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van Amstel R, Noten K, Malone S, Vaes P. Fascia Tissue Manipulations in Chronic Low Back Pain: A Pragmatic Comparative Randomized Clinical Trial of the 4xT Method ® and Exercise Therapy. Life (Basel) 2023; 14:7. [PMID: 38276256 PMCID: PMC10820544 DOI: 10.3390/life14010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment effects of the use of the 4xT method. METHODS A randomized controlled trial was conducted to compare the effectiveness of the 4xT method and exercise therapy-only in patients with chronic nonspecific low back pain. Based on a priori sample size calculation, fifty-one individuals with chronic nonspecific low back pain were randomly assigned to either the 4xT or exercise group. Both groups underwent a six-week rehabilitation program with two treatments per week. The primary outcomes were trunk flexion and extension mobility, trunk flexion, and extension mobility-dependent pain, and quality of life evaluated during a 6-week therapy period and after a 6-week therapy-off period. RESULTS Interaction effects were noted in all outcomes. The 4xT group showed significant improvements over time for trunk flexion and extension mobility, trunk flexion and extension mobility-dependent pain, and quality of life (p < 0.05), with no significant relapse post-therapy (except for extension mobility). The exercise group exhibited significant within-time changes in the quality of life, as measured with the VAS (p < 0.05), but not for EQ-5D-3L. CONCLUSIONS The results of this study demonstrate that the 4xT method stands out as a promising and impactful treatment option for chronic nonspecific low back pain individuals, as it demonstrated significant reductions in mobility-dependent pain, increased trunk mobility, and improved quality of life compared to exercise-only treatments.
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Affiliation(s)
- Robbert van Amstel
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
- Fysio Science Department, Fysio Physics Groups, 3401 IJsselstein, The Netherlands
| | - Karl Noten
- Fysio Science Department, Fysio Physics Groups, 3401 IJsselstein, The Netherlands
| | - Shaun Malone
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), University of Antwerp, Wilrijk, 2000 Antwerpen, Belgium
| | - Peter Vaes
- Faculty of Rehabilitation Science and Physical Therapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
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Slowik JS, McCutcheon TW, Lerch BG, Fleisig GS. Comparison of a single-view image-based system to a multi-camera marker-based system for human static pose estimation. J Biomech 2023; 159:111746. [PMID: 37659353 DOI: 10.1016/j.jbiomech.2023.111746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/12/2023] [Accepted: 07/28/2023] [Indexed: 09/04/2023]
Abstract
The purpose of this study was to compare human static pose estimation data measured with a single-view image-based system and a multi-camera marker-based system. Thirty participants (20 male/10 female, mean ± standard deviation 29.1 ± 10.0 years old, 1.75 ± 0.10 m tall, 79.1 ± 18.0 kg) performed six repetitions each of static holds of arm-raises and squats, in a different orientation for each repetition. These trials were captured simultaneously with a 120-Hz 12-camera marker-based system and a variable-frequency single-view image-based system. Data for each trial were time-synchronized between the two systems using a near-infrared LED-light that was visible to both systems. Discrete measurements of bilateral shoulder angles during arm-raises and bilateral knee angles during squats were compared between the systems using Bland-Altman plots and descriptive statistics. Pearson correlation coefficients were calculated, comparing the participant trial mean values across systems. Finally, a two-way ANOVA was used to examine whether participant orientation in the capture volume significantly affected either system. Biases for discrete measurements ranged in magnitude from 1.3 to 1.9°, and standard deviations of the differences between systems ranged from 2.4 to 4.7°. Pearson correlation coefficients were all above 0.97, and the ANOVA was unable to find a statistically significant orientation effect for either system. Thus, the marker-based and image-based systems produced similar measurements of static shoulder and knee angles. Future work should examine more complex measurements using volumetric scan-based models and also investigate the ability of single-view image-based systems to measure dynamic movements.
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Montag LT, Salomons TV, Wilson R, Duggan S, Bisson EJ. Examining the roles of depression, pain catastrophizing, and self-efficacy in quality of life changes following chronic pain treatment. Can J Pain 2023; 7:2156330. [PMID: 36874232 PMCID: PMC9980521 DOI: 10.1080/24740527.2022.2156330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Adults with chronic pain have a lower quality of life (QOL) compared to the general population. Chronic pain requires specialized treatment to address the multitude of factors that contribute to an individual's pain experience, and effectively managing pain requires a biopsychosocial approach to improve patients' QOL. Aim This study examined adults with chronic pain after a year of specialized treatment to determine the role of cognitive markers (i.e., pain catastrophizing, depression, pain self-efficacy) in predicting changes in QOL. Methods Patients in an interdisciplinary chronic pain clinic (N = 197) completed measures of pain catastrophizing, depression, pain self-efficacy, and QOL at baseline and 1 year later. Correlations and a moderated mediation were completed to understand the relationships between the variables. Results Higher baseline pain catastrophizing was significantly associated with increased mental QOL (b = 0.39, 95% confidence interval [CI] 0.141; 0.648) and decreased depression (b = -0.18, 95% CI -0.306; -0.052) over a year. Furthermore, the relationship between baseline pain catastrophizing and the change in depression was moderated by the change in pain self-efficacy (b = -0.10, 95% CI -0.145; -0.043) over a year. Patients with high baseline pain catastrophizing reported decreased depression after a year of treatment, which was associated with greater QOL improvements but only in patients with unchanged or improved pain self-efficacy. Conclusions Our findings highlight the roles of cognitive and affective factors and their impact on QOL in adults with chronic pain. Understanding the psychological factors that predict increased mental QOL is clinically useful, because medical teams can optimize these positive changes in QOL through psychosocial interventions aimed at improving patients' pain self-efficacy.
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Affiliation(s)
- Landon T Montag
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Tim V Salomons
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Rosemary Wilson
- School of Nursing, Queen's University, Kingston, Ontario, Canada.,Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Ontario, Canada.,Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada
| | - Scott Duggan
- Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Ontario, Canada.,Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Etienne J Bisson
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Ontario, Canada.,Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.,School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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4
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Salik E, Ozden AV, Alptekin HK. Chiropractic Care and Quality of Life Among Office Workers With Nonspecific Pain: A Cross-Sectional Study. J Chiropr Med 2022; 21:157-167. [PMID: 36118107 PMCID: PMC9479198 DOI: 10.1016/j.jcm.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to evaluate the quality of life by a self-administered World Health Organization Quality of Life short version survey (WHOQoL-BREF) among office workers with nonspecific pain receiving chiropractic care in Istanbul, Turkey. Methods This cross-sectional study included 77 office workers (age interval, 18-65) with nonspecific neck, thoracic, back and/or extremity pain who underwent chiropractic care. Two weeks later, the quality of life was evaluated by a self-administered WHOQoL-BREF. The Numeric Pain Scale to evaluate the perceived pain was administered to all of the participants in the beginning and at the end of the study. Group-level changes on WHOQoL-BREF total score and subdimensions were compared according to descriptive data of office workers. The significance level was set at P ≤ .05. Results WHOQoL-BREF scale scores after chiropractic care (mean ± standard deviation) were 71.21% ± 7.91% (total score), 81.49% ± 14.43% (general health), 80.38% ± 10.49% (physical health), 73.16% ± 11.68% (psychological), 70.41% ± 12.43% (social), and 65.58% ± 10.91% (environment). Numeric Pain Scale scores decreased in a statistically significant way when compared with baseline (P ≤ .05). The descriptive statistical analysis of WHOQoL-BREF dimensions revealed that women had significantly higher scores than men, the 18-to-35 age group had higher scores compared with the 50-to-65 age group, and those married had significantly higher scores than those who were not married (P ≤ .05). Conclusion The findings of our study suggest that chiropractic care had positive effects on the quality of life of office workers.
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Affiliation(s)
- Emsal Salik
- Corresponding author: Emsal Salik, MD, PhD, DC, Faculty of Health Sciences, Bahcesehir University, Abbasaga, Ihlamur Yildiz Cd. No:8, 34353 Besiktas, Istanbul, Turkey
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Hnatešen D, Pavić R, Radoš I, Dimitrijević I, Budrovac D, Čebohin M, Gusar I. Quality of Life and Mental Distress in Patients with Chronic Low Back Pain: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10657. [PMID: 36078372 PMCID: PMC9518072 DOI: 10.3390/ijerph191710657] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to examine the levels of health-related quality of life (HRQoL), pain intensity, and mental distress in participants with chronic low back pain (CLBP), and to examine the differences in the HRQoL of participants with respect to mental distress and the correlations of the examined variables. Data were collected from 148 patients using the SF-36 Health Status Questionnaire (SF-36), the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) questionnaire, and the visual-analog pain scale (VAS). The results indicate poorer self-assessment of physical health (Me = 28.1) compared to mental health (Me = 39.4). Participants with higher levels of mental distress reported significant emotional limitations (p = 0.003), lower energy (p < 0.001), poorer psychological health (p < 0.001) and social functioning (p < 0.001), more pain (p = 0.007), and, ultimately, poorer general health (p < 0.001). The level of mental distress was related to the level of HRQoL, while a correlation with the level of pain of the participants was not found. The study results indicate a connection between the presence of mental distress and almost all aspects of HRQoL in participants with CLBP.
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Affiliation(s)
- Dijana Hnatešen
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Roman Pavić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital of Traumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - Ivan Radoš
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Iva Dimitrijević
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Dino Budrovac
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Maja Čebohin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School Osijek, 31000 Osijek, Croatia
| | - Ivana Gusar
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia
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Pellekooren S, Ben ÂJ, Bosmans JE, Ostelo RWJG, van Tulder MW, Maas ET, Huygen FJPM, Oosterhuis T, Apeldoorn AT, van Hooff ML, van Dongen JM. Can EQ-5D-3L utility values of low back pain patients be validly predicted by the Oswestry Disability Index for use in cost-effectiveness analyses? Qual Life Res 2022; 31:2153-2165. [PMID: 35040002 PMCID: PMC9188530 DOI: 10.1007/s11136-022-03082-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/26/2022]
Abstract
Purpose To assess whether regression modeling can be used to predict EQ-5D-3L utility values from the Oswestry Disability Index (ODI) in low back pain (LBP) patients for use in cost-effectiveness analysis. Methods EQ-5D-3L utility values of LBP patients were estimated using their ODI scores as independent variables using regression analyses, while adjusting for case-mix variables. Six different models were estimated: (1) Ordinary Least Squares (OLS) regression, with total ODI score, (2) OLS, with ODI item scores as continuous variables, (3) OLS, with ODI item scores as ordinal variables, (4) Tobit model, with total ODI score, (5) Tobit model, with ODI item scores as continuous variables, and (6) Tobit model, with ODI item scores as ordinal variables. The models’ performance was assessed using explained variance (R2) and root mean squared error (RMSE). The potential impact of using predicted instead of observed EQ-5D-3L utility values on cost-effectiveness outcomes was evaluated in two empirical cost-effectiveness analysis. Results Complete individual patient data of 18,692 low back pain patients were analyzed. All models had a more or less similar R2 (range 45–52%) and RMSE (range 0.21–0.22). The two best performing models produced similar probabilities of cost-effectiveness for a range of willingness-to-pay (WTP) values compared to those based on the observed EQ-5D-3L values. For example, the difference in probabilities ranged from 2 to 5% at a WTP of 50,000 €/QALY gained. Conclusion Results suggest that the ODI can be validly used to predict low back pain patients’ EQ-5D-3L utility values and QALYs for use in cost-effectiveness analyses. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03082-6.
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Affiliation(s)
- Sylvia Pellekooren
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands.
- Department Human Movement Sciences, Faculty of Behavioral & Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Ângela J Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Department Human Movement Sciences, Faculty of Behavioral & Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esther T Maas
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands
| | - Frank J P M Huygen
- Center of Pain Medicine Erasmusmc, Rotterdam, The Netherlands
- Center of Pain Medicine UMCU, Utrecht, The Netherlands
| | - Teddy Oosterhuis
- Netherlands Society of Occupational Medicine, Centre of Excellence, Utrecht, the Netherlands
- Coronel Institute of Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Adri T Apeldoorn
- Rehabilitation Departement, Noordwest Ziekenhuisgroep, Alkmaar, Netherlands, Breederode Hogeschool, Rotterdam, Netherlands
| | - Miranda L van Hooff
- Departement Research, Sint Maartenskliniek, Nijmegen, The Netherlands
- Department of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Jacob KC, Patel MR, Collins AP, Ribot MA, Pawlowski H, Prabhu MC, Vanjani NN, Singh K. The Effect of the Severity of Preoperative Disability on Patient-Reported Outcomes and Patient Satisfaction Following Minimally Invasive Transforaminal Lumbar Interbody Fusion. World Neurosurg 2021; 159:e334-e346. [PMID: 34942388 DOI: 10.1016/j.wneu.2021.12.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/14/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare patient-reported outcomes (PROMs), satisfaction, and minimum clinically important difference (MCID) achievement following minimally invasive transforaminal lumbar interbody fusion stratified by preoperative disability. METHODS Minimally invasive transforaminal lumbar interbody fusions were grouped by preoperative Oswestry Disability Index (ODI) score: ODI <41 or ODI ≥41. PROMs administered pre/postoperatively included Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF), visual analog scale (VAS) back/leg, ODI, and 12-Item Short-Form Physical Composite Score (SF-12 PCS)/12-Item Short-Form Mental Composite Score (SF-12 MCS). Satisfaction scores were collected for VAS back/leg and ODI. Coarsened exact match controlled for differences between cohorts. T tests compared mean PROMs and postoperative improvement/satisfaction between cohorts. Simple logistic regression compared MCID achievement. RESULTS After coarsened exact matching, there were 118 patients in the ODI ≤41 and 377 patients in the ODI >41 cohort. The ODI >41 cohort saw greater postoperative inpatient VAS pain score and narcotic consumption on days 0/1 (P < 0.018, all). PROMs differed between cohorts: PROMIS-PF, SF-12 PCS, ODI, VAS back/leg at all postoperative time points and SF-12 MCS at 6 weeks/12 weeks/6 months/1 year (P < 0.045, all). Patients in the ODI >41 cohort demonstrated greater proportion achieving MCID for ODI at all postoperative time points and for SF-12 MCS 6-week/12-week/6-month/1-year (P < 0.040, all). The ODI ≤41 cohort demonstrated greater MCID achievement for overall PROMIS-PF and SF-12 PCS 6 months (P < 0.047, all). Postoperative satisfaction was greater in the ODI ≤41 cohort for VAS leg 6 weeks/12 weeks, VAS back 6 weeks/12 weeks, and ODI all postoperative time points (P < 0.048, all). CONCLUSIONS Preoperative disability associated with worse postoperative PROMs and patient satisfaction for disability, back/leg pain at multiple time points. MCID achievement rates across cohorts were similar for most PROMs at most postoperative time points. Patients with severe disability may have unrealistic expectations for surgical benefits, influencing corresponding postoperative satisfaction.
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Affiliation(s)
- Kevin C Jacob
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Madhav R Patel
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Andrew P Collins
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Max A Ribot
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Hanna Pawlowski
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Michael C Prabhu
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Nisheka N Vanjani
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Kern Singh
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
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Yamada K, Suzuki A, Takahashi S, Inui K, Koike T, Okano T, Yabu A, Hori Y, Toyoda H, Nakamura H. Risk Factors for Low Back Pain Increase in Rheumatoid Arthritis: Analysis of a 7-year Follow-up Study. Mod Rheumatol 2021; 32:1027-1034. [PMID: 34878544 DOI: 10.1093/mr/roab106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/30/2021] [Accepted: 11/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Several studies have demonstrated that low back pain (LBP) is related to disease activity in patients with rheumatoid arthritis (RA). However, there is no longitudinal research. This study aimed to determine the impacts and risk factors for LBP increase in RA in a longitudinal cohort study. METHODS The study evaluated 113 patients with RA who completed the secondary survey. LBP increase was defined as ≥1 standard deviation of mean change in visual analog scale (VAS) between the baseline and secondary surveys. The impacts of LBP increase on quality of life (QOL) and psychological status were evaluated. Risk factors were assessed among patient demographic characteristics, radiological changes. RESULTS Mean change in VAS for LBP was -0.8±30.4 mm during a mean 7-year follow-up. LBP increase was defined as ≥30-mm increase in VAS for LBP. Patients with LBP increase had significantly lower QOL and worse mental status than patients without. Poor control of RA was identified as an independent risk factor for LBP increase (odds ratio, 9.82, p=0.001). CONCLUSION Patients with poor control of RA were likely to experience LBP increase in the long-term. Control of RA disease activity is important for control of LBP, QOL, and mental status.
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Affiliation(s)
- Kentaro Yamada
- Department of Orthopaedic Surgery, PL Hospital, Tondabayashi City, Osaka, Japan.,Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Akinobu Suzuki
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Shinji Takahashi
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Kentaro Inui
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Tatsuya Koike
- Center for Senile Degenerative Disorders (CSDD), Osaka City University, Osaka City, Osaka, Japan
| | - Tadashi Okano
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Akito Yabu
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Yusuke Hori
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Hiromitsu Toyoda
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan
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Corrêa Pinto RN, da Silva MC, Caputo EL, Domingues MR. Low back pain prevalence and associated factors in nurses from Brazilian primary health units. Work 2021; 70:279-285. [PMID: 34511471 DOI: 10.3233/wor-213572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Primary health unit (PHU) nursing work is different when compared to hospital environment. Although low back pain (LBP) literature presents studies conducted in hospital nursing personnel, there is a lack of studies in PHU nurses. OBJECTIVE This study aimed to measure the prevalence of LBP in PHU nursing personnel in the city of Pelotas, Brazil. METHODS Sociodemographic (age, gender, number of children, skin color, income and marital status), occupational (PHU type, formal education, professional experience, weekly workload, extra work activity, workload perception), nutritional (BMI), health (self-perceived health, smoking, sleep quality and minor psychiatric disorders, PHU physical structure perception) and behavioral (leisure-time physical activity) characteristics were assessed. LBP was defined as pain or discomfort between the last rib and gluteal fold. Poisson regression was used to evaluate the relationship among LBP and covariates. RESULTS LBP prevalence was 65.2%. Chronic (12 weeks) and acute (7 days) LBP prevalence were 22.4%and 53.4%, respectively. LBP was associated with obesity (PR 1.39 95%CI 1.01-1.92) and poor self-perceived health (PR 2.77 95%CI 1.32-5.80). CONCLUSIONS Prevalence of LBP in PHU nursing personnel is high and similar to hospital nurses. Individual characteristics such as body mass and health perception were associated with LBP.
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Affiliation(s)
| | | | - Eduardo Lucia Caputo
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
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10
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Aminde JA, Aminde LN, Bija MD, Lekpa FK, Kwedi FM, Yenshu EV, Chichom AM. Health-related quality of life and its determinants in patients with chronic low back pain at a tertiary hospital in Cameroon: a cross-sectional study. BMJ Open 2020; 10:e035445. [PMID: 33028543 PMCID: PMC7539580 DOI: 10.1136/bmjopen-2019-035445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate health-related quality of life (HRQoL) and its determinants in chronic low back pain (CLBP) patients in Cameroon. DESIGN Observational cross-sectional study. SETTING Tertiary hospital. PARTICIPANTS There were 150 eligible adults with low back pain of at least 12 weeks who provided informed consent. Of these, 136 with complete questionnaires were analysed. OUTCOMES HRQoL was measured using the WHO Quality of Life questionnaire (WHOQOL-BREF). Outcome measures included its four domain (physical health, psychological, social relationships and environmental) scores and two independent scores for overall quality of life (OQOL) and general health satisfaction (GH). RESULTS Participants had a median age of 52 years, and median pain duration of 33 (IQR: 69) months. The median OQOL score was 50 (IQR: 25). After multivariable adjustment, tertiary education (β=11.43, 95% CI 3.12 to 19.75), age (β=0.49, 95% CI 0.12 to 0.87) and being a student (β=23.07, 95% CI 0.28 to 45.86) contributed to better OQOL. Age (β=0.57, 95% CI 0.10 to 1.04) and physical-type employment (β=-14.57, 95% CI -25.83 to -3.31) affected GH. Smoking (β=-20.49, 95% CI -35.49 to -5.48) and radiological anomalies (β=-7.57, 95% CI -14.64 to -0.49) affected the physical health domain, while disability (β=-0.67, 95% CI -1.14 to -0.20) and duration of pain (β=-0.13, 95% CI -0.20 to -0.05) affected the psychological domain. Income (β=14.94, 95% CI 4.06 to 25.81) affected the social domain, while education (β=9.96, 95% CI 1.41 to 18.50) and disability (β=-0.75, 95% CI -1.26 to -0.24) affected the environmental domain. CONCLUSIONS Our findings suggest that CLBP affects HRQoL and multiple socioeconomic and clinical factors influence its impact on different domains of HRQoL. Multipronged management programmes, especially those that reduce disability, could improve HRQoL in patients with CLBP.
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Affiliation(s)
- Jeannine Anyingu Aminde
- Cameroon Baptist Convention Health Service, Bamenda, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Leopold Ndemnge Aminde
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
- Non-communicable diseases Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon
| | - Marie Doualla Bija
- Rheumatology Unit, Douala General Hospital, Douala, Cameroon
- Department of Internal Medicine & Specialties, Faculty of Medicine & Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
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Ibrahim AA, Akindele MO, Ganiyu SO, Kaka B, Abdullahi BB, Sulaiman SK, Fatoye F. The Hausa 12-item short-form health survey (SF-12): Translation, cross-cultural adaptation and validation in mixed urban and rural Nigerian populations with chronic low back pain. PLoS One 2020; 15:e0232223. [PMID: 32379769 PMCID: PMC7205304 DOI: 10.1371/journal.pone.0232223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/09/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Measuring health-related quality of life (HRQOL) in patients with chronic low back pain (LBP) is crucial to monitor and improve the patients' health status through effective rehabilitation. While the 12-item short-form health survey (SF-12) was developed as a shorter alternative to the 36-item short-form health survey for assessing HRQOL in large-scale studies, to date, no cross-culturally adapted and validated Hausa version exists. This study aimed to translate and cross-culturally adapt the SF-12 into Hausa language, and test its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP. METHODS The Hausa version of the SF-12 was developed following the guidelines of the International Quality of Life Assessment project. Fifteen patients with chronic LBP recruited from urban and rural communities of Nigeria pre-tested the Hausa SF-12. A consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the instrument, among which 100 respondents re-tested the instrument after two weeks. Factorial structure and invariance were assessed using confirmatory factor analysis (CFA) and multi-group CFA respectively. Multi-trait scaling analysis (for convergent and divergent validity) and known-groups validity were performed to assess construct validity. Composite reliability (CR), internal consistency (Cronbach's α), intraclass correlation coefficients (ICC), and Bland-Altman plots were computed to assess reliability. RESULTS After the CFA of the original conceptual SF-12 model, 2 redundant items were removed and 4 error terms were allowed to covary, thus providing adequate fit to the sample. The refined model demonstrated good fit and evidence of factorial invariance in three demographic groups (age, gender, and habitation). Convergent (11:12; 91% success rate) and divergent (10:12; 83% success rate) validity were satisfactory. Known-groups comparison showed that the instrument discriminated well for those who differed in age (p < 0.05) but in gender and habitation (p > 0.05). The physical component summary and the mental component summary demonstrated acceptable CR (0.69 and 0.79 respectively), internal consistency (α = 0.73 and 0.78 respectively), test-rest reliability (ICC = 0.79 and 0.85 respectively), and good agreement between test-retest values. CONCLUSIONS The Hausa SF-12 was successfully developed and showed evidence of factorial invariance across age, gender, and habitation. The instrument demonstrated satisfactory construct validity, internal consistency, and test-retest reliability. However, stronger psychometric properties need to be established in general population and other patients groups in future studies. The instrument can be used clinically and for research in Hausa-speaking patients with chronic LBP.
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Affiliation(s)
- Aminu Alhassan Ibrahim
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Kano State, Nigeria
- Department of Physiotherapy, Muhammad Abdullahi Wase Teaching Hospital, Hospital Management Board, Kano, Kano State, Nigeria
- * E-mail:
| | - Mukadas Oyeniran Akindele
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Kano State, Nigeria
| | - Sokunbi Oluwaleke Ganiyu
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Kano State, Nigeria
| | - Bashir Kaka
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Kano State, Nigeria
| | - Bashir Bello Abdullahi
- Department of Physiotherapy, Sir Muhammadu Sunusi Specialist Hospital, Hospital Management Board, Kano, Kano State, Nigeria
| | - Surajo Kamilu Sulaiman
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Medicine, Kaduna State University, Kaduna, Nigeria
| | - Francis Fatoye
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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12
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Al Zoubi FM, French SD, Patey AM, Mayo NE, Bussières AE. Professional barriers and facilitators to using stratified care approaches for managing non-specific low back pain: a qualitative study with Canadian physiotherapists and chiropractors. Chiropr Man Therap 2019; 27:68. [PMID: 31857892 PMCID: PMC6909494 DOI: 10.1186/s12998-019-0286-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/01/2019] [Indexed: 12/28/2022] Open
Abstract
Background Recent clinical practice guidelines for the management of non-specific low back pain (LBP) recommend using stratified care approaches. To date, no study has assessed barriers and facilitators for health professionals in using stratified care approaches for managing non-specific LBP in the Canadian primary care setting. This study aimed to identify and contrast barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors. Methods Individual telephone interviews, underpinned by the Theoretical Domains Framework (TDF), explored beliefs and attitudes about, and identified barriers and facilitators to the use of stratified care approaches for managing non-specific LBP in a purposive sample of 13 chiropractors and 14 physiotherapists between September 2015 and June 2016. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using directed content analysis. Results Three and seven TDF domains were identified as likely relevant for physiotherapists and chiropractors, respectively. Shared key beliefs (and relevant domains of the TDF) for both physiotherapists and chiropractors included: lack of time, cost, and expertise (Environmental Context and Resources); and consulting more experienced colleagues and chronic patients with important psychological overlay (Social Influences). Unique key domains were identified among physiotherapists: incompatibility with achieving other objectives (Goals), and chiropractors: confidence in using stratified care approaches (Beliefs about Capabilities); intention to use stratified care approaches (Intentions); awareness and agreement with stratified care approaches (Knowledge); assessment of readiness for change and intentional planning behaviour (Behavioural Regulation); and improving the management of non-specific LBP patients and the uptake of evidence-based practice (Beliefs about Consequences). Conclusions Several shared and unique barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors were identified. Findings may help inform the design of tailored theory-based knowledge translation interventions to increase the uptake of stratified care approaches in clinical practice.
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Affiliation(s)
- Fadi M Al Zoubi
- 1School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC Canada.,2Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC Canada
| | - Simon D French
- 3Department of Chiropractic, Macquarie University, Sydney, NSW Australia.,4School of Rehabilitation Therapy, Queen's University, Kingston, ON Canada
| | - Andrea M Patey
- 5Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Nancy E Mayo
- 1School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC Canada.,2Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC Canada
| | - André E Bussières
- 1School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3630 Promenade Sir-William-Osler, H3G 1Y5, Montreal, QC Canada.,2Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, QC Canada.,6Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC Canada
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13
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Eilayyan O, Thomas A, Hallé MC, Ahmed S, Tibbles AC, Jacobs C, Mior S, Davis C, Evans R, Schneider MJ, Owens H, Zoubi FA, Barnsley J, Long CR, Bussières A. Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention. Chiropr Man Therap 2019; 27:44. [PMID: 31636895 PMCID: PMC6794734 DOI: 10.1186/s12998-019-0267-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/05/2019] [Indexed: 12/29/2022] Open
Abstract
Background The literature supports the effectiveness of self-management support (SMS) to improve health outcomes of patients with chronic spine pain. However, patient engagement in SMS programs is suboptimal. The objectives of this study were to: 1) assess participation in self-care (i.e. activation) among patients with spine pain, 2) identify patients’ barriers and enablers to using SMS, and 3) map behaviour change techniques (BCTs) to key barriers to inform the design of a knowledge translation (KT) intervention aimed to increase the use of SMS. Methods In summer 2016, we invited 250 patients with spine pain seeking care at the Canadian Memorial Chiropractic College in Ontario, Canada to complete the Patient Activation Measure (PAM) survey to assess the level of participation in self-care. We subsequently conducted individual interviews, in summer 2017, based on the Theoretical Domains Framework (TDF) in a subset of patients to identify potential challenges to using SMS. The interview guide included 20 open-ended questions and accompanying probes. Findings were deductively analysed guided by the TDF. A panel of 7 experts mapped key barriers to BCTs, designed a KT intervention, and selected the modes of delivery. Results Two hundred and twenty-three patients completed the PAM. Approximately 24% of respondents were not actively involved in their care. Interview findings from 13 spine pain patients suggested that the potential barriers to using SMS corresponded to four TDF domains: Environmental Context and Resources; Emotion; Memory, Attention & Decision-Making; and Behavioural Regulation. The proposed theory-based KT intervention includes paper-based educational materials, webinars and videos, summarising and demonstrating the therapeutic recommendations including exercises and other lifestyle changes. In addition, the KT intervention includes Brief Action Planning, a SMS strategy based on motivational interviewing, along with a SMART plan and reminders. Conclusions Almost one quarter of study participants were not actively engaged in their spine care. Key barriers likely to influence uptake of SMS among patients were identified and used to inform the design of a theory-based KT intervention to increase their participation level. The proposed multi-component KT intervention may be an effective strategy to optimize the quality of spine pain care and improve patients’ health-outcomes. Electronic supplementary material The online version of this article (10.1186/s12998-019-0267-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Owis Eilayyan
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Aliki Thomas
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Marie-Christine Hallé
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Sara Ahmed
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Anthony C Tibbles
- 3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada
| | - Craig Jacobs
- 3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada
| | - Silvano Mior
- 3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada
| | - Connie Davis
- 4University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4 Canada.,Centre for Collaboration, Motivation and Innovation, PO Box 1343, Vernon, BC V1T 6N6 Canada
| | - Roni Evans
- 6University of Minnesota, Minneapolis, MN 55455 USA
| | | | - Heather Owens
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada
| | - Fadi Al Zoubi
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Jan Barnsley
- 8University of Toronto, 27 King's College Cir, Toronto, ON M5S Canada
| | - Cynthia R Long
- 9Palmer College, Davenport, 1000 Brady St, Davenport, IA 52803 USA
| | - Andre Bussières
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
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14
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Shariat A, Alizadeh R, Moradi V, Afsharnia E, Hakakzadeh A, Ansari NN, Ingle L, Shaw BS, Shaw I. The impact of modified exercise and relaxation therapy on chronic lower back pain in office workers: a randomized clinical trial. J Exerc Rehabil 2019; 15:703-708. [PMID: 31723560 PMCID: PMC6834712 DOI: 10.12965/jer.1938490.245] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/18/2019] [Indexed: 02/05/2023] Open
Abstract
This study aimed to evaluate the effectiveness of a modified package of exercise therapy combined with relaxation on pain intensity, range of motion (ROM), anxiety, and quality of life (QoL) in office workers with chronic lower back pain. In this clinical trial, 72 office workers aged 20 to 50 years with chronic low back pain were randomized to one of four groups including; group 1, exercise therapy; group 2, psychotherapy (relaxation therapy); group 3, modified protocol (exercise therapy followed by relaxation therapy); group 4, control group (no intervention). Participants exercised 3 times weekly for 6 weeks for 40-45 min of exercise/relaxation. Pain intensity, ROM, anxiety, and QoL were evaluated at baseline, 6 weeks, and 12 weeks after the end of the intervention. Results showed significant decreases in pain intensity and anxiety in the three experimental groups compared to the control group. The three intervention groups indicated a significant decrease in pain intensity and anxiety after 6 and 12 weeks. ROM significantly improved in the exercise therapy and the modified protocol over time (after 6 and 12 weeks). A significant difference in QoL was found between the groups, with the greatest improvement found in the psychotherapy and modified protocol groups. This therapeutic package (including exercise movements and psychological interventions) was found to have a superior effect on pain intensity, ROM, anxiety, and QoL after 6 and 12 weeks compared to other interventions (only exercise and psychotherapy).
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Affiliation(s)
- Ardalan Shariat
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Alizadeh
- Department of Anesthesiology, AJA University of Medical Sciences, Tehran, Iran
| | - Vahideh Moradi
- Department of Orthotics and Prosthetics, Iran University of Medical Sciences, Tehran, Iran
| | - Elahe Afsharnia
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Hakakzadeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhsotin Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Lee Ingle
- Department of Sport, Health & Exercise Science, University of Hull, Kingston-upon-Hull, UK
| | - Brandon S. Shaw
- Department of Human Movement Science, University of Zululand, KwaDlangezwa, South Africa
| | - Ina Shaw
- Department of Human Movement Science, University of Zululand, KwaDlangezwa, South Africa
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The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients. Qual Life Res 2019; 29:275-287. [PMID: 31531837 PMCID: PMC6962124 DOI: 10.1007/s11136-019-02302-w] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Previous studies found higher levels of pain severity and disability to be associated with higher costs and lower health-related quality of life. However, these findings were based on cross-sectional data and little is known about the longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients. This study aims to cover this knowledge gap by exploring these longitudinal relationships in a consecutive cohort. METHODS Data of 6316 chronic low back pain patients were used. Measurements took place at 3, 6, 9, and 12 months. Pain severity (Numeric pain rating scale; range: 0-100), disability (Oswestry disability index; range: 0-100), health-related quality of life (EQ-5D-3L: range: 0-1), societal and healthcare costs (cost questionnaire) were measured. Using linear generalized estimating equation analyses, longitudinal relationships were explored between: (1) pain severity and health-related quality of life, (2) disability and health-related quality of life, (3) pain severity and societal costs, (4) disability and societal costs, (5) pain severity and healthcare costs, and (6) disability and healthcare costs. RESULTS Higher pain and disability levels were statistically significantly related with poorer health-related quality of life (pain intensity: - 0.0041; 95% CI - 0.0043 to - 0.0039; disability: - 0.0096; 95% CI - 0.0099 to - 0.0093), higher societal costs (pain intensity: 7; 95% CI 5 to 8; disability: 23; 95% CI 20 to 27) and higher healthcare costs (pain intensity: 3; 95% CI 2 to 4; disability: 9; 95% CI 7 to 11). CONCLUSION Pain and disability were longitudinally related to health-related quality of life, societal costs, and healthcare costs. Disability had a stronger association with all outcomes compared to pain.
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Dong HJ, Larsson B, Rivano Fischer M, Gerdle B. Maintenance of quality of life improvement for patients with chronic pain and obesity after interdisciplinary multimodal pain rehabilitation - A study using the Swedish Quality Registry for Pain Rehabilitation. Eur J Pain 2019; 23:1839-1849. [PMID: 31343806 DOI: 10.1002/ejp.1457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/03/2019] [Accepted: 07/21/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Throughout the world many people have both obesity and chronic pain, comorbidities that decrease Health-Related Quality of Life (HRQoL). It is uncertain whether patients with comorbid obesity can maintain improved HRQoL after Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). METHODS Data from 2016, 2017, and 2018 were obtained from a national pain database for Swedish specialized pain clinics and collected at three time points: Pre-IMMPR; Post- IMMPR; and 12-month follow-up (FU-IMMPR). Participants (N = 872) reported body weight, height, pain aspects, and HRQoL (RAND 36-Item Health Survey). Severe obesity (Body Mass Index, BMI ≥35 kg/m2 ) was defined according to WHO classifications. We used linear mixed regression models to examine BMI group differences in HRQoL over time. RESULTS More than 25% of patients (224/872) were obese and nearly 30% (63/224) of these were severely obese. All BMI groups improved significantly in both physical and mental composites of HRQoL after IMMPR (Pre- vs. Post-IMMPR, p < .001). The improvements were maintained at a 12-month follow-up (Post- vs. FU-IMMPR, p > .05). The severe obesity group had the lowest physical health score and least improvement (pre- vs. FU-IMMPR, Cohen's d = o.422, small effect size). Severe obesity had negative impact on physical health (β = -4.39, p < .05) after controlling for sociodemographic factors and pain aspects. CONCLUSION Improvements in HRQoL after IMMPR were achieved and maintained across all weights, including patients with comorbid obesity. Only severe obesity was negatively associated with physical health aspects of HRQoL. SIGNIFICANCE Patients with chronic pain and comorbid obesity achieve sustained Health-Related Quality of Life (HRQoL) improvements from Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). This finding suggests that rehabilitation professionals should consider using IMMPR for patients with comorbid obesity even though their improvement may not reach the same level as for non-obese patients.
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Affiliation(s)
- Huan-Ji Dong
- Department of Medical and Health Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Britt Larsson
- Department of Medical and Health Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Health Sciences, Rehabilitation Medicine, Lund University, Lund, Sweden.,Department of Neurosurgery and Pain Rehabilitation, Skane University Hospital, Lund, Sweden
| | - Björn Gerdle
- Department of Medical and Health Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
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Abdelhalim NM, Samhan AF, Abdelbasset WK. Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university's employees with non-specific low back pain: A pilot study. Pak J Med Sci 2019; 35:987-991. [PMID: 31372129 PMCID: PMC6659051 DOI: 10.12669/pjms.35.4.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health–Related Quality of Life (HRQOL). Methods: Forty-two University’s employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment. Results: All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05). Conclusions: PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university’s employees with nonspecific LBP.
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Affiliation(s)
- Nermeen Mohamed Abdelhalim
- Nermeen Mohamed Abdelhalim, Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj City, Saudi Arabia
| | - Ahmed Fathy Samhan
- Ahmed FathySamhan, Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj City, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Walid Kamal Abdelbasset Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj City, Saudi Arabia
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18
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Prevalence of and factors associated with dysfunctional low back pain in patients with rheumatoid arthritis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:976-982. [PMID: 30850879 DOI: 10.1007/s00586-019-05938-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 02/18/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the prevalence of and factors associated with dysfunctional low back pain (LBP) in patients with rheumatoid arthritis (RA). METHODS This cross-sectional study included 1276 RA outpatients from two hospitals. The Roland-Morris Disability Questionnaire was used to address the functional-dysfunctional state criterion. Clinical variables, such as medical status, disease activity, bone mineral density, and spinopelvic alignment parameters, were compared between patients with and without dysfunctional LBP. RESULTS Mean age and disease duration were 64.6 and 13.4 years, respectively; the prevalence of dysfunctional LBP was 32.8%. On univariate analysis, significant differences existed in many variables, except sex, body weight, C-reactive protein (CRP) level, and prevalence of biological agent users, between patients with and without dysfunctional LBP. Multivariate logistic regression analysis revealed body mass index (BMI; odds ratio [OR], 1.116; P < 0.001), onset age of RA (OR, 1.020; P = 0.020), disease duration of RA (OR, 1.043; P < 0.001), methotrexate (MTX) use (OR, 0.609; P = 0.007), vertebral fractures (OR, 2.189; P = 0.001), vertebral endplate and/or facet erosion (OR, 1.411; P = 0.043), disease activity score (DAS) in 28 joints-CRP (DAS-28CRP) (OR, 1.587; P = 0.001), pelvic tilt (PT; OR, 1.023; P = 0.019), and sagittal vertical axis (SVA; OR, 1.007; P = 0.043) as associated factors. CONCLUSION The factors associated with dysfunctional LBP in patients with RA were more vertebral fractures, higher DAS-28CRP, vertebral endplate and/or facet erosion, higher BMI, longer disease duration, greater PT, older onset age, greater SVA, and less MTX use. Strictly controlling patients' body weight and disease activity with MTX and avoiding spinopelvic malalignment through vertebral fracture prevention are important. These slides can be retrieved under Electronic Supplementary Material.
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Ibrahim AA, Akindele MO, Ganiyu SO, Bello B. Effects of motor control exercise and patient education program in the management of chronic low back pain among community-dwelling adults in rural Nigeria: a study protocol for a randomized clinical trial. Integr Med Res 2019; 8:71-81. [PMID: 31080731 PMCID: PMC6506610 DOI: 10.1016/j.imr.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/31/2019] [Accepted: 02/11/2019] [Indexed: 01/10/2023] Open
Abstract
Background The impact of chronic low back pain (CLBP) is disproportionally higher in rural Nigeria than in urban areas but lack access to rehabilitation. While exercise and education are commonly advocated interventions for the rehabilitation of CLBP, there is a paucity of community-based randomized clinical trials assessing their benefits among adults with CLBP in rural Nigeria. The purpose of this study is to investigate the effects of motor control exercise (MCE) and patient education (PE) in the management of CLBP among community-dwelling adults in rural Nigeria. Methods This is an assessor-blind, three-arm parallel randomized clinical trial and will be conducted at Tsakuwa Primary Health Care Center in Kano, Northwestern Nigeria. One hundred and twenty adults with CLBP will be recruited and randomized to one of three intervention arms; MCE plus PE, MCE, or PE groups. The MCE will be administered twice a week for 8 weeks while the PE will be provided once a week for 8 weeks. Participants will be assessed pre-intervention, immediately post-intervention and at 3-month post-intervention. Primary outcomes will be pain intensity and functional disability. Secondary outcomes will be quality of life, fear-avoidance beliefs, pain catastrophizing, back beliefs, global perceived recovery, and physical performance. Discussion This will be the first community-based trial to assess the benefits of exercise and education in the management of CLBP among adults in rural Nigeria. The study may provide a relatively inexpensive, assessable, and effective alternative intervention for reducing CLBP disability in a low-resource rural Nigerian community. Trial registration:This study is registered at ClinicalTrial.gov and the trial registration number is NCT03393104.
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Affiliation(s)
- Aminu A. Ibrahim
- Corresponding author at: Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Nigeria.
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Doualla M, Aminde J, Aminde LN, Lekpa FK, Kwedi FM, Yenshu EV, Chichom AM. Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC Musculoskelet Disord 2019; 20:25. [PMID: 30646894 PMCID: PMC6334448 DOI: 10.1186/s12891-019-2403-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 01/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very little is known about the burden of chronic low back pain in Africa. This study aimed at assessing disability and associated factors in chronic low back patients in Cameroon. METHODS We carried a hospital-based cross-sectional study including patients suffering from low back pain (LBP) of at least 12 weeks' duration. Disability was assessed using the Roland Morris Disability Questionnaire (RMDQ). RMDQ > 4 described persons with dysfunctional levels of disability. Multivariable linear regression was used to investigate factors associated with higher RMDQ scores hence greater disability. Variables investigated included; gender, age, marital status, employment status and type, smoking history, alcohol consumption, income, pain intensity, LBP duration, psychological wellbeing, sleep satisfaction, leg pain, numbness/paresthesia, bowel/bladder dysfunction symptoms (BBDS), body mass index (BMI), and days of work absence. RESULTS A sample of 136 adults (64% female) with a mean age of 50.6 ± 12.2 years participated in the study. Median duration of LBP was 33 (25th - 75th percentile: 12-81) months. Mean RMDQ score was 12.8 ± 6. In multivariable linear regression, pain intensity (β = 0.07, p = 0.002), longer days of work absence (β = 0.15, p = 0.003) and BBDS (β =2.33, p = 0.029) were associated with greater disability. Factors such as consumption of alcohol (β = - 3.55, p = 0.005) and higher psychological wellbeing scores (β = - 0.10, p = 0.004) significantly contributed to less disability (lower RMDQ scores). Dysfunctional levels of disability were present in 88.1% of patients. CONCLUSION CLBP is associated with significant disability and this relationship is driven by several factors. Multidisciplinary management strategies especially those targeted to improve pain control, manage BBDS and improve psychological wellbeing could reduce disability and improve quality of life.
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Affiliation(s)
- Marie Doualla
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Jeannine Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Leopold Ndemnge Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Fernando Kemta Lekpa
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Felix Mangan Kwedi
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Douala General Hospital, Douala, Cameroon
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Nishimura A, Ohtsuki M, Kato T, Nagao R, Ito N, Kato K, Ogura T, Sudo A. Locomotive syndrome testing in young and middle adulthood. Mod Rheumatol 2019; 30:178-183. [DOI: 10.1080/14397595.2018.1551176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Akinobu Nishimura
- Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
- Departments of Orthopaedics and Sports Medicine, Mie University Graduate School of Medicine, Mie, Japan
| | - Makoto Ohtsuki
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science, Tsu City, Japan
| | - Toshihiro Kato
- Department of Rehabilitation, Suzuka Kaisei Hospital, Tsu City, Japan
| | - Rie Nagao
- Department of Nursing, Faculty of Health Science, Suzuka University of Medical Science, Tsu City, Japan
| | - Naoya Ito
- Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Ko Kato
- Department of Orthopaedic Surgery, Suzuka Kaisei Hospital, Tsu City, Japan
| | - Toru Ogura
- Clinical Research Support Center, Mie University Hospital, Tsu City, Japan
| | - Akihiro Sudo
- Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
- Departments of Orthopaedics and Sports Medicine, Mie University Graduate School of Medicine, Mie, Japan
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Predicting quality of life among family caregivers of people with spinal cord injury having chronic low back pain in Nepal: a cross-sectional pilot study. Spinal Cord Ser Cases 2018; 4:72. [DOI: 10.1038/s41394-018-0110-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 11/09/2022] Open
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Eilayyan O, Thomas A, Hallé MC, Ahmed S, Tibbles AC, Jacobs C, Mior S, Davis C, Evans R, Schneider MJ, Alzoubi F, Barnsley J, Long CR, Bussières A. Promoting the use of self-management in novice chiropractors treating individuals with spine pain: the design of a theory-based knowledge translation intervention. BMC Musculoskelet Disord 2018; 19:328. [PMID: 30205825 PMCID: PMC6134709 DOI: 10.1186/s12891-018-2241-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/24/2018] [Indexed: 12/19/2022] Open
Abstract
Background Clinical practice guidelines generally recommend clinicians use self-management support (SMS) when managing patients with spine pain. However, even within the educational setting, the implementation of SMS remains suboptimal. The objectives of this study were to 1) estimate the organizational readiness for change toward using SMS at the Canadian Memorial Chiropractic College (CMCC), Toronto, Ontario from the perspective of directors and deans, 2) estimate the attitudes and self-reported behaviours towards using evidence-based practice (EBP), and beliefs about pain management among supervisory clinicians and chiropractic interns, 3) identify potential barriers and enablers to using SMS, and 4) design a theory-based tailored Knowledge Translation (KT) intervention to increase the use of SMS. Methods Mixed method design. We administered three self-administered questionnaires to assess clinicians’ and interns’ attitudes and behaviours toward EBP, beliefs about pain management, and practice style. In addition, we conducted 3 focus groups with clinicians and interns based on the Theoretical Domain Framework (TDF) to explore their beliefs about using SMS for patients with spine pain. Data were analysed using deductive thematic analysis by 2 independent assessors. A panel of 7 experts mapped behaviour change techniques to key barriers identified informing the design of a KT intervention. Results Participants showed high level of EBP knowledge, positive attitude of EBP, and moderate frequency of EBP use. A number of barrier factors were identified from clinicians (N = 6) and interns (N = 16) corresponding to 7 TDF domains: Knowledge; Skills; Environmental context and resources; Emotion; Beliefs about Capabilities; Memory, attention & decision making; and Social Influence. To address these barriers, the expert panel proposed a multifaceted KT intervention composed of a webinar and online educational module on a SMS guided by the Brief Action Planning, clinical vignettes, training workshop, and opinion leader support. Conclusion SMS strategies can help maximizing the health care services for patients with spine pain. This may in turn optimize patients’ health. The proposed theory-based KT intervention may facilitate the implementation of SMS among clinicians and interns. Electronic supplementary material The online version of this article (10.1186/s12891-018-2241-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Owis Eilayyan
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada. .,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada.
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Marie-Christine Hallé
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | | | - Craig Jacobs
- Canadian Memorial Chiropractic College, North York, Canada
| | - Silvano Mior
- Canadian Memorial Chiropractic College, North York, Canada
| | - Connie Davis
- University of British Columbia, Vancouver, Canada.,Centre for Collaboration, Motivation and Innovation, Vancouver, Canada
| | - Roni Evans
- University of Minnesota, Minneapolis, USA
| | | | - Fadi Alzoubi
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | | | | | - Andre Bussières
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
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Bussières AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Haskett D, Hincapié C, Pagé I, Passmore S, Srbely J, Stupar M, Weisberg J, Ornelas J. Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative. J Manipulative Physiol Ther 2018; 41:265-293. [PMID: 29606335 DOI: 10.1016/j.jmpt.2017.12.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/18/2017] [Accepted: 12/23/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. METHODS The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention. The panel updated the search strategies in Medline. We assessed admissible systematic reviews and randomized controlled trials for each question using A Measurement Tool to Assess Systematic Reviews and Cochrane Back Review Group criteria. Evidence profiles were used to summarize judgments of the evidence quality and link recommendations to the supporting evidence. Using the Evidence to Decision Framework, the guideline panel determined the certainty of evidence and strength of the recommendations. Consensus was achieved using a modified Delphi technique. The guideline was peer reviewed by an 8-member multidisciplinary external committee. RESULTS For patients with acute (0-3 months) back pain, we suggest offering advice (posture, staying active), reassurance, education and self-management strategies in addition to SMT, usual medical care when deemed beneficial, or a combination of SMT and usual medical care to improve pain and disability. For patients with chronic (>3 months) back pain, we suggest offering advice and education, SMT or SMT as part of a multimodal therapy (exercise, myofascial therapy or usual medical care when deemed beneficial). For patients with chronic back-related leg pain, we suggest offering advice and education along with SMT and home exercise (positioning and stabilization exercises). CONCLUSIONS A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain.
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Affiliation(s)
- André E Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Québec, Canada.; Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada..
| | - Gregory Stewart
- Private Practice, Winnipeg, Manitoba, Canada; Immediate Past President, World Federation of Chiropractic, North American Region, Canada
| | - Fadi Al-Zoubi
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Philip Decina
- Department of Clinical Education, Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Martin Descarreaux
- Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Danielle Haskett
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Cesar Hincapié
- Epidemiologist, Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Isabelle Pagé
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Steven Passmore
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
| | - John Srbely
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Maja Stupar
- Department of Clinical Education, Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | | | - Joseph Ornelas
- Health Systems Management, Rush University, Chicago, Illinois
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Ng SK, Cicuttini FM, Davis SR, Bell R, Botlero R, Fitzgibbon BM, Urquhart DM. Poor general health and lower levels of vitality are associated with persistent, high-intensity low back pain and disability in community-based women: A prospective cohort study. Maturitas 2018; 113:7-12. [PMID: 29903650 DOI: 10.1016/j.maturitas.2018.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/15/2018] [Indexed: 11/30/2022]
Abstract
While low back pain significantly impacts on an individual's well-being, our understanding of the role of well-being in the natural history of low back pain is limited. This cohort study aimed to investigate the association between psychological and general well-being and the development and progression of low back pain and disability in community-based women over a 2-year period. 506 women recruited from a research database were invited to participate. Overall psychological and general well-being and its subdomains were assessed at baseline using the Psychological General Well-Being Index (PGWB). The intensity of and degree of disability arising from low back pain were examined using the Chronic Pain Grade Questionnaire at baseline and at 2-year follow-up. Participants were categorized as having no, developing, resolving, or persistent high-intensity pain and disability. 444 participants (87.8%) completed the study. Women with persistent high-intensity pain had lower PGWB scores at baseline than those with no high-intensity pain at follow-up, after adjusting for confounders (M(SE) = 69.9(2.55) vs 80.1(2.63), p < 0.005). Furthermore, women with persistent high disability scores had lower well-being scores than those without persistent high disability scores (M(SE) = 69.1(3.49) vs. 81.2(0.802), p = 0.001). Moreover, lower scores in the well-being subdomains of general health and vitality were associated with persistent high pain intensity and disability (all p < 0.007). In summary, lower levels of general health and vitality were associated with persistent high-intensity low back pain and disability, suggesting that improving these aspects of well-being has the potential to reduce high levels of chronic low back pain and disability in community-based women.
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Affiliation(s)
- Sin Ki Ng
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, 4/607 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - Susan R Davis
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - Robin Bell
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - Roslin Botlero
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - Bernadette M Fitzgibbon
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, 4/607 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
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Influence of Chronic Pain on Perceived Health Status and Physical Activity in Elderly People After Lumbar Surgery. TOPICS IN GERIATRIC REHABILITATION 2018. [DOI: 10.1097/tgr.0000000000000180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Du S, Hu L, Bai Y, Dong J, Jin S, Zhang H, Zhu Y. The Influence of Self-Efficacy, Fear-Avoidance Belief, and Coping Styles on Quality of Life for Chinese Patients with Chronic Nonspecific Low Back Pain: A Multisite Cross-Sectional Study. Pain Pract 2018; 18:736-747. [PMID: 29171174 DOI: 10.1111/papr.12660] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/17/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND As a bio-psycho-social issue, chronic low back pain (CLBP) has been a significant topic in health management, and patients' quality of life (QOL) is gaining extensive attention. Self-efficacy, pain fear-avoidance belief (FAB), and coping styles play important roles in the QOL of CLBP patients. However, it remains unclear how self-efficacy and FAB influence QOL through specific coping styles. This study aimed to explore the influencing paths of self-efficacy, FAB, and coping styles on the QOL of patients with CLBP. METHODS This study relies on a multisite, cross-sectional design involving 221 CLBP patients. Stepwise multiple regression and structural equation modeling were employed. RESULTS CLBP patients lived with a poor global QOL. Self-efficacy played a direct, positive role in predicting QOL for patients with CLBP (β = 0.35), and it also played an indirect, positive role in predicting QOL (β = 0.19) through active coping styles (β = 0.31). FAB played a direct, negative role in predicting QOL (β = -0.33), and it also played an indirect, negative role in predicting QOL (β = -0.32) through passive coping styles (β = 0.32). CONCLUSIONS Self-efficacy and FAB are both directly and indirectly related to global QOL, and coping styles are important mediating variables. Self-efficacy and active coping are protective factors for the QOL of CLBP patients, while FAB and passive coping are risk factors. Health education strategies are recommended by medical personnel to enhance CLBP patients' pain self-efficacy, decrease pain FAB, and modify pain coping styles, so that their global QOL can be improved.
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Affiliation(s)
- Shizheng Du
- School of Nursing, Fudan University, Shanghai, China.,School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Hu
- Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianshu Dong
- Shanghai Health Promotion Center, Shanghai, China
| | - Shengji Jin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Heng Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ying Zhu
- Department of General Surgery, The First People's Hospital of Taicang, Taicang, China
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Abstract
PURPOSE Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain. METHODS Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury. RESULTS A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary after the injury were significant factors for low scores in all domains of the WHOQOL-BREF. In addition, unmarried participants had low scores in the social relationship domain. Workers with family members requiring care scored low in the physical and environment domains. Workers whose injuries had major effects on their physical appearance had low scores in the physical and psychological domains. Workers with unstable employment had low scores in physical, psychological, and environment domains. CONCLUSION At 6 years after occupational injury, workers' HRQOL was poor among those whose salaries decreased after the injury, after adjustment for other factors.
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Virk SS, Diwan A, Phillips FM, Sandhu H, Khan SN. What is the Rate of Revision Discectomies After Primary Discectomy on a National Scale? Clin Orthop Relat Res 2017; 475:2752-2762. [PMID: 28849429 PMCID: PMC5638742 DOI: 10.1007/s11999-017-5467-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/01/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lumbar discectomy has been shown to be clinically beneficial in numerous studies for appropriately selected patients. Some patients, however, undergo revision discectomy, with previously reported estimates of revisions ranging from 5.1% to 7.9%. No study to date has been able to precisely quantify the rate of revision surgery over numerous years on a national scale. QUESTIONS/PURPOSE We performed a survival analysis for lumbar discectomy on a national scale using a life-table analysis to answer the following questions: (1) What is the rate of revision discectomy on a national scale over 5 to 7 years for patients undergoing primary discectomy alone? (2) Are there differences in revision discectomy rates based on age of patient, region of the country, or the payer type? METHODS The Medicare 5% National Sample Administrative Database (SAF5) and a large national database from Humana Inc (HORTHO) were used to catalog the number of patients undergoing a lumbar discectomy. Both of these databases have been cited in numerous peer-reviewed publications during the previous 5 years and routinely are audited by PearlDiver Inc. We identified patients using relevant ICD-9 codes and Current Procedural Terminology (CPT) codes, including ICD-9 72210 (lumbar disc displacement) for disc herniation. We used appropriate CPT codes to identify patients who had a lumbar discectomy. We analyzed patients undergoing additional surgery including those who had repeat discectomy (CPT-63042: laminotomy, reexploration single interspace, lumbar) and patients who had additional more-extensive decompressive procedures with or without fusion after their primary procedure. Revision surgery rates were calculated for patients 65 years and older and those younger than 65 years and for each database (Humana Inc and Medicare). Patients from the two databases also were analyzed based on four distinct geographic regions in the United States where their surgery occurred. There were a total of 7520 patients who underwent a lumbar discectomy for an intervertebral disc displacement with at least 5 years of followup in the HORTHO and SAF5 databases. We used cumulative incidence of revision surgery to estimate the survivorship of these patients. RESULTS In the HORTHO (2613 patients) and SAF5 (4907 patients) databases, 147 patients (5.6%; 95% CI, 1.8%-9.2%) and 305 patients (6.2%; 95% CI, 3.5%-8.9%) had revision surgery at 7 years after the index discectomy respectively. Survival analysis showed survival rates greater than 93% (95% CI, 91%-98%) for all of the cohorts for a primary discectomy up to 7 years after the surgery. The survivorship was lower for patients younger than 65 years (93% [95% CI, 87%-99%, 1016 of 1091] versus 95% [95% CI, 90%-100%, 1450 of 1522], p = 0.02). When nondiscectomy lumbar surgeries were included, the survivorship of patients younger than 65 years remained lower (83% [95% CI, 76%-89%, 902 of 1091] versus 87% [95% CI, 82%-92%, 1324 of 1522], p = 0.02). There was no difference in revision discectomy rates across geographic regions (p = 0.41) at 7 years. Similarly, there was no difference in additional nondiscectomy lumbar surgery rates (p = 0.68) across geographic regions at 7 years. There was no difference in survivorship rates between patients covered by Medicare (94% [95% CI, 91%-97%], 4602 of 4907) versus Humana Inc (94% [95% CI, 90%-98%], 2466 of 2613) (p = 0.31). CONCLUSIONS Our study shows rates of cumulative survival after an index lumbar discectomy with revision discectomy as the endpoint. We hope these data allow physicians to offer accurate advice to patients regarding the risk of revision surgery for patients of all ages during 5 to 7 years after their index procedure to enhance shared decision making in spinal surgery. These data also will help public policymakers and accountable care organizations accurately allocate scarce resources to patients with symptomatic lumbar disc herniation. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Sohrab S. Virk
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH USA
| | - Ashish Diwan
- Department of Orthopaedic Surgery, St. George Hospital, The University of New South Wales, Sydney, NSW Australia
| | | | | | - Safdar N. Khan
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH USA ,Department of Orthopaedics, The Ohio State University Wexner Medical Center, 725 Prior Hall, 410 West 10th Avenue, Columbus, OH 43210 USA
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Pereira MG, Roios E, Pereira M. Functional disability in patients with low back pain: the mediator role of suffering and beliefs about pain control in patients receiving physical and chiropractic treatment. Braz J Phys Ther 2017; 21:465-472. [PMID: 28716365 PMCID: PMC5693431 DOI: 10.1016/j.bjpt.2017.06.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/03/2017] [Accepted: 01/18/2017] [Indexed: 12/26/2022] Open
Abstract
Subjective suffering mediated the relationship between depression and functional disability regardless of the type of treatment. Beliefs about chance events mediated the relationship between depression and functional disability only in the physical therapy treatment. Intervention should target cognitive and psychological factors in LBP patients.
Background Low back pain is the leading cause of disability worldwide. There is evidence that depression, anxiety, and external locus of control are negative predictors of functional disability in low back patients. Methods This study focused on the mediator role of suffering and beliefs about pain control in the relationship between psychological morbidity and functional disability in patients receiving physical therapy and chiropractic treatment for chronic low back pain. The sample included 213 patients receiving chiropractic treatment and 125 receiving physical therapy, who answered the following instruments: Beliefs about Pain Control Questionnaire; Inventory of Subjective Experiences of Suffering in Illness; Oswestry Low Back Pain Disability Questionnaire; and the Hospital Anxiety and Depression Scales. Results Suffering was a mediator in the relationship between depression and functional disability in both treatment groups. Only beliefs related to external chance events mediated the relationship between depression and functional disability in the physical therapy group, but not in the chiropratic teratment group. Conclusion Intervention should focus on suffering regardless of the type of treatment and target beliefs about pain control, in patients receiving physical therapy treatment since they seem to play a key role in functional disability in patients with low back pain.
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Affiliation(s)
- M Graça Pereira
- Universidade do Minho, Escola de Psicologia, Departamento de Psicologia Aplicada, Braga, Portugal.
| | - Edite Roios
- Universidade do Minho, Escola de Psicologia, Departamento de Psicologia Aplicada, Braga, Portugal
| | - Marta Pereira
- Universidade do Minho, Escola de Psicologia, Departamento de Psicologia Aplicada, Braga, Portugal
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Santos MMA, Souza ELD, Barroso BIDL. Análise sobre a percepção de policiais militares sobre o conforto do colete balístico. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/16629324022017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O policial militar é submetido a condições fatigantes em seu turno de trabalho, que podem comprometer a qualidade de sua vida, saúde e bem-estar físico e psicológico. Apesar desses fatores, pouca atenção é dada aos riscos ocupacionais dessa profissão. Este estudo teve como objetivo dar uma maior ênfase à promoção de saúde e prevenção de doenças do policial militar e avaliar o conforto desses profissionais em relação ao colete balístico e suas possíveis associações com quadros de fadiga e de dor. A pesquisa foi realizada a partir de um questionário estruturado com questões relacionadas ao conforto em relação ao uso do colete balístico, à dor e à fadiga no fim do turno de trabalho. A amostra foi composta de 29 policiais militares do sexo masculino. Os resultados mostraram associação entre o grau de desconforto geral e nas atividades ocupacionais e o peso do colete (correlação de Spearman igual a 0,697 e 0,7091, respectivamente). Houve queixas relacionadas à dor na região lombar e fadiga no fim do turno de trabalho. Os policiais militares demonstraram insatisfação em relação ao conforto com o colete balístico e queixas de fadiga e dor.
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Salah El-din Mahmoud W, Yousef A, Manssor E, Ahmed S. The relationship between pain and functional disability with morphological changes of psoas major in discogenic low back pain patients. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.8.363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Ahmed Yousef
- Chief, Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Al-Kharj, KSA, Physics Department, Faculty of Science, South Valley University, Qena, Egypt
| | - E Manssor
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Al-Kharj, KSA
| | - Sameh Ahmed
- Lecturer Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Egypt
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Gamus D, Glasser S, Langner E, Beth-Hakimian A, Caspi I, Carmel N, Siev-Ner I, Amir H, Ziv A, Papa M, Lerner-Geva L. Psychometric properties of the Hebrew version of the Oswestry Disability Index. J Back Musculoskelet Rehabil 2016; 30:BMR726. [PMID: 27341645 DOI: 10.3233/bmr-160726] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain (LBP) is one of the most common health complaints, with lifetime prevalence rates as high as 84%. The Oswestry Disability Index (ODI) is often the measure of choice for LBP in both research and clinical settings and, as such, has been translated into 29 languages and dialects. Currently, however, there is no validated version of Hebrew-translated ODI (ODI-H). OBJECTIVE To examine the psychometric properties of the ODI-H. METHODS Cross-culturally appropriate translation into Hebrew was conducted. A convenience sample of 115 participants (Case Group) with LBP and 68 without LBP (Control Group) completed the ODI-H, SF-36 Health Survey, and two Visual Analog Scales (VAS). RESULTS Internal consistency was α = 0.94 and test-retest reliability for 18 participants repeating the ODI-H was 0.97. No floor or ceiling effects were noted for Cases, although there was a floor effect for the Control Group. Scores were significantly different for the two groups, indicating discriminant validity. Concurrent validity was reflected by significant correlations with SF-36 scores, particularly the Physical Functioning and Bodily Pain subscales (-0.83 and -0.79, respectively) and with the VAS (0.84 and 0.79). CONCLUSIONS The ODI-H is a valid and reliable measure of low back pain-related disability for the Hebrew-speaking public.
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Affiliation(s)
- Dorit Gamus
- Complementary Medicine Service, Sheba Medical Center, Tel Hashomer, Israel
| | - Saralee Glasser
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Elisheva Langner
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Israel Caspi
- Department of Orthopedics, Spine Deformity Unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Narin Carmel
- Complementary Medicine Service, Sheba Medical Center, Tel Hashomer, Israel
| | - Itzhak Siev-Ner
- Orthopedic Rehabilitation Department, Sheba Medical Center, Tel Hashomer, Israel
| | - Hagai Amir
- Orthopedic Rehabilitation Department, Sheba Medical Center, Tel Hashomer, Israel
| | - A Ziv
- MSR - Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel
| | - M Papa
- Surgery & Surgical Oncology & Breast Service, Sheba Medical Center, Tel Hashomer, Israel
| | - Liat Lerner-Geva
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
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Ogunlana MO, Odole AC, Adejumo A, Odunaiya N. Catastrophising, pain, and disability in patients with nonspecific low back pain. Hong Kong Physiother J 2015; 33:73-79. [PMID: 30930571 PMCID: PMC6385129 DOI: 10.1016/j.hkpj.2015.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Attention has been drawn to examining the contributions of "catastrophising" to the prediction of pain and disability in individuals with low back pain (LBP). OBJECTIVES This study investigated the proportion of patients with LBP who engaged in catastrophic thinking about pain and its association with pain intensity and disability. We also investigated the components of pain catastrophising that is predictive of disability. METHODS A total of 275 participants with nonspecific LBP completed the Pain Catastrophizing Scale, the quadruple visual analog scale, and the Revised Oswestry Disability Questionnaire (RODQ). The associations among pain intensity, disability, and catastrophising were investigated using t test. The components of catastrophising that best predicts disability were investigated using multiple linear regressions, and the level of significance was set at 0.05. RESULTS The majority (85.5%) of the participants had LBP for more than 6 weeks, with 45.5% of the participants having moderate disability and 52.7% being high catastrophisers. High catastrophisers to pain had a significantly higher rating of pain intensity (p < 0.001) and higher score on the RODQ than low catastrophisers to pain. The main components of catastrophising that predicts disability were magnification (p < 0.001) and rumination (p = 0.006). CONCLUSION Clinicians should screen patients with nonspecific LBP for a heightened level of catastrophic thinking and endeavour to manage such when present.
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Influence of Knee Pain and Low Back Pain on the Quality of Life in Adults Older Than 50 Years of Age. PM R 2015; 7:955-961. [PMID: 25758532 DOI: 10.1016/j.pmrj.2015.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 01/26/2015] [Accepted: 03/01/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To investigate the impact of knee pain and low back pain (LBP) on quality of life (QoL) in people ≥50 years of age. DESIGN Cross-sectional study. SETTING A nationwide survey. PARTICIPANTS A total of 1295 men and 1658 women aged ≥50 years from the Fifth Korea National Health and Nutrition Examination Survey, conducted in 2010. METHODS Knee pain and LBP were assessed by a questionnaire, and QoL was assessed by the EuroQol (EQ)-5D, consisting of the EQ-5D descriptive system and the EuroQol visual analogue scale (EQ-VAS). Multiple linear regression models were used to evaluate associations between knee pain or LBP and the EQ-5D index or EQ-VAS score. MAIN OUTCOME MEASUREMENTS Standardized coefficient (β) for QoL according to the presence of knee pain or LBP. RESULTS Both men and women with knee pain or LBP had a lower QoL than those without them in all dimensions of the EQ-5D, EQ-5D index, and EQ-VAS scores. Compared with most other chronic diseases, knee pain and LBP showed stronger negative correlations with the EQ-5D index and EQ-VAS score. In men, LBP showed a stronger negative correlation with the EQ-VAS score than knee pain. The relative impact of LBP on knee pain was greater in people aged ≥65 years than in people aged 50-64 years, especially men. CONCLUSIONS These results suggest that knee pain and LBP are important factors affecting QoL in middle-aged and elderly people and that LBP may be relatively more important than knee pain in elderly people, especially men. Proper management and prevention of these conditions can help to improve QoL.
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The health effects of a forest environment on subclinical cardiovascular disease and heath-related quality of life. PLoS One 2014; 9:e103231. [PMID: 25068265 PMCID: PMC4113370 DOI: 10.1371/journal.pone.0103231] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 06/30/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Assessment of health effects of a forest environment is an important emerging area of public health and environmental sciences. PURPOSE To demonstrate the long-term health effects of living in a forest environment on subclinical cardiovascular diseases (CVDs) and health-related quality of life (HRQOL) compared with that in an urban environment. MATERIALS AND METHODS This study included the detailed health examination and questionnaire assessment of 107 forest staff members (FSM) and 114 urban staff members (USM) to investigate the long-term health effects of a forest environment. Air quality monitoring between the forest and urban environments was compared. In addition, work-related factors and HRQOL were evaluated. RESULTS Levels of total cholesterol, low-density lipoprotein cholesterol, and fasting glucose in the USM group were significantly higher than those in the FSM group. Furthermore, a significantly higher intima-media thickness of the internal carotid artery was found in the USM group compared with that in the FSM group. Concentrations of air pollutants, such as NO, NO2, NOx, SO2, CO, PM2.5, and PM10 in the forest environment were significantly lower compared with those in the outdoor urban environment. Working hours were longer in the FSM group; however, the work stress evaluation as assessed by the job content questionnaire revealed no significant differences between FSM and USM. HRQOL evaluated by the World Health Organization Quality of Life-BREF questionnaire showed FSM had better HRQOL scores in the physical health domain. CONCLUSIONS This study provides evidence of the potential beneficial effects of forest environments on CVDs and HRQOL.
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Agborsangaya CB, Lahtinen M, Cooke T, Johnson JA. Comparing the EQ-5D 3L and 5L: measurement properties and association with chronic conditions and multimorbidity in the general population. Health Qual Life Outcomes 2014; 12:74. [PMID: 24885017 PMCID: PMC4030014 DOI: 10.1186/1477-7525-12-74] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/09/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Studies comparing the measurement properties of EQ-5D 3L (3L) and EQ-5D 5L (5L) are limited to specific patient populations with small sample sizes. Using a general population sample, we compared 3L and 5L in terms of their measurement properties and association with number of chronic conditions, including multimorbidity--the concurrent occurrence of two or more chronic conditions. METHODS Data were available from two consecutive cycles of a cross-sectional telephone interview survey using 3L (2010 cycle) and 5L (2012 cycle), in the general population of adults (age ≥ 18 years) in Alberta, Canada. Measurement properties were compared by determining their feasibility, ceiling effect, and discriminatory power (Shannon indices) for 3L and 5L. Linear regression models were fitted to test the associations between multimorbidity and EQ-5D index score. RESULTS Data were available for 4946 (2010) and 4752 (2012) survey respondents with information on HRQL. Compared to 3L, 5L showed lower ceiling effect (32.3% versus 42.1%), higher absolute discriminatory power (Shannon index, mean 0.79 versus 0.52) and higher relative discriminatory power (Shannon Evenness index, mean 0.09 versus 0.06 for 3L). Despite these differences, similar relationships of lower HRQL with greater multimorbidity were observed for the 3L (ß = -0.13, 95% CI -0.15; -0.11) and 5L (ß = -0.12, 95% CI -0.13; -0.11). CONCLUSIONS Using a general population sample, the EQ-5D 5L showed better measurement properties than the EQ-5D 3L. Nonetheless, clinically important differences in HRQL associated with multimorbidity were similar in magnitude using both versions of EQ-5D.
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Affiliation(s)
| | | | | | - Jeffrey A Johnson
- Department of Public Health Sciences, 2-040 Li Ka Shing Center for Health Research and Innovation, University of Alberta, Edmonton, Alberta, T6G 2E1, Canada.
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Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N. Impact of knee and low back pain on health-related quality of life in Japanese women: the Research on Osteoarthritis Against Disability (ROAD). Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0307-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Impact of low back pain, knee pain, and timed up-and-go test on quality of life in community-living people. J Orthop Sci 2014; 19:164-71. [PMID: 24132792 DOI: 10.1007/s00776-013-0476-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 09/17/2013] [Indexed: 02/09/2023]
Abstract
BACKGROUND The Japanese Orthopaedic Association (JOA) has proposed the term "locomotive syndrome" (LS) to designate a condition in people from high-risk groups with musculoskeletal disease who are highly likely to require nursing care at some point. This syndrome is caused by weakening of the musculoskeletal organs such as bone, joint, and muscle. The current study investigated factors that influence quality of life (QOL) loss caused by LS, which builds upon our previous study showing that LS affects individuals' QOL. METHODS We enrolled 386 subjects >50 years old. Sex, age, body mass index and bone mineral density, plus physical function tests of grip strength, back muscle strength, maximum stride, 10-m gait time, functional reach (cm), timed up-and-go test (TUG) (s) and one-leg standing time (s), and the visual analogue scale assessments for leg numbness and knee, low back and leg pain were selected as independent variables in a multiple regression model for the JOA Back Pain Evaluation Questionnaire (JOABPEQ), the Short Form-36 (SF-36), and the Roland Morris Disability Questionnaire (RDQ) scores. RESULTS Low back pain contributed significantly to all JOABPEQ scores. Knee pain and TUG contributed significantly to 4/5 and 3/5 of the JOABPEQ scores, respectively. Age, TUG, knee pain, and low back pain contributed significantly to the RDQ and the physical component summary of the SF-36. CONCLUSIONS Low back and knee pain proved to be significant contributors to individuals' QOL. TUG might be the most valuable function test for effectively evaluating an individual's QOL.
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Almeida JGD, Braga PE, Lotufo Neto F, Pimenta CADM. Chronic pain and quality of life in schizophrenic patients. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:13-20. [PMID: 23567595 DOI: 10.1016/j.rbp.2011.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 11/28/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify the prevalence and characteristics of chronic pain in schizophrenic patients and to compare the quality of life in patients with and without chronic pain. METHODS Crossover design with a probablistic sample of 205 adult schizophrenic outpatients (80% paranoid schizophrenia). Socio-demographic, psychiatric disorder, pain and quality of life (WHOQOL- brief) data were collected between June and September 2008. RESULTS Mean age was 37 years, 65% were men, and the mean time spent in school was 9 years; 87% were single, 65% lived with parents and 25% had a job. Among patients with chronic pain, 70% did not receive treatment for pain. Regarding quality of life, patients with pain had more physical disabilities compared to those without pain (p < .001). There were no differences in other domains. Comparisons between patients with and without pain did not show any differences in how much they felt their mental health problems disabled them. CONCLUSION Chronic pain was common in schizophrenic patients (similar to the general population of a similar age) and decreased their quality of life. It is necessary to pay more attention to this co-morbidity.
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Pedisic Z, Pranic S, Jurakic D. Relationship of back and neck pain with quality of life in the Croatian general population. J Manipulative Physiol Ther 2013; 36:267-75. [PMID: 23790715 DOI: 10.1016/j.jmpt.2013.05.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 03/09/2013] [Accepted: 03/25/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the prevalence of back pain and neck pain and their relationship with the quality of life in the Croatian general population. METHODS This was a cross-sectional study using home-based face-to-face interviews of 1030 participants (51.6% females) 15 years or older. Back and neck pain frequencies were assessed using single items and quality of life using the Short Form Survey and Satisfaction with Life Scale. Analysis of covariance was conducted, where back pain or neck pain frequency was used as the categorical predictor; physical component summary or mental component summary, as the dependent variable; and age, body mass index, and physical activity level, as covariates. RESULTS The prevalence of back pain was 66.3% (95% confidence interval [CI], 62.3%-70.3%) and 62.9% (95% CI, 58.7%-67.2%) in females and males, respectively. The prevalence of neck pain was 58.0% (95% CI, 53.8%-62.2%) for females and 53.6 (95% CI, 49.2%-58.0%) for males. Differences between men and women were not significant (P>.05). Adjusted mean values for physical component summary and mental component summary were substantially lower in participants who reported back or neck pain often/almost always compared with those without pain. Differences ranged from 8.11 to 11.86 points (95% CI, 5.54-13.99) and from 9.61 to 10.99 points (95% CI, 7.35-13.45) in females and males, respectively. CONCLUSIONS The findings of this study showed that back and neck pain are highly prevalent and negatively related to quality of life in the Croatian general population. These data might raise the awareness of local government health authorities and lead to improvements in health care service for people with back and neck pain.
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Affiliation(s)
- Zeljko Pedisic
- Researcher, Institute of Sport Science, Karl-Franzens-University of Graz, Graz, Austria.
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Muramoto A, Imagama S, Ito Z, Hirano K, Ishiguro N, Hasegawa Y. Physical performance tests are useful for evaluating and monitoring the severity of locomotive syndrome. J Orthop Sci 2012; 17:782-8. [PMID: 22961424 DOI: 10.1007/s00776-012-0283-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 07/25/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND The concept of the locomotive syndrome (LS), first proposed in Japan in 2007, has become widely accepted, and the 25-question Geriatric Locomotive Function Scale (GLFS-25), a quantitative, evidence-based diagnostic tool for LS, has been developed. However, the association between the GLFS-25 score and the outcome of physical capacity tests has never been investigated. Furthermore, which physical tests are good indices for evaluating and monitoring the severity of locomotive syndrome have not been identified. In addition, the impact of knee and low back pain on locomotive syndrome is unclear. The purpose of this study is to confirm the validity of GLFS-25 by demonstrating its significant correlation with the outcome of physical function tests and to determine which tests are good indicators for monitoring the severity of LS. The secondary aim of the project is to investigate how much influence knee and low back pain may have on the LS of the middle-aged and elderly. METHODS A total of 358 subjects were drawn from a general health checkup in a rural area of Japan. We measured back muscle strength, grip strength, one-leg standing time with eyes open, 10-m gait time, timed up-and-go test, maximum stride, functional reach, height, weight, % body fat and bone mineral density, and we obtained a visual analog scale of low back pain and knee pain. The degree of the locomotive syndrome was evaluated using the GLFS-25. Associations of all the variables with the GLFS-25 score were analyzed using both univariate and multivariate analyses. RESULTS The GLFS-25 score was significantly higher in females than in males in both the total and in the age older than 60 years groups. The GLFS-25 score showed a significant positive correlation with age (r = 0.360), knee pain (r = 0.576), low back pain (r = 0.526), timed up-and-go test (r = 0.688) and 10-m gait time (r = 0.634), and it showed a significant negative correlation with one-leg standing time with eyes open (r = -0.458), maximum stride (r = -0.408), functional reach test (r = -0.380), back muscle strength (r = -0.364) and grip strength (r = -0.280). Multiple regression analysis indicated that knee pain (β = 0.282), low back pain (β = 0.304), one-leg standing time (β = -0.116), timed up-and-go test (β = -0.319) and back muscle strength (β = -0.090) were significantly associated with the GLFS-25 score. Grip strength (β = -0.99) was a good substitute for back muscle strength in the multiple regression analysis. CONCLUSIONS We confirmed the validity of GLFS-25 by demonstrating a significant correlation and association of its score with the outcome of a series of functional performance tests. One-leg standing time with eyes open, timed up-and-go test and grip strength proved to be easy, reliable and safe performance tests to evaluate and monitor an individual's severity of LS as a complement to the GLFS-25. We also proved that knee and low back pain significantly impact the degree of LS.
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Affiliation(s)
- Akio Muramoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
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Muraki S, Akune T, Oka H, Ishimoto Y, Nagata K, Yoshida M, Tokimura F, Nakamura K, Kawaguchi H, Yoshimura N. Incidence and risk factors for radiographic lumbar spondylosis and lower back pain in Japanese men and women: the ROAD study. Osteoarthritis Cartilage 2012; 20:712-8. [PMID: 22484574 DOI: 10.1016/j.joca.2012.03.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 03/01/2012] [Accepted: 03/14/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the incidence of radiographic lumbar spondylosis (LS)and lower back pain, and their risk factors in Japan using a large-scale population from the nationwide cohort Research on Osteoarthritis/osteoporosis Against Disability (ROAD) Study. METHODS Participants in the ROAD study who had been recruited between 2005 and 2007 were followed up with lumbar spine radiography for 3 years. A total of 2,282 paired radiographs (75% of the original sample) were scored using Kellgren and Lawrence (KL) grades, and the incidence and progression rate of radiographic LS was analyzed. The incidence of lower back pain was also examined. In addition, associations between risk factors and incident and progressive radiographic LS as well as incident lower back pain were tested. RESULTS Given a 3.3-year follow-up, the incidence of KL≥2 radiographic LS was 50.0% and 34.4% (15.3% and 10.5% per year), while that of KL≥3 LS was 15.3% and 23.7% (4.6% and 7.2% per year) in men and women, respectively. The progression rate of LS was 20.5% and 27.4% (6.2% and 8.3% per year) in men and in women, respectively. In addition, the incidence of lower back pain was 28.3% and 31.2% (8.6% and 9.5% per year) in men and women. Lower back pain was not significantly associated with incident radiographic LS, while a more severe KL grade at baseline was associated with incident lower back pain. CONCLUSION The present longitudinal study revealed a high incidence of radiographic LS in Japan.
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Affiliation(s)
- S Muraki
- Department of Clinical Motor System Medicine, 22nd Century Medical & Research Center, Faculty of Medicine, the University of Tokyo, Tokyo, Japan.
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Treatment of chronic low back pain: a randomized clinical trial comparing multidisciplinary group-based rehabilitation program and oral drug treatment with oral drug treatment alone. Clin J Pain 2012; 27:811-8. [PMID: 21642845 DOI: 10.1097/ajp.0b013e31821e7930] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This randomized clinical trial examined the efficacies of a group-based multidisciplinary rehabilitation program and oral drug treatment versus oral drug treatment alone in Iran. METHODS A total of 197 patients with chronic low back pain were randomized to either intervention group (n=97) receiving a group-based, 5-session multidisciplinary rehabilitation program plus oral medication or to control group (n=100) receiving just oral medication. At baseline and at 3 and 6-month follow-ups, patients filled out questionnaires on health-related quality of life (36-item Short-form General Health Survey) and disability Questionnaires (Quebec Disability Scale and Ronald-Morris Disability). Repeated measure analysis of variance was used to compare 2 groups during time. RESULTS The 2 groups were comparable regarding all baseline characteristics (P>0.05). There were significant differences within each group by time in terms of all subscales of 36-item Short-form (P<0.01) except for mental health (P=0.7). Furthermore, there were significant differences between groups in terms of all domains of SF-36 scale except for general health (P=0.06), social function (P=0.08) and role emotional (P=0.7). Furthermore, according to the scores of Ronald-Morris Disability Questionnaire and Quebec Disability Scale, the disability of patients in the intervention group was improved over time significantly (P=0.01 and P<0.0001, respectively). DISCUSSION The findings revealed that the group-based multidisciplinary program could improve most domains of quality of life in chronic low back pain patients in the 6-month period. However, there were no significant differences between two groups in sub scales such as general health, social function and role emotional.
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Breen A, Austin H, Campion-Smith C, Carr E, Mann E. “You feel so hopeless”: A qualitative study of GP management of acute back pain. Eur J Pain 2012; 11:21-9. [PMID: 16434220 DOI: 10.1016/j.ejpain.2005.12.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Revised: 12/09/2005] [Accepted: 12/14/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND Biopsychosocial management of non-specific back pain in general practice has been problematical, with frequent inappropriate referral for imaging and secondary care interventions and lack of self-confidence in the ability to provide evidence-based care. AIMS To examine GP attitudes to managing back pain as a biopsychosocial problem in order to inform future educational strategies that may improve practice. METHODS Twenty-one GPs from separate practices within the Dorset and Somerset Strategic Health Authority area (UK) participated in telephone interviews leading to the development of vignettes to refine the theoretical framework for subsequent focus group interviews about evidence-based back pain management. Transcripts were analysed thematically. RESULTS There were 5 main emergent themes. These were generally negative and dominated by concerns about doctor-patient interaction. They included feelings of frustration, mismatches of perceptions in the doctor-patient relationship, problems in relation to time, challenges and discord between stakeholders in the process (for example, over sickness certification) and a lack of resources for education, awareness and local services to refer to. Psychosocial aspects of the actual care process were rarely raised. Participants favoured education that is multidisciplinary, in small group format and involves the participation of patients. CONCLUSIONS This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation.
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Affiliation(s)
- Alan Breen
- Institute for Musculoskeletal Research and Clinical Implementation, AECC, 13-15 Parkwood Road, Bournemouth, Dorset BH5 2DF, UK.
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Chen YC, Chou SW, Tseng HM, Liu WY, Ke YJ, Lin YH. Physical Fitness of Patients with Nonspecific Low Back Pain Who Performed a Progressive Four-week Fitness Exercise Program. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ying-Chian Chen
- Physical Therapy Division, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University
| | - Shih-Wei Chou
- Physical Therapy Division, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital
| | - Hsu-Min Tseng
- Department and Graduate Institute of Health Care Management, College of Management, Chang Gung University
| | - Wen-Yu Liu
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University
| | - Yi Ju Ke
- Department of Physical Medicine and Rehabilitation, Hsin Chu Branch of McKay Memorial Hospital
| | - Yang-Hua Lin
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University
- Healthy Aging Research Center, Chang Gung University
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Health-related quality of life in subjects with low back pain and knee pain in a population-based cohort study of Japanese men: the Research on Osteoarthritis Against Disability study. Spine (Phila Pa 1976) 2011; 36:1312-9. [PMID: 21730819 DOI: 10.1097/brs.0b013e3181fa60d1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional surveys of health-related quality of life (QOL) in subjects with low back pain and knee pain using a population-based cohort. OBJECTIVE The purpose of the present study was to clarify the impact of low back pain and knee pain on QOL in men. In addition, we analyzed the impacts of vertebral fracture (VFx), lumbar spondylosis, and knee osteoarthritis (OA) on the magnitude of QOL loss in men with low back pain and knee pain. SUMMARY OF BACKGROUND DATA Low back pain and knee pain are major public health issues causing disability among the elderly men, but there were no population-based studies to compare the impact of low back pain on QOL with that of knee pain in Japanese men. METHODS From 3040 participants in the Research on Osteoarthritis Against Disability study, data from 767 men older than 40 years who completed questionnaires (mean age = 69.7 years) were examined. To carry out the QOL assessment, the Medical Outcomes Study Short Form 8 (SF-8) and EuroQol (EQ-5D) were used. We examined the association of low back pain and knee pain with QOL. Furthermore, we also examined the presence of VFx and the severity of lumbar spondylosis and knee OA with the magnitude of QOL loss in men with low back pain and knee pain, respectively. RESULTS The impact of low back pain on QOL was larger than that of knee pain. In men with low back pain, there were few associations between Kellgren-Lawrence grade and QOL, whereas VFx was associated with physical QOL. For men with knee pain, Kellgren-Lawrence grade equal to 4 knee OA was associated with QOL. CONCLUSION This study revealed that low back pain has a larger impact than knee pain on QOL. Furthermore, low back pain with VFx is strongly associated with physical QOL loss.
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Tekur P, Chametcha S, Hongasandra RN, Raghuram N. Effect of yoga on quality of life of CLBP patients: A randomized control study. Int J Yoga 2011; 3:10-7. [PMID: 20948896 PMCID: PMC2952119 DOI: 10.4103/0973-6131.66773] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT In two of the earlier Randomized Control Trials on yoga for chronic lower back pain (CLBP), 12 to 16 weeks of intervention were found effective in reducing pain and disability. AIM To study the efficacy of a residential short term intensive yoga program on quality of life in CLBP. MATERIALS AND METHODS About 80 patients with CLBP (females 37) registered for a week long treatment at SVYASA Holistic Health Centre in Bengaluru, India. They were randomized into two groups (40 each). The yoga group practiced a specific module for CLBP comprising of asanas (physical postures), pranayama (breathing practices), meditation and lectures on yoga philosophy. The control group practiced physical therapy exercises for back pain. Perceived stress scale (PSS) was used to measure baseline stress levels. Outcome measures were WHOQOL Bref for quality of life and straight leg raising test (SLR) using a Goniometer. RESULTS There were significant negative correlations (Pearson's, P<0.005, r>0.30) between baseline PSS with all four domains and the total score of WHOQOLBref. All the four domains' WHOQOLBref improved in the yoga group (repeated measures ANOVA P=0.001) with significant group*time interaction (P<0.05) and differences between groups (P<0.01). SLR increased in both groups (P=0.001) with higher increase in yoga (31.1 % right, 28.4 % left) than control (18.7% right, 21.5 % left) group with significant group*time interaction (SLR right leg P=0.044). CONCLUSION In CLBP, a negative correlation exists between stress and quality of life. Yoga increases quality of life and spinal flexibility better than physical therapy exercises.
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Affiliation(s)
- Padmini Tekur
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Research Foundation (SVYASA), Bangalore, India
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Lee JG, Jin K. [The determinants of the quality of life and pain of back pain patients]. J Prev Med Public Health 2011; 43:505-12. [PMID: 21139411 DOI: 10.3961/jpmph.2010.43.6.505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Because of the changing life style of Koreans, we have witnessed an increase of patients with back pain. The development of medical knowledge and technology has resulted in more numerous and better treatment methods. However, the outcomes of diverse treatments have been examined by using a few medicine-oriented measures like pain. This study aims at identifying the factors that influence the outcomes of back pain treatments by using two outcome measures (e.g., quality of life and pain). METHODS We used the questionnaire survey method for data collection. The questionnaires contained 5 categories(treatment methods, clinical conditions, exercise, quality of life and, socio-demographic characteristics). We interviewed 188 back pain patients. We used the regression analysis method to predict the quality of life or pain. RESULTS Surgery showed a statistically significant effect on the quality of life as well as pain. The illness period, age and exercise were turned out to be significant factors for both of the dependent variables. The social class and surgery methods showed a statistically significant effect solely on the quality of life. CONCLUSIONS In choosing the surgical methods, doctors need to provide detailed explanations on the quality of life outcomes for each of the surgical methods to the patients.
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