scholarly journals Facial Expression Overrides Lumbopelvic Kinematics for Clinical Judgements about Low Back Pain Intensity

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
A. Courbalay ◽  
T. Deroche ◽  
M. Descarreaux ◽  
E. Prigent ◽  
J. O'Shaughnessy ◽  
...  

Background.Through real-time behavioral observation systems, pain behaviors are commonly used by clinicians to estimate pain intensity in patients with low back pain. However, little is known about how clinicians rely on pain-related behaviors to make their judgment. According to the Information Integration Theory (IIT) framework, this study aimed at investigating how clinicians value and integrate information from lumbopelvic kinematics (LK), a protective pain behavior, and facial expression intensity (FEI), a communicative pain behavior, to estimate pain in patients with chronic low back pain (cLBP).Methods.Twenty-one experienced clinicians and twenty-one novice clinicians were asked to estimate back pain intensity from a virtual character performing a trunk flexion-extension task.Results.Results revealed that both populations relied on facial expression and that only half of the participants in each group integrated FEI and LK to estimate cLBP intensity. Among participants who integrated the two pain behaviors, averaging rule predominated among others. Results showed that experienced clinicians relied equally on FEI and LK to estimate pain, whereas novice clinicians mostly relied on FEI.Discussion.The use of additive rule of integration does not appear to be systematic when assessing others’ pain. When assessing pain intensity, communicative and protective pain behaviors may have different relevance.

2013 ◽  
Vol 13 (9) ◽  
pp. S142
Author(s):  
Shira S. Weiner ◽  
Mandi W. Gibbons ◽  
Sherri Weiser ◽  
Dorice L. Vieira

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Britta K. Krautwurst ◽  
Jürgen R. Paletta ◽  
Sylvia Mendoza ◽  
Adrian Skwara ◽  
Melvin Mohokum

Objective. Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data. A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods. Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. Results. The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). Discussion. Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. Conclusion. The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takahiro Miki ◽  
Daisuke Higuchi ◽  
Tsuneo Takebayashi ◽  
Mina Samukawa

AbstractThis study aimed to explore factors associating with disability, which means physical impairment affecting a person’s mobility, capacity, stamina, or agility, of non-specific low back pain (NSLBP) of the acute and non-acute groups. Two hundred thirty-five patients with NSLBP of less than 8 weeks’ duration as acute groups (n = 124) and more than 8 weeks’ duration as non-acute group (n = 111) were recruited. It was collected data on pain intensity, disability and psychosocial factors, including pain catastrophising, fear of movement and pain self-efficacy. Disability was measured Roland Morris Disability Questionnaire. A hierarchical multiple regression analysis was performed to analyse factors associating with disability of the acute and non-acute groups. The Result was that explanatory power increased with each additional variable of the order of demographic characteristics, pain intensity and psychosocial factors for both groups. Pain intensity, pain catastrophising and pain self-efficacy had significant explanatory power, with pain self-efficacy having the most significant association on the acute group. Only pain self-efficacy having the most significant association on disability of the non-acute group. In conclusion, the factors associating with disability differed depending on the duration of the disease, and pain self-efficacy might be one of the factors associating with disability of patients with NSLBP.


2017 ◽  
Author(s):  
Paul Thiry ◽  
Francois Reumont ◽  
Jean-Michel Brismée ◽  
Frédéric Dierick

ABSTRACTPain perception, trunk mobility in flexion, extension, and lateral flexion, and apparent diffusion coefficient (ADC) within nucleus pulposus of all lumbar discs were collected before and after posterior-to-anterior mobilization in 16 adults with acute low back pain. ADC was computed from diffusion maps and 3 specific portions of the nucleus pulposus were investigated: anterior (ADCant), middle (ADCmid), and posterior (ADCpost), and their mean as ADCall, a summary measure of ADC within nucleus pulposus. Pain ratings were significantly reduced after mobilization, and mobility of the trunk was significantly increased. Concomitantly, a significant increase in ADCall values was observed. The greatest ADCall changes were observed at the L3-L4 and L4-L5 levels and were mainly explained by changes in ADCant and ADCpost. The simultaneous reduction in pain and increase of water diffusion within nucleus pulposus has has been previously observed in subjects with chronic conditions and exists in the acute phase of the disease. Since the largest changes in ADC were observed at the periphery of the nucleus pulposus, and taken together with pain decrease, our results suggest that increased peripheral random motion of water molecules is implicated in the modulation of the intervertebral disc nociceptive response.


Author(s):  
Jay Kumar Soni ◽  
Edrish Contractor

Aims: Non specific Low back pain is defined as pain without any known pathology which affects almost all the leading occupation where body's awkward posture, twisting and stress forces are commonly encountered across the globe and it is highly prevalent 60% to 70% in a year. Studies have shown various exercise regimen individual effect on the same but superiority of regimen out of these is not clear. Study Design: Comparative Study Place and Duration of Study: Ahmedabad Institute of Medical Sciences, Duration 2013-15 Objective: To assess and compare the effect of core stability exercise, back school program and Swiss ball exercise on Pain, core endurance and Functional disability. Methodology: A group of 24 patients having non-specific low back pain between age groups 18-40 were randomly selected and allocated in to two groups. Group A(n=12) received traditional exercise whereas Swiss ball exercise was given to Group B(n=12). The subjects were treated for two weeks. Baseline data for VAS, Core endurance and MODI were taken on day1 and at the end of two weeks Result: The results were analyzed by wilcoxon signed rank test within both groups. Both groups showed significant improvement in VAS, core endurance and MODI at the end of 2weeks.Comparison between both the Group A and Group B was done by Mann- whitney U test and statistically no significant difference was seen in VAS, core endurance and MODI between the groups Conclusion: The study concluded that both the exercises are equally effective in reducing pain intensity, improves core endurance and functional status in subjects with non specific low back pain


2020 ◽  
pp. 1-8
Author(s):  
Claudia G. Levenig ◽  
Michael Kellmann ◽  
Jens Kleinert ◽  
Johanna Belz ◽  
Tobias Hesselmann ◽  
...  

Context: Low back pain (LBP) is a serious health problem, both in the general population as well as in athletes. Research has shown that psychosocial aspects, such as dysfunctional pain responses, play a significant role in the chronification of LBP. Recent research supports the relevance of the multidisciplinary concept of body image in the interpretation of LBP. Objective: To examine the differences in 2 psychosocial aspects, body image and pain responses, between athletes and nonathletes with LBP. Design: Cross-sectional design. Setting: The questionnaires were distributed in the course of LBP treatment. Participants: Data from 163 athletes (mean age = 28.69 [9.6] y) and 75 nonathletes (mean age = 39.34 [12.63] y) were collected. Interventions: Data were collected by questionnaires assessing body image, pain behavior, training activity, and LBP. Main Outcome Measures: To examine group differences between athletes and nonathletes regarding body image and pain behavior, the authors performed 2-way analyses of variance with Bonferroni post hoc tests. Results: The results showed (1) a significant main effect regarding pain responses and body image, showing that participants with eustress endurance or adaptive pain behavior revealed a more positive body image in both groups compared with participants with distress endurance or fear-avoidance behavior, and (2) a significant main effect for the factor group in the body image dimension of physical efficacy, indicating a more positive body image for athletes. Conclusion: These results suggest that considering multiple risk factors for LBP, such as body image and dysfunctional pain behavior, as well as subgrouping, might be valuable for research and for broadening therapy options.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Larissa O. Soares ◽  
Giovanni E. Ferreira ◽  
Leonardo O. P. Costa ◽  
Leandro C. Nogueira ◽  
Ney Meziat-Filho ◽  
...  

Abstract Objectives We aim to determine the effectiveness of meditation for adults with non-specific low back pain. Methods We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability. Results We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = −0.22; 95% CI = −0.42 to −0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = −0.28; 95% CI = −0.54 to −0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period. Conclusions We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.


AAOHN Journal ◽  
1988 ◽  
Vol 36 (5) ◽  
pp. 198-199

A program utilizing patient response to repeated lumbar movements (including flexion, extension, lateral bending and rotation), known as the McKenzie method, has now been demonstrated to be twice as effective in alleviating low back pain compared to traction and back schools. This is a capsule summary of the “Extrac '86” study as detailed in The Journal of Musculoskeletal Medicine 1987; vol. 4(9):27–34 and 4(12):63–74.


Author(s):  
Pongsatorn Saiklang ◽  
Rungthip Puntumetakul ◽  
James Selfe ◽  
Gillian Yeowell

Objective The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. Background Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. Method Thirty participants with CLBP were randomly allocated: (a) control—sitting without exercise, and (b) intervention—supported dynamic lumbar extension with the ADIM technique. Results Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. Conclusion The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. Application Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.


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