Spine
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We conducted a cohort study of clinically asymptomatic spondylotic cervical cord compression cases with the primary end point of the development of clinical signs of cervical myelopathy. ⋯ Electrophysiological abnormalities together with clinical signs of cervical radiculopathy could predict clinical manifestation of preclinical spondylotic cervical cord compression.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A randomized clinical trial of manipulative therapy and interferential therapy for acute low back pain.
A multicenter assessor-blinded randomized clinical trial was conducted. ⋯ For acute low back pain, there was no difference between the effects of a combined manipulative therapy and interferential therapy package and either manipulative therapy or interferential therapy alone.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized clinical trial of treatment for lumbar segmental rigidity.
A randomized single-blind clinical trial of facet injections plus exercise, versus exercise alone, in chronic disabling work-related lumbar spinal disorders (CDWRLSD), accompanied by pilot interrater reliability and facet syndrome prevalence studies. ⋯ The detection of SR and measurement of 3-segment true lumbar ROM by experienced examiners is highly reliable. Only 17% of CDWRLSD patients with lumbar SR met criteria for the facet syndrome, a rate approximately equal to that of unselected low back pain cohorts. This indicates that lumbar SR may be found whether or not pain of facet joint origin is present. In the randomized trial, facet injections significantly increased the percentage of patients with SR showing ROM improvement, as well as the degree of improvement in lumbar mobility after treatment. There is no evidence that facet injections increase the improvements in pain/disability report noted in both groups.
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A systematic review of qualitative and quantitative studies. ⋯ Patients have explicit expectations on diagnosis, instructions, and interpersonal management. New strategies need to be developed in order to meet patients' expectations better. Practice guidelines should pay more attention to the best way of discussing the causes and diagnosis with the patient and should involve them in the decision-making process.
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Comparative Study
The pain disability questionnaire: a new psychometrically sound measure for chronic musculoskeletal disorders.
The Pain Disability Questionnaire (PDQ) is a psychometric evaluation study of a new measure of functional status. ⋯ The present study represents a comprehensive psychometric evaluation of a new functional status measure for musculoskeletal conditions in general, and a CDMD population in particular. The psychometric properties of the PDQ are excellent, demonstrating strong reliability, responsiveness, and validity, relative to many other existing measures of functional status. The many weaknesses cited for some of the existing measures were taken into account in designing this instrument. Consequently, the characteristics commonly noted as weaknesses for these other measures (such as a restriction to only the low back pain population, and inconsistent responsiveness) can be cited as strengths of the PDQ. Its generalizability and utility for assessing orthopedic treatment progress and functional outcomes must now be evaluated in broader settings.