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At least 991 records · Page 55Linked to original sources
PubMed1999

The coordinated movement of the lumbo-pelvic-hip complex during running: a literature review.

The purpose of this review article is to summarise the literature to date regarding the movement of the lumbar spine, pelvis and hips during running gait. Both two-dimensional and three-dimensional studies are analysed to illustrate the apparent coordination in the angular kinematics of each of these segments during running. Knowledge of this coordination is essential in order to facilitate the successful rehabilitation of running injuries to the back, pelvis, hip and thigh.

Back Injuries↗
PubMed2006

Investigating risk factors for chronicity: the importance of distinguishing between return-to-work status and self-report measures of disability.

OBJECTIVE: The objective of this study was to examine whether the outcome of psychosocial risk factor analyses varied as a function of whether the outcome variable was return-to-work status or self-reported functional disability. METHODS: Participants were 255 workers who sustained a soft tissue injury to the back and participated in a community-based secondary prevention program. Assessment of psychologic risk factors (pain severity, pain catastrophizing, fear of movement/reinjury, depression) was conducted at pretreatment. RESULTS: Logistic regression revealed that pain catastrophizing (odds ratio [OR], 0.53; 95% confidence interval [CI] = 0.32-0.88) and pain severity (OR, 0.65; 95% CI = 0.45-0.94) were significant predictors of return to work. However, when change in self-reported disability was used as the outcome variable, none of the psychosocial risk factors emerged as significant predictors. CONCLUSIONS: Given the important theoretical, clinical, and policy implications of the outcome of risk factor research, more research is needed to further clarify the respective advantages and limitations to using self-reported versus return to work-based measures of disability.

Adult↗
PubMed2004

Changing manual-handling practice in a stroke rehabilitation unit.

Patients who have had a stroke are often unable to support their full weight when moving. Recent guidelines on patient handling stress the risk of injury to nurses' backs if they lift patients or support their body weight. Nurses in one stroke rehabilitation unit who used a 'pivot' transfer had to reconsider their practice and explore other options for moving patients.

Attitude of Health Personnel↗
PubMed1996

Low back pain and other overuse injuries in a group of Japanese triathletes.

OBJECTIVE: To document the incidence of low back pain and other overuse injuries in a group of triathletes, and to investigate any associations with various physical and triathlon related factors. METHODS: By means of a questionnaire, the physical characteristics, training habits, and the incidences of overuse injuries of 92 Japanese triathletes (70 males, 22 females) were documented. Student's t and chi 2 tests were used to determine the significance of any associations with injury incidence, as well as differences between subjects experiencing or not experiencing low back pain in the previous year. RESULTS: Low back pain was experienced by 32% of subjects in the previous year. The majority (54%) of low back pain episodes lasted under seven days, suggesting mainly soft tissue involvement, and 19% lasted over three months, suggesting involvement of the intervertebral discs. Weekly trunk flexor muscle training frequency was significantly greater (P = 0.035) for the low back pain subjects. Close to significant differences for average weekly cycling time, trunk flexor muscle training time, and low intensity aerobic training, as well near significant associations for weight training and average weekly triathlon training load, were also found. No other factors were significantly associated with low back pain. Low back injuries accounted for 28% of all injuries. Only the knee was a more common single site of injury (33%). CONCLUSIONS: The three most common injuries suffered by the triathletes were of the knee, back and shoulder. The low back pain suffered by many triathletes could be of a potentially serious nature. It is suggested that cycling is a major risk factor for low back pain in triathletes.

Adult↗
PubMed1991

Low back pain in young athletes. A practical approach.

Lumbar spine pain accounts for 5 to 8% of athletic injuries. Although back pain is not the most common injury, it is one of the most challenging for the sports physician to diagnose and treat. Factors predisposing the young athlete to back injury include the growth spurt, abrupt increases in training intensity or frequency, improper technique, unsuitable sports equipment, and leg-length inequality. Poor strength of the back extensor and abdominal musculature, and inflexibility of the lumbar spine, hamstrings and hip flexor muscles may contribute to chronic low back pain. Excessive lifting and twisting may produce sprains and strains, the most common cause of low back pain in adolescents. Blows to the spine may create contusions or fractures. Fractures in adolescents from severe trauma include compression fracture, comminuted fracture, fracture of the growth plate at the vertebral end plate, lumbar transverse process fracture, and a fracture of the spinous process. Athletes who participate in sports involving repeated and forceful hyperextension of the spine may suffer from lumbar facet syndrome, spondylolysis, or spondylolisthesis. The large sacroiliac joint is also prone to irritation. The signs and symptoms of disc herniation in adolescents may be more subtle than in adults. Disorders simulating athletic injury include tumours and inflammatory connective tissue disease. Often, however, a specific diagnosis cannot be made in the young athlete with a low back injury due to the lack of pain localisation and the anatomic complexity of the lumbar spine. A thorough history and physical examination are usually more productive in determining a diagnosis and guiding treatment than imaging techniques. Diagnostic tests may be considered, though, for the adolescent athlete whose back pain is severe, was caused by acute trauma, or fails to improve with conservative therapy after several weeks. Radiographs, bone scanning, computed tomography, and magnetic resonance imaging may help identify, or exclude serious pathology. Fortunately, the majority of cases of low back pain in adolescents respond to conservative therapy. Immediate treatment of an acute injury, such as a sprain or strain, includes cryotherapy, electrogalvanic stimulation, anti-inflammatory medications and gentle exercises. Prolonged bed rest should be avoided since atrophy may occur rapidly. Strong analgesics are also usually contraindicated, except for sleep, since they mask pain and may allow overvigorous activity. Early strengthening exercises include the Williams flexion exercises and/or McKenzie extension exercises. Both exercise motions may often be prescribed. Athletes with an acute disc herniation, however, should only perform extension exercises initially. Athletes with spondylolysis, spondylolisthesis and facet joint irritation should initially be limited to flexion exercises.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1993

[Socioeconomic incidences and prognostic factors of low back pain caused by occupational injuries among the hospital personnel of Grenoble University Hospital Center].

Low back pain is generally believed to be common among hospital employees. This cross-sectional, retrospective study was carried out to determine the annual incidence of low back pain ascribable to occupational injuries in hospital employees and to evaluate factors influencing the prognosis of these injuries. In 1989, 70 employees working at the Grenoble Teaching Hospital (GTH) reported an occupational injury responsible for low back pain. Each of these employees filled out an epidemiological questionnaire during a routine evaluation by a rheumatologist. Overall annual incidence of occupational injuries with subsequent low back pain was 1.9% among GTH employees. Higher incidences were seen among employees whose occupations involved patient transfer, as well as among nursing assistants. Activities associated with an increased risk of low back pain included handling of patients or objects and work requiring prolonged periods in uncomfortable positions or in the standing position. A previous history of low back disease and a longer period of time in the current work were also associated with an increased risk of low back pain. Characteristic clinical profiles of patients with low back pain subsequent to occupational injury were determined by occupation and type of hospital department. The analysis of long-duration absence from work and long-term consequences on career confirmed the significant adverse socioeconomic impact of these injuries.

Academic Medical Centers↗
PubMedDate not supplied

Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction?

Clinical research of graded exposure in vivo with behavioral experiments in patients with chronic low back pain who reported fear of movement/(re)injury shows abrupt changes in self-reported pain-related fears and cognitions. The abrupt changes are more characteristics of insight learning rather than the usual gradual progression of trial and error learning. The educational session at the start of the exposure might have contributed to this insight. The current study examines the contribution of education and graded exposure versus graded activity in the reduction of pain-related fear and associated disability and physical activity. Six consecutive patients with chronic low back pain who reported substantial fear of movement/(re)injury were included in the study. After a no-treatment baseline measurement period, all the patients received a single educational session, followed again by a no-treatment period. Patients were then randomly assigned to either a graded exposure with behavioral experiments or an operant graded activity program. A diary was used to assess daily changes in pain intensity, pain-related fear, pain catastrophizing, and activity goal achievement. Standardized questionnaires of pain-related fear, pain vigilance, pain intensity, and pain disability were administered before and after each intervention and at the 6-month follow-up. An activity monitor was carried at baseline, during the interventions, and 1 week at 6-month follow-up. Randomization tests of the daily measures showed that improvements in pain-related fear and catastrophizing occurred after the education was introduced. The results also showed a further improvement when exposure in vivo followed the no-treatment period after the education and not during the operant graded activity program. Performance of relevant daily activities, however, were not affected by the educational session and improved significantly only in the exposure in vivo condition. All improvements remained at half-year follow-up only in patients receiving the exposure in vivo. These patients also reported a significant decrease in pain intensity at follow-up.

Activities of Daily Living↗
PubMed2004

The association between pain and disability.

A clearer understanding of how pain intensity relates to disability could have important implications for pain treatment goals and definitions of treatment success. The objectives of this study were to determine the optimal pain intensity rating (0-10 scale) cutpoints for discriminating disability levels among individuals with work-related carpal tunnel syndrome (CTS) and low back (LB) injuries, whether these cutpoints differed for these conditions and for different disability measures, and whether the relationship between pain intensity and disability was linear in each injury group. Approximately 3 weeks after filing work injury claims, 2183 workers (1059 CTS; 1124 LB) who still had pain completed pain and disability measures. In the LB group, pain intensity rating categories of 1-4, 5-6, and 7-10 optimally discriminated disability levels for all four disability measures examined. In the CTS group, no pain intensity rating categorization scheme proved superior across all disability measures. For all disability measures examined, the relationship between pain intensity and disability level was linear in the CTS group, but nonlinear in the LB group. Among study participants with work-related back injuries, when pain level was 1-4, a decrease in pain of more than 1-point corresponded to clinically meaningful improvement in functioning, but when pain was rated as 5-10, a 2-point decrease was necessary for clinically meaningful improvement in functioning. The findings indicate that classifying numerical pain ratings into categories corresponding to levels of disability may be useful in establishing treatment goals, but that classification schemes must be validated separately for different pain conditions.

Adult↗
PubMed1990

On-the-job injury: a costly problem.

Musculoskeletal injuries, including back disorders, rank second among work-related injuries in the United States. Back pain is an expensive problem that is difficult to treat. Studies show that workers with the greatest prevalence of back, shoulder, and knee injuries are employed in the health care industry. The PACU is an area where staff members are especially vulnerable to musculoskeletal injuries. Expenses related to on-the-job injury add significantly to the cost of health care. This article focuses on the problem and offers some suggestions for reducing the incidence of work-related injuries.

Back Pain↗
PubMed2006

Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study.

OBJECTIVE: To examine whether adolescent flexibility, endurance strength, and physical activity can predict the later occurrence of recurrent low back pain, tension neck, or knee injury. METHODS: In 1976, 520 men and 605 women participated in a sit and reach test (flexibility) and a 30 second sit up test (endurance strength). In 1976 and 2001 (aged 37 and 42 years) they completed a questionnaire. Lifetime occurrence and risk of self reported low back pain and self reported, physician diagnosed tension neck and knee injury were calculated for subjects divided into tertiles by baseline results of strength and flexibility tests. RESULTS: Men from the highest baseline flexibility tertile were at lower risk of tension neck than those from the lowest tertile (odds ratio (OR) 0.51, 95% confidence interval (CI) 0.28 to 0.93). Women from the highest baseline endurance strength tertile were at lower risk of tension neck than those from the lowest tertile (OR 0.60, 95% CI 0.40 to 0.91). Men from the highest baseline endurance strength tertile were at higher risk of knee injury than those from the lowest tertile (OR 1.96, 95% CI 1.05 to 3.64). Men who at school age participated in physical activity were at lower risk of recurrent low back pain (OR 0.61; 95% CI 0.42 to 0.88) than those who did not. CONCLUSIONS: Overall good flexibility in boys and good endurance strength in girls may contribute to a decreased risk of tension neck. High endurance strength in boys may indicate an increased risk of knee injury.

Adolescent↗
PubMed2004

[Study on lower back pain in home helpers and development of materials for occupational health education].

People who are engaged in home health care services often have to transfer clients while in a half standing posture using repetitious movement including gravitational changes. Transferring heavy patients at homes for the severely mental and physical handicapped is equivalent to the care giving work, listed in the "guideline for prevention of lower back pain in work places" (1994/9/6). The purpose of this study was to investigate incidences of lower back pain and injuries among home helpers as well as to determine the relationship between their level of protective knowledge and prevalence of lower back pain. The results of the study revealed that home helpers complained of a mild type of lower back pain. Although almost all of them had the protective knowledge for lower back injuries that was taught in their training courses, they still felt the need for more knowledge through continuous education regarding protective measures for lower back injuries and pain. Regarding the method of teaching, they want to learn by TV programs, books, texts and self-learning materials. Few of them wanted to learn by computer assisted instructions or the internet. Based upon the results of this study, we have developed new teaching materials for home helpers which explain adequate postures in home care through utilizing their protective knowledge to avoid lower back pain.

Adult↗