Articles: low-back-pain.
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To investigate whether patients with chronic low back pain (CLBP) show "guarded" movements during walking. It is hypothesized that guarding will be reflected by increased lumbar muscle activity during all periods of stride and secondary, relatively lesser relaxation during periods of swing compared with double support. Furthermore, it is hypothesized that higher levels of perceived fear and disability are related to increased muscle activity and less relative relaxation. ⋯ In patients with CLBP, increased lumbar muscle activity during all periods of stride, with comparable alteration between swing and double support, suggests difficulties with total muscle relaxation. On the basis of this evaluation, it is concluded that patients with CLBP show a guarding mechanism during walking. No relationship is found between perceived fear, disability, and muscle activity.
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Bmc Musculoskel Dis · Jan 2010
Randomized Controlled TrialThe cost-effectiveness of a treatment-based classification system for low back pain: design of a randomised controlled trial and economic evaluation.
Systematic reviews have shown that exercise therapy and spinal manipulation are both more effective for low back pain (LBP) than no treatment at all. However, the effects are at best modest. To enhance the clinical outcomes, recommendations are to improve the patient selection process, and to identify relevant subgroups to guide clinical decision-making. One of the systems that has potentials to improve clinical decision-making is a treatment-based classification system that is intended to identify those patients who are most likely to respond to direction-specific exercises, manipulation, or stabilisation exercises. ⋯ The present study will contribute to our knowledge about the effectiveness and cost-effectiveness of classification-based treatment in patients with LBP.
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Bmc Musculoskel Dis · Jan 2010
Randomized Controlled TrialThe COPE LBP trial: cognitive patient education for low back pain--a cluster randomized controlled trial in primary care.
Non-specific low back pain (LBP) is usually self-limiting within 4-6 weeks. Longstanding pain and disability are not predictable from clinical signs or pathoanatomical findings. Pain cognition and physical performance have been shown to improve patients with chronic LBP following neurophysiological education. The primary aim of this study is to evaluate whether a specific cognitive based education programme for patients with LBP in primary care is more effective than normal care in terms of increased function. The secondary aims of the study are to evaluate whether this intervention also results in earlier return to work, decreased pain, increased patient satisfaction, increased quality-of-life, and cost utility. ⋯ We present the rationale and design of an ongoing RCT study that potentially offers an easily implemented treatment strategy for LBP patients in primary care. The results will be available in 2012.
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Low back pain is a common presenting complaint to sports medicine providers. The lumbar spine is a complex anatomic structure with multiple potential pain generators. Epidemiologic studies have shown that the intervertebral disc is the most common pain generator in all patients with low back pain. ⋯ Facet pain can have different presentations, and pain emanating from other lumbopelvic structures can present similarly as facet joint pain. This article reviews the anatomy and biomechanics of the lumbar facet joints, presenting symptoms and physical examination findings seen with facet pain. We also will discuss diagnostic and treatment paradigms that are helpful to the clinician treating low back pain in athletes.
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J. Occup. Environ. Med. · Jan 2010
Do fear-avoidance beliefs play a role on the association between low back pain and sickness absence? A prospective cohort study among female health care workers.
Health care workers have a high prevalence of sickness absence because of low back pain (LBP). This study examined whether fear-avoidance beliefs (FAB): 1) predicted sickness absence and 2) moderated the association between LBP and sickness absence among 1724 newly educated health care workers with LBP >or= day during the previous 12 months. ⋯ Furthermore, the results showed that health care workers with high degree of LBP would have more sickness absence days if they also had high FAB. To reduce sickness absence, education about pain management must be presumed to be beneficial.