Articles: back-pain.
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Contemp Clin Trials · Nov 2015
Randomized Controlled TrialLumbar Imaging With Reporting Of Epidemiology (LIRE)--Protocol for a pragmatic cluster randomized trial.
Diagnostic imaging is often the first step in evaluating patients with back pain and likely functions as a "gateway" to a subsequent cascade of interventions. However, lumbar spine imaging frequently reveals incidental findings among normal, pain-free individuals suggesting that treatment of these "abnormalities" may not be warranted. Our prior work suggested that inserting the prevalence of imaging findings in patients without back pain into spine imaging reports may reduce subsequent interventions. We are now conducting a pragmatic cluster randomized clinical trial to test the hypothesis that inserting this prevalence data into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. ⋯ If our study shows that adding prevalence data to spine imaging reports decreases subsequent back-related RVUs, this intervention could be easily generalized and applied to other kinds of testing, as well as other conditions where incidental findings may be common. Our study also serves as a model for cluster randomized trials that are minimal risk and highly pragmatic.
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A retrospective study was designed to evaluate clinical outcomes and sagittal alignment following single-level unilateral instrumented transforaminal lumbar interbody fusion (TLIF). ⋯ Unilateral instrumented TLIF is a safe and effective treatment option for single-level lumbar degenerative disease, and is less invasive, yields good outcomes and has a low complication rate. In addition, the procedure has the potential to partly restore sagittal alignment.
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Retrospective case-control study. ⋯ 4.
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Scand J Public Health · Nov 2015
Randomized Controlled TrialPhysical exercise at the workplace reduces perceived physical exertion during healthcare work: cluster randomized controlled trial.
High physical exertion during work is a risk factor for musculoskeletal pain and long-term sickness absence. Physical exertion (RPE) reflects the balance between physical work demands and physical capacity of the individual. Thus, increasing the physical capacity through physical exercise may decrease physical exertion during work. This study investigates the effect of workplace-based versus home-based physical exercise on physical exertion during work (WRPE) among healthcare workers. ⋯ Physical exercise performed at the workplace appears more effective than home-based exercise in reducing physical exertion during daily work tasks in healthcare workers.
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J Spinal Disord Tech · Nov 2015
Clinical TrialProspective Clinical and Radiographic Results of Activ L Total Disk Replacement at 1- to 3-Year Follow-up.
A prospective clinical study. ⋯ The 1- to 3-year follow-up of this cohort of patients showed satisfactory clinical outcomes. The IDHs at index and adjacent segments were well maintained after the surgery. The ROM at the lower adjacent segment remained unchanged, but the ROM at the index and upper adjacent segments showed a slight increase. The long-term results of activ L TDR was to be investigated.