PMID: 29280888 DOI: 10.1097/prs.0000000000003961] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Musculoskeletal injuries are more common among surgeons than among the general population. However, little is known about these types of injuries among plastic surgeons specifically. The authors' goals were to evaluate the prevalence, nature, causes, and potential solutions of these musculoskeletal injuries among plastic surgeons in three different countries: the United States, Canada, and Norway. METHODS A survey was e-mailed to plastic surgeons in the United States, Canada, and Norway, soliciting their demographics, practice description, history of musculoskeletal issues, potential causes of these symptoms, and proposed suggestions to address these injuries. The prevalence of various musculoskeletal symptoms was calculated, and predictors of these symptoms were evaluated using multivariate logistic regression. RESULTS The survey was sent to 3314 plastic surgeons, with 865 responses (response rate, 26.1 percent); 78.3 percent of plastic surgeons had musculoskeletal symptoms, most commonly in the neck, shoulders, and lower back. U.S. surgeons were significantly more likely to have musculoskeletal symptoms than Norwegian surgeons (79.5 percent versus 69.3 percent; p < 0.05); 6.7 percent of all respondents required surgical intervention for their symptoms. The most common causative factors were long surgery duration, tissue retraction, and prolonged neck flexion. The most common solutions cited were core-strengthening exercises, stretching exercises, and frequent adjustment of table height during surgery. CONCLUSIONS Plastic surgeons are at high risk for work-related musculoskeletal injuries. Ergonomic principles can be applied in the operating room to decrease the incidence and severity of those injuries, and to avoid downstream sequelae, including the need for surgery.
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Keilman BM, Hanney WJ, Kolber MJ, Pabian PS, Salamh PA, Rothschild CE, Liu X. The Short-Term Effect of Kettlebell Swings on Lumbopelvic Pressure Pain Thresholds: A Randomized Controlled Trial. J Strength Cond Res 2017; 31:3001-3009. [DOI: 10.1519/jsc.0000000000001743] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Antúnez Sánchez LG, de la Casa Almeida M, Rebollo Roldán J, Ramírez Manzano A, Martín Valero R, Suárez Serrano C. [Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain]. Aten Primaria 2017; 49:417-425. [PMID: 28089225 PMCID: PMC6876041 DOI: 10.1016/j.aprim.2016.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 07/29/2016] [Accepted: 09/05/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. DESIGN Randomised clinical trial. LOCATION Health Area of University Hospital Virgen del Rocío, Seville, Spain. PARTICIPANTS A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. INTERVENTION The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. MAIN MEASURES Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. RESULTS Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. CONCLUSIONS Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective.
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Affiliation(s)
| | | | | | - Antonio Ramírez Manzano
- Centro de Especialidades Dr. Fleming, Área sanitaria Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Rocío Martín Valero
- Departamento de Fisioterapia, Escuela Universitaria Francisco Maldonado, Osuna, Sevilla, España
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McCluskey A, Lovarini M, Bennett S, McKenna K, Tooth L, Hoffmann T. What Evidence Exists for Work-Related Injury Prevention and Management? Analysis of an Occupational Therapy Evidence Database (OTseeker). Br J Occup Ther 2016. [DOI: 10.1177/030802260506801003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to summarise the quantity and quality of research contained in an online evidence database (OTseeker) in one practice area, work-related injury prevention and management, to highlight the available evidence. In May 2004, the systematic reviews and randomised controlled trials (RCTs) contained in OTseeker were analysed. The number and proportion of systematic reviews and RCTs and the number and proportion of RCTs meeting each of the 10 criteria on the PEDro scale (partitioned) were calculated and the topics and conclusions of the systematic reviews were summarised. Of the 2330 records contained in OTseeker, 346 (14.8%) related to work-related injury prevention and management (86 systematic reviews and 260 RCTs). Of the 260 RCTs, the majority (n = 140, 53.8%) scored between 3/8 and 5/8 for internal validity on the PEDro scale (partitioned); a few scored 6/8 or more (n = 13, 5.0%). The majority of the RCTs scored 2/2 for the reporting of results (n = 217, 83.5%). Evidence was identified, mostly for the treatment of low back pain, to support the use of multidisciplinary biopsychosocial rehabilitation including workplace visits, back schools, workplace exercise, and advice to stay active and/or return to normal activities. OTseeker contains a substantial body of research on the effectiveness of work-related injury prevention and management, although this research is of varying methodological quality.
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Bogaert I, De Martelaer K, Beutels M, De Ridder K, Zinzen E. Posture analysis among Flemish secondary school teachers: difference between the use of chalkboards and electronic school boards during classroom teaching. ERGONOMICS 2016; 59:1487-1493. [PMID: 26853262 DOI: 10.1080/00140139.2016.1139751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to (i) make a posture analysis of teachers during theoretical classroom teaching; (ii) to estimate the risk for the development of musculoskeletal problems (MSP); (iii) test the hypotheses that an electronic school board (EB) has more ergonomic advantages for teachers. Thirty-five secondary school teachers, of which 15 used an EB and 20 used chalkboards, were selected by convenience sampling and filmed during 30 min of a theoretical course. Posture analysis of back, arms, legs and risk assessment was performed using the Ovako Working Posture Analysis System. Most of the teachers' postures did not indicate a higher risk for MSP. However, some postures may be harmful when accumulated for several hours of teaching a day; especially, long periods of standing and standing with a bended back. Results also indicated that currently the use of an EB does not improve teachers' posture. Practitioner Summary: The relationship between objectively measured physical work load and risk for injuries among teachers was not analysed so far. In this study teachers' posture was analysed using the OWAS method. Prolonged standing and forward bending were identified as risk postures. Also, using an electronic school board currently does not improve posture.
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Affiliation(s)
- Inge Bogaert
- a Faculty of Physical Education and Physiotherapy, Department of Movement Education and Sport Training , Vrije Universiteit Brussel , Brussels , Belgium
| | - Kristine De Martelaer
- a Faculty of Physical Education and Physiotherapy, Department of Movement Education and Sport Training , Vrije Universiteit Brussel , Brussels , Belgium
| | - Michèle Beutels
- a Faculty of Physical Education and Physiotherapy, Department of Movement Education and Sport Training , Vrije Universiteit Brussel , Brussels , Belgium
| | - Karolien De Ridder
- a Faculty of Physical Education and Physiotherapy, Department of Movement Education and Sport Training , Vrije Universiteit Brussel , Brussels , Belgium
| | - Evert Zinzen
- a Faculty of Physical Education and Physiotherapy, Department of Movement Education and Sport Training , Vrije Universiteit Brussel , Brussels , Belgium
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Zronek M, Sanker H, Newcomb J, Donaldson M. The influence of home exercise programs for patients with non-specific or specific neck pain: a systematic review of the literature. J Man Manip Ther 2016; 24:62-73. [PMID: 27559275 DOI: 10.1179/2042618613y.0000000047] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
STUDY DESIGN Systematic review of randomized controlled trials (RCT). OBJECTIVES To examine the effects of a therapeutic home exercise program (HEP) for patients with neck pain (associated with whiplash, non-specific, or specific neck pain, with or without radiculopathy, or cervicogenic headache) on pain, function, and disability. Our secondary aim was to describe the design, dosage, and adherence of the prescribed HEPs. BACKGROUND Neck pain is a leading cause of disability that affects 22-70% of the population. Different techniques have been found effective for the treatment of neck pain. However, there is conflicting evidence to support the role of a therapeutic HEP to reduce pain, disability, and improve function and quality of life (QOL). METHODS A systematic review in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement for reporting systematic reviews. The full-text review utilized the Maastricht-Amsterdam assessment tool to assess quality among RCTs. RESULTS A total of 1927 subjects included within seven full-text articles met our specific search strategy. It was found that HEPs with a focus on strength and endurance-training exercises, as well as self- mobilization, have a positive effect when used in combination with other conservative treatments or alone. CONCLUSIONS Home exercise programs that utilize either self-mobilizations within an augmented HEP to address specific spinal levels, or strengthening, and/or endurance exercise are effective at reducing neck pain, function, and disability and improving QOL. The benefit of HEPs in combination with other conservative interventions yields some benefit with a range of effect sizes.
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Affiliation(s)
- Margaret Zronek
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Holly Sanker
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Jennifer Newcomb
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Megan Donaldson
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
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Ratzon NZ, Bar-Niv NA, Froom P. The effect of a structured personalized ergonomic intervention program for hospital nurses with reported musculoskeletal pain: An assigned randomized control trial. Work 2016; 54:367-77. [DOI: 10.3233/wor-162340] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Navah Z. Ratzon
- Department of Occupational Therapy, Tel Aviv University, Tel Aviv, Israel
| | - Netta Abraham Bar-Niv
- Department of Occupational and Environmental Health, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Paul Froom
- Department of Occupational and Environmental Health, School of Public Health, Tel Aviv University, Tel Aviv, Israel
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Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. PLoS One 2016; 11:e0153828. [PMID: 27082110 PMCID: PMC4833298 DOI: 10.1371/journal.pone.0153828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/03/2016] [Indexed: 02/02/2023] Open
Abstract
The main objectives of the current study was i) to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii) to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995–97 and in 2006–08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR) with 95% confidence interval (CI). In total, 1,674 offspring (35.3%) developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55) and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57) was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52) versus high (RR: 1.32, 95% CI: 0.95, 1.84) level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24) of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.
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Effect of education on non-specific neck and low back pain: A meta-analysis of randomized controlled trials. ACTA ACUST UNITED AC 2016; 22:31-41. [DOI: 10.1016/j.math.2015.10.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 10/19/2015] [Accepted: 10/25/2015] [Indexed: 01/05/2023]
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Williams A, Wiggers J, O'Brien KM, Wolfenden L, Yoong S, Campbell E, Robson E, McAuley J, Haskins R, Kamper SJ, Williams CM. A randomised controlled trial of a lifestyle behavioural intervention for patients with low back pain, who are overweight or obese: study protocol. BMC Musculoskelet Disord 2016; 17:70. [PMID: 26864851 PMCID: PMC4750252 DOI: 10.1186/s12891-016-0922-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/03/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Low back pain is a highly prevalent condition with a significant global burden. Management of lifestyle factors such as overweight and obesity may improve low back pain patient outcomes. Currently there are no randomised controlled trials that have been conducted to assess the effectiveness of lifestyle behavioural interventions in managing low back pain. The aim of this trial is to determine if a telephone-based lifestyle behavioural intervention is effective in reducing pain intensity in overweight or obese patients with low back pain, compared to usual care. METHODS/DESIGN A randomised controlled trial will be conducted with patients waiting for an outpatient consultation with an orthopaedic surgeon at a public tertiary referral hospital within New South Wales, Australia for chronic low back pain. Patients will be randomly allocated in a 1:1 ratio to receive a lifestyle behavioural intervention (intervention group) or continue with usual care (control group). After baseline data collection, patients in the intervention group will receive a clinical consultation followed by a 6-month telephone-based lifestyle behavioural intervention (10 individually tailored sessions over a 6-month period) and patients in the control group will continue with usual care. Participants will be followed for 26 weeks and asked to undertake three self-reported questionnaires at baseline (pre-randomisation), week 6 and 26 post randomisation to collect primary and secondary outcome data. The study requires a sample of 80 participants per group to detect a 1.5 point difference in pain intensity (primary outcome) 26 weeks post randomisation. The primary outcome, pain intensity, will be measured using a 0-10 numerical rating scale. DISCUSSION The study will provide robust evidence regarding the effectiveness of a lifestyle behavioural intervention in reducing pain intensity in overweight or obese patients with low back pain and inform management of these patients. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry, ACTRN12615000478516 , Registered 14/05/2015.
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Affiliation(s)
- Amanda Williams
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
| | - John Wiggers
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
| | - Kate M O'Brien
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
| | - Luke Wolfenden
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
| | - Serene Yoong
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
| | - Elizabeth Campbell
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
| | - Emma Robson
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
| | - James McAuley
- Neuroscience Research Australia, PO Box 1170, Randwick, NSW 2031, Australia.
- Prince of Wales Clinical School, University of New South Wales, Randwick, 2031, Australia.
| | - Robin Haskins
- Ambulatory Care Centre, John Hunter Hospital, Hunter New England Local Health District, Locked Bag 664 J, Newcastle, NSW 2300, Australia.
| | - Steven J Kamper
- The George Institute for Global Health, University of Sydney, PO Box M201, Sydney, NSW 2050, Australia.
| | - Christopher M Williams
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mc, NSW 2310, Newcastle, Australia.
- University of Newcastle, Newcastle, 2308, Australia.
- The George Institute for Global Health, University of Sydney, PO Box M201, Sydney, NSW 2050, Australia.
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A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther 2016; 46:44-55. [PMID: 26755405 DOI: 10.2519/jospt.2016.5979] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Randomized clinical trial. BACKGROUND Little is known about the efficacy of providing manual therapy in addition to cervical and scapulothoracic stabilization exercises in people with mechanical neck pain (MNP). Objectives To compare the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone on disability, pain, range of motion (ROM), and quality of life in patients with MNP. METHODS One hundred two patients with MNP (18-65 years of age) were recruited and randomly allocated into 2 groups: stabilization exercise without (n = 51) and with (n = 51) manual therapy. The program was carried out 3 days per week for 4 weeks. The Neck Disability Index, visual analog pain scale, digital algometry of pressure pain threshold, goniometric measurements, and Medical Outcomes Study 36-Item Short-Form Health Survey were used to assess participants at baseline and after 4 weeks. RESULTS Improvements in Neck Disability Index score, night pain, rotation ROM, and the Medical Outcomes Study 36-Item Short-Form Health Survey score were greater in the group that received stabilization exercise with manual therapy compared to the group that only received stabilization exercise. Between-group differences (95% confidence interval) were 2.2 (0.1, 4.3) points for the Neck Disability Index, 1.1 (0.0, 2.3) cm for pain at night measured on the visual analog scale, -4.3° (-8.1°, -0.5°) and -5.0° (-8.2°, -1.7°) for right and left rotation ROM, respectively, and -2.9 (-5.4, -0.4) points and -3.1 (-6.2, 0.0) points for the Medical Outcomes Study 36-Item Short-Form Health Survey physical and mental components, respectively. Changes in resting and activity pain, pressure pain threshold, and cervical extension or lateral flexion ROM did not differ significantly between the groups. Pressure pain threshold increased only in those who received stabilization exercise with manual therapy (P<.05). CONCLUSION The results of this study suggest that stabilization exercises with manual therapy may be superior to stabilization exercises alone for improving disability, pain intensity at night, cervical rotation motion, and quality of life in patients with MNP. LEVEL OF EVIDENCE Therapy, level 1b.
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Freimann T, Merisalu E, Pääsuke M. Effects of a home-exercise therapy programme on cervical and lumbar range of motion among nurses with neck and lower back pain: a quasi-experimental study. BMC Sports Sci Med Rehabil 2015; 7:31. [PMID: 26640694 PMCID: PMC4670527 DOI: 10.1186/s13102-015-0025-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/01/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cervical and lumbar range of motion limitations are usually associated with musculoskeletal pain in the neck and lower back, and are a major health problem among nurses. Physical exercise has been evaluated as an effective intervention method for improving cervical and lumbar range of motion, and for preventing and reducing musculoskeletal pain. The purpose of this study was to investigate the effects of a home-exercise therapy programme on cervical and lumbar range of motion among intensive care unit nurses who had experienced mild to moderate musculoskeletal pain in the neck and or lower back during the previous six months. METHODS A quasi-experimental study was conducted among intensive care unit nurses at Tartu University Hospital (Estonia) between May and July 2011. Thirteen nurses who had suffered musculoskeletal pain episodes in the neck and or lower back during the previous six months underwent an 8-week home-exercise therapy programme. Eleven nurses without musculoskeletal pain formed a control group. Questions from the Nordic Musculoskeletal Questionnaire and the 11-point Visual Analogue Scale were used to select potential participants for the experimental group via an assessment of the prevalence and intensity of musculoskeletal pain. Cervical range of motion and lumbar range of motion in flexion, extension, lateral flexion and (cervical range of motion only) rotation were measured with a digital goniometer. A paired t-test was used to compare the measured parameters before and after the home-exercise therapy programme. A Student's t-test was used to analyse any differences between the experimental and control groups. RESULTS After the home-exercise therapy, there was a significant increase (p < 0.05) in cervical range of motion in flexion, extension, lateral flexion and rotation, and in lumbar range of motion in lateral flexion. Cervical range of motion in flexion was significantly higher (p < 0.01) in the experimental group compared to the control group after therapy. CONCLUSIONS Our results suggest an 8-week intensive home-exercise therapy programme may improve cervical and lumbar range of motion among intensive care nurses. Further studies are needed to develop this simple but effective home-exercise therapy programme to help motivate nurses to perform such exercises regularly. TRIAL REGISTRATION Current Controlled Trials ISRCTN19278735. Registered 27 November 2015.
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Affiliation(s)
- Tiina Freimann
- Tartu University Hospital, Puusepa 8, Tartu, 51014 Estonia ; Department of Public Health, Medical Faculty, University of Tartu, Ravila 14a, Tartu, 50411 Estonia
| | - Eda Merisalu
- Institute of Technology, Estonian University of Life Sciences, Kreuzwaldi 56, Tartu, 51014 Estonia
| | - Mati Pääsuke
- Institute of Exercise Biology and Physiotherapy, University of Tartu, Ravila 14a, Tartu, 50411 Estonia
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Ojoawo AO, Odewole O, Odejide SA, Arilewola BO, Badru AG. Therapeutic efficacy of Lofnac Gel via phonophoresis in the management of chronic nonspecific low back pain: A randomised controlled trial. Hong Kong Physiother J 2015; 33:89-94. [PMID: 30930573 PMCID: PMC6385132 DOI: 10.1016/j.hkpj.2014.12.004] [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: 10/23/2022] Open
Abstract
BACKGROUND The prevalence of nonspecific low back pain is very high among Nigerians and in Africa. Lofnac Gel is a nonsteroidal anti-inflammatory gel that has been used to treat musculoskeletal pain, but its efficacy on nonspecific low back pain is inconclusive. OBJECTIVE The objective of this study was to examine the therapeutic efficacy of Lofnac Gel in the management of nonspecific low back pain. METHODS Seventy patients diagnosed with mechanical low back pain of 3 months' duration were divided into two groups: experimental group (n = 35) and control group (n = 35). Participants in both groups were placed on supervised strengthening exercises for multifidus muscles of the low back. The experimental group was placed on ultrasound phonophoresis therapy with Lofnac Gel (with diclofenac and methyl salicylate as active ingredients), whereas the control group was placed on ultrasound with water as coupling medium. The treatment was applied twice per week for 6 weeks. Present pain intensity and disability were measured before treatment, and in the 3rd week and 6th week of treatment. Data were analysed using descriptive and inferential statistics, and post hoc analysis was carried out when necessary. RESULTS There was a significant difference between the pre- and posttreatment pain intensity and disability index for both the experimental (F = 17.947, p < 0.001; F = 20.712, p < 0.001) and control (F = 14.791, p < 0.001; F = 10.418, p < 0.001) groups. There was also a significant difference between the experimental and control group data in terms of pain intensity (F = 28.76, p < 0.001) and disability index (F = 39.817, p < 0.001) in the 6th week. CONCLUSION Exercise combined with Lofnac phonophoresis was more effective in the management of patients with chronic low back pain than exercise and ultrasound alone.
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Affiliation(s)
- Adesola O. Ojoawo
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University (OAU), Ile Ife, Nigeria
| | - Olamide Odewole
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University (OAU), Ile Ife, Nigeria
| | - Sunday A. Odejide
- Department of Medical Rehabilitation, OAU Teaching Hospitals Complex, Ile Ife, Nigeria
| | - Bosede O. Arilewola
- Department of Medical Rehabilitation, OAU Teaching Hospitals Complex, Ile Ife, Nigeria
| | - Abiodun G. Badru
- Department of Medical Rehabilitation, OAU Teaching Hospitals Complex, Ile Ife, Nigeria
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Horn ME, Brennan GP, George SZ, Harman JS, Bishop MD. Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain. Arch Phys Med Rehabil 2015; 96:1756-62. [PMID: 26166733 DOI: 10.1016/j.apmr.2015.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 06/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the effect of clinical presentations of neck pain on short-term physical therapy outcomes. DESIGN Retrospective analysis of pair-matched groups from a clinical cohort. SETTING Thirteen outpatient physical therapy clinics in 1 health care system. PARTICIPANTS Patients (N=1069) grouped by common clinical presentations of neck pain: nonspecific neck pain (NSNP) with duration <4 weeks; NSNP with duration >4 weeks; neck pain with arm pain; neck pain with headache; and neck pain from whiplash. INTERVENTION Conservative interventions provided by physical therapists. MAIN OUTCOME MEASURES Neck Disability Index (NDI) and numerical pain rating scale (NPRS) recorded at the initial and last visits. The main outcome of interest was achieving recovery status on the NDI. Changes in NDI and NPRS were compared between clinical presentation groups. RESULTS Compared with patients presenting with NSNP >4 weeks, patients with NSNP <4 weeks had increased odds of achieving recovery status on the NDI (P<.0001) and demonstrated the greatest changes in clinical outcomes of pain (P≤.0001) and disability (P≤.0001). Patients with neck pain and arm pain demonstrated an increased odds of achieving recovery status on the NDI (P=.04) compared with patients presenting with NSNP >4 weeks. CONCLUSIONS Treating patients with NSNP within <4 weeks of onset of symptoms may lead to improved clinical outcomes from physical therapy compared with other common clinical presentations.
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Affiliation(s)
- Maggie E Horn
- Department of Physical Therapy, Langston University, Langston, OK.
| | | | - Steven Z George
- Department of Physical Therapy, Brooks-PHHP Research Collaboration, University of Florida, Gainesville, FL
| | - Jeffrey S Harman
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL
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Williams-Whitt K, White MI, Wagner SL, Schultz IZ, Koehn C, Dionne CE, Koehoorn M, Harder H, Pasca R, Warje O, Hsu V, McGuire L, Schulz W, Kube D, Hook A, Wright MD. Job demand and control interventions: a stakeholder-centered best-evidence synthesis of systematic reviews on workplace disability. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2015; 6:61-78. [PMID: 25890601 PMCID: PMC6977041 DOI: 10.15171/ijoem.2015.553] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical and psychological job demands in combination with the degree of control a worker has over task completion, play an important role in reducing stress. Occupational stress is an important, modifiable factor affecting work disability. However, the effectiveness of reducing job demands or increasing job control remains unclear, particularly for outcomes of interest to employers, such as absenteeism or productivity. OBJECTIVE This systematic review reports on job demand and control interventions that impact absenteeism, productivity and financial outcomes. METHODS A stakeholder-centered best-evidence synthesis was conducted with researcher and stakeholder collaboration throughout. Databases and grey literature were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO, TRIP, health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. Articles were assessed independently by two researchers for inclusion criteria and methodological quality. Differences were resolved through consensus. RESULTS The search resulted in 3363 unique titles. After review of abstracts, 115 articles were retained for full-text review. 11 articles finally met the inclusion criteria and are summarized in this synthesis. The best level of evidence we found indicates that multimodal job demand reductions for either at-work or off-work workers will reduce disability-related absenteeism. CONCLUSION In general, the impacts of interventions that aim to reduce job demands or increase job control can be positive for the organization in terms of reducing absenteeism, increasing productivity and cost-effectiveness. However, more high quality research is needed to further assess the relationships and quantify effect sizes for the interventions and outcomes reviewed in this study.
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Affiliation(s)
- K Williams-Whitt
- Faculty of Management, University of Lethbridge, Calgary, AB, Canada.
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36
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Non-specific low back pain: occupational or lifestyle consequences? Wien Klin Wochenschr 2015; 127 Suppl 5:S277-81. [DOI: 10.1007/s00508-015-0770-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
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National survey of back & neck pain amongst consultant ophthalmologists in the United Kingdom. Int Ophthalmol 2015; 35:769-75. [PMID: 25609503 DOI: 10.1007/s10792-015-0036-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 01/04/2015] [Indexed: 01/09/2023]
Abstract
Repetitive tasks, awkward or prolonged working postures, and high cognitive load are risk factors for occupational musculoskeletal disorders. Ophthalmologists may be vulnerable given that they are exposed to a combination of these factors. This national study assesses the prevalence, severity and associations of back and neck pain amongst UK consultant ophthalmologists. A postal survey was conducted using addresses supplied by the Royal College of Ophthalmologists. Statistical analysis was performed using Pearson correlation coefficient, two-tailed probability testing, analysis of variance (ANOVA) and Dunn's multiple comparison test. 518 responses were received (50.3 % response rate). Back and neck pain were reported by 50.6 % (262/518) and 31.8 % (165/518) of respondents, respectively, with 62.4 % (323/518) reporting one or both. 33.6 % (174/518) reported pain whilst operating, of whom 78.7 % (137/174) found operating exacerbated their pain. 31.7 % (164/518) reported pain when using the slit lamp, of whom 71.3 % (117/164) found it exacerbated their pain. Individual subspecialties showed a significant relative risk of back or neck pain in some circumstances, when compared to ophthalmologists as a whole. Occupational back and neck pain remains a problem amongst ophthalmologists. Recommendations are made for modifications to the working environment, and consideration should be given to improving education for trainees.
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Saito H, Sekiguchi M, Yamada H, Kubota T, Shigihara T, Iwasaki T, Yabuki S, Konno S. Comparison of postural changes and muscle fatigue between two types of lumbar support: a prospective longitudinal study. Fukushima J Med Sci 2014; 60:141-8. [PMID: 25410441 DOI: 10.5387/fms.2014-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lumbar supports are used in the management of low back pain (LBP). Although various types of lumbar supports are available, insufficient evidence exists regarding their effectiveness. The aim of this study was to investigate the effect of two types of lumbar support on postural change and muscle fatigue in a prospective longitudinal study. METHODS A total of 144 subjects (9 men and 135 women) with LBP were enrolled in this study. Subjects were divided into 2 groups: a conventional lumbosacral support (LS) group and a wear-type support (SW) group. They filled in questionnaires that included the Short Form 36-Item Health Survey (SF-36), the Roland-Morris Disability Questionnaire (RDQ), and a questionnaire that evaluated the severity of LBP at baseline, 1, 2, and 3 months. The first 40 enrolled subjects were investigated for muscle fatigue and walking efficacy during a gait-loading test, and posture at baseline, 1 month, and 3 months. RESULTS The intensity of LBP and the number of days with LBP significantly decreased over time in both groups. The decrease was similar in both groups at each time point. Wearing either support for 3 months did not induce erector spinae muscle fatigue. Furthermore, walking efficacy improved but spinal alignment was not affected by either support. Subjects in the SW group reported that the support was comfortable to wear for long periods, while subjects in the LS group mentioned that the LS relieved LBP by tightly supporting the lower back. CONCLUSION Both types of support reduced mild LBP and improved walking efficiency without causing muscle fatigue.
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Affiliation(s)
- Hiroharu Saito
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
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Bertozzi L, Villafañe JH, Capra F, Reci M, Pillastrini P. Effect of an Exercise Programme for the Prevention of Back and Neck Pain in Poultry Slaughterhouse Workers. Occup Ther Int 2014; 22:36-42. [DOI: 10.1002/oti.1382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/20/2014] [Accepted: 09/23/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | | | | | - Paolo Pillastrini
- Department of Internal Medicine, Geriatrics and Nephrology; University of Bologna; Bologna Italy
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Taylor JB, Goode AP, George SZ, Cook CE. Incidence and risk factors for first-time incident low back pain: a systematic review and meta-analysis. Spine J 2014; 14:2299-319. [PMID: 24462537 DOI: 10.1016/j.spinee.2014.01.026] [Citation(s) in RCA: 186] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 11/12/2013] [Accepted: 01/14/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND CONTEXT Great effort has been made toward limiting low back pain (LBP). Recent focus has included factors involved with secondary and tertiary prevention, with less attention given to primary prevention. PURPOSE This review provided a current estimate of the incidence of LBP and risk factors associated with either first-time LBP or transition to LBP from a baseline of a pain-free state. STUDY DESIGN A systematic review and meta-analyses were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT SAMPLE Studies included subjects aged 18 years or older, from longitudinal, observational, cohort designs that included baseline risk factors to an outcome of either first-time LBP or transition to LBP from a baseline of a pain-free state. OUTCOME MEASURES Risk factors and incidence rates were reported using descriptive analysis and the PRISMA guidelines. METHODS Electronic search strategies in PubMed, CINAHL/SPORTDiscus, and Cochrane Central Register of Controlled Trials were combined with a hand search to identify articles for inclusion. Studies were classified based on the population studied (community vs. occupational based) and type of LBP outcome (first ever vs. transition from a baseline pain-free state). RESULTS A total of 41 studies were included for review. Meta-analytical incidence rates for first-time LBP and transition to pain from a pain-free state were similar (∼25%), regardless of community or occupational populations. Risk factors for first-time LBP or transition to LBP from a baseline of a pain-free state were psychosocial and physically related. No consistent risk factor emerged as predictive of first-time LBP, although prior LBP was a consistent predictor of future incident LBP. Significant heterogeneity was found across studies in most models, which limits these findings. CONCLUSIONS The results of this study suggest that incidence of LBP is similar in community and occupational settings regardless of LBP definition. There were multiple diverse physical and psychosocial risk factors for first-time LBP. A history of LBP was the most consistent risk factor for transition to LBP from a baseline of a pain-free state.
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Affiliation(s)
- Jeffrey B Taylor
- Department of Physical Therapy, High Point University, 833 Montlieu Ave., High Point, NC 27262, USA.
| | - Adam P Goode
- Department of Community and Family Medicine, Duke University, Durham, NC 27707, USA
| | - Steven Z George
- Department of Physical Therapy, University of Florida, 355 Tigert Hall, Gainesville, FL 32611, USA
| | - Chad E Cook
- Department of Physical Therapy, Walsh University, 2020 East Maple St, North Canton, OH 44720, USA
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Cho KH, Beom JW, Lee TS, Lim JH, Lee TH, Yuk JH. Trunk muscles strength as a risk factor for nonspecific low back pain: a pilot study. Ann Rehabil Med 2014; 38:234-40. [PMID: 24855618 PMCID: PMC4026610 DOI: 10.5535/arm.2014.38.2.234] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 10/12/2013] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the effects of asymptomatic back muscle weakness and spinal deformity on low back pain (LBP). METHODS Sixty healthy subjects without LBP participated in this study. Radiography and an isokinetic/isometric dynamometer were used to respectively measure spinal scoliosis/lordosis and the strength of the trunk flexors/extensors. After 2 years, 48 subjects visited the hospital again and LBP episodes, its severity and the Korean version of the Oswestry Disability Index were assessed. Differences between the group with LBP and the group without LBP were evaluated and the association with LBP incidence and severity was determined. RESULTS Sex, age, and trunk strength were significantly different in both group. Sex and age were significantly positive associated with LBP incidence. The isometric trunk flexor and extensor strength, maximum isokinetic trunk flexor and extensor strength were significantly and negatively associated with the LBP severity. The maximum isokinetic trunk extensor and maximum isometric trunk extensor strength was significantly negative associated with the LBP incidence. CONCLUSION LBP incidence is associated with isometric and isokinetic trunk extensor weakness, whereas LBP severity is associated with age, sex, isokinetic trunk extensor and flexor weakness, isometric trunk extensor and flexor weakness.
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Affiliation(s)
- Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jae Won Beom
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Tae Sung Lee
- Department of Rehabilitation Medicine, Yuseong Wellness Rehabilitation Hospital, Daejeon, Korea
| | - Jun Ho Lim
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Tae Heon Lee
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ji Hyun Yuk
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
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Prevention of low back pain in the military cluster randomized trial: effects of brief psychosocial education on total and low back pain-related health care costs. Spine J 2014; 14:571-83. [PMID: 23608562 DOI: 10.1016/j.spinee.2013.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 02/18/2013] [Accepted: 03/07/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Effective strategies for preventing low back pain (LBP) have remained elusive, despite annual direct health care costs exceeding $85 billion dollars annually. In our recently completed Prevention of Low Back Pain in the Military (POLM) trial, a brief psychosocial education program (PSEP) that reduced fear and threat of LBP reduced the incidence of health care-seeking for LBP. PURPOSE The purpose of this cost analysis was to determine if soldiers who received psychosocial education experienced lower health care costs compared with soldiers who did not receive psychosocial education. STUDY DESIGN/SETTING The POLM trial was a cluster randomized trial with four intervention arms and a 2-year follow-up. Consecutive subjects (n=4,295) entering a 16-week training program at Fort Sam Houston, TX, to become a combat medic in the U.S. Army were considered for participation. METHODS In addition to an assigned exercise program, soldiers were cluster randomized to receive or not receive a brief psychosocial education program delivered in a group setting. The Military Health System Management Analysis and Reporting Tool was used to extract total and LBP-related health care costs associated with LBP incidence over a 2-year follow-up period. RESULTS After adjusting for postrandomization differences between the groups, the median total LBP-related health care costs for soldiers who received PSEP and incurred LBP-related costs during the 2-year follow-up period were $26 per soldier lower than for those who did not receive PSEP ($60 vs. $86, respectively, p=.034). The adjusted median total health care costs for soldiers who received PSEP and incurred at least some health care costs during the 2-year follow-up period were estimated at $2 per soldier lower than for those who did not receive PSEP ($2,439 vs. $2,441, respectively, p=.242). The results from this analysis demonstrate that a brief psychosocial education program was only marginally effective in reducing LBP-related health care costs and was not effective in reducing total health care costs. Had the 1,995 soldiers in the PSEP group not received PSEP, we would estimate that 16.7% of them would incur an adjusted median LBP-related health care cost of $517 compared with the current 15.0% soldiers incurring an adjusted median cost of $399, which translates into an actual LBP-related health care cost savings of $52,846 during the POLM trial. However, it is likely that the unaccounted for direct and indirect costs might erase even these small cost savings. CONCLUSION The results of this study will help to inform policy- and decision-making regarding the feasibility of implementing psychosocial education in military training environments across the services. It would be interesting to explore in future research whether cost savings from psychosocial education could be enhanced given a more individualized delivery method tailored to an individual's specific psychosocial risk factors.
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Tutzschke R, Anders C, Borys C, Nodop S, Rößler O, Strauß B, Scholle HC. [Evaluation of the German new back school: muscular physiological characteristics]. Schmerz 2014; 28:166-74. [PMID: 24643752 DOI: 10.1007/s00482-014-1390-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND According to the biopsychosocial approach of the German new back school the core objectives are sustainable improvement of physical and psychosocial health resources. Subjects with non-specific low back pain were investigated to evaluate the desired physical effects. METHODS Coordinative and postural motor exercises were evaluated by means of surface electromyography (EMG). Applying a modified waiting group design 56 participants were examined 3 months before the start, at the beginning and at the end of the new back school program as well as 3 and 12 months after completion and the results were compared to a healthy control group (n=56) matched for age and body mass index (BMI). RESULTS Initially significant group differences were found in 18 % of all statistical calculations of the static and 6 % of the dynamic test situations. Considering the trunk muscles the most frequent significant alterations from normative data were found in the lumbar multifidus muscle (static tests 29 % and dynamic tests 7 %). No relevant changes in the number of statistical results could be detected directly after completion of the new back school program. Nevertheless, at 12 months follow-up the number of significant differences to the normative data of the control group dropped by one third to 12 % of all calculations with static loads. CONCLUSION The adjustment effects at 12 months follow-up indicate a delayed positive influence of the new back school program on muscular physiological parameters. Individuals with chronic non-specific back pain showed a long-term profit from participation in the new back school program due to the initiated orientation to a modified more active lifestyle.
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Affiliation(s)
- R Tutzschke
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, FB Motorik, Pathophysiologie und Biomechanik, Universitätsklinikum, Friedrich-Schiller-Universität Jena, Bachstr. 18, 07740, Jena, Deutschland,
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Zarra T, Lambrianidis T. Musculoskeletal disorders amongst Greek endodontists: a national questionnaire survey. Int Endod J 2014; 47:791-801. [PMID: 24283200 DOI: 10.1111/iej.12219] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/25/2013] [Indexed: 11/25/2022]
Abstract
AIM To investigate amongst Greek endodontists the prevalence and characteristics of musculoskeletal disorders (MSDs) in the past 12 months, the treatment followed, their postures during practice and the adoption of ergonomic standards. METHODOLOGY One hundred and forty-seven endodontists met the inclusion criteria and were invited to participate in the survey. Participants were asked for personal/professional data, prevalence, characteristics and treatment for MDSs in the past 12 months. Endodontists' postures during practice as well as ergonomic factors were also recorded. Data were analysed using chi-square test, independent samples t-test and logistic regression. The level of significance was set at P = 0.05. RESULTS The response rate was 84%. MSDs were reported by 61% of the participants. Of them, 69% reported pain to more than one body part. The prevalence of disorders was highest in the lower back (30%) and neck (30%). Medical care was applied in 53% of the disorders. A sitting position was always used by 83% of endodontists. Awkward postures during practice (OR:4.561, 95% CI:1.341-15.512), regular stretching exercises (OR:0.032, 95% CI:0.010-0.110) and number of patients day(-1) (OR:3.524, 95% CI:1.686-18.100) were significant predictors for MSDs. Properly adjusted stools, sufficient lighting and space in the operating room were reported by 71%, 96% and 93% of participants, respectively. CONCLUSIONS A high percentage of endodontists reported MSDs. Adoption of correct/neutral postures, regular performance of stretching exercises and reduced number of patients/day were associated with a low prevalence of disorders. The majority of endodontists had adopted ergonomic innovations/standards to control disorders.
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Affiliation(s)
- T Zarra
- Department of Endodontology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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A formação de profissionais de saúde para a prevenção de lesões musculoesqueléticas ligadas ao trabalho a nível da coluna lombar: uma revisão sistemática. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.rpsp.2014.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mork PJ, Vik KL, Moe B, Lier R, Bardal EM, Nilsen TIL. Sleep problems, exercise and obesity and risk of chronic musculoskeletal pain: the Norwegian HUNT study. Eur J Public Health 2013; 24:924-9. [PMID: 24293504 DOI: 10.1093/eurpub/ckt198] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The objective was to investigate the association between self-reported sleep problems and risk of chronic pain in the low back and neck/shoulders, and whether physical exercise and body mass index (BMI) alter this association. METHODS The study comprised data on 26 896 women and men in the Nord-Trøndelag Health Study (Norway) without chronic pain or physical impairment at baseline in 1984-86. Occurrence of chronic pain was assessed at follow-up in 1995-97. A generalized linear model was used to calculate adjusted risk ratios. RESULTS Sleep problems were dose-dependently associated with risk of pain in the low back and neck/shoulders in both women and men (P < 0.001 both genders). Women and men who reported sleep problems 'sometimes' and 'often/always' had a higher risk of chronic pain of 23-32% and 51-66%, respectively, than those who reported sleep problems 'never'. Combined analyses showed that persons with sleep problems 'sometimes' and who exercised ≥1 hour per week had lower risk of chronic pain in the low back (P < 0.04) and neck/shoulders (P < 0.001) than inactive persons with a similar level of sleep problems (P < 0.04). Likewise, persons with BMI <25 kg/cm(2) and sleep problems 'sometimes' had lower risk of chronic pain in the low back (P < 0.001) and neck/shoulders (P < 0.001) than persons with BMI ≥25 kg/cm(2) and a similar level of sleep problems. CONCLUSION Sleep problems are associated with an increased risk of chronic pain in the low back and neck/shoulders. Regular exercise and maintenance of normal body weight may reduce the adverse effect of mild sleep problems on risk of chronic pain.
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Affiliation(s)
- Paul Jarle Mork
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kirsti Lund Vik
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 2 Liaison Committee between the Central Norway Regional Health Authority (RHA), Stjørdal, Norway, and the Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Børge Moe
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ragnhild Lier
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 2 Liaison Committee between the Central Norway Regional Health Authority (RHA), Stjørdal, Norway, and the Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ellen Marie Bardal
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Callander EJ, Schofield DJ, Shrestha RN. Chronic health conditions and poverty: a cross-sectional study using a multidimensional poverty measure. BMJ Open 2013; 3:e003397. [PMID: 24285627 PMCID: PMC3845066 DOI: 10.1136/bmjopen-2013-003397] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To identify the chronic health conditions associated with multidimensional poverty. DESIGN Cross-sectional study of the nationally representative Survey of Disability, Ageing and Carers, conducted by the Australian Bureau of Statistics. SETTING Australian population in 2003. PARTICIPANTS 35 704 individuals randomly selected from the Australian population by the Australian Bureau of Statistics. OUTCOME MEASURES Multidimensional poverty status, costs of disability, short form 6D health utility score, income, education attainment. RESULTS Among those who were multidimensionally poor, 75% had a chronic health condition and the most common health conditions were back problems (11% of those in multidimensional poverty had back problems) and arthritis (11%). The conditions with the highest proportion of individuals in multidimensional poverty were depression/mood affecting disorders (26% in multidimensional poverty) and mental and behavioural disorders (22%). Those with depression/mood affecting disorders were nearly seven times (OR 6.60, 95% CI 5.09 to 8.55, p<0.0001) more likely to be multidimensionally poor than those with no health condition. Equivalising for the additional costs of disability increased the proportion of individuals in multidimensional poverty for all conditions and the conditions with the highest proportion of individuals in multidimensional poverty changed. CONCLUSIONS Owing to the influence of certain health conditions on poverty status, health interventions have the potential to improve national living standards and poverty rates in a similar way that 'traditional' policy responses such as changes to welfare payment currently do. Using a multidimensional poverty measure reveals the health conditions that should be the focus of such efforts.
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Affiliation(s)
- Emily J Callander
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
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Bihari V, Kesavachandran CN, Mathur N, Pangtey BS, Kamal R, Pathak MK, Srivastava AK. Mathematically derived body volume and risk of musculoskeletal pain among housewives in North India. PLoS One 2013; 8:e80133. [PMID: 24223218 PMCID: PMC3819295 DOI: 10.1371/journal.pone.0080133] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/30/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Global Burden of Disease Study 2010 demonstrates the impact of musculoskeletal diseases as the second greatest cause of disability globally in all regions of the world. The study was conducted to determine the role of mathematically derived body volume (BV), body volume index (BVI), body mass index (BMI), body surface area (BSA) and body fat % (BF %) on musculoskeletal pain (MSP) among housewives in National Capital Region (NCR). METHODS A cross sectional study was undertaken among 495 housewives from Gurgaon and New Okhla Industrial Development Area (NOIDA) in National Capital Region (NCR), New Delhi, India. The study includes questionnaire survey, clinical examination and body composition monitoring among housewives. RESULTS A significantly higher BMI, BVI, BV and BSA were observed in subjects with MSP as compared to those who had no MSP. This was also true for subjects with pain in knee for BMI category for overweight. Subjects with pain in limbs had significantly high BMI and BVI as compared to subjects with no MSP. A significant positive correlation of age with BMI, BVI, BV and BSA was observed among subjects having no MSP denoting a direct relationship of age and these body factors. CONCLUSIONS The prevalence of MSP among housewives is associated with increasing age, BMI and BVI. This can possibly be used for formulating a strategy for prevention of MSP.
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Affiliation(s)
- Vipin Bihari
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | | | - Neeraj Mathur
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Balram Singh Pangtey
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Ritul Kamal
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar Pathak
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Anup Kumar Srivastava
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
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Mork PJ, Holtermann A, Nilsen TIL. Physical exercise, body mass index and risk of chronic arm pain: longitudinal data on an adult population in Norway. Eur J Pain 2013; 17:1252-8. [PMID: 23456909 DOI: 10.1002/j.1532-2149.2013.00298.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/09/2022]
Abstract
AIM The aim of this study was to prospectively investigate the association between leisure time physical exercise, body mass index (BMI) and risk of chronic arm pain. METHODS The study population comprises 14,041 women and 13,674 men in the Norwegian HUNT Study without musculoskeletal pain or physical impairment at baseline in 1984-86. Chronic arm pain was assessed at follow-up in 1995-97. A generalized linear model was used to calculate adjusted relative risks (RRs). RESULTS At follow-up, 2205 women and 1458 men reported chronic arm pain. Level of physical exercise was inversely associated with risk of chronic arm pain (P-trend, ≤0.03 for both sexes). Compared with inactive persons, women and men who exercised ≥ 2 h/week had adjusted RRs of 0.84 [95% confidence interval (CI), 0.73-0.96] and 0.74 (95% CI, 0.63-0.87), respectively. BMI was positively associated with risk of chronic arm pain (P-trend, ≤0.002 for both sexes). Compared with normal-weight persons, women and men classified as obese (BMI ≥ 30 kg/m2) had adjusted RRs of 1.26 (95% CI, 1.11-1.44) and 1.29 (95% CI, 1.07-1.57), respectively. Combined analysis showed that obese women and men who exercised ≥ 1 h/week had a RR of 1.20 (95% CI 0.97-1.48) compared with normal-weight women and men with a similar activity level, whereas the RR was 1.41 (95% CI 1.21-1.65) for obese women and men who were physically inactive. CONCLUSION Regular physical exercise reduces risk of chronic arm pain while high BMI increases the risk. Exercise can to some extent compensate for the adverse effect of obesity on risk of chronic arm pain.
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Affiliation(s)
- P J Mork
- Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
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Ferreira PH, Beckenkamp P, Maher CG, Hopper JL, Ferreira ML. Nature or nurture in low back pain? Results of a systematic review of studies based on twin samples. Eur J Pain 2013; 17:957-71. [PMID: 23335362 DOI: 10.1002/j.1532-2149.2012.00277.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 12/17/2022]
Abstract
Twin studies are becoming popular to investigate risk factors for low back pain (LBP) because they consider the genetic factor and allow for more precise estimates of risks. We aimed to identify and summarize the results of studies based on twin samples investigating risk factors for LBP. The MEDLINE, CINAHL, LILACS, Web of Science and EMBASE databases were searched. Prospective and cross-sectional observational studies of LBP involving twins were included. The exposure factors could be genetics (heritability) or environmental such as smoking, alcohol consumption, body mass index and medical history. Pooling was attempted using an inverse variance weighting and fixed effects model. Twenty-seven studies were included. Estimates of heritability effects ranged from 21% to 67%. The genetic component was higher for more chronic and disabling LBP than acute and less disabling LBP. Smoking was significantly associated with LBP [pooled odds ratio (OR) = 3.0; 95% confidence interval (CI) 2.8-3.3] with a longitudinal and a cross-sectional study also identifying a dose-response relationship in people with chronic LBP. Obesity was associated with LBP (pooled OR = 1.9; 95% CI 1.6-2.2) with a cross-sectional study identifying a dose-response relationship. No association between alcohol consumption and LBP was identified. Co-morbidities such as asthma, diabetes and osteoarthritis were associated with LBP (pooled OR ranging from 1.6 to 4.2). The contribution of genetics to LBP appears to be dependent on the severity of the condition. Twin studies could be better used to explore possible causation paths between lifestyle factors, co-morbidities and LBP.
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Affiliation(s)
- P H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
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