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Graded activity low back pain

Adam W A Geraghty, Rosie Stanford, Beth Stuart, Paul Little, Lisa C Roberts, Nadine E Foster, Jonathan C Hill, Elaine M Hay, David Turner, Wansida Malakan, Linda Leigh, Lucy Yardley
OBJECTIVE: To determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using three arms: (1) usual care, (2) usual care plus an internet intervention or (3) usual care plus an internet intervention with additional physiotherapist telephone support. DESIGN AND SETTING: A three-armed randomised controlled feasibility trial conducted in 12 general practices in England. PARTICIPANTS: Primary care patients aged over 18 years, with current LBP, access to the internet and without indicators of serious spinal pathology or systemic illness...
March 9, 2018: BMJ Open
Ulrich Weber, Anne Grethe Jurik, Anna Zejden, Ejnar Larsen, Steen Hylgaard Jørgensen, Kaspar Rufibach, Christian Schioldan, Søren Schmidt-Olsen
OBJECTIVE: Low grade bone marrow edema (BME) was reported in the sacroiliac joints (SIJ) of 25% of healthy individuals and mechanical back pain patients, challenging the imaging discrimination from early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may trigger BME. We explored frequency and anatomical distribution of SIJ MRI lesions in recreational and elite athletes. METHODS: After pre-test calibration, semicoronal SIJ MRI scans of 20 recreational runners (RR) before/after running and 22 elite ice-hockey players (IP) were assessed by 3 blinded readers for BME and structural lesions using an SIJ quadrant-based module...
February 12, 2018: Arthritis & Rheumatology
Pooriput Waongenngarm, Kantheera Areerak, Prawit Janwantanakul
The purpose of this study was to evaluate the effectiveness of breaks on low back pain, discomfort, and work productivity in office workers. Publications were systematically searched in several databases from 1980 to December 2016. Relevant randomized and non-randomized controlled trials were retrieved and assessed for methodological quality by two independent reviewers. Quality of evidence was assessed and rated according to GRADE guidelines. Eight randomized controlled trials and three non-randomized controlled trials were included in this review, of which 10 were rated as high-quality studies...
April 2018: Applied Ergonomics
Ian D Coulter, Cindy Crawford, Eric L Hurwitz, Howard Vernon, Raheleh Khorsan, Marika Suttorp Booth, Patricia M Herman
BACKGROUND CONTEXT: Mobilization and manipulation therapies are widely used to benefit patients with chronic low back pain. However, questions remain about their efficacy, dosing, safety, as well as how these approaches compare to other therapies. PURPOSE: To determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic low back pain. STUDY DESIGN/SETTING: A systematic literature review and meta-analysis...
January 22, 2018: Spine Journal: Official Journal of the North American Spine Society
Jens Erik Jorgensen, Tamana Afzali, Allan Riis
INTRODUCTION: Low back pain (LBP) is one of the health conditions that lead to the most disability worldwide. Guidelines aimed at management of LBP recommend non-invasive and non-pharmacological management, including patient education, advice to stay active and exercise therapy; however, the guidelines offer no recommendation as to the allowable level of pain during exercise or how specific levels of pain should be reflected in the stage and progression of exercises or activities. The purpose of this review is to study the effect of differentiation of exercise guidance based on the level of LBP in patients in primary care...
January 23, 2018: BMJ Open
Fahed Mehyar, Marcio Santos, Sara E Wilson, Vincent S Staggs, Neena K Sharma
Objective: The purpose of this study was to investigate the effect of grade IV lumbar mobilization on the activity/contraction of erector spinae (ES) and lumbar multifidus (LM) muscles in healthy people. Methods: A randomized, repeated-measures design was used. Sixteen healthy subjects attended 3 testing sessions with a different intervention in each session (no intervention, grade IV central lumbar mobilization at L4, and placebo/light touch). Lying in a prone position, subjects lifted a light weight with their right arm while ultrasound images of LM and surface electromyography signals of ES were captured before and immediately after application of the intervention in the session...
December 2017: Journal of Chiropractic Medicine
George J Beneck, Andrea N Gard, Kimberly A Fodran
57-year-old woman was recruited for a research study of muscle activation in persons with low back pain. She described a progressive worsening of left lower lumbar pain, which began 5 years prior without any precipitating incident, and intermittent pain at the left gluteal fold (diagnosed as a proximal hamstring tear 2 years prior). Ultrasound revealed marked anterior displacement of the L3-4 and L4-5 facet joints. The subject was recommended for a radiograph using a lateral recumbent view, which demonstrated a grade II spondylolisthesis...
December 2017: Journal of Orthopaedic and Sports Physical Therapy
Susan R Stock, Nektaria Nicolakakis, Nicole Vézina, Michel Vézina, Louis Gilbert, Alice Turcot, Hélène Sultan-Taïeb, Kathryn Sinden, Marie-Agnès Denis, Céline Delga, Clément Beaucage
Objectives We sought to determine whether interventions that target work organization or the psychosocial work environment are effective in preventing or reducing work-related musculoskeletal disorders (WMSD) compared to usual work. Methods We systematically reviewed the 2000-2015 English- and French-language scientific literature, including studies evaluating the effectiveness of an organizational or psychosocial work intervention on incidence, prevalence or intensity of work-related musculoskeletal pain or disorders in the neck, shoulders, upper limbs and/or back or of work absence due to such problems, among non-sick-listed workers...
March 1, 2018: Scandinavian Journal of Work, Environment & Health
Prasoon Kumar, Vishal Kumar, Rakesh John, Rajbahadur Sharma
Introduction: Unilateral pedicle screw fixation and transforaminal cage for interbody fusion are well-established form of treatment for lumbar spondylolisthesis. It is cost effective and has shown to have a comparable outcome to bilateral pedicle screw fixation. We present a case of unilateral pedicle screw fixation and transforaminal cage for interbody fusion in a patient of Grade 1 Degenerative spondylolisthesis who had an early implant failure, and try to assess the possible events leading to it...
July 2017: Journal of Orthopaedic Case Reports
Matias Noll, Cláudia Tarragô Candotti, Bruna Nichele da Rosa, Marja Bochehin do Valle, Arthur Antoniolli, Adriane Vieira, Jefferson Fagundes Loss
There is a paucity of information regarding the development of body posture during adolescence. This three-year prospective study aimed to evaluate sitting and sleeping postures among adolescents, and to determine whether these postures are associated with age and sex. We assessed 525 adolescents aged 11-16 years from the fifth to eighth grades. These adolescents were reassessed three years later. The Back Pain and Body Posture Evaluation Instrument was used to evaluate the sleeping posture and three sitting positions: sitting to write, to use a computer, and during leisure activities...
November 2, 2017: Scientific Reports
John Paul G Kolcun, Lee Onn Chieng, Karthik Madhavan, Michael Y Wang
Spondylolysis from pars fracture is a common injury among young athletes, which can limit activity and cause chronic back pain. While current literature has examined the relative benefits of surgical and conservative management of these injuries, no study has yet compared outcomes between conventional direct repair of pars defects and modern minimally invasive procedures. The goals of surgery are pain resolution, return to play at previous levels of activity, and a shorter course of recovery. In this review, the authors have attempted to quantify any differences in outcome between patients treated with conventional or minimally invasive techniques...
October 2017: Asian Spine Journal
Jeannie F Bailey, Stephanie L Miller, Kristine Khieu, Conor W O'Neill, Robert M Healey, Dezba G Coughlin, Jojo V Sayson, Douglas G Chang, Alan R Hargens, Jeffrey C Lotz
Background context Prolonged microgravity exposure is associated with localized low back pain and an elevated risk of post-flight disc herniation. Though the mechanisms by which microgravity impairs the spine are unclear, they should be foundational for developing in-flight countermeasures for maintaining astronaut spine health. Because human spine anatomy has adapted to upright posture on Earth, observations of how spaceflight affects the spine should also provide new and potentially important information on spine biomechanics that benefit the general population...
September 26, 2017: Spine Journal: Official Journal of the North American Spine Society
Maurício Oliveira Magalhães, Josielli Comachio, Paulo Henrique Ferreira, Evangelos Pappas, Amélia Pasqual Marques
BACKGROUND: Low back pain (LBP) is a major health and economic problem worldwide. Graded activity and physiotherapy are commonly used interventions for nonspecific low back pain. However, there is currently little evidence to support the use of one intervention over the other in the medium-term. OBJECTIVE: To compare the effectiveness of graded activity exercises to physiotherapy-based exercises at mid-term (three and six months' post intervention) in patients with chronic nonspecific LBP...
July 12, 2017: Brazilian Journal of Physical Therapy
Alison Whitehead, Susan Gould Fogerite
Wieland LS, Skoetz N, Pilkington K, Vempati R, D׳Adamo CR, Berman BM. Yoga treatment for chronic non-specific low back pain.Cochrane Database Syst Rev2017, Issue 1. Art. No.: CD010671. DOI: 10.1002/14651858.CD010671.pub2. BACKGROUND: Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain...
July 2017: Explore: the Journal of Science and Healing
Teresa J Marin, Dwayne Van Eerd, Emma Irvin, Rachel Couban, Bart W Koes, Antti Malmivaara, Maurits W van Tulder, Steven J Kamper
BACKGROUND: Low back pain (LBP) is associated with enormous personal and societal burdens, especially when it reaches the chronic stage of the disorder (pain for a duration of more than three months). Indeed, individuals who reach the chronic stage tend to show a more persistent course, and they account for the majority of social and economic costs. As a result, there is increasing emphasis on the importance of intervening at the early stages of LBP.According to the biopsychosocial model, LBP is a condition best understood with reference to an interaction of physical, psychological, and social influences...
June 28, 2017: Cochrane Database of Systematic Reviews
William C Warner, Rodrigo Góes Medéa de Mendonça
The most common causes of low back pain in adolescents are spondylolysis and spondylolisthesis. Mechanical factors combined with rapid growth during adolescence place stress on the spine and can result in a stress fracture. Sports that require athletes to repeatedly place the spine in hyperextension may exacerbate both spondylolysis and spondylolisthesis. Many adolescent athletes with spondylolysis or low-grade spondylolisthesis have minimal symptoms and require no treatment or alteration in activity, including sports activity...
February 15, 2017: Instructional Course Lectures
Alan Breen, Alexander Breen
PURPOSE: Evidence of intervertebral mechanical markers in chronic, non-specific low back pain (CNSLBP) is lacking. This research used dynamic fluoroscopic studies to compare intervertebral angular motion sharing inequality and variability (MSI and MSV) during continuous lumbar motion in CNSLBP patients and controls. Passive recumbent and active standing protocols were used and the relationships of these variables to age and disc degeneration were assessed. METHODS: Twenty patients with CNSLBP and 20 matched controls received quantitative fluoroscopic lumbar spine examinations using a standardised protocol for data collection and image analysis...
May 29, 2017: European Spine Journal
Mette Jensen Stochkendahl, Per Kjaer, Jan Hartvigsen, Alice Kongsted, Jens Aaboe, Margrethe Andersen, Mikkel Ø Andersen, Gilles Fournier, Betina Højgaard, Martin Bach Jensen, Lone Donbæk Jensen, Ture Karbo, Lilli Kirkeskov, Martin Melbye, Lone Morsel-Carlsen, Jan Nordsteen, Thorvaldur Skuli Palsson, Zoreh Rasti, Peter Frost Silbye, Morten Zebitz Steiness, Simon Tarp, Morten Vaagholt
PURPOSE: To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority. METHODS: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. RESULTS: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active...
April 20, 2017: European Spine Journal
Vittorio M Russo, Ranju T Dhawan, Nishanth Dharmarajah, Irene Baudracco, Antonio I Lazzarino, Adrian T Casey
BACKGROUND AND OBJECTIVE: Multiple radiologic modalities are used in the evaluation of patients with low back pain (LBP). Only limited evidence currently exists to support the use of bone hydroxydiphosphonate single photon emission computed tomography (SPECT/CT) in patients with Modic changes (MCs) and degenerative disc disease. The aim of this study was to assess the value of the hybrid bone SPECT/CT imaging in patients with chronic LBP. We evaluate the correlation of hybrid bone SPECT/CT imaging patterns with MCs and disc abnormalities on magnetic resonance imaging (MRI)...
August 2017: World Neurosurgery
Mathieu D'Hondt, Frederiek Nuytens, Emi Yoshihara, Els Adriaens, Franky Vansteenkiste, Hans Pottel
BACKGROUND: The use of a self-expanding nitinol framed prosthesis (ReboundHRD(®)) for totally extraperitoneal laparoscopic inguinal hernia repair (TEP-IHR) could solve issues of mesh shrinkage and associated pain. We prospectively evaluated the use of the ReboundHRD(®) mesh for TEP-IHR. MATERIALS AND METHODS: All patients who underwent a TEP-IHR using the ReboundHRD(®) Large mesh from April 2014 till May 2015, were included. No mesh fixation was performed. Follow-up assessments were performed at the day of surgery, 1, 2, and 7 days, 1, 3, 6, and 12 months...
April 2017: International Journal of Surgery
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