Efficiency examination of a 6-month trunk prevention program among recruitment kayak-canoe athletes: A randomized control trial

Effectiveness of physiotherapy interventions for back care and the prevention of non-specific low back pain in children and adolescents: a systematic review and meta-analysis

BACKGROUND

Non-specific low back pain in children and adolescents has increased in recent years. The purpose of this study was to upgrade the evidence of the most effective preventive physiotherapy interventions to improve back care in children and adolescents.

METHODS

The study settings were children or adolescents aged 18 years or younger. Data were obtained from the Cochrane Library, MEDLINE, PEDro, Web of Science, LILACS, IBECS, and PsycINFO databases and the specialized journals BMJ and Spine. The included studies were published between May 2012 and May 2020. Controlled trials on children and adolescents who received preventive physiotherapy for back care were considered. Data on all the variables gathered in each individual study were extracted by two authors separately. Two authors assessed risk of bias of included studies using the RoB2 and quality of the body of evidence using the GRADE methodology. Data were described according to PRISMA guidelines. To calculate the effect size, a standardized mean difference "d" was used and a random-effects model was applied for the following outcome variables: behaviour, knowledge, trunk flexion muscle endurance, trunk extension muscle endurance, hamstring flexibility and posture.

RESULTS

Twenty studies were finally included. The most common physiotherapy interventions were exercise, postural hygiene and physical activity. The mean age of the total sample was 11.79 years. When comparing the change from baseline to end of intervention in treatment and control groups, the following overall effect estimates were obtained: behaviour d+ = 1.19 (95% CI: 0.62 and 1.76), knowledge d+ = 1.84 (0.58 and 3.09), trunk flexion endurance d+ = 0.65 (-0.02 and 1.33), trunk extension endurance d+ = 0.71 (0.38 and 1.03), posture d+ = 0.65 (0.24 and 1.07) and hamstrings flexibility d+ = 0.46 (0.36 and 0.56). At follow-up, the measurement of the behaviour variable was between 1 and 12 months, with an effect size of d+ = 1.00 (0.37 and 1.63), whereas the knowledge variable obtained an effect size of d+ = 2.08 (-0.85 and 5.02) at 3 months of follow-up.

CONCLUSIONS

Recent studies provide strong support for the use of physiotherapy in the improvement of back care and prevention of non-specific low back pain in children and adolescents. Based on GRADE methodology, we found that the evidence was from very low to moderate quality and interventions involving physical exercise, postural hygiene and physical activity should be preferred.

Common Injuries in Whitewater Rafting, Kayaking, Canoeing, and Stand-Up Paddle Boarding

Paddle sports continue to be popular forms of outdoor recreation in the United States and around the world. This includes not only the more traditional sports of rafting, kayaking, and canoeing but also the newer and growing sport of stand-up paddle boarding. Because these sports are based in an aquatic environment, and frequently whitewater, there are unique, significant risks of injury. Overall, injuries in paddling sports are mostly musculoskeletal and are both acute and chronic in nature. Some injuries, such as environmental and head injuries, are especially problematic because they can lead to serious morbidity and mortality, most importantly drowning. This review describes the epidemiology, type, and location of injuries across paddle sports. It not only focuses on whitewater injuries but also includes information on injuries sustained in other aquatic paddling environments.

Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania

Background

LBP is a common and serious problem affecting vast populations of the world. However, only few studies on LBP in sub-Saharan Africa have been conducted. Studies report that LBP and pelvic angle are interrelated, and African residents have a high pelvic tilt. The strategy to prevent LBP should focus on activities that promote holistic health. For that purpose, it is important to grasp the state of LBP and how it affects people’s lifestyle in Tanzania to clarify the direction of implementation of physiotherapy treatment and reduce the incidences of LBP among adults. This study aimed to investigate the prevalence and presentation of low back pain (LBP) and the relationship between anthropometric measurements and LBP among people in Moshi city, Kilimanjaro region Tanzania.

Methods

Following signing consent forms, participants were given questionnaires regarding LBP and then grouped accordingly into either asymptomatic or symptomatic cohorts. Anthropometric measurements of participants’ height, weight, curvature of the spine, and pelvic angle were obtained.

Results

A Mann-Whitney U test analysis showed a significant difference in pelvic angle, body mass index (BMI), and thoracic kyphosis angle between the asymptomatic group and the symptomatic group. No significant differences in lumbar lordosis angle or abdominal muscle strength were found between the two groups.

Conclusions

A person with symptomatic LBP in Tanzania has a large anteversion of the pelvic tilt and a thoracic kyphotic posture. This study shows a relationship between sagittal spinal alignment and LBP in Tanzania, which could allow for prospective identification of subjects prone to developing LBP in the future.

[Changes in disability, reduced working ability and rehabilitation benefits in Hungary between 1990 and 2015]

INTRODUCTION

In our study, based on the data of the last 25 years, we analyzed the changes in the cash benefits paid to people with reduced working capacity, currently accounting for nearly 30% of the budget of the National Health Insurance Fund of Hungary.

AIM

The purpose of our study is to compare the statistical data of the past 25 years and the changes in the legal environment.

METHODS

Our research was based on the data series of the National Health Insurance Fund of Hungary and the Hungarian Central Statistical Office as well as on the public finance reports of the State Audit Office of Hungary and the Ministry for National Economy. For the period under review, we analyzed the extent of the cash benefits paid to people with reduced working capacity, the measures taken to reduce these benefits, and the related legal background. In the long term, we examined the relevant dimension of the complex sociological processes in the background as well as the medical evaluation of the changed working ability.

RESULTS

In the last 25 years, benefits (annuity, retirement) paid under different denominations (disability, work ability reduction, health impairment, rehabilitation benefit) are still a decisive part of the health insurance budget (HUF 315 billion in 2016). Serious efforts have been made to replace the previously funded system of invalidity pension and annuity system, with the complex medical, occupational, and social rehabilitation, maintenance and improvement of the remaining state of health. The purpose of the measures is essentially to reduce budget expenditures and to improve the utilization of the amount paid on rehabilitation benefits.

CONCLUSION

The sociological changes that occurred during the long period of time regrettably helped to initially increase the number of recipients of invalidity benefits, to stabilize them at a high level and to have a significant burden on the budget. This could not be counterbalanced by the rehabilitation approach of money supply either. Orv Hetil. 2019; 160(Suppl 1): 29-36.

[Sick-pay trends of the National Health Insurance Fund of Hungary between 1997 and 2017]

INTRODUCTION

The role of sick-pay is to compensate for loss of wage in case of incapacity for work, to ensure that there will be no break in the existential state of the incapacitated person.

AIM

The purpose of our research was to examine data on sickness benefit and payroll data for the period 1997-2017.

DATA AND METHODS

Our research was based on the data of the National Health Insurance Fund of Hungary, the Hungarian Central Statistical Office, the State Audit Office of Hungary and the Hungarian State Treasury as well as on the background reports of the European Commission's Social Protection Committee and the Organisation for Economic Co-operation and Development (OECD), and it is based on the legal environment of sick-pay.

RESULTS

In 1997, there were 119 000 of 3.558 million, in 1998 114 000 of 3.530 million, in 1999 115 000 of 3.433 million, in 2000 112 000 of 3.465 million, in 2006 100 000 of 3.523 million, in 2012 55 000 of 3.769 million entitled people on sick leave on average per day. In 2017, the number of entitled persons increased to 4.018 million, while the average number of sick days per day was 70 000. According to data from gender and age-based analysis, in most cases, women with childbearing were on sick-leave, the proportion of males was higher in relation to industrial accident. Between 2014 and 2016, the proportion of women on sick leave per day was 59-60%, while the major reason for sick-pay among men was the industrial accident. The distribution by age did not change significantly. In 2014-2015, the age-group 30-34, while in 2016 the age-group 35-39 had the highest utilization of sick-pay.

CONCLUSION

We can conclude that the use of sick-pay is affected by the employment rate, legal changes affecting the amount of sick-pay and social trends like substitution difficulties due to labor shortages and fear of losing jobs. Orv Hetil. 2019; 160(Suppl 1): 37-42.