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At least 127 records · Page 7Linked to original sources
PubMed2001

Treadmill study of the range of back movement at the walk in horses without back pain.

OBJECTIVE: To evaluate back movement during walking in horses. ANIMALS: 22 adult horses with no history or signs of back pain. PROCEDURE: 3-dimensional movements of markers on the hooves, head, and back were measured with a motion analysis system while the horses were walking on a treadmill. The positions of markers on the hooves, head, and the skin above the spinous processes of T5, T10, T16, L3, and 2 sacral vertebrae were recorded. From a minimum of 6 walking motion cycles/horse, marker movement and the time of occurrence of minimum and maximum marker positions within the motion cycle were determined. Angles were calculated between the markers on the head, T16, and S4 or S5 and between the markers on T5, T16, and S4 or S5. RESULTS: Lateral back movement was maximal at L3, where it reached (mean +/- SD) 3.5 +/- 0.8% of the horses' height at the withers. Maximum dorsoventral back movement was found at the sacrum, where it reached 4.7 +/- 1.3% of the height at the withers. In the horizontal plane, the angle between T5, T16, and S4 or S5 was altered by 11 +/- 2.5 degrees during the motion cycle. In the sagittal plane, the angle between the head, T16, and S4 or S5 was altered by 7 +/- 3 degrees. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study may be used as basic kinematic reference data for evaluation of back movement in horses.

Animals↗
PubMed1975

Back pain and isometric back muscle strength of workers in a Danish factory.

105 factory workers (38 females and 67 males) have been questioned about their frequency of back pain. 60% of the females and 61% of the males have previously experienced episodes of back pain. 21% of the females and 37% of the males have been absent from work due to back pain. The incidence of back pain is not related to age, height, sort of work, or isometric muscle strength of the back (IS). For the males the incidence rises with increasing weight, i.e. combination of height and obesity, but is not related to any two single factors. For the females there is no correlation between the incidence of pain and weight. IS is correlated to height and age in the males but not in the females. Standards for IS are presented and suggested as a guide to evaluation of the working capabilities of individual subjects with back pain.

Adult↗
PubMed1993

The Back Injury Prevention Project pilot study. Assessing the effectiveness of back attack, an injury prevention program among nurses, aides, and orderlies.

The Back Injury Prevention Project was a pilot study of "Back Attack," an educational program designed to prevent back injuries among nurses, nurses' aides, and orderlies. The pilot tested program feasibility, developed and tested instruments, and generated preliminary data measuring program effectiveness. Fifty-five nurses, aides, and orderlies on two medical/surgical units at two Kaiser Permanente medical centers in Portland, Oregon participated in the study. Intervention group scores on the composite back pain and composite fatigue scales decreased relative to the control group, but this did not reach statistical significance. A 19% improvement in scores for quality of patient transfer was observed for the intervention group (P < .0003), while the control group did not show any significant improvement during the same time period. Results of the pilot suggest that the Back Attack program changes behavior at least in the short term. Further study will be necessary to determine if the behavior change persists and back pain and injury rates are subsequently reduced.

Accidents, Occupational↗
PubMed2001

Extending the Aberdeen Back Pain Scale to include the whole spine: a set of outcome measures for the neck, upper and lower back.

Many therapists treat the spine as a 'functional unit', but suitable condition-specific outcome measures for the whole spine are not available. One of the most rigorously tested measures for back pain related health status is the Aberdeen Back Pain Scale, but it is only suitable for the lower back. The Aberdeen Back Pain Scale was extended to create a set of interlocking outcome measures for the neck, upper and lower back. Questions in these extended outcome measures had to fulfil a series of psychometric criteria before being accepted into the final questionnaires. This involved response frequency, item-total correlation and principal component analysis. The final questionnaires were tested for reliability, criterion and construct validity, responsiveness and acceptability, on patients attending a primary care musculoskeletal clinic. One question was discarded from all three sets of questionnaires and a further question was removed from the neck questionnaire. Baseline scores approximated to normal distributions. Although not completely reproducible, they were internally consistent, so showed evidence of reliability. They were highly correlated with the SF-12 and their mean scores changed according to whether their health status, measured by a transition question, improved, stayed the same or worsened. Modified standardised response means showed large changes when health status improved and moderate-sized changes when health status worsened. Patients made few adverse comments about the questionnaires and found them acceptable. The Extended Aberdeen Spine Pain Scales for neck, upper and lower back pain, showed evidence of reliability, validity, responsiveness and acceptability. They can be used for single regions of the spine or combined as clinically necessary. They are particularly recommended for primary care patients.

Adult↗
PubMed1999

Assessment of functional status, low back disability, and use of diagnostic imaging in patients with low back pain and radiating leg pain.

We analyzed data from outpatients with chronic low back pain (LBP) in the Veterans Health Study (n = 563) to examine the relationship between localized LBP intensity and radiating leg pain in assessing patient functional status, low back disability, and use of diagnostic imaging. Based on the localized LBP intensity, the study subjects were divided into tertiles (low, moderate, and high intensity). The study subjects were also stratified by the extent of radiating leg pain. Using analysis of variance and multiple regression analysis, we compared the relative importance of localized LBP intensity and radiating leg pain in explaining the variability in the means of the SF-36 scales and low back disability days, and in the proportion of patients who had used diagnostic imaging. The results of the study indicate that measures of localized LBP intensity and radiating leg pain contribute separately to the assessment of patient functional status, low back disability, and use of diagnostic imaging. These results suggest that localized LBP intensity and radiating leg pain may represent two different approaches in assessing back pain severity. Future epidemiological and health services research should consider both measures in assessing the impact of LBP on patient functional status, low back disability, and use of diagnostic imaging.

Adult↗
PubMed2003

Implicit attitude towards pictures of back-stressing activities in pain-free subjects and patients with low back pain: an affective priming study.

In this paper, it is investigated whether an implicit evaluative-negative attitude towards back-stressing activities exists in pain-free subjects and in chronic low back pain patients. Using an affective priming task, it was investigated whether pictures of threatening back-stressing movements (primes) facilitate (respectively, slow down) the categorisation of subsequent evaluative-negative (evaluative-positive) words (targets). In study 1 using 20 pain-free subjects, the affective priming effect indicated evidence for an implicit negative attitude towards pictures of back-stressing activities. In study 2 using 30 low back pain patients, a reverse priming effect was found. In line with previous research, it is argued that this reverse priming effect is owing to the evaluative extremity of the primes: patients recognize the possibility that extreme primes will interfere with the categorisation of the targets and overcompensate for this possible effect. The implications for the prevention of negative attitudes towards back-stressing activities in non-clinical and clinical samples are discussed.

Adult↗
PubMed2004

The influence of individual low back health status on workplace trunk kinematics and risk of low back disorder.

A case-control study was conducted to determine whether or not kinematic-based low back disorder risk measurement (Marras et al. 1993) of the job was significantly different for those workers suffering from recent low back injuries compared to asymptomatic controls. Two hundred low back injured workers returning to full duty work and 200 asymptomatic controls were evaluated while performing the same job. There were no statistically significant differences between the two groups on any trunk motion measures or workplace measures. Therefore, job design is dictating the kinematic motions of the torso and not the worker's low back health. In addition, there was not a significant difference in job risk estimates using the lumbar motion monitor risk model. The mean risk (and standard deviation) for the low back injured group and the asymptomatic controls was 0.502 (0.178) and 0.501 (0.193), respectively. This study suggests that trunk kinematics and subsequent risk estimates are dictated primarily by job design and not influenced by the low back health status of the worker.

Adult↗
PubMed1989

Back pain in physiotherapists involved in back care education.

The pattern of back pain in physiotherapists was compared to that in a control group, matched for age and sex, using a self-administered questionnaire. The annual incidence and prevalence, point and life-time prevalence as well as anatomical distribution were similar in both groups to that found previously in nurses and the general population despite the fact that almost all the physiotherapists had been involved with back care education. The recurrence rate was also similar despite the physiotherapists taking earlier steps to avoid further back pain. Physiotherapy was seen to be a stressful occupation in terms of the presence of occupational factors associated with back pain. Physiotherapists were more likely to attribute their back pain to work and the initial onset to a work-related incident. Newly qualified physiotherapists were particularly vulnerable, although they were more satisfied with their training in lifting skills than their older colleagues. Although further research is required, an ergonomics approach to the clinical working environment and a critical appraisal of the value of training in lifting skills and back education programmes are recommended.

Adult↗
PubMed1999

Recurrence and care seeking after acute back pain: results of a long-term follow-up study. North Carolina Back Pain Project.

OBJECTIVE: To explore the relationship between type of initial care as well as the likelihood of recurrence and consequent care seeking behavior. RESEARCH DESIGN: Prospective observational cohort recruited from 208 randomly selected North Carolina practices. Cohort study examined the recurrence of low back pain among patients free of back pain 3 months after their index visit to a practitioner for that problem. The following four practitioner strata were examined: primary care providers, chiropractors, orthopedic surgeons, and practitioners in a group model HMO. Patients were interviewed by telephone at 6 and 22 months after the initial visit. MAIN OUTCOME MEASURES: Rates of disabling and non-disabling low back pain; functional status using the Roland back disability scale; and care seeking. RESULTS: Rates of recurrence were substantial; functionally disabling recurrence rates varied between 8% and 14% between 3 to 6 months, and 20% to 35% between 6 to 22 months. Differences in rates among practitioner strata were statistically significant only between 6 to 22 months with higher recurrence rates for HMO patients. Functional status, number of bed days, and time off work were very similar among the practitioner strata. Care seeking, however, was greater among those patients who had initially seen a chiropractor for their back pain. Patients with recurrence saw the same practitioner type they had seen for the index episode 88% of the time. Satisfaction was slightly greater for patients who saw chiropractors when compared with patients seeing allopathic physicians. CONCLUSIONS: The recurrence of low back pain is common. Severe disability is rare. Patients who had sought care from chiropractors are more likely to return for recurrences than patients who had initially sought care from MDs.

Acute Disease↗
PubMed1991

Effects of spinal flexion and extension exercises on low-back pain and spinal mobility in chronic mechanical low-back pain patients.

It has been estimated that one fourth to one half of all patients treated in physical therapy clinics suffer from low-back pain. The purpose of this study was to compare the effects of spinal flexion (Group I) and extension (Group II) exercises on low-back pain severity and thoracolumbar spinal mobility in chronic mechanical low-back pain patients. Both groups had significantly less low-back pain after treatment (P less than .10). There was no significant difference, however, between the spinal flexion and extension exercises in reduction of low-back pain severity. The results indicated a significant difference between the groups in increasing the sagittal mobility (P less than .10). The results did not indicate any significant difference between and within groups in increasing the coronal and transverse mobility of the thoracolumbar spine. Either the spinal flexion or extension exercises could be used to reduce chronic mechanical low-back pain severity, but the flexion exercises had an advantage in increasing the sagittal mobility within a short period of time.

Adult↗
PubMed2000

Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.

STUDY DESIGN: Repositioning error of the trunk was tested in 20 subjects with chronic low back pain and in 20 control subjects. The 3Space Tracker (Polhemus, Colchester, VT), a device that measures three-dimensional position in space, was used to determine the subject's trunk position. OBJECTIVES: To determine whether repositioning error is different in subjects with chronic low back pain than in control subjects. SUMMARY OF BACKGROUND DATA: Proprioception allows the body to maintain proper orientation during static and dynamic activities. In peripheral joint injuries, researchers have demonstrated a loss of some aspects of proprioception and improvement in outcome with retraining. Although the components of proprioception in subjects with low back pain have not been well studied, it is thought that these persons lose some elements of proprioception that can be measured in a quantifiable way. If so, then rehabilitation to improve these deficits is important. In this pilot study, one aspect of proprioception, repositioning error, was examined. METHODS: The subjects attempted to replicate target positions of the trunk in flexion, extension, lateral bending, and lateral rotation. Repositioning error was calculated as the absolute difference between the actual and the subject-replicated target positions. RESULTS: No significant difference was found in repositioning error between the control subjects and the persons with chronic low back pain. CONCLUSIONS: Because proprioception is complex and entails the use of many afferent receptors, it is difficult to measure any one afferent deficiency discretely. The authors believe that this study, in which one aspect of proprioception was measured in an indirect manner, provides important background information on low back position sense. Further studies analyzing aspects of proprioception in subjects with low back pain are recommended.

Adult↗
PubMed2000

Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group.

STUDY DESIGN: A systematic review of randomized controlled trials. SUMMARY OF BACKGROUND DATA: The treatment of chronic low back pain is not primarily focused on removing an underlying organic disease but at the reduction of disability through the modification of environmental contingencies and cognitive processes. Behavioral interventions are commonly used in the treatment of chronic (disabling) low back pain. OBJECTIVES: To determine whether behavioral therapy is more effective than reference treatments for chronic nonspecific low back pain and which type of behavioral treatment is most effective. METHODS: The authors searched the Medline and PsychLit databases and the Cochrane Controlled Trials Register up to April 1999, and Embase up to September 1999. Also screened were references of identified randomized trials and relevant systematic reviews. Methodologic quality assessment and data extraction were performed independently by two reviewers. The magnitude of effect was assessed by computing a pooled effect size for each domain (i.e., behavioral outcomes, overall improvement, back pain-specific and generic functional status, return to work, and pain intensity) using the random effects model. RESULTS: Only six (25%) studies were high quality. There is strong evidence (level 1) that behavioral treatment has a moderate positive effect on pain intensity (pooled effect size 0.62; 95% confidence interval [CI] 0. 25, 0.98), and small positive effects on generic functional status (pooled effect size 0.35; 95% CI: 0.04, 0.74) and behavioral outcomes (pooled effect size 0.40; 95% CI: 0.10, 0.70) of patients with chronic low back pain when compared with waiting-list controls or no treatment. There is moderate evidence (level 2) that a addition of behavioral component to a usual treatment program for chronic low backpain has no positive short-term effect on generic functional status (pooled effect size 0.31; 95% CI: 0.01, 0.64), pain intensity (pooled effect size 0.03; 95% CI: 0.30,0.36), and behavioral outcomes (pooled effect size 0.19; 95% CI: 0.08, 0.45). CONCLUSIONS: Behavioral treatment seems to be an effective treatment for patients with chronic low back pain,but it is still unknown what type of patients benefit most from what type of behavioral treatment.

Analgesics↗
PubMed2001

Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group.

STUDY DESIGN: A systematic review of randomized controlled trials. SUMMARY OF BACKGROUND DATA: The treatment of chronic low back pain is not primarily focused on removing an underlying organic disease but at the reduction of disability through the modification of environmental contingencies and cognitive processes. Behavioral interventions are commonly used in the treatment of chronic (disabling) low back pain. OBJECTIVES: To determine whether behavioral therapy is more effective than reference treatments for chronic nonspecific low back pain and which type of behavioral treatment is most effective. METHODS: The authors searched the Medline and PsychLit databases and the Cochrane Controlled Trials Register up to April 1999, and Embase up to September 1999. Also screened were references of identified randomized trials and relevant systematic reviews. Methodologic quality assessment and data extraction were performed independently by two reviewers. The magnitude of effect was assessed by computing a pooled effect size for each domain (i.e., behavioral outcomes, overall improvement, back pain-specific and generic functional status, return to work, and pain intensity) using the random effects model. RESULTS: Only six (25%) studies were high quality. There is strong evidence (level 1) that behavioral treatment has a moderate positive effect on pain intensity (pooled effect size 0.62; 95% confidence interval [CI] 0.25, 0.98), and small positive effects on generic functional status (pooled effect size 0.35; 95% CI: -0.04, 0.74) and behavioral outcomes (pooled effect size 0.40; 95% CI: 0.10, 0.70) of patients with chronic low back pain when compared with waiting-list controls or no treatment. There is moderate evidence (level 2) that a addition of behavioral component to a usual treatment program for chronic low backpain has no positive short-term effect on generic functional status (pooled effect size 0.31; 95% CI: -0.01, 0.64), pain intensity (pooled effect size 0.03; 95% CI:-0.30, 0.36), and behavioral outcomes (pooled effect size 0.19; 95% CI: -0.08, 0.45). CONCLUSIONS: Behavioral treatment seems to be an effective treatment for patients with chronic low back pain,but it is still unknown what type of patients benefit most from what type of behavioral treatment.

Chronic Disease↗
PubMed2002

The reliability of the Low Back Outcome Score for back pain.

STUDY DESIGN: A prospective test-retest study was conducted to investigate both new and follow-up patients with low back pain presenting to an orthopedic surgeon specializing in back pain. OBJECTIVES: To further validate the internal consistency and test-retest reliability of the Low Back Outcome Score, and to compare these results with other condition-specific disability scales. SUMMARY OF BACKGROUND DATA: To be useful in clinical practice, health-specific questionnaires must demonstrate reliability and validity. Several disease-specific questionnaires for low back pain have been validated to different extents. METHODS: In this study, 102 new and 42 follow-up patients consecutively attending a consultant clinic completed the Low Back Outcome Score on their visit, then again after an interval of 1 week in postal form. This instrument also was completed by 230 patients presenting to a physiotherapist. RESULTS: A response rate of 90% was achieved for the postal questionnaire. A test of internal consistency conducted with the study sample achieved a Cronbach alpha coefficient of 0.85. Overall agreement for test-retest reliability was 84%, and the reliability coefficient (K) reached a range of 0.51 to 0.86 (P < 0.05). A Bland/Altman plot was calculated, demonstrating that only 5% of patient scores change by more than 11.6 scale points between test and retest, which is not sufficient to change outcome categories. CONCLUSION: The Low Back Outcome Score appears to have good internal consistency and test-retest reliability for use in clinical practice.

Adult↗
PubMed2003

Back to work: predictors of return to work among patients with back disorders certified as sick: a two-year follow-up study.

STUDY DESIGN: A 2-year follow-up study of patients with back disorders certified as sick. OBJECTIVES: To identify predictors of return to work. SUMMARY OF BACKGROUND DATA: Back disorders are common health problems and the most important disorders associated with absence from work in the welfare states. Predictors of future absence may be of help in allocating rehabilitation efforts to such patients. Possible predictors include demographic and medical factors, the patients' functional status, and former absence. METHODS: For this study, 190 patients certified as sick who attended a back disorder outpatient clinic from September 1997 to December 1998 answered a questionnaire. Demographic data, medical factors, self-assessed function, and absence data were recorded. Return to work, defined as returning to work for at least 60 consecutive calendar days, was used in Cox regression analyses. RESULTS: According to multiple Cox regression analyses, age of 40 to 49 years (HR, 0.52; 95% confidence interval [95%CI], 0.29-0.94), high pain intensity (HR, 0.30; 95%CI, 0.17-0.55), low self-assessed work ability (HR, 0.43; 95%CI, 0.25-0.73), and a self-predicted absence status of not returning to work (HR, 0.31; 95%CI, 0.17-0.54) predicted longer time until return to work. Back disorders with radiation predicted shorter time until return to work (HR, 2.08; 95%CI, 1.37-3.16). The COOP/WONCA chart's physical fitness, daily activities, overall health, and change in health were associated with time until return to work in univariate analyses only, as was the duration of the sickness certification episodes from start to inclusion and the degree of sickness certification at inclusion. CONCLUSIONS: Information about the age of the patients, diagnoses, pain intensity, self-assessed work ability, and self-predicted absence status may be used as predictors of time until return to work in patients with back disorders certified as sick who attend a back disorder outpatient clinic.

Adult↗
PubMed2003

Looking back on back pain: trial and error of diagnoses in the 20th century.

CONTEXT: The societal costs of low back pain and associated disability are immense. However, very little is known about the etiology of low back pain. Lumbar disc disease was discovered in the last century and became the predominant etiology for back pain. Today we know that for the majority of low back pain cases, a specific etiology cannot be determined. OBJECTIVE: To analyze the evolution of the "disc paradigm" and to compare our contemporary understanding to the scientific discussion in the beginning of the last century. DESIGN: Survey of the highest ranked German medical journal from 1900 to 1999. DATA EXTRACTION: The indexes of 5185 journal issues of the Deutsche Medizinische Wochenschrift were reviewed for articles about low back pain. DATA SYNTHESIS: For each article, the etiologies were identified, categorized, and counted per decade. In addition, each important etiology was described. CONCLUSIONS: In the beginning of the last century, many heterogeneous etiologies coexisted. In the second half of the century, the theory of disc degeneration took over almost the entire literature about low back pain. Pre-existing theories disappeared, but re-entered the discussion in the last decade. Two factors seemed to influence this development: 1) a tendency to prefer organic, visible abnormalities as etiologies; and 2) an inclination to trust technical diagnostic results more than clinical judgment.

History, 20th Century↗
PubMed2004

The effect of previous low back surgery on general health status: results from the National Spine Network initial visit survey of patients with low back pain.

STUDY DESIGN: A cross-sectional study on 18,325 patients with back pain enrolled at first visit in the National Spine Network (NSN) database from January 1998 to April 2000. OBJECTIVES: To examine whether patients who had previous low back surgeries had poorer general health status than patients with no surgery. SUMMARY OF BACKGROUND DATA: Several studies have described the role of psychological abnormalities in patients with chronic low back pain. Some of these patients have had previous spinal surgeries performed. No study has examined the effects of previous low back surgery on the general health status. METHODS: The Short Form Health Survey 36 was administered to the initial visit NSN patients. Of the 18,325 patients enrolled, 3,632 had previous low back surgeries. RESULTS: Patients who had previous lumbar surgeries fared significantly poorly in all 10 scores of the SF-36 health survey, even after adjustment for confounding factors. Among these patients, decompression achieved significantly higher scores for General Health, Role-Physical, and Mental Component Summary scales. Patients who had decompression as their most recent surgery had higher scores for General Health, Role-Physical, Role-Emotional, and Mental Component Summary scales, when compared to those who had other surgeries. Patients who had instrumentation as their most recent surgery had higher scores for Bodily Pain and Physical Component Summary scores. There is a positive correlation between time since last surgery and the SF-36 outcomes. CONCLUSIONS: Previous back surgery is associated with significantly worse general health status than those without surgery. Among patients who had previous surgeries, decompression seems to exert better effects on SF-36 health status. There is a positive correlation between time since last surgery and the SF-36 outcomes, although the SF-36 scores are significantly lower than those without previous surgery.

Adolescent↗
PubMed2005

A novel back school using a multidisciplinary team approach featuring quantitative functional evaluation and therapeutic exercises for patients with chronic low back pain: the Japanese experience in the general setting.

STUDY DESIGN: A prospective cohort study. OBJECTIVES: To introduce a novel back school for the treatment of patients with chronic low back pain (CLBP), and to report its clinical results. SUMMARY OF BACKGROUND DATA: Although back school is one of the treatment methods for patients with CLBP, its efficacy and appropriate style remain controversial. No studies have been published regarding the combined program of back school with a multidisciplinary team approach. METHODS: A total of 182 patients with CLBP (74 men and 108 women; average age, 43.8 years) participated in this study. All patients were enrolled in the back school using a multidisciplinary team approach featuring quantitative functional evaluation and therapeutic exercises. The following outcome measures were evaluated at the baseline, and 6 and 12 months after the enrollment: the level of pain evaluated with a Visual Analog Scale (VAS), flexibility of trunk and hamstrings (finger-floor distance, straight leg raising), trunk muscle strength and endurance, frequency of therapeutic exercises, and self-reported patient satisfaction. RESULTS: An averaged VAS score was 6.2 before enrollment in the program and 2.8 at follow-up. The pain improved in 141 patients (80.8%), did not change in 27 (15.4%), and was aggravated in 7 (3.8%). There was statistically significant improvement of finger-floor distance, trunk muscle strength, and endurance in the patients whose pain was relieved after enrollment in the program (P < 0.05). The compliance with the exercise program was significantly correlated with the clinical results (P < 0.05). CONCLUSIONS: We developed a novel back school using a multidisciplinary team approach, featuring quantitative functional evaluation and therapeutic exercises. The current study demonstrated that our program could provide a satisfactory result for the treatment of patients with CLBP. The quantitative functional evaluation was a worthwhile outcome measure when evaluating the efficacy of the treatment program. Teaching body mechanics and performing the therapeutic exercises through the multidisciplinary team approach are essential to managing CLBP in a general setting.

Adult↗