scholarly journals Evaluation of Absenteeism, Pain, and Disability in Nurses With Persistent Low Back Pain Following Cognitive Functional Therapy: A Case Series Pilot Study With 3-Year Follow-Up

2020 ◽  
Author(s):  
Wannes Van Hoof ◽  
Kieran O’Sullivan ◽  
Sabine Verschueren ◽  
Peter O’Sullivan ◽  
Wim Dankaerts
Keyword(s):  
Health Care ◽  
Low Back Pain ◽  
Pilot Study ◽  
Case Series ◽  
Health Care Seeking ◽  
Low Back ◽  
Care Seeking ◽  
Functional Therapy ◽  
Secondary Outcomes

Abstract Objective Persistent low back pain (PLBP) is a common and costly health problem worldwide. Better strategies to manage it are required. The purpose of this study was to longitudinally evaluate absenteeism, pain, and disability in nurses with PLBP following a cognitive functional therapy (CFT) intervention. Methods In this case series pilot study, 33 eligible nurses with PLBP were recruited. During the baseline phase (phase A; no intervention), outcome measures were collected on 2 occasions 6 months apart (A1 and A2). During phase B, participants received an individualized CFT intervention for 14 weeks. During phase C (no intervention), outcomes were measured immediately after the intervention, as well as 3, 6, 9, 12, and 36 months after the intervention (secondary outcomes only until 12 months). LBP-related work absenteeism, pain intensity (numerical pain rating scale) and disability (Oswestry Disability Index) were the primary outcomes. Health care seeking, a range of psychological and lifestyle variables, and global perceived effect were secondary outcomes. Results Days of absenteeism due to LBP were significantly reduced in the first and second calendar years after the CFT intervention but not the third and fourth. Disability was significantly reduced immediately after (−4.4; 95% CI = −6.5 to −2.2) and at 3 months (−4.3; 95% CI = −6.6 to −2.0), 9 months (−6.0; 95% CI = −8.1 to −3.9), and 12 months (−4.9; 95% CI = −7.0 to −2.8) after the intervention. Pain was significantly reduced immediately after (−1.2; 95% CI = −1.7 to −0.8) and at 3 months (−1.5; 95% CI = −2.0 to −0.9), 9 months (−1.1; 95% CI = −1.9 to −0.3), and 12 months (−0.9; 95% CI = −1.5 to −0.2) after the intervention. Total health care seeking (consults and proportion of participants) was significantly reduced after the intervention. All psychosocial variables, except for 1, demonstrated significant improvements at all follow-up assessments. Conclusions This case series pilot study demonstrated significant reductions in LBP-related absenteeism, pain intensity, disability, health care seeking, and several psychological and lifestyle behaviors until the 1-year follow-up among nurses with PLBP following an individualized CFT intervention. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among nurses is recommended.

scholarly journals Randomized Pilot Trial for a Community-Based Group Stretching Exercise Program for Chronic Low Back Pain

2019 ◽  
Vol 8 ◽  
pp. 216495611984605 ◽  
Author(s):  
Marc Brodsky ◽  
Ann Hansen ◽  
Wendy Bjerke
Keyword(s):  
Health Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Pilot Study ◽  
Chronic Low Back Pain ◽  
Pilot Trial ◽  
Exercise Program ◽  
Self Report ◽  
Low Back

Background Authors of meta-analyses concluded that exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic low back pain (CLBP), particularly in health-care populations. Similar to health-care settings, community organizations provide wellness and lifestyle modification programs. Different versions of the Young Men’s Christian Association (YMCA) Y’s Way to a Healthy Back program were offered from 1974 to 2004. Champions of the YMCA program and authors of the pilot study designed a Healthy Back Curriculum to update and reintroduce the program. Objective: The research aim of this randomized pilot trial was to investigate the feasibility of a follow-up larger randomized controlled trial on the program’s effectiveness for CLBP. The randomized pilot trial addressed subject recruitment, retention, and subject compliance with protocol. Methods: The pilot trial employed a 2-arm parallel group randomized design. Seventy-eight subjects aged 18 to 64 years with low back pain on at least half the days over the previous 6 months were assigned to either (1) a group stretching exercise arm with 12 weekly classes or (2) a self-care book arm. Results: Sixty participants, 30 in each group, completed the study. Out of the 130 members who accepted invitation, 60% were eligible. Retention rate over the 24-week study in the group stretching exercise arm was 30 out of 43 participants (70%). Participants in the group stretching exercise program attended an average of 5 of the 12 classes (42%). Participants completed baseline and follow-up self-report items with no missing data. Conclusion: The pilot study did not prove to be feasible based on the prespecified benchmarks. We suggest that a larger trial should include changes gleaned from the pilot study.

scholarly journals Health Care Seeking Behavior of Obstetric Danger Signs and its Associated Factors Among Pregnant and Delivered Mothers in Kewot District, North Shoa Zone, Amara Region, Ethiopia: A Cross-Sectional Study

2021 ◽  
Author(s):  
Daniel Tadesse ◽  
Akine Eshete ◽  
Tadesse Mamo ◽  
Sadat Mohammed
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Cross Sectional ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior

Abstract Background: Many mothers died due to preventable causes in developing countries like Ethiopia. so, this study aims to assess the healthcare-seeking behavior of obstetric danger signs among pregnant and delivered mothers in 1 year before the study period in Kewot districts. Method: A community-based descriptive cross-sectional study design supplemented by qualitative technique was conducted from April 20 -April 30, 2019, in the Kewot district. Pregnant and delivered mothers were selected by systematic random sampling technique and interviewed with a response rate of 98.2%, Using purposive sampling 3 key-informants and 5 mothers were selected for in-depth interview of a qualitative study. Data were entered into Epi data version 3.1.1 and analyzed using SPSS version 21 and the logistic regressions model was applied to identify the associated factors. Results: A total of 363 participants were involved in the study. Among participants, 211(58.1 %) at (95% CI; CI: 53.7%-63.1%) were sought appropriate health care action. Women who have ANC follow up (AOR=1.735,95%CI:1.107-2.721), knowledgeable about danger sign, (AOR=2.430,95 % CI:1.360-4.342), the decision for own health care seeking (AOR=2.514,95% CI:1.130-5.501), and women who cannot able to judge graveness of condition (AOR=0.509,95% CI:0.302-0.859) were significantly associated with appropriate healthcare-seeking behavior.Conclusion: Having antenatal care follow up, knowledge about danger signs, inability to judge the graveness of conditions and inability to decide alone for own health care were factors that prevent appropriate health care seeking action. So, there should be health information dissemination about danger signs for every pregnant mother in the catchment area and during their visit to health institutions.

McKenzie Method of Mechanical Diagnosis and Therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up

2017 ◽  
Vol 52 (9) ◽  
pp. 594-600 ◽  
Author(s):  
Alessandra Narciso Garcia ◽  
Lucíola da Cunha Menezes Costa ◽  
Mark J Hancock ◽  
Fabrício Soares de Souza ◽  
Geórgia Vieira Freschi de Oliveira Gomes ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Treatment Effect ◽  
Controlled Trial ◽  
Low Back ◽  
End Of Treatment ◽  
Mckenzie Method ◽  
Secondary Outcomes

BackgroundThe McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is one of the exercise approaches recommended by low back pain (LBP) guidelines. We investigated the efficacy of MDT compared with placebo in patients with chronic LBP.MethodsThis was a prospectively registered, two-arm randomised placebo controlled trial, with a blinded assessor. A total of 148 patients seeking care for chronic LBP were randomly allocated to either MDT (n=74) or placebo (n=74). Patients from both groups received 10 treatment sessions over 5 weeks. Patients from both groups also received an educational booklet. Clinical outcomes were obtained at the end of treatment (5 weeks) and 3, 6 and 12 months after randomisation. Primary outcomes were pain intensity and disability at the end of treatment (5 weeks). We also conducted a subgroup analysis to identify potential treatment effect modifiers that could predict a better response to MDT treatment.ResultsThe MDT group had greater improvements in pain intensity at the end of treatment (mean difference (MD) −1.00, 95% CI −2.09 to −0.01) but not for disability (MD −0.84, 95% CI −2.62 to 0.93). We did not detect between-group differences for any secondary outcomes, nor were any treatment effect modifiers identified. Patients did not report any adverse events.ConclusionWe found a small and likely not clinically relevant difference in pain intensity favouring the MDT method immediately at the end of 5 weeks of treatment but not for disability. No other difference was found for any of the primary or secondary outcomes at any follow-up times.Trial registration numberClinicalTrials.gov (NCT02123394)

Does Self-Assessed Physical Capacity Predict Development of Low Back Pain Among Health Care Workers? A 2-Year Follow-up Study

Spine ◽  
2013 ◽  
Vol 38 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Charlotte D. N. Rasmussen ◽  
Marie B. Jørgensen ◽  
Thomas Clausen ◽  
Lars L. Andersen ◽  
Jesper Strøyer ◽  
...  
Keyword(s):  
Health Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Health Care Workers ◽  
Physical Capacity ◽  
Low Back ◽  
Follow Up Study ◽  
Care Workers

scholarly journals A digital decision support system (selfBACK) for improved self-management of low back pain: a pilot study with 6-week follow-up

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Louise Fleng Sandal ◽  
Cecilie K. Øverås ◽  
Anne Lovise Nordstoga ◽  
Karen Wood ◽  
Kerstin Bach ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Decision Support ◽  
Pilot Study ◽  
Decision Support System ◽  
Support System ◽  
Self Management ◽  
Low Back

scholarly journals Cognitive Functional Therapy for People with Nonspecific Persistent Low Back Pain in a Secondary Care Setting—A Propensity Matched, Case–Control Feasibility Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2061-2070
Author(s):  
Kasper Ussing ◽  
Per Kjaer ◽  
Anne Smith ◽  
Peter Kent ◽  
Rikke K Jensen ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Secondary Care ◽  
Case Control ◽  
Leg Pain ◽  
Low Back ◽  
Functional Therapy

Abstract Background Effective, inexpensive, and low-risk interventions are needed for patients with nonspecific persistent low back pain (NS-PLBP) who are unresponsive to primary care interventions. Cognitive functional therapy (CFT) is a multidimensional behavioral self-management approach that has demonstrated promising results in primary care and has not been tested in secondary care. Objective To investigate the effect of CFT and compare it with usual care for patients with NS-PLBP. Design Case–control study. Setting A secondary care spine center. Subjects Thirty-nine patients received a CFT intervention and were matched using propensity scoring to 185 control patients receiving usual care. Methods The primary outcome was Roland Morris Disability Questionnaire (0–100 scale) score. Group-level differences at six- and 12-month follow-up were estimated using mixed-effects linear regression. Results At six-month follow-up, a statistically significant and clinically relevant difference in disability favored the CFT group (–20.7, 95% confidence interval [CI] = –27.2 to –14.2, P < 0.001). Significant differences also occurred for LBP and leg pain, fear, anxiety, and catastrophizing in favor of CFT. At 12-month follow-up, the difference in disability was smaller and no longer statistically significant (–8.1, 95% CI = –17.4 to 1.2, P = 0.086). Differences in leg pain intensity and fear remained significantly in favor of CFT. Treatment satisfaction was significantly higher in the CFT group at six- (93% vs 66%) and 12-month (84% vs 52%) follow-up. Conclusions These findings support that CFT is beneficial for patients with NS-PLBP who are unresponsive to primary care interventions. Subsequent randomized controlled trials could incorporate booster sessions, which may result in larger effects at 12-month follow-up.

Independent Evaluation of a Multidisciplinary Rehabilitation Program for Chronic Low Back Pain

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 877-883 ◽  
Author(s):  
Jeffrey E. Cassisi ◽  
George W. Sypert ◽  
Anita Salamon ◽  
Larry Kapel
Keyword(s):  
Health Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Care Utilization ◽  
Low Back ◽  
Independent Evaluation ◽  
Percent Decrease ◽  
Group 1

Abstract Severe chronic low back pain was diagnosed in 236 patients by one physician and they were referred to the University of Miami Comprehensive Pain and Rehabilitation Center (UMCPRC) over a 5-year period for an intensive 4-week inpatient treatment program. Of these 143 (61%) were able to be contacted by telephone and given a structured interview designed for the study. The average time elapsed at follow-up from referral for all patients was 22.5 months. Outcome was measured in the following terms: current levels of pain, percent decrease in pain, subsequent health care utilization, activities of daily living, and attitudes toward treatment. After completion of the interview, the McGill Pain Questionnaire and the Oswestry Low Back Pain Disability Questionnaire were sent to the patients. The patients fell into five groupings: Group 1—participants in the UMCPRC program (n = 39); Group 2—those whose participation was not approved by insurance (n = 30); Group 3—those who declined participation (n = 46); Group 4—participants in other programs (n = 14); Group 5—dropouts (n = 14). The five groups were not meaningfully different with regard to prereferral demographics. Interestingly, Group 1 patients exhibited significantly greater prereferral pain and unemployment levels. Despite this, at follow-up significantly more Group 1 members were employed and they exhibited a greater percent decrease in pain as compared to the nonparticipant groups. Returned McGill and Oswestry Questionnaires mirrored these findings. Group 1 members also demonstrated significantly lower rates of subsequent health care utilization, i.e., physician visits, hospitalizations, and surgery than the nonparticipant groups. In conclusion, independent evaluation suggests that the type of program given at UMCPRC is effective for the treatment of chronic intractable low back pain. Future directions are briefly discussed.

Sign in / Sign up

Export Citation Format

Share Document