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At least 775 records · Page 43Linked to original sources
PubMed1999

A back school program at the Toulouse-Purpan teaching hospital. Evaluation of 144 patients.

UNLABELLED: This article reports our experience with a five-day back school program focusing on active exercises, safe lifting, and occupational therapy. PATIENTS AND METHODS: The medical charts of 144 back school patients were reviewed retrospectively. Age, gender, type of low back pain, radiological findings, impact on work and psychological well-being, surgical history, and history of prior back school experience were recorded on the first and last back school session days (D1 and D5), after six months (M6), and after 12 months (M12). Efficacy was evaluated based on the number of days off work, Schöber's index, a visual analog scale pain score, and scores evaluating the active exercise, safe lifting, and occupational therapy techniques taught during the back school course. RESULTS: All evaluation scores were significantly better on D5 than on D1. This effect was sustained over time. The pain score fell by 50% between D1 and D5 (32.6 +/- 23.1 versus 16.3 +/- 18.5) and remained low at M6 and M12 (18.1 +/- 19.5 and 14.8 +/- 19.3) The number of days off work fell dramatically from baseline to M6 (51.2 +/- 63.8 vs 9.8 +/- 38.8) and remained low at M12. Forty-four patients were lost-to-follow-up between D5 and M6. CONCLUSION: Back school interventions are helpful in preventing recurrences of low back pain. Our promising data deserve to be confirmed in a larger study involving quality of life assessments, determination of the number of physician visits for low back pain during the M0-M6 and M6-M12 periods, and a comprehensive evaluation after 18 months.

Adult↗
PubMed2003

How common is back pain in Al-Qaseem region.

OBJECTIVE: The aim of this study was to estimate the prevalence of back pain in the adult population of Al-Qaseem Central Province, Kingdom of Saudi Arabia and to find associated features and factors. METHODS: A house-to-house survey covering 1,000 household in the towns and villages of Al-Qaseem province was carried out over a period of 18 months extending from September 1993 until the end of February 1995. A total of 5,894 adults, aged 16 years and above, were questioned by trained staff regarding back pain, and the demographic data in addition to general, medical and social history. RESULTS: A response was obtained in 5,743 (97.4%). Their mean age was 34.14 15.16 (range 16-99). Back pain was reported by 1,081 (18.8%), wherein 499 (8.8%) were men, and 574 (10%) were women. Back pain was more prevalent in married (23.3%) individuals than unmarried (6.4%). Adjusted odds ratio (OR) for back pain in married individuals was 1.88 (95% confidence intervals [CI] 1.49-2.37). Back pain was strongly correlated with age (correlation coefficient = 0.378 P < 0.01). It also showed significant correlation with weight and height, depression, family history of back pain, change in work ability, frequency of attendance at local doctor, use of medication and lower education level. The association with body mass index became evident only after comparing the heaviest 20th percentile to the lightest (OR 1.335 [95% CI, 1.279-1.402]). Certain occupational status (unemployed, farmers, professional workers and housewives) were associated with back pain. CONCLUSION: Back pain was relatively common in this largely unindustrialized community although its prevalence is lower than reported from some western countries.

Adolescent↗
PubMed2005

Longterm reduction of back pain risk in women with osteoporosis treated with teriparatide compared with alendronate.

OBJECTIVE: To compare the effects on back pain of teriparatide versus alendronate, we analyzed the reporting of back pain in a head to head comparator trial and a followup study. METHODS: In the comparator trial, women were randomized to receive either daily self-injected teriparatide 40 microg plus an oral placebo (n = 73), or daily oral alendronate 10 mg plus self-injected placebo (n = 73). Treatment was for a median 14 months. After completion of the comparator trial, 72% of these patients enrolled in a nontreatment followup study. Adverse events were recorded at each comparator trial visit and followup study visit, and the incidence of new or worsening back pain in each group was compared. RESULTS: During the comparator trial, compared with women randomized to alendronate 10 mg, women randomized to teriparatide 40 microg had reduced risk for any back pain (relative risk 0.27, 95% CI 0.09-0.82) and moderate or severe back pain (relative risk 0.19, 95% CI 0.04-0.86). The differences in the reporting of back pain between the teriparatide treated women and the alendronate treated women were sustained during an interval including the comparator trial plus 18 additional months. During an interval including the comparator trial plus 30 additional months, teriparatide treated patients had numerically fewer occurrences of back pain and moderate or severe back pain. CONCLUSION: Compared with women randomized to alendronate 10 mg, women randomized to teriparatide 40 microg had reduced risk of back pain during the trial and 2.5 years of followup.

Aged↗
PubMed2005

[Occupational aspects of low back pain].

Low back pain is a very common ailment among workers of all ages. Approximately 60-90% of the adult population suffers from low back pain at least once during their life time. The yearly incident rate of low back pain is about 1-2%. This is one of the major causes of occupational illnesses and absence from work. A high rate of low back pain is found among workers involved with heavy physical labour and also among truck drivers. Risk factors for low back pain are intense heavy labour, lifting heavy objects, protracted static positions, repetitive movements and awkward body postures accompanied by vibration. Prolonged standing and sitting are not risk factors for low back pain. Work dissatisfaction, low wages and low levels of education are possible predictors for low back pain. The only reliable predictor of future low back pain is the evidence of previous back pain as disclosed during the preemployment health examination.

Automobile Driving↗
PubMed1991

Back injury prevention program on a spinal cord injury unit.

A back injury prevention program was developed for the Spinal Cord Injury (SCI) nursing staff at the San Diego Veterans Affairs Medical Center (SDVAMC). This preventive program has the following components: 1. All nursing staff are sent to a one hour "back school" in order to learn and practice proper body mechanics. This program is held in the therapy clinic and conducted by a kinesiotherapist. In addition, each nurse must be certified in transfer techniques by our clinical nurse specialist, before performing transfers on patients. 2. All nursing staff participate in 5-10 minutes of stretching, warm-up exercises at the beginning of their shift. These exercises are helpful as injuries are less likely to occur when muscles have been warmed up prior to lifting and moving patients. 3. All nursing staff wear a lumbar sacral back support while on duty. This device will offer physical support to the lower back as well as provide a mental reminder to use proper body mechanics when transferring patients. This back injury prevention program has been in effect since the opening of the SCI unit in March 1989. The rate of low-back injuries on the SCI unit from October 1989 to September 1990 was compared to the rate of low-back injuries on the other hospital units. As a result of this program, there were only four low-back injuries with six lost work days on the SCI unit. This rate compares favorably with the incidence of low-back injuries in other patient care areas.

Back Pain↗
PubMed1990

Fatigue, recovery, and low back pain in varsity rowers.

The purpose of this study was to determine whether surface electromyography (EMG) from the erector spinae muscles could correctly identify individuals with low back pain without a population of elite athletes. A similar technique had previously been successful in identifying low back pain patients within a non-athletic population. A Back Analysis System was used to compute the median frequency of the EMG power density spectrum to monitor metabolic changes in back muscles associated with muscle fatigue. Twenty-three members of a men's collegiate varsity crew team consisting of port (N = 13) and starboard (N = 10) rowers were tested in a laboratory during a fatigue-inducing isometric contraction sustained at a relatively high, constant force. Six of the rowers tested were further classified as having low back pain. A brief test contraction was repeated at a fixed interval following the fatiguing contraction to monitor recovery. A two-group discriminant analysis procedure correctly classified 100% of the rowers with low back pain and 93% of the rowers without back pain on the basis of the median frequency data. The median frequency parameters related to recovery were the best discriminators of back pain. A similar analysis correctly classified 100% of the port rowers and 100% of the starboard rowers on the basis of their spectral parameters. The best discriminating variables in this instance were the median frequency parameters relating to both fatigability and recovery. Results from this study demonstrate that low back pain and asymmetrical muscle function in rowers can be assessed on the basis of EMG spectral analysis.

Adult↗
PubMed1989

Back strengthening exercises: quantitative evaluation of their efficacy for women aged 40 to 65 years.

In this prospective study, the efficacy of exercise on the strength of the back extensors was evaluated. Fifty healthy women volunteers, aged 40 to 65 years (mean = 56 years), participated in a back exercise program. Subjects were screened to exclude those with diseases or treatment programs that could affect muscle strength. Seventeen subjects participated in a conventional back strengthening program, consisting mainly of antigravity upper back extension exercises in the prone position. Thirty-three control subjects continued to perform their usual athletic and daily physical activities. The control group were postmenopausal women who had volunteered to participate in a study of the effect of back strengthening exercises on bone mineral density. Subjects were blindly assigned to the control group without any selection procedures. We used this group as the control for this study because two studies were performed concurrently, and it seemed unnecessary to have two control groups. All subjects were instructed in proper posture principles. Physical activity and back extensor strength were evaluated every four to six weeks for three months. Milestones were completed by 16 subjects in the exercise group and 31 control subjects. The strength of the back extensors was significantly increased (p less than 0.001) in the exercise group. This study indicates that the back extensors can be strengthened with conventional back extension exercise.

Adult↗
PubMed1980

Evaluation and prediction of back pain during military field service.

Questions regarding back pain in different body positions and earlier sick-listing due to back disorders have been answered by 5093 men aged 23--47 (average age 37) who were about to do military field service. Fifty-three % reported that they had had back pain at some time and 14% stated that they had been sick-listed for more than one month in all due to back troubles. A subsample was subjected to a standardized physical examination of the back, average examination time 9 min, and the frequency and location of pain, stiffness of other impairments are given. Subjects who experienced back pain during the field service and whose military post was physically heavier than their civilian occupation had on an average lower isometric strength in abdominal muscles as well as in back muscles than other subjects. The physical examination of the lumbar spine was more efficient in separating subjects who experienced back pain during military field service, than information on earlier sick-listing due to back troubles and heaviness of the military post as compared to civilian occupation.

Abdominal Muscles↗
PubMed1995

[Back problems in conscripts. A 10-year follow-up].

One hundred and twenty-three conscripts called up for national service in 1979-80 were re-examined 10 years after call up with a questionnaire identical to one answered at the time of call up. The study group consisted of three subgroups. Group A had been rejected for service because of back problems (back-rejects). Group B were conscripts with back symptoms at the time of call up, but all completed their national service (non back-rejects). Group C did not have back symptoms at the time of call up. The back-rejects had a significantly higher incidence of: back pain; radiating pain to lower extremities; contacts (hospital, G. P., radiographs etc.) and sick leave from job as compared to group B and C. Out of 19 conscripts with radiographically verified Mb. Scheuermann, 89% had back symptoms at the time of follow-up including all with lumbar and thoracolumbar Mb. Scheuermann. All conscripts in this study had a job at follow-up. It is recommended that the criteria for rejection of conscripts in Denmark concerning back symptoms and Mb. Scheuermann remains unchanged.

Adult↗
PubMed1995

Reporting of acute low back pain in a telephone interview. Identification of potential biases.

STUDY DESIGN: This was a survey of 235 individuals with and 132 individuals without documented low back pain. OBJECTIVES: To approximate the magnitude of potential reporting biases in estimates of prevalence of and medical care use in low back pain. SUMMARY OF BACKGROUND DATA: The use of survey techniques presents several possible biases in the reporting of acute symptoms. These biases are especially pertinent in musculoskeletal symptoms, which often are recurrent and not life-threatening. METHODS: Two-hundred-thirty-five patients with acute low back pain were contacted by telephone 4-16 months after their physician visit and surveyed regarding the presence and date of back pain episodes. One-hundred-thirty-two patients who had no functionally disabling back pain on physician interview were interviewed. RESULTS: Of the patients who had sought care for back pain, 21% indicated they had not had back pain when interviewed 4-16 months later. Episodes of pain that occurred more than 8 months before the interview tended to be recalled as occurring more recently than they actually occurred, confirming "forward telescoping" of the illness episode. Only 3% of the individuals without functionally impairing pain reported such pain on a separate interview. CONCLUSIONS: Lack of recall occurs regarding acute low back pain, usually a self-limited illness. This potential under-estimate of back pain prevalence may be balanced by forward telescoping of the date of illness occurrence.

Acute Disease↗
PubMed1994

[Back school as a preventive measure against backache: method of intervention or neurotigenic method?].

The therapeutic objectives of conventional back schools are a) instruction of people with and without back pain to use their backs according to currently accepted ergonomic principles, b) improvement of the cardiovascular performance of back school participants and c) acquisition of knowledge of simple methods of pain and stress management. Due to the diversity of back pain causes and the biopsychosocial complexity of back pain as the therapeutic target, back schools can never be the sole solution of a multifaceted problem. The prime objectives of this review are to describe the recent back school curriculums and to define possible therapeutic components of future back schools.

Activities of Daily Living↗
PubMed1996

Back pain in aircrew--an initial survey.

BACKGROUND: In the early 1990's staff at a Royal Naval Air Station formed the view that pilots and observers of the Navy Lynx helicopter fleet appeared to have a higher incidence of back pain, to be seeking medical assistance more frequently and to be spending more time medically "unfit to fly" when compared to their counterparts in other helicopters. HYPOTHESIS: To quantify the incidence of low back pain in helicopter aircrew by use of a questionnaire. METHODS: A questionnaire was used to establish the prevalence and nature of back pain in Naval aircrew (161) compared to a control group of randomly selected non-flying military personnel (310). RESULTS: Results show that aircrew (82%) experience significantly more back pain than controls (52%) (p < 0.01) though the nature of pain was similar in both groups. Significantly more aircrew (73%) than controls (49%) (p < 0.01) reported a previous history of back pain and report pain in shoulders (19%), midback (42%), lower back (72%) and across the buttocks (12%). Ergonomic factors were thought to be causative. Of aircrew surveyed, 11 (8%) had been issued with personal lumbar supports which resulted in major subjective improvements in flight-related symptoms. CONCLUSIONS: Helicopter aircrew have a higher incidence of back pain. Crew station design was identified as a major contributor to the prevalence of back pain while personal supports reduced the levels of discomfort. While these findings are not new, no significant steps have been taken to redesign the crew station. It is recommended that personal supports are provided to all aircrew and that a more detailed study of crew station ergonomics is indicated following a more comprehensive study of prevalence of back pain in Royal Navy aircrew.

Adult↗
PubMedDate not supplied

Average hospital charges for medical and surgical treatment of back problems: United States, 1993.

During 1993, more than 6,000 patients covered by MetLife group health contracts were hospitalized for the surgical or medical treatment of back pain. Among the 3,480 patients aged 21 to 64 with surgically treated back problems, the total charge averaged $13,990, with just over half of this total attributed to the hospital charges. The average length of hospital stay was 3.1 days for these patients. Of the 2,529 nonsurgically treated patients with back problems aged 21 to 64, the average charge totaled $7,120--approximately half the charges of the surgically treated patients. A full 90 percent of this total was accounted for by the hospital portion of the bill, which included an average length of stay of 4.1 days. Of the states with at least 50 admissions, the total charges ranged from a high of $20,040 in California to a low of $10,070 in Washington State for patients with surgical back claims. Among the states with at least 50 admissions, the California total charge was also the highest for the medically treated back problem patients ($11,460), but the lowest total charge was registered in Indiana ($5,490). Total average hospital charges (room and board and ancillary fees) were $7,610 for the surgical back patients and $6,430 for the medically treated back patients. Ancillary fees were 84 and 73 percent of the hospital charges to insurance for surgical back and medical back claims, respectively. Physician fees averaged $6,380 for the surgical category and $690 for the medically treated group of patients.

Adult↗
PubMed1997

[Low back pain problems among steelworkers].

The associations between low-back pain and occupational work loads, life-style factors, and sociodemographic factors were examined in 469 steel plant workers (436 males, 33 females), mean age (sd): 40 (12) years. Fifty-one per cent had experienced low-back pain during the preceding year. The strongest associations were found between recent low-back pain and domestic recreational activities (> or = h/wk vs 0-2 h/wk), and between recent low-back pain and work pace (too fast vs. adequate), odds ratios (95% confidence limits) being respectively 3.0 (1.5-5.8), and 2.3 (1.2-4.2). We considered a subject to have a particularly severe history of low-back pain if he or she due to low-back trouble (i) had ever been admitted to a hospital, (ii) had ever had to change work or, (iii) had had more than one week's sick-leave accumulated during the preceding year. There was a strong association between a severe low-back pain history and life-time occupational exposure to heavy and frequent lifting on the job. Forty-seven per cent of severe low-back pain events could be ascribed to heavy and frequent lifting, provided the associations were causal. We conclude that domestic recreational activities may be an important potential confounder in studies on occupational risk factors for low-back pain, and that, based on the results of this and of other studies, a case for prevention still seems to exist regarding lifting of heavy burdens in the work environment.

Adult↗
PubMedDate not supplied

[Back pain in industry: prevalence, correlation with work conditions and requests for reassignment by employees].

Using data from a cross-sectional survey of 974 employees of a metal company in Germany, we analysed the frequency of chronic back pain, ist associations with working conditions, and the requests for workplace modifications, expressed by persons afflicted with chronic back pain. With a prevalence of 32% chronic back pain was the most common health problem. Physical work exposures, such as lifting and carrying as well as working in an awkward position, were strongly (multivariable odds ratios > or = 2.8) associated with chronic back pain, whereas environmental factors were moderately (multivariable odds ratios = 1.6) associated. Most psychosocial stressors, such as time pressure, and conflicts with co-workers and superiors, were moderately associated with chronic back pain as well (age-adjusted odds ratios between 1.4 and 1.8). Stress symptoms, such as irritation and strain, are rated as mediators by possibly linking psychosocial stressors to chronic back pain. If the individual subject is compelled to perform monotonous or repetitive work, he feels underrated, and this has proved to be a risk factor in its own right. Prolonged exposure to physical stressors (> 7 years) was associated with a strongly elevated risk for chronic back pain (age-adjusted odds ratios > or = 4.0 compared to the nonexposed). Blue collar workers afflicted with chronic back pain requested a reduction of their physical work load significantly more often than their non-afflicted colleagues. In contrast, female white collar employees with chronic back pain layed most emphasis on more physical exercise at work. Worksite health promotion programmes should consider these differences in order to meet the specific needs and preferences of different occupational groups.

Adult↗
PubMed1998

Back injuries in competitive squash players.

BACKGROUND: The aim of this investigation was to examine the prevalence of back injuries in competitive squash players. METHODS EXPERIMENTAL DESIGN: a retrospective analysis was made using a cross-section of current competitive squash players (survivor population). SETTING/PARTICIPANTS: an attempt was made to distribute a questionnaire on back injuries to all competitive squash players registered in the Otago provincial area, New Zealand, (n = 1047), of which 495 questionnaires were returned (47.3% compliance). INTERVENTIONS: variables were cross-tabulated and analysed via descriptive statistics, paired t-tests, chi-analyses of trend and chi 2 tests of significance. MEASURES: the questionnaire obtained information on demographics, the level of play (ability), overall volume of play (average frequency and duration of all exposures), plus the occurrence and severity of back injury. RESULTS: Nearly 52% of the sample reported they had suffered back injury. Of these, 33.5% claimed squash initiated their injury, 20.6% claimed squash exacerbated a previous back injury and the remaining 45.9% felt that squash had no detrimental effect on their back injury. Significantly higher frequencies of back injury were observed in males (56.5% compared to 46.4% in females, p = 0.033), in players of higher grade (p = 0.006),and with increased frequency (p = 0.01), but not duration of play (p = 1.0). CONCLUSIONS: These results suggest that the greater activity and possible over-reaching for the ball associated with higher levels of play may increase the risk of back injury and provides tentative support for the notion that back injuries in squash players might be related to periods of relative over-use.

Adult↗
PubMed1996

[Multidisciplinary treatment program for chronic low back pain, part 1. Overview].

UNLABELLED: A multimodal treatment program is presented in cases of functional restoration for chronic low back pain. The study comprises four parts. Part I gives an overview of the different results of the study. Part II focuses on the medical and functional examination in comparison with persons who do not suffer from back pain. Part III describes psychosocial aspects (depression, complaints, ways of coping, disability) and psychotherapy. In part IV prognostic factors and their reliability for predicting treatment outcome (return to work, pain intensity, self-assessment of success by patients) are examined. In addition the relevant effects of the program on social and health care systems are also addressed. PROBLEM: The incidence of low back pain is continuously increasing, causing tremendous costs for the health insurance system. Therefore effective treatment methods are needed that take into account somatic, psychological and social factors. Chronic low back pain is conceptualized as a complex phenomenon including biological, social and psychological aspects, all of which should be addressed in a treatment program. A multimodal treatment program for chronic low back pain is presented, in which physical activity and cooperation of the patient are the primary targets. Therapeutic aims focus less on pain reduction and emphasize instead pain control, individual responsibility of the patient, and early reintegration into the working environment. The specific goals of the program are to increase the physical abilities of the patients (i. e., flexibility, strength and endurance), to increase patients' knowledge and the use of body mechanics and back protection techniques, to decrease medication-intake, to decrease dependency on the medical community, to improve patients' own positive coping skills and levels of emotional control, to increase the patient's activity level at home and to facilitate a return to work. METHODS: A total of 90 disabled patients with chronic low back pain were admitted to an 8-week program of functional restoration and behavioral support. The program consisted of a pre-program (3 weeks: education, stretching and calisthenic exercises) and an intensive treatment period (aerobics, functional strength and endurance exercises, back exercises, cognitive behavioral group therapy, relaxation training, socioeconomic and vocational counseling) which took place for 5 weeks, 7 h a day, on an outpatient basis. Apart from a medical examination and a personal interview, the patients' physical impairment, pain descriptions, and psychological distress (according to different criteria for evaluation) were also measured. This includes variables such as depression, psychovegetative complaints, quality of life and workplace satisfaction, disability, and coping with disease. Measurements were repeated at the end of the 8-week program, and after 6 and 12 months. RESULTS: In total 84 patients (94 %) were examined following treatment. There was a statistically significant improvement in flexibility, strength, lifting capacity, and endurance measurements ( p < 0.001) at the end of the treatment. In addition, significant reductions in pain, disability, depression, and psychovegetative signs were demonstrated ( p < 0.001). There was a decreased use of medical treatment for back pain following the program, with 42 % of the patients refraining from the intake of analgesics, followed by a significant reduction in physiotherapy and the consultation of physicians. Assessment of the patients' reported increased activity levels at home also supported findings that statistical improvements were significant. Sixty-three percent of the patients were found to have returned to active, productive work following discharge from the program. Most of the improvements remained stable at the 6- and 12-month follow-up examinations. CONCLUSION: The results demonstrate the effectiveness of the multimodal program of functional restoration, not only concerning positive changes in somatic, psychological and physical variables, but also with respect to the number of patients who returned to work. Our methods are also compared with the discrepant results of multimodal treatment in the United States and Scandinavia.

English Abstract↗
PubMed2005

Spontaneous polarization in eukaryotic gradient sensing: a mathematical model based on mutual inhibition of frontness and backness pathways.

A key problem of eukaryotic cell motility is the signaling mechanism of chemoattractant gradient sensing. Recent experiments have revealed the molecular correlate of gradient sensing: Frontness molecules, such as PI3P and Rac, localize at the front end of the cell, and backness molecules, such as Rho and myosin II, accumulate at the back of the cell. Importantly, this frontness-backness polarization occurs spontaneously even if the cells are exposed to uniform chemoattractant profiles. The spontaneous polarization suggests that the gradient sensing machinery undergoes a Turing bifurcation. This has led to several classical activator-inhibitor and activator-substrate models which identify the frontness molecules with the activator. Conspicuously absent from these models is any accounting of the backness molecules. This stands in sharp contrast to experiments which show that the backness pathways inhibit the frontness pathways. Here, we formulate a model based on the mutually inhibitory interaction between the frontness and backness pathways. The model builds upon the mutual inhibition model proposed by Bourne and coworkers [Xu et al., 2003. Divergent signals and cytoskeletal assemblies regulate self-organizing polarity in neutrophils. Cell 114, 201-214.]. We show that mutual inhibition alone, without the help of any positive feedback (autocatalysis), can trigger spontaneous polarization of the frontness and backness pathways. The spatial distribution of the frontness and backness molecules in response to inhibition and activation of the frontness and backness pathways are consistent with those observed in experiments. Furthermore, depending on the parameter values, the model yields spatial distributions corresponding to chemoattraction (frontness pathways in-phase with the external gradient) and chemorepulsion (frontness pathways out-of-phase with the external gradient). Analysis of the model suggests a mechanism for the chemorepulsion-to-chemoattraction transition observed in neurons.

Animals↗