Articles: low-back-pain.
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Complement Ther Med · Jun 2008
Randomized Controlled TrialAcupuncture for acute non-specific low back pain: a pilot randomised non-penetrating sham controlled trial.
A pilot study to assess the feasibility of a trial to investigate the efficacy of acupuncture compared to placebo needling for the treatment of acute low back pain (LBP). As part of this, the study was designed to establish the credibility of the placebo control, and to provide data to inform a power analysis to determine numbers for a future trial. ⋯ This study has demonstrated the feasibility of a randomized controlled trial of penetrating needle acupuncture compared to a non-penetrating sham for the treatment of acute LBP in primary care; 120 participants would be required in a fully powered trial. The placebo needle used in this study proved to be a credible form of control.
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Randomized Controlled Trial
Multidisciplinary rehabilitation treatment of patients with chronic low back pain: a prognostic model for its outcome.
(1) To determine if treatment outcome in chronic low back pain can be predicted by a predefined multivariate prognostic model based on consistent predictors from the literature and (2) to explore the value of potentially prognostic factors further. ⋯ The results of this study do not support the construction of a clinical prediction model. Future confirmative studies of homogeneous rehabilitation treatments and outcome measures are needed to shed more light on relevant prognostic factors.
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J Manipulative Physiol Ther · Jun 2008
Comparative StudyManual therapy provided by physical therapists in a hospital-based setting: a retrospective analysis.
The purpose of this study was to compare outcomes, complications, and hospital disposition in a cohort of patients hospitalized for low back pain who receive physical therapist (PT)-administered manual therapy (mobilization and manipulation) vs those who do not receive manual therapy. ⋯ Of 106 340 patients admitted for low back pain originally queried, only 75 patients (0.07%) received manual therapy, a markedly small number of patients. Outcomes may be reflective of the low effect size of manual therapy in a hospital setting or the inability to control for referral and hospital care patterns, thus disallowing appropriate matching.
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Animal experiments and studies in humans clearly show that the relation between pain (acute and chronic) and sleep quality is two-way: sleep disorders can increase pain, which in turn may cause sleep disorders. Sleep disorders and chronic low back pain are frequent health problems and it is unsurprising that the two can co-exist. This study was conducted to evaluate if sleep disorders and chronic pain associated are more frequently than one would expect. ⋯ Sleep disorders were greater when the impact of CLBP on daily life (the four aspects of the DPQ) was greater [P < 0.0001]). The sleep of the patients with CLBP was significantly altered compared with that of the healthy controls, in proportion to the impact of low back pain on daily life. Our findings do not indicate whether sleep disorders are a cause or a consequence of CLBP.
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Deep cross-friction pressure with a finger or an elbow in the proximal gluteal region causes a sciaticlike pain along the side of the thigh and the leg as a clinical presence of referred pain (RP) in patients with nonspecific low back pain (LBP). This study investigated the reliability and discriminative ability of experimentally provoked RP as a result of deep cross-friction with the aid of a Fischer algometer. The new clinical examination method measures the provoked RP threshold resulting in an outcome, expressed in kg/cm2. ⋯ This clinical study support the reliability and discriminative ability of a new method of experimentally provoked RP, using deep cross-friction pressure with the aid of a Fischer algometer in patients with LBP. The experimentally "provoked referred pain threshold" (PPT-RP) values lower than 6 kg/cm correspond clinically with the presence of a referred muscle pain area in the thigh and/or the leg. Further studies of a similar kind are nevertheless needed to confirm those conclusions and to assess the responsiveness of the provoked RP measurements in different treatment follow-up periods.