Articles: low-back-pain.
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The management of chronic low back pain (CLBP) has proven to be very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. ⋯ Although this special focus issue was focused on nonoperative care, it was deemed important to provide an overview of the surgical management of CLBP. This is intended to inform stakeholders of surgical options that are available to them should nonsurgical interventions prove ineffective or contraindicated. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.
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Scand J Prim Health Care · Jan 2008
Comparative StudyHealthcare provider back pain beliefs unaffected by a media campaign.
Healthcare providers play a key role in transmitting knowledge and beliefs about LBP to their patients. There are differences in back pain beliefs between the various professionals groups treating LBP patients. This study examined whether LBP beliefs changed among the healthcare providers exposed to a media campaign. ⋯ An LBP mass media campaign with educational initiatives aimed at healthcare providers did not result in important improvement in LBP beliefs of providers exposed to the campaign. Important differences were observed between beliefs of the different healthcare provider groups in their view of LBP.
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Bmc Musculoskel Dis · Jan 2008
Randomized Controlled TrialStay@Work: Participatory Ergonomics to prevent low back and neck pain among workers: design of a randomised controlled trial to evaluate the (cost-)effectiveness.
Low back pain (LBP) and neck pain (NP) are a major public health problem with considerable costs for individuals, companies and society. Therefore, prevention is imperative. The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics (PE) to prevent LBP and NP among workers. ⋯ Prevention of LBP and NP is beneficial for workers, employers, and society. If the intervention is proven (cost-)effective, the intervention can have a major impact on LBP and NP prevention and, thereby, on work disability prevention. Results are expected in 2010.
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Posterior-anterior (PA) assessment of the lumbar spine correlates with radiographic signs of instability and can guide treatment choices, yet studies of the validity of lumbar PA assessments have not been conducted in vivo. The purposes of this study were to determine the intertester reliability of the PA examination in assessing intersegmental lumbar spine motion and to evaluate the validity of this procedure in vivo with dynamic magnetic resonance imaging (MRI). ⋯ Despite good intertester reliability for identifying the least mobile segment, PA assessments of lumbar segmental mobility did not agree with sagittal-plane motion measured by dynamic MRI. This finding calls into question the validity of the PA procedure for assessing intervertebral lumbar spine motion.
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Bmc Musculoskel Dis · Jan 2008
Regional differences in lumbar spinal posture and the influence of low back pain.
Spinal posture is commonly a focus in the assessment and clinical management of low back pain (LBP) patients. However, the link between spinal posture and LBP is not fully understood. Recent evidence suggests that considering regional, rather than total lumbar spine posture is important. The purpose of this study was to determine; if there are regional differences in habitual lumbar spine posture and movement, and if these findings are influenced by LBP. ⋯ This study supports the concept of regional differences within the lumbar spine during common postures and movements. Global lumbar spine kinematics do not reflect regional lumbar spine kinematics, which has implications for interpretation of measures of spinal posture, motion and loading. BMI influenced regional lumbar posture and movement, possibly representing adaptation due to load.