Articles: low-back-pain.
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Comparative Study
Interrelationships among pain, disability, and psychological factors in young Korean conscripts with lumbar disc herniation.
The aim of this study was to compare the psychological factors between young Korean conscripts with lumbar disc herniation (LDH) and healthy controls and to evaluate the interrelationships among pain, disability, and psychological factors in LDH conscripts. The subjects consisted of 56 young conscripts with LDH and 76 controls. All subjects completed Beck's Depression Inventory and Spielberger's State-Trait Anxiety Inventory. ⋯ Pain intensity and state anxiety significantly contributed to the functional disability in the LDH conscripts. This study suggests that LDH conscripts have some psychological problems, such as depression and anxiety, in comparison to healthy controls. Furthermore, the pain intensity and state anxiety predict the functional disability in LDH conscripts.
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Changes in coordination of postural control during dynamic stance in chronic low back pain patients.
The human postural system operates on the basis of integrated information from three independent sources: vestibular, visual and somatosensory. It is conceivable that a derangement of any of these systems will influence the overall output of the postural system. The peripheral proprioceptive system or the central processing of proprioceptive information may be altered in chronic low back pain (CLBP). ⋯ Control experiments ruled out that increased sway was due to pain interference. In CLBP patients, postural stability under challenging conditions is maintained by an increased sway in AP direction. This change in postural strategy may underlie a dysfunction of the peripheral proprioceptive system or the central integration of proprioceptive information.
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Over the past 10 years, a plethora of back-specific patient-orientated outcome measures have appeared in the literature. Standardisation has been advocated by an expert panel of researchers proposing a core set of instruments. Of the condition-specific questionnaires the Oswestry Disability Index (ODI) is recommended for use with low back pain (LBP) patients. ⋯ Longitudinal external construct validity showed moderate correlations (range 0.56-0.78). We conclude that the Danish version of the ODI is both a valid and reliable outcome instrument in two LBP patient populations. The ODI is probably most appropriate for use in SeS patients.
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The Oswestry Disability Index (ODI) is one of the most used assessment scales for patients with spine conditions, and translations into several languages have already been available. However, the scale's discriminative validity and responsiveness to the clinical change was somewhat understudied in these translated versions of the ODI. In this study, we independently developed a Japanese version of the ODI, and tested its discriminative and responsive performances among outpatients with various spinal conditions. ⋯ The translated ODI and the SF36 Physical Function (PF) subscale showed a significant trend increase as the numbers of symptoms/signs increased. They also showed comparable performance in discriminating the existence of signs/symptoms (AUC=0.70-0.76 for ODI, 0.69-0.70 for SF36 PF, P=0.15-0.81), and clinical status change over time (AUC=0.82 for ODI, 0.72 for SF36 PF, P=0.31). Our results showed that the translated Japanese ODI showed fair discriminative validity and responsiveness as the original English scale showed.
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Functional restoration programs for chronic low back pain (CLBP) have been shown to be successful in improving function and, to a lesser extent, in reducing pain. The Munich Functional Restoration Program (MFRP) is a 4-week outpatient program designed to reduce pain and to improve health-related quality of life in patients with a long history of CLBP. ⋯ Compared with standard treatment, a functional restoration program for CLBP significantly improves some aspects of health-related quality of life. It results in a decrease of pain and pain-related disability even in patients with a long history of CLBP.