Comparison of supervised exercise therapy with or without biopsychosocial approach for chronic nonspecific low back pain: a randomized controlled trial.

BACKGROUND: A biopsychosocial rehabilitation is recommended for chronic nonspecific low back pain (CNLBP); however, its effectiveness compared to the traditional supervised exercise therapy of CNLBP treatment is still unclear. METHODS: This was a parallel-group randomized controlled clinical trial. The sample consisted of 180 participants of both sexes, aged ≥18 years, with CNLBP for ≥3 months. Using web randomization and concealed allocation, they were assigned to three groups; graded activity receiving cognitive-behavioral therapy, group-based combined exercise therapy and education (GA; n = 59), supervised group-based combined exercise therapy and education (SET; n = 63), and a control group receiving usual care (n = 58). Interventions were administered for 4 weeks (8 sessions). The primary outcome was pain intensity. Outcome measures were collected baseline, after interventions (4 weeks), and during two follow-up periods (3 and 6 months). RESULTS: After the intervention, GA had a significant large effect on pain reduction compared to the control group (MD of 22.64 points; 95% CI = 16.10 to 29.19; p < 0.0001; Cohen's d = 1.70), as well as SET compared with the control group (MD of 21.08 points; 95% CI = 14.64 to 27.52; p < 0.0001; Cohen's d = 1.39), without significant difference between two intervention groups. At 3 and 6 months of follow-up, GA had a statistically significantly better effect in reducing pain, disability and fear-avoidance beliefs, and improving spinal extensor endurance, range of extension and quality of life compared to SET and the control group. A statistically significantly better effect of SET compared with the control group was found in reducing pain, disability, fear-avoidance beliefs, and improving the physical component of quality of life. Harms were not reported. CONCLUSION: This study suggests that graded activity and group-based supervised exercise therapy have beneficial effects over the control group in the treatment of CNLBP. The graded activity was more beneficial than supervised group-based exercise therapy only during the follow-up. TRIAL REGISTRATION: Clinicaltrials.gov (NCT04023162; registration date: 17/07/2019).

Prevalence of spinal pain in a population of Bosnia and Herzegovina.

Objectives: To determine the prevalence and risk factors of spinal pain in the population of Bosnia and Herzegovina (BiH). Methods: This was a cross-sectional survey conducted online in November/December 2018. Participants were inhabitants of BiH of both sexes, aged ≥ 16 years. The sample was stratified based on region and demographic characteristics. Current pain was analyzed; point prevalence was measured. Results: We received 1048 responses, of which data from 1017 could be used. The prevalence of spinal pain in BiH was 70.9%: 75.5% in women (n = 440) and 64.7% in men (n = 281). Low back pain (LBP) was more common compared to neck pain (NP) and thoracic pain (TP) in both sexes and all age groups. Significant associations with spinal pain in the bivariate analysis were found for the following groups: women, aged from 30 to 50 years, with high school education, employed persons and retirees, spinal pain in parents, smoking, irregular physical activity, longer use of TV or computer/mobile phone per day. Conclusion: To our knowledge, this is the first study of the prevalence of spinal pain in BiH. Some factors associated with spinal pain are modifiable. Therefore, public health interventions should target those factors to reduce the burden of spinal pain in BiH.

Relationship between Education of Pregnant Women and Listening to Classical Music with the Experience of Pain in Childbirth and the Occurrence of Psychological Symptoms in Puerperium.

INTRODUCTION: Pregnancy is a unique experience accompanied by significant physiological, biochemical, and psychological changes that may affect a woman's mental health status. With the development of a holistic approach, midwives have become continuous support during pregnancy and childbirth. Childbirth education is an intervention that affects delivery outcomes and the experience of childbirth. Music therapy has been proven to be a safe and effective non - pharmacological method to gain in pregnancy and puerperium. The study aimed to prove the impact of educating pregnant women and listening to classical music on the experience of childbirth pains and the occurrence of psychological symptoms during puerperium. METHODS: A prospective randomized controlled trial (n=198) was conducted. The experimental group of pregnant women was educated during pregnancy and listened to classical music the rest of the pregnancy, while the control group received the usual care. The VAS scale was used to assess pain, and the 90 - point scale was used to assess the incidence of psychological symptoms. RESULTS: The difference in pain assessment between the experimental and control groups was significant (p<0.001). The experimental group rated their childbirth pain as moderate (M=5.98), while the control group experienced severe pain (M=8.42). A significant difference in the incidence of psychological symptoms between groups was found in the dimensions of interpersonal sensitivity, hostility, phobic anxiety, and paranoid ideations (p=0.042; p=0.014; p=0.013; p=0.008). CONCLUSION: This study demonstrated the impact of midwifery education and listening to classical music on the perception of childbirth pain and mental health in the puerperium. The experimental group rated childbirth pain significantly lower compared to the control group and had significantly fewer psychological symptoms 6 weeks after delivery.

The Influence of Religiosity and Personality Dimensions on the Attitudes about Abortion.

BACKGROUND: A major public health problem is illegal abortion and its consequences and reliable data on abortions is globally unavailable. The Catholic Church advocates the protection of the human right for life that begins with conception. Religion was proven as an important predictor in forming abortion attitudes. Low points on openness and experience scales correlate with social prejudices and conservative orientation. THE AIM: To determine the impact of religiosity and personality dimension on abortion attitudes using Questionnaire of Religion, Abortion Attitudes Questionnaire and Big Five Questionnaire. SUBJECTS AND METHODS: An in - depth study was conducted on a sample of 310 citizens of Herzeg-Bosnian County in Bosnia and Herzegovina. The instruments used in the research were: a short questionnaire with socio-demographic features, a questionnaire of religiosity, an abortion questionnaire and a Big Five questionnaire. RESULTS: Citizens of Herzeg-Bosnian County, 89.1% of them, believe that abortion terminates life. For legal prohibition of abortion 73.1% of the respondents' advocate, and Catholics are the most rigorous. Catholics mostly do not agree with the attitude that only a pregnant woman can decide on abortion in comparison to Islamic religion (χ2(4)=16.36; p<0.01). Only 13% of citizens are against the interference of the Church in the matter of abortion. The most insecurity can be seen in the attitude about the father's participation in the abortion decision. Almost half of citizens who oppose abortion would still leave it as an option for women. CONCLUSION: Citizens of Herzeg-Bosnian County support the legal prohibition of abortion and see it as a termination of life. Orthodox respondents are the least opposed to abortion and they also see themselves the least as believers. In Catholic and Islamic religions, religious identity and condemnation of abortion are expressed. Younger and mature people and male gender are important predictors of abortion condemnation. The influence of personality dimension on abortion attitudes was also not found in this research.