| 181. |
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| 182. |
- Suzuki, Nobuyuki, 1971, et al.
(författare)
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Physical exercise affects cell proliferation in lumbar intervertebral disc regions in rats
- 2012
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Ingår i: Spine. - 0362-2436. ; 37:17, s. 1440-1447
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. Descriptive experimental study.Objective. The aim of this study was to investigate the effect of exercise on cell proliferation in different areas of the IVD and recruitment of cells possibly active in regeneration of normal rat lumbar IVDs.Summary of Background Data. Little is known about the effects of physical exercise on lumbar intervertebral disc (IVD) tissue. Recently, stem cell niches in the perichondrium area of the IVD were identified and cells in these niches have been suggested to be involved in the normal regeneration of the IVD.Methods. Thirty Sprague-Dawley rats were exposed to 5-bromo-2-deoxyuridine (BrdU) diluted in the drinking water during 14 days. Fifteen rats ran on a treadmill daily for 50 min/day, 5 days/week (exercise group) and 15 non-exercised rats served as controls. Immunohistochemical analyses (anti-BrdU antibody) were performed at 9, 14, 28, 56 and 105 days after the start of the exercise protocol. BrdU positive cells were counted in the stem cell niche area (SN), peripheral region of epiphyseal cartilage area (pEC), the annulus fibrous outer and inner area (AFo and AFi). Data were analyzed by two-way ANOVA (significance level; p<0.05).Results. The BrdU positive cell numbers in the SN and AFo region were increased in discs from the exercising group on days 14 (p<0.01) and 105 (p<0.05) and at day 14 (p<0.01) in the pEC region as compared to controls.Conclusions. Physical exercise was shown to have positive effects on cell proliferation in intervertebral discs with involvement of various disc regions, indicating a differential response by disc tissue to exercise depending on anatomical location and tissue characteristics.
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| 183. |
- Svensson, Elisabeth, 1942-, et al.
(författare)
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The balanced inventory for spinal disorders : the validity of a disease specific questionnaire for evaluation of outcomes in patients with various spinal disorders
- 2009
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 34:18, s. 1976-1983
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. A prospective validation study. Objective. To validate the Balanced Inventory for Spinal Disorders (BIS), a questionnaire concerning the extent to which pain affects perceived physical health, social life, mental health, and quality of life. The operational definitions of the items and the verbal descriptive scales were compared with corresponding items in the Short-Form 36 (SF-36), European Quality of Life Scale (EQ), and Oswestry Disability Index (ODI). Summary of Background Data. In validation studies, scales that intend to measure the same variable are compared. Methods. The SF-36, EQ, ODI, and the BIS were filled in by 101 patients before surgical treatment. The comparisons were analyzed by statistical methods that take account of the nonmetric properties of ordered categorical data to obtain reliable results. The level of order-consistency between BIS and comparing items, when present, was calculated. The Spearman rank-order correlation coefficient was also calculated. Results. In the paired comparisons between the BIS pain scales and the other pain scales about 80% units more pairs were ordered than disordered, and the disorder was explained by the discriminating ability of the BIS back and leg pain items. The BIS and ODI items of limitation in walking were comparable, and the assessments of social limitations on the questionnaires were consistent; the disordered pairs being explained by different coverage of activities in the items. The assessments of physical and mental health on BIS were disordered, with the responses in SF-36 in favor of the BIS type of scale categories. The few items and response categories in the EQ did not discriminate the assessments. Conclusion. The BIS assessments can be regarded as being a valid disease-specific questionnaire that provides interpretable information regarding the impact of back end leg pain on well-defined physical, social and mental aspects, and on the quality of life.
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| 184. |
- Svensson, Jard, et al.
(författare)
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Neck-Related Headache in Patients With Cervical Disc Disease After Surgery and Physiotherapy A 1-Year Follow-up of a Prospective Randomized Study
- 2020
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Ingår i: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 45:14, s. 952-959
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. A prospective randomized multicenter trial. Objective. To investigate the effects of surgery with either structured postoperative physiotherapy or standard postoperative approach on neck-related headache in patients with cervical radiculopathy. Secondary, to investigate associations between change in neck-related headache and change in neck muscle endurance, neck mobility, or neck pain. Summary of Background Data. The effect of physiotherapy on individuals with neck-related headache after surgery for cervical radiculopathy due to magnetic resonance imaging-verified disc disease is unknown. Methods. One hundred six patients with neck-related headache and participating in a randomized controlled trial evaluating the additional effects of physiotherapy after surgery for cervical radiculopathy were included. Patients were randomized preoperatively to structured postoperative physiotherapy (n = 51) or the standard postoperative approach (n = 55). Outcome measures were headache intensity and neck pain intensity, neck muscle endurance, and neck mobility. Measures were obtained preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Results. Headache intensity significantly changed from baseline to 1 year postoperatively (P < 0.001) in both groups.Post-hoctests showed a significant difference between baseline and 6 weeks (P <= 0.05). No significant differences were found between groups (P > 0.05) or between-group differences in changes over time (P > 0.05). The change in current headache intensity over time was associated with a change in current neck pain intensity over time (P = 0.003, beta = 0.40). Conclusion. There was a significant improvement in headache intensity 1 year postoperatively in patients with cervical radiculopathy and neck-related headache, but there were no differences between groups over time. Change in current headache intensity was only associated with a change in current neck pain intensity.
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| 185. |
- Sydsjö, Adam, et al.
(författare)
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Gender differences in sick leave related to back pain diagnoses : Influence of pregnancy
- 2003
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Ingår i: Spine. - : Ovid Technologies (Wolters Kluwer Health). - 0362-2436 .- 1528-1159. ; 28:4, s. 385-389
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. A cross-sectional population-based study was conducted. Objective. To investigate the influence of pregnancy on any gender differences in sickness absence related to back pain diagnoses in the group 16 to 44 years of age. Summary of Background Data. Back pain diagnoses are a major reason for sickness absence, especially among pregnant women. There is, however, little knowledge on the extent to which back pain during pregnancy may account for any differences in sickness absence when compared with men and nonpregnant women. Methods. Data on sick leave periods certified by a physician were combined from two research databases: one including all insured persons (n = 50,167) and one including pregnant women (n = 1342) for the duration of 1 year. Results. When pregnant women were subtracted from "all women," nonpregnant women had the same cumulative incidence of sickness absence related to back pain diagnoses as men. Among "all women" sick-listed with back pain diagnoses, 37% were pregnant, a finding not evident from official statistics. Sickness absence increased with age among nonpregnant women and men, but decreased among pregnant women. Conclusions. The proportion of sickness absence related to back pain diagnoses did not differ between nonpregnant women and men ages 16 to 44 years. The importance of back pain diagnosis as a reason for sickness absence may thus be overrated among nonpregnant women.
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| 186. |
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| 187. |
- Söderlund, Anne
(författare)
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The role of educational and learning approaches in rehabilitation of whiplash : Associated disorders in lessening the transition to chronicity
- 2011
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 36:25 Suppl, s. S280-S285
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: The study design was descriptive.OBJECTIVE: The aim of this chapter was to illustrate and discuss educational and learning perspectives in the rehabilitation of patients with acute whiplash-associated disorders (WAD).SUMMARY OF BACKGROUND DATA: WAD is a major problem for the individual and the society. Several treatment options have been studied without giving convincing results for lessening the transition to chronicity. Current management of acute WAD include among other things advice of exercise and educational activities.METHODS: A literature search on the PubMed database was conducted with additional topic discussions with the research colleagues at a symposium. These resulted the present state-of-the-art review.RESULTS: There are several possible cognitive factors and behavioral learning processes such as self-efficacy, fear of movement and (re)injury, and catastrophizing that are important to focus on in decreasing acute WAD to becoming a chronic condition. Learning based on behavioral medicine approach in physiotherapy framework has gained evidence in other musculoskeletal pain conditions.CONCLUSION: Exercise, education, and learning with a behavioral medicine approach should be focused on in the future studies of acute WAD management.
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| 188. |
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| 189. |
- Torén, Leif, et al.
(författare)
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Different Load-Induced Alterations in Intervertebral Discs Between Low Back Pain Patients and Controls
- 2024
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Ingår i: SPINE. - 0362-2436 .- 1528-1159. ; 49:15
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. Prospective cohort study. Objective. Investigate load-induced effects in lumbar intervertebral discs (IVDs) and differences between low back pain (LBP) patients and controls. Summary of Background Data.T2-map values, obtained from quantitative MRI sequences, reflect IVD tissue composition and integrity. Feasibility studies with T2-mapping indicate different load-induced effects in entire IVDs and posterior IVD parts between LBP patients and controls. Larger studies are required to confirm these findings and increase the understanding of specific characteristics distinguishing IVD changes in LBP patients compared with controls. Materials and Methods. Lumbar IVDs of 178 patients (mean age: 43.8 yr; range: 20-60 yr) with >3 months of LBP and 74 controls (mean age: 40.3 yr; range: 20-60 yr) were imaged with T2-map sequence in a 3T scanner in supine position without axial load, immediately followed by a repeated examination, using the same sequence, with axial load. On both examinations, mean T2-map values were obtained from entire IVDs and from central/posterior IVD parts on the three midsagittal slices in 855 patient IVDs and 366 control IVDs. Load-induced effect was compared with Fold-change ratio and adjusted for IVD-degeneration grade. Results. Loading induced an increase in T2-map values in both patients and controls. Excluding most extreme values, the ranges varied between -15% and +35% in patients and -11% and +36% in controls (first to 99th percentile). Compared with controls, the T2-map value increase in patients was 2% smaller in entire IVDs (Fold-change: 0.98, P=0.031), and for central and posterior IVD parts 3% (Fold-change: 0.98, P=0.005), respectively, 2% (Fold-change: 0.9, P=0.015) smaller. Conclusions. This quantitative study confirmed diverse load-induced behaviors between LBP patients and controls, suggesting deviant biomechanical characteristics between IVDs in patients and controls not only attributed to the global grade of degeneration. These findings are an important step in the continuous work of identifying specific IVD phenotypes for LBP patients. Level of Evidence.Level II.
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| 190. |
- Torén, Leif, et al.
(författare)
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MRI During Spinal Loading Reveals Intervertebral Disc Behavior Corresponding to Discogram Findings of Annular Fissures and Pain Provocation. : Torén L, Lagerstrand K, Waldenberg C, Brisby H, Hebelka H.
- 2020
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 45:22
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Retrospective analysis of prospectively collected data. Objective: The aim of this study was to investigate whether spinal loading, depicted with magnetic resonance imaging (MRI), induces regional intervertebral disc (IVD) differences associated with presence and width of annular fissure and induced pain at discography. Summary of background data: Annular fissures play a role in low back pain (LBP) but cannot be accurately characterized with conventional MRI. Recently, annular fissures were suggested to influence different load-induced IVD behavior during MRI when comparing LBP-patients and controls. Thus, the loading effect could characterize behavior related to annular fissures noninvasively with MRI. Methods: Lumbar spines of 30 LBP-patients were investigated with MRI with and without loading, discography and CT. Five IVD regions were outlined on sagittal MRI images. Difference in normalized signal intensity (SI) with and without loading was calculated for each region. Eighty-three CT-discograms were graded regarding presence and width of fissures. Discograms were classified as pain-positive if a concordant pain response was obtained at a pressure <50 psi. Results: Comparing IVDs with outer fissures with IVDs without fissures, loading induced different behavior in the two ventral regions and in the posterior region. Higher SI increase in the central region was induced in IVDs with narrower fissures compared to IVDs with wider fissures. In the group of pain-negative discograms, a SI decrease was induced in the dorsal region whereas lack of such in the pain-positive group. Conclusion: The spinal loading-effect, depicted with MRI, reveals different regional behaviors between IVDs with outer fissures compared to those without, and between IVDs with narrow and broad fissures, as well as within posterior annulus between pain-positive and pain-negative discograms. Findings are of importance for future attempts to uncover phenotypes of painful IVDs.
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