Manual therapy
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Review Comparative Study
Clinical prediction rules in the physiotherapy management of low back pain: a systematic review.
To identify, appraise and determine the clinical readiness of diagnostic, prescriptive and prognostic Clinical Prediction Rules (CPRs) in the physiotherapy management of Low Back Pain (LBP). ⋯ The current body of evidence does not enable confident direct clinical application of any of the identified CPRs. Further validation studies utilizing appropriate research designs and rigorous methodology are required to determine the performance and generalizability of the derived CPRs to other patient populations, clinicians and clinical settings.
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Comparative Study
Two different courses of impaired cervical kinaesthesia following a whiplash injury. A one-year prospective study.
A longitudinal study was conducted to observe persons with neck pain after motor vehicle collisions. The aims were to reveal the prospective development of cervical kinaesthesia and to investigate the association between the test results and self-reported pain and disabilities. Two different cervical kinaesthetic tests, the Fly test and the Head-Neck Relocation test, measured movement control and the relocation accuracy of the cervical spine, respectively. ⋯ Accordingly, the results of the questionnaires correlated poorly or weakly with the kinaesthetic test results at all assessment points. The need for developing a new questionnaire, capturing the symptoms prevalent in patients with neck pain and cervical sensorimotor impairments is urgent. What determines the two different kinaesthetic courses need to be scrutinised in future research.
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Many factors are associated with low back pain (LBP), including provocative spinal postures. Consequently, lumbo-pelvic posture is commonly assessed in LBP patients. A novel wireless monitor (BodyGuard™) can monitor lumbo-pelvic sagittal plane movements reliably, and has demonstrated concurrent validity during non-functional tasks. ⋯ The mean difference observed was small (<10% lumbo-pelvic ROM), however some tasks displayed greater error. The results support the concurrent validity of the wireless monitor for analysing lumbo-pelvic posture during functional tasks. Specific limitations of the monitor for certain postural tasks were identified, and should be considered before implementation in future field studies.
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Comparative Study
The relationships between measures of stature recovery, muscle activity and psychological factors in patients with chronic low back pain.
Individuals with low back pain (LBP) often exhibit elevated paraspinal muscle activity compared to asymptomatic controls during static postures such as standing. This hyperactivity has been associated with a delayed rate of stature recovery in individuals with mild LBP. This study aimed to explore this association further in a more clinically relevant population of NHS patients with LBP and to investigate if relationships exist with a number of psychological factors. ⋯ Stature recovery was not found to be related to pain, disability, muscle activity or any of the psychological factors. The findings confirm the importance of muscle activity within LBP, in particular as a pathway by which psychological factors may impact on clinical outcome. The mediating role of muscle activity between psychological factors and pain suggests that interventions that are able to reduce muscle tension may be of particular benefit to patients demonstrating such characteristics, which may help in the targeting of treatment for LBP.
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Comparative Study
Investigation of sleep disturbance in chronic low back pain: an age- and gender-matched case-control study over a 7-night period.
Sleep disturbance is frequently reported by people with chronic low back pain (>12 weeks; CLBP), but few studies have comprehensively investigated sleep in this population. This study investigated differences in subjectively and objectively measured sleep patterns of people with CLBP, and compared this to age- and gender matched controls. ⋯ However, no significant differences between groups were found on objective actigraphy (p > 0.05). The findings provide some evidence to support self-reported sleep assessment as an outcome measure in CLBP research, while further research is needed to determine the validity of objective sleep measurement in this population.