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PubMed1996

Pain expectancies, pain, and functional self-efficacy expectancies as determinants of disability in patients with chronic low back disorders.

This study tested the relative predictive power of self-efficacy expectations of physical capabilities (functional self-efficacy [FSE]), expectations of pain, and expectations of reinjury on physical function in chronic back patients. Before behavioral assessment of function, 85 patients rated their abilities to perform essential job tasks (FSE) and the likelihood that their performances would be accompanied by pain and reinjury. Partial correlations revealed that FSE was significantly related to function when reinjury and pain were partialed out. Neither reinjury nor pain expectancies correlated significantly with function when FSE was partialed out. Further support for an FSE approach came from regression analyses that found pain intensity, gender, and FSE--not expected pain or reinjury--related consistently with physical performance. Thus, performance-specific cognitions may have greater explanatory power over disability than pain-specific ones.

Activities of Daily Living↗
PubMed1996

How to organize and implement health care ergonomics teams.

Using a systems approach to safety and health management through a comprehensive ergonomic program addresses workplace processes, operations and conditions as interdependent systems in order to identify and eliminate or reduce all types of ergonomic hazards to employees. This document examines the way one health care facility improved its ergonomic program using this approach, from early data collection to implementation of the new plan. By creating several teams with different areas of concern, they set out to reduce ergonomic-related injuries in their facility by 10 percent.

Back Injuries↗
PubMedDate not supplied

[Hospitalisations for vertebral fractures in Apulia during 1998-2000].

Vertebral fractures are a relevant problem in public health. This is mainly due to the high prevalence of elderly people and the high social costs implied as regards disability and health care. The authors have carried out a survey about hospitalisation rates for vertebral fractures in Apulia in the years 1998-2000. The gross hospitalisation rate for vertebral fractures without spinal injuries concerned 47.3 people out of 100.000 per year, whereas the rate for fractures with spinal cord injuries concerned 4,0 people out of 100.000 per year. Fractures concerned more frequently the dorso-lumbar tract and males were more affected than women. During the period concerned, the total DRG cost for vertebral fractures was higher than 15 million Euros and the extra-regional mobility rate for vertebral fractures without spinal injuries was 11,2% of all case-studies. The results will allow better health programmes aimed at enhancing treatment of back bone injuries.

English Abstract↗
PubMed2006

Risk factors in developing pregnancy-related pelvic girdle pain.

BACKGROUND: In this prospective epidemiologic cohort study the aim was to identify possible risk factors for developing four different syndromes of pelvic girdle pain during pregnancy. METHODS: Over a one-year period a total of 2,269 consecutive pregnant women -- at week 33 of gestation -- responded to a structured questionnaire and underwent a thorough physical examination. Women who at baseline reported daily pain from pelvic joints and had corresponding objective findings were allocated, according to symptoms, into one of four classification groups, and followed up with questionnaires and physical examinations up to two years after delivery. RESULTS: Multivariate analysis could distinguish the four pelvic pain sub groups from the "Pelvic healthy" group with respect to 13 of 24 variables. The pelvic girdle syndrome group revealed a history of previous low back pain, trauma of the back or pelvis, multiparae, had a relatively higher weight, a higher level of self reported stress and of job At a higher risk of developing symphysiolysis were women who were multiparae, had a relatively higher weight, and were smokers. If a woman had vocational training or a professional education, was stressed, had a poorer experience of previous delivery, had previous low back pain, trauma of back, or previous salpingitis, she had an increased risk of developing one-sided sacroiliac syndrome. The risk factors for developing double-sided sacroiliac syndrome were previous low back pain and trauma of the back or pelvis, multiparae, poorer relationship with spouse, and less job satisfaction. CONCLUSIONS: This study demonstrates no single dominant risk factor for developing pelvic girdle pain in pregnancy, but reveals a set of physical and psychosocial factors. The risk factors for developing pelvic girdle pain in general are: history of previous low back pain, trauma of the back or pelvis, multivariate, higher level of stress, and low job satisfaction.

Back Injuries↗
PubMed1993

Isokinetic trunk strength and lifting strength measures. Differences and similarities between low-back-injured and noninjured workers.

Fifty-eight back pain patients and 21 entry-level Postal Service workers without low-back pain were evaluated using a variety of lumbar function measures. Isolated trunk strength and full lifting strength were gauged with isokinetic and isometric methods. Lumbar range-of-motion was computed using toe-touch and goniometers. Conventional clinical techniques such as toe touch and straight leg raise were effective in distinguishing back-injured from normal subjects. Isometric and isokinetic peak force and torque tests failed to show significant differences between low-back pain and job applicant groups. When compared with published norms, our job applicant group was significantly deconditioned. Our data suggest that asymptomatic, deconditioned subjects could be mistaken for back-impaired patients or symptom magnifiers.

Adult↗
PubMed2000

Effects of a lifting belt on spine moments and muscle recruitments after unexpected sudden loading.

STUDY DESIGN: Ten men and eight women participated in a repeated-measures experiment in which sudden loads were applied unexpectedly to a container held in the hands. Three independent variables were investigated: lifting belt use, preload, and load symmetry. OBJECTIVES: To determine whether a lifting belt would help protect the spine in sudden symmetric and asymmetric loading situations. SUMMARY OF BACKGROUND DATA: Unexpected loading events have long been associated with the onset of back pain. Based on work showing that lifting belts restrict motion of the torso, the hypothesis was that a lifting belt would stiffen the spine, thereby protecting its supporting tissues. METHODS: A weight, equal to 7.5% of the subjects' trunk extension force, was allowed to fall 1 m before the bottom of a box held by blindfolded subjects was pulled. Kinetic and kinematic data, obtained from two force plates and a magnetic motion measurement system, were used in a three-dimensional, dynamic, linked-segment biomechanical model to calculate spine moments. Electromyogram data were simultaneously obtained from eight trunk muscles. RESULTS: The belt reduced the forward bending of the spine during the symmetric loadings. In the men, the belt also reduced the forward flexion moment acting on the spine. The belt restricted lateral bending in the women and men, when the box was preloaded. The peak electromyogram amplitudes from posterior contralateral erector spinae and latissimus dorsi muscles increased during the asymmetric loadings, whereas three ipsilateral muscles were less active. CONCLUSIONS: The conflicting moment and electromyographic results, combined with the influence of load symmetry, preload, and gender make the benefits of the lifting belt difficult to delineate. Although the data support the hypothesis that the belt stiffens the torso's response to sudden loading, the effects are small, and considerable individual differences exist. The findings show that during unexpected sudden loading, a belt may reduce the net external moment loading. At the same time the belt appears to alter the muscle response strategy so that the belt's overall effect on an individual's safety is hard to determine.

Adult↗
PubMedDate not supplied

Injuries in Rugby Union football.

In a prospective study of 185 players attached to 10 British rugby clubs, 151 injuries were recorded among 98 of them (53%) during a single season. Forwards sustained significantly more injuries than backs. The standard of rugby, players' body weights, degree of fitness, and presence of joint hypermobility did not affect the risk of injury. The leg was the most common site of injury. Head and neck injuries were significantly more common when play was static and on wet pitches. Scrummaging accounted for no neck injuries. Almost half the injuries occurred during the last quarter of games. Foul play might have caused as many as 47 (31%) of all reported injuries. Complete eradication of deliberately dangerous play would considerably reduce the high incidence of injuries in this sport.

Adult↗
PubMed2002

Manual handling and nursing children.

The aim of this article is to highlight some of the unique challenges relating to handling children, such as: their stage of physical and cognitive development, their position in relation to the carer's centre of gravity, their level of comprehension and their ability to communicate.

Back Injuries↗
PubMed2002

The relationships between biomechanical and postural stresses, musculoskeletal injury rates, and perceived body discomfort experienced by industrial workers: a field study.

A combination of archival, subjective, and observational field data collection methods were used to investigate the relationship between biomechanical and postural stresses, and the resulting physical strain experienced by industrial workers of a packaging plant. Assessment of physical strain was based on the number and incidence rate of Occupational Safety and Health Administration (OSHA)-reportable injuries that were recorded over a period of 27 months, and based on the self-reported ratings of perceived body discomfort. Both the biomechanical and postural stresses correlated with the musculoskeletal injury rate. The results illustrate the usefulness of postural and biomechanical analyses for assessing the risk of injury in industry.

Adult↗
PubMed1980

[Investigations of combined injuries, 28th communication: Troubles of hemostatic equilibrium arising from radiation and combined injuries (author's transl)].

In female mice the influence of total-body irradiation combined with excision of skin on the blood-clotting system was examined. Whereas the general tests of plasmatic coagulation showed no significant change, a biphasic course of coagulation disturbances in thrombelastography and euglobulin-clot-lysis following combined radiation injury was found. During the first time a pronounced increase of coagulability appeared, followed by the development of a hypocoagulability due to thrombocytopenia and functional disturbances of blood platelets. In this hemorrhagic period the euglobulin-clotlysis time was accelerated, but only after combined injury. Possible reasons are discussed.

Animals↗
PubMed2003

Exploring variables among medical center employees with injuries: developing interventions and strategies.

Data for this study were collected via retrospective chart review. The study shows the variables associated with work related injury (WRI) in Central Arkansas Veterans Healthcare System medical center employees from 1998 to 2000 in terms of age, gender, employment type, employment status, shift length, body mass index (BMI), workers' compensation claims prior to current employment, employee health and wellness activity attendance, lost time claims, medical/loss of productivity costs. Notable characteristics of injured employees included advancing age, female gender, long working hours, increased BMI, history of prior back and upper extremity injuries, no health and wellness activity attendance, and lost time with injury. Back and shoulder strain, falling accidents, and repetitive motion injuries were the most severe and costly injuries. Further study of medical center employees is warranted to determine risk factors for WRI and develop appropriate protective interventions and safety promotion strategies.

Accidents, Occupational↗
PubMed2001

Back pain and radiological changes in the thoraco-lumbar spine of athletes. A long-term follow-up.

From 1996 to 1999, back pain and radiological changes in the thoraco-lumbar spine were investigated in 134 former top athletes, representing wrestling, gymnastics, soccer and tennis (age 27-39 years) and a group of 28 non-athletes of comparable age. This is a long-term follow-up investigation of a previous radiological study of the spine with clinical correlation. Despite significantly more radiological abnormalities among the athletes, they did not report higher frequency of back pain than the non-athletes. A decrease in disc height or new disc height reduction in one or more of the intervertebral discs between the two examinations correlated significantly with back pain at follow-up.

Adolescent↗
PubMed2000

A cross-sectional study correlating lumbar spine degeneration with disability and pain.

STUDY DESIGN: Cross-sectional design. OBJECTIVES: To investigate the correlation between degeneration in the lumbar spine and self-reported disability and pain levels in patients with and without a history of trauma. SUMMARY OF BACKGROUND DATA: The link between lumbar spine degeneration and low back pain remains controversial, as does the correlation between trauma and spinal degeneration. METHODS: Radiographic and questionnaire data were collected from 172 consecutive patients with low back pain. Back pain severity was measured using two scales: one for pain over the entire episode and one for pain during the previous week. All patients also completed the Revised Oswestry Disability Questionnaire before radiography was performed. Further questions concerning the chronicity of symptoms and trauma were included. RESULTS: Controlling for age, patients with low back pain with a history of trauma had a statistically significant increase in the severity of facet degeneration (P < 0.02) compared with nontrauma patients with low back pain. However, there was no difference in disability and pain scores between the trauma and nontrauma patients or between the genders. A weak correlation between pain severity ratings and the number of levels of degeneration and the severity of the degeneration at the disc and facets was noted. CONCLUSIONS: Patients with low back pain with a history of trauma had more severe facet arthrosis than do nontrauma patients with low back pain, but there were no differences in pain and disability. There was a weak correlation between the quantity and severity of lumbar degeneration with pain levels, but not with disability scores. These findings are discussed in the light of recent reports regarding the cervical spine.

Adolescent↗