Articles: low-back-pain.
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A validation study of the Acute Low Back Pain Screening Questionnaire Dutch Language Version (ALBPSQ-DLV). ⋯ The internal consistency and both construct and convergent validity of the ALBPSQ-DLV are well established in a Dutch population of 69 patients with (sub) acute nonspecific LBP referred to primary care physical therapy.
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Acute low back pain (LBP) is primarily managed in general practice. We aimed to describe the usual care provided by general practitioners (GPs) and to compare this with recommendations of best practice in international evidence-based guidelines for the management of acute LBP. ⋯ The usual care provided by GPs for LBP does not match the care endorsed in international evidence-based guidelines and may not provide the best outcomes for patients. This situation has not improved over time. The unendorsed care may contribute to the high costs of managing LBP, and some aspects of the care provided carry a higher risk of adverse effects.
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In this study the effectiveness of prolotherapy in the treatment of deficient load transfer of the sacroiliac joint (SIJ) was determined. ⋯ This descriptive study of prolotherapy in private practice has shown positive clinical outcomes for the 76% of patients who attended the 3-month follow-up visit (76% at 12 months and 32% at 24 months). Similar results were found in the questionnaires (Quebec Back Pain Disability Scale, Roland-Morris 24 and Roland-Morris 24 Multiform questionnaires) at 3, 12 and 24 months.
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J Bone Joint Surg Br · Feb 2010
Coccygectomy: an effective treatment option for chronic coccydynia: retrospective results in 41 consecutive patients.
Between 1993 and 2008, 41 patients underwent total coccygectomy for coccydynia which had failed to respond to six months of conservative management. Of these, 40 patients were available for clinical review and 39 completed a questionnaire giving their evaluation of the effect of the operation. Excellent or good results were obtained in 33 of the 41 patients, comprising 18 of the 21 patients with coccydynia due to trauma, five of the eight patients with symptoms following childbirth and ten of 12 idiopathic onset. ⋯ The only post-operative complication was superficial wound infection which occurred in five patients and which settled fully with antibiotic treatment. One patient required re-operation for excision of the distal cornua of the sacrum. Total coccygectomy offered satisfactory relief of pain in the majority of patients regardless of the cause of their symptoms.
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Randomized Controlled Trial
What factors influence the measurement properties of the Roland-Morris disability questionnaire?
Although the Roland disability questionnaire (RDQ) is a commonly used questionnaire for patients with low back pain (LBP), several important issues remain understudied. The purposes of this study were to investigate the impact that several parameters (length of test-retest interval, interpretation of the global perceived effect (GPE) scores, methods to estimate standard error of measurement (SEM), intervention and baseline scores) have on various measurement properties, such as agreement (Limits of Agreement (LOA), SEM(agreement)), responsiveness (area under the ROC curve, sensitivity, specificity) and interpretability (optimal cut-off point, Minimal Detectable Change), of the RDQ. RDQ was administered four times to 212 patients with chronic non-specific LBP (first consultation (T-1), eligibility check (T0), randomization/start of treatment (T1) and end of treatment (T2)). ⋯ Results revealed that agreement parameters decreased with increasing time interval between test-retest. They confirmed the influence of the interpretation of the GPE as well as of the method to calculate the SEM on the magnitude of the Minimal Detectable Change and ROC parameters. Baseline RDQ scores and the way to cluster patients with regard to baseline scores influenced mainly the optimal cut-off point and responsiveness parameters; intervention did not affect the magnitude of the Minimal Detectable Change.