Articles: low-back-pain.
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Randomized Controlled Trial Clinical Trial
Does early intervention with a light mobilization program reduce long-term sick leave for low back pain?
A controlled randomized clinical trial was performed. ⋯ Early intervention with examination, information, and recommendations to stay active showed significant effects in reducing sick leave for patients with low back pain.
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Flexion and extension movements or positions have been advocated in the treatment of various forms of low back dysfunction due to the potential pain relieving effects attributed to displacements of the intervertebral disc (IVD). Objective in vivo determination of the segmental behaviour of the disc to contrasting positions has until recently been difficult. Magnetic resonance imaging (MRI) was used in this study to evaluate the influence of sagittal plane positions on lumbar IVD height and nucleus displacement in a small asymptomatic population. ⋯ Lumbar spine position was found to be associated with small measured changes in anterior disc height and nucleus position, however, this response was variable within and between individuals. The theoretical concept of a stereotypical effect of spinal position on the lumbar IVD is challenged by these initial data. Since the health of the disc is often unknown in clinical practice, manual therapy treatment for lumbar spine pain should be based on the symptomatic response to movement and position rather than biomechanical theory.
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Although guidelines for the management of low back pain have been published in the past decade, there is potential for further improvement in back pain care. ⋯ The management of low back pain met the guidelines to a large extent. Management decisions were often related to characteristics in which the guidelines lack differentiation. Important reasons for non-adherence were perceived patients' preferences. Further implementation of guidelines will be difficult unless doctors' and patients' views are more explicitly known.
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Comparative Study
A comparison study of the back pain functional scale and Roland Morris Questionnaire. North American Orthopaedic Rehabilitation Research Network.
To determine whether the measurement properties of the Back Pain Functional Scale (BPFS) are superior to the Roland-Morris Questionnaire (RMQ). ⋯ The BPFS is a competitive functional status measure for patients with low back pain.
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A longitudinal cohort study of patients with acute, work-related low back pain undergoing physical therapy treatment. ⋯ Because the nonorganic tests are purported to serve as screening tests, cut-off values were selected that minimized false-negative results. Even with optimal cut-off values, none of the nonorganic tests served as effective screening tools. Other screening tools may prove more effective for the early identification of patients at increased risk for delay in returning to work after an episode of acute low back pain.