ABSTRACT
BACKGROUND: According to the biopsychosocial approach of the German new back school the core objectives are sustainable improvement of physical and psychosocial health resources. Subjects with non-specific low back pain were investigated to evaluate the desired physical effects. METHODS: Coordinative and postural motor exercises were evaluated by means of surface electromyography (EMG). Applying a modified waiting group design 56 participants were examined 3 months before the start, at the beginning and at the end of the new back school program as well as 3 and 12 months after completion and the results were compared to a healthy control group (n=56) matched for age and body mass index (BMI). RESULTS: Initially significant group differences were found in 18 % of all statistical calculations of the static and 6 % of the dynamic test situations. Considering the trunk muscles the most frequent significant alterations from normative data were found in the lumbar multifidus muscle (static tests 29 % and dynamic tests 7 %). No relevant changes in the number of statistical results could be detected directly after completion of the new back school program. Nevertheless, at 12 months follow-up the number of significant differences to the normative data of the control group dropped by one third to 12 % of all calculations with static loads. CONCLUSION: The adjustment effects at 12 months follow-up indicate a delayed positive influence of the new back school program on muscular physiological parameters. Individuals with chronic non-specific back pain showed a long-term profit from participation in the new back school program due to the initiated orientation to a modified more active lifestyle.
Subject(s)
Low Back Pain/rehabilitation , Pain Clinics , Activities of Daily Living/classification , Adult , Aged , Disability Evaluation , Electromyography , Exercise Therapy , Female , Follow-Up Studies , Germany , Humans , Low Back Pain/diagnosis , Low Back Pain/physiopathology , Low Back Pain/psychology , Male , Matched-Pair Analysis , Middle Aged , Muscle, Skeletal/physiopathology , Pain Measurement , Posture/physiology , Quality of Life/psychology , Young AdultABSTRACT
BACKGROUND: Results related to the outcome of the classical back schools are inconsistent. Accordingly, a reformulation of the program integrating psychological and social aspects was performed as a necessary step for the development of the new back school in Germany. The aim of this study was to assess the effectiveness and sustainability of the new back school in subjects with non-specific back pain in the prevention setting. MATERIAL AND METHODS: In a modified waiting design, individuals were investigated with respect to demographical, pain-related and psychological characteristics 3 months before the start, at the start and at the end of the back school and as well as 12 months after completion. In addition, predictors for a successful participation were analyzed. RESULTS: A total of 88 subjects with back pain initially participated in the study. In the short and long-term course, low to moderate effects were detected; however, during follow-up a reduction of pain showed high effects. Depression as assessed by the hospital anxiety and depression scale (HADS) and passive coping strategies assessed using the coping strategies questionnaire (CSQ) were identified as predictors for response to the intervention. CONCLUSION: On the basis of the sample studied, the new back school proved to be an effective treatment for short and long-term reduction of pain-related stress and associated psychological aspects. Maladaptive, passive coping strategies and higher depression scores were associated with a higher probability of success in terms of pain reduction and functional improvement.
Subject(s)
Back Pain/psychology , Back Pain/rehabilitation , Patient Education as Topic , Somatoform Disorders/psychology , Somatoform Disorders/rehabilitation , Adaptation, Psychological , Adult , Aged , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Electromyography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain Measurement/psychology , Surveys and Questionnaires , Young AdultABSTRACT
UNLABELLED: The quadriceps femoris muscle (QF) plays an important role in locomotion. However, assessing the total number of attempts to evaluate the maximal isometric strength (Fmaxiso) regarding reliability and feasibility remain less characterised. PATIENTS, METHODS: 28 patients with haemophilia (H) (26 severe, 2 moderate) and 27 healthy controls (C) matched for age (H: 44 ± 11, C: 42 ± 12) and anthropometric data were measured separately for the left and right leg for Fmaxiso of QF using m3 diagnos (SCHNELL®). We repeated the Fmaxiso measures after 48 h in 14 H and 13 C. RESULTS: The system m3 diagnos showed strong reliability (ICC = 1.0; SEM = 0.0; CA = 1.0). H and C demonstrated significant differences in Fmaxiso (H r = 153 Nm, l = 164 Nm; K r= 289 Nm, l = 280 Nm; p ≤ 0.001). Additionally, H and C revealed significant differences between the 1st and 3rd to 6th attempts. No differences were observed between the 3rd, 4th, 5th and 6th attempts. CONCLUSION: Both groups showed high test-retest-reliability of Fmaxiso (ICC/SEM: H l = 0.98/7.1 r = 0.99/4.9; K l = 0.69/11.3 r = 0.95/5.8). Starting from the 3rd attempt, reliable measurements of the Fmaxiso in patients suffering from severe haemophilia are feasible.
