Satisfaction as a Predictor of Clinical Outcomes Among Chiropractic and Medical Patients Enrolled in the UCLA Low Back Pain Study

Spine ◽  
2005 ◽  
Vol 30 (19) ◽  
pp. 2121-2128 ◽  
Author(s):  
Eric L. Hurwitz ◽  
Hal Morgenstern ◽  
Fei Yu
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Low Back ◽  
Medical Patients

scholarly journals Low Back Pain in Adolescents: A Comparison of Clinical Outcomes in Sports Participants and Nonparticipants

2010 ◽  
Vol 45 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Julie M. Fritz ◽  
Shannon N. Clifford
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
Sports Participation ◽  
Mean Difference ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Baseline Characteristics

Abstract Context: Back pain is common in adolescents. Participation in sports has been identified as a risk factor for the development of back pain in adolescents, but the influence of sports participation on treatment outcomes in adolescents has not been adequately examined. Objective: To examine the clinical outcomes of rehabilitation for adolescents with low back pain (LBP) and to evaluate the influence of sports participation on outcomes. Design: Observational study. Setting: Outpatient physical therapy clinics. Patients or Other Participants: Fifty-eight adolescents (age  =  15.40 ± 1.44 years; 56.90% female) with LBP referred for treatment. Twenty-three patients (39.66%) had developed back pain from sports participation. Intervention(s): Patients completed the Modified Oswestry Disability Questionnaire and numeric pain rating before and after treatment. Treatment duration and content were at the clinician's discretion. Adolescents were categorized as sports participants if the onset of back pain was linked to organized sports. Additional data collected included diagnostic imaging before referral, clinical characteristics, and medical diagnosis. Main Outcome Measure(s): Baseline characteristics were compared based on sports participation. The influence of sports participation on outcomes was examined using a repeated-measures analysis of covariance with the Oswestry and pain scores as dependent variables. The number of sessions and duration of care were compared using t tests. Results: Many adolescents with LBP receiving outpatient physical therapy treatment were involved in sports and cited sports participation as a causative factor for their LBP. Some differences in baseline characteristics and clinical treatment outcomes were noted between sports participants and nonparticipants. Sports participants were more likely to undergo magnetic resonance imaging before referral (P  =  .013), attended more sessions (mean difference  =  1.40, 95% confidence interval [CI]  =  0.21, 2.59, P  =  .022) over a longer duration (mean difference  =  12.44 days, 95% CI  =  1.28, 23.10, P  =  .024), and experienced less improvement in disability (mean Oswestry difference  =  6.66, 95% CI  =  0.53, 12.78, P  =  .048) than nonparticipants. Overall, the pattern of clinical outcomes in this sample of adolescents with LBP was similar to that of adults with LBP. Conclusions: Adolescents with LBP due to sports participation received more treatment but experienced less improvement in disability than nonparticipants. This may indicate a worse prognosis for sports participants. Further research is required.

scholarly journals The Theoretical Framework of the Clinical Pilates Exercise Method in Managing Non-Specific Chronic Low Back Pain: A Narrative Review

Biology ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1096
Author(s):  
Boon Chong Kwok ◽  
Justin Xuan Li Lim ◽  
Pui Wah Kong
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Chronic Low Back Pain ◽  
Early Stage ◽  
Current Evidence ◽  
Future Research ◽  
Low Back ◽  
Exercise Interventions ◽  
Directional Preference

Exercise plays an important role in rehabilitating people with chronic low back pain. Aerobic exercise and resistance training are general exercise strategies to manage chronic low back pain, but these strategies require longer intervention period to achieve clinical outcomes in pain reduction and functional improvements. Directional preference is recognised as an important exercise strategy in managing low back pain. The Clinical Pilates exercise method leverages on the directional preference of an individual to achieve clinical outcomes faster. Clinical Pilates is a hybrid of two of the best exercise interventions for low back pain, which are general Pilates and the McKenzie method. Due to the scarcity of Clinical Pilates literature, a review of its theory and studies was undertaken to provide a structured guide to the technique in managing people with chronic low back pain. Hypothetical algorithms are developed to support translation into clinical practice and future research studies. These algorithms are useful in the management of complex cases involving multiple directional trauma. Although limited, current evidence suggests that the Clinical Pilates exercise method is safe and provides faster functional recovery in the early stage of rehabilitation and similar longer term outcomes as general exercises.

Longer-Term Clinical and Economic Benefits of Offering Acupuncture to Patients with Chronic Low Back Pain Assessed as Suitable for Primary Care Management – 3 Month Clinical Outcomes from a Controlled Trial of 241 Patients

2002 ◽  
Vol 20 (2-3) ◽  
pp. 121-137
Author(s):  
H Macpherson ◽  
K Thomas ◽  
J Brazier ◽  
M Fitter ◽  
L Thorpe ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomised Controlled Trial ◽  
Clinical Outcomes ◽  
Controlled Trial ◽  
Bodily Pain ◽  
Control Group ◽  
Low Back ◽  
Randomised Controlled ◽  
Pragmatic Randomised Controlled Trial

Objectives To undertake a pragmatic randomised controlled trial to test the hypothesis that a population of patients with persistent low back pain, when given access to an acupuncture service, gain more relief from pain than those offered usual management only, for equal or less cost. Methods The study is a pragmatic randomised controlled trial (n=241). Suitable patients are identified by their general practitioners. Patients randomised to the experimental arm are offered the option of referral for up to 10 individualised treatments from one of six qualified acupuncture practitioners. The control group continues to receive usual management from their general practitioner. The primary scale used for measuring change is the Bodily Pain (SF–36) at 3 months and 12 months post randomisation. The main outcome is cost-effectiveness at 12 months. Results A total of 43 general practitioners participated in the trial and 241 patients were randomised. All patients randomised to the option of acupuncture chose to receive treatment. Clinical outcomes at 3 months show that the SF-36 Bodily Pain scores improved by 29.4 and 24.9 points in the acupuncture and normal management group respectively (p=0.125). Patients in the acupuncture group reported lower levels of worry at three months (p<0.001). Conclusions It is possible to conduct a large pragmatic randomised controlled trial of acupuncture in a primary care setting. Acupuncture is seen as an acceptable treatment by patients with low back pain. Clinical outcomes at three months suggest that the acupuncture group are in less pain than the control group.

Chiropractic Management for US Female Veterans With Low Back Pain: A Retrospective Study of Clinical Outcomes

2017 ◽  
Vol 40 (8) ◽  
pp. 573-579 ◽  
Author(s):  
Kelsey L. Corcoran ◽  
Andrew S. Dunn ◽  
Lance R. Formolo ◽  
Gregory P. Beehler
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Retrospective Study ◽  
Clinical Outcomes ◽  
Female Veterans ◽  
Low Back

scholarly journals Comparison of Clinical Outcomes of Two-Level PELD and Foraminoplasty PELD for Highly Migrated Disc Herniations: A Comparative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Xinbo Wu ◽  
Guoxin Fan ◽  
Shisheng He ◽  
Xin Gu ◽  
Yunfeng Yang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postoperative Complications ◽  
Clinical Outcomes ◽  
Nucleus Pulposus ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Low Back ◽  
Satisfaction Rate ◽  
Disc Herniations

Objective. The aim of this study is to compare the clinical outcomes of two-level percutaneous endoscopic lumbar discectomy (PELD) and foraminoplasty PELD in treating highly migrated lumbar disc herniations. Methods. Patients with highly migrated lumbar disc herniations were enrolled from May 2014 to June 2016. Low back pain and leg pain were evaluated by the Visual Analog Scale (VAS), and functional outcomes were assessed with the Oswestry Disability Index (ODI). The satisfaction rate of clinical outcomes was assessed according to the modified MacNab criteria. In addition, the intraoperative duration and postoperative complications were also recorded. Results. Forty patients, 14 cases in two-level PELD group and 26 cases in foraminoplasty PELD group, were included. The VAS scores of low back pain (P=0.67) and leg pain (P=0.86), as well as the ODI scores (P=0.87), were comparative between two-level PELD and foraminoplasty PELD groups. The satisfaction rate of clinical outcomes based on the modified MacNab criteria in the two-level PELD group was equivalent to that in foraminoplasty PELD group (92.9% versus 92.3%, P=0.92). In addition, the intraoperative duration of two-level PELD group was longer than that of foraminoplasty PELD group (80.2 ± 6.6 min versus 64.1 ± 7.3 min, P<0.01). The postoperative complications in the two-level PELD group (postoperative dysesthesia: N = 1) were relatively fewer as compared to those in the foraminoplasty PELD group (postoperative dysesthesia: N = 1; recurrence: N = 1; nucleus pulposus residues: N = 1). Conclusions. Both two-level PELD and foraminoplasty PELD are safe and effective surgical procedures for the patients with highly migrated lumbar disc herniations. Moreover, the two-level PELD technique has merits in reducing the incidence of postoperative nucleus pulposus residue.

scholarly journals Prediction based on preoperative opioid use of clinical outcomes after transforaminal lumbar interbody fusions

2017 ◽  
Vol 26 (2) ◽  
pp. 144-149 ◽  
Author(s):  
Alan T. Villavicencio ◽  
E. Lee Nelson ◽  
Vinod Kantha ◽  
Sigita Burneikiene
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Low Back ◽  
Opioid Use ◽  
Pain Disability ◽  
Vas Scores ◽  
Opioid Medications

OBJECTIVE Opioid analgesics have become some of the most prescribed drugs in the world, despite the lack of long-term studies evaluating the benefits of opioid medications versus their risks associated with chronic use. In addition, long-term opioid use may be associated with worse long-term clinical outcomes. The primary objective of this study was to evaluate whether preoperative opioid use predicted inferior clinical outcomes among patients undergoing transforaminal lumbar interbody fusion (TLIF) for symptomatic lumbar degenerative disc disease. METHODS The authors of this observational study prospectively enrolled 93 patients who underwent 1-level to 2-level TLIFs in 2011–2014; the patient cohort was divided into 2 groups according to preoperative opioid use or no such use. Visual analog scale (VAS) scores for low-back pain and leg pain, Oswestry Disability Index scores, and the scores of the mental component summary (MCS) and physical component summary (PCS) on the 36-Item Short Form Health Survey were used to assess pain, disability, and health-related quality of life outcomes, respectively. The clinical scores for the 2 groups were determined preoperatively and at a 12-month follow-up examination. RESULTS In total, 60 (64.5%) patients took prescribed opioid medications preoperatively. Compared with those not taking opioids preoperatively, these patients had significantly higher VAS scores for low-back pain (p = 0.016), greater disability (p = 0.013), and lower PCS scores (p = 0.03) at the 12-month follow-up. The postoperative MCS scores were also significantly lower (p = 0.035) in the opioid-use group, but these lower scores were due to significantly lower baseline MCS scores in this group. A linear regression analysis did not detect opioid dose–related effects on leg and back pain, disability, and MCS and PCS scores, suggesting that poorer outcomes are not significantly correlated with higher opioid doses taken by the patients. CONCLUSIONS The use of opioid medications to control pain before patients underwent lumbar fusion for degenerative lumbar conditions was associated with less favorable clinical outcomes postoperatively. This is the first study that has demonstrated this association in a homogeneous cohort of patients undergoing TLIF; this association should be studied further to evaluate the conclusions of the present study. Clinical trial registration no.: NCT01406405 (clinicaltrials.gov)

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