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PubMedDate not supplied

[Physical impairments and comorbidities in a sample of members of a pension fund of blue-collar workers suffering from severe low back pain].

AIM: Idiopathic (unspecific) low back pain is the most common rheumatological complaint. Results of international studies give evidence that in about 80 % of the cases a specific diagnosis is not possible, thus creating an unsatisfactory situation for the orthopaedist. We feel that it is necessary to keep the discussion on the rate of specific causes for low back pain open. METHODS: In the context of a research project on the need for rehabilitation, 335 subjects suffering from severe low back pain were subjected to a physical (orthopaedic-neurological) examination. Also, a questionnaire was distributed assessing psychological status, work situation, comorbid conditions, risk factors, and demography. RESULTS: In more than half of the subjects, clues for a specific cause for the back pain were found; in more than one third of the cases there were one or more neurological signs. CONCLUSION: The data presented demonstrate that specific causes for low back pain might be more common than generally assumed. This leads us to the conclusion that there is a need for more clinically-oriented, population-based (epidemiological) research on possible pathologic causes of low back pain and comorbid conditions.

Adult↗
PubMed1991

A controlled trial of corticosteroid injections into facet joints for chronic low back pain.

BACKGROUND: Chronic low back pain is a common problem with many treatments, few of which have been rigorously evaluated. This randomized, placebo-controlled trial was designed to evaluate the efficacy of injections of corticosteroid into facet joints to treat chronic low back pain. METHODS: Patients with chronic low back pain who reported immediate relief of their pain after injections of local anesthetic into the facet joints between the fourth and fifth lumbar vertebrae and the fifth lumbar and first sacral vertebrae were randomly assigned to receive under fluoroscopic guidance injections of either methylprednisolone acetate (20 mg; n = 49) or isotonic saline (n = 48) in the same facet joints. Ninety-five patients were followed for six months and their condition assessed with scales of pain severity, back mobility, and limitation of function. RESULTS: After one month, none of the outcome measures evaluating pain, functional status, and back flexion differed clinically or statistically between the two study groups. Forty-two percent of the patients who received methylprednisolone and 33 percent of those who received placebo reported marked or very marked improvement (95 percent confidence interval for the difference, -11 to 28 percentage points; P = 0.53). The results were similar after three months. At the six-month evaluation, the patients treated with methylprednisolone reported more improvement, less pain on the visual-analogue scale, and less physical disability. The differences were reduced, however, when concurrent interventions were taken into account. Moreover, only 11 patients (22 percent) in the methylprednisolone group and 5 (10 percent) in the placebo group had sustained improvement from the first month to the sixth month (95 percent confidence interval for the difference, -2 to 26; P = 0.19). CONCLUSIONS: We conclude that injecting methylprednisolone acetate into the facet joints is of little value in the treatment of patients with chronic low back pain.

Adrenal Cortex Hormones↗
PubMed1994

Magnetic resonance imaging of the lumbar spine in people without back pain.

BACKGROUND: The relation between abnormalities in the lumbar spine and low back pain is controversial. We examined the prevalence of abnormal findings on magnetic resonance imaging (MRI) scans of the lumbar spine in people without back pain. METHODS: We performed MRI examinations on 98 asymptomatic people. The scans were read independently by two neuroradiologists who did not know the clinical status of the subjects. To reduce the possibility of bias in interpreting the studies, abnormal MRI scans from 27 people with back pain were mixed randomly with the scans from the asymptomatic people. We used the following standardized terms to classify the five intervertebral disks in the lumbosacral spine: normal, bulge (circumferential symmetric extension of the disk beyond the interspace), protrusion (focal or asymmetric extension of the disk beyond the interspace), and extrusion (more extreme extension of the disk beyond the interspace). Nonintervertebral disk abnormalities, such as facet arthropathy, were also documented. RESULTS: Thirty-six percent of the 98 asymptomatic subjects had normal disks at all levels. With the results of the two readings averaged, 52 percent of the subjects had a bulge at at least one level, 27 percent had a protrusion, and 1 percent had an extrusion. Thirty-eight percent had an abnormality of more than one intervertebral disk. The prevalence of bulges, but not of protrusions, increased with age. The most common nonintervertebral disk abnormalities were Schmorl's nodes (herniation of the disk into the vertebral-body end plate), found in 19 percent of the subjects; annular defects (disruption of the outer fibrous ring of the disk), in 14 percent; and facet arthropathy (degenerative disease of the posterior articular processes of the vertebrae), in 8 percent. The findings were similar in men and women. CONCLUSIONS: On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.

Adult↗
PubMed2000

Alcohol and low-back pain: a systematic literature review.

BACKGROUND: The role of lifestyle factors is an important issue in the prevention and treatment of disease. Although certain lifestyle factors in relation to low-back pain have evoked much interest, interest has not focused on alcohol consumption. An appraisal of the epidemiologic literature seems warranted. OBJECTIVES: To establish if there is evidence in the literature for a causal link between alcohol consumption and low-back pain. DATA SOURCES: Nine original research reports published between 1987 and 1995 were obtained through a MEDLINE search for the years 1992 to 1998, with various combinations of the terms "alcohol," "substance abuse," "life-style, " "risk factor," "epidemiology" and "low back pain." An additional manual search was made of relevant bibliographies without limitation for year of publication. DATA SYNTHESIS: A systematic review was made of the epidemiologic literature to uncover any evidence for a causal relation between alcohol consumption and low-back pain. RESULTS: None of the studies reported a positive link between alcohol consumption and low-back pain, and no positive gradient was found in studies that included an analysis of the dose-response. None of the studies was prospective in design. CONCLUSIONS: Alcohol consumption does not seem to be associated with low-back pain, but well-designed specific alcohol/low-back pain-centered studies are lacking.

Adult↗
PubMed2001

Isometric back extension endurance tests: a review of the literature.

OBJECTIVE: To review the literature that describes and evaluates the use of isometric back extension endurance tests. DATA COLLECTION: Relevant articles in English were retrieved through a search of MEDLINE and the Index to Chiropractic Literature. Key search terms were back muscle endurance, isometric back endurance, trunk extensors, back muscle performance, and Sorensen test. DATA SYNTHESIS: The principal criterion for inclusion was as follows: any study that discussed or tested an isometric type of back endurance extension test. Studies that were excluded did not use an isometric testing protocol. Thirty-seven of the initial studies are included in this review. RESULTS: Six different types of isometric back extension endurance testing methods were found. Three of these procedures require special testing devices. Much of the research on this topic has centered on a procedure known as the Sorensen test. Normative databases have been established for the Sorensen test and 2 other test types. Validity and reliability have been assessed for some of the procedures. CONCLUSIONS: The influence of motivation and effort exerted by the subject are limiting factors in all of the tests reviewed. These psychologic factors warrant further research. On the basis of the literature reviewed, we determined that the Sorensen is probably the most clinically useful of these tests; it is easy to perform, requires no special equipment, and enjoys the most support from the literature.

Adult↗
PubMed2001

Prognostic values of physical examination findings in patients with chronic low back pain treated conservatively: a systematic literature review.

BACKGROUND: Most patients undergo physical examination. However, low back pain can only rarely be clearly diagnosed as having an irrefutable pathoanatomic cause on the basis of the classical battery of noninvasive physical examination procedures. However, physical examination findings are also used to predict the prognosis of treatment of chronic low back pain. A systematic review of the clinical literature is needed for an understanding of findings in this area. OBJECTIVES: To establish whether various physical examination procedures can be used to predict treatment outcome in the conservative (noninvasive) treatment of chronic low back pain. DATA SOURCES: From 910 titles published between 1986 and 1998, 10 original research reports were selected. These were obtained by means of a computerized MEDLINE search through use of various combinations of the key words low back pain, treatment, physical findings, predictors, prognosis, prognostic factors, prognostic indicators, and predictors and outcome(s); manual search strategies were also used. DATA SYNTHESIS: Articles that fitted the objectives of this review were retained and systematically reviewed for the prognostic value of the relevant tests/observations. In addition, results were studied in relation to type of outcome variable and type of treatment. RESULTS: The most commonly investigated tests were lumbar range-of-motion tests, which were found to have a clear-cut significant predictive value in 3 of 9 studies. Further analyses in relation to definition of outcome (back-to-work or reduction of symptoms) were not possible because study results were usually not clearly reported for each definition and because therapies were multimodal rather than distinctly well defined. CONCLUSIONS: This area has not been fully investigated. Therefore, there is no satisfactory answer to the question of whether some physical examination tests have a prognostic value in the conservative treatment of chronic low back pain.

Chronic Disease↗
PubMed2002

Effectiveness of a selected bedding system on quality of sleep, low back pain, shoulder pain, and spine stiffness.

OBJECTIVE: To determine whether clinical and statistically significant changes in back pain, shoulder pain, spine stiffness, and quality of sleep may be documented after use of a prescribed bedding system. DESIGN: Quasi-experimental field study of single group pretest-posttest design with subjects serving as their own controls. SETTING: Two chiropractic clinics and the Oklahoma State University Program of Health and Human Performance. SUBJECTS: Convenience sample of 22 subjects (women, n = 13; men, n = 9) between the ages of 25 and 75 years with documented disturbed sleep, shoulder pain, low back pain, and spine stiffness of a chronic nature. OUTCOME MEASURES: Pretest and posttest 28-day Visual Analog Scales for pain, spine stiffness, and quality of sleep. MAIN RESULTS: The experimental bedding system reduced back pain by 57.21% (P =.000001), reduced shoulder pain by 60.83% (P =.000005), reduced back stiffness by 59.12% (P =.000004), and improved quality of sleep by 60.73% (P =.000001). CONCLUSIONS: Results suggest that subjects obtain significant improvement in shoulder and back pain, back stiffness, and quality of sleep after 28 days of prescribed bedding system use as compared with 28 days of personal bedding use. Female subjects and those with lower body weight were more likely to significantly improve than heavier and more obese subjects.

Adult↗
PubMed2002

Evaluation of a specific home exercise program for low back pain.

BACKGROUND: The prescription of exercise as a conservative treatment for lumbar pain is frequent and seems effective for the chronic cases of nonspecific low back pain. However, there is no evidence favoring one type of exercise over another. Often, exercise programs are prescribed without adequate evaluation of the individual characteristics like posture, muscular force, and extensibility. Patients with totally different causes of low back pain will often be given the same type of exercises. OBJECTIVE: Our objective was to compare the effectiveness of 2 home exercise programs in decreasing disability and pain related to subacute and chronic nonspecific low back pain. To do so we compared a specific (individualized) exercise program with a program of commonly prescribed exercises for low back pain. METHOD: In a control group study, 20 patients with chronic or subacute nonspecific low back pain participated after giving their informed consent. All subjects were evaluated (physical evaluation of lumbar and pelvic muscles [1] force and [2] extensibility, [3] trunk range of motion) and then divided in 2 groups: 10 patients received specific exercises (experimental group) based on their evaluation, and 10 patients received a commonly prescribed exercise program for low back pain (control group). Six weeks later a second physical evaluation was conducted. Pain (visual analog pain scale) and disability (modified Oswestry) questionnaires were also completed by each subject at both evaluations. DESIGN: This was a randomized experimental study. RESULTS: Both groups had similar age, weight, and sex characteristics. The experimental group showed significant improvements for some components targeted by the program. The control group significantly had improvement of some physical characteristics not related to their initial deficits. Even if both groups showed some improvements in muscular force and extensibility, only the members of the group who received specific exercises significantly reduced their level of pain and disability. Both groups showed a similar rate of participation in the program. CONCLUSION: The results of this study suggest that applying a specific physical evaluation and exercise prescription is an appropriate treatment for people having subacute or chronic nonspecific pain. Thus clinicians should prescribe exercise programs based on individual muscular deficits rather than most commonly prescribed exercise programs.

Activities of Daily Living↗
PubMed2003

Comparative analysis of low-back loading on chiropractors using various workstation table heights and performing various tasks.

BACKGROUND: There is epidemiologic evidence that chiropractors are a high-risk group for low-back disorders. However, to date there are no known biomechanical studies to determine whether their workstations may be a contributing factor. OBJECTIVE: To investigate whether chiropractors' workstation table height or the tasks they perform make them susceptible to low-back strain. As well as investigating low-back strain, a screening was performed to determine whether chiropractors' upper extremities were at risk for undue strain as workstation table height was varied. STUDY DESIGN: Experimental pilot study. SETTING: A university ergonomic laboratory. METHODS: An adjustable manipulation table was set at 3 different heights: 465 mm, 665 mm and 845 mm. Each of the 7 volunteer chiropractors were fitted with a triaxial electrogoniometer and were videotaped and photographed for analysis while performing spinal manipulation to the cervical, thoracic, and lumbar spine of a volunteer patient at each workstation table height. Two biomechanical models, one static and one dynamic, were used to record the dependent variables. A screening of various upper extremity variables was also performed with the static model. RESULTS: For the subjects under study, a significant difference was found for the variables maximum sagittal flexion, disk compression force, and ligament strain as table height was varied. For the lumbar and thoracic manipulation tasks, the medium table height (655 mm) was found to create the least low-back strain. For the cervical manipulation task, the high table height (845 mm) was found to be the least straining on the low-back. The low height table (465 mm) was the most straining for all tasks. Upper extremities were not significantly affected by changes to table height. Significant differences were found for the task performed for axial rotational velocity, disk compression force, ligament strain, maximum sagittal flexion, dominant (right) elbow moment, and dominant (right) shoulder moment variables. There was no significant interaction between table height and task performed. CONCLUSION: Workstation table height was found to have a significant effect on low-back load of subjects under study. The results of this study demonstrate an overall unacceptably high amount of sagittal flexion, ligament strain, and disk compression force on the chiropractor subjects in the tasks performed.

Adult↗
PubMed2000

Effect of foot movement and an elastic lumbar back support on spinal loading during free-dynamic symmetric and asymmetric lifting exertions.

The aim of this study was to assess the effect of an elastic lumbar back support on spinal loading and trunk, hip and knee kinematics while allowing subjects to move their feet during lifting exertions. Predicted spinal forces and moments about the L5/S1 intervertebral disc from a three-dimensional EMG-assisted biomechanical model, trunk position, velocities and accelerations, and hip and knee angles were evaluated as a function of wearing an elastic lumbar back support, while lifting two different box weights (13.6 and 22.7 kg) from two different heights (knee and 10 cm above knee height), and from two different asymmetries at the start of the lift (sagittally symmetric and 60 degrees asymmetry). Subjects were allowed to lift using any lifting style they preferred, and were allowed to move their feet during the lifting exertion. Wearing a lumbar back support resulted in no significant differences for any measure of spinal loading as compared with the no-back support condition. However, wearing a lumbar back support resulted in a modest but significant decrease in the maximum sagittal flexion angle (36.5 to 32.7 degrees), as well as reduction in the sagittal trunk extension velocity (47.2 to 40.2 degrees s(-1)). Thus, the use of the elastic lumbar back support provided no protective effect regarding spinal loading when individuals were allowed to move their feet during a lifting exertion.

Adult↗
PubMed2000

Trunk muscle activation and low back loading in lifting in the absence of load knowledge.

People who know the actual mass of an object to be lifted normally prepare themselves before attempting a lift to control the movement and to minimize low back loading. In this study, the trunk muscular reactions and low back torque were investigated in the situation in which the individual did not know the actual mass but only had some idea of the range within which the mass lay. Nine males lifted boxes weighing 6.5 or 16.5 kg under the condition in which they knew the actual mass before attempting a lift (the 'known' condition) and the condition in which they only had the information that the mass would be within the range of 6.5-16.5 kg (the 'unknown' condition). The ground reaction forces and body movements were measured in the trials and, from these, the L5/S1 torques were calculated. The activation of back and abdominal muscles was also measured. For the 6.5 kg weight, a higher (16%) back muscle activation in grasping the box and a higher (10%) peak L5/S1 torque in actual lifting were observed in the 'unknown' compared with the 'known' weight condition. For the 16.5 kg weight, the back muscle activation was lower (10%) during grasping, and higher (10%) during lifting in the 'unknown' compared with the 'known' weight condition. Knowledge of the load had no effect on the activation of the abdominal muscles. It was concluded that in the so-called 'unknown' conditions, the risks of low back injury were increased in comparison with the conditions where the actual weight was known in advance.

Abdominal Muscles↗
PubMed2000

Prospective validation of a low-back disorder risk model and assessment of ergonomic interventions associated with manual materials handling tasks.

The evaluation of low-back disorder risk associated with materials handling tasks can be performed using a variety of assessment tools. Most of these tools vary greatly in their underlying logic, yet few have been assessed for their predictive ability. It is important to document how well an assessment tool realistically reflects the job's injury risk, since only valid and accurate tools can reliably determine whether a given ergonomic intervention will result in a future reduction in back injuries. The goal of this study was to evaluate how well a previously reported low-back disorder (LBD) risk assessment model (Marras et al. 1993) could predict changes in LBD injury rates as the physical conditions to which employees are exposed were changed. Thirty-six repetitive materials handling jobs from 16 different companies were included in this prospective cohort study. Of these 36 jobs, 32 underwent an ergonomic intervention during the observation period, and four jobs in which no intervention occurred served as a comparison group. The trunk motions and workplace features of 142 employees performing these jobs were observed both before and after workplace interventions were incorporated. In addition, the jobs' LBD rates were documented for these pre- and post-intervention periods. The results indicated that a statistically significant correlation existed between changes in the jobs' estimated LBD risk values and changes in their actual low-back incidence rates over the observation period. Linear and Poisson regression models also were developed to predict a change in a job's incidence rate and the number of LBD on ajob respectively, as a function of the job's risk change using this assessment model. Finally, this prospective study showed which ergonomic interventions consistently reduced the jobs' mean low-back incidence rates. These results support use of the LBD risk model to assess accurately a job's potential to lead to low-back injuries among its employees.

Adult↗
PubMed2004

The influence of a back support harness on spinal forces during sheep shearing.

Previous research has classified the occupation of sheep shearing as heavy work where shearers flex their spine and hips for long periods of time, handle awkward loads and expend high amounts of energy. The aim of this research was to investigate the magnitude of spinal forces produced during the shearing phase of the work and to determine whether the use of a commercially available back support harness would reduce these forces. Following discussion on task complexity and risk of back injury with senior shearing instructors, three component tasks of the shearing phase were identified as posing high risk of injury and were prioritized for primary analysis. Although the dragging out of a sheep in preparation for shearing and an unexpected loss of animal control were also identified as being of high risk, technological and instrumentation difficulties precluded their analysis. Twelve experienced shearers were videotaped while shearing with and without the use of a back harness. Surface mounted retro-reflective markers placed on the trunk defined three linked segments: Pelvis, Lumbar and Head, Arms, and Upper Trunk (HAUT). A 3D, link segment, top down, inverse dynamics approach was used to describe the motion and to estimate forces involved during the identified tasks of shearing. The spinal force/time profiles of this sample of shearers demonstrated large compressive and shear forces for all three tasks that are close to the NIOSH and University of Waterloo action limits for compressive and shear forces respectively (McGill 1997, Yingling and McGill 1999, Marras 2000). The use of the back support harness reduced these forces by substantial and statistically significant amounts. This effect was consistent across all three tasks. The results of this study demonstrate the production of high levels of compressive and shear forces within the spine of shearers during the three shearing tasks studied and that the use of a back support harness can substantially reduce these forces. Therefore the use of a back harness may reduce the cumulative load on the spine during shearing thereby moderating damage to the articular structures. However it is not known whether the harness would protect the spine from a sudden or unexpected force.

Adult↗
PubMed1990

Back pain and exposure to whole body vibration in helicopter pilots.

In a questionnaire survey the prevalence of back pain in 163 helicopter pilots was compared to that in a control group of 297 non-flying air force officers who underwent the same pre-employment medical examination. Since pilots document their hours of flight in a personal flight log, an accurate estimate of the duration of exposure could be made. In addition, vibration levels of the helicopters were measured and an accumulative vibration dose was calculated for each pilot. 'Transient' back pain of a short duration was more frequent amongst the pilots compared to the control group, and the prevalence of 'chronic' back pain of a persistent nature was also higher amongst the helicopter pilots. Transient back pain seemed to be most strongly related to the average hours of flight per day, whereas chronic back pain was more closely related to total hours of flight or the accumulative vibration dose. A significant higher prevalence of this chronic back pain was observed only after 2000 hours of flight or a vibration dose of 400 m2h/s4. The observed health effects may be due to vibration or constrained posture but are most likely due to concomitant exposure to both factors.

Adult↗
PubMed1999

Do workplace interventions prevent low-back disorders? If so, why?: a methodologic commentary.

The demand for workplace interventions to prevent low-back disorders has increased in recent years. At the same time, a crisis in the literature has become apparent: there are conflicting reports on whether or not these interventions work. With the aim of understanding the reason for the dissension in the literature, six studies were selected for close examination. These were studies of interventions based on differing principles, i.e. a change in organizational ethos to promote back safety, back belt use, the introduction of ergonomic devices, and back-strengthening exercises. If the studies are taken at face value, any of the interventions, regardless of type, has a tremendous effect. Methodological problems inherent in these studies may provide a clue to why essentially different interventions were found to be consistently successful. Study design quality has long been noted to exert a particular influence on the evaluation of outcomes: the quality of the study design is often inversely related to reported outcomes. Of the six studies selected for examination, four did not include a contemporaneous control group, five did not randomly assign subjects to test and control groups, and none included a placebo group. Given these research designs, variables other than those tested by the studies may have produced the reported results. These variables include 'beliefs of the intervention providers' and 'coalescence of the work group', both of which are discussed. Two approaches, the pragmatic and the explanatory, may be used to study workplace interventions to prevent low-back disorders. Most of the examined studies are pragmatically oriented. Having dealt with study design problems expeditiously, these studies may be characterized as more immediately responsive to the demand to evaluate workplace interventions than explanatory studies. On the other hand, explanatory studies, most notably associated with randomized clinical trials in medicine, are more rigorous. Enough pragmatically oriented studies have been conducted to suggest that workplace interventions may have an effect on low-back disorders. More conclusive explanatory studies may now be conducted.

Accidents, Occupational↗
PubMed2000

Clinical findings in a population with back pain. Relation to one-year outcome and long-term sick leave.

OBJECTIVE: To investigate whether physical examination findings can be used in predicting recovery from back pain and new episodes of sick leave. DESIGN: One-year prospective study of a single cohort. SETTINGS: Semi-rural Swedish county. POPULATION: A cross-section of a general population with back pain (207 women, 176 men) between 20 and 59 years of age. MAIN OUTCOME MEASURES: Cumulative incidence of sick leave due to back pain, cumulative incidence of sick leave due to back pain > 30 days, incidence of recovery from back pain. RESULTS: For recovery from pain, the absence of tenderness in the trapezius muscle (OR 0.33; CI 0.1-0.5) was predictive. New sick leave was predicted by tenderness in the trapezius muscle (OR 2.67; CI 1.5-4.9), and had a tendency to be associated with a flattened lumbar lordosis and a restricted cervical range of motion. For long-term sick leave, the same findings and also observation of scoliosis (OR 3.44; CI 1.1-10.5) were predictive. CONCLUSION: There are subgroups with back pain predisposed to development of more persistent symptoms and a higher risk for sick-listing.

Adult↗
PubMedDate not supplied

Therapy outcome after multidisciplinary treatment for chronic neck and chronic low back pain: a prospective clinical study in 365 patients.

OBJECTIVES: This prospective longitudinal clinical study analyses the therapy outcome of 365 patients with either chronic neck (n = 134) or low back (n = 231) pain treated with a multidisciplinary biopsychosocial therapy approach. METHODS: Patients with chronic neck pain (NP) or low back pain (LBP) for 3 months or longer, corresponding sick leave for longer than 6 weeks, and clearly defined inclusion and exclusion criteria underwent a 3-week standardized inpatient multidisciplinary biopsychosocial therapy. Baseline sociodemographic, occupational, functional, and psychological data at entry into the study (T0) were comparable in both groups. At the 6-month follow-up (T1), five different therapy outcomes were analysed in both groups: back-to-work status, generic health status (the 36-item Short Form Health Survey, SF-36), pain intensity (visual analogue scale), functional capacity (Hannover back capacity score), and satisfaction with the therapy. RESULTS: Both treatment groups improved significantly in all outcome criteria between T0 and T1. In the total group, the back-to-work rate was 67.4%. At the final follow-up there were no significant differences between the group with chronic NP and the group with chronic LBP in the outcome criteria back-to-work status, improvement of health status and functional capacity, satisfaction with therapy, and reduction of pain. CONCLUSION: Evaluation of the main results of this study suggests that patients with chronic NP also derive significant benefit from a multidisciplinary treatment strategy, demonstrated in the literature so far mainly for patients with chronic LBP.

Activities of Daily Living↗
PubMed2001

Generalization of back education principles by elementary school children: evaluation with a practical test and a candid camera observation.

UNLABELLED: The efficacy of back education in elementary school children was shown using a practical test. Similar results in a candid camera evaluation were questioned. The purposes of this study were (i) to explore the relationship between the results of a practical test and the results of a candid camera procedure when evaluating back education principles, and (ii) to investigate whether in a candid camera procedure scores are still better in pupils who followed a back education programme than in controls. A candid camera evaluation followed by a practical test was performed in 71 pupils who had participated in a back education programme and 60 controls. Correlations between the two evaluation methods were significant but weak for 5 of the 9 test items in the intervention group (Rs 0.26-0.46) and for 7 test items in the control group (Rs 0.38-0.58). The difference in sum scores between the evaluation methods was significantly higher in the intervention group than in the control group (p < 0.001). The intervention group scored higher than the control group for 8 practical test items and 7 candid evaluation items. CONCLUSION: The study results question the use of a practical test for the individual evaluation of back education principles but show the usefulness of a practical test to study programme efficacy. As some principles seem to have become a habit, while for the implementation of others the pupils need external stimuli, the effects of more specific guidelines for parents and teachers to generalize back education principles require further study.

Back Pain↗