Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Back”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,279 records · Page 71Linked to original sources
PubMed2004

Depression as a risk factor for onset of an episode of troublesome neck and low back pain.

The objective of this study is to determine whether depression is an independent risk factor for onset of an episode of troublesome neck and low back pain. There is growing evidence that pain problems increase the risk of depression. However, the evidence about the role of depression as a risk factor for onset of pain problems is contradictory. This lack of consistency in research findings may be due in part to methodological weaknesses in existing studies, for example, use of an inappropriate study design and inadequate consideration of confounding. A population-based random sample of adults was surveyed and followed at 6 and 12 months. Individuals at risk of troublesome (intense and/or disabling) neck or low back pain are the subjects of this report (n=790). We used Cox proportional hazards models to measure the time-varying effect of depressive symptoms on the onset of troublesome neck and low back pain. Our multivariable analysis considered the possible confounding effects of demographic and socio-economic factors, health status, co-morbid medical conditions and injuries to the neck or low back. We found an independent and robust relationship between depressive symptoms and onset of an episode of pain. In comparison with the lowest quartile of scores (the least depressed), those in the highest quartile of depression scores had a four-fold increased risk of troublesome neck and low back pain (adjusted HRR 3.97; 95% CI 1.81-8.72). Depression is a strong and independent predictor for the onset of an episode of intense and/or disabling neck and low back pain.

Adult↗
PubMed2005

A trial of an activating intervention for chronic back pain in primary care and physical therapy settings.

In primary care and physical therapy settings, we evaluated an intervention for chronic back pain patients which incorporated fear reducing and activating techniques. Primary care patients seen for back pain in primary care were screened to identify persons with significant activity limitations 8-10 weeks after their visit. Eligible and willing patients were randomized (N=240). A brief, individualized program to reduce fear and increase activity levels was delivered by a psychologist and physical therapists. Over a 2 year follow-up period, intervention patients reported greater reductions in pain-related fear (P<0.01), average pain (P<0.01) and activity limitations due to back pain (P<0.01) relative to control patients. The percent with greater than a one-third reduction in Roland Disability Questionnaire scores at 6 months was 42% among Intervention patients and 24% among control patients (P<0.01). Over the 2 year follow-up, fewer intervention patients reported 30 or more days unable to carry out usual activities in the prior 3 months (P<0.01). The adjusted mean difference in activity limitation days was 4.5 days at 6 months, 2.8 days at 12 months, and 6.9 days at 24 months. No differences were observed in the percent unemployed or the percent receiving worker's compensation or disability benefits, but these outcomes were relatively uncommon. We conclude that an intervention integrating fear reducing and activating interventions into care for chronic back pain patients produced sustained reductions in patient fears, common activity limitations related to back pain, and days missed from usual activities due to back pain.

Activities of Daily Living↗
PubMed2006

Back pain in direct patient care providers: early intervention with cognitive behavioral therapy.

Back pain and injury are a widespread problem for direct care providers and can lead to disability and job loss. Although most intervention studies focus on the number of reported injuries as the outcome variable, pain is a leading indicator of impending injury. More secondary prevention interventions focusing on early detection and treatment of pain are needed to reduce injuries. The primary aim of this study was to assess the feasibility and effect size of a cognitive behavioral therapy (CBT) intervention to reduce the measures of back pain, stress, and disability in direct care providers working with back pain. The secondary aim was to assess the association between affect and outcome variables, particularly unscheduled work absence, which is a component of disability. This randomized clinical trial recruited 32 registered nurses and nursing assistants with a history of back pain in the past year and assigned them to either an intervention or a control group. The CBT intervention was a weekly stress and pain management session over 6 weeks led by a clinical psychologist. Data for both groups were collected at baseline and at 6 weeks, with work absence data caused by back pain self-reported for 12 weeks. Pain intensity scores declined in the intervention group, indicating a large effect. However, stress scores increased. Depression scores accounted for one-third of the variance in hours absent because of back pain. Although there was a high dropout rate in the intervention group, a cognitive-behavioral intervention shows promise as a secondary prevention intervention.

Absenteeism↗
PubMed2005

Lower back pain in the athlete: common conditions and treatment.

Athletes younger than 12 years of age commonly have pathology related to the lower back pain. Spondylolysis is the most common condition in these athletes. Other conditions, including lumbar Scheuermann's disease,scoliosis, disc herniation, fractures, and muscular stains, can occur. Most of the mature general population experiences low back at some time in life. Athletes may be at increased risk, but outcomes are good. The majority of low back pain in mature athletes is mechanical in nature. Herniated discs,spinal stenosis, sacoilitis, and sacral stress fractures can also cause low back pain in these athletes. Low back conditions mentioned above may be treated with rest, specific exercise programs, and medication. Surgery is indicated for severe spinal stenosis, pain with evidence of neurological compromise,and some painful deformities. Newer treatments for back pain are emerging,but few controlled clinical trials are available.

Athletic Injuries↗
PubMedDate not supplied

Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.

BACKGROUND CONTEXT: Despite the many published randomized clinical trials (RCTs), a substantial number of reviews and several national clinical guidelines, much controversy still remains regarding the evidence for or against efficacy of spinal manipulation for low back pain and neck pain. PURPOSE: To reassess the efficacy of spinal manipulative therapy (SMT) and mobilization (MOB) for the management of low back pain (LBP) and neck pain (NP), with special attention to applying more stringent criteria for study admissibility into evidence and for isolating the effect of SMT and/or MOB. STUDY DESIGN: RCTs including 10 or more subjects per group receiving SMT or MOB and using patient-oriented primary outcome measures (eg, patient-rated pain, disability, global improvement and recovery time). METHODS: Articles in English, Danish, Swedish, Norwegian and Dutch reporting on randomized trials were identified by a comprehensive search of computerized and bibliographic literature databases up to the end of 2002. Two reviewers independently abstracted data and assessed study quality according to eight explicit criteria. A best evidence synthesis incorporating explicit, detailed information about outcome measures and interventions was used to evaluate treatment efficacy. The strength of evidence was assessed by a classification system that incorporated study validity and statistical significance of study results. Sixty-nine RCTs met the study selection criteria and were reviewed and assigned validity scores varying from 6 to 81 on a scale of 0 to 100. Forty-three RCTs met the admissibility criteria for evidence. RESULTS: Acute LBP: There is moderate evidence that SMT provides more short-term pain relief than MOB and detuned diathermy, and limited evidence of faster recovery than a commonly used physical therapy treatment strategy. Chronic LBP: There is moderate evidence that SMT has an effect similar to an efficacious prescription nonsteroidal anti-inflammatory drug, SMT/MOB is effective in the short term when compared with placebo and general practitioner care, and in the long term compared to physical therapy. There is limited to moderate evidence that SMT is better than physical therapy and home back exercise in both the short and long term. There is limited evidence that SMT is superior to sham SMT in the short term and superior to chemonucleolysis for disc herniation in the short term. However, there is also limited evidence that MOB is inferior to back exercise after disc herniation surgery. Mix of acute and chronic LBP: SMT/MOB provides either similar or better pain outcomes in the short and long term when compared with placebo and with other treatments, such as McKenzie therapy, medical care, management by physical therapists, soft tissue treatment and back school. Acute NP: There are few studies, and the evidence is currently inconclusive. Chronic NP: There is moderate evidence that SMT/MOB is superior to general practitioner management for short-term pain reduction but that SMT offers at most similar pain relief to high-technology rehabilitative exercise in the short and long term. Mix of acute and chronic NP: The overall evidence is not clear. There is moderate evidence that MOB is superior to physical therapy and family physician care, and similar to SMT in both the short and long term. There is limited evidence that SMT, in both the short and long term, is inferior to physical therapy. CONCLUSIONS: Our data synthesis suggests that recommendations can be made with some confidence regarding the use of SMT and/or MOB as a viable option for the treatment of both low back pain and NP. There have been few high-quality trials distinguishing between acute and chronic patients, and most are limited to shorter-term follow-up. Future trials should examine well-defined subgroups of patients, further address the value of SMT and MOB for acute patients, establish optimal number of treatment visits and consider the cost-effectiveness of care.

Databases, Factual↗
PubMedDate not supplied

Low back pain incident episodes: a community-based study.

BACKGROUND CONTEXT: The available evidence regarding low back pain (LBP) incident episodes is not consistent. Such knowledge can add information for the potential contribution of preventive programs. PURPOSE: a) To evaluate annual incident episodes of LBP among the general population. b) To evaluate the contribution of demographic, lifestyle, and back pain history to LBP incident episodes. STUDY DESIGN: A community-based longitudinal study. PATIENT SAMPLE: A randomized sample of individuals, free of LBP at a previous cross-sectional survey. OUTCOME MEASURES: Low back pain during the past year. METHODS: Subjects were followed up after 1 year. Baseline data included back pain history, perception of general health, physical activity, smoking, work satisfaction, and demographic characteristics. RESULTS: Annual incident episodes of LBP were 18.4%. Those who experienced LBP during the past year had a lower baseline perception of general health and were less involved in sporting activities than those free of pain. Those without history of LBP were more likely to be free of back pain after 1 year. CONCLUSIONS: The annual incident episodes of LBP are relatively high and relate indirectly to baseline perception of general health and to level of sporting activities. Those without history of LBP are more likely to be free of back pain after 1 year. These results raise the potential of LBP preventive programs for adult populations.

Adult↗
PubMedDate not supplied

The association of low back pain, neuromuscular imbalance, and trunk extension strength in athletes.

BACKGROUND CONTEXT: Imbalanced patterns of erector spinae activity and reduced trunk extension strength have been observed among patients with low back pain (LBP). The association between LBP and neuromuscular imbalance still remains unclear. PURPOSE: To examine the relationship between LBP, neuromuscular imbalance, clinical symptoms, and trunk extension strength on two independent occasions, after dynamic neuromuscular changes through a back exercise program. STUDY DESIGN/SETTING: Experimental longitudinal study of the lower back in a clinical setting. PATIENT SAMPLE: Eighty-two elite amateur tennis players with and without LBP. OUTCOME MEASURES: Clinical testing of spinal mobility and muscular flexibility of the lower back. Isometric voluntary maximum trunk extension strength. Surface electromyography (EMG) of lumbar erector spinae. METHODS: Athletes underwent a standardized clinical examination with common tests for spinal mobility and muscular flexibility, followed by an isometric trunk extension tests in a specially built apparatus with simultaneous surface EMG recording from right and left lumbar erector spinae. Imbalance quotients were calculated using integrated EMG (IEMG) measures. The relationships between LBP, neuromuscular imbalance, trunk extension strength, and clinical findings were investigated before and after a back exercise program using univariate and multivariate logistic regression models. RESULTS: A significant association between neuromuscular imbalance of erector spinae and the occurrence of LBP was observed, whereas no significant imbalances were found in subjects without LBP. The number of subjects with LBP decreased proportionally with the occurrence of neuromuscular imbalance in the lumbar region after the completion of a back exercise program. However, neuromuscular imbalances were still present during retesting among subjects whose LBP did not resolve; the relationship between neuromuscular imbalance of lumbar erector spinae and LBP was significant again. On the contrary, no significant association between LBP and maximum isometric trunk extension strength or neuromuscular imbalance and maximum isometric trunk extension strength was found before or after the exercise program. No clear relationship between LBP and clinical testing of the lumbar spine or neuromuscular imbalance and clinical testing was found on the two independent testing occasions. CONCLUSION: A direct relationship between LBP and neuromuscular imbalance was documented in athletes with LBP. Maximum isometric trunk extension strength had no relationship to the presence of LBP or the occurrence of neuromuscular imbalance of erector spinae. Common clinical testing of spinal mobility and muscular flexibility had only limited correlation to LBP and neuromuscular imbalance.

Adult↗
PubMed2006

Is every chronic low back pain benign? Case report.

BACKGROUND: There is a well-recognized association between chronic back pain and the existence of an AAA. In literature, there are few reported AAA cases that describe patients with extensive pressure erosion of the vertebral body. CASE DESCRIPTION: The authors present the case of a 38-year-old woman with chronic low back pain for the last 2 years in whom an AAA was formed during the follow-up period. The patient presented with an episode of low back pain following hard work 2 years ago. MR imaging of the lumbar spine was reported as disc degeneration at the L4-5 and L5-S1 levels. She was given medical treatment and was doing well with occasional back pain for a year. One year later, she suffered another disabling pain attack, and MR imaging revealed an additional focal disc protrusion at the L4-5 level. She was again medically treated. In August 2004, she presented with severe low back pain, and this time, MR imaging showed edema and erosion at the anterior part of L3 vertebra body. MR imaging studies (2- and 3-dimensional) depicted AAA as the cause. She was operated on, and the aneurysm was resected with graft repair of the site. She was pain-free in the postoperative period. CONCLUSIONS: The evaluation of a patient with chronic back pain needs a thorough clinical and radiological workup. Limited evaluation of the bony and nervous structures of the spinal canal radiologically is insufficient. Pre- and paravertebral structures as well as vertebral body should carefully be evaluated to diagnose other causes of pain.

Adult↗
PubMed1988

Evaluation of patients with back pain of suspected inflammatory nature.

PURPOSE: Detection of early inflammatory back disease is often difficult. Certain clinical characteristics have been reported to increase the likelihood of its detection in referral patients, but the usefulness of these clinical characteristics has not been evaluated in an open population. In our study, we undertook to evaluate the value of the clinical history as a screening test for inflammatory back disease in a general population. PATIENTS AND METHODS: Twenty-three male patients with back pain of moderate duration and with clinical characteristics suggestive of inflammatory back disease were recruited by advertising and were studied by various means, including computed tomography (CT), scintigraphy, and radiography. RESULTS: One patient had radiographic sacroiliitis. Two had positive results for the B27 antigen, and another had positive results for the cross-reacting HLA antigen B7. Eight patients had abnormal scintiscans of the sacroiliac joints. Twenty-one of 23 patients and 20 of 23 control subjects had abnormalities that were detected by CT. Repeat plain radiographs of the pelvis done 36 months after enrollment into the study did not uncover further evidence of sacroiliitis. CONCLUSIONS: These results indicate plain radiographic evidence of sacroiliitis will often not develop in patients with historical features suggestive of inflammatory back disease even with long-term evaluation, thus vitiating the specificity of these historical findings in men with back pain of relatively brief duration.

Adult↗
PubMed2003

Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool.

OBJECTIVE: To investigate the efficacy of using ratings of perceived exertion (RPEs) to regulate exercise intensity for patients with chronic back pain while they undergo hydrotherapy. DESIGN: Experimental study. SETTING: Hydrotherapy pool in the United Kingdom. PARTICIPANTS: Twenty-six patients (16 women, 10 men) with chronic low back pain of more than 12 months in duration. All were referred for hydrotherapy after attending a back pain triage clinic. INTERVENTIONS: Not applicable. Main outcome measures Borg Ratings of Perceived Exertion Scale; heart rate expressed as a percentage of age-predicted maximum heart rate, computed from readings using heart rate monitors; Oswestry Disability Questionnaire; and pain score from a visual analog scale. RESULTS: At workloads below 55% of age-predicted maximum heart rate, great variability was found in the relation between RPE and exercise intensity. However, for workloads between 55% and 85% of age-predicted maximum heart rate, RPE had a strong correlation with relative exercise intensity during hydrotherapy. CONCLUSIONS: At workloads sufficient to induce an aerobic training response, and yet be safe for patients with chronic back pain, RPE was an accurate predictor of exercise intensity. At lower intensities, back and leg pain may exert a mediating influence. Further investigation is needed to determine the exact relation between back pain, exercise type, and RPE at low exercise intensities.

Adult↗
PubMed1995

Postural aberrations in low back pain.

The purpose of this study was to measure and describe postural aberrations in chronic and acute low back pain in search of predictors of low back pain. The sample included 59 subjects recruited to the following three groups: chronic, acute, or no low back pain. Diagnoses included disc disease, mechanical back pain, and osteoarthritis. Lumbar lordosis, thoracic kyphosis, head position, shoulder position, shoulder height, pelvic tilt, and leg length were measured using a photographic technique. In standing, chronic pain patients exhibited an increased lumbar lordosis compared with controls (p < .05). Acute patients had an increased thoracic kyphosis and a forward head position compared with controls (p < .05). In sitting, acute patients had an increased thoracic kyphosis compared with controls (p < .05). These postural parameters identified discrete postural profiles but had moderate value as predictors of low back pain. Therefore other unidentified factors are also important in the prediction of low back pain.

Acute Disease↗
PubMed1997

An association between the flat back and postpolio syndromes: a report of three cases.

The cases of three patients with a history of paralytic poliomyelitis in childhood who developed the flat back syndrome before or after spinal fusion for degenerative disease as adults were reviewed. The flat back syndrome, a combination of an inability to stand erect because of forward flexion of the trunk and pain in the low back and/or legs, typically occurs in the setting of decreased lumbar lordosis as a result of distraction instrumentation of the spine for scoliosis, vertebral fracture, or degenerative disease. Focus was placed on determining the factors responsible for the development and/or persistence of the flat back syndrome in these patients despite maintenance of, or partial operative restoration of, lumbar lordosis. Considering the essential role that the trunk extensor musculature plays in maintaining upright posture, it may be that a new onset of weakness (postpolio syndrome) in this musculature represents a major contributing factor to the flat back syndrome in these patients. Spine surgeons considering operative procedures in patients with a remote history of paralytic poliomyelitis should be aware of the possible increased risk of the flat back syndrome in this population of patients.

Back Pain↗
PubMed1997

Does folk medicine work? A randomized clinical trial on patients with prolonged back pain.

OBJECTIVE: To determine whether traditional bone-setting or continuous light exercise therapy could case back pain and improve function better than ordinary physiotherapy. DESIGN: Observer-blinded, randomized clinical trial with a 6-month follow-up. SETTING: An outpatient institution for folk medicine research. PATIENTS: Of 147 back pain patients recruited from local health centers and by newspaper announcements, 132 were found eligible (non-retired-no contraindications to manipulation) and entered. A final 114 (one dropout) with back pain for longer than 7 weeks were included in this intent to treat analysis. INTERVENTIONS: Bone-setting, guidance for continuous light back movements or physiotherapy for up to ten 1-hour sessions during 6 weeks. MAIN OUTCOME MEASURES: Spinal mobility and muscular performance. Back pain assessed by visual analog scales (VAS). RESULTS: The physical measures changed only modestly, from one tenth to half of standard deviation, while the VAS was halved. The thoracolumbar side-bending, the modified Schober, and the VAS were significantly better improved by bone-setting than by exercise but not better than by physiotherapy. CONCLUSION: Neither bone-setting nor exercise differed significantly from physiotherapy, but bone-setting improved lateral and forward bending of the spine and back pain more than did exercise.

Adolescent↗
PubMed1999

Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds.

OBJECTIVE: To compare trunk muscle coordination in people with and without low back pain with varying speeds of limb movement. STUDY DESIGN: Abdominal and back extensor muscle activity in association with upper limb movement was compared among three speeds of movement and between people with and without low back pain. PARTICIPANTS: Fourteen subjects with a history of recurrent low back pain and a group of age- and sex-matched control subjects. MEASURES: The onsets of electromyographic activity of the trunk and limb muscles, frequency of trunk muscle responses, and angular velocity of arm movements. RESULTS: Early activation of transversus abdominis (TrA) and obliquus internus abdominis (OI) occurred in the majority of trials, with movement at both the fast and intermediate speeds for the control group. In contrast, subjects with low back pain failed to recruit TrA or OI in advance of limb movement with fast movement, and no activity of the abdominal muscles was recorded in the majority of intermediate speed trials. There was no difference between groups for slow movement. CONCLUSION: The results indicate that the mechanism of preparatory spinal control is altered in people with lower back pain for movement at a variety of speeds.

Abdominal Muscles↗
PubMed1998

Asymmetric low back loading in asymmetric lifting movements is not prevented by pelvic twist.

Asymmetric lifting is associated with an increased risk of low back disorders. Especially in lifting movements, characterized by a small amount of asymmetry, it is still the question if asymmetric lumbosacral torques occur, or if subjects try to avoid asymmetric back loading by twisting their pelvis with respect to the feet. An increase of the lifting speed or the box weight might amplify the lumbar torques but might also result in an attempt to limit further increase of asymmetric torques by increasing pelvic twist. In the current study, asymmetrical lifting movements were analyzed with the aid of a 3D linked segment model, using cuffs mounted to the body segments. Eight subjects performed lifting movements with five different asymmetry conditions, ranging from 0 to 90 degrees lifting asymmetry with respect to the sagittal plane, using two lifting speeds and two box weights. A significant increase in lateral flexing and twisting low back torque was found for each increase in asymmetry of the lifting movement. Pelvic twist accounted more or less constantly for about 25% of the lifting asymmetry and was hardly influenced by lifting speed or box weight. Even for 10 or 30 degrees of lifting asymmetry, subjects did not twist their pelvis far enough to avoid asymmetric loading of the low back. Assuming that asymmetric loading of the low back is more strenuous to the spine than symmetric loading, the current results indicate that even small deviations of a lifting movement from the sagittal plane can explain an increased risk of low back disorders.

Back↗
PubMed1997

Nerve ingrowth into diseased intervertebral disc in chronic back pain.

BACKGROUND: In the healthy back only the outer third of the annulus fibrosus of the intervertebral disc is innervated. Nerve ingrowth deeper into diseased intervertebral disc has been reported, but how common this feature is and whether it is associated with chronic pain are unknown. We examined nerve growth into the intervertebral disc in the pathogenesis of chronic low back pain. METHODS: We collected 46 samples of intervertebral discs from 38 patients during spinal fusion for chronic back pain. 30 samples were from pain levels clinically established by discography and 16 samples were from adjacent vertebral levels with no pain. We obtained 34 control samples of intervertebral disc from previously healthy individuals with normal histology within 8 h of recorded death. We used standard immunohistochemical techniques to test for a general nerve marker, a nociceptive neurotransmitter (substance P), and a protein expressed during axonogenesis (growth-associated protein 43 [GAP43]). FINDINGS: We identified nerve fibres in the outer third of the annulus fibrosus in 48 (60%) of the 80 samples of intervertebral discs. Nerves were restricted to the outer or middle third of the annulus fibrosus in the 34 control samples. Among the patients with chronic low back pain, nerves extended into the inner third of the annulus fibrosus and into the nucleus pulposus in 21 (46%) and ten (22%) samples, respectively. Nerves usually accompanied blood vessels, but in 14 of the samples from back-pain patients, isolated nerve fibres were seen in the discal matrix. Both types of nerve fibres expressed substance P, but only non-vessel-associated fibres expressed GAP43. Deep nerve ingrowth into the inner third of the annulus fibrosus, the nucleus pulposus, or both was seen in four (25%) of 16 biopsy samples from non-pain levels and in 17 (57%) samples from pain levels. Of the 16 paired samples from both pain and non-pain levels, five pain-level samples and one non-pain-level sample showed deep nerve ingrowth. INTERPRETATION: Our finding of isolated nerve fibres that express substance P deep within diseased intervertebral discs and their association with pain suggests an important role for nerve growth into the intervertebral disc in the pathogenesis of chronic low back pain.

Adult↗
PubMed2003

Interobserver reliability of the 24-hour schedule in patients with low back pain: a questionnaire measuring the daily use and loading of the spine.

BACKGROUND: Low back pain is a major health problem in western industrialized countries. The 24-Hour Schedule (24HS) is an instrument which intends to obtain insight in the use (ie, posture and applied load) of the back. It consists of a questionnaire, a series of photos, and a registration form. OBJECTIVE: To assess the interexaminer reliability of the 24-Hour Schedule in patients with low back pain. Study design Reliability study. METHODS: People with low back pain were included in the study. Sample size calculation indicated that 40 participants would be sufficient to answer the research question. Participants were coded to remain anonymous, and after giving informed consent, they completed a questionnaire. Two trained examiners assessed each participant independently. In total, 5 examiners participated. RESULTS: Forty participants were analyzed. In our study population, the use of the back was approximately 10 times more in a flexed position compared to a lordotic position. Flexed activity was registered in all 80 assessments, but in 39 assessments, there was no registration of any activity in a lordotic posture. In only 1 participant (diagnosed with Bechterew's disease), the use of the back was more in a lordotic than in a flexed posture. The intraclass correlation coefficient of the assessment was 0.81 (95% confidence interval = 0.67-0.89), corresponding with a high level of agreement between the examiners. CONCLUSION: The interobserver reliability of the 24HS appeared to be high.

Female↗
PubMed1999

The Bournemouth Questionnaire: a short-form comprehensive outcome measure. I. Psychometric properties in back pain patients.

OBJECTIVE: Develop and test a short-form comprehensive outcome measure for back pain. DESIGN: Prospective longitudinal study of 3 consecutive cohorts of back pain patients. SETTING: Anglo-European College of Chiropractic outpatient clinic and several field chiropractic practices. METHOD: Domains judged important in the back pain model and responsive to clinical change were identified from the literature. Items were scored on an 11-point numerical rating scale. The instrument was psychometrically tested by use of those tests relevant to an evaluative measure. RESULTS: Seven dimensions of the back pain model were included in the questionnaire. Having established face validity, the instrument was shown to demonstrate high internal consistency (Cronbach's alpha = 0.9) and good test-retest reliability (ICC = 0.95). All items were retained on the basis that they contributed to the overall score (item-corrected total score correlations) and to the instrument's responsiveness to clinical change (item change-corrected total change score correlations). The instrument demonstrated acceptable construct and longitudinal construct validity with established external measures. The effect size of the instrument was high (1.29) and comparable with established measures. CONCLUSION: A reliable, valid, and responsive instrument has been developed for use in back pain patients. It is practical for use in investigations of both the efficacy and effectiveness of back pain treatments.

Activities of Daily Living↗