European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The aim of the present study was to investigate the 2-year outcome of a cognitive-behavioral training program for the management of depressive symptoms for patients with chronic low back pain (CLBP) and co-existing depressive symptoms compared with the standard rehabilitation. Therefore, a quasi-experimental 3 × 2 × 5 (treatment condition × gender × time) repeated measures design with five assessment points (pre-treatment, post-treatment, 6-, 12-, and 24-month follow-up) was employed among N = 153 patients with CLBP, aged 33-62 years. ⋯ Only short- or mid-term improvements were found in the CG(depr). In conclusion, the new cognitive-behavioral training program augmented the long-term rehabilitation success in this highly strained subgroup of patients with CLBP and depressive symptoms.
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This is a European cohort study on predictors of spinal injury in adult (≥16 years) major trauma patients, using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Predictors for spinal fractures/dislocations or spinal cord injury were determined using univariate and multivariate logistic regression analysis. 250,584 patients were analysed. 24,000 patients (9.6%) sustained spinal fractures/dislocations alone and 4,489 (1.8%) sustained spinal cord injury with or without fractures/dislocations. Spinal injury patients had a median age of 44.5 years (IQR = 28.8-64.0) and Injury Severity Score of 9 (IQR = 4-17). 64.9% were male. 45% of patients suffered associated injuries to other body regions. ⋯ Multilevel injury was found in 10.4% of fractures/dislocations and in 1.3% of cord injury patients. As spinal trauma occurred in >10% of major trauma patients, aggressive evaluation of the spine is warranted, especially, in males, patients <45 years, with a GCS <15, concomitant chest injury and/or dangerous injury mechanisms (falls >2 m, sports injuries, RTCs and shooting). Diagnostic imaging of the whole spine and a diligent search for associated injuries are substantial.
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We evaluated the reliability and validity of an adapted Korean version of the Roland-Morris Disability Questionnaire (RMDQ). Translation/retranslation of the English version of RMDQ was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the Visual Analog Scale (VAS) measure of pain, RMDQ, and the previously validated Oswestry Disability Index (ODI) were mailed to 100 consecutive patients with chronic lower back pain (LBP) of at least 3 months. ⋯ Internal consistency was found to be very good at both assessments with Cronbach's α (0.942 and 0.951 at first and second assessments, respectively). The RMDQ was correlated with the VAS (r = 0.692; P = 0.000 and r = 0.668; P = 0.000 at first and second assessments, respectively), and with the ODI (r = 0.789; P = 0.000 and r = 0.802; P = 0.000, respectively). The adapted Korean version of the RMDQ was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for outcome assessments in the Korean speaking patients with LBP.