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At least 217 records · Page 12Linked to original sources
PubMed2003

Disappearance of back-to-back high-pT hadron correlations in central Au+Au collisions at sqrt[s NN ] =200 GeV.

Azimuthal correlations for large transverse momentum charged hadrons have been measured over a wide pseudorapidity range and full azimuth in Au+Au and p+p collisions at sqrt[s(NN)]=200 GeV. The small-angle correlations observed in p+p collisions and at all centralities of Au+Au collisions are characteristic of hard-scattering processes previously observed in high-energy collisions. A strong back-to-back correlation exists for p+p and peripheral Au+Au. In contrast, the back-to-back correlations are reduced considerably in the most central Au+Au collisions, indicating substantial interaction as the hard-scattered partons or their fragmentation products traverse the medium.

Journal Article↗
PubMed2005

[On functional area of Back-shu based on relationship between Back-shu points and Jiaji points].

OBJECTIVE: To prove the existence of functional area of Back-shu and provide a new thinking for clinical practice. METHODS: The consistency between the Back-shu points and Jiaji points at the same level of spinal column was discussed from the origin and development, mechanisms and clinical application of Back-shu and Jiaji points. CONCLUSION: The points at the same level of spinal column has same origin of development, mechanisms and clinical functions, so as to prove the existence of functional area of Back-shu.

Acupuncture Points↗
PubMed1993

Rapid back to back adenosine stress/rest technetium-99m teboroxime myocardial perfusion SPECT using a triple-detector camera.

Technetium-99m-teboroxime is characterized by a high extraction fraction over a wide range of blood flow rates, rapid myocardial clearance and avid hepatic uptake. This study determined the imaging parameters and examined the clinical efficacy of a rapid back to back adenosine stress/rest teboroxime myocardial perfusion SPECT protocol using a triple-detector camera. Acquisition parameters were determined using cardiac phantom studies which were then applied in SPECT studies of 51 catheterized patients (22 with prior myocardial infarction) and 20 patients with a "low" (7.9% +/- 4.3%) likelihood of coronary artery disease. Technetium-99m-teboroxime (20-25 mCi) was injected at the third minute of adenosine infusion. Teboroxime (20-25 mCi) was also injected at rest, 15 min later. Stress followed by rest SPECT were completed within 25 min using a triple-detector camera and sequential, 1-min continuous rotations in alternating directions. Summed raw data from the first to second (1-2 min), second to third (2-3 min) and second to fifth (2-5 min) minutes of imaging following stress teboroxime injection were reconstructed and compared for image quality, degree of liver interference, and accuracy for diagnostic efficacy. In a subgroup of 30 patients, 2-8-min summed images were also reconstructed to compare this more conventional imaging protocol with our rapid acquisition. Image quality was fair to good in 75% of the 1-2-min, 84% of the 2-3-min and 2-5-min studies and 53% of the 2-8-min scans. The frequency of severe liver interference appeared to increase with the duration of imaging time (1-2 min: 3%; 2-3 min: 7%; 2-5 min: 8%) and was greatest (30%, p = 0.08) with 2-8-min images. Three patients (4%) had uninterpretable studies due to intense hepatic uptake. Overall sensitivity (95%) and specificity (71%) were equal for the 2-3-min and 2-5-min stress images and appeared better than in the 1-2-min images (84% and 57%, respectively). For the 2-8-min scans, vessel sensitivity (69%) and specificity (63%) appeared poorer than with 2-3-min studies (83% and 81%, respectively). Normalcy rates were 89% for the 2-3-min and 2-5-min and 79% for 1-2-min images. The back to back adenosine stress/rest teboroxime SPECT can be performed in 30 min using a triple-detector camera. Although overall high sensitivity and normalcy rates were achieved, the protocol is technically demanding. Interference due to intense liver uptake remains problematic.

Adenosine↗
PubMedDate not supplied

Flexion-relaxation phenomenon in the back muscles. A comparative study between healthy subjects and patients with chronic low back pain.

At a certain position of trunk flexion, there is a sudden onset of electrical silence in back muscles. This is called "flexion-relaxation (F-R) phenomenon." The goals of this study were (1) to evaluate the relationship between flexion angle and activity of back muscles during flexion movement and (2) to determine what the difference is between healthy subjects and patients with chronic low back pain (CLBP). Twenty-five healthy subjects (13 males and 12 females; average age, 28.3 yr) and 20 patients with CLBP (12 males and 8 females; average age, 34.1 yr) volunteered for this study. The subjects were asked to flex forward maximally from the erect position and to maintain full flexion, followed by returning to the initial upright position. Flexion angle of trunk and hip was measured during the examination. Electromyographic activity of erector spinae was also monitored simultaneously. F-R phenomenon was observed in all healthy subjects before reaching the maximum flexion. Electrical silence continued even after extending the trunk began. In contrast, no patients with CLBP demonstrated F-R phenomenon. A significant difference in muscular activities of erector spinae between the groups was obtained when returning to the erect position from the maximum flexion. Moreover, time lag between trunk and hip movement was much greater in patients than in healthy subjects. This study demonstrated that neuromuscular coordination between trunk and hip could be abnormal in patients with CLBP.

Adult↗
PubMed2002

[Deficits in the psychological care of low back pain patients--Comments on the expertise of the expert committee for the health care system regarding low back pain].

A committee of health specialists examined the demand characteristics and efficiency of German health care services and published an expertise on the misallocation of services that among other subjects also covered the area of low back pain. Although we agree with their principal statements, we like to underscore that the objectives mentioned in the report cannot be achieved without the participation of psychologists. The process of chronicity is determined in a significant way by psychological mechanisms. Psychologists investigated these mechanisms, developed interventions for the prevention and treatment of low back pain on the basis of the results, and tested their efficacy in trials with a high methodological standard. Incorporation of psychological expertise does not only optimise prevention and treatment of low back pain and helps to prevent unnecessary suffering of the afflicted, in addition, it offers a contribution a cost containment.

Delivery of Health Care↗
PubMed2006

Danish version of the Oswestry disability index for patients with low back pain. Part 2: Sensitivity, specificity and clinically significant improvement in two low back pain populations.

In studies evaluating the efficacy of clinical interventions, it is of paramount importance that the functional outcome measures are responsive to clinically relevant change. Knowledge thereof is in fact essential for the choice of instrument in clinical trials and for clinical decision-making. This article endeavours to investigate the sensitivity, specificity and clinically significant improvement (responsiveness) of the Danish version of the Oswestry disability index (ODI) in two back pain populations. Two hundred and thirty three patients with low back pain (LBP) and/or leg pain completed a questionnaire booklet at baseline and 8 weeks follow-up. Half of the patients were seen in the primary (PrS) and half in the secondary sectors (SeS) of the Danish Health Care System. The booklet contained the Danish version of the ODI, along with the Roland Morris Questionnaire, the LBP Rating Scale, the SF36 (physical function and bodily pain scales) and a global pain rating. At follow-up, a 7-point transition question (TQ) of patient perceived change and a numeric rating scale relating to the importance of the change were included. Responsiveness was operationalised using three strategies: change scores, standardised response means (SRM) and receiver operating characteristic (ROC) analyses. All methods revealed acceptable responsiveness of the ODI in the two patient populations which was comparable to the external instruments. SRM of the ODI change scores at 2 months follow-up was 1.0 for PrS patients and 0.3 for SeS (raw and percentage). A minimum clinically important change (MCID) from baseline score was established at 9 points (71%) for PrS patients and 8 points (27%) for SeS patients using ROC analyses. This was dependable on the baseline entry score with the MCID increasing with 5 points for every 10 points increase in the baseline score. We conclude that the Danish version of the ODI has comparable responsiveness to other commonly used functional status measures and is appropriate for use in low back pain patients receiving conservative care in both the primary and secondary sector.

Denmark↗
PubMed2000

Influence of age and duration of symptoms on fibre type distribution and size of the back muscles in chronic low back pain patients.

Many studies have documented an association between chronic low back pain (LBP) and deficits in back muscle strength and endurance. The sub-optimal performance is believed to be the result of alterations in the size and structure of the muscle, although the long-standing issue of whether the observed changes precede or are a consequence of the pain remains unresolved. If consequent to the problem, and predominantly related to disuse of the muscles, then it may be expected that a relationship between muscle structure and symptom duration would exist. Lumbar paraspinal muscle samples were obtained from 59 chronic LBP patients using the percutaneous biopsy technique. The samples were subject to routine histochemical analysis for the examination of muscle fibre type characteristics and cytochemical architectural changes. In 55 of the patients, the gross cross-sectional areas of magnetic resonance images of the trunk muscles were also measured. Multivariate analysis showed that symptom duration was the strongest predictor of the individual proportions of the fast-fatigable type IIX fibres; with age and gender included in the model, nearly 30% of the variance in fibre type distribution could be accounted for. Duration of pain had no influence on fibre size. Gross muscle cross-sectional area correlated directly with lean body mass and inversely with age, but showed no relationship with symptom duration. Pathological changes in the internal fibre structure were more frequently encountered in older patients, and were independent of symptom duration. The results suggest that, over the long term, fibre type transformations rather than alterations in fibre size are the predominant changes to be found in the muscles of chronic LBP patients. The direction of change supports the results of many previous studies that have demonstrated corresponding differences in the fatigability of the muscles. There is a strong case for the early implementation of active measures to attempt to offset the development of these changes in back pain patients.

Adult↗
PubMed1996

Influence of previous pain experience on the episode incidence of low back pain: results from the South Manchester Back Pain Study.

BACKGROUND: A pathological cause cannot be identified for most new episodes of low back pain (LBP) presenting to the general practitioner. One important potential influence on susceptibility is previous pain experience. To accurately investigate the contribution of this phenomenon to the onset of new episodes of LBP a prospective population study is required. AIMS: To determine the relationship of prior pain in the back and other musculoskeletal sites to risk of subsequent new episodes of LBP. METHODS: The population studied included all 2715 adults from the South Manchester Back Pain Study who were free of LBP during the month prior to the baseline survey. At baseline a detailed musculoskeletal pain history was obtained. New episodes of LBP over the subsequent 12 months were ascertained by: (i) prospectively monitoring all primary care consultations in the study cohort (consulting episodes) and (ii) a follow-up survey after 1 year to determine new episodes during that 12-month period not leading to consultation (non-consulting episodes). RESULTS: The 12-month cumulative incidence of new consulting episodes was 3% in males and 5% in females, and for new non-consulting episodes 31% in males and 32% in females. Those with a history of previous LBP had twice the rate of new episodes, both consulting and non-consulting, compared to those with no LBP in the past. Neck pain or pain in other musculoskeletal sites at baseline also doubled the risk of a subsequent new episode of LBP. Adjusting for psychological distress and the other pain variables had little influence on the findings. CONCLUSION: In those currently free of LBP a previous history of the symptom substantially increases the risk of a further episode, with pain in other sites an equally strong independent predictor of subsequent LBP.

Adolescent↗
PubMed2006

Spinal cord stimulation in complex regional pain syndrome and refractory neuropathic back and leg pain/failed back surgery syndrome: results of a systematic review and meta-analysis.

The drive for good quality evidence has highlighted the importance of well-conducted systematic reviews and meta-analyses that critically evaluate and grade studies for new or existing therapies. A systematic review and meta-analysis was performed to review the efficacy, safety, and cost effectiveness of spinal cord stimulation (SCS) in complex regional pain syndrome (CRPS) and refractory neuropathic back and leg pain/failed back surgery syndrome (FBSS). The results support the use of SCS in patients with refractory neuropathic back and leg pain/FBSS (Grade B evidence) and CRPS type I (Grade A evidence)/type II (Grade D evidence). SCS not only reduces pain, improves quality of life, reduces analgesic consumption, and allows some patients to return to work, with minimal significant adverse events, but may also result in significant cost savings over time.

Back Pain↗
PubMed2006

Neurostimulation for chronic neuropathic back pain in failed back surgery syndrome.

Failed back surgery syndrome (FBSS) is defined as persistent or recurrent pain, mainly in the lower back and/or legs, even after previous anatomically successful spinal surgery. Treatment of such patients is difficult, with conservative therapy and repeated back surgery often proving unsuccessful at providing adequate pain relief. Spinal cord stimulation (SCS) is a minimally invasive procedure that allows physicians and patients to inexpensively evaluate the response to therapy before permanent implantation. Both trial stimulation and permanent implantation are fully reversible. Early treatment with SCS has been shown to be very effective in well-selected FBSS patients and should be considered instead of reoperation. Clinical studies have demonstrated that SCS provides a sustained, long-term, 50% or more reduction in pain in over 60% of patients and allows concomitant pain medication to be reduced. The substantial improvements in quality of life and functional status permit many patients to return to work. Patients express great satisfaction with SCS and minimal side effects are observed. Moreover, SCS has been shown to be a cost-effective alternative to conventional therapies. Thus, SCS is the treatment of choice in medically refractory FBSS patients where recurrent neuropathic pain persists after surgery and analgesics are no longer effective or accompanied by intolerable side effects.

Back Pain↗
PubMed2006

Preventing chronic back pain: evaluation of a theory-based cognitive-behavioural training programme for patients with subacute back pain.

OBJECTIVE: For long-term treatment effects, patients with subacute back pain need to adhere to treatment recommendations beyond the prescribed exercise treatment. Adherence rates are as low as 30%, so we developed a cognitive-behavioural training programme to enhance patients' self-efficacy, maximise severity perceptions and reduce barrier perceptions. METHOD: A 2 x 4 (group x time) repeated measurement design was applied. Forty-seven patients with non-specific, subacute back pain were randomly assigned to a training group (exercise treatment plus cognitive-behavioural training programme) or a control group (exercise treatment only). RESULTS: Repeated measures ANOVA revealed significant main and interaction effects; the training group reported enhanced self-efficacy and severity perceptions, reduced barrier perceptions, and self-reported that they exercised more often than the control group over time. However, no group differences regarding pain intensity emerged. CONCLUSION: Our findings demonstrate that a short and inexpensive cognitive-behavioural training programme is an effective tool to enable back pain patients to follow treatment recommendations on a regular basis. PRACTICE IMPLICATIONS: The short and simple intervention can easily be conducted by personnel, other than psychologists, i.e., physiotherapists.

Adult↗
PubMed1991

Variations in balance and body sway in middle-aged adults. Subjects with healthy backs compared with subjects with low-back dysfunction.

In a preliminary investigation of 45 middle aged adult subjects, 20 with low-back pain (LBP) and 25 with healthy backs (HB), balance responses (body sway) were measured under different sensory conditions with computerized force plate stabilometry. Compared with HB subjects, in the most stable and then the least stable balance positions, the LBP subjects demonstrated significantly greater postural sway, kept their center of force (COF) significantly more posterior, and were significantly less likely to be able to balance on one foot with eyes closed. Based on subjective observations, the LBP subjects were more likely to fulcrum about the hip and back to maintain uprightness in challenging balance tasks compared with healthy controls who maintained their fulcrum for the COF around the ankle. Research is needed to determine the incidence of balance problems in LBP patients compared with controls. Effective physical therapy assessment and treatment of LBP patients may require attention to postural alignment, strength, flexibility, joint stability, balance reactions, and postural strategies.

Adult↗
PubMed1992

Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.

The interexaminer reliability of an inclinometer procedure to measure lumbar rotation was evaluated by two chiropractic clinicians who examined 25 chronic (greater than 6 months) low-back pain patients and 25 subjects without low-back pain. These groups were compared for differences in mean left, right, and total rotation. Patients who had lumbar spinal surgery were excluded. Twenty-eight men and 22 women, ranging in age from 28-38 years, were evaluated. Reliability between examiners was evaluated by Pearson's correlation coefficient and the intraclass correlation coefficient. All coefficients were significant (P less than 0.01). Errors in prediction and examiner disagreement were evaluated by the standard error of estimate and the interexaminer measurement error. The standard errors of estimate (range: 1.4-4.4) and the interexaminer measurement errors (range: 3.8-10.4) were large compared to the scale of measurement. An analysis of variance of differences between the chronic low-back pain patients and asymptomatics revealed significantly more left rotation in the asymptomatic subjects (F = 8.4; df = 1; P less than 0.006). Also, there was significantly more total rotation in the asymptomatic subjects (F = 4.143; df = 1; P less than 0.048). However, because of the large error attributed to this procedure, it is not possible to say whether the difference between the two groups is a result of the large error or some "real" difference. Therefore, the procedure described in this study should not be used as a clinical outcome measure.

Adult↗
PubMed1994

Distinguishable groups of musculoskeletal low back pain patients and asymptomatic control subjects based on physical measures of the NIOSH Low Back Atlas.

STUDY DESIGN: The authors performed an empirical prospective study of 115 patients referred to physical therapy for low back pain and 112 control subjects of similar age and gender. OBJECTIVES: The authors defined and compared subgroups based on physical tests and described demographic and psychosocial characteristics by group. SUMMARY OF BACKGROUND DATA: Prospective studies of intervention for persons with low back pain are limited by inability to randomize subjects into distinguishable groups. Previous attempts have not been empirical and have not focused on musculoskeletal LBP. METHODS: Ten physical therapists administered 52 tests and 6 questionnaires to subjects in seven different clinics. Data were subjected to reliability and cluster and comparative analyses. RESULTS: Tests were reliable. Groups were distinguished by measures of symmetry, flexibility, strength, and dynamic mobility. CONCLUSION: Distinguishable groups can be determined; decreased trunk mobility characterized all groups of patients and imbalances in muscle length, strength, and symmetry described specific groups of subjects with and without low back pain.

Cluster Analysis↗
PubMed1977

Symposium on arthritis in older persons. Section III. Osteoarthritis and back pain. Examination of the back in the geriatric patient.

Older people often complain of back pain, but it usually is not a major complaint except in the presence of serious disease such as malignancy, compression fractures from osteoporosis, or disc-space infections. When back pain is a serious symptom in the elderly patient, the physician should look beyond the obvious evidences of degenerative joint disease for these other more serious conditions. Satisfactory examination of the back does not require an undue amount of time. It is important that it be done systematically. Simple, rapid, and adequate procedures are described.

Aged↗
PubMed1981

Evaluation of low back pain and assessment of lumbar corsets with and without back supports.

A method is described for evaluating the progress of patients with back pain. Various symptoms were scored on analogue scales and spinal motion was measured by various techniques. These data were integrated to make subjective and objective indices respectively. Reasonable reproducibility of the measurements was obtained. This technique was used to elucidate the role of the lumbar support in surgical corsets in relief of back pain. Sufferers from back pain were randomly allocated to corsets with and without lumbar supports. There was significant improvement in those with a support compared with those without. On the other hand objective changes measured with the corset removed did not differ between the 2 groups. This study indicates that the spinal support in a lumbosacral corset makes a significant contribution towards the relief of symptoms.

Adult↗
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↗