Articles: low-back-pain.
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A systematic review of randomized and nonrandomized controlled trials. ⋯ There continues to be a need for high quality randomized trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realization of adequate compliance.
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Case Reports Randomized Controlled Trial Comparative Study Clinical Trial
Graded exposure in vivo in the treatment of pain-related fear: a replicated single-case experimental design in four patients with chronic low back pain.
The aim of this investigation was to examine the effectiveness of a graded exposure in vivo treatment with behavioural experiments as compared to usual graded activity in reducing pain-related fears, catastrophising and pain disability in chronic low back pain patients reporting substantial fear of movement/(re)injury. Included in the study were four consecutive CLBP patients who were referred for outpatient behavioural rehabilitation, and who reported substantial fear of movement/(re)injury (Tampa Scale for Kinesiophobia score>40). A replicated single-case cross-over design was used. ⋯ Using time series analysis on the daily measures of pain-related cognitions and fears, we found that improvements only occurred during the graded exposure in vivo, and not during the graded activity, irrespective of the treatment order. Analysis of the pre-post treatment differences also revealed that decreases in pain-related fear concurred with decreases in pain catastrophising and pain disability, and in half of the cases an increase in pain control. This study shows that the external validity of exposure in vivo also extends to the subgroup of chronic low back pain patients who report substantial fear of movement/(re)injury.
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This prospective, non-controlled pilot-study examines the potential benefit of acupuncture in patients with low back pain and radicular symptoms. ⋯ Acupuncture as a noninvasive treatment with very few complications is a promising therapeutical option of low back pain, especially when associated with radicular symptoms.
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Arch Phys Med Rehabil · Feb 2001
Comparative StudyPelvic mobility when bending forward in standing position: validity and reliability of 2 motion analysis devices.
To evaluate the validity and reliability of 2 measurement devices that assess pelvic mobility in persons bending forward while in a standing position. ⋯ The Rachimètre and the CMS 50 have acceptable metric properties. Because few simple clinical measurements are available to evaluate pelvic mobility during trunk flexion in standing position, these 2 devices could be useful in the clinical evaluation of low back pain.
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Fifty patients with an average age of 47 years received epidural steroid injections for lumbosacral radicular pain due to disk herniation or spinal stenosis. All patients had failed previous conservative treatment. Mean follow-up was 24 months (range: 12-36 months). ⋯ At the last follow-up examination, 68% of patients were asymptomatic, 20% had no change in preinjection radicular symptoms, and 12% had various degrees of relief. No significant correlation was found between pain relief, age, or number of injections. Early pain relief may be anticipated after epidural steroid injections in 80% of patients with radicular symptoms due to disk herniation or spinal stenosis.