scholarly journals Factors Related to the Inability of Individuals With Low Back Pain to Improve With a Spinal Manipulation

2004 ◽  
Vol 84 (2) ◽  
pp. 173-190 ◽  
Author(s):  
Julie M Fritz ◽  
Julie M Whitman ◽  
Timothy W Flynn ◽  
Robert S Wainner ◽  
John D Childs
Keyword(s):  
Logistic Regression ◽  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Spinal Manipulation ◽  
Symptom Duration ◽  
Low Back ◽  
Duration Of Symptoms ◽  
Fear Avoidance Beliefs ◽  
Pain Disability

Abstract Background and Purpose. Although spinal manipulation is one of the few interventions for low back pain supported by evidence, it appears to be underutilized by physical therapists, possibly due to therapists' concerns that a patient may not benefit from the intervention. The purpose of this study was to identify factors that are associated with an inability to benefit from manipulation. Subjects. Seventy-five people with nonradicular low back pain (mean age=37.6 years, SD=10.6, range=19–59; mean duration of symptoms=41.7 days, SD=54.7, range=1–252) participated. Methods. Subjects underwent a standardized examination that included history-taking; self-reports of pain, disability, and fear-avoidance beliefs; measurement of lumbar and hip range of motion; and use of various tests. All subjects received a spinal manipulation intervention for a maximum of 2 sessions. Subjects who did not show greater than 5 points of improvement on the modified Oswestry Low Back Pain Disability Questionnaire were considered to have shown no improvement with the manipulation. Baseline variables were tested for univariate relationship with the outcome of the manipulation. Variables showing a univariate relationship were entered into a logistic regression equation, and adjusted odds ratios were calculated. Results. Twenty subjects (28%) did not improve with manipulation. Six variables were identified as being related to inability to improve with manipulation: longer symptom duration, having symptoms in the buttock or leg, absence of lumbar hypomobility, less hip rotation range of motion, less discrepancy in left-to-right hip medial rotation range of motion, and a negative Gaenslen sign. The resulting logistic regression model explained 63% of the variance in manipulation outcome. Discussion and Conclusion. The majority of subjects improved with manipulation. Baseline variables could be identified that were predictive of which subjects would not improve.

scholarly journals Effectiveness of Dry Needling and Low-Level Laser Therapy in Nonspecific Low Back Pain

2020 ◽  
Author(s):  
Alagiathiruvevenkadam Ilayaraja ◽  
MK Franklin Shaju ◽  
Singh Sumer Singh ◽  
Edwin Raj Gerald ◽  
D Sathyanarayana ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
T Test ◽  
Low Back ◽  
Dry Needling ◽  
Low Level Laser ◽  
Pain Disability ◽  
Level Laser ◽  
Significant Difference

Introduction: Musculoskeletal spinal disorders are an immense problem in industrialised societies resulting in tremendous personal and economic costs. Younger adults (30 to 60-year-old) are more likely to experience Low Back Pain (LBP) from the disc space or from back muscle strain or other soft tissue strain. Experiencing it earlier in life may lead to recurrent and chronic LBP in adulthood. Dry Needling (DN) which are utilised to treat low back torment in current patterns. Low Level Laser Treatment (LLLT) is utilised to treat LBP by concentrating on the trigger focuses. Aim: To identify the effectiveness of DN and LLLT in the management of selected outcome variables among patients with nonspecific LBP. Materials and Methods: The Quasi experimental study was conducted among a total of 30 subjects who met the inclusion criteria. The subjects were divided into 15 each as group A (DN) and group B (LLLT). The Numerical Pain Distress Scale (NPDS), Quebec Back Pain Disability Scale (QBPDS) and lumbar flexion range of motion were assessed, before and after two weeks of intervention program to identify the effectiveness. Data analysis was done through SPSS and graph pad, using paired t-test and independent t-test. Results: Both groups have shown improvement after two weeks of intervention treatment program. Both groups showed significant difference in relieving pain, reducing disability and improving lumbar range of motion on nonspecific LBP individually. However, there was no significant difference found between the groups, thus null hypothesis was accepted and rejecting the alternate hypothesis. Conclusion: Both the techniques are equally effective in reducing the pain, disability level and improving range of motion individually after two weeks of intervention.

scholarly journals Paravertebral Muscle Mechanical Properties and Spinal Range of Motion in Patients with Acute Neck or Low Back Pain: A Case-Control Study

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 352
Author(s):  
Sandra Alcaraz-Clariana ◽  
Lourdes García-Luque ◽  
Juan Luis Garrido-Castro ◽  
César Fernández-de-las-Peñas ◽  
Cristina Carmona-Pérez ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Spinal Pain ◽  
Explanatory Models ◽  
Low Back ◽  
Lumbar Flexion ◽  
Acute Low Back Pain ◽  
Pain Disability

Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify if ROMs and MMPs are able to identify subjects among the three groups. Clinical variables (pain, disability, fear of movement, kinesiophobia, quality of life), MMPs and ROMs were obtained in 33 subjects with acute LBP, 33 with acute NP, and 33 healthy control subjects. Between-groups differences and explanatory models to discriminate groups depending on MMPs and ROMs were calculated. The results showed that cervical tone was higher in patients with acute NP than in controls, while cervical decrement was higher in both spinal pain groups. Patients with acute NP showed reduced cervical flexion when compared to acute LBP and control groups, and also cervical rotation, but just against controls. Furthermore, lumbar flexion was reduced in patients with acute LBP when compared to those with acute NP. Cervical decrement was able to discriminate spinal pain individuals from controls in a multinominal regression (R2: Cox–Snell estimation = 0.533; Nagelkerke estimation = 0.600). Lumbar flexion differentiated patients with acute LBP and controls, whereas cervical flexion differentiated patients with acute NP and controls. This study supports a tendency of the affectation of other spinal regions when only one is affected.

scholarly journals The Effect of Kinesio Taping on Pain, Functional Disability, and Trunk Range of Motion in People With Nonspecific Chronic Low Back Pain: A Single-group Pretest-Posttest Trial

2020 ◽  
Vol 14 (1) ◽  
pp. 47-54
Author(s):  
Soheila Abbasi ◽  
Mohammad Reza Hadian Rasanani ◽  
Nastaran Ghotbi ◽  
Gholam Reza Olyaei ◽  
Omid Rasouli
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Chronic Low Back Pain ◽  
Functional Disability ◽  
Low Back ◽  
Kinesio Taping ◽  
Pain Disability ◽  
Disability Questionnaire

Introduction: This study aimed to evaluate the effect of Kinesio Taping (KT) on low back/pelvis pain, disability, and trunk Range of Motion (ROM) in individuals with nonspecific chronic low back pain (CLBP) after 72 h.Materials and Methods: Eighteen patients with nonspecific CLBP participated in this study. Pain intensity, Oswestry low back pain disability questionnaire, and lumbar ROM were evaluated once before the intervention (KT with 50% tension) and then 72 h after. For statistical analysis, we used the paired sample t-test. Results: Pain intensity was significantly reduced (P<0.01). But KT did not improve disability and lumbar ROM (P>0.05).Conclusion: Based on the results, 72 h KT over the lumbopelvic area did not improve disability and lumbar ROM in people with nonspecific CLBP while there was a significant reduction in pain intensity. The proposed mechanism of the KT effects is inconsistent with these results.

Effect of hippotherapy simulator on pain, disability and range of motion of the spinal column in subjects with mechanical low back pain: A randomized single-blind clinical trial

2018 ◽  
Vol 31 (6) ◽  
pp. 1183-1192 ◽  
Author(s):  
Mohammad Rahbar ◽  
Yaghoub Salekzamani ◽  
Fatemeh Jahanjou ◽  
Fariba Eslamian ◽  
Alireza Niroumand ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Spinal Column ◽  
Low Back ◽  
Pain Disability ◽  
Single Blind

Avaliação de Medos, Crenças e Comportamentos de Evitação em Policiais Militares de Minas Gerais Portadores de Dor Lombar Crônica/Fear-Avoidance Assessment in Minas Gerais Military Police Agents With Low Back Pain

1970 ◽  
Vol 5 (3) ◽  
pp. 18-26
Author(s):  
Marcelo von Sperling de Souza ◽  
Maximiliano Ferreira Torres de Carvalho ◽  
Anna Florence Alves Paulino Souza ◽  
Flávia Corrêa Assumpção
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Minas Gerais ◽  
Low Back ◽  
Fear Avoidance ◽  
Invasive Procedures ◽  
Military Police ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

RESUMO Objetivo: descrever os índices de medos, crenças e evitação em policiais militares portadores de dor lombar crônica, acompanhados pelo Grupo de Coluna Vertebral do Hospital da Polícia Militar de Minas Gerais (PMMG). Materiais e métodos: durante um período de três anos, estas variáveis foram medidas pelo Fear-avoidance beliefs questionnaire (FABQ) versão português-brasileira, preenchido por autorrelato. As demais variáveis utilizadas para classificação da amostra em subgrupos e comparação destes quanto aos seus escores no FABQ foram idade, sexo, histórico de procedimento invasivo de coluna, presença de radiculopatia e encaminhamento pela Junta Central de Saúde (JCS), órgão oficial de perícias médicas na PMMG. Resultados: 248 militares preencheram o questionário satisfatoriamente e foram incluídos no estudo. A média de pontuação do FABQ-Work foi de 23,18 ± 10,79, enquanto a média de pontuação do FABQ-Phys foi de 18,10 ± 6,09. Não foram encontradas diferenças significativas nos escores dos subgrupos divididos por sexo, histórico de procedimento invasivo ou presença de radiculopatia. Indivíduos com idade superior a 40 anos apresentaram maiores índices de medo e evitação para atividades físicas (FABQ-Phys). Indivíduos que se encontravam em afastamento prolongado do trabalho (encaminhados pela JCS) apresentaram maior medo e evitação tanto para atividades físicas quanto atividades de trabalho. Conclusão: estes resultados permitiram identificar características dos policias militares em risco de incapacidade prolongada, ressaltando a necessidade de medidas educativas focadas na correção de crenças errôneas sobre dor lombar crônica para um melhor prognóstico na sua reabilitação.Palavras-chave: Dor lombar, Polícia, Medo, Questionários ABSTRACTObjectives: the purpose of this study was to describe fear-avoidance levels in military police agents with chronic low back pain followed by the Spine Group of the Military Police Hospital. Materials and Methods: The Brazilian Portuguese version of the Fear-avoidance Beliefs Questionnaire (FABQ) was applied during a three-year period. Secondary variables (age, sex, history of spinal invasive procedures, presence of radiculopathy, referral from medical experts due to prolonged sick-leave) were used for subgroup analysis and FABQ mean scores comparison. Results: 248 patients filled out FABQ correctly and were included in the study. FABQ-work and FABQ-Phys means were 23.18±10.79 and 18.10±6.09, respectively. There were no differences in FABQ scores between subgroups divided by sex, invasive procedures or radiculopathy. Age subgroup comparisons revealed that older individuals (> 40-years old) showed higher FABQ-Phys scores. Individuals with prolonged sick-leave showed higher scores at both FABQ-Phys and FABQ-Work subscales. Conclusion: Our results allowed identification of variables possibly related to long-time disability in military police agents and put emphasis on the need of educational interventions in which fear-avoidance beliefs are addressed in order to improve their rehabilitation prognosis.Keywords: Low back pain, Police, Fear, Questionnaires.

scholarly journals Changes in pain sensitivity and spinal stiffness in relation to responder status following spinal manipulative therapy in chronic low Back pain: a secondary explorative analysis of a randomized trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Casper Glissmann Nim ◽  
Gregory Neil Kawchuk ◽  
Berit Schiøttz-Christensen ◽  
Søren O’Neill
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Trial ◽  
Clinical Improvement ◽  
Spinal Manipulation ◽  
Pain Sensitivity ◽  
Spinal Manipulative Therapy ◽  
Low Back ◽  
Manipulative Therapy ◽  
Pressure Pain Thresholds

Abstract Background In a prior randomized trial, we demonstrated that participants receiving spinal manipulative therapy at a pain-sensitive segment instead of a stiff segment experienced increased mechanical pressure pain thresholds. We hypothesized that the targeted segment mediated this increase through a segment-dependent neurophysiological reflective pathway. Presently, it is not known if this decrease in pain sensitivity is associated with clinical improvement. Therefore, we performed an explorative analysis to examine if changes in experimental pain sensitivity (mechanical and thermal) and lumbar stiffness were further dependent on clinical improvement in disability and patient-reported low back pain. Methods This study is a secondary explorative analysis of data from the randomized trial that compared 132 participants with chronic low back pain who received lumbar spinal manipulative therapy applied at either i) the stiffest segment or ii) the segment having the lowest pain threshold (i.e., the most pain-sensitive segment). We collected data at baseline, after the fourth session of spinal manipulation, and at 14-days follow-up. Participants were dichotomized into responders/non-responders using different clinical variables (disability and patient-reported low back pain) with varying threshold values (0, 30, and 50% improvement). Mixed models were used to assess changes in experimental outcomes (stiffness and pain sensitivity). The fixed interaction terms were time, segment allocation, and responder status. Results We observed a significant increase in mechanical pressure pain thresholds for the group, which received spinal manipulative therapy at the most pain-sensitive segment independent of whether they improved clinically or not. Those who received spinal manipulation at the stiffest segment also demonstrated increased mechanical pain sensitivity, but only in the subgroup with clinical improvement. We did not observe any changes in lumbar stiffness. Conclusion Our results suggest the existence of two different mechanistic pathways associated with the spinal manipulation target. i) A decrease of mechanical pain sensitivity independent of clinical outcome (neurophysiological) and ii) a decrease as a reflection of the clinical outcome. Together, these observations may provide a novel framework that improves our understanding of why some respond to spinal manipulative therapy while others do not. Trial registration ClinicalTrials.gov identifier: NCT04086667 registered retrospectively September 11th 2019.

Psychologic Factors in Low-Back-Pain Disability

1985 ◽  
Vol &NA; (195) ◽  
pp. 178???184 ◽  
Author(s):  
J. W. FRYMOYER ◽  
J. C. ROSEN ◽  
JANICE CLEMENTS ◽  
M. H. POPE
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Pain Disability

scholarly journals A mixed treatment comparison of selected osteopathic techniques used to treat acute nonspecific low back pain: a proof of concept and plan for further research

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
James W. Price
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Manipulation ◽  
Conventional Care ◽  
Mixed Treatment Comparison ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Treatment Comparison ◽  
Randomized Controlled ◽  
Mixed Treatment

Abstract Context Back injuries have a high prevalence in the United States and can be costly for both patients and the healthcare system at large. While previous guidelines from the American College of Physicians for the management of acute nonspecific low back pain (ANLBP) have encouraged nonpharmacologic management, those treatment recommendations involved only superficial heat, massage, acupuncture, and spinal manipulation. Investigation about the efficacy of spinal manipulation in the management of ANLBP is warranted. Objectives To compare the results in previously-published literature documenting the outcomes of osteopathic manipulative treatment (OMT) techniques used to treat ANLBP. The secondary objective of this study was to demonstrate the utility of using Bayesian network meta-analysis (NMA) to perform a mixed treatment comparison (MTC) of a variety of osteopathic techniques. Methods A literature search for randomized controlled trials (RCTs) of ANLBP treatments was performed in April 2020 according to PRISMA guidelines by searching MEDLINE/PubMed, OVID, Cochrane Central, PEDro, and OSTMED.Dr databases; scanning the reference lists of articles; and using the Canadian Agency for Drugs and Technologies in Health grey literature checklist. Each database was searched from inception to April 1, 2020. The following search terms were used: acute low back pain, acute low back pain plus physical therapy, acute low back pain plus spinal manipulation, and acute low back pain plus osteopathic manipulation. The validity of eligible trials was assessed by the single author using an adapted National Institute for Health and Care Excellence methodology checklist for randomized, controlled trials and an extraction form based on that checklist. The outcome measure chosen for this NMA was the Visual Analogue Scale of pain. The NMA were performed using the GeMTC user interface for automated NMA utilizing a Bayesian hierarchical model of random effects. Results The literature search initially found 483 unduplicated records. After screening and full text assessment, five RCTs were eligible for the MTC, yielding a total of 430 participants. Results of the MTC model suggested that there was no statistically significant decrease in reported pain when exercise, high-velocity low-amplitude (HVLA), counterstrain, muscle energy technique, or a mix of techniques were added to conventional treatment to treat ANLBP. However, the rank probabilities assessment determined that HVLA and the OMT mixed treatment protocol plus conventional care were ranked superior to conventional care alone for improving ANLBP. Conclusions While this study failed to provide definitive evidence upon which clinical recommendations can be based, it does demonstrate the utility of performing NMA for MTCs of osteopathic modalities used to treat ANLBP. However, to take full advantage of this statistical technique, future studies should be designed with consideration for the methodological shortcomings found in past osteopathic research.

Sign in / Sign up

Export Citation Format

Share Document