Articles: low-back-pain.
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Randomized Controlled Trial Comparative Study
Self-report measures best explain changes in disability compared with physical measures after exercise rehabilitation for chronic low back pain.
Sixteen-week intervention for chronic patients with low back pain (LBP) with 9-month follow-up. Primary randomization at 4 weeks into either supervised Swiss ball exercise or an exercise advice group. ⋯ Supervised exercise is a more successful subsequent to manual treatment compared with exercise advice. The improvements associated with this type of program were primarily manifested in the psychologic self-report measures rather than physical measurements.
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Comparative Study
[Practicability of a German version of the "Oswestry Low Back Pain Disability Questionnaire". A questionnaire to assess disability caused by back pain].
While caring for patients with chronic low back pain, a standardized measurement of pain and pain-related reduction of the quality of life is needed. Easy application and data collection are decisive for routine use. ⋯ A higher pain disability was related to age, female gender, limitations experienced in social life, impact of pain, use of analgetics, low net income, and patients in Eastern Germany. The available German version of the questionnaire is suitable for daily use to measure the intensity of pain and pain-related disability in everyday life, including social impairment due to low back pain.
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To determine the accuracy of clinical features in diagnosing vertebral fracture in low back pain patients and assess the psychometric properties of the Quality Assessment of Studies of Diagnostic Accuracy Included in Systematic Reviews (QUADAS) scale. ⋯ Five clinical features were identified that can be used to screen for vertebral fracture. The psychometric properties of the QUADAS scale raise concerns about its use to rate the quality of low back pain diagnosis studies.
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Meta Analysis
Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials.
We performed a meta-analysis of randomised controlled trials to investigate the effectiveness of surgical fusion for the treatment of chronic low back pain compared to non-surgical intervention. Several electronic databases (MEDLINE, EMBASE, CINAHL and Science Citation Index) were searched from 1966 to 2005. The meta-analysis comparison was based on the mean difference in Oswestry Disability Index (ODI) change from baseline to the specified follow-up of patients undergoing surgical versus non-surgical treatment. ⋯ This difference in ODI was not statistically significant and is of minimal clinical importance. Surgery was found to be associated with a significant risk of complications. Therefore, the cumulative evidence at the present time does not support routine surgical fusion for the treatment of chronic low back pain.
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J Orthop Sports Phys Ther · Feb 2008
Diffusion-weighted magnetic resonance imaging of normal and degenerative lumbar intervertebral discs: a new method to potentially quantify the physiologic effect of physical therapy intervention.
Observational, repeated measures design. ⋯ The ADC of the nuclear region of the lumbar IVDs may be reliably measured from diffusion-weighted images. Degenerative discs had lower mean ADC values than normal discs but demonstrated greater variation between scans. Diffusion-weighted imaging may be a useful procedure to assess change in diffusion of water in lumbar discs that occurs over time.