Articles: low-back-pain.
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Comparative Study
Relationship between spinal stiffness and outcome in patients with chronic low back pain.
Many manual therapists assess and treat spinal stiffness of people with low back pain. The objectives of this study were to investigate: (i) whether spinal stiffness changes after treatment; (ii) the relationship between pre-treatment spinal stiffness and change in stiffness with treatment; (iii) the relationship between spinal stiffness, pain, disability and global perceived effect of treatment; (iv) whether spinal stiffness predicts outcome of treatment or response to treatment in chronic low back pain patients. One hundred and ninety-one subjects with chronic low back pain were randomly allocated to groups that received either spinal manipulative therapy, motor control exercise, or a general exercise program. ⋯ No significant association was observed between initial stiffness score and any of the final outcome measures following treatment. Initial stiffness did not predict response to any treatment. In conclusion, spinal stiffness decreases over the course of an episode of treatment, more so in those with the stiffest spines, but the decrease is not dependent on treatment and is not generally related to outcome.
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Arch Phys Med Rehabil · Feb 2009
A prospective outcome study on the effects of facet joint radiofrequency denervation on pain, analgesic intake, disability, satisfaction, cost, and employment.
To assess the effect of radiofrequency denervation (RFD) on patients with chronic low back pain (LBP) of facet joint origin. ⋯ RFD provides safe and significant short-term improvement in pain, analgesic requirements, function, satisfaction, and direct costs in patients with chronic LBP of facet origin.
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The current study examined the Photograph Series of Daily Activities (PHODA) Scale in a sample of chronic low back pain patients with high and low levels of kinesiophobia (pain-related fear). Thirty-three participants completed a modified version of the PHODA (PHODA-M) that obtained ratings of both anticipated pain and harm. Participants' responses on the PHODA-M were compared to predicted and experienced pain and harm ratings collected during a graded-difficulty reaching task. ⋯ In comparison to low fear participants, high fear participants showed larger correlations between pain expectancies for movements depicted in the PHODA and their ratings of predicted and experienced pain on each movement comprising the reaching task. Additionally, high fear participants showed larger associations between the perceived harmfulness of PHODA activities and predicted and experienced harm ratings in response to the reaching task. Implications for the findings are discussed.
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There is conflicting evidence regarding erector spinae muscle fatigability because previous studies have not considered the thoracic and lumbar components separately. These muscles have very different mechanical responses and, therefore, would be recruited differentially for the chosen task. ⋯ The results of this study suggested that subjects with LBP demonstrated higher fatigability of the erector spinae muscles at the thoracic part than at the lumbar part. The increased fatigability of the thoracic part needs to be emphasized in rehabilitation strategies for subjects with LBP. In addition, as age increased, the median frequency of the lumbar part of the erector spinae muscles significantly decreased. Understanding the anatomical and biomechanical characteristics of the erector spinae muscle may enhance clinical outcomes and rehabilitation strategies for subjects with LBP.
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Review of oral and poster presentations and of workshop summaries from the Ninth International Forum for Primary Care Research on Low Back Pain held in Majorca, Spain, October 4-6, 2007. ⋯ The research presented at the forum has contributed to the advancement of understanding of how to improve primary care for low back pain. The Tenth International Forum will occur on June 14-17, 2009, in Boston.