Articles: low-back-pain.
-
Comparative Study
The role of TNF-alpha in patients with chronic low back pain-a prospective comparative longitudinal study.
In this prospective longitudinal clinical study with a matched-pair design, we evaluated the role of tumor necrosis factor-alpha (TNF-alpha) and its clinical relevance in patients with chronic low back pain. ⋯ TNF-alpha seems to have a significant role in patients with chronic low back pain. However, the pathophysiology of this process, the clinical relevance of TNF-alpha and, especially, its part in a potential therapy regimen in these patients need to be more closely examined and defined in additional studies.
-
Design of the experiment is to study the cross-sectional sample with retrospective information. The objective is to identify the types of physical activity associated with the decreased occurrence of low-back pain (LBP) in schoolchildren. Physical activity may be hypothesized to possess a potential for LBP prevention. ⋯ Among sports activities, only swimming and the number of hours per week participating in soccer were associated with a decreased LBP prevalence. With the exception of swimming and soccer, the types of sport reported by this schoolchild population do not offer themselves for consideration as tools for LBP prevention. Based on the associations found with indicators of physical inactivity, attempts to motivate the children to increase their general physical activity level should be considered for trial.
-
Review Meta Analysis
Methodological quality and homogeneity influenced agreement between randomized trials and nonrandomized studies of the same intervention for back pain.
To determine the influence of methodological quality and homogeneity on the agreement between pairs of randomized trials (RCTs) and nonrandomized studies (NRSs) of the same interventions for low-back problems. Homogeneity was assessed regarding settings, population, interventions, and outcomes. ⋯ Pairs of low-quality studies disagreed more than pairs where at least one study was of high quality. However, pairs with similar settings, population, interventions, and outcomes showed higher agreement than pairs that were not as homogeneous.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists.
Guidelines for the management of low back pain (LBP) have existed for many years, but adherence to these by health care practitioners (HCPs) remains suboptimal. The aim of this study was to measure the attitudes, beliefs and reported clinical behaviour of UK physiotherapists (PTs) and general practitioners (GPs) about LBP and to explore the associations between these. A cross-sectional postal survey of GPs (n=2000) and PTs (n=2000) was conducted that included the Pain Attitudes and Beliefs Scale (PABT. ⋯ Many HCPs held the belief that LBP necessitates some avoidance of activities and work. The attitudes and beliefs of these HCPs were associated with their self-reported clinical behaviour regarding advice about work. Future studies need to investigate whether approaches aimed at modifying these HCP factors can lead to improved patient outcomes.
-
In this post hoc observational study, we investigated psychological predictors of outcome after radiofrequency and injection treatments, commonly performed in the management of chronic low back pain (CLBP). ⋯ Minimally invasive treatment for CLBP leads to significant pain reduction, including potential placebo effects. However, psychologically vulnerable patients, characterized by, among others, reduced life control, disturbed mood, negative self-efficacy, catastrophizing, high anxiety levels, inadequacy, and poor mental health, tend not to respond to this treatment. Patients characterized by a.o. reduced pain and interference levels, positive expectations, and reasonable physical and social functioning, react more favorably. From both a clinical and a financial perspective, psychosocial evaluation and selection of patients seems appropriate, before applying minimally invasive procedures for CLBP.