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BACKGROUND:Lumbar facet arthritis is one of the main causes of low back pain.At present,MRI is mainly used for preliminary diagnosis,and there is still a certain probability of missed diagnosis and misdiagnosis.Therefore,MR T2* mapping imaging technology is expected to become an important means of quantitative detection of cartilage damage in lumbar facet arthritis. OBJECTIVE:To investigate the application value of MR T2* mapping imaging technique in quantitative analysis of cartilage damage and degeneration of lumbar facet joint. METHODS:A total of 110 outpatient or inpatient patients with low back pain in Fourth Affiliated Hospital of Nanjing Medical University from April 2020 to March 2022 were collected and set as case group.At the same time,80 asymptomatic volunteers were recruited as the control group.T2* mapping transectal images and T2WI images were obtained by 3.0T MR Scanning for the facet joints of all included subjects L1-S1.Weishaupt grading and T2* value measurement were performed for all facet joint cartilage,and the data were collected for parallel statistical analysis.The comparison of T2* values of facet joint cartilage between different articular Weishaupt grades was performed by one-way analysis of variance. RESULTS AND CONCLUSION:(1)Statistical analysis found that the T2* value of lumbar facet joint cartilage in the case group(17.6±1.5)ms was significantly lower than that in the control group(21.4±1.3)ms(P<0.05).(2)In the case group,with the hierarchical increase of lumbar facet joint Weishaupt,the T2*value of facet joint cartilage also showed a gradual decreasing trend,and the difference was statistically significant(P<0.05).(3)It is concluded that T2*mapping can better display the early pathological changes of lumbar facet joint cartilage injury,and T2* value of lumbar facet joint cartilage can quantitatively evaluate the degree of lumbar facet joint cartilage injury.T2* mapping imaging technique can provide a good theoretical basis for the imaging diagnosis of the early cartilage injury induced by lumbar facet arthritis and has important clinical application value.
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Introduction: Disc degenerative disorders are the leading cause for the Lower Back Pain (LBP) throughout the globe. The data on LBP is limited. A study was conducted to find the correlation between age, socio-demographic and occupational factors with. Methods: It was a prospective research conducted in the department of Anatomy, GSL Medical College, and Rajahmundry. Study was conducted between December 2021 to January 2023. Individuals >18 years, both gender with LBP attended on outpatient basis were included. The socio-demographic data of the participants was recorded as per the Modified Kuppuswamy scale, Body Mass Index (BMI) was also estimated by entering height and weight in the National Institute of Health. Type of work, way of sitting posture, duration of continuous sitting, job related stress, requirement of outdoor activity for the job, junk food eating habits, frequency were also be recorded. Data was presented by mean for continuous variables and percentage for categorical data. Logistic Regression Analysis (LRA) was applied and P<0.05 were considered to be statistically significant. Results: Total 412 members were included, male female ratio was 1.2. Maximum (18.5%) participants were in >68, lowest (13.9%) in 48 years-57 years group. LRA did not show any association between LBP and age (OR=0.923, 95% CI: 1.2 -2.9, P=0.62). Maximum (35.7%; 150) number with LBP was detected in obesity group. The mean weight of the study members was 56.2 kgs; LRA did not show any association between BMI and LBP (OR=0.968, 95% CI: 2.1-3.6, P=0.820). There was significant association between socioeconomic status and LBP (OR=0.986, 95% CI: 0.931-1.124, P=0.0423). Based on the continuous sitting time, LBP is high (54.4%) among those sit continuously for >8 hours. Conclusion: LBP is common in all age groups and socio-economical groups. Continuous sitting for long time, obesity are important risk factors. LBP affects the quality of life, but not analysed in this research. Long term community based research with high sample size is recommended.
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A realização das tarefas dos trabalhadores em restaurantes universitários (RUs) envolve movimentos repetitivos de coluna, levantamento de pesos excessivos e permanência na postura em pé por períodos prolongados de tempo, sendo indicada avaliação da região lombar desses trabalhadores. Assim, o objetivo deste estudo foi traçar o perfil da dor lombar em trabalhadores dos RUs de uma Universidade Pública do Sul do Brasil. Trata-se de estudo quantitativo observacional de corte transversal, no qual foram selecionados participantes de 18 a 59 anos, de ambos os sexos, que exerciam alguma função dentro dos restaurantes de uma universidade do sul do Brasil e que relataram presença dor lombar. Os participantes foram avaliados, por: questionário sociodemográfico, escala visual numérica da dor (EVN), amplitude de movimento (ADM) da coluna lombar e questionário Start Back Screening Tool Brasil (SBST). Os resultados são apresentados em frequência absoluta e relativa, correlação de Spearman, e as variáveis numéricas em média e desvio padrão ou mediana, mínimo, máximo. Foram incluídos no estudo 28 participantes sendo 71,4% mulheres, que possuíam média de idade de 36,3 (±10,8) anos. O relato de dor acima de 4 na EVN foi de 71,4% dos participantes e todos possuíam diminuição da ADM em todos os movimentos avaliados na coluna lombar. A maioria (71,4%) apresentou baixo risco para fatores psicossociais pelo SBST. O perfil dos trabalhadores de restaurantes da universidade avaliada é caracterizado por ser prioritariamente realizado por mulheres, sendo que estas trabalhadoras apresentaram quadro álgico intenso e limitação dos movimentos articulares na região lombar.
The tasks that workers in university restaurants (URs) perform involves repetitive movements of the back, lifting excessive weight, remaining in a standing posture for prolonged periods of time, and, thus, an evaluation of the lumbar region of these workers is indicated. Therefore, the objective of this study was to outline the profile of lower back pain in workers from the URs of a Public University in the South of Brazil. This is a cross-sectional, observational, quantitative study, in which participants aged 18 to 59 years, of both sexes, who performed some function within the restaurants of a university in southern Brazil and who reported the presence of lower back pain were selected. Participants were evaluated by a sociodemographic questionnaire, a visual analogue scale (VAS) for pain, a range of motion (ROM) of the lumbar spine evaluation, and the Brazilian Start Back Screening Tool (SBST) questionnaire. Results are presented as absolute and relative frequencies, with a Spearman correlation, and numerical variables as mean and standard deviation or median, minimum, and maximum. Twenty-eight participants were included in the study, 71.4% of whom were women, with a mean age of 36.3 (±10.8) years old. The report of pain above 4 in the VAS was 71.4% of the participants and all had a decrease in ROM in all movements evaluated in the lumbar spine. Most (71.4%) had low risk for psychosocial factors by SBST. The profile of restaurant workers at the evaluated university is characterized by being primarily performed by women, and these workers presented severe pain and limited joint movements in their lumbar region.
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Abstract Objective To show the accuracy of the most used maneuvers in the clinical diagnosis of lumbosciatalgia, the slump test and the Laségue sign. Methods In order to perform the present study, 101 patients with magnetic resonance imaging (MRI) discopathy (gold standard) were selected and had their medical records reviewed to identify which had the positive maneuvers on the initial physical examination. Results The sensitivity found for the slump test and the Laségue sign in the diagnosis of disc herniation was 55.3% and 18.1%, respectively. Nonetheless, when they were compared with each other for the diagnosis of disc bulging, the sensitivity obtained was of 85.7% for the slump test and of 28.6% for the Laségue sign. Conclusion Comparing both clinical exams with MRI, it was found that the slump test presents superior sensitivity compared with the Laségue sign for both the diagnosis of hernia and disc bulging, and should be more present in clinical practice.
Resumo Objetivo Mostrar a acurácia das manobras mais usadas no diagnóstico clínico da lombociatalgia, a manobra de slump ea de Laségue. Métodos Para a realização do presente estudo, foram selecionados 101 pacientes com discopatia na ressonância magnética (RM) (padrão ouro), sendo posteriormente realizada a revisão dos prontuários para identificar quais tiveram as manobras positivas no exame físico inicial. Resultados A sensibilidade encontrada para as manobras de slump e Laségue no diagnóstico de hérnia discal foi respectivamente 55,3% e 18,1%. Já quando comparamos as manobras para o diagnóstico de abaulamento discal, a sensibilidade obtida foi de 85,7% para a manobra de slump e de 28,6% para a manobra de Laségue. Conclusão Foi constatado que a manobra de slump apresenta sensibilidade superior à da manobra de Laségue tanto para o diagnóstico de hérnia quanto para o de abaulamento discal quando comparadas a RM, e deveria estar mais presente na prática clínica.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Radiculopatía , Imagen por Resonancia Magnética , Diagnóstico Clínico , Registros Médicos , Sensibilidad y Especificidad , Dolor de la Región Lumbar , Hernia , Desplazamiento del Disco IntervertebralRESUMEN
[Objective] Photographers perform a variety of tasks, including taking photographs for extended periods of time, using personal computers to organize photographic data, and preparing and transporting their equipment. Although photographers may exhibit a variety of symptoms, there have been no reports on investigations of pain or disease in photographers. In this study, we conducted a questionnaire survey on the actual status of work-related pain in photographers. We, then, performed acupuncture and evaluated the effects in subjects for pain or stiffness in the neck and shoulders, which was the most common chief complaint in the questionnaire.[Subjects and Methods] The survey was sent to 138 professional photographers. The survey included seven items, such as symptoms experienced during work activities and the content of the work. Among the respondents who reported chief complaints of pain in the neck and shoulder regions, six (one male and five females) opted to receive acupuncture treatment. We used the visual analog scale (VAS) scores to determine the amount of shoulder stiffness and tenderness in the shoulders and neck, as well as induration, before and immediately after treatment.[Results] Responses were obtained from 60.1% subjects. The most common chief complaint involved the neck and shoulder region in 86% of subjects. In the analysis of sex differences, the most common chief complaint in females was in the neck and shoulder region, whereas the most common chief complaint in males was in the lower back region. In the assessment of effects of acupuncture, the VAS scores for shoulder stiffness decreased after acupuncture (p < 0.05) and tenderness and induration scores decreased after acupuncture (p < 0.05).[Discussion and Conclusion] Low muscle strength may be a contributing factor for a higher complaint of neck and shoulder pain and stiffness in females. A higher complaint of pain and stiffness in the lower back region in males may be attributable to a higher load on the lower back region because they tend to have poor posture owing to height differences with the object being photographed. These results suggest that acupuncture is useful for work-related pain in the neck and shoulder region, which is the most common chief complaint in photographers.
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Background:Back pain is a very common public health problem in the manufacturing industry and a major cause of disability that affects work performance and wellbeing. Currently, manufacturing sectors in Ethiopia, including automotive manufacturing is growing well but there is poor culture of work place safety. The aim of this study wasto assess the prevalence of back pain and disability status at Bishoftu automotive industry workers.Methods:A cross sectional study was conducted among 412 workers in a period of February to May 2018. Simple random sampling technique was applied to select participants. Data was collected by face-to-face interview using standard Nordic and Oswestry back pain disability index tools. Analysis was done by using SPSS version 24. Bivariate and multivariate logistic regression analyses were used to determine associations.Results:Prevalence of work related back pain among automotive production factory workers during last 12 months and last seven days were 51.7% and 25% respectively and related disability was 87%. The risk factors of the work related back pain that were identified include; work experience (11-15 years) AOR: 0.02, 95% CI (0.001-0.46), tasks that involve bending and twisting AOR: 2.03, 95% CI (1.19-3.45) and lifting of heavy loads AOR: 4.89, 95% CI (2.83-8.47).Conclusions:High prevalence of back pain among automotive industry workers was seen. Furthermore, this study verified workers with back pain and more specifically those working in tasks that involve with the identified associated risk factors were suffer from disability. The problem should need more attention to promote the health and safety of workers
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Background: Acute back pain is any pain located at the back that lasts for less than 4 weeks duration. Theprevalence is fair with as many as 84% of the adult population around the globe experience back pain at somepoint in life and is often self-limiting. However, in few selected patients it may serve as indicator of a seriousunderlying disease making it crucial to properly evaluate, characterize and address this concern. Objectives: Inthis review we intend to explore the prevalence, risk factors and highlight the available methods using diagnosticimaging modalities to evaluate and address this condition. Materials and Methods: A review of relevant articlespublished from 1987 onwards in English language was done using the electronic databases of PubMed Pico and,Google Scholar with preset keywords. Conclusion: Acute back pain prevalence range between 22 to 48 percentand risk factors are non-modifiable such as advanced age and female gender while modifiable risk factors areobesity, smoking, low education, sedentary lifestyle, etc. Employment related factors such as physically strenuouswork also increase the risk of developing back pain. Notably, under-appreciated risk factors includingpsychological risk factors such as anxiety should be screened for while evaluating patients. Evaluation of backpain mostly relies on comprehensive history and physical examination, as most cases are self-limited. Diagnosticimaging is only recommended in cases presenting with red flag symptoms.
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Objective: The purpose of this research is to clarify whether the current situation of the lower back pain prevention education of manual therapists is different between the colleges for sighted persons and those for the visually impaired. This research investigated the current situation of the guidance using an up-and-down type treatment table and the current situation of lower back pain prevention education at manual therapist colleges in Japan. Method: A mail-in survey was conducted for 85 colleges providing a manual therapist training program. For data analysis, descriptive statistics were used to calculate proportions. The type of colleges and implementation of lower back pain prevention education were chi-square tested against other questions. Results: Of the 52 colleges that responded to the survey form, those for sighted persons which offered lower back pain prevention education numbered 8 of 8 (100%), while such institutions for the visually impaired were 22 of 44 (50%) (p<0.001). Among the 51 colleges responding to the question about the up-and-down treatment table, 1 in 8 (12.5%) institutions for the sighted used the device, as did 43 of 43 (100%) (p<0.001) institutions for the visually impaired. Of the 44 colleges which use the up-and-down type treatment table, 38 (86.4%) taught the height of the treatment table and 43 (97.7%) taught the posture, but there was no common guidance method used by a majority of the colleges. Among the 44 colleges using the up-and-down type treatment table, those which provided lower back pain prevention education and taught the height of the treatment table were 23 of 23 (100%) (p=0.008). Discussion: Manual therapist colleges have paid attention to teaching a posture, but that instruction is not connected to lower back pain prevention by teaching the height of a treatment table. Training colleges need a common teaching method to give systematic lower back pain prevention education. Conclusion: Manual therapist training differs by environment for sighted and visually impaired students, suggesting that teaching method of lower back pain prevention education is different.
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To determine pain in lower back and calf muscles among females due to high heels shoe wear. Methodology: A sample size of 87 females working women and students were recruited on the basis of the purposive sampling technique. Participants were requested to wear 5 cm stiletto high heels and they were asked to walk on treadmill at the pace of 4km/hr for 20 minutes. Modified McGill Questionnaire for pain measurement was used as a tool before and after test data collection. Results: In this study observation of muscular pain was significant in lower limb and lower back muscles due to high heels i.e. 29.6% and 24.7% respectively. Conclusion: Back and lower limbs musculature pain contribute only 8.6% whereas, only back pain had been observed in 9.9%. Paired sample t-test was used to determine pain before and after test was significant with p-value 0.000.
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Lower back pain (LBP) is recognized as a cause of morbidity in developed nations in different occupational situations. Health care workers (HCWs), in particular nurses, are especially vulne-rable to LBP. About 6080% of the general people suffer from LBP at some time during their lives. However, there is not enough care about workplace health and safety problems facing the health care workforce in developing nations, such as Libya. Thus, this study aimed to find out the status of low back pain and factors affecting pain among the nurses in Benghazi Medical Centre (BMC), Libya. Cross-sectional study was conducted on BMC in 2018. The data was collected by a self-administered questionnaire. Chi-square was used to determine the association between associated risk factors and LBP prevalence (p<0.05). There is a high prevalence (79%) of low back pain among nurses in BMC. Individual and work-related factors were found as risk factors for LBP. In Libya, nurses are considered as a critical health and safety concern, as a result of the weakness of policies in healthcare organizations. Consequently, a proper no weight lifting policy should be considered. If not, proper manual lifting must be implemented.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Enfermería , Personal de Salud , Dolor de la Región Lumbar/epidemiología , Enfermedades Profesionales , Distribución de Chi-Cuadrado , Prevalencia , Encuestas y Cuestionarios , Factores de Riesgo , Libia/epidemiologíaRESUMEN
Resumen: La lumbalgia y el sobrepeso-obesidad son patologías que se han constituido en tema de interés en salud pública, dado el incremento de incidencia y prevalencia de estas enfermedades en la población mundial. Investigaciones al respecto han sido realizadas especialmente en población anglosajona. Este artículo presenta un estudio analítico de corte transversal, en el que se incluyeron 100 pacientes escogidos con un muestreo por conveniencia, con diagnóstico de lumbalgia, y atendidos en la consulta externa institucional de Ortopedia-Columna del Hospital Militar Central, durante el periodo de abril-junio de 2015. Se analizaron variables sociodemográficas y relacionadas con severidad del dolor, sobrepeso-obesidad e imbalance muscular, variables que se consideraban factores asociados a la presentación y severidad de lumbalgia. De los pacientes analizados, el 52 % fueron mujeres y el 48 %, hombres. Se encontró que las mujeres con porcentaje de grasa corporal elevado tienen un riesgo mayor de padecer dolor lumbar severo, y los hombres con porcentaje de grasa corporal bajo tienen menos riesgo de presentar esta afección. El índice de masa corporal (IMC) para este estudio no pudo predecir la intensidad de dolor lumbar; sin embargo, se logró observar que ser hombre mayor de 50 años es un factor de riesgo para presentar lumbalgia severa.
Abstract: Low back pain and overweight/obesity have become a topic of interest in public health, given the increased incidence and prevalence of these pathologies in the world population. Research in this regard has been carried out, especially in the Anglo-Saxon population. This article presents a cross-sectional analytical study, which included 100 patients chosen by convenience sampling, with a diagnosis of low back pain and attending the institutional Orthopedics-Column outpatient clinic of the Hospital Militar Central during April-June 2015. Sociodemographic variables related to pain severity, overweight/obesity, and muscular imbalance were analyzed, as they were considered factors associated with the occurrence and severity of low back pain. Of the patients analyzed, 52% were women and 48 % men. It was found that women with high fat percentage have a higher risk of severe low back pain, while men with low fat percentage have a lower risk of having this condition. Body mass index (BMI) for this study could not predict the intensity of low back pain; however, it was observed that being a man older than 50 is a risk factor for severe low back pain.
Resumo: O lumbago e o sobrepeso-obesidade são patologias que se constituem em tema de interesse em saúde pública, tendo em vista o aumento de incidência e a prevalência dessas doenças na população em todo o mundo. Pesquisas sobre isso têm sido realizadas, em especial, com população anglo-sa-xã. Este artigo apresenta um estudo analitico, de corte transversal, do qual participaram 100 pacientes selecionados por conveniência, com diagnóstico de lumbago, e atendidos em consulta institucional de Ortopedia-Coluna do Hospital Militar Central, entre abril e junho de 2015. Foram analisadas variáveis sociodemográficas e relacionadas com severidade da dor, sobrepeso-obesidade e desequilíbrio muscular, variáveis consideradas fatores associados com a apresentação e a severidade de lumbago. Dos pacientes analisados, 52% eram mulheres e 48%, homens. Foi verificado que as mulheres com porcentagem de gordura elevada têm um risco maior de padecer dor lombar severa, e os homens com porcentagem de gordura baixa têm menos risco de apresentar essa condição. O indice de massa corporal para este estudo não pode predizer a intensidade de dor lombar; contudo, pôde-se observar que ser homem com mais de 50 anos é um fator de risco para apresentar lumbago grave.
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Humanos , Persona de Mediana Edad , Dolor de la Región Lumbar , Sobrepeso , Salud Pública , Factores de Riesgo , ObesidadRESUMEN
PURPOSE: This study examined the effects of stretching and strengthening exercises on the pain, pelvic tilt (PT), functional disability, and balance of patients with chronic lower back pain (CLBP). METHODS: A total of 42 patients with CLBP were randomly divided randomly into either experimental group I (EG I, n=21), who received stretching exercise, or experimental group II (EG II, n=21), who received strengthening exercise. Both interventions were applied three times a week for eight weeks. Assessments were made with a visual analogue scale (VAS), PT, Oswestry disability index (ODI), and Berg's balance scale (BBS) before and after the eight weeks intervention period. A paired t-test was conducted to compare the within-group changes before and after the intervention. An independent t-test was used compare the between-group difference. The statistical significance level was set to α=0.05 for all variables. RESULTS: The EG I and II showed significant within-group changes in the VAS, PT, ODI, and BBS (p<0.05). The changes in VAS, PT, ODI, and BBS were similar regardless of the exercise form. CONCLUSION: In this study, the application of stretching and strengthening exercise for subjects who complain of CLBP was effective in changing the level of pain, PT, functional disability, and balance.
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Humanos , Ejercicio Físico , Dolor de la Región Lumbar , Dolor PélvicoRESUMEN
PURPOSE: Hip rotation testing is important in the evaluation of chronic back pain. The purpose of this study was to investigate hip and lumbopelvic movement during hip medial rotation (HMR) in individuals with chronic lower back pain (CLBP). METHODS: This study targeted 112 subjects in total: 28 healthy males and 28 healthy females, and 27 males with CLBP and 29 females with CLBP. Motion-capture device was used to measure the hip medial rotation angle (HMRA), lumbopelvic rotation angle (LPRA), and the rotation angle of the hip when lumbopelvic rotation starts during hip medial rotation. RESULTS: When evaluating the healthy males and females using the hip medial rotation test (HMRT), healthy males showed a smaller HMRA than did healthy females (p<0.05). When evaluating the healthy males and the males with CLBP using the HMRT, males with CLBP showed a smaller HMRA and more lumbopelvic movements than did healthy males (p<0.05) in addition, their lumbopelvic movements occurred earlier during HMR (p<0.05). Finally, when evaluating the males and the females with CLBP using the HMRT, males with CLBP showed a smaller HMRA and more lumbopelvic movements (p<0.05), and their lumbopelvic movements occurred earlier during HMR (p<0.05). CONCLUSION: The HMRT is an important test for the evaluation of males, and especially males with CLBP, as they often experience an increased LPRA and decreased HMRA, with lumbopelvic movement occurring earlier during HMR when compared to other groups.
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Femenino , Humanos , Masculino , Dolor de Espalda , Cadera , Dolor de la Región Lumbar , Caracteres SexualesRESUMEN
PURPOSE: This study examined the effect of visual feedback squat on the core muscle thickness of young adults experiencing back pain. METHODS: Thirty adult men and women who experienced back pain were assigned randomly to 15 members of the visual feedback squat group (VSG) and 15 of the normal squat group (NSG) to train three times a week for a total of eight weeks. The core muscle thickness was compared prior to the test for four weeks and eight weeks after the test by dividing it into warm-up exercise, main exercise, and 10 minutes finishing exercise. Before, and four weeks and eight weeks later, the thickness of the core muscle was compared using an ultrasonic imaging system. Repeated measured ANOVA was performed to compare the groups, and a Bonferroni test was performed as a post-hoc test to assess the significance of the timing of the measurements in each group according to the periods. An independent t-test was conducted to test the significance between the groups according to the measurement points. RESULTS: A significant change in the main effects of time and interactions of the time difference in muscle thickness of transvers abdominis were observed between the visual feedback squat and control groups according to the measurement point (p0.05). CONCLUSION: These findings suggest that visual feedback squat exercise is expected to have positive effects on the development of transverse abdominis in core muscles.
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Adulto , Femenino , Humanos , Masculino , Adulto Joven , Dolor de Espalda , Retroalimentación Sensorial , Dolor de la Región Lumbar , Músculos , Ultrasonografía , Ejercicio de CalentamientoRESUMEN
Objective: The purpose of this research is to clarify whether the current situation of the lower back pain prevention education of manual therapists is different between the colleges for sighted persons and those for the visually impaired. This research investigated the current situation of the guidance using an up-and-down type treatment table and the current situation of lower back pain prevention education at manual therapist colleges in Japan. Method: A mail-in survey was conducted for 85 colleges providing a manual therapist training program. For data analysis, descriptive statistics were used to calculate proportions. The type of colleges and implementation of lower back pain prevention education were chi-square tested against other questions. Results: Of the 52 colleges that responded to the survey form, those for sighted persons which offered lower back pain prevention education numbered 8 of 8 (100%), while such institutions for the visually impaired were 22 of 44 (50%) (p<0.001). Among the 51 colleges responding to the question about the up-and-down treatment table, 1 in 8 (12.5%) institutions for the sighted used the device, as did 43 of 43 (100%) (p<0.001) institutions for the visually impaired. Of the 44 colleges which use the up-and-down type treatment table, 38 (86.4%) taught the height of the treatment table and 43 (97.7%) taught the posture, but there was no common guidance method used by a majority of the colleges. Among the 44 colleges using the up-and-down type treatment table, those which provided lower back pain prevention education and taught the height of the treatment table were 23 of 23 (100%) (p=0.008). Discussion: Manual therapist colleges have paid attention to teaching a posture, but that instruction is not connected to lower back pain prevention by teaching the height of a treatment table. Training colleges need a common teaching method to give systematic lower back pain prevention education. Conclusion: Manual therapist training differs by environment for sighted and visually impaired students, suggesting that teaching method of lower back pain prevention education is different.
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INTRODUCTION@#Epidural steroid injections are an integral part of nonsurgical management of radicular pain from lumbar spine disorders. We studied the effect of dexamethasone 8 mg epidural injections on the hypothalamic-pituitary-adrenal axis and serum glucose control of Asian patients.@*METHODS@#18 patients were recruited: six diabetics and 12 non-diabetics. Each patient received a total of dexamethasone 8 mg mixed with a local anaesthetic solution of lignocaine or bupivacaine, delivered into the epidural space. Levels of plasma cortisol, adrenocorticotropic hormone (ACTH), serum glucose after an overnight fast and two-hour postprandial glucose, as well as weight, body mass index, blood pressure and heart rate were measured within one week prior to the procedure (baseline) and at one, seven and 21 days after the procedure.@*RESULTS@#Median fasting blood glucose levels were significantly higher on post-procedure Day 1 than at baseline. However, there was no significant change in median two-hour postprandial blood glucose from baseline levels. At seven and 21 days, there was no significant difference in fasting or two-hour postprandial glucose levels. Both ACTH and serum cortisol were significantly reduced on Day 1 compared to baseline in all patients. There was no significant difference in ACTH and serum cortisol levels from baseline at Days 7 and 21.@*CONCLUSION@#Our study shows that epidural steroid injections with dexamethasone have a real, albeit limited, side effect on glucose and cortisol homeostasis in an Asian population presenting with lower back pain or sciatica.
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Hormona Adrenocorticotrópica , Sangre , Glucemia , Índice de Masa Corporal , Dexametasona , Usos Terapéuticos , Diabetes Mellitus , Terapéutica , Sistema Endocrino , Glucocorticoides , Hidrocortisona , Sangre , Sistema Hipotálamo-Hipofisario , Inyecciones Epidurales , Métodos , Sistema Hipófiso-Suprarrenal , Periodo Posprandial , SingapurRESUMEN
Objective To observe the clinical efficacy of Bai Xiao moxibustion plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH). Method Ninety-six LIDH patients were randomized into a treatment group and a control group, 48 cases each. The treatment group was intervened by Bai Xiao moxibustion plus electroacupuncture, while the control group was intervened by electroacupuncture alone. Before and after the treatment, the lower back pain scores of Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) were evaluated, and the clinical efficacies of the two groups were compared. Result The JOA and VAS lower back pain scores were changed significantly after the treatment in both groups (P<0.05). After the treatment, the JOA and VAS lower back pain scores of the treatment group were significantly different from those of the control group (P<0.05). The pain release time was (2.95±0.59)d after the intervention in the treatment group versus (4.26±0.68)d in the control group, and the between-group difference was statistically significant (P<0.05). The total effective rate was 95.7% in the treatment group versus 91.7% in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Bai Xiao moxibustion plus electroacupuncture is an effective method in treating LIDH and it can reduce the lower back pain.
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Introducción: la acupuntura constituye una terapia alternativa para aliviar distintas afecciones y mejorar la calidad de vida de los pacientes. Objetivo: evaluar el efecto terapéutico de la acupuntura en el tratamiento a pacientes con sacrolumbalgia. Métodos: se realizó una investigación cuasi experimental con 50 pacientes atendidos en la Sala de Rehabilitación de la Policlínica Pedro del Toro Saad, remitidos de los consultorios y con diagnóstico de sacrolumbalagia. El tratamiento consistió en tres sesiones semanales de acupuntura para un total de 12, que permitieron monitorear el comportamiento del dolor y la movilidad, así como, su eficacia en las afecciones del sistema osteomioarticular. Se empleó la distribución de frecuencias y las tablas de contingencia del paquete estadístico Statistics Program for Social Sciences 20.0 (2011) para el procesamiento de los datos. Resultados: se observó que el sexo femenino, así como, el grupo de edad entre 41 y 50 años resultan los más afectados con la enfermedad, que representó el 58% y 46%, respectivamente. Los pacientes tratados tuvieron una evolución satisfactoria con un total de seis a doce sesiones. Con la aplicación de la terapia el comportamiento de dolor se evaluó de bueno en 37 pacientes (74%) y 42 pudieron realizar movimientos amplios (84%). Conclusiones: se evidenció la efectividad de la acupuntura en el tratamiento de la sacrolumbalgia, se logró que, al terminar la terapia, un número significativo de pacientes pudieran realizar amplios movimientos de cadera y miembros inferiores.
Introduction: acupuncture is an alternative therapy to relieve different affection and to improve the quality of life of patients. Objective: to evaluate the therapeutic effect of acupuncture in the treatment of patients with low back pain. Methods: a quasi-experimental study with 50 patients treated at the rehabilitation ward of the Pedro del Toro Saad polyclinic, referred from clinics and diagnosed with low back pain was conducted. Treatment consisted of three weekly acupuncture sessions for 12, which allowed monitoring the behavior of pain and mobility, as well as its efficacy in diseases of osteomioarticular system. Frequency distributions and contingency tables Statistics Program for Social Sciences 20.0 (2011) for processing the data was used. Results: female sex and the age group between 41 and 50 years old were the most affected by the disease, representing 58% and 46% respectively. Treated patients had a satisfactory evolution with a total of six to 12 sessions. With the application of the treatment of pain, behavior was assessed as good in 37 patients and 42 were able to perform extensive movements. Conclusions: the effectiveness of acupuncture in the treatment of low back pain was evident; making the completion of therapy a significant number of patients could make extensive movements of hip and lower limbs.
RESUMEN
OBJECTIVE: The purpose of this study was to investigate the prevalence of and the relevant risk factors for lumbar spondylosis (LS) among middle-aged and elderly rural Korean residents and to explore the association between radiographic LS and lower back pain (LBP) in relation to age and gender. METHODS: This community-based, cross-sectional study evaluated 1512 subjects with available radiograph. The prevalence of LBP was obtained using a questionnaire and disability resulting from LBP was measured using a validated Korean version of the Oswestry disability index (ODI). In lumbar spine radiographs, vertebral levels from L1/2 to L4/5 were evaluated for the presence of osteophytes and joint-space narrowing (JSN), and Kellgren-Lawrence (KL) grading was applied. RESULTS: Of 4261 subjects aged 40–79 years, data from 1512 subjects were included. The prevalence of radiographic LS indicated by grade ≥2 osteophytes and JSN were 53.9 and 15.8%, respectively. Seventy-three percent of subjects had KL grade ≥2 spondylosis and LBP was present in 36.5% of subjects. Although LS was more common among males, the prevalence of LBP was higher among females. Age, male gender and history of hand or knee arthritis were risk factors for LS. LS was significantly associated with LBP mostly among females over 60 years old and correlated with the ODI after adjusting for age and gender. CONCLUSION: Our study among rural Korean residents revealed a high prevalence of LS and LBP. The association between LS and LBP was observed mostly among females and LS was significantly correlated with the severity of back pain.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Artritis , Dolor de Espalda , Estudios Transversales , Mano , Rodilla , Dolor de la Región Lumbar , Osteofito , Prevalencia , Factores de Riesgo , Columna Vertebral , EspondilosisRESUMEN
BACKGROUND: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. METHODS: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: ‘Complete’, when twitching was observed at all needles; ‘Partial’, when twitching was present at 1 or 2 needles; and ‘None’, when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. RESULTS: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). CONCLUSIONS: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.