Articles: low-back-pain.
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Comparative Study
Predictive validity of the Chronic Pain Coping Inventory in subacute low back pain.
The Chronic Pain Coping Inventory (CPCI) was developed to assess eight behavioral coping strategies hypothesized to be important for pain adaptation. But the predictive validity of the CPCI has yet to be tested in a longitudinal study. Here, 321 workers on sick leave after a work accident affecting the low back pain (LBP) region completed the CPCI during the subacute stage (T1) of LBP as well as the Catastrophizing scale of the Coping Strategies Questionnaire (CSQ). ⋯ Catastrophizing and Guarding were the most strongly associated with depressive mood at T1 but at T2, only depressive mood at T1 predicted this same variable. Results indicated also that the Guarding and Catastrophizing scales were able to predict future work status. The present study clearly reveals the usefulness of Guarding from the CPCI and Catastrophizing from the CSQ, when predicting different outcomes of adjustment to low back pain.
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Best Pract Res Clin Rheumatol · Aug 2005
Review Comparative StudyTrend in methodological quality of randomised clinical trials in low back pain.
During the past decades, the number of published randomised clinical trials evaluating the efficacy of conservative treatments for low back pain has substantially increased. At the same time several initiatives were undertaken in order to improve the methodological quality of published randomised clinical trials, also in the field of low back pain. We investigated how the methodological quality of randomised clinical trials in the field of low back pain developed over time since the first published trial in 1961. ⋯ The median overall quality scores ranged from 36 to 82% depending on the type of intervention. There were no improvements in median overall methodological quality over time from 1960 to 2004. Improvements were apparent for a few validity criteria only.
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Multicenter Study Comparative Study
The transition from acute to subacute and chronic low back pain: a study based on determinants of quality of life and prediction of chronic disability.
Follow-up study. ⋯ LBP influences disability and quality of life more than RP. Disability is predicted by pain duration and quality of life is predicted by disability, but pain severity predicts neither one of them. Changes related to determinants of disability and quality of life, and to the prediction of chronic disability, appear 14 days after the onset of pain, supporting that cutoff point for considering a patient as being subacute.
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Clinical Trial
Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results.
The unilateral transforaminal approach for lumbar interbody fusion as an alternative to the anterior (ALIF) and traditional posterior lumbar interbody fusion (PLIF) combined with pedicle screw instrumentation is gaining in popularity. At present, a prospective study using a standardized tool for outcome measurement after the transforaminal lumber interbody fusion (TLIF) with a follow-up of at least 3 years is not available in the current literature, although there have been reports on specific complications and cost efficiency. Therefore, a study of TLIF was undertaken. ⋯ At the latest follow-up, significant differences of the ODI were neither found between isthmic spondylolistheses and degenerative diseases, nor between one- and multiple-level fusions. In conclusion, the TLIF technique has comparable results to other interbody fusions, such as the PLIF and ALIF techniques. The potential advantages of the TLIF technique include avoidance of the anterior approach and reduction of the approach related posterior trauma to the spinal canal.
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The purpose of this study was to investigate the pressure pain thresholds (PPTs) with respect to the Erector spinae and the hip muscles in 87 patients with subacute non-specific low back pain (LBP) and to evaluate the relationship between the PPTs and disability. In order to establish reference values, 64 healthy subjects were examined with respect to PPTs and used as a control group against the group of LBP patients. The mean PPT values of the Erector spinae and the hip at all examined points of the LBP group were significantly lower (p<0.001) in comparison to the PPT values of the healthy group. ⋯ The correlation between having LBP or not in the whole group (n=151) and PPT, was highest at the L3 level of the Erector spinae (r=-0.710, p<0.001). When the group of patients with LBP was divided into two subgroups in terms of having an Oswestry disability index (ODI) lower than 40 ("moderate LBP disability") or an ODI higher than 40 ("severe LBP disability") it was surprising to notice that there was no significant difference between the PPTs of the Erector spinae and the hip musculature. This study has shown the possibility of the existence of muscular disorder in the lumbar part of the Erector spinae in patients with non-specific low back pain, but also reveals the strong inter-individual differences in muscular fibrosis sensitivity and pain behaviour related to gender.