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Matei D, Trăistaru R, Pădureanu V, Avramescu TE, Neagoe D, Genunche A, Amzolini A. The Efficiency of Kinesiotherapy versus Physical Modalities on Pain and Other Common Complaints in Fibromyalgia. Life (Basel) 2024; 14:604. [PMID: 38792625 PMCID: PMC11122147 DOI: 10.3390/life14050604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/28/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Due to its variety of signs and symptoms, there have been numerous attempts to treat fibromyalgia (FM), but a cure has yet to be established. The aim of this study was to evaluate the effects of a complex kinetic therapy program and a combined physical modality program on pain and other common symptoms of FM. Patients and methods: A total of 78 female patients were included in this study; 39 subjects underwent a kinesiotherapy (KT) intervention (combining aerobic and Pilates exercises), and 39 participated in a physical modality (PM) program (including electrotherapy (TENS and low-laser therapy) and thermotherapy). Results: Regarding the parameter of pain assessment, kinesiotherapy demonstrated its superiority both during the treatment period and in the evaluation 3 months after therapy cessation. Both in terms of patient-reported pain (inter-group comparisons: p = 0.000 at T3) and the examination of tender points (inter-group comparisons: p = 0.000 at T3), as well as the algometric assessment, pain was alleviated by the two forms of applied kinetic therapy. The observed functional impairment was statistically significantly influenced (p = 0.001) at the end of the kinetic program application, while for the perceived functional impairment, neither therapy proved superiority over the other at any point of evaluation (inter-group comparisons: p = 0.715 at T3). Regarding the influence of the emotional consequences implied by fibromyalgia, neither the forms of kinesiotherapy nor the chosen physical modalities proved superiority at any point of evaluation (HAQ anxiety inter-group comparisons: p = 0.000 at T3). In conclusion, even though kinesiotherapy had superior influences on fibromyalgia pain in the studied group, the current research lends credence to the significance of non-pharmacological therapy in managing fibromyalgia. Participants demonstrated positive advancements in subjective and objective pain assessments, as well as improvements in functional and emotional well-being.
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Affiliation(s)
- Daniela Matei
- Department of Medical Rehabilitation, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.M.); (R.T.)
| | - Rodica Trăistaru
- Department of Medical Rehabilitation, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.M.); (R.T.)
| | - Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
| | | | - Daniela Neagoe
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
| | - Amelia Genunche
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
| | - Anca Amzolini
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
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Nunes JC, Costa GPA, Weleff J, Rogan M, Compton P, De Aquino JP. Assessing pain in persons with opioid use disorder: Approaches, techniques and special considerations. Br J Clin Pharmacol 2024. [PMID: 38556851 DOI: 10.1111/bcp.16055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/30/2024] [Accepted: 02/29/2024] [Indexed: 04/02/2024] Open
Abstract
Pain and opioid use disorder (OUD) are inextricably linked, as the former can be a risk factor for the development of the latter, and over a third of persons with OUD suffer concomitant chronic pain. Assessing pain among people with OUD is challenging, because ongoing opioid use brings changes in pain responses and most pain assessment tools have not been validated for this population. In this narrative review, we discuss the fundamentals of pain assessment for populations with OUD. First, we describe the biological, psychological and social aspects of the pain experience among people with OUD, as well as how opioid-related phenomena may contribute to the pain experience in this population. We then review methods to assess pain, including (1) traditional self-reported methods, such visual analogue scales and structured questionnaires; (2) behavioural observations and physiological indicators; (3) and laboratory-based approaches, such as quantitative sensory testing. These methods are considered from a perspective that encompasses both pain and OUD. Finally, we discuss strategies for improving pain assessment in persons with OUD and implications for future research, including educational strategies for multidisciplinary teams. We highlight the substantial gaps that persist in this literature, particularly regarding the applicability of current pain assessment methods to persons with OUD, as well as the generalizability of the existing results from adjacent populations on chronic opioid therapy but without OUD. As research linking pain and OUD evolves, considering the needs of diverse populations with complex psychosocial backgrounds, clinicians will be better equipped to reduce these gaps.
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Affiliation(s)
- Julio C Nunes
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gabriel P A Costa
- Faculty of Medicine, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Jeremy Weleff
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael Rogan
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Peggy Compton
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joao P De Aquino
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Clinical Neuroscience Research Unit, Connecticut Mental Health Center, New Haven, Connecticut, USA
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Shaw J, Jacobs JV, Van Dillen LR, Beneck GJ, Smith JA. Understanding the Biering-Sørensen test: Contributors to extensor endurance in young adults with and without a history of low back pain. J Electromyogr Kinesiol 2024; 74:102854. [PMID: 38171249 PMCID: PMC10842485 DOI: 10.1016/j.jelekin.2023.102854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
The Biering-Sørensen test is commonly used to assess paraspinal muscle endurance. Research using a single repetition of the test has provided conflicting evidence for the contribution of impaired paraspinal muscle endurance to low back pain (LBP). This study investigated how Sørensen test duration, muscle activation, and muscle fatigability are affected by multiple repetitions of the test and determined predictors of Sørensen test duration in young adults with and without a history of LBP. Sixty-four young individuals performed three repetitions of the Sørensen test. Amplitude of activation and median frequency slope (fatigability) were calculated for the lumbar and thoracic paraspinals and hamstrings. Duration of the test was significantly less for the 3rd repetition in individuals with LBP. In individuals without LBP, test duration was predicted by fatigability of the lumbar paraspinals. In individuals with LBP, Sørensen test duration was predicted by fatigability of the hamstrings and amplitude of activation of the thoracic and lumbar paraspinals. Our findings demonstrate that it is necessary to amplify the difficulty of the Sørensen test to reveal impairments in young, active adults with LBP. Training programs aiming to improve lumbar paraspinal performance should monitor performance of other synergist muscles during endurance exercise.
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Affiliation(s)
- Jonathan Shaw
- Crean College of Health and Behavioral Sciences, Chapman University, CA, USA
| | - Jesse V Jacobs
- Rehabilitation and Movement Science, University of Vermont, VT, USA
| | - Linda R Van Dillen
- Program in Physical Therapy, Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, WA, USA
| | - George J Beneck
- Department of Physical Therapy, California State University, Long Beach, CA, USA
| | - Jo Armour Smith
- Crean College of Health and Behavioral Sciences, Chapman University, CA, USA.
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De la Corte-Rodriguez H, Roman-Belmonte JM, Resino-Luis C, Madrid-Gonzalez J, Rodriguez-Merchan EC. The Role of Physical Exercise in Chronic Musculoskeletal Pain: Best Medicine-A Narrative Review. Healthcare (Basel) 2024; 12:242. [PMID: 38255129 PMCID: PMC10815384 DOI: 10.3390/healthcare12020242] [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: 12/20/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of musculoskeletal pain, physical exercise is an effective, cheap, and safe therapeutic option, given that it does not produce the adverse effects of pharmacological treatments or invasive techniques. In addition to its analgesic capacity, physical exercise has an effect on other pain-related areas, such as sleep quality, activities of daily living, quality of life, physical function, and emotion. In general, even during periods of acute pain, maintaining a minimum level of physical activity can be beneficial. Programs that combine several of the various exercise modalities (aerobic, strengthening, flexibility, and balance), known as multicomponent exercise, can be more effective and better adapted to clinical conditions. For chronic pain, the greatest benefits typically occur with programs performed at light-to-moderate intensity and at a frequency of two to three times per week for at least 4 weeks. Exercise programs should be tailored to the specific needs of each patient based on clinical guidelines and World Health Organization recommendations. Given that adherence to physical exercise is a major problem, it is important to empower patients and facilitate lifestyle change. There is strong evidence of the analgesic effect of physical exercise in multiple pathologies, such as in osteoarthritis, chronic low back pain, rheumatoid arthritis, and fibromyalgia.
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Affiliation(s)
- Hortensia De la Corte-Rodriguez
- Department of Physical Medicine and Rehabilitation, La Paz University Hospital, 28046 Madrid, Spain;
- IdiPAZ Institute for Health Research, 28046 Madrid, Spain
| | - Juan M. Roman-Belmonte
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.); (C.R.-L.)
- Medical School, Universidad Alfonso X El Sabio (UAX), 28691 Madrid, Spain
| | - Cristina Resino-Luis
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.); (C.R.-L.)
| | - Jorge Madrid-Gonzalez
- Department of Physical Medicine and Rehabilitation, La Paz University Hospital, 28046 Madrid, Spain;
| | - Emerito Carlos Rodriguez-Merchan
- Department of Orthopedic Surgery, La Paz University Hospital, 28046 Madrid, Spain;
- Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research—IdiPAZ (La Paz University Hospital—Autonomous University of Madrid), 28046 Madrid, Spain
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5
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Moriki K, Ogihara H, Yoshikawa K, Kikuchi K, Endo R, Sato T. Effects of sleep quality on pain, cognitive factors, central sensitization, and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil 2024; 37:119-125. [PMID: 37694349 DOI: 10.3233/bmr-220429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Sleep quality in patients with chronic low back pain (CLBP) may affect quality of life (QoL), possibly due to worsening pain, central sensitization (CS), and cognitive factors. However, causal relationship among the factors has not been confirmed yet. OBJECTIVE The purpose of this study was to test the hypothesis that sleep quality in patients with CLBP is attributable to pain, cognitive factors, and CS, and influences QoL, by structural covariance analysis. METHODS This is a cross-sectional study. Participants were recruited from six health care facilities and 101 patients with CLBP were included. Structural covariance analysis assessed the fit of data to the model using goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and mean squared approximation error (RMSEA). RESULTS The structural covariance analysis showed that the goodness-of-fit indices were high (GFI = 0.993, AGFI = 0.964, CFI = 1.00, RMSEA < 0.01). Sleep quality was not directly influenced by QoL but rather by CS and cognitive factors. CONCLUSION This study suggests that sleep quality in patients with CLBP is indirectly mediated through multiple pathways, including cognitive factors and CS, which may influence QoL.
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Affiliation(s)
| | - Hirofumi Ogihara
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Koji Yoshikawa
- Graduate school of Health Sciences, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Kenta Kikuchi
- Department of Physical Therapy, Iwate Rehabilitation College, Iwate, Japan
| | - Ryunosuke Endo
- Graduate school of Health Sciences, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Takaaki Sato
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
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Shaw J, Jacobs JV, Van Dillen LR, Beneck GJ, Smith JA. Understanding the Biering-Sørensen test: contributors to extensor endurance in young adults with and without low back pain. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.11.23284452. [PMID: 36712062 PMCID: PMC9882630 DOI: 10.1101/2023.01.11.23284452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Impaired paraspinal muscle endurance may contribute to persistent low back pain (LBP) and is frequently assessed using a single repetition of the Biering-Sørensen test. This study investigated how Sørensen test duration, muscle activation, and muscle fatigability are affected by multiple repetitions of the test, and determined predictors of Sørensen test duration in young, active adults with and without a history of LBP. Sixty-four individuals with and without persistent LBP performed 3 repetitions of the Sørensen test. Amplitude of activation and median frequency slope (fatigability) were calculated for the lumbar and thoracic paraspinals and the hamstrings. Duration of the test was significantly less for the 2nd and 3rd repetitions in individuals with LBP. In individuals without LBP, fatigability of the lumbar paraspinals was the best predictor of test duration. In individuals with LBP, Sørensen test duration was predicted by fatigability of the hamstrings and amplitude of activation of the thoracic and lumbar paraspinals. Our findings demonstrate that it is necessary to amplify the difficulty of the Sørensen test to elucidate impairments in young, active adults with LBP. Training programs aiming to improve lumbar paraspinal performance in individuals with LBP should monitor performance of other synergist muscles during endurance exercise.
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ALMohiza MA, Reddy RS, Asiri F, Alshahrani A, Tedla JS, Dixit S, Gular K, Kakaraparthi VN. The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065193. [PMID: 36982105 PMCID: PMC10049448 DOI: 10.3390/ijerph20065193] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/27/2023] [Accepted: 03/14/2023] [Indexed: 06/10/2023]
Abstract
(1) Background: Fear of movement (kinesiophobia) and impaired lumbar joint position sense (LJPS) play a vital role in developing and maintaining non-specific chronic low back pain (CLBP). However, how kinesiophobia impacts LJPS is still being determined. The aims of this study are to (1) assess the correlation between kinesiophobia and LJPS in individuals with chronic low back pain; (2) compare LJPS between individuals with CLBP and those who are asymptomatic; and (3) evaluate if pain can mediate the relationship between kinesiophobia and LJPS in CLBP individuals. (2) Methods: Eighty-three individuals (mean age = 48.9 ± 7.5 years) with a diagnosis of CLBP and 95 asymptomatic individuals (mean age = 49.4 ± 7.0 years) were recruited into this cross-sectional study. Fear of movement in CLBP individuals was assessed using the Tampa Scale for Kinesiophobia (TSK). LJPS was determined using the active target repositioning technique using a dual-digital inclinometer. LJPS was evaluated in lumbar flexion, extension, and side-bending left and right directions, and the repositioning accuracy was determined in degrees using a dual digital inclinometer. (3) Results: Kinesiophobia showed a significant (p < 0.001) moderate positive correlation with LJPS (flexion: r = 0.51, extension: r = 0.41, side-bending left: r = 0.37 and side-bending right: r = 0.34). LJPS errors were larger in CLBP individuals compared to asymptomatic individuals (p < 0.05). Mediation analyses showed that pain significantly mediated the relationship between kinesiophobia and LJPS (p < 0.05) in CLBP individuals. (4) Conclusions: Kinesiophobia and LJPS were positively associated. LJPS is impaired in CLBP individuals compared to asymptomatic individuals. Pain may mediate adverse effects on LJPS. These factors must be taken into account when assessing and developing treatment plans for those with CLBP.
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Affiliation(s)
- Mohammad A. ALMohiza
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Adel Alshahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Najran University, Najran 55461, Saudi Arabia
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
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Lee K. Motion Analysis of Core Stabilization Exercise in Women: Kinematics and Electromyographic Analysis. Sports (Basel) 2023; 11:sports11030066. [PMID: 36976952 PMCID: PMC10051858 DOI: 10.3390/sports11030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
As core stabilization exercise is essential for maintaining a stable spine and improving functional performance, understanding the activation of core muscles and the stabilization of the trunk and pelvis during such exercise is crucial. The purpose of this study was to investigate the muscle activation and stabilization of the lumbar–pelvic region during core stabilization exercise, with a specific focus on analyzing EMG and 3D motion kinematic data. The study aimed to understand how different tension settings on the reformer affect muscle activation and hip motion, as well as how these factors impact pelvic and trunk stability during the exercise. The reformer consists of a carriage that slides back and forth on rails, with springs providing resistance. The springs can be adjusted to vary the resistance level. Twenty-eight healthy women participating in this study were asked to perform ‘side splits’, a hip abduction exercise, on the reformer in both heavy and light tension settings. Activation of the internal oblique (IO), rectus abdominis (RA), multifidus (MU), costal lumbosacral (IL), gluteus medius (GM), and adductor muscles (AL) were measured using electromyography (EMG) and 3D motion. Kinematic data using an assay were also measured during exercise. GM, IO, and MU muscles were more active when heavy springs were used, and AL muscles were more active when light springs were used. Hip motion was more symmetrical when lighter springs were used with a greater range of hip motion. There was less pelvis and torso weight transfer and more torso and pelvis stability when the heavier springs were used. In this study, we confirmed that core stabilization exercise on an unstable surface activates the deep muscles of the abdomen and back and is effective for pelvic and trunk stabilization training.
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Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, College of Health Science, Kyungdong University, Wonju 24764, Republic of Korea
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Christe G, Benaim C, Luthi F, Jolles BM, Favre J. Reduction in pain-related fear is not associated with improvement in spinal biomechanics but with decrease in movement-evoked pain in patients with chronic low back pain. Pain Pract 2023; 23:290-300. [PMID: 36479806 DOI: 10.1111/papr.13191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/10/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS While a causal relationship between pain-related fear and spinal movement avoidance in patients with chronic low back pain (CLBP) has frequently been postulated, evidence supporting this relationship is limited. This study aimed to test if decreases in pain-related fear or catastrophizing were associated with improvements in spinal biomechanics, accounting for possible changes in movement-evoked pain. METHODS Sixty-two patients with CLBP were assessed before and after an interdisciplinary rehabilitation program (IRP). Pain-related fear was assessed with general and task-specific measures. Lower and upper lumbar angular amplitude and velocity as well as paraspinal muscle activity were recorded during five daily-life tasks to evaluate spinal biomechanics. Relationships were tested with multivariable linear regression analyses. RESULTS The large decreases in pain-related fear and catastrophizing following the IRP were scarcely and inconsistently associated with changes in spinal biomechanics (< 3% of the models reported a statistically significant association). Results remained comparable for activities inducing more or less fear, for specific or general measures of pain-related fear, and for analyses performed on the entire population or limited to subgroups of patients with higher levels of task-specific fear. In contrast, reductions in task-specific pain-related fear were significantly associated with decreases in movement-evoked pain in all tasks (r = 0.26-0.62, p ≤ 0.02). CONCLUSION This study does not support an association between pain-related fear and spinal movement avoidance. However, it provides evidence supporting a direct relationship between decreased pain-related fear and decreased movement-evoked pain, possibly explaining some mechanisms of the rehabilitation programs.
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Affiliation(s)
- Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Charles Benaim
- Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
| | - François Luthi
- Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Brigitte M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
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Karayannis NV, Smuck M, Law C, Mackey SC, Gross JJ, Darnall BD, Hush J. Self-reported physical function is strongly related to pain behavior and pain interference and weakly related to physical capacity in people with chronic low back pain. Musculoskelet Sci Pract 2023; 63:102721. [PMID: 36759316 PMCID: PMC10566747 DOI: 10.1016/j.msksp.2023.102721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/15/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Inclusion of self-reported and capacity-based measures may help to further elucidate the interactive link between how people think and move. OBJECTIVE To characterize the relationship between self-reported factors of physical function and pain with objective physical capacity measures. DESIGN Cross-sectional study of 328 adults with chronic low back pain (CLBP). METHOD Spearman correlations assessed the relationship between pairs of measures. Multiple linear regression models assessed the association between self-reported measures of physical function and the grouping of physical capacity measures. Self-reported measures included Roland Morris Disability Questionnaire (RMDQ), PROMIS Physical Function, Pain Behavior, and Pain Interference; Fear-Avoidance Beliefs Questionnaire (FABQ), Pain Catastrophizing Scale (PCS), and Chronic Pain Acceptance Questionnaire (CPAQ). Capacity measures included walking speed and endurance, lower extremity functional strength, lumbopelvic range of motion, and trunk endurance. RESULTS PROMIS Physical Function was directly and weakly correlated with walking speed (ρ = 0.26, 2-min walk) and inversely and weakly correlated with lower extremity strength (ρ = -0.29, 5x sit-to-stand). RMDQ was not correlated with any of the capacity-based measures. PROMIS Physical Function was inversely and moderately correlated with Pain Interference (ρ = -0.48) and Pain Behavior (ρ = -0.43), PCS (ρ = -0.36), and FABQ (ρ = -0.31). The RMDQ was strongly correlated with PROMIS Physical Function (ρ = -0.56), Pain Behavior (ρ = 0.51) and Pain Interference (ρ = 0.49); and moderately correlated with PCS (ρ = 0.37) and FABQ (ρ = 0.33). PROMIS Physical Function and RMDQ were not correlated with CPAQ. Lower scores on PROMIS Physical Function were weakly associated with lower measures of lower extremity strength (-0.30, 95% CI: -0.51 to -0.09, p = 0.005). Higher scores on RMDQ were also weakly associated with lower measures of lower extremity strength (0.26, 95% CI: 0.11 to 0.41, p = 0.001). CONCLUSIONS A strong association emerged between self-reported limitations in physical function, pain behavior, and pain interference. A weak association emerged between self-reported physical function and lower extremity strength.
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Affiliation(s)
| | | | | | | | | | | | - Julia Hush
- MacQuarie University, Sydney, Australia.
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11
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Liew BXW, Hartvigsen J, Scutari M, Kongsted A. Data-driven network analysis identified subgroup-specific low back pain pathways: a cross-sectional GLA:D Back study. J Clin Epidemiol 2023; 153:66-77. [PMID: 36396075 DOI: 10.1016/j.jclinepi.2022.11.010] [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: 09/12/2022] [Revised: 11/02/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To understand the physical, activity, pain, and psychological pathways contributing to low back pain (LBP) -related disability, and if these differ between subgroups. METHODS Data came from the baseline observations (n = 3849) of the "GLA:D Back" intervention program for long-lasting nonspecific LBP. 15 variables comprising demographic, pain, psychological, physical, activity, and disability characteristics were measured. Clustering was used for subgrouping, Bayesian networks (BN) were used for structural learning, and structural equation model (SEM) was used for statistical inference. RESULTS Two clinical subgroups were identified with those in subgroup 1 having worse symptoms than those in subgroup 2. Psychological factors were directly associated with disability in both subgroups. For subgroup 1, psychological factors were most strongly associated with disability (β = 0.363). Physical factors were directly associated with disability (β = -0.077), and indirectly via psychological factors. For subgroup 2, pain was most strongly associated with disability (β = 0.408). Psychological factors were common predictors of physical factors (β = 0.078), pain (β = 0.518), activity (β = -0.101), and disability (β = 0.382). CONCLUSIONS The importance of psychological factors in both subgroups suggests their importance for treatment. Differences in the interaction between physical, pain, and psychological factors and their contribution to disability in different subgroups may open the doors toward more optimal LBP treatments.
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Affiliation(s)
- Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, UK.
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Chiropractic Knowledge Hub, Odense, Denmark
| | - Marco Scutari
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), Lugano, Switzerland
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Chiropractic Knowledge Hub, Odense, Denmark
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Keshavarzi F, Azadinia F, Talebian S, Khalkhali Zavieh M, Rasouli O. Effect of a semi-rigid backpack type thoracolumbar orthosis on thoracic kyphosis angle and muscle performance in older adults with hyperkyphosis: a randomized controlled trial. Disabil Rehabil 2022; 45:1488-1497. [PMID: 35452347 DOI: 10.1080/09638288.2022.2065541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate the effect of a semi-rigid backpack type thoracolumbar orthosis (TLO) on thoracic kyphosis angle (TKA) and potentially contributing factors of hyperkyphosis, including position sense and back muscle strength and endurance. METHOD This randomized, controlled trial was conducted on 48 older adults with hyperkyphosis, randomly allocated to an experimental or control group. The experimental group wore a semi-rigid TLO for 3 consecutive months. The control group received no external support or exercise. Thoracic kyphosis angle (TKA), joint position sense, back muscle strength and endurance were evaluated at the baseline and at the end of week 6 and week 12. RESULTS The two-way (group × time) interactions were significant in terms of TKA (F = 37.88, p ≤ 0.001, ηp2 = 0.45), muscle strength (F = 26.005, p ≤ 0.001, ηp2 = 0.36), muscle endurance measured via load cell (F = 3.417, p = 0.039, ηp2 = 0.06), and endurance holding time of Ito test (F = 3.629, p = 0.045, ηp2 = 0.07). A further analysis using one-way repeated measures of ANOVA showed that TKA, muscle strength and endurance were significantly improved in the experimental group. Also, two-way interactions were significant for absolute error and variable error of trunk neutral repositioning test from a trunk flexed and/or extended position for global components and horizontal components trunk repositioning test. CONCLUSION Wearing a semi-rigid backpack type TLO even from an unknown brand for short periods during the day (e.g., 2-4 h) over 3 months not only modifies kyphotic posture but also can enhance back muscle performance in older adults with hyperkyphosis. IMPLICATIONS FOR REHABILITATIONPrescription of a semi-rigid backpack type thoracolumbar orthosis for older adults has no adverse effects such as muscle weakness if it is applied for short periods during the day.A semi-rigid backpack thoracolumbar orthosis can prevent position sense degradation in older adults with hyperkyphosis.A semi-rigid backpack type thoracolumbar orthosis may counteract trunk flexion and kyphotic posture by applying the biomechanical principles of the three-point pressure system.Improvement in spinal alignment resulting from wearing thoracolumbar orthosis should not occur in exchange for muscle deconditioning.
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Affiliation(s)
- Fatemeh Keshavarzi
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Azadinia
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences and Health Services, Tehran, Iran
| | - Minoo Khalkhali Zavieh
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Rasouli
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Keshavarzi F, Azadinia F, Talebian S, Rasouli O. Test-retest reliability of a load cell setup, Ito, and timed loaded standing tests for measuring muscle strength and endurance in older adults with and without hyperkyphosis. Musculoskelet Sci Pract 2022; 58:102475. [PMID: 34801467 DOI: 10.1016/j.msksp.2021.102475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The association of back muscle weakness with greater thoracic kyphosis has been widely documented. Reliable and easy-to-use techniques are needed to monitor changes in muscle function over time and assess the effectiveness of therapeutic interventions. Therefore, the present study aimed to evaluate the test-retest reliability of a designed load-cell setup and two clinical tests, namely Ito and Timed loaded standing (TLS) tests for measuring back muscle function (i.e., strength and endurance) in older adults with and without hyperkyphosis. METHOD Fifty-three older people (28 with thoracic hyperkyphosis and 25 normal age-matched controls) completed the present test-retest reliability study. A two-way random model of the Intraclass Correlation Coefficient (ICC2,3) was used to estimate relative reliability. Absolute reliability was assessed by calculating Standard Error of the Measurements (SEM) and Minimal Detectable Change (MDC). RESULTS The findings showed excellent test-retest reliability in all performed tests for this population (ICC = 0.95-0.99). In addition, the MDC values for measuring endurance time via load cell, Ito, and TLS tests in the hyperkyphosis group, were 16.5, 28.2, and 35.1 s, respectively. These values ranged from 36 to 39 s for the control group. CONCLUSION The present study suggests high test-retest reliability of the designed load-cell setup, Ito, and TLS for assessing back extensor muscle strength and endurance in older adults with and or without hyperkyphosis.
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Affiliation(s)
- Fatemeh Keshavarzi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Azadinia
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences and Health Services, Tehran, Iran.
| | - Omid Rasouli
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
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New comprehensive clinical tests to measure endurance of back muscles and their comparison with the Sorenson’s test. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00880-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Physiotherapy combined with therapeutic neuroscience education versus physiotherapy alone for patients with chronic low back pain: A pilot, randomized-controlled trial. Turk J Phys Med Rehabil 2021; 67:283-290. [PMID: 34870114 PMCID: PMC8606998 DOI: 10.5606/tftrd.2021.5556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/25/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives
The aim of this study was to investigate the effect of therapeutic neuroscience education (TNE) combined with physiotherapy on pain, kinesiophobia, endurance, and disability in chronic low back pain (CLBP) patients.
Patients and methods
Between November 2016 and December 2017, a total of 31 patients with CLBP (5 males, 26 females; mean age: 42.3±10.8 years; range, 20 to 58 years) were randomly allocated to receive physiotherapy combined with TNE (experimental group, EG, n=16) and physiotherapy alone (control group, CG, n=15). All participants received physiotherapy consisting of five sessions per week for a total of three weeks. In addition to physiotherapy, the EG received TNE sessions consisting of two sessions per week for a total of three weeks. The primary outcomes were pain intensity as assessed by Visual Analog Scale (VAS) and kinesiophobia by Tampa Scale for Kinesiophobia (TSK), while and the secondary outcomes were trunk muscle endurance as assessed by the partial curl-up test (trunk flexor endurance [TFE]) and modified Sorensen test (trunk extensor endurance [TEE]) and disability by Roland-Morris Disability Questionnaire (RMDQ).
Results
All patients completed the study. The median VAS, TSK, TFE, TEE, and RMDQ scores for the EG significantly improved after three weeks, while there was only significant improvement in the VAS, TSK, and RMDQ scores in the CG. The TSK decreased more in the EG than in the CG. The significant difference was evident in TSK and TFE in favor of the EG (p<0.05).
Conclusion
These results suggest that the combination of TNE with physiotherapy can improve kinesiophobia and trunk flexor muscle endurance of patients with CLBP in the short-term.
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Elgueta-Cancino E, Sheeran L, Salomoni S, Hall L, Hodges PW. Characterisation of motor cortex organisation in patients with different presentations of persistent low back pain. Eur J Neurosci 2021; 54:7989-8005. [PMID: 34719827 PMCID: PMC10138737 DOI: 10.1111/ejn.15511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/14/2021] [Accepted: 10/24/2021] [Indexed: 02/06/2023]
Abstract
Persistence of low back pain is thought to be associated with different underlying pain mechanisms, including ongoing nociceptive input and central sensitisation. We hypothesised that primary motor cortex (M1) representations of back muscles (a measure of motor system adaptation) would differ between pain mechanisms, with more consistent observations in individuals presumed to have an ongoing contribution of nociceptive input consistently related to movement/posture. We tested 28 participants with low back pain sub-grouped by the presumed underlying pain mechanisms: nociceptive pain, nociplastic pain and a mixed group with features consistent with both. Transcranial magnetic stimulation was used to study M1 organisation of back muscles. M1 maps of multifidus (deep and superficial) and longissimus erector spinae were recorded with fine-wire electromyography and thoracic erector spinae with surface electromyography. The nociplastic pain group had greater variability in M1 map location (centre of gravity) than other groups (p < .01), which may suggest less consistency, and perhaps relevance, of motor cortex adaptation for that group. The mixed group had greater overlap of M1 representations between deep/superficial muscles than nociceptive pain (deep multifidus/longissimus: p = .001, deep multifidus/thoracic erector spinae: p = .008) and nociplastic pain (deep multifidus/longissimus: p = .02, deep multifidus/thoracic erector spinae: p = .02) groups. This study provides preliminary evidence of differences in M1 organisation in subgroups of low back pain classified by likely underlying pain mechanisms. Despite the sample size, differences in cortical re-organisation between subgroups were detected. Differences in M1 organisation in subgroups of low back pain supports tailoring of treatment based on pain mechanism and motor adaptation.
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Affiliation(s)
- Edith Elgueta-Cancino
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Liba Sheeran
- Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, Cardiff, UK.,School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Sauro Salomoni
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne Hall
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul W Hodges
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Chronic musculoskeletal pain, catastrophizing, and physical function in adult women were improved after 3-month aerobic-resistance circuit training. Sci Rep 2021; 11:14939. [PMID: 34294740 PMCID: PMC8298582 DOI: 10.1038/s41598-021-91731-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
Although exercise is beneficial for chronic musculoskeletal pain (CMP), the optimal type and amount of exercise are unclear. This study aimed to determine the impact of circuit training that combines aerobic and resistance exercises on adult women with CMP. A total of 139 women with CMP underwent circuit training for 3 months and were asked to complete the following questionnaires at baseline and 3 months later: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Roland-Morris Disability Questionnaire (RDQ), Shoulder36, and Knee injury and Osteoarthritis Outcome Score (KOOS). Significant improvements were observed in NRS, PCS, RDQ, and KOOS activities of daily living (ADL) scores after the intervention relative to baseline (p < 0.0001, p = 0.0013, 0.0004, and 0.0295, respectively), whereas shoulder function did not improve. When considering the impact of exercise frequency, NRS scores improved regardless of exercise frequency. Furthermore, PCS, RDQ, and KOOS scores improved in participants who exercised at least twice a week (24 sessions over the course of 3 months). In conclusion, CMP, pain catastrophizing, and physical function in adult female fitness club participants with CMP of NRS 4 or higher improved after 3 months of aerobic-resistance circuit training.
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18
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Christe G, Crombez G, Edd S, Opsommer E, Jolles BM, Favre J. Relationship between psychological factors and spinal motor behaviour in low back pain: a systematic review and meta-analysis. Pain 2021; 162:672-686. [PMID: 33591109 DOI: 10.1097/j.pain.0000000000002065] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022]
Abstract
ABSTRACT This meta-analysis investigated whether more negative psychological factors are associated with less spinal amplitude of movement and higher trunk muscle activity in individuals with low back pain. Furthermore, it examined whether pain intensity was a confounding factor in this relationship. We included studies that provided at least 1 correlation coefficient between psychological (pain-related fear, catastrophizing, depression, anxiety, and self-efficacy) and spinal motor behaviour (spinal amplitude and trunk muscle activity) measures. In total, 52 studies (3949 participants) were included. The pooled correlation coefficients (95% confidence interval; number of participants) were -0.13 (-0.18 to -0.09; 2832) for pain-related fear, -0.16 (-0.23 to -0.09; 756) for catastrophizing, -0.08 (-0.13 to -0.03; 1570) for depression, -0.08 (-0.30 to 0.14; 336) for anxiety, and -0.06 (-0.46 to 0.36; 66) for self-efficacy. The results indicated that higher levels of pain-related fear, catastrophizing, and depression are significantly associated with reduced amplitudes of movement and larger muscle activity and were consistent across subgroup and moderation analyses. Pain intensity did not significantly affect the association between these psychological factors and spinal motor behaviour and had a very small independent association with spinal motor behaviour. In conclusion, the very small effect sizes found in the meta-analyses question the role of psychological factors as major causes of spinal movement avoidance in low back pain. Experimental studies with more specific and individualized measures of psychological factors, pain intensity, and spinal motor behaviour are recommended.
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Affiliation(s)
- Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Shannon Edd
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Emmanuelle Opsommer
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Brigitte M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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19
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王 伟, 李 危, 陈 仲. [Progress on the evaluation method of paraspinal muscle and its correlation with lumbar diseases]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:1462-1467. [PMID: 33191707 PMCID: PMC8171695 DOI: 10.7507/1002-1892.201912120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/21/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review the evaluation method of paraspinal muscle and its role in lumbar spine diseases, and offer reference for further research on paraspinal muscles. METHODS The related literature of paraspinal muscle measurement and its role in lumbar spine diseases was reviewed. The evaluation methods of paraspinal muscle were analyzed from the advantages and disadvantages and the role of paraspinal muscle in lumbar spine diseases was summarized. RESULTS Radiographic methods are often used to evaluate the atrophy of paraspinal muscle, mainly including CT and MRI. The cross-sectional area and fatty infiltration of paraspinal muscle are two key parameters. Radiographic methods are reproducible and widely applied, but CT has the disadvantage of radiation exposure, while the cost of MRI is high. Besides, more and more researchers focus on the functional evaluation of paraspinal muscle, which mainly includes surface electromyogram analysis and back muscle strength test. The surface electromyogram analysis can quantitatively measure neuromuscular function, but the results could be affected by many influencing factors. The back muscle strength test is simple, but it lacks standardized posture. The atrophy of paraspinal muscle is related to many lumbar spine diseases, while the results of different researches are different. CONCLUSION There are many methods to evaluate paraspinal muscles, but there is no unified standard. The role of paraspinal muscle in lumbar spine diseases need to be further studied.
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Affiliation(s)
- 伟 王
- 北京大学第三医院骨科(北京 100191)Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P.R.China
- 北京大学医学部(北京 100191)Peking University Health Science Center, Beijing, 100191, P.R.China
| | - 危石 李
- 北京大学第三医院骨科(北京 100191)Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P.R.China
| | - 仲强 陈
- 北京大学第三医院骨科(北京 100191)Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P.R.China
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20
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Cruz-Montecinos C, Núñez-Cortés R, Guzmán-González B, Andersen LL, García-Massó X, Calatayud J. The Relevance of Dual Tasking for Improving Trunk Muscle Endurance After Back Surgery. Arch Phys Med Rehabil 2020; 102:463-469. [PMID: 32888906 DOI: 10.1016/j.apmr.2020.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the effect of dual tasking on trunk muscle endurance in patients after lumbar diskectomy. DESIGN Cross-sectional study. SETTING Rehabilitation hospital setting. PARTICIPANTS Individuals (N=14) undergoing primary lumbar diskectomy. INTERVENTION Using a randomized design on 2 separate days, muscle endurance was evaluated during prone bridging and Biering-Sorensen tests. Each test was randomly performed under 2 cognitive conditions: single task without cognitive condition and self-regulated dual task (ie, mathematical task). MAIN OUTCOME MEASURES The primary outcomes were time to failure and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale and disability assessed by the Oswestry Disability Index. Associations were tested using a repeated measures analysis of variance with relevant interaction test. RESULTS A significant interaction between condition, endurance tests, and kinesiophobia (P=.005) was found. The post hoc comparison showed positive effects between cognitive conditions in both endurance tests (prone bridging test: mean difference, 15.7s; 95% confidence interval [CI], 7.5-24s; P=.001; Biering-Sorensen test: mean difference, 7.9s; 95% CI, 1.9-14s; P=.014). The linear regression analysis between the Tampa Scale for Kinesiophobia and the difference of time to failure between cognitive conditions showed a positive correlation only during the Biering-Sorensen test (r=0.80; P=.001). CONCLUSIONS A self-regulated dual task increases trunk muscle endurance in patients after lumbar diskectomy. The results suggest that the difference observed in time to failure between the single task and dual task is associated with fear avoidance, especially during back extension. This strategy seems especially relevant for patients with high levels of fear avoidance and may be used to improve trunk muscle endurance.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile
| | - Rodrigo Núñez-Cortés
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Service of Physical Therapy, Hospital Clínico La Florida, Santiago, Chile
| | - Benjamín Guzmán-González
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain; Human Movement Analysis Group, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group, Department of Physiotherapy, University of Valencia, Valencia, Spain.
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Izquierdo-Alventosa R, Inglés M, Cortés-Amador S, Gimeno-Mallench L, Chirivella-Garrido J, Kropotov J, Serra-Añó P. Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103634. [PMID: 32455853 PMCID: PMC7277480 DOI: 10.3390/ijerph17103634] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/21/2022]
Abstract
Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain and other physical and psychological features. In this study, we aimed to analyze the effect of a low-intensity physical exercise (PE) program, combining endurance training and coordination, on psychological aspects (i.e., pain catastrophizing, anxiety, depression, stress), pain perception (i.e., pain acceptance, pressure pain threshold (PPT), and quality of life and physical conditioning (i.e., self-perceived functional capacity, endurance and functional capacity, power and velocity) in women with FM. For this purpose, a randomized controlled trial was carried out. Thirty-two women with FM were randomly allocated to a PE group (PEG, n = 16), performing an eight-week low-intensity PE program and a control group (CG, n = 16). Pain catastrophizing, anxiety, depression, stress, pain acceptance, PPT, quality of life, self-perceived functional capacity, endurance and functional capacity, power, and velocity were assessed before and after the intervention. We observed a significant improvement in all studied variables in the PEG after the intervention (p < 0.05). In contrast, the CG showed no improvements in any variable, which further displayed poorer values for PPT (p < 0.05). In conclusion, a low-intensity combined PE program, including endurance training and coordination, improves psychological variables, pain perception, quality of life, and physical conditioning in women with FM.
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Affiliation(s)
- Ruth Izquierdo-Alventosa
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 València, Spain; (R.I.-A.); (S.C.-A.); (P.S.-A.)
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES-ISCIII), Fundación Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), 46010 València, Spain
- Correspondence: ; Tel.: +34-963-98-38-55
| | - Sara Cortés-Amador
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 València, Spain; (R.I.-A.); (S.C.-A.); (P.S.-A.)
| | - Lucia Gimeno-Mallench
- Freshage Research Group, Department of Physiology, Faculty of Medicine, Universitat de València, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES-ISCIII), Fundación Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), 46010 València, Spain;
| | | | - Juri Kropotov
- N.P. Bechtereva Institute of Human Brain, Russian Academy of Science, 197022 St. Petersburg, Russia;
| | - Pilar Serra-Añó
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 València, Spain; (R.I.-A.); (S.C.-A.); (P.S.-A.)
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22
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Lazaridou A, Martel MO, Cornelius M, Franceschelli O, Campbell C, Smith M, Haythornthwaite JA, Wright JR, Edwards RR. The Association Between Daily Physical Activity and Pain Among Patients with Knee Osteoarthritis: The Moderating Role of Pain Catastrophizing. PAIN MEDICINE 2020; 20:916-924. [PMID: 30016486 DOI: 10.1093/pm/pny129] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The primary objective of this study was to examine the day-to-day association between physical activity and pain intensity among a sample of patients with knee osteoarthritis (KOA) and the potential moderation of this association by negative cognitive processes. METHODS In this micro-longitudinal daily diary study, KOA patients (N = 121) completed questionnaires assessing pain (Brief Pain Inventory) and psychosocial functioning (pain catrophizing scale, WOMAC McMaster Universities Osteoarthritis Index function, Patient-Reported Outcomes Measurement Information System [PROMIS; anxiety and depression], the Godin-Shephard Leisure-Time Physical Activity questionnaire, the six-minute walking test) and were then asked to report their levels of physical activity and pain intensity once per day for a period of seven days using an electronic diary. RESULTS Multilevel modeling analyses indicated that day-to-day increases in physical activity were associated with heightened levels of pain intensity (B = 0.13 SE = 0.03, P < 0.001). In addition, it was revealed that the association between physical activity and pain intensity was moderated by catastrophizing (B = -0.01 SE = 0.002, P < 0.05), with patients scoring higher in catastrophizing showing a relatively stronger link between day-to-day physical activity and increased knee pain. This effect was specific to catastrophizing, as depression and anxiety did not moderate the activity-pain relationship (P > 0.05). CONCLUSIONS Our findings suggest that increases in daily physical activity are associated with concurrent increases in KOA patients' levels of knee pain, particularly among patients reporting higher levels of pain catastrophizing. These results may have clinical implications for the design and testing of interventions targeted at reducing catastrophizing and increasing physical activity among patients with chronic osteoarthritis pain.
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Affiliation(s)
- Asimina Lazaridou
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Marc O Martel
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Marise Cornelius
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Olivia Franceschelli
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Claudia Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John R Wright
- Department of Orthopedic Surgery, Harvard Medical School, Brigham & Women's Hospital, Chestnut Hill, Massachusetts, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
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Age- and sex-specific effects in paravertebral surface electromyographic back extensor muscle fatigue in chronic low back pain. GeroScience 2019; 42:251-269. [PMID: 31773454 PMCID: PMC7031171 DOI: 10.1007/s11357-019-00134-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/04/2019] [Indexed: 01/07/2023] Open
Abstract
The impact of aging on the back muscles is not well understood, yet may hold clues to both normal aging and chronic low back pain (cLBP). This study sought to investigate whether the median frequency (MF) surface electromyographic (SEMG) back muscle fatigue method—a proxy for glycolytic muscle metabolism—would be able to detect age- and sex-specific differences in neuromuscular and muscle metabolic functions in individuals with cLBP in a reliable way, and whether it would be as sensitive as when used on healthy individuals. With participants seated on a dynamometer (20° trunk anteflexion), paraspinal SEMG activity was recorded bilaterally from the multifidus (L5), longissimus (L2), and iliolumbalis (L1) muscles during isometric, sustained back extensions loaded at 80% of maximum from 117 younger (58 females) and 112 older (56 female) cLBP individuals. Tests were repeated after 1–2 days and 6 weeks. Median frequency, the SEMG variable indicating neuromuscular fatigue, was analyzed. Maximum back extensor strength was comparable between younger and older participants. Significantly less MF-SEMG back muscle fatigue was observed in older as compared to younger, and in older female as compared to older male cLBP individuals. Relative reliability was excellent, but absolute reliability appeared large for this SEMG-fatigue measure. Findings suggest that cLBP likely does not mask the age-specific diagnostic potential of the MF-SEMG back extensor fatigue method. Thus, this method possesses a great potential to be further developed into a valuable biomarker capable of detecting back muscle function at risk of sarcopenia at very early stages.
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Nolan D, O’Sullivan K, Newton C, Singh G, Smith BE. Are there differences in lifting technique between those with and without low back pain? A systematic review. Scand J Pain 2019; 20:215-227. [DOI: 10.1515/sjpain-2019-0089] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022]
Abstract
Abstract
Background and aims
To systemically review the literature to compare freestyle lifting technique, by muscle activity and kinematics, between people with and without low back pain (LBP).
Methods
Five databases were searched along with manual searches of retrieved articles by a single reviewer. Studies were included if they compared a freestyle lifting activity between participants with and without LBP. Data were extracted by two reviewers, and studies were appraised using the CASP tool for case-control studies.
Results
Nine studies were eligible. Heterogeneity did not allow for meta-analysis. Most studies (n = 8 studies) reported that people with LBP lift differently to pain-free controls. Specifically, people with LBP lift more slowly (n = 6 studies), use their legs more than their back especially when initiating lifting (n = 3 studies), and jerk less during lifting (n = 1 studies). Furthermore, the four larger studies involving people with more severe LBP also showed that people with LBP lift with less spinal range of motion and greater trunk muscle activity for a longer period.
Conclusions
People with LBP move slower, stiffer, and with a deeper knee bend than pain-free people during freestyle lifting tasks. Interestingly, such a lifting style mirrors how people, with and without LBP, are often told how to lift during manual handling training. The cross-sectional nature of the comparisons does not allow for causation to be determined.
Implications
The changes described may show embodiment of cautious movement, and the drive to protect the back. There may be value in exploring whether adopting a lifting style closer to that of pain-free people could help reduce LBP.
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Affiliation(s)
- David Nolan
- Sheffield Teaching Hospitals NHS Foundation Trust , PhysioWorks, Firth Park Clinic, North Quadrant , Sheffield , UK , Phone: 07725854140
| | - Kieran O’Sullivan
- Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital , Doha , Qatar
- School of Allied Health , University of Limerick , Limerick , Ireland
- Health Research Institute , University of Limerick , Limerick , Ireland
| | - Chris Newton
- Physiotherapy Department , University Hospitals of Leicester NHS Trust , Leicester , UK
- Division of Rehabilitation and Ageing, School of Medicine , University of Nottingham , Nottingham , UK
| | - Gurpreet Singh
- Physiotherapy Department , University Hospitals of Leicester NHS Trust , Leicester , UK
| | - Benjamin E. Smith
- Division of Rehabilitation and Ageing, School of Medicine , University of Nottingham , Nottingham , UK
- University Hospitals of Derby and Burton NHS Foundation Trust , Derby , UK
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Asymmetry of lumbar muscles fatigability with non-specific chronic low back pain patients. 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; 28:2526-2534. [DOI: 10.1007/s00586-019-06140-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 01/10/2023]
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Wattananon P, Klomjai W, Sung W. One session of motor control exercise improves joint position sense assessed by an iPhone application: a randomized controlled trial. J Phys Ther Sci 2019; 31:583-589. [PMID: 31417226 PMCID: PMC6642896 DOI: 10.1589/jpts.31.583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/22/2019] [Indexed: 01/04/2023] Open
Abstract
[Purpose] To establish the test-retest reliability of an iPhone application and determine
the immediate effect of motor control exercise (MCE) on lumbar position sense.
[Participants and Methods] This study used a two-arm, randomized controlled trial design
with a blinded assessor. Sixty healthy participants were randomized into the exercise or
control group. The exercise group underwent 30-min MCE, whereas the control group rested
for 15 min. Lumbar motion measured by two iPhones with goniometer application was used to
determine the test-retest reliability. Absolute repositioning errors (pre- and post-test)
from the control and exercise groups were used to determine the immediate effect of MCE on
lumbar position sense. [Results] The test-retest reliability was 0.67–0.95. A significant
interaction effect was found for Angle*Time, main effect of Angle, and main effect of
Time. Post-hoc comparison showed a significant improvement in position sense at 45° and
60° in the exercise group. [Conclusion] The findings suggest that a mobile phone
application has the ability to detect changes in lumbar position sense between sessions
that exceed measurement error following MCE. One session of specific MCE can improve
lumbar position sense at high lumbar flexion.
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Affiliation(s)
- Peemongkon Wattananon
- Faculty of Physical Therapy, Mahidol University: 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand
| | - Wanalee Klomjai
- Faculty of Physical Therapy, Mahidol University: 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand
| | - Won Sung
- Good Shepherd Penn Partners, Penn Therapy and Fitness, USA
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Grande-Alonso M, Suso-Martí L, Cuenca-Martínez F, Pardo-Montero J, Gil-Martínez A, La Touche R. Physiotherapy Based on a Biobehavioral Approach with or Without Orthopedic Manual Physical Therapy in the Treatment of Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial. PAIN MEDICINE 2019; 20:2571-2587. [DOI: 10.1093/pm/pnz093] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Objective
To compare the effectiveness of a biobehavioral approach with and without orthopedic manual physical therapy on the intensity and frequency of pain in patients diagnosed with nonspecific chronic low back pain.
Methods
A single-blind randomized controlled trial. Fifty patients were randomly allocated into two groups: one group received biobehavioral therapy with orthopedic manual physical therapy, and the other group received only biobehavioral therapy. Both groups completed a total of eight sessions, with a frequency of two sessions per week. The somatosensory, physical, and psychological variables were recorded at baseline and during the first and third month after initiation of treatment.
Results
In both groups, the treatment was effective, presenting significant differences for all the variables in the time factor. There were no significant differences between groups in intensity or frequency of pain, with a large effect size (>0.80), but there were intragroup differences for both intervention groups at one- and three-month follow-up. There were also no significant differences between groups in the secondary variables during the same follow-up period.
Conclusions
The results of this study suggest that orthopedic manual physical therapy does not increase the effects of a treatment based on biobehavioral therapy in the short or medium term, but these results should be interpreted with caution.
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Affiliation(s)
- Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Joaquín Pardo-Montero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
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Larivière C, Henry SM, Gagnon DH, Preuss R, Dumas J. Ultrasound Measures of the Abdominal Wall in Patients with Low Back Pain Before and After an 8‐week Lumbar Stabilization Exercise Program, and Their Association With Clinical Outcomes. PM R 2019; 11:710-721. [DOI: 10.1002/pmrj.12000] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Christian Larivière
- Institut de recherche Robert‐Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest Montréal Québec H3A 3C2 Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM)Centre intégré universitaire de santé et de services sociaux du Centre‐Sud‐de‐l'Ile‐de‐Montréal (CCSMTL)MontréalQuébecCanada
| | - Sharon M. Henry
- Department of Rehabilitation TherapyThe University of Vermont Medical Center Burlington VT
| | - Dany H. Gagnon
- School of Rehabilitation, Faculty of MedicineUniversité de Montréal Montréal Québec Canada
| | - Richard Preuss
- School of Physical & Occupational TherapyMcGill University Montréal Québec Canada
| | - Jean‐Pierre Dumas
- School of Rehabilitation, Faculty of MedicineUniversité de Sherbrooke Sherbrooke Québec Canada
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Trunk postural adjustments: Medium-term reliability and correlation with changes of clinical outcomes following an 8-week lumbar stabilization exercise program. J Electromyogr Kinesiol 2018; 41:66-76. [DOI: 10.1016/j.jelekin.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/09/2018] [Accepted: 04/20/2018] [Indexed: 12/25/2022] Open
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de Souza A, Caumo W, Calvetti PU, Lorenzoni RN, da Rosa GK, Lazzarotto AR, Dussan-Sarria JA. Comparison of pain burden and psychological factors in Brazilian women living with HIV and chronic neuropathic or nociceptive pain: An exploratory study. PLoS One 2018; 13:e0196718. [PMID: 29718965 PMCID: PMC5931638 DOI: 10.1371/journal.pone.0196718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 04/18/2018] [Indexed: 02/05/2023] Open
Abstract
Psychological factors including pain catastrophizing and resilience associate with adjustment and quality of life in people living with chronic pain. Nevertheless, their presentation among females living with HIV and chronic pain has been poorly studied. Given that chronic pain in those living with HIV might occur due to different mechanisms (nociceptive or neuropathic), we hypothesize that the associated psychological states could also differ between these groups. We aimed to compare pain frequency and interference, psychological factors and sleep quality between females living with chronic nociceptive or neuropathic pain. Also, we explored correlations between psychological factors, pain severity and interference in females living with HIV and chronic pain. We performed a cross sectional study assessing females living with HIV and chronic pain, and compared it with a female HIV-positive, pain-free control sample in Brazil. To discriminate the most likely underlying mechanism for the chronic pain, we applied the Leeds Assessment for Neuropathic Signs and Symptoms (LANSS). Forty-nine females living with HIV and chronic pain were assessed, and divided in control (n = 12), nociceptive (n = 10) and neuropathic pain (n = 27) groups. Using validated scales, their pain catastrophizing, resilience, depression, anxiety and sleep disorders were assessed between May 2014 and August 2015. Compared to controls, females living with HIV and neuropathic chronic pain had higher pain frequency (p<0.001), interference on activities (p = 0.002), interference with emotions (p<0.001), catastrophizing (p<0.001), depression (p = 0.015), and lower resilience (p = 0.011). Catastrophizing was also significantly correlated to the burden of chronic pain. The type of chronic pain in females living with HIV should raise concerns regarding significant burden in psychological states in this population (particularly neuropathic pain). Using scales such as the LANSS to identify the type of choric pain, could be of use to address relevant issues for the patients, and to propose tailored therapies.
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Affiliation(s)
- Andressa de Souza
- Post-Graduate Program in Health and Human Development, La Salle University, Canoas, Brazil
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Wolnei Caumo
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Pain and Palliative Care Service, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Surgery Department, Anesthesia and Perioperative Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Prisla Ucker Calvetti
- Post-Graduate Program in Health and Human Development, La Salle University, Canoas, Brazil
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rachel Nunes Lorenzoni
- Post-Graduate Program in Health and Human Development, La Salle University, Canoas, Brazil
| | - Gisele Keller da Rosa
- Post-Graduate Program in Health and Human Development, La Salle University, Canoas, Brazil
| | | | - Jairo Alberto Dussan-Sarria
- Department of Clinical Research Center, Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Rose-Dulcina K, Vuillerme N, Tabard-Fougère A, Dayer R, Dominguez DE, Armand S, Genevay S. Identifying Subgroups of Patients With Chronic Nonspecific Low Back Pain Based on a Multifactorial Approach: Protocol For a Prospective Study. JMIR Res Protoc 2018; 7:e104. [PMID: 29685875 PMCID: PMC5938595 DOI: 10.2196/resprot.9224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023] Open
Abstract
Background Low back pain, especially nonspecific chronic low back pain (LBP), the leading cause of disability worldwide, represents both social and economic problems. Different therapeutic management techniques can be used, but their effects vary. Clinicians and researchers attribute the variation in the efficacy of therapeutic and management techniques to the heterogeneity of the nonspecific chronic low back pain population, and they agree that nonspecific chronic LBP must be subgrouped. Objective This study aims to identify nonspecific chronic LBP subgroups based on a multifactorial approach, including biomechanical, physical, and psychosocial data. Methods A total of 100 nonspecific chronic LBP patients and 30 healthy participants aged between 18 and 60 years will be recruited for this prospective study. A psychosocial profile will be established using questionnaires on anxiety, depression, functional disability, pain, fear of pain, avoidance belief, and physical activity. A physical capacity evaluation will be conducted. It will evaluate flexibility of the hips, lumbar spine, and lateral thoracolumbar segment, as well as trunk (extensor and flexor) muscle endurance. The subjects will perform functional daily life activities, such as walking, object lifting, forward bending, sit-to-stand, stand-to-sit, balance, and usual postures. Full body kinematics, kinetics, and surface electromyography of the trunk and hip muscles will be assessed during these tasks. The clustering classification methods for the statistical analysis will be determined according to the data and will be used to identify the subgroups of nonspecific chronic LBP patients. Results Data collection started in September 2017 and will be completed with the inclusion of all the participants (100 nonspecific chronic LBP and 30 control). The study results will be published in peer-reviewed journals and presented at relevant international conferences. Conclusions Numerous studies have showed that the therapeutic management of nonspecific chronic LBP is difficult and has inconstant effects caused by the complexity and heterogeneity of nonspecific chronic LBP. Identifying subgroups with a multifactorial approach is more comprehensive and closer to the pathophysiology of nonspecific chronic LBP. It also represents benefit interests and a challenge both clinically and socially. The perspective of this study is expected to support clinicians for a more adapted therapeutic management for each subgroup.
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Affiliation(s)
- Kevin Rose-Dulcina
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Nicolas Vuillerme
- Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Anne Tabard-Fougère
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Romain Dayer
- Division of Paediatric Orthopaedics, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dennis E Dominguez
- Division of Orthopaedic and Trauma Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Armand
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Stéphane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Adams H, Thibault P, Ellis T, Moore E, Sullivan M. The Relation Between Catastrophizing and Occupational Disability in Individuals with Major Depression: Concurrent and Prospective Associations. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:405-412. [PMID: 27770242 DOI: 10.1007/s10926-016-9669-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background Catastrophic thinking has been associated with occupational disability in individuals with debilitating pain conditions. The relation between catastrophic thinking and occupational disability has not been previously examined in individuals with debilitating mental health conditions. The present study examined the relation between catastrophic thinking and occupational disability in individuals with major depression. Methods The study sample consisted of 80 work-disabled individuals with major depressive disorder (MDD) who were referred to an occupational rehabilitation service. Participants completed measures of depressive symptom severity, catastrophic thinking and occupational disability at admission and termination of a rehabilitation intervention. Return-to-work outcomes were assessed 1 month following the termination of the rehabilitation intervention. Results Cross-sectional analyses of admission data revealed that catastrophic thinking contributed significant variance to the prediction of self-reported occupational disability, beyond the variance accounted for by depressive symptom severity. Prospective analyses revealed that reductions in catastrophic thinking predicted successful return to work following the rehabilitation intervention, beyond the variance accounted for by reductions in depressive symptom severity. Conclusions The findings suggest that catastrophic thinking is a determinant of occupational disability in individuals with major depressive disorder. The findings further suggest that interventions designed to reduce catastrophic thinking might promote occupational re-integration in individuals with debilitating mental health conditions.
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Affiliation(s)
- Heather Adams
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
| | - Pascal Thibault
- Department of Psychology, McGill University, Montréal, Canada
| | - Tamra Ellis
- Centre for Rehabilitation and Health, Toronto, Canada
| | - Emily Moore
- Department of Psychology, McGill University, Montréal, Canada
| | - Michael Sullivan
- Faculty of Health and Behavioural Sciences, Recover Injury Research Centre, The University of Queensland, 288 Herston Road, Level 7, Herston, QLD, 4006, Australia.
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Hayashi K, Kako M, Suzuki K, Hattori K, Fukuyasu S, Sato K, Kadono I, Sakai T, Hasegawa Y, Nishida Y. Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty. World J Orthop 2017; 8:336-341. [PMID: 28473962 PMCID: PMC5396019 DOI: 10.5312/wjo.v8.i4.336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/25/2016] [Accepted: 02/13/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty (TKA) or total hip arthroplasty (THA).
METHODS The study group of 46 participants underwent TKA or THA. The participants were evaluated within 7 d before the operation and at 14 d afterwards. Physical performance was measured by the Timed Up and Go (TUG) test, and 10-m gait time was measured at comfortable and maximum speeds. They rated their knee or hip pain using a visual analog scale (VAS) for daily life activities. Psychological characteristics were measured by the Pain Catastrophizing Scale (PCS). Physical characteristics were measured by isometric muscle strength of knee extensors and hip abductors on the operated side. The variables of percent changes between pre- and post-operation were calculated by dividing post-operation score by pre-operation score.
RESULTS Postoperative VAS and PCS were better than preoperative for both TKA and THA. Postoperative physical performance and muscle strength were poorer than preoperative for both TKA and THA. The percent change in physical performance showed no correlation with preoperative variables. In TKA patients, the percent change of PCS showed correlation with percent change of TUG (P = 0.016), 10-m gait time at comfortable speeds (P = 0.003), and 10-m gait time at maximum speeds (P = 0.042). The percent change of muscle strength showed partial correlation with physical performances. The percent change of VAS showed no correlation with physical performances. On the other hand, in THA patients, the percent change of hip abductor strength showed correlation with percent change of TUG (P = 0.047), 10-m gait time at comfortable speeds (P = 0.001), and 10-m gait time at maximum speeds (P = 0.021). The percent change of knee extensor strength showed partial correlation with physical performances. The percent change of VAS and PCS showed no correlation with physical performances.
CONCLUSION Changes in pain catastrophizing significantly associated with changes in physical performance in the early period after TKA. It contributes to future postoperative rehabilitation of arthroplasty.
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Sullivan M, Adams H, Ellis T, Clark R, Sully C, Thibault P. Treatment-related reductions in catastrophizing predict return to work in individuals with post-traumatic stress disorder. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/jabr.12087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Michael Sullivan
- Faculty of Health and Behavioural Sciences; The University of Queensland; Herston Qld Australia
- Department of Psychology; McGill University; Montreal QC Canada
| | - Heather Adams
- Recover, Injury Research Centre; The University of Queensland; Herston Qld Australia
| | - Tamra Ellis
- Centre for Rehabilitation and Health; Toronto ON Canada
| | | | | | - Pascal Thibault
- Department of Psychology; McGill University; Montreal QC Canada
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35
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Felício DC, Pereira DS, de Queiroz BZ, da Silva JP, Leopoldino AAO, Pereira LSM. Kinesiophobia is not associated with disability in elderly women with acute low back pain: Back Complaints in the Elders (BACE) Brazil study results. Spine J 2016; 16:619-25. [PMID: 26780753 DOI: 10.1016/j.spinee.2016.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/01/2015] [Accepted: 01/01/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The study of low back pain (LBP) is complex, and the physical and psychological aspects, including kinesiophobia, should be considered. Several studies have investigated the relationship between kinesiophobia and functionality in patients with chronic LBP. However, to the best of the authors' knowledge, no studies have investigated the association between kinesiophobia and self-reported assessments of disability and physical performance in elderly patients with acute LBP. PURPOSE The study aimed to investigate the association between kinesiophobia and self-reported and physical performance measures among the elderly with acute LBP. DESIGN This was an observational, cross-sectional, ancillary study of the Back Complaints in the Elders study, a longitudinal observational epidemiologic research project by an international consortium involving Brazil, the Netherlands, and Australia. PATIENT SAMPLE Sample selection was carried out by convenience. The study included women from the community aged 60 years old and older who presented with a new episode of LBP. Volunteers with severe diseases, as well as visual, hearing, and mobility losses, or cognitive dysfunction, were excluded. Four hundred fifty nine elderly women (mean age: 69.0±6.1 years) were included. OUTCOME MEASURES Kinesiophobia was evaluated by Fear Avoidance Beliefs Questionnaire (FABQ), subscale FABQ-Phys. Functionality was investigated by the Roland-Morris Questionnaire and the gait speed test. METHODS Statistical analysis was performed using hierarchical linear regression model. Statistical significance was established at the level of .05. RESULTS The additional predictive value because of the inclusion of the FABQ-Phys was 0.1%, using the Roland-Morris score, and 0.2% for the gait speed test. CONCLUSIONS This was the first study to investigate the association between the FABQ-Phys and functionality in elderly patients with acute LBP. The results provide preliminary evidence that kinesiophobia assessed by the FABQ-Phys cannot be generalized to disability.
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Affiliation(s)
- Diogo C Felício
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Antônio Carlos, 31270-901 Belo Horizonte, MG, Brazil; Universidade Federal de Juiz de Fora, São Pedro, 36036-900 Juiz de Fora, MG, Brazil.
| | - Daniele S Pereira
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Antônio Carlos, 31270-901 Belo Horizonte, MG, Brazil
| | - Barbara Z de Queiroz
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Antônio Carlos, 31270-901 Belo Horizonte, MG, Brazil
| | - Juscelio P da Silva
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Antônio Carlos, 31270-901 Belo Horizonte, MG, Brazil
| | - Amanda A O Leopoldino
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Antônio Carlos, 31270-901 Belo Horizonte, MG, Brazil
| | - Leani S M Pereira
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Antônio Carlos, 31270-901 Belo Horizonte, MG, Brazil
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Boucher JA, Preuss R, Henry SM, Dumas JP, Larivière C. The effects of an 8-week stabilization exercise program on lumbar movement sense in patients with low back pain. BMC Musculoskelet Disord 2016; 17:23. [PMID: 26762185 PMCID: PMC4712498 DOI: 10.1186/s12891-016-0875-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 01/06/2016] [Indexed: 12/19/2022] Open
Abstract
Background Lumbar stabilization exercises have gained popularity and credibility in patients with non-acute low back pain. Previous research provides more support to strength/resistance and coordination/stabilisation programs. Some authors also suggest adding strength/resistance training following motor control exercises. However, the effect of such a lumbar stabilization program on lumbar proprioception has never been tested so far. The present study investigated the effects of an 8-week stabilization exercise program on lumbar proprioception in patients with low back pain (LBP) and assessed the 8-week test-retest reliability of lumbar proprioception in control subjects. Methods Lumbar proprioception was measured before and after an 8-week lumbar stabilization exercise program for patients with LBP. Control subjects participated in the same protocol but received no treatment. Results The lumbar proprioception measure showed moderate reliability. Patients with LBP and control subjects demonstrated no differences in lumbar proprioception at baseline. Participants from both groups showed better proprioception following the 8-week interval, demonstrating the presence of learning between testing days. Conclusions The improvement of lumbar proprioception seen in both groups was ascribed to motor learning of the test itself. The effect of lumbar stabilization exercises on lumbar proprioception remains unknown because the LBP group did not show lumbar proprioception impairments. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-0875-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean-Alexandre Boucher
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada. .,Occupational Health and Safety Research Institute Robert-Sauvé (IRSST), Montréal, Québec, Canada. .,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Québec, Canada.
| | - Richard Preuss
- School of Physical & Occupational Therapy, McGill University, Montréal, Québec, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Québec, Canada
| | - Sharon M Henry
- Deparment of Rehabilitation and Movement Science, The University of Vermont, Burlington, Vermont, USA
| | - Jean-Pierre Dumas
- School of Rehabilitation, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Larivière
- Occupational Health and Safety Research Institute Robert-Sauvé (IRSST), Montréal, Québec, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Québec, Canada
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Skolasky RL, Maggard AM, Li D, Riley LH, Wegener ST. Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes. Arch Phys Med Rehabil 2015; 96:1200-7. [PMID: 25827657 DOI: 10.1016/j.apmr.2015.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To examine whether a brief motivational interviewing [MI]-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. DESIGN Prospective clinical trial. SETTING Academic medical center. PARTICIPANTS From December 2009 through August 2012, consecutive patients (N=122) underwent surgery for degenerative lumbar spinal stenosis and, based on enrollment date, were prospectively assigned to a control (n=59) or HBCC intervention (n=63) group in a prospective, lagged-control clinical trial. INTERVENTIONS Brief MI-based HBCC versus attention control. MAIN OUTCOME MEASURES Rehabilitation participation (primary); disability and health status (secondary). Therapists assessed engagement in, and patients reported attendance at, postoperative rehabilitation (physical therapy and/or HEP). At 3 and 6 months, disability and health status were assessed (Oswestry Disability Index [ODI] and Medical Outcomes Study 12-Item Short-Form Health Survey, version 2 [SF-12v2]) (significance, P<.05). RESULTS Compared with controls, HBCC patients had significantly higher rehabilitation engagement (21.20±4.56 vs 23.57±2.71, respectively; P<.001), higher physical therapy (.67±.21 vs .82±.16, respectively; P<.001) and HEP (.65±.23 vs .75±.22, respectively; P=.019) attendance, and better functional outcomes at 3 months (difference: ODI, -10.7±4.4, P=.015; SF-12v2, 6.2±2.2, P=.004) and 6 months (difference: ODI, -12.7±4.8, P=.008; SF-12v2, 8.9±2.4, P<.001). The proportion of the HBCC intervention impact on functional recovery mediated by rehabilitation participation was approximately half at 3 months and one-third at 6 months. CONCLUSIONS HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
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Affiliation(s)
- Richard L Skolasky
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Anica M Maggard
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - David Li
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lee H Riley
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD
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Larivière C, Ludvig D, Kearney R, Mecheri H, Caron JM, Preuss R. Identification of intrinsic and reflexive contributions to low-back stiffness: medium-term reliability and construct validity. J Biomech 2015; 48:254-61. [DOI: 10.1016/j.jbiomech.2014.11.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
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Penney T, Ploughman M, Austin MW, Behm DG, Byrne JM. Determining the Activation of Gluteus Medius and the Validity of the Single Leg Stance Test in Chronic, Nonspecific Low Back Pain. Arch Phys Med Rehabil 2014; 95:1969-76. [DOI: 10.1016/j.apmr.2014.06.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 01/14/2023]
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Van Damme B, Stevens V, Van Tiggelen D, Perneel C, Crombez G, Danneels L. Performance based on sEMG activity is related to psychosocial components: differences between back and abdominal endurance tests. J Electromyogr Kinesiol 2014; 24:636-44. [PMID: 24956968 DOI: 10.1016/j.jelekin.2014.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 05/08/2014] [Accepted: 05/29/2014] [Indexed: 10/25/2022] Open
Abstract
The influence of psychosocial components on back and abdominal endurance tests in patients with persistent non-specific low back pain should be investigated to ensure the correct interpretation of these measures. Three-hundred and thirty-two patients (291 men and 41 women) from 19 to 63years performed an abdominal and back muscle endurance test after completing some psychosocial questionnaires. During the endurance tests, surface electromyography signals of the internal obliques, the external obliques, the lumbar multifidus and the iliocostalis were recorded. Patients were dichotomized as underperformers and good performers, by comparing their real endurance time, to the expected time of endurance derived from the normalized median frequency slope. Independent t-tests were performed to examine the differences on the outcome of the questionnaires. In the back muscle endurance test, the underperformers had significantly lower (p<0.05) scores on some of the physical subscales of the SF-36. The underperformers group of the AE test scored significantly higher on the DRAM MZDI (p=0.018) and on the PCS scale (p=0.020) and showed also significantly lower scores on the SF-36 (p<0.05). Back muscle endurance tests are influenced by physical components, while abdominal endurance tests seem influenced by psychosocial components.
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Affiliation(s)
- Benedicte Van Damme
- Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Veerle Stevens
- Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Damien Van Tiggelen
- Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Steele J, Bruce-Low S, Smith D. A reappraisal of the deconditioning hypothesis in low back pain: review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning. Curr Med Res Opin 2014; 30:865-911. [PMID: 24328452 DOI: 10.1185/03007995.2013.875465] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE 'Disuse' and 'Deconditioning' in relation to low back pain (LBP) are terms often used interchangeably. Discussions of 'disuse' refer to general physical inactivity, which evidence suggests does not differ between symptomatic and asymptomatic persons. 'Deconditioning' refers to a decrease in function, commonly both cardiovascular/aerobic fitness and muscular strength/endurance, again noting little difference. However, examination of decreased function relating specifically to lumbar extensor musculature deconditioning has yet to be examined, corroborating all possible methods. Thus, this review attempts to reappraise the deconditioning hypothesis in LBP, specifically considering lumbar extensor deconditioning. METHODS A literature review was conducted examining both cross-sectional and prospective data on specific lumbar extensor deconditioning and LBP. A narrative approach and 'snowballing' style literature search was used involving initial use of PubMed and Google Scholar databases searching up to December 2012. Included were studies utilizing the following three research methods, allowing specific induction of the role of such deconditioning; (1) strength/endurance testing of the isolated lumbar extensor musculature, (2) imaging and histochemical examination of the lumbar extensor musculature, and (3) fatigue testing of the lumbar extensor musculature using electromyography. RESULTS/FINDINGS Despite issues interpreting individual studies due to methods, the majority of evidence suggests LBP is associated with decreased strength/endurance, atrophy, and excessive fatigability of the lumbar extensors. Prospective studies also suggest lumbar extensor deconditioning may be a common risk factor predicting acute low back injury and LBP. CONCLUSIONS The hypothesis of specific lumbar extensor deconditioning as being a causal factor in LBP is presently well supported. It is by no means the only causative factor and further research should more rigorously test this hypothesis addressing the methodological issues highlighted regarding previous studies. However, its role suggests specific exercise may be a worthwhile preventative and rehabilitative approach.
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Affiliation(s)
- James Steele
- Southampton Solent University , Southampton, Hampshire , UK
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Demoulin C, Huijnen IPJ, Somville PR, Grosdent S, Salamun I, Crielaard JM, Vanderthommen M, Volders S. Relationship between different measures of pain-related fear and physical capacity of the spine in patients with chronic low back pain. Spine J 2013; 13:1039-47. [PMID: 23623193 DOI: 10.1016/j.spinee.2013.02.037] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 12/17/2012] [Accepted: 02/18/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT It has been controversially stated that pain-related fear is a more important determining factor for disability in chronic low back pain (CLBP) than pain or physical impairment in itself. So far, the relationship between psychological and physiological determinants of chronic pain, that is, pain-related fear and physiological abilities, remains unclear. PURPOSE To evaluate whether pain-related fear assessed by different tools (both task specific and non task specific) is related to physical capacity measured by specific spine tests and, secondarily, to explore the relationship between different pain-related fear assessment tools. STUDY DESIGN/SETTING Cross-sectional study. PATIENT SAMPLE Fifty patients with CLBP (50% women; meanage [standard deviationage]: 44.2 [9.5 years]). OUTCOME MEASURES Physical capacity by means of three specific spine tests, that is, the finger-floor distance test (flexibility), a maximal isometric strength test of trunk extensor muscles (strength), and the Sorensen test (endurance). Pain-related fear by means of self-report measures, that is, the Tampa Scale for Kinesiophobia (TSK), the Photograph Series of Daily Activities (PHODA), and a fear visual analog scale (FVAS) tailored to the spine tests. METHODS Participants were asked to complete the TSK and PHODA and to perform the three spine tests. Right before performing each of the spine tests, an FVAS was filled out. Linear regression analyses controlling for gender and age were performed to study the association between the pain-related fear measurements and the results of the spine tests. To investigate the relationship between the pain-related fear measurements, correlation tests were performed. RESULTS The linear regression analyses revealed that neither the TSK and PHODA scores nor the FVAS scores were significantly related to the physical capacity measurements. The correlational tests showed no significant correlation between the PHODA, TSK, and FVAS scores. CONCLUSIONS The present study shows that neither the task-specific tool (FVAS) nor the non task-specific questionnaires (TSK and PHODA) were significantly correlated to the spine tests in patients with CLBP. This is contrary to earlier evidence according to which physical capacity is inversely related to the level of pain-related fear, and it suggests that one should not draw conclusions about physical capacity based on pain-related fear scores. Furthermore, the different assessment tools for pain-related fear were surprisingly not correlated with each other.
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Affiliation(s)
- Christophe Demoulin
- Department of Sport and Rehabilitation Sciences, University of Liege, ISEPK BAT B21, Sart-Tilman, 4000 Liège, Belgium; Department of Physical Medicine and Rehabilitation, Liège University Hospital, Sart Tilman, 4000 Liège, Belgium.
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Huijnen IPJ, Verbunt JA, Wittink HM, Smeets RJEM. Physical performance measurement in chronic low back pain: measuring physical capacity or pain-related behaviour? EUROPEAN JOURNAL OF PHYSIOTHERAPY 2013. [DOI: 10.3109/21679169.2013.830643] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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del Pozo-Cruz B, Gusi N, Adsuar JC, del Pozo-Cruz J, Parraca JA, Hernandez-Mocholí M. Musculoskeletal fitness and health-related quality of life characteristics among sedentary office workers affected by sub-acute, non-specific low back pain: a cross-sectional study. Physiotherapy 2012; 99:194-200. [PMID: 23219627 DOI: 10.1016/j.physio.2012.06.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 06/07/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To establish the level of musculoskeletal fitness and health-related quality of life (HRQoL) in sedentary office workers with sub-acute, non-specific low back pain, and compare the results with reference data for healthy sedentary office workers. DESIGN Cross-sectional study. SETTING Occupational secondary prevention setting. PARTICIPANTS One-hundred and ninety sedentary office workers: 118 suffering from sub-acute, non-specific low back pain (47 men and 71 women) and 72 age-matched healthy controls (30 men and 42 women). MAIN OUTCOME MEASURES Participants were assessed using a musculoskeletal fitness battery (sit-and-reach test, hand grip strength, lumbar and abdominal trunk muscle endurance, and back scratch test), the EuroQol-5D-3L, Oswestry Disability Questionnaire, and Roland Morris Disability Questionnaire. Data for both genders and conditions were compared. RESULTS Subjects with low back pain achieved lower scores in most of the fitness tests compared with healthy, age-matched controls. Trunk flexor and extensor endurance demonstrated the greatest difference in both men {flexion: median difference 59 [95% confidence interval (CI) 26 to 90]seconds; extension: median difference 24 [95% CI 20 to 68]} and women [flexion: median difference 59 (95% CI 5 to 85.50)seconds; extension: median difference 41 (95% CI 30 to 55)seconds]. Differences in HRQoL were also demonstrated between groups for both men and women, with the exception of the pain/discomfort dimension in women. CONCLUSIONS Sedentary office workers with sub-acute, non-specific low back pain had lower musculoskeletal fitness than healthy, age-matched controls, with the main difference found in endurance of the trunk muscles. HRQoL was also lower in workers with low back pain.
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Affiliation(s)
- B del Pozo-Cruz
- Faculty of Sports Science, University of Extremadura, Caceres, Spain.
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Abstract
Pain catastrophizing has been described for more than half a century which adversely affects the pain coping behavior and overall prognosis in susceptible individuals when challenged by painful conditions. It is a distinct phenomenon which is characterized by feelings of helplessness, active rumination and excessive magnification of cognitions and feelings toward the painful situation. Susceptible subjects may have certain demographic or psychological predisposition. Various models of pain catastrophizing have been proposed which include attention-bias, schema-activation, communal-coping and appraisal models. Nevertheless, consensus is still lacking as to the true nature and mechanisms for pain catastrophizing. Recent advances in population genomics and noninvasive neuroimaging have helped elucidate the known determinants and neurophysiological correlates behind this potentially disabling behavior.
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Affiliation(s)
- Lawrence Leung
- Department of Family Medicine, Centre of Neurosciences Study, Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada
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Chronic low back pain is associated with reduced vertebral bone mineral measures in community-dwelling adults. BMC Musculoskelet Disord 2012; 13:49. [PMID: 22458361 PMCID: PMC3359205 DOI: 10.1186/1471-2474-13-49] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 03/30/2012] [Indexed: 11/21/2022] Open
Abstract
Background Chronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, although this issue has not been investigated as a primary aim previously. This study investigated the associations between CLBP and dual energy X-ray absorptiometry (DXA)-derived vertebral bone mineral measures acquired from postero-anterior and lateral-projections, among community-dwelling, middle-aged adults. Methods Twenty-nine adults with CLBP (11 male, 18 female) and 42 adults with no history of LBP in the preceding year (17 male, 25 female) were evaluated. Self-reported demographic and clinical data were collected via questionnaires. Areal bone mineral density (aBMD) was measured in the lumbar spine by DXA. Apparent volumetric (ap.v) BMD in the lumbar spine was also calculated. Multiple linear regression models were used to examine associations between study group (CLBP and control) and vertebral DXA variables by gender, adjusting for height, mass and age. Results There was no difference between groups by gender in anthropometrics or clinical characteristics. In the CLBP group, the mean (SD) duration of CLBP was 13.3 (10.4) years in males and 11.6 (9.9) years in females, with Oswestry Disability Index scores of 16.2 (8.7)% and 15.4 (9.1)%, respectively. Males with CLBP had significantly lower adjusted lateral-projection aBMD and lateral-projection ap.vBMD than controls at L3 with mean differences (standard error) of 0.09 (0.04) g/cm2 (p = 0.03) and 0.02 (0.01) g/cm3 (p = 0.04). These multivariate models accounted for 55% and 53% of the variance in lateral-projection L3 aBMD and lateral-projection L3 ap.vBMD. Conclusions CLBP in males is associated with some lumbar vertebral BMD measures, raising important questions about the mechanism and potential clinical impact of this association.
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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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Catastrophizing and perceived injustice: risk factors for the transition to chronicity after whiplash injury. Spine (Phila Pa 1976) 2011; 36:S244-9. [PMID: 22020619 DOI: 10.1097/brs.0b013e3182387fed] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN The article will summarize research that has supported the role of pain catastrophizing and perceived injustice as risk factors for problematic recovery after whiplash injury. OBJECTIVE This article focuses on two psychological variables that have been shown to impact on recovery trajectories after whiplash injury; namely pain catastrophizing and perceived injustice. SUMMARY OF BACKGROUND DATA Research has shown that psychological variables play a role in determining the trajectory of recovery after whiplash injury. METHODS This article will focus on two psychological variables that have been shown to impact on recovery trajectories after whiplash injury; namely pain catastrophizing and perceived injustice. The article will summarize research that has supported the role of pain catastrophizing and perceived injustice as risk factors for problematic recovery after whiplash injury. RESULTS Several investigations have shown that measures of catastrophizing and perceived injustice prospectively predict problematic trajectories of recovery after whiplash injury. Basic research points to the potential roles of expectancies, attention, coping and endogenous opioid dysregulation as possible avenues through which catastrophizing might heighten the probability of the persistence of pain after whiplash injury. Although research has yet to systematically address the mechanisms by which perceived injustice might contribute to prolonged disability in individuals with whiplash injuries, there are grounds for suggesting the potential contributions of catastrophizing, pain behavior and anger. CONCLUSION A challenge for future research will be the development and evaluation of risk factor-targeted interventions aimed at reducing catastrophizing and perceived injustice to improve recovery trajectories after whiplash injury.
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An exploration of the relationship between back muscle endurance and familial, physical, lifestyle, and psychosocial factors in adolescents and young adults. J Orthop Sports Phys Ther 2011; 41:486-95. [PMID: 21654097 DOI: 10.2519/jospt.2011.3638] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Cross-sectional investigation. OBJECTIVE To explore the relationship between back muscle endurance (BME) and a range of familial, physical, lifestyle, and psychosocial variables in adolescents and young adults. BACKGROUND There is evidence that low back pain interventions which focus on improved BME are effective. However, the mechanisms associated with BME performance in adolescents and young adults are largely unclear. In particular, the potential familial relationship between parents and their children remains unexplored. METHODS This study utilized a subset of participants from the Joondalup Spinal Health Study cohort. One hundred nine children (47 boys, 62 girls) and 101 parents (39 fathers, 62 mothers) completed a series of physical, lifestyle, and psychosocial assessments. The univariable relationship between each covariate and BME was explored. Those found to have an association with child BME (P<.2) were included in an initial multivariable model and sequentially removed, until all remaining covariates were statistically significant (P<.05). RESULTS Mothers' BME performance was related to children's performance, accounting for 14.4% of the variance in the children's BME. Fathers' BME performance had a similar, albeit nonsignificant effect. Children's sitting trunk angle, pain sensitivity, percent trunk fat, waist girth, and body mass index were associated with their BME performance, accounting for between 5.2% and 20.9% of BME. CONCLUSIONS The final multivariable model, including mother's BME, percent trunk fat, and sitting trunk angle, explained 28% of the variance in BME performance, suggesting that for successful BME intervention a range of multidimensional variables should be considered.
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