Bmc Musculoskel Dis
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There are many different reasons why patients could be experiencing pain in the gluteal area. Previous studies have shown an association between radicular low back pain (LBP) and gluteal pain (GP). Studies locating the specific level responsible for gluteal pain in lumbar disc hernias have rarely been reported. ⋯ As a clinical finding, gluteal pain is related to low lumbar disc hernia. The L4/5 level is the main level responsible for gluteal pain in lumbar disc hernia. No patients with gluteal pain exhibited involvement at the L3/4 level.
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Bmc Musculoskel Dis · Aug 2016
Randomized Controlled TrialUse of the PREPARE (PREhabilitation, Physical Activity and exeRcisE) program to improve outcomes after lumbar fusion surgery for severe low back pain: a study protocol of a person-centred randomised controlled trial.
Following lumbar fusion surgery, a successful outcome is empirically linked to effective rehabilitation. While rehabilitation is typically postoperative, the phase before surgery - termed prehabilitation - is reportedly an ideal time to prepare the patient. There are presently no guidelines for prehabilitation before lumbar fusion surgery. Physical activity has well-known health benefits, and staying physically active despite pain is a major principle in non-pharmacological chronic low back pain treatment. Psychological factors such as fear of movement, pain catastrophizing and low self-efficacy are known to be barriers to staying active. No studies have investigated prehabilitation protocols that promote physical activity and target psychological risk factors before lumbar fusion surgery. The aim of our proposed randomised controlled trial is to investigate whether patients who undergo lumbar fusion surgery for degenerative disc disease experience better functioning with a physiotherapeutic prehabilitation program (PREPARE) based on a cognitive behavioural approach compared to conventional care. ⋯ We hypothesise that the focus on promoting physical activity and targeting psychological risk factors before surgery will decrease disability and help the patients to be more active despite pain both before and after surgery. We will use a combination of outcome measures both patient-reported and performance-based, as well as accelerometer data. This will provide a more comprehensive picture of the patient's functioning than just patient-reported outcomes alone.
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Bmc Musculoskel Dis · Aug 2016
Intra-session absolute and relative reliability of pressure pain thresholds in the low back region of vine-workers: ffect of the number of trials.
Pressure pain thresholds (PPT) are commonly used to quantify mechanical pain sensitivity of deep structures. Excellent PPT reliability has been previously reported among the low back of healthy subjects. However, there is a lack of studies assessing PPT over the low back of workers exposed to biomechanical risk factors of low back pain. Thus, the purpose of this study was threefold: (1) to evaluate the intra-session absolute and relative reliability as well as minimal detectable change (MDC) values of PPT within 14 locations covering the low back region of vine-workers and (2) to determine the number of trial required to ensure reliable PPT assessments and (3) to assess the effect of modifier factors such as gender, age, body mass index (BMI) and pain intensity on PPT reliability. ⋯ The assessment of PPTs of the lower back among vine-workers was found to have excellent relative and absolute reliability. Moreover, reliable measurements can be equally achieved when using the mean of three PPT measurement or with the first one.
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Bmc Musculoskel Dis · Aug 2016
Correlations between the feature of sagittal spinopelvic alignment and facet joint degeneration: a retrospective study.
Sagittal spinopelvic alignment changes associated with degenerative facet joint arthritis have been assessed in a few studies. It has been documented that patients with facet joint degeneration have higher pelvic incidence, but the relationship between facet joint degeneration and other sagittal spinopelvic alignment parameters is still disputed. Our purpose was to evaluate the correlation between the features of sagittal spinopelvic alignment and facet joint degeneration. ⋯ Our results indicate that a high PI is a predisposing factor for facet joint degeneration at the lower lumbar spine, and that severe facet joint degeneration may accompany with greater PT at lumbar spine.
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Bmc Musculoskel Dis · Aug 2016
Clinical Trial Observational StudyCombined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction in knees with osteoarthritis and deficient anterior cruciate ligament.
Relative young and more active patients with osteoarthritis (OA) of the isolated medial femorotibial compartment in conjunction with anterior cruciate ligament (ACL) deficiency are difficult to treat. The aim of this study was to explore the early clinical outcomes of combined Oxford unicompartmental knee arthroplasty (UKA) and ACL reconstruction for the patients presenting ACL deficiency and isolated OA of the medial compartment. ⋯ The early clinical data have shown that combined surgery of UKA and ACL reconstruction has revealed promising results. However, long-term follow-up studies should be done in these patients.