Articles: low-back-pain.
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Arch Phys Med Rehabil · Aug 2003
Comparative StudyFear of injury and physical deconditioning in patients with chronic low back pain.
To test the assumption that fear of injury leads to disability and physical deconditioning in patients with chronic low back pain (CLBP) and to evaluate the relation between disability and physical deconditioning. ⋯ Fear of injury appears to be more strongly associated with perceived disability than with aerobic fitness. The assumption that fear of injury leads to physical deconditioning was not confirmed in this sample of patients with CLBP.
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Bmc Health Serv Res · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialUK Back pain Exercise And Manipulation (UK BEAM) trial--national randomised trial of physical treatments for back pain in primary care: objectives, design and interventions [ISRCTN32683578].
Low back pain has major health and social implications. Although there have been many randomised controlled trials of manipulation and exercise for the management of low back pain, the role of these two treatments in its routine management remains unclear. A previous trial comparing private chiropractic treatment with National Health Service (NHS) outpatient treatment, which found a benefit from chiropractic treatment, has been criticised because it did not take treatment location into account. There are data to suggest that general exercise programmes may have beneficial effects on low back pain. The UK Medical Research Council (MRC) has funded this major trial of physical treatments for back pain, based in primary care. It aims to establish if, when added to best care in general practice, a defined package of spinal manipulation and a defined programme of exercise classes (Back to Fitness) improve participant-assessed outcomes. Additionally the trial compares outcomes between participants receiving the spinal manipulation in NHS premises and in private premises. ⋯ We sought to randomise 1350 participants with simple low back pain of at least one month's duration. These came from 14 locations across the UK, each with a cluster of 10-15 general practices that were members of the MRC General Practice Research Framework (GPRF). All practices were trained in the active management of low back pain. Participants were randomised to this form of general practice care only, or this general practice care plus manipulation, or this general practice care plus exercise, or this general practice care plus manipulation followed by exercise. Those randomised to manipulation were further randomised to receive treatment in either NHS or private premises. Follow up was by postal questionnaire one, three and 12 months after randomisation. The primary analysis will consider the main treatment effects before interactions between the two treatment packages. Economic analysis will estimate the cost per unit of health utility gained by adding either or both of the treatment packages to general practice care.
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Clinical biomechanics · Aug 2003
Clinical Trial Controlled Clinical TrialLumbar muscle fatigue and recovery in patients with long-term low-back trouble--electromyography and health-related factors.
The aim was to explore the validity and reliability of EMG for assessing lumbar muscle fatigue. ⋯ The ability to fatigue the back muscles during a test requiring a high force output might be achieved with back muscle training focused on increasing strength and self-efficacy.
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To test the hypothesis that work-related mechanical, psychosocial and physical environment factors would predict new-onset low back pain (LBP) in newly employed workers. ⋯ In this cohort of newly employed workers, from a range of occupations, several aspects of the work-place environment, other than mechanical factors, were important in predicting new-onset LBP. These results emphasize that interventions aimed at reducing the occurrence of LBP are likely to be most successful if they intervene across these domains.
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In Hong Kong, the measurement of perceived health status in patients with low back pain (LBP) can be facilitated by the availability of a health profile specifically designed for the Chinese culture. This prospective observational study investigated the psychometric properties of the generic Current Perceived Health 42 (CPH42) Profile in four separate samples (totalling 473) of Chinese patients with LBP in Hong Kong. The patients completed the CPH42 Profile and the Roland LBP Disability Scale at various points in the course of physiotherapy. ⋯ Validity was confirmed by a moderate correlation with the Chinese adaptations of the Roland LBP Disability Scale and the NRS at the commencement of physiotherapy (Spearman's correlation coefficients were 0.48 and 0.42, respectively). The responsiveness, measured from the commencement of physiotherapy to weeks 3 and 6 (standard response means of 0.33 and 0.58, respectively), were commensurate with the respective changes in pain intensity. The psychometric properties of the CPH42 Profile suggest its suitability for use as an outcome instrument in future efficacy studies on LBP intervention.