Spine
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A systematic review of randomized controlled trials. ⋯ The quality of the design, execution, and reporting of randomized controlled trials should be improved, to establish strong evidence for the effectiveness of the various therapeutic interventions for acute and chronic low back pain.
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Comparative Study
Community studies of the health service implications of low back pain.
Retrospective study using primary care physician case notes and a self-report questionnaire on the same randomly selected population sample. ⋯ Prevalence rates were comparable with those reported in other studies. The significant discrepancies between data sources suggest patient recall bias or underrecording in case notes. The low consultation rate, time off, and day-to-day disability indicate that most episodes are self-limiting.
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Back and neck pain was studied cross-sectionally in 1,449 urban transit drivers by linking medical data, self-reported ergonomic factors, and company records on job history. ⋯ The results support the hypothesis of a causal role of physical workload for the development of back and neck pain. Ergonomic factors partially mediated the risk of back and neck pain associated with driving, suggesting a potential for prevention of back and neck pain by ergonomic redesign of transit vehicles. Elevated risks for back and neck pain for female drivers were not explained by anthropometric and ergonomic factors.
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Multicenter Study
Predictors of outcome in patients with chronic back pain and low-grade spondylolisthesis.
Retrospective case series. ⋯ This investigation, although limited by a number of factors including small sample size and retrospective, unblinded review, suggests that active worker's compensation and litigation issues are associated strongly with poor results of operative management for chronic low back pain in adult patients with low-grade spondylolisthesis.
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In this prospective, observational, cohort study of 192 individuals with chronic low back pain, the group of individuals was divided based on compensation involvement, and their presentation pain and disability, treatment recommendations, and compliance were compared. For 85 of these individuals who completed a spine rehabilitation program, their pain and disability at 3 and 12 months were compared. ⋯ In chronic low back pain, compensation involvement may have an adverse effect on self-reported pain, depression, and disability before and after rehabilitation interventions.