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At least 1,207 records · Page 67Linked to original sources
PubMed1995

Role of acid back-diffusion in the formation of mucosal ulceration and its treatment with drugs in diabetic rats.

We have studied the role of acid back-diffusion in the formation of gastric mucosal ulceration and its treatment with several drugs in streptozotocin-induced diabetic rats. After vagotomy, the stomach of 1-8 week-old diabetic rats and age-matched control rats were irrigated with acid solutions of graded concentrations (50-150 mm HCl) for 1 or 3 h. A marked increase in acid back-diffusion and in haemorrhagic ulceration was found in diabetic rats. The extent of acid back-diffusion and the severity of mucosal ulceration were dependent on the concentration and the time of contact of acid solutions with the gastric mucosa. A high correlation (r = 0.9227) between acid back-diffusion and mucosal ulceration was found in 3-h acid-irrigated diabetic rats. In the 2-week diabetic rat, intragastric cimetidine (300 mg kg-1) or NaHCO3 (52 mg kg-1) significantly (P < 0.05) reduced both acid back-diffusion and haemorrhagic ulcer formation, while atropine (1.0 mg kg-1) or bupivacaine (0.5%, 0.4 mL/rat) was ineffective. High blood glucose levels in diabetic rats were not influenced by these agents. Acid back-diffusion and ulceration in the diabetic rat were markedly reduced by daily administration but not single injection of insulin (50 units kg-1, s.c.). Taken together, in the early stage of diabetes development, chronic insulin deficiency rather than nerve degeneration or hyperglycaemia may be responsible for the disruption of mucosal barriers. It is concluded that acid back-diffusion played an important role in the formation of acute haemorrhagic ulceration that can be inhibited by intragastric cimetidine, NaHCO3 or daily injection of insulin.

Animals↗
PubMed1978

Further observations on back-firing in the motor nerve fibres of a muscle during twitch contractions.

1. The tension developed by a muscle in response to a single supramaximal nerve volley is often the sum of two contractions, the second resulting from re-excitation of some nerve terminals during the first contraction. Re-excitation or back-firing can be prevented if the muscle nerve is stimulated twice with the second volley arriving in the muscle at a time when muscle fibres are still refractory following the first volley (Brown & Matthews, 1960). 2. Back-firing has been studied here in the medial gastrocnemius muscle of the spinal cat and responses have been recorded, either representing the summed activity of the muscle's motor supply or discharges of single functional motor axons. 3. When stimulating at a distance from the muscle, the second of two shocks is effective in suppressing back-firing over a narrower range of stimulus intervals than when stimulating close to the muscle. 4. The amount of back-firing can be reduced by stretching the muscle. At a length corresponding to the optimum for a twitch little if any back-firing remains. 5. Measurements of threshold to electrical stimulation of single functional motor axons suggests that low threshold axons are more likely to show back-firing. In the majority of cases, most or all of the motor units in the muscle have to be active before back-firing can be observed.

Animals↗
PubMed2006

How consistently distributed are the socioeconomic differences in severe back morbidity by age and gender? A population based study of hospitalisation among Finnish employees.

AIMS: To study the socioeconomic distribution of severe back morbidity by age and gender, and to examine to what extent the differences in back morbidity between socioeconomic groups are particularly related to manual work in different age groups. METHODS: Hospital admissions in 1996 for back disorders of 25-64 year old men (3123 of a total 743,961) and women (3043 of 773,936) from the Finnish Hospital Discharge Register were linked with demographic and socioeconomic data from the 1995 population census. Poisson regression analysis was used to calculate the rate ratios for back related hospitalisation by occupational class and education. The distribution of cases according to occupational status and education was presented in relation to the whole occupationally active workforce by age and gender. RESULTS: Blue-collar (manual) workers had a higher risk of being hospitalised because of back disorders compared with white-collar employees (non-manual) in all age groups among both genders. Manual work versus non-manual work was associated with a 1.3 to 1.4-fold risk (95% CI 1.0 to 1.8) among women and a 1.3 to 1.6-fold risk (95% CI 1.1 to 2.2) among men. The risk of hospitalisation was further inversely associated with educational level within manual and non-manual work in all other age groups except in those aged 55-64 years. Gender related differences were much smaller compared with the socioeconomic ones. CONCLUSIONS: Socioeconomic differences in back morbidity leading to hospitalisation were consistent by age and gender. The results suggest that not only the physical strenuousness of work, but also other causes of severe back disorders are clustered around a subject's socioeconomic status, indicated by formal education. This may have implications for prevention and the planning of rehabilitation.

Adult↗
PubMed1999

Prediction and compensation by an internal model for back forces during finger opening in an overarm throw.

Previous studies have indicated that timing of finger opening in an overarm throw is likely controlled centrally, possibly by means of an internal model of hand trajectory. The present objective was to extend the study of throwing to an examination of the dynamics of finger opening. Throwing a heavy ball and throwing a light ball presumably require different neural commands, because the weight of the ball affects the mechanics of the arm, and particularly, the mechanics of the finger. Yet finger control is critical to the accuracy of an overarm throw. We hypothesized that finger opening in an overarm throw is controlled by a central mechanism that uses an internal model to predict and compensate for movement-dependent back forces on the fingers. To test this idea we determined whether finger motion is affected by back forces, i.e., whether larger back forces cause larger finger extensions. Back forces were varied by having subjects throw, at the same fast speed, tennis-sized balls of different weights (14, 55, and 196 g). Arm- and finger-joint rotations were recorded with the search-coil technique; forces on the middle finger were measured with force transducers. Recordings showed that during ball release, the middle finger experienced larger back forces in throws with heavier balls. Nevertheless, most subjects showed proximal interphalangeal joint extensions that were unchanged or actually smaller with the heavier balls. This was the case for the first throw and for all subsequent throws with a ball of a new weight. This suggests that the finger flexors compensated for the larger back forces by exerting larger torques during finger extension. Supporting this view, at the moment of ball release, all finger joints flexed abruptly due to the now unopposed torques of the finger flexors, and the amplitude of this flexion was proportional to ball weight. We conclude that in overarm throws made with balls of different weights, the CNS predicts the different back forces from the balls and adjusts finger flexor torques accordingly. This is consistent with the view that finger opening in overarm throws is controlled by means of an internal model of the motor apparatus and the external load.

Adaptation, Physiological↗
PubMedDate not supplied

Evaluation of superior rectus muscle attachment following hang-back recession in rabbit eyes.

PURPOSE: The hang-back suture technique has been advocated to decrease the risk of scleral perforation during strabismus surgery. In this study, we evaluated the muscle insertion site in rabbits 4 weeks after a hang-back recession was performed. METHODS: Twenty-five eyes of 13 rabbits underwent hang-back recessions of between 5 and 8 mm of the superior rectus muscle. Four weeks later, the attachment sites were examined. RESULTS: Four weeks following the surgery, 14 muscles (n=25, 56%) were anteriorly displaced. In the 5 mm recession group, one muscle was anteriorly displaced (n=7, 14.3%). In the 6 mm recession group, 50% of the muscles recessed were displaced anteriorly (n=8). The 7 mm hang-back recession group demonstrated forward displacement in five muscles operated (n=6, 83%) and in the 8 mm recession group, all four muscles (100%) were anteriorly displaced. The magnitude of displacement was positively correlated to the amount of the hang-back recession performed (Pearson correlation p<0.001). CONCLUSIONS: Anterior displacement of muscles using the hang-back technique in the rabbit eye is unacceptably high and occurred in 56% of the cases. A positive, statistically significant correlation exists between the amount of recession performed and the number of muscles displaced from their new insertion. Therefore, when performing large recessions using the hang-back technique displacement should be anticipated.

Animals↗
PubMed2004

Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push-back method: preliminary results.

OBJECTIVE: This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. SUBJECTS: Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. METHOD: Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. RESULTS: In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. CONCLUSION: The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

Alveolar Process↗
PubMed2003

The effects of McKenzie exercises for patients with low back pain, our experience.

OBJECTIVE: To investigate influence of McKenzie exercises on decreasing the pain in patients with low back pain, to show occurrence of Centralization sign, as a predictor of good treatment outcomes and to evaluate use of McKenzie exercises, as a routine method for lower back pain in Physical Medicine and Rehabilitation Centres. DESIGN: Clinical, prospective, manipulative study. SETTING: Physiotherapy and Rehabilitation Clinic in Community Based Rehabilitation Centers and Institute for Physical Medicine and Rehabilitation affiliated with a Medical College Sarajevo. PARTICIPANTS: Thirty-four patients with symptoms of low back pain. INTERVENTIONS: McKenzie exercise program for low back pain were performed individually to the need and possibility of each patient. Patients attended exercise program daily, under supervision of physiatrist and physiotherapist and do it also at home, five times a day in series of 5 to 10 repetition each time, depending of stage of disease and pain intensity. The average training period was 15,5 days. MAIN OUTCOME MEASURES: All patients were assessed before and after the treatment. Visual Analog Scale (VAS) measured intensity of pain, localization of pain was noted on special forms and Shober test was used to show differences in spinal movement before and after the treatment. RESULTS: Measurements of spinal movements and flexibility of spine showed significant improvement in all patients. Average difference in values of Shober test before and after treatment was 1,1 cm with SD 0,98. Difference test was t=6,263 with significant difference p<0,01. Mean pain intensity was reduced significantly as a result of treatment. Pain was reduced on VAS for X=2,8 with S.D. 1,56. Difference Test was t=10,332, with significant difference p<0.01. 61,5% of total number of participants had signs of centralisation (6% were in acute stage of pain, 32% in subacute and 23,5% in chronic pain). Centralisation sign was noted in 40% of acute patients, 57.5% subacute and 80% of chronic patients with a low back pain who exercised McKenzie program. CONCLUSIONS: McKenzie exercises for low back pain are beneficial treatment for increasing flexibility of spine and improving the pain with better results in pain relief. Although done by minimally trained physiotherapists in McKenzie approach, McKenzie exercises are successful method for decreasing and centralising the pain and increasing spinal movements in patients with low back pain.

Journal Article↗
PubMed1995

Long-term gonadotropin-releasing hormone agonist therapy: the evolving issue of steroidal "add-back" paradigms.

The introduction of steroid "add-back" regimen draws on the recognition that several clinical entities targeted for treatment with GnRHa are not "six-month diseases". Included under this heading are individuals suffering from symptomatic endometriosis (not desirous of pregnancy), uterine fibroids (ineligible or disinterested in definitive surgical therapy), ovarian hyperandrogenism, premenstrual syndrome, menopausal transition, or dysfunctional uterine bleeding. A six month course of therapy with a GnRHa does not adversely affect lipoprotein economy and therefore presumably the corresponding cardiovascular risk. A six month course of GnRHa therapy appears to be associated with a substantial decrease (of up to 8.2%) in lumbar bone density, a phenomenon which may not be entirely reversible six months after discontinuation of therapy. In principle, steroid "add-back" therapy should diminish some or all of the side effects associated with GnRHa therapy, may provide a medical treatment option for patients representing a high surgical risk, and may delay surgical intervention if desired. On the other hand, a steroid "add-back" therapy may delay tissue diagnosis, be associated with a substantial cost as well as with the need in parenteral route of administration. Norethindrone-only (but not medroxyprogesterone acetate-only) "add-back" regimens have proved promising in the context of endometriosis. Non-concurrent estrogen/progestin "add-back" regimens proved promising in the context of uterine fibroids. Substantial additional studies would have to be carried out to validate the utility of steroid "add-back" regimens. Special emphasis will have to be placed on the evaluation of long-term utility with an eye towards assessing clinical efficacy, impact on lipoprotein economy, impact on bone density, impact on urogenital tissues, and impact on the hot flash. The concurrent or non-concurrent use of non-steroid "add-back" regimen will also most likely constitute a major component of future studies.

Bone Density↗
PubMed2000

Back-up antibiotic prescriptions for common respiratory symptoms. Patient satisfaction and fill rates.

BACKGROUND: In recent years much has been written about the overuse of antibiotics, especially for common respiratory illnesses. One approach to this issue is the use of a back-up prescription, only to be filled if a patient's condition deteriorates or fails to improve. The purpose of our study was to determine patient satisfaction, prescription fill rates, and correlates of these outcomes among patients receiving back-up antibiotic prescriptions. METHODS: In our observational study we obtained survey data from 28 physicians and 2 physician extenders in 3 family practice clinics and their patients presenting with complaints of common respiratory symptoms. We computed patient satisfaction and fill rates of back-up antibiotic prescriptions. Agreement between the perceived need of patients for antibiotics before the office visit and the subjective rating of their physicians of the clinical necessity to prescribe antibiotics for these patients was assessed using the kappa statistic. Finally, we determined correlates of satisfaction and the rate of filling back-up prescriptions. RESULTS: Of the 947 patients enrolled in the study, 46.6% received no antibiotic prescriptions, 30.2% received back-up antibiotic prescriptions, and 23.2% were given immediate-fill prescriptions for an antibiotic. Patients' self-reported satisfaction and fill rates for back-up antibiotic prescriptions were 96.1% and 50.2%, respectively. CONCLUSIONS: Our findings indicate that patients were very satisfied with a back-up antibiotic prescription. The fact that half of the patients chose not to fill these prescriptions suggests a potential health care cost savings.

Anti-Bacterial Agents↗
PubMed2000

Shape optimization of metal backing for cemented acetabular cup.

Stresses are generated in implant materials and bone, and at their interfaces. These stresses may affect the structural properties of the implant/bone system, or bring it to failure at some time in the postoperative period. Due to these stresses, acetabular cup loosening becomes an important problem for long term survival of total hip arthroplasty. It was found that metal backing would tend to reduce stresses in the underlying acrylic cement and bone. Yet, recent studies of load transfer around acetabular cups have shown that metal backing generates higher stress peaks in cement at the cup edges, while generates lower stress peaks in bone at the central part of acetabulum (dome), thus the bone at the dome becomes more stress shielded. In this study a numerical shape optimization procedure in combination with an axisymmetric finite element model was used in order to optimize the shape of a stainless steel metal backing shell. The design was to minimize fatigue notch factor in cement along cement/bone and cement/metal backing interfaces in order to prevent failure of cement mantel and loosening of acetabular components, at the same time increasing fatigue notch factor in bone at the center of acetabulum to prevent stress shielding. The results of this study indicate that cemented acetabular cup designs can be improved by using metal backing shells of non-uniform thickness, thick at the dome and thin at edges. Fatigue notch factor in cement was reduced by 2.3% at cement/metal backing interface and increased by 1.3% in the central bone of acetabulum. Von Mises stresses in the cement edge were reduced by 17.8% and 19.3% along cement/bone and cement/metal backing interfaces, respectively. Thus the optimal design will reduce the possibility of fatigue fracture of cement and decrease the stress shielding effect and the likely incidence of bone resorption, whereby extend the expected life of the prostheses.

Acetabulum↗
PubMed2002

Herring gulls and great black-backed gulls as indicators of contaminants in bald eagles in Lake Ontario, Canada.

In 2000, a pair of bald eagles (Haliaeetus leucocephalus) nested successfully along the shorelines of Lake Ontario in North America for the first time since 1957. However, it is a continuing question whether bald eagles will be able to reproduce successfully as they return to nest on Lake Ontario. Great black-backed gulls (Larus marinus) and herring gulls (L. argentatus) were selected as surrogate species to predict contaminant levels in eggs of bald eagles nesting on Lake Ontario. Because of the suspected overlap in the diets of great black-backed gulls and bald eagles (i.e., fish, gull chicks, and waterfowl), the two species probably occupy a similar trophic level in the Lake Ontario food web and, thus, may have similar contaminant levels. Fresh great black-backed gull and herring gull eggs were collected from three study sites in eastern Lake Ontario in 1993 and 1994 and analyzed for contaminants. Average contaminant levels of dichlorodiphenyldichloroethane (p,p'-DDE), total polychlorinated biphenyls (PCBs), and dieldrin in great black-backed gull eggs were 12.85, 26.27, and 0.27 microg/g, respectively. The mean ratio of contaminant levels in great black-backed gull eggs to contaminant levels in herring gull eggs for these three contaminants was 2.09 (range of means, 1.73-2.38). Predicted levels of contaminants in bald eagle eggs in Lake Ontario would be expected to be similar to the mean levels reported for great black-backed gull eggs. As a comparison, contaminant levels in bald eagle eggs collected from other Great Lakes nesting sites were compared to mean levels reported for herring gull eggs collected from nearby sites in 1986 to 1995. The mean ratio of contaminant levels in bald eagle eggs to contaminant levels in herring gull eggs from these sites for DDE, total PCBs, and dieldrin was 2.40 (range of means, 1.73-3.28). These ratios are very similar to those reported using great black-backed gull eggs, illustrating the apparent similarity in trophic status shared by the two top predator species at these Great Lakes sites. Predicted levels of contaminants in bald eagle eggs at Lake Ontario are similar to levels reported for bald eagles breeding at other Great Lakes sites, suggesting that bald eagles may be able to breed on the shores of Lake Ontario. However, it is unclear at this time what level of breeding success should be expected, given that productivity at other similarly contaminated Great Lakes sites may be below that required to sustain a successful breeding population. The absence of an inland bald eagle population from which bald eagles may begin to colonize the shorelines of Lake Ontario may be delaying initiation of nesting site selection; other factors such as habitat and prey availability would likely not limit reproductive success.

Animals↗
PubMed2004

Symptomatic efficacy of stabilizing treatment versus laser therapy for sub-acute low back pain with positive tests for sacroiliac dysfunction: a randomised clinical controlled trial with 1 year follow-up.

AIM: Back pain is a highly frequent condition due to many causes, although most of them cannot be established with certainty. It is also the current clinical and scientific belief that sacroiliac joint syndrome can be a specific low back pain cause. Nonetheless the existence of clinical tests aimed at highlighting the responsibility for lumbar pain secondary to sacroiliac dysfunction, it is not easy to diagnose it with either manual or instrumental means. Moreover, uncertainty is diffuse when facing a correct treatment for patients involved. The aim of this study was to verify, in patients with acute or sub-acute low back pain and positive sacroiliac signs, the efficacy of a stabilising therapy (orthosis and exercises, with previous mesotherapy) directly targeted to sacroiliac dysfunction versus a symptomatic usual care such as He-Ne laser therapy. METHODS: Over a period of 14 months, we recruited 22 patients (10 females, mean age 44+/-11) with acute and sub-acute low back pain and symptoms and signs suggesting a sacroiliac dysfunction. They were randomised in a Group laser (GL), 11 patients treated with He-Ne laser therapy targeting the sacroiliac region, and a Group stabilisation (GS), 11 patients treated with mesotherapy, a specific dynamic sacroiliac support (ILSA) and specific exercises. Outcome criteria included VAS, and Mens and Laslett sacroiliac tests. RESULTS: Out of 449 acute and sub-acute low back pain out-patients, 22 (4.9%) had symptoms and signs suggesting a sacroiliac dysfunction. A reduction of pain was achieved only in the GS. All pain-provocation and stability tests were negative both after the end of treatment and at the follow-up only in the GS. CONCLUSIONS: A targeted approach based on mesotherapy, a specific sacroiliac belt and specific stabilizing exercises proved its efficacy in acute and sub-acute low back pain patients with symptoms and signs suggesting a sacroiliac dysfunction. As soon as it will be possible to identify particular spine syndromes in the universe of non specific low back pain, there will also be the possibility to employ specific therapies.

Journal Article↗
PubMedDate not supplied

Core temperature and percentage of dehydration in professional football linemen and backs during preseason practices.

CONTEXT: Thermal responses of average-sized male subjects (mass of approximately 70 kg) may not accurately reflect the rate of heat storage in larger athletes with greater muscle mass. OBJECTIVE: To determine if core temperature (T(c)) is different in National Football League linemen and backs and if T(c) is related to percentage of dehydration or sweat rate. DESIGN: We measured T(c) and sweat rate in professional football players during preseason twice-daily practices. SETTING: Preseason training camp. PATIENTS OR OTHER PARTICIPANTS: Eight linemen (age = 26.6 +/- 2.1 years, height = 191.8 +/- 4.5 cm, mass = 134.8 +/- 10.7 kg, body surface area = 2.61 +/- 0.12 m2) and 6 backs (age = 27.0 +/- 4.2 years, height = 185.0 +/- 6.3 cm, mass = 95.6 +/- 11.1 kg, body surface area = 2.19 +/- 0.16 m2). MAIN OUTCOME MEASURE(S): We measured T(c) using ingestible sensors. Resting T(c) was recorded in the mornings of data collection with players dressed in shorts and then every 15 minutes during 2-hour practices in full pads or shells. Mass was recorded before and after practices for determining the percentage of dehydration. In 8 of the 14 subjects (4 linemen, 4 backs), sweat rate was calculated using the change in mass adjusted for fluid intake and urine production. RESULTS: Height, mass, and body surface area were greater in linemen than in backs. We noted a linear trend over time for T(c) in both groups. Maximal T(c) was higher in linemen (38.65 +/- 0.48 degrees C) than in backs (38.44 +/- 0.32 degrees C), but linemen were less dehydrated than backs (-0.94 +/- 0.6% versus -1.3 +/- 0.7%). Sweat rate was 2.11 +/- 0.77 L/h and correlated significantly with body surface area (r = 0.77, P < .05). Maximal T(c) was not correlated with either percentage of dehydration or sweat rate. CONCLUSIONS: Maximal T(c) was not associated with percentage of dehydration or sweat rate. Linemen were less dehydrated but demonstrated higher T(c) than backs during practice. Maximal T(c) was generally achieved during live scrimmaging.

Journal Article↗
PubMed1990

Pediatric injuries in the back of pickup trucks.

Travel in the back of pickup trucks has not been adequately addressed as an occupant protection issue. This study compares injuries sustained by children riding in the back of pickup trucks with those of children riding in the cab. Data were obtained from a multihospital monitoring system and the coroner in a single urban county. The series of injured children consisted of 290 children 0 through 14 years of age, 201 of whom had been riding in the cab and 89 in the back. Age distribution of the children demonstrated that it is most frequently the 10- to 14-year-olds who travel in the back. Children riding in the back were more frequently injured in noncrash events (absence of a collision), had more ejections, had more injuries, and sustained more severe injuries as measured by the Maximum Injury Score. With increased restraint use in the cab, it is likely that even greater differentials in injury severity and patterns would be realized. Education regarding the hazards of travel in the back of pickups and stronger legislation limiting the transport of children in the back of trucks are recommended.

Accidents, Traffic↗
PubMed1993

Use of the surface EMG signal for performance evaluation of back muscles.

For well over a decade my associates and I have been developing an objective, noninvasive technique to evaluate the performance of low-back muscles, with emphasis on being able to distinguish between healthy and dysfunctioned backs. Our approach is based on the well-known fact that the EMG signal undergoes a compression in the frequency domain during a sustained muscle contraction. In particular we track the median frequency of EMG signals detected from six muscles in the lower back during an isometric extension of the trunk. The measurements are taken with the Back Analysis System which consists of a postural restraining device, special electrodes for detecting the EMG signals, a muscle fatigue monitor which calculates the median frequencies, and the appropriate software. We have found that the pattern of fatigue exhibited by the six median frequency curves can be used to distinguish individuals who have low-back pain from those who do not with an accuracy of at least 84%. An even more relevant and timely application of our technique is for quantifying the progression of the performance of low-back muscles during a rehabilitation program. Although more work is required to explore the intricacies of the technique, present results provide a convincing indication that it is reliable and that it is ready to be placed into practice.

Back↗
PubMed2005

Back strength and flexibility of EMS providers in practicing prehospital providers.

In the execution of prehospital care duties, an EMS provider may be required to carry equipment and patients over long distances or over multiple flights of stairs at any time of the day. At a minimum, a prehospital provider must have sufficient lower back strength and hamstring flexibility to prevent musculoskeletal injury while lifting. This study administered fitness assessments related to the occupational activities of the prehospital provider with the purpose of describing the incidence of occupational back injury and percentage of providers with known risk factors for back injury. Ninety subjects were tested during a regional EMS conference. Men were significantly taller and heavier than women and had significantly less hamstring flexibility. Body Mass Index was 30.7 +/- 7.2 in men and 28 +/- 5.7 in women. However, no significant differences were noted in an extension test of back strength. When surveyed, 47.8% of subjects reported a back injury in the previous 6 months but only 39.1% of these injuries were sustained while performing EMS duties. While only 13% of these injuries resulted in missed work, 52.2% reported their injury interfered with their daily activities. In spite of the physical nature of the profession, EMS providers in our sample were significantly overweight according to their Body Mass Index and may lack sufficient back strength and flexibilityfor safe execution of their duties. This group of professionals may be at risk for occupational injury and should be targeted for interventions to improve strength and flexibility.

Adult↗
PubMed2004

Workplace design guidelines for asymptomatic vs. low-back-injured workers.

While numerous efforts have attempted to provide quantitative guidelines for the prevention of initial low back disorders during material handling tasks, none have appeared in the literature that address the issue of recurrent low back disorders due to materials handling when returning to the workplace. A study comparing the spine loads of low back pain patients and asymptomatic controls was conducted. Subjects lifted weights varying from 4.5-11.4 kg at four vertical heights, two horizontal distances and five task asymmetries collectively representing common industrial lifting situations. Spine loading was calculated using a validated EMG-assisted biomechanical model. Spine loads observed during lifting tasks were compared to spine tolerance values believed to initiate low back injuries. In addition, the percentage of patients successfully performing the lift was noted and used as an indication of the willingness of the subject to perform the task. These evaluations are summarized in a series of three lifting guidelines indicating safe, medium risk and high risk lifting tasks for low back patients as well as asymptomatic workers. It is believed that adherence to these guidelines can minimize the risk of recurrent low back disorders due to occupational lifting.

Back Injuries↗
PubMed2005

How to prevent low back pain.

This chapter summarizes the European Guidelines for Prevention in Low Back Pain, which consider the evidence in respect of the general population, workers and children. There is limited scope for preventing the incidence (first-time onset) of back pain and, overall, there is limited robust evidence for numerous aspects of prevention in back pain. Nevertheless, there is evidence suggesting that prevention of various consequences of back pain is feasible. However, for those interventions where there is acceptable evidence, the effect sizes are rather modest. The most promising approaches seem to involve physical activity/exercise and appropriate (biopsychosocial) education, at least for adults. Owing to its multidimensional nature, no single intervention is likely to be effective at preventing the overall problem of back pain, although there is likely to be benefit from getting all the players onside. However, innovative studies are required to better understand the mechanisms and delivery of prevention in low back pain.

Exercise Therapy↗