scholarly journals RELATIONSHIP BETWEEN URODYNAMIC PARAMETERS AND LEVEL OF SPINAL CORD INJURY

Author(s):  
Anna Barnaś ◽  
Ewa Chlebuś ◽  
Agnieszka Wareńczak ◽  
Joanna Pałucka ◽  
Przemysław Lisiński

Introduction Low back pain and comorbid afflictions influence negatively on the quality of life, postural control and gait. Facet joint syndrome is one of the causes of low back pain. Cryoablation is a minimal invasive percutaneuous technique for zygapophysial joint syndrome. Aim The aim of the study was to investigate the effectiveness of the cryoablation in patients with chronic low back pain on pain, disability and spatiotemporal gait parameters in the course of facet joint syndrome. Material and methods The study included 19 patients (13 women, 7 men) with chronic low back and facet arthropathic changes in MRI, and with failure in conservative treatment. The evaluation was performed before and with one-month follow-up after cryoablation and included pain assessment (Numeric Rating Scale), the evaluation of functional state and disability (Revised Oswestry Low Back Pain Disability Index, Roland-Morris Disability Questionnaire) and an analysis of spatiotemporal gait parameters (treadmill). Results A significant improvement in pain, functioning and spatiotemporal gait parameters such as distance and the number of steps were found. Conclusions Cryoablation is an effective method for pain reduction in facet joint syndrome, which improves functioning and gait. Cryoanalgesia is a safe procedure for the treatment of low back pain related to facet joint syndrome if earlier conservative management failed. Keywords: cryoablation, low back pain, functional assessment, gait

Author(s):  
Małgorzata Eliks ◽  
Jeremi Kościński ◽  
Przemysław Lisiński ◽  
Agnieszka Wareńczak

Introduction Low back pain and comorbid afflictions negatively influence the quality of life, postural control and gait. Facet joint syndrome is one of the causes of low back pain. Cryoablation is a minimal invasive percutaneuous technique for zygapophysial joint syndrome. Aim The aim of the study was to investigate the effectiveness of the cryoablation in patients with chronic low back pain on pain, disability and spatiotemporal gait parameters in the course of facet joint syndrome. Material and methods The study included 19 patients (13 women, 7 men) with chronic low back and facet arthropathic changes in MRI, and with failure in conservative treatment. The evaluation was performed before and with one-month follow-up after cryoablation and included pain assessment (Numeric Rating Scale), the evaluation of functional state and disability (Revised Oswestry Low Back Pain Disability Index, Roland-Morris Disability Questionnaire) and analysis of spatiotemporal gait parameters (treadmill). Results A significant improvement in pain, functioning and spatiotemporal gait parameters such as distance and the number of steps were found. Conclusions Cryoablation is an effective method for pain reduction in facet joint syndrome, which improves functioning and gait. Cryoanalgesia is a safe procedure for the treatment of low back pain related to facet joint syndrome if earlier conservative management failed. Keywords: cryoablation, low back pain, functional assessment, gait


2020 ◽  
Vol 12 ◽  
pp. 1759720X2095897
Author(s):  
Stefano Meloncelli ◽  
Giorgio Germani ◽  
Ignazio Urti ◽  
Marco Divizia ◽  
Maria Rosciano ◽  
...  

Aims: The aim of the study was to evaluate the efficacy of endoscopic rhizotomy (ER) for denervation of lumbar facet joints in patients with chronic low back pain (LBP) due to facet joint syndrome (FJS). Methods: A total of 50 consecutive patients suffering from chronic LBP due to facet joints were screened to be treated with ER. The patients participating in the study had a 2-year follow up. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were assessed in the preoperative and postoperative period. To evaluate secondary endpoints, patients were divided into groups. One group included the patients previously treated with percutaneous radiofrequency (RF). The other group comprised patients at their first interventional treatment. We also compared patients dividing them by age and by number of joints treated, trying to elucidate if these parameters could be predictive of effectiveness of the procedure. Results: All patients had a reduction in NRS and an improvement in ODI. NRS was reduced significantly after 1 month and remained the same until the end of the study. ODI was significantly improved from T1 (1 month after surgery) up to T7 (end of the study). The improvements did not differ whether already treated with percutaneous rhizotomy or not. Patients less than 60 years or with 1–2 joints treated had better improvement compared with the others. Conclusion: The results obtained demonstrate that ER for denervation of the facet joint is an effective treatment in patients with chronic LBP, with consistent and stable results at 2-year follow up. The technique has a rapid learning curve and no major complications occurred. Moreover, the previous percutaneous RF treatment had no influence on the results obtained with endoscopic technique. There is evidence that best results are obtained in younger patients and/or in patients with 1–2 joints treated. Lay summary Low-back pain has facet joints inflammation or degeneration as pain generator in 20–40% of cases. Nervous lesion of the dorsal ramus innervating the facet joints has been shown as an efficacious treatment to obtain good analgesia. Percutaneous techniques have provided short term results for several reasons. This research aimed to see whether endoscopic denervation, which guarantees a more precise approach to anatomical structure, would result in more durable results. The study conducted on 40 patients has made it clear that this approach gives significant analgesia for at least 2 years, which was the time of patient follow up.


2020 ◽  
Vol 29 (2) ◽  
pp. 179-185 ◽  
Author(s):  
TaeYeong Kim ◽  
JaeHyuk Lee ◽  
SeJun Oh ◽  
Seungmin Kim ◽  
BumChul Yoon

Context: A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Design: A randomized controlled trial. Settings: Community and university campus. Participants: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Interventions: The exercises were performed for 30 minutes, 2 days per week for 8 weeks. Main Outcome Measures: Numeric rating scale, functional disabilities (Oswestry disability index and Roland–Morris disability), and fear-avoidance beliefs questionnaire (FABQ) scores were measured at baseline and at 4 weeks, 8 weeks, and 6 months. Results: A 2-way repeated analysis of variance identified that between-group comparisons showed significant differences in the FABQ related to work scale (F = 21.422; P = .01). There were no significant differences in the numeric rating scale (F = 1.696; P = .21), Oswestry disability index (F = 1.848; P = .20), Roland–Morris disability (F = 0.069; P = .80), and FABQ related to physical scale (F = 1.579; P = .24). In within-group comparisons, both groups presented significant differences in numeric rating scale (both SHR and STB after 4 wk), Oswestry disability index (both SHR and STB after 6 mo), and Roland–Morris disability (SHR after 6 mo and STB after 8 wk) compared with baseline values. In FABQ-related physical (SHR after 4 wk) and work scales (SHR after 6 mo), there were only significant differences in the SHR compared with baseline values. Conclusions: SHR exercise for 8 weeks had a greater effect than STB exercise for reducing work-related FABQ. The SHR exercise performed in a seated position could substantially decrease pain-related fear disability in young adults with chronic low back pain.


2021 ◽  
Vol 15 (3) ◽  
pp. 35-42
Author(s):  
Vladimir A. Parfenov ◽  
Irina A. Lamkova

The aim of this study was to evaluate the effectiveness of physical therapy (kinesiotherapy or KT) for chronic non-specific low back pain (CNSLBP) in managing pain, improving functional and emotional state, and overall physical activity. Materials and methods. The study included 71 patients (17 men and 54 women) aged 1875 years (mean age 55.09 13.0 years) with CNSLBP, of whom 34 patients received standard KT and 37 patients received enhanced KT. Patients were asked to complete the Numeric Pain Rating Scale (NPRS), the Oswestry Low Back Pain Disability Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ-SF) at baseline, after 7 days and 90 days. Results. In patients who received treatment, we observed a reduction in pain intensity as measured by the NPRS, from a score of 8 at baseline (68) to 3 (24) points after 7 days and down to 2 (04) after 3 months (p 0.0001). Depression severity decreased from 7 (59) points to 5 (37) after 7 days (p = 0.002) and 4 (36) points after 90 days (p = 0.002). Anxiety decreased from 7 (510) to 6 (48) after 7 days (p = 0.0003) and 5 (37) points after 90 days (p = 0.0003). The Oswestry Low Back Pain Disability Questionnaire score decreased from 46% (3457.77) to 28% (1235.55) after 7 days (p 0.0001), and then to 11.11% (4.4426) after 90 days (p 0.0001). Physical activity as measured by the IPAQ-SF increased from 11 (716) to 16 (1319) points after 7 days (p = 0.001) and to 23 (1526) points after 90 days (p = 0.0002). The patient group receiving enhanced KT had a more significant reduction in pain as measured by the NPRS after 7 days and 3 months (p = 0.02 and p = 0.055, respectively), depression as measured by the HADS (p 0.05), and disability as measured by the Oswestry Questionnaire (p = 0.015), accompanied by an increase in physical activity as measured by the IPAQ-SF after 90 days (p = 0.0002), as compared to the patient group receiving standard KT. Conclusion. KT not only reduces pain but also improves the functional and emotional state, and increases physical activity in patients with CNSLBP. Enhancing KT by using a personalized approach and educational programmes improves long-term treatment outcomes.


2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Adriaan Louw ◽  
Kory Zimney ◽  
Merrill R. Landers ◽  
Mark Luttrell ◽  
Bob Clair ◽  
...  

Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP).Methods: Sixty-seven patients with LBP < 3 months were randomly allocated to one of three groups – traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm2 for 10 minutes at 1 Megahertz, pulsed 20% over a 20 cm2 area), but received different explanations (CG, EG or EEG). Before and immediately after US,measurements of LBP and leg pain (numeric rating scale), lumbar flexion (distance to floor) and straight leg raise (SLR) (inclinometer) were taken. Statistical analysis consisted of mixed-factorial analyses of variance and chi-square analyses to measure differences between the three groups, as well as meeting or exceeding minimal detectable changes (MDCs) for pain, lumbar flexion and SLR.Results: Both EG and EEG groups showed a statistically significant improvement for SLR (p < 0.0001), while the CG did not. The EEG group participants were 4.4 times (95% confidence interval: 1.1 to 17.5) more likely to improve beyond the MDC than the CG. No significant differences were found between the groups for LBP, leg pain or lumbar flexion.Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment.


2020 ◽  
Vol 9 (2) ◽  
pp. 535-542
Author(s):  
Putri Maretyara Saptyani ◽  
Ari Suwondo ◽  
Runjati Runjati

One of the discomforts in third-trimester pregnancy is lower back pain.The prevalence of back pain during pregnancy can reach 80%. The study aims to prove the use of back movement technique to decrease the intensity of low back pain in third trimester pregnant women. The study used quasy-experimental, pretest-posttest with control group design. The sample of the study was third-trimester pregnant women with low back pain totaling 40 respondents. The instrument used to measure back pain in pregnancy is the Numeric Rating Scale (NRS). Data analysis used wilcoxon and man-whitney. There was a decrease in intensity of low back pain before treatment by 4.75 cm and after being given a back movement technique of 1.55 cm (p = 0.001). Back movement technique is proven to be more effective in reducing the intensity of low back pain in third-trimester pregnant women.


2020 ◽  
Vol 54 (2) ◽  
pp. 110-113
Author(s):  
Bolanle Nottidge ◽  
Matthew Akpa ◽  
Nse Odunaiya ◽  
Adesola Odole ◽  
Olufunmilayo Fawole ◽  
...  

Background: The Ibadan Low Back Pain Disability Questionnaire (ILBPDQ) was developed to meet the need for a LBP treatment outcome measure that was appropriate for the Nigerian culture and environment. The objective of this study was to determine the psychometric properties of ILBPDQ.Methods: This study used the validation design. One hundred and forty-two participants with LBP (LBPPs) and 142 age and sex-matched participants without LBP (NLBPPs) were included. The LBPPs were recruited consecutively from Physiotherapy clinics of selected tertiary hospitals in the six geopolitical zones of Nigeria. Both LBPPs and NLBPPs completed the ILBPDQ - the LBPPs completed the Numerical Pain Rating Scale (NPRS). The ILBPDQ was completed by 113 LBPPs two days after initial assessment. Sixty-four of the LBPPs received physiotherapy for 5-weeks, after which they were reassessed using ILBPDQ and NPRS.Results: ILBPDQ score of LBPPs was significantly higher than that of NLBPPs (construct validity) and LBPPs NPRS score correlated significantly with their ILBPDQ score (r = 0.50) at baseline and post intervention (r =0.35) (divergent validity). ILBPDQ scores at baseline and 48 hours later for LBPPs correlated significantly (Intra Class Correlation =0.80) (test re -test reliability). Cronbach’s α for ILBPDQ was 0.84 (internal consistency). The postintervention ILBPDQ and NPRS scores for LBPPs were significantly lower than their pre-intervention ILBPDQ scores (responsiveness) and NPRS scores. The changes in ILBPDQ and NPRS scores of the LBPPs correlated significantly (r =0.62) (responsiveness).Conclusion: The ILBPDQ demonstrated evidence of validity, reliability and responsiveness.Keywords: Low back pain, Functional disability, Outcome measure, Psychometric testing, NigeriaFunding: University of Ibadan Senate Research Grant.


Author(s):  
Mayang Ameilia Putri ◽  
Mila Citrawati ◽  
Riezky Valentina Astari

Low back pain (LBP) merupakan sebuah sindrom klinis ditandai dengan timbulnya gejala nyeri di sekitar punggung bawah yang tanpa atau dapat disertai penjalaran pada tungkai bawah. Posisi tidak ergonomis seperti membungkuk, memiringkan badan, dan posisi menggapai atau berlutut yang dapat menyebabkan beberapa dampak, salah satunya LBP. Penelitian ini dilakukan untuk menganalisis hubungan postur tubuh dan lama berdiri dengan kejadian LBP pada pekerja bidang produksi dan logistik di Cikarang. Penelitian ini menggunakan analitik observasional dengan desain penelitian potong lintang karena membahas dua variabel (independen dan dependen) selanjutnya diobservasi atau diukur hanya sekali pada setiap variabel dalam waktu yang sama. Sampel penelitian berjenis kelamin lakilaki, berjumlah 62 responden, berusia 18-40 tahun dengan kata lain termasuk kriteria inklusi dan teknik pengambilan sampel berupa simple random sampling. Analisis postur tubuh menggunakan Rapid Entire Body Assessment (REBA), untuk lokasi serta pengukuran intensitas nyeri LBP menggunakan kuesioner Nordic Body Map (NBM) dan Numeric Rating Scale (NRS), analisis bersifat kuantitatif karena didasarkan pada skala yang tersedia pada kategori setiap instrumen penelitian. Hasil uji Fisher hubungan postur tubuh dengan kejadian LBP diperoleh nilai signifikansi p=1,000 (p> 0,05) dan untuk lama berdiri dengan kejadian LBP didapatkan nilai signifikansi p=0,067 (p> 0,05). Kesimpulan hasil tersebut tidak terdapat hubungan antara postur tubuh dan lama berdiri dengan kejadian LBP pada pekerja. Hal ini dapat dipengaruhi usia pekerja yang dominan termasuk kategori usia produktif sehingga sifat fisiologis otot masih sangat menunjang produktivitas kerja. Selain itu disela-sela kegiatan, para pekerja dapat leluasa melakukan peregangan minimal pada tubuhnya sehingga kekakuan pada otot di sekitar punggung bawah dapat dihindari.


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