British journal of sports medicine
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Chronic pain experienced in the proximal, lateral, lower limb may arise from the femoro-acetabular joint, from the muscles and tendons that act upon it, from any of the structures that traverse the area, and from more remote structures such as the lumbar spine. The aetiology of pathology in this area is not confined to either trauma or overuse. As a result many different sporting activities may have a causal role. ⋯ Anatomical reference points were selected to form a triangle, which provides the discriminative power to restrict the differential diagnosis, and form the basis of ensuing investigation. This paper forms part of a series addressing the three-dimensional nature of proximal lower limb pathology. The 3G approach (groin, gluteal, and greater trochanter triangles) acknowledges this, permitting the clinician to move throughout the region, considering pathologies appropriately.
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Sedentary and inactive lifestyle continues to increase and is associated with a substantial economic burden in most industrialised countries. To implement effective physical activity interventions on a broad population basis, their cost-effectiveness needs to be evaluated. ⋯ There was evidence that current physical activity intervention strategies can be a cost-effective means of resource allocation. But, despite the growing literature on physical activity promotion, appropriate cost-effectiveness analyses are rare and the generalisability of presented findings is limited. Further research is warranted to investigate the cost-effectiveness of behavioural and environmental intervention strategies.
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Promoting physical activity has become a priority because of its role in preventing childhood obesity and chronic disease. Ecological approaches that recognise the interaction between individuals and the settings in which they spend their time are currently at the forefront of public health action. Schools have been identified as a key setting for health promotion. ⋯ School initiatives must be supported and reinforced in other community settings. Health professionals play a key role as champions in the community, based on their influence and credibility. Health professionals can lend support to school-based efforts by asking about and emphasising the importance of physical activity with patients, encouraging family-based activities, supporting local schools to adopt an "active school" approach and advocating for support to sustain evidence-based and promising physical activity models within schools.
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To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain. ⋯ One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.
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The aim of this study was to assess the clinical effect of antibiotic treatment in a cohort of patients with low-back pain (LBP) and Modic changes Type 1 (bone oedema) following a lumbar herniated disc. ⋯ In this uncontrolled trial, the clinical effect of antibiotic treatment was large in a group of patients with Modic changes suffering from persistent LBP following a disc herniation. These results provide tentative support for a hypothesis that bacterial infection may play a role in LBP with Modic changes and indicate the need for randomised controlled trials to test this hypothesis.