Manual therapy
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Impaired integration of the body schema with motor processes may contribute to painful and/or restricted movement in chronic pain. Laterality judgment tasks assess this integration of the body schema with motor processes. The purpose of this study was to assess if patients with chronic whiplash associated disorders (WAD) are impaired on laterality judgment tasks. ⋯ Cervical spine PPT were significantly correlated with accuracy (r = 0.36) and RT (r = 0.29) in patients with WAD. These findings suggest that patients with chronic WAD are not impaired on neck or foot laterality judgment tasks. Laterality training is not indicated in the management of chronic WAD.
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Comparative Study
Is the psychosocial profile of people with low back pain seeking care in Danish primary care different from those in secondary care?
Differences between the psychosocial risk factors of low back pain (LBP) patients in primary and secondary care are under-investigated. Similarly, differences in the psychosocial profile of people classified into STarT Back Screening Tool (SBT) subgroups in primary and secondary care settings have not been investigated. The aim of the study was to determine: (1) if movement-related fear, catastrophisation, anxiety and/or depression in LBP patients are different between primary and secondary care settings, and (2) if those differences are retained when stratified by SBT subgroup. ⋯ These differences in psychosocial scores were broadly retained when stratified by SBT subgroup. However, questionnaire-specific reported thresholds for important difference scores indicate the size of these differences between the care settings were unlikely to be clinically important from a patient perspective. Longitudinal studies are required to investigate the predictive ability of SBT in secondary care settings and whether treatment targeted to SBT subgroups is effective in secondary care.
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The original Örebro Musculoskeletal Pain Questionnaire (original-ÖMPQ) was developed to identify patients at risk of developing persistent back pain problems and is also advocated for musculoskeletal work injured populations. It is critiqued for its informal non-clinimetric development process and narrow focus. A modified version, the Örebro Musculoskeletal Screening Questionnaire (ÖMSQ), evolved and progressed the original-ÖMPQ to broaden application and improve practicality. ⋯ Baseline-ÖMSQ scores correlated strongly with recovery time to 80% functional status (r = 0.73, p < 0.01). The ÖMSQ was validated prospectively in an acute work-injured musculoskeletal population. The ÖMSQ cut-off scores retain the predictive capacity intent of the original-ÖMPQ and provide clinicians and insurers with identification of patients with potentially high and low risks of unfavourable outcomes.
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Lumbar muscle degeneration is a common feature in non-specific low back pain (LBP). It is hypothesized that degenerated muscles might compromise spinal stability and lead to further injury/pain. However, little is known about lumbar muscle morphometry after resolution of LBP. ⋯ There were no differences between the previously painful and non-painful side of the LBP group for any of the parameters. These results show a generalized increase in intramuscular fatty infiltration in lean muscle tissue in the absence of macroscopical signs of muscle degeneration after resolution of LBP. These findings reflect a decreased muscle quality, but not quantity, and might indicate a pathophysiological mechanism contributing to recurrence of LBP.