Low Back Pain Perceptions and Coping Strategies in Pre-Professional Dancers: A Qualitative Study.

AIMS: Low back pain (LBP) is a common health problem in pre-professional dancers which could hamper the dancers' professional career. However, pre-professional dancers are not often studied, although they may have their own pain perceptions and coping strategies towards LBP. Considering the biopsychosocial nature of LBP, it is important to increase the understanding of these perceptions and coping strategies. The aim of this qualitative research study was to explore the dancers' perceptions about LBP and their coping strategies when they suffered from LBP. METHODS: Eighteen pre-professional dancers with and without LBP from different dance schools in Belgium were included in this study. Participants were invited for an in-depth online video interview. These in-depth interviews were based on a topic list. Afterwards, the interview transcripts were analyzed thematically. RESULTS: Two primary themes emerged from the data: 1) perceptions of LBP and 2) coping strategies which dancers applied when they suffered from LBP. The perceptions about LBP were related to two different themes: "it's all about the body" and "it's all about the psychosocial and contextual factors." In addition, the coping strategies were divided into "active coping strategies" and "passive coping strategies," whereas the most popular coping strategies were stretching exercises and passive coping strategies such as massages or heating cream. CONCLUSION: Although LBP has clearly been shown to be a biopsychosocial phenomenon, this qualitative study showed that dancers mainly considered biomedical factors as contributing factors to LBP. Additionally, instead of relying on coping strategies aimed at directly improving pain or trying to treat LBP on the basis of a single-cause diagnosis, it is important to consider the biopsychosocial origin of LBP in the management plans.

[Critical appraisal of the battery of questionnaires used in the French-speaking Belgian spine rehabilitation centers for low back pain]. / Analyse critique de la batterie de questionnaires utilisée par les centres francophones belges de revalidation du rachis pour la lombalgie.

OBJECTIVES: to investigate the questionnaires used in French-speaking Belgian spine multidisciplinary rehabilitation centers for patients with low back pain and to propose a minimal core set of questionnaires based on the results of our survey and on the (inter)national guidelines. METHODS: the spine centers offering the 36 two-hour sessions defined by the Belgian national Institute for Health and disability insurance were invited to provide their battery of questionnaires. RESULTS: among the 37 identified and contacted centers, 21 participated in our survey. Results pointed out the use of questionnaires assessing pain intensity, disability, anxiety/depression and kinesiophobia in most centers as well as a huge heterogeneity regarding the questionnaires (and even the version of the questionnaire) reported and the non-systematic use of questionnaires recommended by the guidelines. CONCLUSION: taking into account the results of this survey, the present article proposes a minimal core set of questionnaires meeting the guidelines, which would make it possible to harmonize the assessments in the different centers and would facilitate the realization of multicenter studies.

Objectifs : examiner les questionnaires utilisés dans les centres francophones belges de revalidation multidisciplinaire du rachis pour la prise en charge des patients lombalgiques et proposer une batterie de questionnaires minimale basée sur les résultats de cette étude et sur les recommandations (inter)nationales. Matériel et méthodes : les centres proposant le programme de 36 séances de 2 heures défini dans la nomenclature de l'INAMI (Institut National d'Assurance Maladie Invalidité), ont été invités à nous fournir leur batterie de questionnaires. Résultats : parmi les 37 centres identifiés et contactés, 21 ont participé à l'enquête. Si celle-ci met en évidence l'utilisation de questionnaires évaluant l'intensité de la douleur, l'incapacité fonctionnelle, l'anxiété/dépression et la kinésiophobie dans les différents centres, elle révèle également une grande hétérogénéité en termes de questionnaires (et même de version du questionnaire) utilisés et la non-utilisation systématique des questionnaires recommandés par les guides de pratique clinique. Conclusion : compte tenu des résultats de l'enquête, cet article propose une batterie minimale de questionnaires répondant aux guidelines, qui permettrait d'harmoniser les évaluations dans les différents centres et faciliterait la réalisation d'études multicentriques.

Integration of fiber Bragg grating temperature sensors in plasma facing components of the WEST tokamak.

Plasma Facing Components (PFC) temperature measurement is mandatory to ensure safe high power and long pulse tokamak operation. IR thermography systems which are widely used in magnetic fusions devices become challenged with the choice of tungsten as a PFC material in the ITER tokamak, mainly due to emissivity uncertainties and reflection issues in a hot environment. Embedded temperature measurements are foreseen to cross-check the IR thermography measurements. Fiber Bragg grating sensors are potentially of great interest for this application because they are immune to electromagnetic interference and allow the measurement of a large number of temperature spots on a single fiber. Four optical fiber temperature sensing probes, each of them including 11 regenerated fiber Bragg gratings equally spaced by 12.5 mm (equivalent to one ITER-like tungsten monoblock), have been specifically designed and manufactured for the WEST project (W-tungsten Environment and Steady State Tokamak). The four probes are embedded in W-coated graphite components at two different distances from the surface, 3.5 mm and 7 mm, to cover a wide range of temperatures up to 900 °C. This paper addresses the design and integration issues and the qualification and performance assessment performed in the laboratory. It also shows the first measurements of this new diagnostic achieved in a tokamak environment during baking of the machine and during early diverted plasma exposure.

Gaining insight into the complexity of pain in patients with haemophilia: State-of-the-art review on pain processing.

Despite the high prevalence of recurrent, constant and/or widespread pain in patients with haemophilia (PwH), there is an immense lack of studies examining the (patho)physiology of pain in this population. This contrasts to the bulk of literature in other pain conditions, such as osteoarthritis, low back pain or rheumatoid arthritis. Understanding the complexity of pain allows to better assess and manage pain. In PwH, the first priority is always to exclude bleeding as a cause of pain. An important next step in pain assessment is the evaluation of the predominant pain mechanism (ie nociceptive, neuropathic pain or altered central pain processing) as the treatment approach will be very different according to the underlying pain mechanism. Pain assessment should include both physiological and psychological components. This review summarizes the evidence regarding nociceptive, neuropathic and altered central pain processing in PwH and serves as a research agenda to prioritize pain research in PwH.

Sensory processing and central pain modulation in patients with chronic shoulder pain: A case-control study.

Chronicity and recurrence in musculoskeletal shoulder pain are highly prevalent and can possibly be attributed to the concept of central sensitization. Available studies suggest a role for central sensitization in explaining chronic shoulder pain, but so far a comprehensive quantitative sensory testing (QST) protocol has not been used. The aim of this study was to gain knowledge on sensory processing and central pain modulatory mechanisms in patients suffering from chronic shoulder pain using such a QST protocol. Fifty study participants, including chronic shoulder pain patients and healthy controls, underwent a standardized, comprehensive psychophysical testing procedure. A static adapted QST protocol (including pressure algometry, vibration and mechanical detection) was applied. Thereafter, all subjects underwent dynamic measures of temporal summation and conditioned pain modulation. Questionnaires assessing psychosocial factors were completed by each subject. No significant differences (P >= .05) were found between patients and controls based on pressure algometry, vibration detection, mechanical detection, temporal summation, and conditioned pain modulation. Moderate positive correlations (r = .5) were found between pressure pain thresholds (PPTs) and the amount of sports participation. Weak-to-moderate negative correlations (r = -.3 à -.5) were found between PPTs and psychosocial factors such as pain catastrophizing. Based on these findings, we can conclude that central sensitization is no characteristic feature in chronic musculo-skeletal shoulder pain but can be present in individual cases.

Systematic review: risk factors for musculoskeletal disorders in musicians.

BACKGROUND: Although many musicians suffer from musculoskeletal disorders, aetiological factors are unclear. AIMS: To systematically search for and synthesize the best available evidence on risk factors for musculoskeletal disorders in musicians. METHODS: A database search was performed in PubMed, EMBASE, CINAHL, Pedro, OTseeker and Psychinfo. A manual search was conducted in the journals Medical Problems of Performing Artists and Psychology of Music. Studies with an objective to investigate determinants associated with playing-related musculoskeletal disorders were included. Papers were selected based on adequacy of statistical methods for the purpose of the study. Search, first screening and selection were performed by one author. Two reviewers independently performed the final selection using full-text reports. Methodological quality assessment was performed by two reviewers independently. RESULTS: One case-control and 14 cross-sectional studies were included. Methodological quality was in general low. Large heterogeneity existed in study design, population, measurement of determinant and outcome and analysis techniques. Data were presented descriptively. Consistent results were found indicating that previous musculoskeletal injury, music performance anxiety, high levels of stress and being a female playing a stringed instrument seemed to be associated with more musculoskeletal disorders. Influence over or support at work, orchestra category/status, exercise behaviour and cigarette smoking seemed to be unrelated with musculoskeletal disorders. No conclusions could be made on causality, as the current data only represent cross-sectional associations. CONCLUSIONS: Because of lack of prospective studies, no causal relations could be identified in the aetiology of (playing-related) musculoskeletal disorders in instrumental musicians.

[THE MALADAPTIVE BELIEFS OF PATIENTS WITH LOW BACK PAIN. A NARRATIVE REVIEW]. / LES CROYANCES DÉLÉTÈRES DES PATIENTS LOMBALGIQUES. Revue narrative de la literature.

OBJECTIVE: to summarize the knowledge regarding the maladaptive beliefs of patients with non-specific low back pain. METHODS: a narrative literature review on these beliefs was conducted by an international and multidisciplinary team of experts in the field. RESULTS: these beliefs, which can result in negative consequences on functioning and on patient prognosis, have various origins: family and friends, media, previous experience and/or health care professionals' messages. The latter, who have a considerable and enduring influence, have the potential to change and correct the patients' misbeliefs; however, they can also reinforce them in case of inappropriate messages and attitudes. Informing and educating the patient (by means of reassurance, explanations of the non-systematic association pain-injury, encouragement to get and stay physically active) are the basis of treatment. Taking into account the consequences of some words which may be misinterpreted, the results of imaging should be wisely discussed with the patient. Pain neurophysiology education and cognitive behavioral therapy (i.a., in vivo graded exposure techniques) are effective additional treatments. CONCLUSIONS: Misbeliefs are frequent in patient with low back pain. They do need to be looked for and corrected.

Does scapular positioning predict shoulder pain in recreational overhead athletes?

The objective of this prospective study is to investigate possible scapular related risk factors for developing shoulder pain. Therefore, a 2-year follow-up study in a general community sports centre setting was conducted. A sample of convenience of 113 recreational overhead athletes (59 women and 54 men) with a mean age of 34 (17-64; SD 12) years were recruited. At baseline, visual observation for scapular dyskinesis, measured scapular protraction, upward scapular rotation and dynamic scapular control were evaluated. 22% (n=25) of all athletes developed shoulder pain during the 24 months following baseline assessment. The Mean Shoulder Disability Questionnaire (SDQ) score for the painful shoulders was 34.8 (6.3-62.5; SD 17.4). None of the scapular characteristics predicted the development of shoulder pain. However, the athletes that developed shoulder pain demonstrated significantly less upward scapular rotation at 45° (p=0.010) and 90° (p=0.016) of shoulder abduction in the frontal plane at baseline in comparison to the athletes that remained pain-free. In conclusion, although these scapular characteristics are not of predictive value for the development of shoulder pain, this study increases our understanding of the importance of a scapular upward rotation assessment among recreational overhead athletes.

Motor control and low back pain in dancers.

Professional dancers suffer a high incidence of injuries, especially to the spine and lower extremities. There is a lack of experimental research addressing low back pain (LBP) in dancers. The aim of this study is to compare lumbopelvic motor control, muscle extensibility and sacroiliac joint pain between dancers with and without a history of LBP. 40 pre-professional dancers (mean age of 20.3 years) underwent a clinical test battery, consisting of an evaluation of lumbopelvic motor control, muscle extensibility, generalized joint hypermobility, and sacroiliac joint pain provocation tests. Also self-reported measurements and standardized questionnaires were used. 41% of the dancers suffered from LBP during at least 2 consecutive days in the previous year. Only one dancer suffered from sacroiliac joint pain. Compared to dancers without a history of LBP, dancers with a history of LBP showed poorer lumbopelvic motor control (p<0.05). No differences in muscle extensibility or joint hypermobility were observed between dancers (p>0.05). Despite their young age, pre-professional dancers suffer from LBP frequently. Sacroiliac joint pain, generalized joint hypermobility or muscle extensibility appears unrelated to LBP in dancers. Motor control is decreased in those with a history of LBP. Further research should examine whether motor control is etiologically involved in LBP in dancers.

Solid-liquid transition and rejuvenation similarities in complex flows of thixotropic materials studied by NMR and MRI.

We study the flow of a typical thixotropic material subjected to very different deformation histories (squeeze, shear, and extrusion) with either local (proton NMR and magnetic resonance imaging) or macroscopic measurements after different times of rest. Specifically, we measure the velocity fields and the spin-spin NMR relaxation of the material after different flow histories. The relaxation data exhibits a long relaxing component revealing information about the reversible microstructural evolution of the sample during aging-rejuvenation cycles. We show that for each deformation process, the evolution of the viscosity during the solid-liquid transition is similar by a factor related to the initial state of the material. Moreover, results examining the impact of the rate at which the deformation is imposed suggest that the state of the material during this transition may be described by a single parameter reflecting the average size and deformation of the material's flocs. These results also show that localization of flow occurs as a result of a progressive differential evolution of the material in different regions of the flow, and thus are determined by the boundary conditions of the flow.

General probabilistic approach to the filtration process.

We show experimentally that clogging is basically a matter of the probability of the presence of particles. We describe this process as a function of the main variables of the process, namely, the ratio of particle to mesh hole size, the solid fraction, and the number of grains arriving at each mesh hole during one test, with the help of a simple model, the predictions of which are in very good agreement with our experimental data.

[Idiopathic liquefying panniculitis with fatal outcome]. / Panniculite liquéfiante idiopathique a évolution fatale.

A 34 year's old female patient died of nodular liquefying panniculitis after a six months evolution. The only systemic lesions found at post mortem histological examination were an involvement of both pleural cavities with an oily fluid. This seemed to have been the cause of death. This symptomatology was not observed in any of the 26 fatal cases of Weber-Christian disease published in the literature among which 11 cases with no other lesions than adipous tissue lesions, 6 cases where death was related to secondary effects of panniculitis and 9 cases where death was related in intercurrent diseases.