Articles: low-back-pain.
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Clinical rheumatology · Mar 2007
Age as a predicting factor in the therapy outcome of multidisciplinary treatment of patients with chronic low back pain--a prospective longitudinal clinical study in 405 patients.
This prospective longitudinal clinical study evaluates the prognostic value of age in the therapy outcome of patients with chronic low back pain treated with a multidisciplinary therapy. Four hundred five patients with chronic low back pain for 3 months or longer and a corresponding sick leave for longer than 6 weeks underwent a 3-week standardized multidisciplinary therapy. Patients were assigned into three groups of age with comparable baseline values at T0. ⋯ In the total group, the back-to-work rate was 61.7%. At the final follow-up, there were significantly better results in terms of functional capacity and pain level in younger patients, whereas back-to-work rate and satisfaction with therapy did not show a significant difference between the groups analysed. According to the results of this study, older patients with chronic low back pain also derive significant benefit from a multidisciplinary treatment strategy, although in some outcome criteria results were inferior to those obtained in younger patients.
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Randomized Controlled Trial
A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain.
Given the complex nature of chronic pain, the effects of high-intensity aerobic exercise on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain were investigated. ⋯ Regular high-intensity aerobic exercise alleviated pain, disability, and psychological strain in subjects with chronic low back pain but did not improve serum cortisol concentrations.
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Percutaneous disc decompression utilizing Nucleoplasty has emerged as one of the minimally invasive techniques for treatment of low back pain and lower extremity pain due to contained herniated discs. Only 1 study to date has examined its effect on functional activity and pain medication use; however, results were not analyzed over time, and recall bias was a limitation. ⋯ Nucleoplasty appears to be safe and effective. Randomized, controlled studies are required to further evaluate its long-term efficacy.
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Comparative Study
Pain behavior and the development of pain-related disability: the importance of guarding.
To examine prospectively the association between the 4 categories of objectively assessed pain behavior and various disability outcomes. In the present study, relationships among the 4 categories of pain behavior and various disability-related outcomes were examined. ⋯ Guarding behavior may play a role in the transition from acute to chronic pain. The findings underscore the multidimensional nature of pain behavior and suggest that there is value in examining overt pain behaviors in prospective studies of the development of chronic occupational pain disability.
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Chronic low back pain (CLBP) patients achieve postural stability during challenging stance conditions by increasing sway speed. We investigated the mechanisms underlying this behavior, and whether postural strategy selection may be influenced by short-term experience of postural perturbation. Thirteen CLBP patients and thirteen age-matched controls underwent posturography tests. ⋯ Platform translation findings show that both groups aimed at optimizing their posture selection strategy based on prior testing experience. CLBP patients make use of a different postural motor strategy to maintain quiet stance. This is probably the consequence of an imprecise internal estimate of body sway, due to reduced accuracy in the sensory integration process.