Supervised Physical Therapy Versus Video-Assisted Technique for Chronic Mechanical Low Back Pain: A Comparative Study

Objective To compare the effect of supervised physical therapy versus video-assisted technique in patients with chronic mechanical low back pain. Materials and Methods This is a comparative study. Forty-two patients were recruited in the study where they were randomized by simple random sampling. Group A (n = 21) received supervised physical therapy, and Group B (n = 21) received the video-assisted technique. The intervention was given 45 minutes per day for 15 days. The measures of visual analog scale (VAS) and Roland–Morris Disability Questionnaire (RMQ) were taken both at baseline and after 15 days of intervention. Results Comparison between the two groups using Mann–Whitney U test, supervised physiotherapy group showed significant improvement in VAS on activity, RMQ, and RMQ percentage (p < 0.005). However, Group A, VAS on rest was not significant (p > 0.005). Conclusion Supervised physical therapy is effective in reducing pain on activity and improved the disability of patients with chronic mechanical low back pain than the video-assisted technique.

Association Between Pain with Disability in the Elderly with Dementia

Background: Elderly is one of the most important and critical periods of life, and paying attention to the issues and problems of this period is very important. Objectives: The present study was performed to investigate the relationship between pain and disability in the elderly with dementia in 2021. Methods: In the present cross-sectional descriptive study, 120 elderly people with dementia were included. The instruments used in the four sections were the demographic profile form, the P-APS pain observation tool, and Stanford Disability Questionnaire questions. the researcher identified the elderly with dementia by available sampling method and if the elderly with dementia were eligible and written informed consent was obtained from the elderly and their primary caregivers, the questionnaires were completed. Conditions of pain and disability were described by descriptive tests, and then the relationship between pain and the degree of disability in patients was analyzed by statistical analysis using SPSS16 software. Results: The results showed mean (SD) pain score was 14.45 (4.23), disability score was 12.75 (3.09), and fall score was 37 (30.8%). According to pain score status classification, 4 (3.3%) of the elderly had no pain, 8 (6.7%) had mild pain, 27 (22.5%) had moderate pain, and 81 (67.5%) had severe pain. There is a significant relationship between pain status and disability in the elderly with dementia. By increase in pain, the patients had more disability (P = 0.000, F = 79.971). Conclusions: As the pain increased, the disability of the elderly with dementia decreased. For this reason, preventive interventions are explained in this field.

Personalized multitarget biologic injection in the spine: prospective case series of multitarget platelet-rich plasma for low back pain

Aim: To evaluate the use of a multitarget platelet-rich plasma (PRP) injection approach for the treatment of chronic low back pain (LBP). Materials & Methods: Forty-six patients with more than 12 weeks of LBP who failed conservative treatments were injected with PRP into the facet joints, intervertebral discs, epidural space and/or paravertebral muscles. Visual analog pain scale and Roland-Morris Disability Questionnaire scores were measured at baseline and predefined intervals. Results: Mean visual analog pain scale was reduced from 8.48 to 5.17 and mean Roland-Morris Disability Questionnaire from 18.0 to 10.98 at 12 weeks (p < 0.001). These statistically significant improvements were sustained over 52 weeks. No adverse effects were observed. Conclusion: Our PRP approach demonstrated clinically favorable results and may be a promising treatment for chronic LBP.

Is There an Effect of an Hour Education for Decreasing the Severity of Low Back Pain and Increasing Functionality in Office Workers?

Objectives: In this study, we gave information about appropriate working position to the office workers who have low back pain for last 3 months and we aimed to determine the effect of this intervention on frequency and level of low back pain and functionality of the workers. Materials and Methods: This study was an interventional study. Data were collected in September 2017 and December 2017 using face to face interview method. Information was given by a one-hour conference and distributing 4 informative brochures between October 2017 and November 2017. Results: 409 persons participated in the study and 141 of them who had low back pain for last 3 months formed the intervention group. 59.7% of the participants noted that they usually perform desk work. Logistic regression analysis showed that low back pain was 3,25 times more frequent among women than men, and 2,41 times more frequent among workers who had non-communicable disease. Among workers who had low back pain and attended the conference and read at least one brochure, mean Visual Analog Scale score was 5,97±1,2 before intervention and 5,03±1,1 after intervention (p<0,001) and mean Roland Morris Low Back Pain and Disability Questionnaire score were and 9,98±1,7 before intervention, and 8,91±1,3 after intervention, respectively (p<0,001). No difference was determined among workers who didn’t attend any of these two interventions (p>0,05). Conclusions: Considering the effect of intervention, this result shows that implementation of intervention with health promotion approach at workplace is an appropriate method for reducing severity of low back pain and increasing functionality.

Evaluation of the correlation between the Istanbul Low Back Pain Disability Index, Back Pain Functional Scale and other back pain disability scales in Turkish patients with low back pain

BACKGROUND: Low back pain is an important health problem that may cause functional loss. Several back pain disability scales have been developed in different languages. OBJECTIVE: The present study evaluates the correlation between the Istanbul Low Back Pain Disability Index (ILBPDI) the Back Pain Functional Scale (BPFS) and other back pain disability scales in patients with mechanical low back pain. METHODS: Included in the study were 105 patients who presented to our outpatient clinics and who were diagnosed with mechanical low back pain. The ILBPDI, BPFS, Quebec back pain disability scale (QBPDS) and Oswestry low back pain disability questionnaire (ODI) were administered to all participants, and Visual analogue scale (VAS) scores were recorded. RESULTS: A strongly negative correlation was identified between ILBPDI and BPFS (p< 0.05), and a strongly positive correlation was noted between ILBPDI and QBPDS, ODI and VAS. CONCLUSION: A strong correlation exists between ILBPDI and BPFS, and a further strong correlation between ILBPDI ODI and QBPDS. These questionnaires can be used interchangeably to evaluate disability associated with chronic mechanical low back pain.

Effectiveness of kinesiotherapy in chronic non-specific low back pain

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.

Telerreabilitação em grupo para pacientes com dor lombar crônica: Estudo longitudinal retrospectivo

Objetivo: Avaliar os efeitos da telerreabilitação em grupo na dor e incapacidade de pacientes com dor lombar crônica. Metodologia: Trata-se de um estudo observacional, analítico de caráter longitudinal retrospectivo, baseado na análise de prontuários de pacientes submetidos a três semanas de atendimentos fisioterapêuticos realizados de maneira on-line e em grupo no período de setembro a dezembro de 2020. Resultados: Foram avaliados os prontuários de 25 participantes, considerando como desfecho primário a sensação dolorosa, avaliada pela Escala Numérica da Dor, e como desfechos secundários a incapacidade relacionada à dor lombar, avaliado pelo Roland Morris Disability Questionnaire, e as perspectivas do paciente quanto aos atendimentos, antes e após a intervenção. Após a análise dos dados, observou-se uma redução significativa da dor (0,007) e melhora da incapacidade (0,002) depois das três semanas de intervenção, além de relatos positivos trazidos pelos pacientes com relação à experiência de telerreabilitação. Conclusão: A telerreabilitação em grupo mostrou-se eficaz na melhora da dor e incapacidade, mostrando-se satisfatória para os pacientes com dor lombar crônica.

The correlation between the angle of calcaneal eversion and gastrocnemius extensibility with nonspecific low back pain in obese women

Background: Individuals with obesity will experience an increase in the angle of calcaneal eversion which has an impact on increasing the workload of the muscles to maintain joint stability, so that tension occurs in the gastrocnemius muscle which affects its extensibility ability. Increasing the angle of calcaneal eversion will cause changes in lumbopelvic alignment so that it can cause low back pain. The aim of the study was to determine the correlation between the angle of calcaneal eversion and gastrocnemius extensibility with nonspecific low back pain in obese women.Methods: This research was a cross sectional analytic study with simple random sampling technique. The number of samples are 78 women aged 36-55 years old. The variables measured were functional pain reduction score in nonspecific low back pain with modified Oswestry disability questionnaire, the angle of calcaneal eversion and gastrocnemius extensibility with goniometer.Results: Our study showed that there was no significant correlation between the angle of calcaneal eversion and gastrocnemius extensibility. However, there was a significant correlation between gastrocnemius extensibility and low back pain at the level of 0.033. In addition, there was a significant correlation between the angle of calcaneal eversion and low back pain at the level of 0,000.Conclusions: There was a significant correlation between the angle of calcaneal eversion and gastrocnemius extensibility with low back pain. However, the angle of calcaneal eversion is not directly related to gastrocnemius extensibility.

Anxiety and Depression as a Factor of Disability in People with Chronic Low Back Pain Referred to the Orthopedic Clinic of Touba Clinic, Sari in 2018

Introduction: Chronic pain is one of the most common diseases in today's world, which has a serious influence on the quality of life. Low back pain (LBP) is very common in developed and developing countries. This study aimed to investigate anxiety & depression as a disability factor in chronic LBP in patients referred to the Orthopedic Clinic of Touba Clinic in Sari, Iran in 2018. Material and Methods: The Ronald-Morris Disability Questionnaire was used to assess disability, the Beck Anxiety Questionnaire was used to assess anxiety, the Beck Depression Questionnaire was used to assess depression, the SF-36 was used to assess quality of life, and the Visual Analog Scale was used to assess pain. Results: In this study, 100 patients were studied. Seventy were female and 30 were male. The mean age of patients was 45.05 ± 11.45 years. Sixty five patients suffered from depression and 35 patients had normal depression. The mean score for disability was 14.05, and the mean and standard deviation from the pain score of patients was 36.2 ± 2.7. Conclusion: Depression is one of the disability factors in people with chronic LBP in patients referring to the orthopedic clinic of Touba Clinic in Sari city in 2018.

INFLUENCE OF MEANS OF PHYSICAL THERAPY ON SIGNS OF DORSOPATHIES AT WOMEN AFTER CESAREAN SECTION

Purpose: to determine the impact of the developed physical therapy program on the dynamics of dorsopathic symptoms in women in the postpartum period after abdominal delivery (cesarean section). Methods. 112 postpartum women were examined. The comparison group (CG) consisted of 47 women who gave birth naturally. The main group 1 (MG1) consisted of 32 women after cesarean section, who recovered on their own. The main group 2 (MG2) consisted of 33 women after cesarean section, who underwent postpartum physical therapy for 12 months. The developed program included: kinesitherapy, abdominal bandage, kinesiological taping, abdominal massage and general; health nutrition, psychological relaxation, education of women. The basis of kinesitherapy as the main method that influenced the symptoms of dorsopathy was functional training (to normalize the motor stereotype, restore the muscles of the torso and limbs, posture) with reference to household movements for child care. During the first weeks after the cesarean section, the movements that contributed to the tension of the postoperative suture were restricted, and the facilitated starting positions were chosen. Women were taught the optimal dynamic stereotype with the prevention of back overload during habitual movements - lifting, feeding the baby, carrying a stroller, and more. Determination of signs of dorsopathy (intensity of pain on a visual analog scale, the state of mobility of the spine with tests Ott, Schober, Tomaer, Sedin, changes in life on Roland-Morris Disability Questionnaire and Pregnancy Mobility Index) was performed 4 times: 5-7 days after birth, in the late postpartum period (6-8 weeks), 6 and 12 months after delivery. Research results. It is estimated that almost 80% of women during pregnancy were determined by signs of dorsopathies. Women after childbirth, regardless of the type of birth, there is a high risk of new and prolonged symptoms of existing dorsopathies due to increased physical and mental stress on the background of structural and functional recovery of the body and the risk of postpartum depression. In the postpartum period, dorsopathy in women manifests itself in the form of moderate back pain (diagnosed on a visual analog scale), limited mobility of the spine even in the absence of pain (determined by Ott, Schober, Tomaer, Sedin tests), limited vital functions (established by Roland-Morris Disability Questionnaire, Pregnancy Mobility Index). The use of physical therapy allowed women to have a statistically significant (p <0.05) improvement in the results of the visual-analog scale and the Roland-Morris Disability Questionnaire, Pregnancy Mobility Index compared to not only MG1 but also CG parameters. As for the flexibility of the spine, women CG and MG2 were able to achieve normalization 6 months after delivery, women MG1 - a year later. Women who underwent a cesarean section, but recovered on their own with the help of general recommendations, were able to reach the levels of women who gave birth naturally and women who underwent physical therapy only one year after giving birth. Conclusions. Physical therapy should be prescribed from the first day of postpartum rehabilitation to reduce the intensity of symptoms of dorsopathy and prevent chronic pain, threatens psychoneurological disorders, disability, reduced quality of life, for rapid postpartum recovery and return of women to full life.