ABSTRACT
The reliability of lumbar paravertebral EMG assessment was investigated in a sample of 70 patients with chronic low back pain, (CLBP). Dual-site EMG monitoring was employed during both static postures and movements. Flexion and rotation indices were divided to assess the reliability of patterning of paravertebral EMG during movement. Within-session reliabilities computed for the full sample ranged from 0.66 to 0.97, and between-session reliabilities, computed on a subset of 29 patients retested after varying intervals, ranged from 0.26 to 0.92. Average EMG levels, flexion, and rotation indices showed no statistically significant differences between surgical (n = 40) and nonsurgical patients (n = 30), although EMG variability was consistently greater for surgical patients across the postures and movements. These results indicate that lumbar paravertebral EMG can be reliably measured and therefore has potential utility as an assessment and treatment variable in CLBP.
Subject(s)
Back Pain/physiopathology , Electromyography/methods , Muscles/physiopathology , Adult , Female , Humans , Male , Middle AgedABSTRACT
We conducted a controlled study of the impact of an education program on the health outcomes and perceptions of patients with varying degrees of airway obstruction in two communities. In one community, patients with chronic obstructive airway disease (COAD) were identified, assessed and offered an educational program. In the other community, patients were identified, assessed and advised of the findings only. Patients at both sites were given the same pretest and, one year later, the same posttest. These tests measured physical and social function, and health outcomes (eg, respiratory symptoms, exercise tolerance, mental health), plus patients' health perceptions. Posttest results showed a significant difference between groups on a health perception measure and locus of control, but no difference on health outcomes. We conclude that education programs for COAD are unlikely to improve patients' health status unless they are part of a comprehensive medical program that includes physical reconditioning.
Subject(s)
Attitude to Health , Lung Diseases, Obstructive/rehabilitation , Patient Education as Topic , Community Health Services , Evaluation Studies as Topic , Female , Health Status , Humans , Internal-External Control , Lung Diseases, Obstructive/psychology , Male , Middle Aged , New Hampshire , Physical Exertion , Surveys and Questionnaires , VermontABSTRACT
Many authors have recommended the development and use of automated recording devices as alternatives to self-report measures of activity patterns in chronic pain patients. An electromechanical device is described that can be used to measure downtime or uptime in chronic pain patients. This monitor has several advantages over mercury tilt-switch devices including freedom from plane dependence, resistance to artifact associated with rapid or vigorous movements, and the flexibility to permit conceptualization of sitting time as either uptime or downtime, depending upon placement of the position switch. The monitor consists of a miniature electronic timer, a switching delay circuit and battery pack, an electromechanical position switch, a belt with carrying cases, and a battery recharger. The device has high reliability (agreement coefficients of 1.0) and concurrent validity (r = 0.99) for both downtime and uptime assessments. Research applications and clinical use of this device are discussed as well as directions for the further development of automated recording devices.
