Articles: low-back-pain.
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For years, physical deconditioning has been thought to be both a cause and a result of back pain. As a consequence physical reconditioning has been proposed as treatment-goal in patients with chronic low back pain (LBP). However, it is still unclear whether a patient's physical fitness level really decreases after pain-onset. ⋯ Results showed that only in a subgroup of patients a PAL-decrease had occurred after the onset of pain, whereas no signs of physical deconditioning were found. Negative affect and the patients' perceived physical activity decline in the subacute phase predicted a decreased level of PAL over one year. Based on these results, we conclude that as to the assumption that patients with CLBP suffer from disuse and physical deconditioning empirical evidence is still lacking.
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Comparative Study
The incidence of donor site pain after bone graft harvesting from the posterior iliac crest may be overestimated: a study on spine fracture patients.
A retrospective cohort study on patients with traumatic vertebral fractures who underwent fusion with iliac crest bone. ⋯ Patients probably cannot differentiate between donor site pain and residual low back pain. The reported incidence of pain related to posterior iliac crest bone graft harvesting may therefore be overestimated.
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Translation, cross-cultural adaptation and psychometric testing of self-report outcome measurements. ⋯ The results of this study indicate that the Brazilian-Portuguese versions of the FRI and RMDQ are reliable and valid instruments for the measurement of disability in Brazilian-Portuguese-speaking patients with LBP presenting for physiotherapy treatment. Both instruments are suitable for use in clinical practice and research studies.
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Current low back pain (LBP) clinical guidelines have helped to summarize the scientific evidence and research, but have failed to provide tools and guide family physicians (FPs). The purpose of this study is to identify barriers and facilitators for the implementation of LBP guidelines from family FPs' perspective. ⋯ Despite an overall positive attitude towards LBP guideline implementation, FPs found it hard to come to terms with the conflicting dimensions of LBP patient care. The patient-doctor interaction determined the outcome of the encounter, whether it complied with the guidelines and whether the encounter leads to a healing process or to a vicious circle of unnecessary utilization of services.
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The results of coccygectomy were evaluated in patients with coccydynia unresponsive to conservative treatment. ⋯ Coccygectomy is a successful treatment option in patients unresponsive to conservative treatment for coccydynia.