Trends of Low Back Pain Research in Older and Working-Age Adults from 1993 to 2023: A Bibliometric Analysis

Reporting and incorporation of social risks in low back pain and exercise studies: A scoping review

BACKGROUND

Exercise is a common intervention for low back pain, but its effect sizes are small to modest. Social risk factors significantly influence health outcomes, yet their consideration in randomized controlled trials on exercise for low back pain is often neglected. Determining their relationship to outcomes may provide better insight into exercise effectiveness.

OBJECTIVES

To assess the reporting of social risk factors (SRFs) in randomized controlled trials (RCTs) of exercise interventions for low back pain (LBP) in adults and explore associations between SRFs and outcomes.

DESIGN

Scoping Review.

METHODS

The databases MEDLINE, CINAHL and Cochrane were searched for studies published between January 2014 to March 2025. RCTs were included if exercise was the primary intervention for LBP treatment and had a minimum follow-up of 12 weeks. A planned analysis of SRF and outcome associations was not conducted due to insufficient data.

RESULTS

A total of 10,292 studies were identified and 157 studies included. Fewer than half (47.1 %) reported any SRFs at baseline. Socioeconomic position (42.7 %) was most frequently reported, followed by social relationships (17.8 %), race/ethnicity/cultural context (8.3 %), residential/community context (1.3 %), and gender (0.6 %). Four studies incorporated SRFs in their outcome analyses; one examined associations with outcomes and found no significant association.

CONCLUSION

SRFs are underreported in RCTs of exercise interventions for LBP and are rarely analyzed in relation to primary outcomes, limiting our understanding of their impact. Future trials should prioritize collecting and reporting SRFs at baseline and incorporating them in outcome analyses to assess their influence on outcomes.

Poor Sleep Quality Worsens Static and Dynamic Balance Control in Individuals With Chronic Low Back Pain: A Cross-Sectional Study

Objective: To investigate the influence of sleep quality and associated factors on balance control in individuals with chronic low back pain (CLBP). Methods: 85 participants (mean age 33.2 ± 12.5 years) with CLBP were recruited. Physical and emotional well-beings were evaluated using a battery of questionnaires. Sleep quality over the last month was assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants were dichotomized into the good sleep quality (GSQ) and poor sleep quality (PSQ) groups if their PSQI scores were ≤ 5 and > 5, respectively. Balance control was measured using the one-leg stance with eyes closed and Y-balance test. Results: The GSQ group included 37 participants, while the PSQ group comprised 48 participants. After controlling for confounds (including gender, age, disability, anxiety, depression, and fear avoidance beliefs), participants with PSQ displayed significantly poorer performance in the one-leg stance with eyes closed and lower normalized posteromedial, posterolateral, and composite scores of the Y-balance test compared with participants with GSQ. Additionally, sleep quality accounted for 16.9%-24.9% of the variance in balance control, while age explained an additional 5.2%-13.2% of the variance. Additionally, higher levels of physical disability and anxiety were associated with poorer balance control. Conclusions: Individuals with concurrent CLBP and PSQ exhibit significantly worse balance control than those with CLBP alone. Future studies should investigate whether improving sleep quality, physical disability, and anxiety can enhance balance in individuals with CLBP.

Chronic lower back pain among occupational workers: effect of relaxation technique on quality of working life, pain and disability level with nurse-led intervention

BACKGROUND

Lower back pain (LBP) is the main cause of workplace impairment and a significant contributor to absenteeism. Implementing relaxation techniques in the workplace can be considered an investment because it can eventually lower the incidence of chronic LBP (chronic lower back pain).

AIM

The purpose of the current study was to evaluate the effect of relaxation techniques on the quality of working life, pain and disability level, with nurse-led interventions among occupational workers with chronic lower back pain (CLBP).

METHOD

A quasi-experimental design with a pre- and post-test method was used.

SETTING

The study took place at a yarn and textile factory in Kafr El-Sheikh City, Kafr El-Sheikh Governorate, Egypt.

SAMPLE

A purposive sample of 100 industrial workers with persistent LBP was chosen. The participants were matched and sorted into two equal groups: the study group and the control group.

INSTRUMENTS

The study used a structured interview questionnaire, the Visual Analogue Scale (VAS), the Quality of Working Life Scale (QWL), and the Oswestry Disability Index.

RESULTS

Participants' average age was 41.4 ± 8.7 years in the study group and 40.5 ± 7.8 years in the control group. Following the relaxation technique intervention, the study group's pain intensity, frequency, and duration were significantly lower than in the control group. Following the intervention, the study group's overall quality of working life improved statistically significantly, with the mean score rising from 72% in the pretest to 93.3% in the post-test. The research group's daily activities and the overall quality of working life improved dramatically when compared to the control group. Furthermore, after the intervention, the study group's disability levels decreased significantly, with only 46% having a disability compared to 86% before the intervention.

CONCLUSIONS

The implementation of relaxation techniques greatly improved the quality of working life in the study group when compared to the control group. There was a notable and statistically significant difference in pain intensity between the study group and the controls. Following the intervention, industrial workers' daily living activities improved, despite persistent LBP.

RECOMMENDATION

Health education and awareness programs should be conducted to improve the quality of life for industrial workers with LBP. Additionally, occupational health nurses' roles in the early detection and referral of LBP patients in diverse industrial settings should be strengthened.

Application trends and strategies of hydrogel delivery systems in intervertebral disc degeneration: A bibliometric review

Hydrogels are widely used to explore emerging minimally invasive strategies for intervertebral disc degeneration (IVDD) due to their suitability as drug and cell delivery vehicles. There has been no review of the latest research trends and strategies of hydrogel delivery systems in IVDD for the last decade. In this study, we identify the application trends and strategies in this field through bibliometric analysis, including aspects such as publication years, countries and institutions, authors and publications, and co-occurrence of keywords. The results reveal that the literature in this field has been receiving increasing attention with a trend of growth annually. Subsequently, the hotspots of hydrogels in this field were described and discussed in detail, and we proposed the "four core factors", hydrogels, cells, cell stimulators, and microenvironmental regulation, required for a multifunctional hydrogel for IVDD. Finally, we discuss the popular and emerging mechanistic strategies of hydrogel therapy for IVDD in terms of five aspects: fundamental pathologic changes in IVDD, counteracting cellular senescence, counteracting cell death, improving organelle function, and replenishing exogenous cells. This study provides a reference and a new perspective for future research in this urgently needed field.

Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis

PURPOSE

The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain (CNSLBP) following conservative interventions is related to corresponding improvements in balance control.

METHODS

Randomized controlled trials were identified from 5 databases (MEDLINE, Cochrane Library, Embase, Web of Science, and PsycINFO). Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control. Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables.

RESULTS

Thirty one studies involving 1280 participants with CNSLBP were included. Moderate-quality evidence suggested that pain reduction was associated with and explained 34%-45% of decreases in body sway, as measured by center-of-pressure (CoP) area and CoP velocity with eyes open. However, no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions. Similarly, there was no significant association between pain reduction and CoP distance or radius. Low-quality evidence indicated that pain relief explained a 15% improvement in one-leg stance with eyes open but not in the eyes-closed condition. Additionally, very low-quality evidence suggested that pain relief explained a 44% decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open, mediolateral, or overall conditions. Furthermore, low-quality evidence indicated that reduced pain was associated with and accounted for 25%-43% of the improved composite and posteromedial scores of the star-excursion balance test, rather than the anterior and posterolateral scores.

CONCLUSION

Depending on the type of balance assessment, pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP. Clinicians should pay close attention to the balance control in patients with CNSLBP, particularly among older adults.

Trends in Physiotherapy of Chronic Low Back Pain Research: Knowledge Synthesis Based on Bibliometric Analysis

BACKGROUND

Physiotherapy and chronic low back pain (CLBP) form a broad and quickly developing research area. The aim of this article was to holistically, thematically and chronologically analyze and synthesize the literature production in this research area and identify the most prolific research entities and research themes.

METHODS

This article quantitatively and qualitatively analyzed research literature production harvested from the Scopus bibliometric database, using a triangulation of bibliometric and thematic analysis. For this, Excel 2024, Bibliometrix Biblioshiny 4.1 and VOSviewer version 1.6.20 softwares were used.

RESULTS

In the Scopus database, 2843 data sources were found, which were published between 1974 and 26 February 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018 exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes (pathophysiology of CLBP and the quantification assessment tools, diagnostics and CLBP treatment, CLBP questionnaires and surveys, quality of life, complementary methods in physiotherapy and psychosocioeconomic aspects), while the chronological analysis revealed three main areas of development: assessment tools, CLBP processing and study methodology.

CONCLUSIONS

The results of this bibliometric study present a good starting point for further research, providing taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends. This article offers an interdisciplinary view of the current issue of public health. The results of this study provide a basis for the development of both the physiotherapy and epidemiological fields.

Research hotspots and frontiers of cluster headaches: a bibliometric analysis

Background

Extensive research on cluster headaches (CHs) has been conducted worldwide; however, there is currently no bibliometric research on CHs. Therefore, this study aimed to analyze the current research hotspots and frontiers of CHs over the past decade.

Methods

Raw data on CHs was obtained from the Web of Science Core Collection database from 2014 to 2023. CiteSpace V6.2 R7 (64 bit) and Microsoft Excel were used to assess the annual publication volume, authors, countries, and references. VOSviewer 1.6.19 software was used to assess the institutions, cited authors, and keywords, and co-occurrence and clustering functions were applied to draw a visual knowledge map.

Results

In the past decade, the overall annual publication volume of articles related to CHs has increased year by year, showing promising development prospects. The total 1909 articles contained six types of literature, among which the proportion of original research articles was the highest (1,270 articles, 66.53%), published in 201 journals. Cephalalgia (439 articles, 23.00%) had the highest publication volume, and the Lancet was the journal with the highest impact factor (IF = 168.9). Furthermore, the United States of America was the country with the most published papers (584 articles, 30.60%), University of London was the research institution with the most published papers (142 articles, 7.44%), and Goodsby, Peter J was found to be the most prolific author (38 articles, 1.99%).

Conclusion

This study may provide some direction for subsequent researcher on CHs. The hotspots and frontiers of future research on CHs are suggested as follows: in basic medicine, more attention should be paid to pathophysiology, especially on increasing research on the pathogenesis mediated by CGRP; in clinical medicine, more attention should be paid to the design of evidence-based medicine methodology, especially the strict design, including double-blind, questionnaire, and follow-up, in randomized controlled trials, using high-quality articles for meta-analyses, and recommending high-level evidence; therapeutic techniques need to be further explored, suggesting the implementation of transcranial magnetic stimulation of the cortex, and stimulation of the sphinopalatine ganglia and occipital nerve to achieve peripheral neuromodulation. Furthermore, chronic migraine and insomnia are inextricably linked to CHs.