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Biomedical subjects

C Manniche

Publications and source records attributed to C Manniche.

34 records · Page 2Linked to original sources
PubMed1994

[Postoperative rehabilitation of patients operated for lumbar disk prolapse. An analysis of the socioeconomic consequences].

A new postoperative rehabilitation program consisting of intensive back training without low back pain being the limiting factor has been tested in a clinical trial and found effective compared to a more traditional training program. The objective of the present investigation was to evaluate the social economic consequences (cost-effectiveness analysis) of the introduction of this new program as a general offer for all patients undergoing first time discectomy for a herniated lumbar intervertebral disc in Denmark. Ninety-six consecutive patients operated on at the Dept. of Neurosurgery. Copenhagen County Hospital of Glostrup were randomized into two intervention groups. One group was offered intensive back training and the other group was offered traditional back training. A historical control group was also selected. The effectiveness of the training programmes was evaluated by a "Low Back Pain Rating Scale" and by the number of patients out of employment one year after operation. The social economic evaluation showed that the new intensive training programme was more effective. Savings in medical expenditure are to be expected if the new programme is offered. Further, as more people are to be expected to keep their employment, a production gain for the society can be expected as well as reduced public expenditures on social benefits.

Adult↗
PubMed1994

Peroperative prednisolone fails to improve the clinical outcome following surgery for prolapsed lumbar intervertebral disc. A randomized controlled trial.

Ninety three patients undergoing their first conventional hemilaminectomy for lumbar disc protusion were randomized to a double blind clinical trial. Half of the patients were treated immediately following surgery with prednisolone; 50 mg per day for fourteen days and then 25 mg per day for another 14 days. The other patients were treated for the same time period with placebo tablets. Assessments using subjective and objective outcome criteria at 26 weeks, 52 weeks and 156 weeks of follow-up, demonstrated no statistically significant differences between the randomized groups. It is concluded that systemic prednisolone administration in the pre- and postoperative period does not in this study improve the clinical outcome after first time lumbar discectomy.

Adult↗
PubMed1994

Back pain, sciatica and disability following first-time conventional haemilaminectomy for lumbar disc herniation. Use of "Low Back Pain Rating Scale" as a postal questionnaire.

To determine the value of "Low Back Pain Rating Scale" as a postal questionnaire, a retrospective study was undertaken of patients who had undergone first-time lumbar disc surgery 14-72 months previously. Rate of response was 86% (261/304). From the results, it was concluded that 87% of the patients felt that a satisfactory surgical outcome was obtained; 67% had minor or major functional restrictions of their daily activities; 65% experienced significant low-back symptoms in the period prior to follow-up examination; and 57% experienced sciatica. Thirty-seven patients were receiving pensions in the postoperative period due to continued back pain. "Low Back Pain Rating Scale" used as a postal questionnaire was found to be useful in determining general overall assessment status in patients who had undergone lumbar surgery. This evaluation method could be used as a quality control in future studies regarding this patient group.

Adult↗
PubMed1994

Analysis of preoperative prognostic factors in first-time surgery for lumbar disc herniation, including Finneson's and modified Spengler's score systems.

In a retrospective study, 18 preoperative demographic and physical variables were evaluated for their preoperative prognostic value in 261 patients, following first-time lumbar disc surgery. Special reference was given to the Spengler and Finneson index-scores. "Low Back Pain Rating Scale" was used as the outcome assessment instrument. Comprehensive statistical analysis was undertaken in order to separate only the contingently independent variables. Gender was a highly significant prognostic factor. Other independently statistically significant prognostic factors include dermatomal hypoalgesia, smoking, and the Finneson index score. Results of the study are discussed with reference to the available literature.

Age Factors↗
PubMed1993

[Low back pain and back exercise].

In the last decennium, information regarding the efficacy of back exercises in the treatment of back pain has increased. It has been shown that exercise programs in acute back pain prevents chronicity, and that back exercises in chronic patients decreases back pain and disability. It is primarily the high intensity and duration of the exercise program which is the most important for a successful result rather than the design of the exercises.

Exercise↗
PubMed1993

[Risk factors for development of low back pain].

The incidence, severity and potential disability of low back pain are related, in particular, to previous back complaints, heavy lifting and the general psychosocial environment and to the physical constitution of the individual, viz the endurance of his back muscles. Recommendations for approach to the problem in future are discussed.

Adult↗
PubMed1993

Clinical trial of postoperative dynamic back exercises after first lumbar discectomy.

Ninety-six patients who had undergone first-time discectomy for herniated lumbar intervertebral discs were consecutively randomized to two physical rehabilitation programs: a program of high-intensity, dynamic back extension and abdominal exercises with occurrence of low back pain being the limiting factor or a traditional program of mild, generally mobility-improving exercises within pain limits. Both groups underwent 14 hours of treatment during a 6-week period 5 weeks after surgery. At 26 weeks' follow-up, results indicated that patients who did the high-intensity exercises experienced greater success with regard to the patient disability-index and work capabilities. After 1 year, a trend that favored the use of intensive exercises could be observed. No differences were found in pain or objective measurements. A rehabilitation program of intensive exercises with occurrence of back pain being the limiting factor appears to increase patient behavioral support, resulting in work capacity improvements and patient self-rated disability levels. The results indicate that a 6-wk, 14-hr postoperative rehabilitation program is inadequate if objective postoperative deficit improvements are the desired goal.

Adult↗
PubMed1993

Intensive dynamic back exercises with or without hyperextension in chronic back pain after surgery for lumbar disc protrusion. A clinical trial.

Sixty-two patients with chronic low back pain occurring 14-60 months after undergoing discectomy for the first time were randomized to two physical treatment groups: 24 sessions of intensive dynamic back exercises with hyperextension or 24 sessions of intensive dynamic back exercises without hyperextension. At the conclusion of therapy and at one-year follow-up, no difference was seen between the randomized groups, with regard to the combined assessments of pain, disability and objective measurements. A difference for back exercises without hyperextension to be superior to the other treatment regimen was statistically significant at the three-month follow-up. In the patient's qualitative assessment of treatment outcome there were seen no significant differences between back exercises with or without hyperextension. There was a similar and significant improvement of the isometric endurance of back muscles in both groups, but the flexibility of the spine was significantly improved only in the group using hyperextension exercises. The overall response rate of an earlier published investigation was reproduced. It is concluded that chronic back patients after first time discectomy may benefit from an intensive rehabilitation protocol including intensive exercises. The added use of hyperextension exercises does not confer any independent benefit. Furthermore, the training had to continue for more than 2-3 months before a statistical significant decrease in back pain was reported in the patient pain diary.

Adult↗
PubMed1989

[Back exercises for patients with chronic low back pain].

The training therapy, which most back therapists consider an indispensable basic element in attempts to treat chronic low back pain, is reviewed, with an historical survey and description of the basic research in the field. Epidemiological studies show concurrence between chronic low back pain and reduced endurance of the back musculature and that the combination of a weak back and a back-straining occupation greatly increases the risk of low back trouble. On the basis of these studies, it is concluded that use of isometric back exercises in low dosage, which are central to the internationally acknowledged Swedish back school, only results in strengthening and increased endurance of the back muscles with difficulty. The author recommends introduction of intensive dynamic back extensor exercises which result in strength and endurance of the muscles. The back muscle training ought to be lifelong; thus, the exercises must be simple, learned over a longer period of time, so that the patients perceive the training as a natural and necessary part of everyday life.

Back Pain↗
PubMed1989

[Intensive dynamic back exercises for patients with chronic low back pain. A controlled study].

The effect of intensive dynamic back extensor exercises for patients with chronic low back was investigated in a controlled clinical trial where the patients underwent a three months intensive training program a total 30 sessions. The 105 patients were divided into three groups: a treatment group, an alternative group which underwent 1/5 of the treatment group's exercise program per session, and an alternative group in which the treatment consisted of thermotherapy, massage and mild exercise. Regardless of whether the outcome of treatment is assessed qualitatively or quantitatively, a statistically significant, favourable difference was found between the results for the treatment group and those for the alternative groups. The therapy was found to be without risk, but patients with clinical signs of current lumbar nerve root compression or radiological signs of spondylolysis or halisteresis of the column were excluded from the study. The authors recommend the introduction of this form of treatment as a general offer in the primary and secondary health sector. Back exercises can advantageously be conducted in a group; thus, the resources required for this treatment do not differ significantly from those required for many of the other forms of treatment generally employed, which often require individual attention.

Adult↗
PubMed1987

Randomised study of the influence of non-steroidal anti-inflammatory drugs on the treatment of peptic ulcer in patients with rheumatic disease.

Sixty-seven patients with rheumatic disease, treated with non-steroidal anti-inflammatory drugs (NSAIDs), entered a controlled trial with a diagnosis of duodenal (n = 51), gastric (n = 14), or gastric and duodenal (n = 2) ulcers. The main objectives of the study were a comparison of ranitidine and sucralfate in ulcer treatment, and to observe the influence of continued NSAID administration during peptic ulcer therapy. Ulcers healed within nine weeks in 52 patients. The mean healing time was similar in 27 patients given ranitidine 150 mg bd (4.9 weeks) and 25 patients given sucralfate 1 g qid (4.6 weeks). In patients with unhealed ulcers after nine weeks of treatment, healing was obtained in seven after further therapy for 3-9 weeks. Of the 30 patients who continued NSAIDs during treatment with either ranitidine or sucralfate, 23 ulcers healed (mean healing time: 5.0 weeks). Of 32 patients in whom NSAIDs were stopped, ulcer healing was documented in 29 (mean healing time: 4.6 weeks). The difference in healing rates was not statistically significant (p greater than 0.10). The outcome of ulcer treatment did not differ in patients with rheumatoid arthritis and patients suffering from osteoarthritis. During a 12 month follow up 14 symptomatic ulcer recurrences were recorded.

Adult↗
PubMedDate not supplied

Clinical trial of intensive muscle training for chronic low back pain.

105 patients who had chronic low back pain without clinical signs of lumbar nerve root compression or radiological evidence of spondylolysis or osteomalacia were randomised to three treatments: 30 sessions of intensive dynamic back extensor exercises over three months; a similar programme at one-fifth the exercise intensity; or one month of thermotherapy, massage, and mild exercises. The results consistently favoured intensive exercise, which had no adverse effects. Since these exercises can be conducted in groups, the intensive programme is no more costly than conventional strategies that require individual attention.

Activities of Daily Living↗