Articles: low-back-pain.
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Randomized Controlled Trial
Postoperative early initiation of sequential exercise program in preventing persistent spinal pain syndrome type-2 after modified transforaminal lumbar interbody fusion: a prospective randomized controlled trial.
This prospective randomized controlled trial aimed to investigate the impact of early postoperative sequential motor control (starting first day post-operatively) and core stabilization training (starting fifth week post-operatively) compared to conventional exercise (starting fifth weeks post-operatively) on the risk of developing persistent spinal pain syndrome type-2 (PSPS-T2). ⋯ Postoperative sequential exercise has more positive effects to avoid PSPS-T2 than conventional exercise in patients with LDDs possibly because of its advantages in improving central and peripheral sensitization.
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It is clear that implicit motor imagery (IMI) is impaired by chronic pain in peripheral regions (hand, feet), but unclear in axial regions (neck, shoulder, back). Previous IMI tasks displayed small-amplitude movements of axial regions, which limits person-centered IMI processes mobilization. This study aimed to assess the impact of chronic low back pain (CLBP) on IMI processes with a new task displaying large-amplitude whole-body movements mobilizing the lumbar spine. ⋯ The laterality judgment task proposed here confirmed that CLBP impacts IMI processes, and that the nature of pain (neuropathic or mechanical) needs to be considered because it seems to modulate IMI processes. PERSPECTIVE: A laterality judgment task with large-amplitude lumbar movements is key to show that CLBP alters processing speed of sensorimotor information originating from the painful region. This task could become an objective tool, transferable in clinical settings, for assessing the impact and the progression of CLBP on motor control processes.
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Pain medicine is an advanced medical subspecialty incorporating trainees from diverse primary disciplines. A curriculum that does not assess or promote the trainees' differential expertise developed from their primary specialties may silo instead of promoting collaborative learning in a multidisciplinary subspecialty. ⋯ We created a novel note-taking and knowledge-sharing platform, anchored by a well-established case-based educational strategy, to improve the learning environment and knowledge retention for multidisciplinary trainees with heterogeneous baseline knowledge.
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This article rewievs the available evidence on low back pain, one of the most prevalent conditions and the main cause of disability in most countries according to the latest Global Disease Burden 2021 study, which has led entities such as the WHO to recently publish recommendations on low back pain management. The causes and associated risk factors are analyzed, with more than 90% of low back pain cases being nonspecific and closely related to biopsychosocial context, as well as the role of imaging tests, whose findings have not been proven to be the source of low back pain. Finally, the effectiveness of the different treatments is analyzed, with non pharmacological being the first-line of treatment and pharmacological treatment having a very limited role, despite the excessive use we make of it.