A Preliminary Study of the Objective Measurement of Compliance Rates for Semirigid Lumbar-Support Use in Patients with Chronic Nonspecific Low Back Pain: How Important Is the Compliance Rate?

STUDY DESIGN: Clinical pilot study. PURPOSE: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. OVERVIEW OF LITERATURE: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. METHODS: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects' disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. RESULTS: The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (p=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p<0.001, p=0.02, respectively). CONCLUSIONS: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.

Clinical Features of Corneal Erosion in Contact Lens Wearers

PURPOSE: To evaluate the clinical patterns of corneal erosion induced by contact lens wear and the relations of corneal complications to the duration of contact lens wear and the final wearing. METHODS: We have examined with slit lamp and questionnaire survey, 161 eyes of 105 patients with complication of contact lens wear who visited KyungHee Medical Center from January 2000 to June 2001. RESULTS: Majority of the corneal complication is diffuse punctate type that comprises 58.3%, corneal erosion 14.4%, corneal ulcer 3.1% and so on. Erosional grading and the final wearing time are not proportional to the clinical presentation. Extended-wear soft contact lens was used by 37.1% and RGP lens by 35.2%. Half of the symptoms starts shortly after the lens removal. Corneal ulcer has a significantly higher incidence in the long-duration of wearing group. CONCLUSIONS: The corneal complication is various as corneal erosion, corneal ulcer, and so forth. Consequently, it is quite necessary to give an intensive education to the contact lens wearers, especially in long-duration ones.