Articles: low-back-pain.
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Review Comparative Study
Clinical decision rules for identification of low back pain patients with neurologic involvement in primary care.
Descriptive study. ⋯ This study has identified differences between the guidelines in the clinical decision rules for identification of neurologic involvement including omission of categories. Decision-making that employs all 3 categories of neurologic involvement will arguably facilitate accurate and timely identification of patients with low back pain so affected in primary care.
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The economic burden of low back pain (LBP) is very large and appears to be growing. It is not possible to impact this burden without understanding the strengths and weaknesses of the research on which these costs are calculated. ⋯ Several studies have attempted to estimate the direct, indirect, or total costs associated with LBP in various countries using heterogeneous methodology. Estimates of the economic costs in different countries vary greatly depending on study methodology but by any standards must be considered a substantial burden on society. This review did not identify any studies estimating the total costs of LBP in the United States from a societal perspective. Such studies may be helpful in determining appropriate allocation of health-care resources devoted to this condition.
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The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. ⋯ Articles in this special focus issue were contributed by leading spine practitioners and researchers, who were invited to summarize the best available evidence for a particular intervention and encouraged to make this information accessible to nonexperts. Each of the articles contains five sections (description, theory, evidence of efficacy, harms, and summary) with common subheadings to facilitate comparison across the 24 different interventions profiled in this special focus issue, blending narrative and systematic review methodology as deemed appropriate by the authors. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.
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Scand J Prim Health Care · Jan 2008
Comparative StudyHealthcare provider back pain beliefs unaffected by a media campaign.
Healthcare providers play a key role in transmitting knowledge and beliefs about LBP to their patients. There are differences in back pain beliefs between the various professionals groups treating LBP patients. This study examined whether LBP beliefs changed among the healthcare providers exposed to a media campaign. ⋯ An LBP mass media campaign with educational initiatives aimed at healthcare providers did not result in important improvement in LBP beliefs of providers exposed to the campaign. Important differences were observed between beliefs of the different healthcare provider groups in their view of LBP.
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Stud Health Technol Inform · Jan 2008
Comparative StudyErgonomically designed kneeling chairs are they worth it? : Comparison of sagittal lumbar curvature in two different seating postures.
General agreement among researchers suggests that poor seating posture may predispose individuals to developing low back pain. A variety of methods such as ergonomically designed chairs have been developed to assist people to maintain good posture and preserve the 'natural' lumbar curve. The aim of this study was to compare lumbar curvature on an ergonomically designed kneeling chair (EKC) with that on a standard computer chair (SCC), with reference to the standing lumbar curvature. ⋯ There was also a statistically significant difference between the two seated positions (p<0.05). This study suggests that ergonomically designed kneeling chairs set at +20 degrees inclination do maintain standing lumbar curvature to a greater extent than sitting on a standard computer chair with an overall mean difference of 7.633 degrees. Further research with a greater number of subjects and on different chair designs is warranted.