Are there any correlations among the number of discopathy levels and pain intensity or disability in patients with symptomatic low back pain?

INTRODUCTION: Low back pain (LBP) is considered a civilization disease that affects people in an increasing number. Discopathy (degeneration of intervertebral discs) is recognised as one of LBP causes. Still, the relationship between the number of discopathy levels and LBP remains unclear. The aim of this study was to evaluate the correlation between the number of discopathy levels with intensity of LBP, functional level and the degree of disability. MATERIALS AND METHODS: The prospective, cohort study involved 200 patients aged 27 to 55 years (44.9 ± 9.2 years) with single- or multilevel lumbar discopathy confirmed by imaging examinations. Functional examination included NRSscale, goniometric measurements, Modified Laitinen Pain Questionnaire, Oswestry Disability Index and Back Pain Function Scale. RESULTS: There were statistically significant positive correlations between the number of discopathy levels and the age of the subjects (r = 0.266; p = 0.000), BMI (r = 0.158; p = 0.029) and ODI (r = 0.157; p = 0.026). Positive correlation (r = 0.142; p = 0.044) was also observed between the results of Fingertip-to-floortest and the number of levels of discopathy. CONCLUSIONS: The number of levels of discopathy was depended on the age and BMI of the patients. It had no effect on pain intensity, range of rotational motion of the lumbar spine and functional status of patients. As the number of levels of discopathy increased, a higher degree of everyday disability was observed.

Level of physical activity of students in Poland, Portugal and Belarus.

INTRODUCTION AND OBJECTIVE: The WHO term 'physical activity' refers to all body movements produced by skeletal muscles which require energy expenditure. The ways to be active include daily activities, exertion in the performance of work, or active recreation. The objective of the study is to compare physical activity of the students of Bialystok University of Technology, Higher School of Physical Education and Tourism in Biaystok (Poland), University of Beira Interior in Covilha (Portugal) and Janka Kupala Grodno State University in Grodno (Belarus). MATERIAL AND METHODS: A total of 1,136 persons participated in the study (398 men and 738 women). The level of physical activity of the students was assessed on the basis of a short version of the International Physical Activity Questionnaire (IPAQ). The individual value of the body mass index (BMI) was calculated for each respondent. RESULTS: Among men studying at WSWFiTB, in Portugal and Belarus, the dominant level of activity was high. Both in the group of men and women, people studying in Portugal spent the most time sitting during one working day. Without taking into account the gender of the respondents, a high level was the dominant among students of WSWFiTB, in Portugal and Belarus. With regard to overweight and obese people, the highest average amount of energy expenditure was recorded in the case of intensive activity. CONCLUSIONS: Men, compared to women, were characterized by a higher average amount of energy consumption related to total activity and intensive exercise. Students in Belarus obtained the highest average amount of energy expenditure related to moderate and intensive activity, compared to students at BUT, WSWFiTB and in Portugal. A high level of activity dominated both in the group of underweight/normal body weight, as well as overweight and obese persons.

The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial.

BACKGROUND: Low back pain (LBP) has a negative impact on patients' life, not only from the physical point of view, but also in terms of psychic, social and economic wellbeing. The increasing costs of treatment and health care encourage the search for the most effective methods of treatment. AIM: The aim of the study was to determine whether the use of combined therapy consisting of manual therapy and proprioceptive neuromuscular facilitation (PNF) is more effective than the use of manual therapy techniques, PNF or traditional kinesiotherapy as single methods in the treatment of LBP. DESIGN: A four-arm RCT. SETTING: Rehabilitation Department of Hospital in Parczew (Poland). METHODS: The study was designed as four-arm randomized comparative controlled RCT and conducted on a group of 200 patients aged 27-55y. (44.9±9.2 years). The patients were randomly divided into four 50-person groups: 1) group A - manual therapy; 2) B - PNF; 3) C - manual therapy and PNF; and 4) group D - traditional kinesiotherapy and control group. Pain intensity was measured using VAS and Laitinen's questionnaire. Functional disability was assessed using Oswestry Disability Index (ODI) and Back Pain Functional Scale (BPFS). RESULTS: There was a statistically significant difference in pain reduction (VAS Scale) between Group C (4.8 points) and Group D (3.9 points). In all the groups there was a statistically significant reduction in a degree of disability as measured by the ODI. A level of functional capabilities (BPFS) increased significantly only in Group C (8.8 points) as compared to Group D (5.7 points). CONCLUSIONS: All the evaluated methods caused pain reduction which lasted for at least 2 weeks after the end of treatment. The degree of disability as measured by ODI lowered evenly in all groups. Patients' functional ability assessed with BPFS improved significantly in the group treated with combined therapy (manual therapy and PNF) as compared to the group of traditional kinesiotherapy. CLINICAL REHABILITATION IMPACT: The therapy consisting of manual therapy and the PNF method seemed to be more effective than the traditional kinesitherapy in improving functioning of patients with non-specific low back pain.

Histological patterns of synovitis and serum chemokines in patients with rheumatoid arthritis.

OBJECTIVE: Studies indicate the genetic, biological, and clinical heterogeneity of rheumatoid arthritis (RA). Recently the histological diversity of RA has been postulated. We investigated whether serum concentrations of interleukin 8 (IL-8), RANTES (regulated upon activation normal T cell expressed and secreted), and monocyte chemoattractant protein-1 (MCP-1) are correlated with histological appearance of the rheumatoid synovitis. METHODS: Using ELISA we assessed IL-8, RANTES, and MCP-1 concentrations in serum of 47 patients with RA and 30 patients with osteoarthritis (OA). RESULTS: Morphological analysis of synovial specimens distinguished 2 types of rheumatoid synovitis. Twenty-eight RA samples presented diffuse infiltrates of mononuclear cells with no specific microanatomical organization and were categorized as diffuse synovitis. In the remaining 19 specimens, classified as follicular synovitis, formation of lymphocytic follicles with germinal center-like structures was observed. Serum levels of studied chemokines were increased in patients with RA compared to the OA control group (p < 0.001 for all comparisons). Concentrations of IL-8, RANTES, and MCP-1 were highest in serum of RA patients with follicular synovitis in comparison with patients with diffuse synovitis (p < 0.01, p < 0.01, and p < 0.05, respectively) and could distinguish RA patients with these 2 histological disease patterns. Serum levels of chemokines correlated with markers of disease activity such as erythrocyte sedimentation rate, C-reactive protein concentrations, and Disease Activity Score. CONCLUSION: Distinct histological variants of rheumatoid synovitis associated with different serum levels of IL-8, RANTES, and MCP-1 reflect clinical activity of the disease and confirm the concept of RA heterogeneity.