PM & R : the journal of injury, function, and rehabilitation
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To determine whether posterior pelvic pain is associated with intra-articular hip abnormalities (labral tears and early degenerative changes) in patients with minimal-to-no radiographic abnormalities. ⋯ Twenty percent of patients at the authors' institution who required surgical intervention to treat their pain after not responding to conservative management had posterior pelvic pain in addition to groin or lateral and anterior hip pain. Of those respondents, 33% had complete resolution of symptoms at 4.75 years after surgery, and all had reduction in pain as compared with completion of conservative care. Patients with early intra-articular hip pathology, such as acetabular labral tears with no or mild hip deformity, and patients with arthrosis and mild hip deformity may experience groin and posterior pelvic pain as part of their clinical presentation.
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Randomized Controlled Trial
The comparative effectiveness of a multimodal program versus exercise alone for the secondary prevention of chronic low back pain and disability.
The objective of this study was to examine whether a multimodal, secondary prevention program (MP) is superior to a general physical exercise program (EP) in influencing the process leading to chronic low back pain (LBP) in nurses with a history of back pain. ⋯ A multimodal program is not superior to a general exercise program in influencing the process leading to chronic LBP in a population of nurses with a history of pain. The most likely explanation is a common psychological mechanism leading to improved pain interference that is irrespective of the program used. Considering the lower resources of the general exercise program, the expense for a multimodal program is not justified for the secondary prevention of LBP and disability.
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Randomized Controlled Trial
The effect of prehabilitation exercise on strength and functioning after total knee arthroplasty.
The purpose of this study was to examine the effect of a preoperative exercise intervention on knee pain, functional ability, and quadriceps strength among patients with knee osteoarthritis before and after total knee arthroplasty (TKA) surgery. ⋯ These findings appear to indicate the efficacy of prehabilitation among TKA patients and support the theory of prehabilitation.
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Clinical Trial
The significance of multifidus atrophy after successful radiofrequency neurotomy for low back pain.
To determine the presence of lumbar multifidus atrophy and pain after successful lumbar medial branch radiofrequency neurotomy for zygapophysial joint mediated pain. ⋯ This preliminary study provides evidence that successful medial branch RFN for lumbar zygapophysial-mediated pain does cause initial denervation but no discernable segmental atrophy of the multifidus at long-term follow-up. Previous denervation and diffuse atrophy in these subjects was not associated with pain.