1
|
Okuyama K, Kilian FC, Kido T, Sato C, Miyakoshi N. Prevalence of global spinal malalignment and the influence on LBP and HR-QOL in a healthy, nonelderly population. A cross sectional analysis, including bone mineral density, skeletal muscle mass index, and back muscle extensor strength. N Am Spine Soc J 2023; 16:100272. [PMID: 37771760 PMCID: PMC10522902 DOI: 10.1016/j.xnsj.2023.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
Background In healthy, nonelderly populations, prevalence of 3 modifiers of global spinal malalignment (GS-MalAlign) (PT ≧20°, PI-LL≧10°, SVA≧40 mm) remains unknown. The clinical significance has not been determined. The purposes are to disclose the prevalence of the 3 modifiers of GS-MalAlign, and evaluate the influence on LBP, and HR-QOL related to bone mineral density (BMD), skeletal muscle mass index (SMI), and back muscle extensors strength (BMES) in a healthy, nonelderly population. Methods A mono-centric, cross-sectional survey. Three hundred and 2 participants (18< age <65 years) without ADL disturbance were consecutively enrolled. Sagittal parameters of the spine and the pelvis were measure on whole spine radiograms. BMD and SMI were determined using DEXA. BMES was defined as a maximum extension force at the T4 to T7 level and measured by a strain-gauge dynamotor. LBP was checked through interview. HR-QOL was ascertained by score of Medical Outcome Study Short-Form 36-Health Survey (SF-36v2). Results The final analysis could be done in 84 females and 179 males. PT≧20°, PI-LL≧10°, and SVA≧40 mm were found in 12% (31/263), 11% (31/263), and 6% (16/263), and each mean value was 25.0 ± 4.0°, 15.3 ± 5.9°, and 52.7 ± 12.2 mm (Mean ± S.D.). Prevalence of LBP was significantly higher in the participants with PI-LL≧10° than with PI-LL<10°; 43% (12/28) versus 21% (49/235) (p<.05). PI-LL≧10° only had an association with LBP (OR: 3.0435, 95% CI, 1.1378-8.141, p<.05). Four 2% of participants (4/263) associated with all 3 modifiers had LBP and a significantly lower mental component summary score of SF-36v2 (p<.05). Conclusions Some of individuals are associated with GS-MalAlign even in healthy, nonelderly populations. There is a possibility that PI-LL ≧10° results in LBP within a degree of no ADL disturbance, and it is speculated that coexistence of all 3 modifiers of GS-MalAlign would lead to a poor mental HR-QOL.
Collapse
Affiliation(s)
- Koichiro Okuyama
- Department of Orthopaedic Surgery, Akita Rosai Hospital, Karuizawa, Aza Shimotai 30, Odate, Japan
| | - Francis Ch. Kilian
- Facharzt für Neurochirurgie Facharzt für Orthopädie, Spezielle Orthopädische Chirurgie Chefarzt der Klinik für Wirbelsäulenchirurgie Wirbelsäulenzentrum DWG Katholisches Klinikum Koblenz MontabaurBrüderhaus Koblenz, Kardinal-Krementz- Strasse 1-5, D-56073 Koblenz, Germany
| | - Tadato Kido
- Department of Orthopaedic Surgery, Akita Rosai Hospital, Karuizawa, Aza Shimotai 30, Odate, Japan
| | - Chiaki Sato
- Department of Orthopaedic Surgery, Akita Rosai Hospital, Karuizawa, Aza Shimotai 30, Odate, Japan
| | - Naohisa Miyakoshi
- Department of Orthopaedic Surgery, Akita University Graduate School of Medicine, Hondo 1-1-1 Akita City, Japan
| |
Collapse
|
2
|
Zhou AF, Li ZY, Cui XJ, Sng KS, Zhu K, Wang YJ, Shu B, Zhang JP, Yao M. Cross-cultural adaptation of The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: A methodological systematic review. J Orthop Sci 2023; 28:984-991. [PMID: 36137918 DOI: 10.1016/j.jos.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) is a reliable and sensitive measure of disability to determine functional status and evaluate curative effects in low back pain, it has now been cross-cultural translated into many other languages and adapted for use in different countries. We aim to evaluate the translation procedures and measurement properties of cross-cultural adaptations of the JOABPEQ. METHODS Studies related to cross-cultural adaptation of the JOABPEQ in a specific language/culture were searched in PubMed, Embase, CINAHL, SciELO, PsycINFO, SinoMed, and Web of Science from their inception to March 2022. The Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and the Consensus-based Standards for the Selection of Health Status Measurement Instruments guideline were used for evaluation. RESULTS Nine different versions of cross-cultural JOABPEQ adaptations in 8 different languages/cultures were included. The adaptation process was not strictly performed, such as standard forward translation and expert committee review were rarely reported. Content validity (8/9), floor and ceiling effects (3/9), reliability (4/9), and interpretability (6/9) were assessed in most of the adaptations, while agreement (2/9), responsiveness (2/9), and the internal consistency (2/9) were not. JOABPEQ can replace functional and quality of life score to reduce the burden of scientific research. CONCLUSION We recommend Persian-Iranian, simplified Chinese-Chinese Mandarin, Thai and Gunaydin G's Turkish adaptations for application. The numerical pain rating scale/visual analogue scale in low back pain and lower extremities, as well as numbness in lower extremities could not be neglected in JOABPEQ adaptations.
Collapse
Affiliation(s)
- Ai-Fang Zhou
- Spine Disease Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; School of Rehabilitation, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhuo-Yao Li
- Spine Disease Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue-Jun Cui
- Spine Disease Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kim Sia Sng
- Spine Disease Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ke Zhu
- Spine Disease Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong-Jun Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bing Shu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian-Ping Zhang
- Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Min Yao
- Spine Disease Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| |
Collapse
|
3
|
Larie MS, Esfandiarpour F, Riahi F, Parnianpour M. Brain Wave Patterns in Patients With Chronic Low Back Pain: A Case-control Study. Basic Clin Neurosci 2023; 14:225-235. [PMID: 38107529 PMCID: PMC10719979 DOI: 10.32598/bcn.2021.2398.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 09/25/2020] [Accepted: 12/23/2020] [Indexed: 12/19/2023] Open
Abstract
Introduction Research evidence indicates that maladaptive reorganization of the brain plays a critical role in amplifying pain experiences and pain chronification; however, no clear evidence of change exists in brain wave activity among patients with chronic low back pain (CLBP). The objective of this study was to assess brain wave activity in patients with CLBP, compared to healthy controls. Methods Twenty-five patients with CLBP and twenty-four healthy controls participated in the study. A quantitative electroencephalography device was used to assess brain wave activity in eyes-open and eyes-closed (EO and EC) conditions. The regional absolute and relative power of brain waves were compared between the groups. Results Our results showed a significant increase in the absolute power of theta (F=5.905, P=0.019), alpha (F=5.404, P=0.024) waves in patients with CLBP compared to healthy subjects in both EC and EO conditions. Patients with CLBP showed a reduced delta absolute power in the frontal region (F=5.852, P=0.019) and augmented delta absolute power in the central region (F=5.597, P=0.022) in the EO condition. An increased delta absolute power was observed in the frontal (F=7.563 P=0.008), central (F=10.430, P=0.002), and parietal (F=4.596, P=0.037) regions in patients with CLBP compared to the healthy subjects in the EC condition. In the EC condition, significant increases in theta relative power (F=4.680, P=0.036) in the parietal region were also found in patients with CLBP. Conclusion The increased absolute power of brain waves in people with CLBP may indicate cortical overactivity and changes in the pain processing mechanisms in these patients. Highlights Chronic low back pain (CLBP) increases the alpha, theta, and delta power in the brain.CLBP is associated with increased brain wave activity in the frontal, central, and parietal regions.Our findings suggest altered central pain processing in CLBP. Plain Language Summary Traditional diagnosis and treatment of CLBP are mainly focused on peripheral pathology. But, the modern neuroscience approach to pain highlights the role of cortical plasticity in chronic musculoskeletal pain. In this regard, several studies found structural and functional changes in the brain in patients with chronic pain. Detailed knowledge about cortical changes in CLBP can improve our understanding of mechanisms involved in CLBP, opening a new window to better treatment of LBP (Low back pain). This study investigated brain wave activity in patients with CLBP compared to healthy individuals. Our findings suggest increased brain activity in various parts of the brain in patients with chronic LBP. This finding indicates that CLBP treatment should focus on both peripheral and cortical factors rather than local tissue damage.
Collapse
Affiliation(s)
- Maryam Sadat Larie
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fateme Esfandiarpour
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Forough Riahi
- Department of Psychiatry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Faculty of Biomechanics, Sharif University of Technology, Tehran, Iran
| |
Collapse
|
4
|
Peters SLA, Tabasi A, Kingma I, van Dijk W, van Dieën JH. Development of a real time estimation method of L5S1 moments in occupational lifting. J Biomech 2023; 146:111417. [PMID: 36563410 DOI: 10.1016/j.jbiomech.2022.111417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Mechanical loading of the low-back is an important risk factor for the development of low-back pain. Real-time estimation of the L5S1 joint moment (ML5S1) can give an insight to reduce mechanical loading. Model accuracy depends on sensor information, limiting the number of input variables to estimate ML5S1 increases practical feasibility, but may decrease accuracy. This study aimed to find a model with a limited set of input variables without a large reduction in accuracy. We compared two approaches. The first was based on a simplified inverse dynamics model (SM) that requires a limited number of input variables (EMG/ground reaction forces, and orientations derived from an optoelectronic system (OMC)). Two variations were examined, to determine to what extent arm orientations were needed. The second approach was based on a regression model (RM) that uses the SMs as ground-truth. Two variations in terms of sensor use and calibration were examined. Test trials consisted of re-stacking a stack of 3 boxes. A high-end lab-based OMC-system was used as the gold standard (GS). Fifteen healthy participants, 9 males and 6 females (age 21-30) participated in this study. R2, RMSE, and peak-difference with the GS ML5S1 estimate were compared between models with a repeated-measures ANOVA. The SM including arm sensors performed similar or better than the regression models (r > 0.9 and RMSE < 15 % of average peak moment). However, from the perspective of practical feasibility and minimizing the required number of sensors during work, the best approach would be using one of the two regression model approaches.
Collapse
Affiliation(s)
- Sjoerd L A Peters
- Dept. of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Ali Tabasi
- Dept. of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Idsart Kingma
- Dept. of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | | | - Jaap H van Dieën
- Dept. of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| |
Collapse
|
5
|
Wang H, Liu C, Meng Z, Zhou W, Chen T, Zhang K, Wu A. Real-world study for identifying the predictive factors of surgical intervention and the value of magnetic resonance imaging in patients with low back pain. Quant Imaging Med Surg 2022; 12:1830-1843. [PMID: 35284262 PMCID: PMC8899926 DOI: 10.21037/qims-21-584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/04/2021] [Indexed: 09/18/2023]
Abstract
BACKGROUND Low back pain (LBP) is a prevalent disease and can be disabling. Currently, many patients with LBP with or without radiculopathy commonly undergo magnetic resonance imaging (MRI) for diagnosis and therapeutic assessment, yet the final intervention is mainly centered around nonoperative treatment. This study's aim was to identify the predictive factors of surgical treatment and the value of MRI in patients with LBP with or without radiculopathy. METHODS The study included a training cohort that consisted of 461 patients with MRI from January 2014 to December 2018. Demographic characteristics and MRI findings were collected from our medical records. We developed and validated 2 nomograms to predict the possibility of receiving surgical treatment in LBP patients, based on multivariable logistic regression analysis. The performance of the 2 nomograms was assessed in terms of their calibration, discrimination, and clinical usefulness. An independent validation cohort containing 163 patients was comparatively analyzed. RESULTS The baseline model incorporated 6 clinicopathological variables, while the MRI model consisted of 9 variables including several MRI findings. Internal validation revealed the good performance of the 2 nomograms in discrimination and calibration, with a concordance index (C-index) of 0.799 (95% CI: 0.743-0.855) for the baseline model and 0.834 (95% CI: 0.783-0.884) for the MRI model, which showed that the addition of MRI findings to the nomogram failed to achieve better prognostic value (Z statistic =-1.509; P=0.131). Application of the 2 models in the validation cohort also showed good discrimination (baseline model: C-index 0.75, 95% CI: 0.671-0.829; MRI model: C-index 0.777, 95% CI: 0.696-0.857) and calibration. No significant predictive benefit was found in the MRI model in the validation cohort (Z statistic =-0.588; P=0.557). CONCLUSIONS This study showed that clinical demographic characteristics provide good prognostic value to determine whether LBP patients with or without radiculopathy require surgical treatment. The addition of MRI findings yielded no significantly incremental prognostic value.
Collapse
Affiliation(s)
- Hui Wang
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopedics, Wenzhou, China
| | - Chang Liu
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Zhou Meng
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | - Wenxian Zhou
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopedics, Wenzhou, China
| | - Tao Chen
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopedics, Wenzhou, China
| | - Kai Zhang
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopedic Implants, Shanghai, China
| | - Aimin Wu
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopedics, Wenzhou, China
| |
Collapse
|
6
|
Klyne DM, Barbe MF, Hodges PW. Relationship between systemic inflammation and recovery over 12 months after an acute episode of low back pain. Spine J 2022; 22:214-225. [PMID: 34547387 DOI: 10.1016/j.spinee.2021.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/02/2021] [Accepted: 09/14/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Individual characteristics can influence outcomes after injury. Our previous work in individuals with early-acute low back pain (LBP) identified subgroups (clusters) with specific biopsychosocial features that recovered poorly or well by 6 months. PURPOSE This study extends on that work by revealing the short- and long-term trajectories of recovery and systemic inflammation of these participant clusters: (1) "inflammatory & poor sleep" (Cluster 1), "high TNF & depression" (Cluster 2), "high pain & high pain-related fear" (Cluster 3), and "low pain & low pain-related fear" (Cluster 4). STUDY DESIGN/SETTING Longitudinal cohort study. PATIENT SAMPLE Eighty-three individuals within 2 weeks of an acute episode of LBP - grouped into their a priori-defined cluster. OUTCOME MEASURES General participant characteristics (sex, age, body mass index, smoking history, previous LBP history); self-reported LBP (0-10 numerical rating scale, LBP-related disability (Roland-Morris Disability Questionnaire), depression (Center for Epidemiological Studies Depression Scale, pain catastrophizing (Pain Catastrophizing Scale), fear avoidance (Fear Avoidance Beliefs Questionnaire), pain self-efficacy (Pain Self-Efficacy Questionnaire), and sleep (Pittsburgh Sleep Quality Index); systemic inflammatory biomarkers (C-reactive protein [CRP], interleukin-6 [IL-6], interleukin-1β, tumor necrosis factor [TNF]). METHODS Participants provided blood for the measurement of CRP/cytokines, and completed questionnaires related to their pain/disability, psychological and sleep status. Blood measures were repeated 3-monthly for 9 months, and pain/disability were self-reported fortnightly for 12 months. Recovery (change in pain) and CRP/cytokines were longitudinally compared between clusters using mixed-models. Associations between baseline factors and follow-up CRP/cytokines levels were assessed with multiple regression. RESULTS Clusters 1 and 2 were associated, but oppositely, with recovery over the 12-months. Cluster 1 reported most recovery at every 3-monthly interval, whereas Cluster 2 reported least recovery. Cluster 1 had elevated CRP (and IL-6) at baseline that continued to decrease from 3 to 9 months. TNF was elevated early and persistently in Cluster 2. Baseline factors other than inflammation generally failed to predict follow-up inflammation. CONCLUSIONS Findings support the early role of CRP (and perhaps IL-6) in control of inflammation and recovery, and a pathological role of persistent TNF overexpression, which may be perpetuated by depressive-like behaviors.
Collapse
Affiliation(s)
- David M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Paul W Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| |
Collapse
|
7
|
Hutchins TA, Peckham M, Shah LM, Parsons MS, Agarwal V, Boulter DJ, Burns J, Cassidy RC, Davis MA, Holly LT, Hunt CH, Khan MA, Moritani T, Ortiz AO, O'Toole JE, Powers WJ, Promes SB, Reitman C, Shah VN, Singh S, Timpone VM, Corey AS. ACR Appropriateness Criteria® Low Back Pain: 2021 Update. J Am Coll Radiol 2021; 18:S361-S379. [PMID: 34794594 DOI: 10.1016/j.jacr.2021.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 01/19/2023]
Abstract
In the United States, acute low back pain, with or without radiculopathy, is the leading cause of years lived with disability and the third ranking cause of disability-adjusted life-years. Uncomplicated acute low back pain and/or radiculopathy is a benign, self-limited condition that does not warrant any imaging studies. Imaging is considered in those patients who have had up to 6 weeks of medical management and physical therapy that resulted in little or no improvement in their back pain. It is also considered for those patients presenting with red flags, raising suspicion for a serious underlying condition, such as cauda equina syndrome, malignancy, fracture, or infection. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Collapse
Affiliation(s)
- Troy A Hutchins
- Chief Value Officer, Department of Radiology, University of Utah Health, Salt Lake City, Utah.
| | - Miriam Peckham
- Research Author, University of Utah Medical Center, Salt Lake City, Utah
| | - Lubdha M Shah
- Panel Chair, University of Utah, Salt Lake City, Utah
| | - Matthew S Parsons
- Panel Vice-Chair, Mallinckrodt Institute of Radiology, Saint Louis, Missouri
| | - Vikas Agarwal
- Vice-Chair, Education, Chief, Neuroradiology, and Director, Spine Intervention, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Daniel J Boulter
- Clinical Director, MRI, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Judah Burns
- Program Director, Diagnostic Radiology Residency Program, Montefiore Medical Center, Bronx, New York
| | - R Carter Cassidy
- UK Healthcare Spine and Total Joint Service, Lexington, Kentucky; Executive Board, Kentucky Orthopaedic Society; and American Academy of Orthopaedic Surgeons
| | - Melissa A Davis
- Director of Quality, Department of Radiology, Emory University, Atlanta, Georgia; and ACR YPS Communications Liaison
| | - Langston T Holly
- UCLA Medical Center, Los Angeles, California, Neurosurgery expert
| | | | | | | | - A Orlando Ortiz
- Chairman, Department of Radiology, Jacobi Medical Center, Bronx, New York
| | | | - William J Powers
- University of North Carolina School of Medicine, Chapel Hill, North Carolina; American Academy of Neurology; and Chair, Writing Group - American Heart Association/American Stroke Association Guidelines for the Early Management of Patients with Acute Ischemic Stroke, 2016-2019
| | - Susan B Promes
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania; American College of Emergency Physicians; Editor-in-Chief, AEM Education & Training; and Board Member, Pennsylvania Psychiatric Hospital
| | - Charles Reitman
- Medical University of South Carolina, Charleston, South Carolina; North American Spine Society
| | - Vinil N Shah
- University of California San Francisco, San Francisco, California; Executive Committee, American Society of Spine Radiology; and Board of Directors, Spine Intervention Society
| | - Simranjit Singh
- Indiana University School of Medicine, Indianapolis, Indiana; American College of Physicians; Secretary, SHM, Indiana chapter; and Secretary, SGIM Midwest Region
| | - Vincent M Timpone
- Co-Director, Neuroradiology, Spine Intervention Service, and Director, Stroke and Vascular Imaging, Department of Radiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Amanda S Corey
- Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia
| |
Collapse
|
8
|
Noorollahzadeh K, Kahrizi S, Fesharaki MG, Heidarian M, Neblett R, Behzadipour S. Cross-cultural adaptation and psychometric validation of the Persian version of the central sensitization inventory. Musculoskelet Sci Pract 2021; 51:102314. [PMID: 33360651 DOI: 10.1016/j.msksp.2020.102314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 11/21/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Central Sensitization Inventory (CSI) is a patient-reported tool to assess symptoms associated with central sensitization (CS). It consists of two parts: Part A assesses 25 somatic and emotional CS-related health symptoms, and part B asks if one has previously been diagnosed with a list of 10 Central Sensitivity Syndromes and related conditions. OBJECTIVES The aim of this study was to translate and cross-culturally adapt the CSI into Persian and to evaluate its psychometric properties. DESIGN Cross-sectional study. METHOD After completing the Persian translation, the psychometric properties of the Persian CSI (CSI-Per) were evaluated in 256 patients with chronic pain and 46 healthy subjects. RESULTS A confirmatory factor analysis confirmed a 1-factor model suggested in a large recent comprehensive multicountry study. Test-retest reliability (ICC = 0.934; P < 0.001) and the internal consistency (Cronbach's α = 0.87) were both good. After dividing the patient subjects into severity level subgroups, based on CSI-Per total scores, significant associations were found with the Persian version of the pain catastrophizing scale, pain duration, current pain intensity, maximum, minimum and average pain intensity in the past week and average pain intensity in the past month. In addition, total CSI-Per scores differentiated between patients and healthy subjects. CONCLUSION The CSI-Per demonstrated good validity and reliability to assess symptoms associated with CS in Persian-speaking patients with chronic pain.
Collapse
Affiliation(s)
- Karim Noorollahzadeh
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sedigheh Kahrizi
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | | | | | | | - Saeed Behzadipour
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran; Mowafaghian Research Centre of Intelligent Neuro-Rehabilitation Technologies, Sharif University of Technology, Tehran, Iran
| |
Collapse
|
9
|
Klyne DM, van den Hoorn W, Barbe MF, Cholewicki J, M Hall L, Khan A, Meroni R, Moseley GL, Nicholas M, O'Sullivan L, Park R, Russell G, Sterling M, Hodges PW. Cohort profile: why do people keep hurting their back? BMC Res Notes 2020; 13:538. [PMID: 33203448 DOI: 10.1186/s13104-020-05356-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/23/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is one of the most disabling and costly conditions worldwide. It remains unclear why many individuals experience persistent and recurrent symptoms after an acute episode whereas others do not. A longitudinal cohort study was established to address this problem. We aimed to; (1) evaluate whether promising and potentially modifiable biological, psychological, social and behavioural factors, along with their possible interactions, predict LBP outcome after an acute episode; (2) compare these factors between individuals with and without acute LBP; and (3) evaluate the time-course of changes in these factors from LBP onset. This paper outlines the methodology and compares baseline characteristics between acute LBP and control, and LBP participants with and without follow-up. RESULTS 133 individuals with acute LBP and 74 pain-free individuals participated. Bio-psycho-social and behavioural measures were collected at baseline and 3-monthly for 12 months (LBP) or 3 months (control). Pain and disability were recorded fortnightly. Baseline characteristics were mostly similar between those who did and did not return for follow-up. Initial analyses of this cohort have revealed important insights into the pathways involved in acute-to-chronic LBP. These and future findings will provide new targets for treatment and prevention of persistent and recurrent LBP.
Collapse
|
10
|
Mobasheri A, Richardson SM. Cell and Gene Therapy for Spine Regeneration: Mammalian Protein Production Platforms for Overproduction of Therapeutic Proteins and Growth Factors. Neurosurg Clin N Am 2020; 31:131-139. [PMID: 31739923 PMCID: PMC6899505 DOI: 10.1016/j.nec.2019.08.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ali Mobasheri
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Santariskiu 5, Vilnius 08661, Lithuania; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, Oulu FI-90014, Finland; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Queen's Medical Centre, Nottingham, UK; King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Stephen M Richardson
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, UK
| |
Collapse
|
11
|
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med 2020; 8:299. [PMID: 32355743 PMCID: PMC7186678 DOI: 10.21037/atm.2020.02.175] [Citation(s) in RCA: 561] [Impact Index Per Article: 140.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Low back pain (LBP) is a common musculoskeletal problem globally. Updating the prevalence and burden of LBP is important for researchers and policy makers. This paper presents, compares and contextualizes the global prevalence and years lived with disability (YLDs) of LBP by age, sex and region, from 1990 to 2017. Methods Data were extracted from the GBD (the Global Burden of Disease, Injuries, and Risk Factors Study) 2017 Study. Age, sex and region-specific analyses were conducted to estimate the global prevalence and YLDs of LBP, with the uncertainty intervals (UIs). Results The age-standardized point prevalence of LBP was 8.20% (95% UI: 7.31–9.10%) in 1990 and decreased slightly to 7.50% (95% UI: 6.75–8.27%) in 2017. The prevalent numbers of people with LBP at any one point in time in 1990 was 377.5 million, and this increased to 577.0 million in 2017. Age-standardized prevalence of LBP was higher in females than males. LBP prevalence increased with age, and peaked around the ages of 80 to 89 years, and then decreased slightly. Global YLDs were 42.5 million (95% UI: 30.2 million–57.2 million) in 1990 and increased by 52.7% to 64.9 million (95% UI: 46.5 million–87.4 million) in 2017. YLDs were also higher in females than males and increased initially with age; they peaked at 35–39 years of age in 1990, before decreasing, whereas in 2017, they peaked at 45–49 years of age, before decreasing. Western Europe had the highest number of LBP YLDs. Conclusions Globally, LBP is the leading global cause of YLDs. Greater attention is urgently needed to mitigate this increasing burden and the impact it is having on health and social systems.
Collapse
Affiliation(s)
- Aimin Wu
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Lyn March
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Surveillance Task Force, Global Alliance for Musculoskeletal Health (G-MUSC), Sydney, Australia
| | - Xuanqi Zheng
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Jinfeng Huang
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Xiangyang Wang
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Jie Zhao
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai 200011, China
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW Australia
| | - Emma Smith
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney & Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Damian Hoy
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Surveillance Task Force, Global Alliance for Musculoskeletal Health (G-MUSC), Sydney, Australia
| |
Collapse
|
12
|
Ben-Ami N, Korn L. Associations between backache and stress among undergraduate students. J Am Coll Health 2020; 68:61-67. [PMID: 30257145 DOI: 10.1080/07448481.2018.1515753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/14/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Objective: Low back pain (LBP) is a very common symptom. It occurs in all age groups from children to the elderly population. Globally, years lived with disability caused by LBP increased by 54% between 1990 and 2015. Our objective was to investigate measures that associate with LBP in students. Participants: A structured, anonymous, self-report questionnaire was distributed in two study years, 2009 and 2015. Participants included 1,026 students, 57.7% of them female, with a mean age of 27.2 (SD = 6.4). Methods: The questionnaire included validated questions on various subjects related to health status and health behaviors. Results: The associated factors of undergraduate students experiencing backaches are higher if they engage in smoking (AOR = 2.15; p<.01), report study-based stress (AOR = 2.39; p<.01), and show depressive symptoms (AOR = 2.69; p<.000). Conclusions: Smoking, stress, and depression are strong measures associated with backache in undergraduate students, significantly more than BMI, physical activity, or sedentary behaviors.
Collapse
Affiliation(s)
- Noa Ben-Ami
- Department of Physiotherapy, Ariel University, Ariel, Israel
| | - Liat Korn
- Department of Health Systems Management, Ariel University, Ariel, Israel
| |
Collapse
|
13
|
Tatsumi M, Mkoba EM, Suzuki Y, Kajiwara Y, Zeidan H, Harada K, Bitoh T, Nishida Y, Nakai K, Shimoura K, Aoyama T. Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania. BMC Musculoskelet Disord 2019; 20:584. [PMID: 31801500 PMCID: PMC6894267 DOI: 10.1186/s12891-019-2953-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/18/2019] [Indexed: 11/10/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Masataka Tatsumi
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Egfrid Michael Mkoba
- Present address: School of Physiotherapy, Kilimanjaro Christian Medical Centre, Moshi (United Republic of Tanzania), P.O.Box 2202, Moshi, Tanzania
| | - Yusuke Suzuki
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuu Kajiwara
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hala Zeidan
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Keiko Harada
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tsubasa Bitoh
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuichi Nishida
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kengo Nakai
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kanako Shimoura
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tomoki Aoyama
- Present address: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (Japan), 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| |
Collapse
|
14
|
Xia K, Gong Z, Zhu J, Yu W, Wang Y, Wang J, Xu A, Zhou X, Tao H, Li F, Liang C. Differentiation of Pluripotent Stem Cells into Nucleus Pulposus Progenitor Cells for Intervertebral Disc Regeneration. Curr Stem Cell Res Ther 2019; 14:57-64. [PMID: 30227822 DOI: 10.2174/1574888x13666180918095121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/31/2018] [Accepted: 09/11/2018] [Indexed: 02/08/2023]
Abstract
Low back pain (LBP) is one of the world's most common musculoskeletal diseases and is frequently associated with intervertebral disc degeneration (IDD). While the main cause of IDD is commonly attributed to a reduced number of nucleus pulposus (NP) cells, current treatment strategies (both surgical and more conservative) fail to replenish NP cells or reverse the pathology. Cell replacement therapies are an attractive alternative for treating IDD. However, injecting intervertebral disc (IVD) cells, chondrocytes, or mesenchymal stem cells into various animal models of IDD indicate that transplanted cells generally fail to survive and engraft into the avascular IVD niche. Whereas pluripotent stem cells (PSCs), including induced pluripotent stem cells (iPSCs) and embryonic stem cells (ESCs), hold great potential for revolutionizing regenerative medicine, current protocols for differentiating these cells into NP-like cells are inadequate. Nucleus pulposus progenitor cells (NPPCs), which are derived from the embryonic notochord, can not only survive within the harsh hypoxic environment of the IVD, but they also efficiently differentiate into NP-like cells. Here we provide an overview of the latest progress in repairing degenerated IVDs using PSCs and NPPCs. We also discuss the molecular pathways by which PSCs differentiate into NPPCs in vitro and in vivo and propose a new, in vivo IDD therapy.
Collapse
Affiliation(s)
- Kaishun Xia
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Zhe Gong
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Jian Zhu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Wei Yu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Yitian Wang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Junjie Wang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Ankai Xu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Xiaopeng Zhou
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Huimin Tao
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Fangcai Li
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| | - Chengzhen Liang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, China.,Orthopedics Research Institute of Zhejiang University, No. 88, Jiefang Road, Hangzhou 310009, China
| |
Collapse
|
15
|
Lewis R, Gómez Álvarez CB, Rayman M, Lanham-New S, Woolf A, Mobasheri A. Strategies for optimising musculoskeletal health in the 21 st century. BMC Musculoskelet Disord 2019; 20:164. [PMID: 30971232 PMCID: PMC6458786 DOI: 10.1186/s12891-019-2510-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/17/2019] [Indexed: 12/19/2022] Open
Abstract
We live in a world with an ever-increasing ageing population. Studying healthy ageing and reducing the socioeconomic impact of age-related diseases is a key research priority for the industrialised and developing countries, along with a better mechanistic understanding of the physiology and pathophysiology of ageing that occurs in a number of age-related musculoskeletal disorders. Arthritis and musculoskeletal disorders constitute a major cause of disability and morbidity globally and result in enormous costs for our health and social-care systems.By gaining a better understanding of healthy musculoskeletal ageing and the risk factors associated with premature ageing and senescence, we can provide better care and develop new and better-targeted therapies for common musculoskeletal disorders. This review is the outcome of a two-day multidisciplinary, international workshop sponsored by the Institute of Advanced Studies entitled "Musculoskeletal Health in the 21st Century" and held at the University of Surrey from 30th June-1st July 2015.The aim of this narrative review is to summarise current knowledge of musculoskeletal health, ageing and disease and highlight strategies for prevention and reducing the impact of common musculoskeletal diseases.
Collapse
Affiliation(s)
- Rebecca Lewis
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Constanza B Gómez Álvarez
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Margaret Rayman
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Susan Lanham-New
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Anthony Woolf
- Department of Rheumatology, Royal Cornwall Hospital, Truro, UK
| | - Ali Mobasheri
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. .,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Queen's Medical Centre, Nottingham, UK. .,Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania. .,The D-BOARD FP7 Consortium, . .,The APPROACH IMI Consortium, .
| |
Collapse
|
16
|
Palada V, Ahmed AS, Finn A, Berg S, Svensson CI, Kosek E. Characterization of neuroinflammation and periphery-to-CNS inflammatory cross-talk in patients with disc herniation and degenerative disc disease. Brain Behav Immun 2019; 75:60-71. [PMID: 30248387 DOI: 10.1016/j.bbi.2018.09.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/28/2018] [Accepted: 09/10/2018] [Indexed: 12/30/2022] Open
Abstract
UNLABELLED The aim of the study was to identify inflammatory cytokines/chemokines associated with neuroinflammation and periphery-to-CNS inflammatory cross-talk in degenerative disc disease (DDD) and lumbar disc herniation (LDH), common causes of low back pain (LBP). A secondary aim was to investigate the associations between cytokines and symptom severity. METHODS In total, 40 DDD and 40 LDH patients were recruited from a surgical waiting list, as well as 39 healthy controls (HC) and 40 cerebrospinal fluid (CSF) controls. The subjects completed questionnaires and pressure algometry was performed at the lumbar spine and forearm. The CSF, serum and disc tissues were collected during surgery. Inflammatory mediators TNF, INFg, IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13 and MCP1 were analysed by immunoassay (Meso Scale Discovery) and quantitative real-time polymerase chain reaction (qPCR) was used for analysis of IL-6, IL-8, MCP1 and TSPO expression in intervertebral discs (IVDs). RESULTS In the LDH group, we found elevated IL-8 concentrations in CSF indicating neuroinflammation, while IL-8 and MCP1 concentrations in serum were lower compared to HC. The IVD expression of IL-6, IL-8 and TSPO was lower in LDH patients compared to DDD. LDH patients had a positive correlation between IL-8 concentrations in CSF and serum and IL-8 in CSF was associated with higher pain intensity and increased spinal pressure pain sensitivity. The MCP1 concentration in serum was associated with higher global pain ratings and increased spinal pressure pain sensitivity, while IL-6 serum concentration correlated with the intensity of the neuropathic pain component (leg pain) in LDH patients. IVD expression of TSPO in LDH patients was associated with increased intensity of back pain. No differences were found in cytokine CSF concentrations between DDD patients and CSF controls, but DDD patients had lower IL-8 and MCP1 serum concentrations than HC. In female DDD patients, IL-8 and MCP1 concentrations in serum were associated with increased intensity of back pain. CONCLUSION Our results suggest that neuroinflammation mediated by elevated IL-8 concentrations in CSF and IL-8 mediated periphery-to-CNS inflammatory cross-talk contributes to pain in LDH patients and suggest a link between TSPO expression in discs and low back pain.
Collapse
|
17
|
Iwakiri K, Sotoyama M, Takahashi M, Liu X, Koda S, Ichikawa K. Effectiveness of re-education based on appropriate care methods using welfare equipment on the prevention of low back pain among care workers: a 1.5 year follow-up study. Ind Health 2018; 56:419-426. [PMID: 29910229 PMCID: PMC6172185 DOI: 10.2486/indhealth.2017-0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Many care workers at elderly care facilities in Japan suffer occupational low back pain (LBP) despite the utilization of welfare equipment. When introducing welfare equipment such as hoists and sliding boards, education on appropriate care methods using welfare equipment is usually conducted, but the effect of education diminishes with time. This intervention study aimed to examine the effect of re-education on appropriate care methods using welfare equipment on the prevention of care workers' LBP at an elderly care facility. At the intervention facility, 49 care workers were enrolled in ergonomic education program for 1.5 yr in order to improve care methods using welfare equipment. At the non-intervention facility, 33 care workers were not enrolled in the program. Rates of severe LBP were not significantly different between the facilities. However, during the study period, the rate of severe LBP among care workers did not increase at the intervention facility, while it doubled among care workers at the non-intervention facility. The care workers at the intervention facility showed improvement in care methods using welfare equipment during the study period. Hence, we think that re-education regarding appropriate care methods using welfare equipment has the potential to prevent exacerbation of LBP.
Collapse
Affiliation(s)
| | | | | | - Xinxin Liu
- National Institute of Occupational Safety and Health, Japan
| | - Shigeki Koda
- National Institute of Occupational Safety and Health, Japan
| | | |
Collapse
|
18
|
Abstract
PURPOSE OF REVIEW This review aims to highlight recent advances in understanding the genetic basis of intervertebral disc degeneration (IDD). RECENT FINDINGS It has been known for some time that IDD is highly heritable. Recent studies, and in particular the availability of agnostic techniques such as genome-wide association studies, have identified new variants in a variety of genes which contribute to the risk of IDD and to back pain. SUMMARY A variety of genetic variants are involved in IDD. Some are shared with variants predisposing to back pain, but few have been identified reliably in either phenotype. Further research is required to explain fully the high heritability and how the genetic variants influence cell biology to lead to IDD.
Collapse
Affiliation(s)
- Sabrina Munir
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| | - Marinko Rade
- Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland
- Faculty of Medicine, Orthopaedic and Rehabilitation Hospital “Prim. dr.Martin Horvat”, Josip Juraj Strossmayer University of Osijek, Rovinj, Croatia
| | - Juhani H. Määttä
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Maxim B. Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| |
Collapse
|
19
|
Klyne DM, Barbe MF, van den Hoorn W, Hodges PW. ISSLS PRIZE IN CLINICAL SCIENCE 2018: longitudinal analysis of inflammatory, psychological, and sleep-related factors following an acute low back pain episode-the good, the bad, and the ugly. Eur Spine J 2018; 27:763-777. [PMID: 29460011 DOI: 10.1007/s00586-018-5490-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/20/2018] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Prospective longitudinal study. OBJECTIVE To determine whether systemic cytokines and C-reactive protein (CRP) during an acute episode of low back pain (LBP) differ between individuals who did and did not recover by 6 months and to identify sub-groups based on patterns of inflammatory, psychological, and sleep features associated with recovery/non-recovery. Systemic inflammation is observed in chronic LBP and may contribute to the transition from acute to persistent LBP. Longitudinal studies are required to determine whether changes present early or develop over time. Psychological and/or sleep-related factors may be related. METHODS Individuals within 2 weeks of onset of acute LBP (N = 109) and pain-free controls (N = 55) provided blood for assessment of CRP, tumor necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-1β, and completed questionnaires related to pain, disability, sleep, and psychological status. LBP participants repeated measurements at 6 months. Biomarkers were compared between LBP and control participants at baseline, and in longitudinal (baseline/6 months) analysis, between unrecovered (≥pain and disability), partially recovered (reduced pain and/or disability) and recovered (no pain and disability) participants at 6 months. We assessed baseline patterns of inflammatory, psychological, sleep, and pain data using hierarchical clustering and related the clusters to recovery (% change in pain) at 6 months. RESULTS CRP was higher in acute LBP than controls at baseline. In LBP, baseline CRP was higher in the recovered than non-recovered groups. Conversely, TNF was higher at both time-points in the non-recovered than recovered groups. Two sub-groups were identified that associated with more ("inflammatory/poor sleep") or less ("high TNF/depression") recovery. CONCLUSIONS This is the first evidence of a relationship between an "acute-phase" systemic inflammatory response and recovery at 6 months. High inflammation (CRP/IL-6) was associated with good recovery, but specific elevation of TNF, along with depressive symptoms, was associated with bad recovery. Depression and TNF may have a two-way relationship. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- David M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Temple University, Philadelphia, USA
| | - Wolbert van den Hoorn
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Paul W Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| |
Collapse
|
20
|
Klyne DM, Barbe MF, Hodges PW. Systemic inflammatory profiles and their relationships with demographic, behavioural and clinical features in acute low back pain. Brain Behav Immun 2017; 60:84-92. [PMID: 27720935 DOI: 10.1016/j.bbi.2016.10.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/28/2016] [Accepted: 10/05/2016] [Indexed: 12/28/2022] Open
Abstract
Systemic inflammation is linked with development and persistence of many pathological pain states. Although chronic phase inflammatory responses are well reported, the acute phase has received limited attention. Here we investigated circulating pro-inflammatory cytokines and C-reactive protein (CRP), and explored their relationships with symptom severity and other factors in acute low back pain (LBP). Ninety-nine individuals within two weeks of onset of acute LBP and 55 pain-free controls completed questionnaires related to their pain (visual analogue scale, VAS) and disability, behaviour, sleep quality and psychological status. CRP, interleukin-6 (IL-6), tumor necrosis factor (TNF) and interleukin-1β (IL-1β) were measured from serum samples. Biomarkers were compared between LBP and control participants, and in a separate analysis, for those with "high-pain" (VAS ⩾4) and "low-pain" (VAS <4). The relationships between biomarkers and all other variables, including other cytokines/CRP were assessed. CRP was higher in LBP than controls and in those with high- than low-pain (p<0.01). IL-6 was higher in those with high- than low-pain (p<0.05), but not controls. Various pain and non-pain factors were associated with each biomarker differently. These findings suggest systemic CRP and IL-6 are important contributors to inflammation in the early post-onset phase of LBP and that various factors can shape these responses.
Collapse
Affiliation(s)
- David M Klyne
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - Mary F Barbe
- Temple University, Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, United States
| | - Paul W Hodges
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Australia.
| |
Collapse
|
21
|
Hiyama A, Watanabe M, Katoh H, Sato M, Sakai D, Mochida J. Effect of depression and neuropathic pain using questionnaires on quality of life in patients with low back pain; cross-sectional retrospective study. Eur Spine J 2016; 25:2750-60. [PMID: 26874952 DOI: 10.1007/s00586-016-4432-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/03/2016] [Accepted: 01/28/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE The present study investigated the percentage of low back pain (LBP) patients who have depressive symptoms and neuropathic pain and analyzed the effects of these on the quality of life (QOL) in these patients. METHODS Of the 650 new patients with LBP that visited the hospital between June 2012 and December 2013, 309 patients who completed questionnaires to assess LBP and QOL were included in the study. The questionnaire included demographic items, the self-rated depression scale (SDS)-Zung, the Japanese version of the PainDETECT questionnaire (PDQ-J), numerical pain rating scale (NRS), and QOL assessments. The patients were divided into two groups according to their SDS-Zung scores: a nondepressed group with SDS scores <40 and a depressed group with SDS-Zung scores ≥50. RESULTS One hundred twenty-five patients (40.5 %) were classified as nondepressed and 63 (20.4 %) as depressed. The mean PDQ-J score was higher in depressed patients than in nondepressed patients. The frequency of neuropathic pain was greater in depressed patients, with neuropathic pain observed in 17 of the 63 (27 %) depressed LBP patients and 11 of the 125 (9 %) nondepressed LBP patients. The SDS-Zung and PDQ-J scores of LBP patients were correlated significantly (r = 0.261, p < 0.001). Depressed patients had higher pain NRS scores and lower QOL scores compared with nondepressed patients. CONCLUSIONS Both the depressed patients and those with neuropathic LBP had a higher level of pain, greater pain-related disability, and poorer QOL compared with nondepressed patients. This is the first study to use the SDS-Zung and PDQ-J screening questionnaires to estimate the presence of neuropathic pain associated with depressive symptoms in LBP patients and to evaluate the impact of these on QOL.
Collapse
Affiliation(s)
- Akihiko Hiyama
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Hiroyuki Katoh
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masato Sato
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Joji Mochida
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| |
Collapse
|
22
|
Richardson SM, Kalamegam G, Pushparaj PN, Matta C, Memic A, Khademhosseini A, Mobasheri R, Poletti FL, Hoyland JA, Mobasheri A. Mesenchymal stem cells in regenerative medicine: Focus on articular cartilage and intervertebral disc regeneration. Methods 2016; 99:69-80. [PMID: 26384579 DOI: 10.1016/j.ymeth.2015.09.015] [Citation(s) in RCA: 308] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 08/10/2015] [Accepted: 09/15/2015] [Indexed: 01/15/2023] Open
Abstract
Musculoskeletal disorders represent a major cause of disability and morbidity globally and result in enormous costs for health and social care systems. Development of cell-based therapies is rapidly proliferating in a number of disease areas, including musculoskeletal disorders. Novel biological therapies that can effectively treat joint and spine degeneration are high priorities in regenerative medicine. Mesenchymal stem cells (MSCs) isolated from bone marrow (BM-MSCs), adipose tissue (AD-MSCs) and umbilical cord (UC-MSCs) show considerable promise for use in cartilage and intervertebral disc (IVD) repair. This review article focuses on stem cell-based therapeutics for cartilage and IVD repair in the context of the rising global burden of musculoskeletal disorders. We discuss the biology MSCs and chondroprogenitor cells and specifically focus on umbilical cord/Wharton's jelly derived MSCs and examine their potential for regenerative applications. We also summarize key components of the molecular machinery and signaling pathways responsible for the control of chondrogenesis and explore biomimetic scaffolds and biomaterials for articular cartilage and IVD regeneration. This review explores the exciting opportunities afforded by MSCs and discusses the challenges associated with cartilage and IVD repair and regeneration. There are still many technical challenges associated with isolating, expanding, differentiating, and pre-conditioning MSCs for subsequent implantation into degenerate joints and the spine. However, the prospect of combining biomaterials and cell-based therapies that incorporate chondrocytes, chondroprogenitors and MSCs leads to the optimistic view that interdisciplinary approaches will lead to significant breakthroughs in regenerating musculoskeletal tissues, such as the joint and the spine in the near future.
Collapse
|
23
|
Lomond KV, Jacobs JV, Hitt JR, DeSarno MJ, Bunn JY, Henry SM. Effects of low back pain stabilization or movement system impairment treatments on voluntary postural adjustments: a randomized controlled trial. Spine J 2015; 15:596-606. [PMID: 25452017 PMCID: PMC4375040 DOI: 10.1016/j.spinee.2014.10.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 09/18/2014] [Accepted: 10/16/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND People with low back pain (LBP) exhibit impaired anticipatory postural adjustments (APAs). OBJECTIVE To evaluate whether current motor retraining treatments address LBP-associated changes in movement coordination during tasks that do and do not require APAs. DESIGN Prospectively registered randomized controlled trial with a blinded assessor. SETTING Outcome evaluations occurred in a university laboratory; treatments were carried out in outpatient physical therapy clinics. PATIENTS Fifteen subjects without LBP and 33 subjects with chronic, recurrent, and nonspecific LBP. INTERVENTION Twelve subjects with LBP received stabilization treatment, 21 received movement system impairment-based treatment, for more than 6 weekly 1-hour sessions plus home exercises. MEASUREMENTS Pre- and post-treatment, surface electromyography (EMG) was recorded bilaterally from trunk and leg muscles during unsupported and supported leg-lifting tasks, which did and did not require an APA, respectively. Vertical reaction forces under the contralateral leg were recorded to characterize the APA. Oswestry disability scores and numeric pain ratings were also recorded. RESULTS Persons with LBP demonstrated an impaired APA compared with persons without LBP, characterized by increased premovement contralateral force application and increased postmovement trunk EMG amplitude, regardless of the task. After treatments, both groups similarly improved in disability and function; however, APA characteristics did not change (ie, force application or EMG amplitude) in either task. LIMITATIONS Treating clinicians were not blinded to treatment allocation, only short-term outcomes were assessed, and main effects of treatment do not rule out nonspecific effects of time or repeated exposure. CONCLUSIONS Movement impairments in persons with LBP are not limited to tasks requiring an APA. Stabilization and movement system impairment-based treatments for LBP do not ameliorate and may exacerbate APA impairments (ie, excessive force application and increased post-movement trunk muscle activation).
Collapse
Affiliation(s)
- Karen V. Lomond
- School of Health Sciences, Central Michigan University, Mount Pleasant, Michigan, USA
| | - Jesse V. Jacobs
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| | - Juvena R. Hitt
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| | - Michael J. DeSarno
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Janice Y. Bunn
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Sharon M. Henry
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| |
Collapse
|
24
|
Lomond KV, Henry SM, Hitt JR, DeSarno MJ, Bunn JY. Altered postural responses persist following physical therapy of general versus specific trunk exercises in people with low back pain. ACTA ACUST UNITED AC 2014; 19:425-32. [PMID: 24853255 DOI: 10.1016/j.math.2014.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 01/22/2014] [Accepted: 04/06/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Interventions that target trunk muscle impairments in people with LBP have been promoted; however, the treatment effects on muscle activation impairments during postural tasks remain unclear. Thus, our objective was to evaluate the effects trunk stabilization vs. general strength and conditioning exercises on the automatic postural response in persons with chronic low back pain (LBP). Fifty-eight subjects with chronic, recurrent LBP (n = 58) (i.e., longer than six months) were recruited and randomly assigned to one of two, 10-week physical therapy programs: stabilization (n = 29) or strength and conditioning (n = 29). Pain and function were measured at 11 weeks and 6 months post-treatment initiation. To quantify postural following support surface perturbations, surface electrodes recorded electromyography (EMG) of trunk and leg muscles and force plates recorded forces under the feet, to calculate the center of pressure. Both groups demonstrated significant improvements in pain and function out to 6 months. There were also changes in muscle activation patterns immediately post-treatment, but not at 6 months. However, changes in center of pressure (COP) responses were treatment specific. Following treatment, the stabilization group demonstrated later onset of COP displacement, while the onset of COP displacement in the strengthening group was significantly earlier following treatment. Despite two different treatments, clinical improvements and muscle activation patterns were similar for both groups, indicating that the stabilization treatment protocol does not preferentially improve treatment outcomes or inter-muscle postural coordination patterns for persons with LBP. CLINICAL TRIAL REGISTRATION NUMBER NCT01611792.
Collapse
Affiliation(s)
- Karen V Lomond
- Health and Exercise Sciences Divison, Central Michigan University, Mt. Pleasant, MI, USA.
| | - Sharon M Henry
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Juvena R Hitt
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Michael J DeSarno
- Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Janice Y Bunn
- Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA
| |
Collapse
|