Articles: low-back-pain.
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Review
Functional restoration. Returning patients with chronic low back pain to work--revolution or fad?
A review was performed to assess the basis for functional restoration programs in returning patients with chronic low back pain to work. ⋯ Further clinical trials based on sound methodology are needed.
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Scand J Med Sci Sports · Apr 1996
Muscular performance after a 3 month progressive physical exercise program and 9 month follow-up in subjects with low back pain. A controlled study.
The purpose of this study was to assess, in subjects with low back pain, the changes and their permanence in muscular performance after a 3 month progressive physical exercise program. Ninety subjects with chronic low back pain participated in the study. The study design was controlled and it was carried out in three groups: intensive training, home exercise, and control group. ⋯ Their muscular performance improved and their back pain intensity decreased significantly. Among the home exercise group, the Oswestry Index also changed positively. The results demonstrate that the home exercise program could be as effective as the intensive training program in increasing muscle strength, as well as decreasing back pain and functional disability among low back pain patients with mild functional limitations.
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Randomized Controlled Trial Comparative Study Clinical Trial
Responsiveness of functional status in low back pain: a comparison of different instruments.
This study compares the responsiveness of three instruments of functional status: two disease-specific questionnaires (Oswestry and Roland Disability Questionnaires), and a patient-specific method (severity of the main complaint). We compared changes over time of functional status instruments with pain rated on a visual analog scale. Two strategies for evaluating the responsiveness in terms of sensitivity to change and specificity to change were used: effect size statistics and receiver-operating characteristic method. ⋯ The sensitivity to change of the rating of Oswestry Questionnaire was lower than that of the other instruments. The main complaint was not very specific to change. The two strategies for evaluating the responsiveness were very useful and appeared to complement each other.
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The Roland-Morris Questionnaire (RMQ) is a self-administered disability measure in which greater levels of disability are reflected by higher numbers on a 24-point scale. The RMQ has been shown to yield reliable measurements, which are valid for inferring the level of disability, and to be sensitive to change over time for groups of patients with low back pain. Little is known about the usefulness of this instrument in aiding decision making regarding individual patients. The purpose of this study was to determine the minimum level of detectable change when the RMQ is applied to individual patients. ⋯ The magnitude of CSEMs is sufficiently small to detect change in patients with initial scores in the central portion of the scale (4-20 RMQ points); however, the magnitude is too large to detect improvement in patients with scores of less than 4 and deterioration in patients who have scores greater than 20.
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Arch Phys Med Rehabil · Apr 1996
Comparative StudyBack pain and peripheral joint pain in an industrial setting.
To develop a self-reported low back pain (LBP) questionnaire and assess its usefulness in (1) describing the incidence of LBP in an industrial setting, compared to medical records and workers' compensation statistics; and (2) targeting specific work sites where the levels and patterns of pain suggest a need for specific intervention. ⋯ This questionnaire appears to be potentially useful in (1) identifying workers who are symptomatic at an early stage of their LBP problem; and (2) identifying pain patterns in different areas of the plant.