Spine
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Clinical Trial
Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy.
Cross-sectional analysis of the factors influencing self-rated disability associated with chronic low back pain and prospective study of the relationship between changes in each of these factors and in disability following active therapy. ⋯ A combination of pain, psychological and physiological factors was best able to predict baseline disability, although its decrease following therapy was determined only by reductions in pain and psychological variables. The active therapy program-in addition to improving physical function-appeared capable of modifying important psychological factors, possibly as a result of the positive experience of completing the prescribed exercises without undue harm.
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Randomized Controlled Trial Clinical Trial
Active therapy for chronic low back pain: part 2. Effects on paraspinal muscle cross-sectional area, fiber type size, and distribution.
Randomized prospective study to compare the effects of three types of active therapy on the back muscle structure of chronic low back pain patients. ⋯ Three months active therapy is not sufficient to reverse the typical "glycolytic" profile of the muscles of cLBP patients or to effect major changes in backmuscle size. The alterations in muscle performance observed (increased strength and endurance; Part 1) werenot explainable on the basis of structural changes within the muscle.
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Randomized Controlled Trial Comparative Study Clinical Trial
Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength.
Randomized prospective study of the effects of three types of active therapy on back muscle function in chronic low back pain patients. ⋯ Significant changes in muscle performance were observed in all three active therapy groups post-therapy, which appeared to be mainly due to changes in neural activation of the lumbar muscles and psychological changes concerning, for example, motivation or pain tolerance.
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A biomechanical investigation using indentation tests in a human cadaveric model to seek variation in the structural properties across the lower lumbar and sacral endplates. ⋯ Highly significant regional strength and stiffness variations were identified in the lumbar and sacral endplates. The center of the bone, where implants are currently placed, is the weakest part of the lumbar endplates and is not the strongest region of the sacral endplate.
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A biomechanical and anatomic study with human cadaveric lumbar spine. ⋯ This study showed that the intervertebral foramen of the lumbar spine changed significantly not only on flexion-extension but also on lateral bending and axial rotation. The percent change in cross-sectional foraminal area was correlated with the amount of segmental motion except for extension motions. Further studies are needed to assess the morphologic changes in the intervertebral foramen in vivo and to correlate clinically.