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  • Aasa, Ulrika, et al. (författare)
  • Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not : A Longitudinal Study
  • 2015
  • Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 40:24, s. 1926-1933
  • Tidskriftsartikel (refereegranskat)abstract
    • STUDY DESIGN: Longitudinal design. A cohort followed in 3 waves of data collection.OBJECTIVE: The aim of the study was to describe the relationships between the performance of 2 tests of spinal control at the age of 52 years and low back pain, physical activity level, and fitness earlier in life, as well as to describe the cross-sectional relationships between these measures.SUMMARY OF BACKGROUND DATA: Altered spinal control has been linked to pain; however, other stimuli may also lead to inability to control the movements of the spine.METHODS: Participants answered questions about physical activity and low back pain, and performed physical fitness tests at the age of 16, 34, and 52 years. The fitness test battery included tests of endurance in the back and abdominal muscles, a submaximal bicycle ergometer test to estimate maximal oxygen uptake, and measurements of hip flexion, thoracic spine flexibility, and anthropometrics. Two tests were aggregated to a physical fitness index. At the age of 52, also 2 tests of spinal control, the standing Waiter's bow (WB) and the supine double leg lower (LL) were performed.RESULTS: Logistic regression analyses showed that higher back muscle endurance at the age of 34 years could positively predict WB performance at 52 years and higher physical fitness at the age of 34 could positively predict LL performance at 52 years. Regarding cross-sectional relationships, an inability to perform the WB correctly was associated with lower physical fitness, flexibility and physical activity, and larger waist circumference. An inability to correctly perform the LL was associated with lower physical fitness. One-year prevalence of pain was not significantly associated with WB or LL test performance.CONCLUSION: An active life resulting in higher physical fitness is related to better spinal control in middle-aged men and women. This further strengthens the importance of physical activity throughout the life span.LEVEL OF EVIDENCE: 3.
  • Ahlqwist, Anna, et al. (författare)
  • Physical therapy treatment of back complaints on children and adolescents.
  • 2008
  • Ingår i: Spine. - 1528-1159. ; 33:20, s. E721-7
  • Tidskriftsartikel (refereegranskat)abstract
    • STUDY DESIGN: A randomized controlled trial was performed. OBJECTIVES: To evaluate how 2 different treatment options affect perception of health, pain, and physical functioning over time among children and adolescents with low back pain (LBP). SUMMARY OF BACKGROUND DATA: LBP among children and adolescents has increased. The literature shows that children with LBP also suffer from this condition as adults. Thus, it is important to prevent and treat LBP in children and adolescents. METHODS: Forty-five children and adolescents were consecutively randomized into one of 2 treatment groups and were studied for 12 weeks. Group 1 was given individualized physical therapy and exercise and a standardized self-training program and back education. Group 2 was given self-training program and back education but no individualized therapy. The children and adolescents were tested before and after the treatment period. Child Health Questionnaire Child Form 87, Roland & Morris Disability Questionnaire, Painometer, Back Saver Sit and Reach, and test of trunk muscle endurance were used to evaluate the interventions. RESULTS: Both groups improved statistically significant in most parameters over time. On comparison between the groups the physical function measured by Roland & Morris Disability Questionnaire and the duration of pain measured by Painometer improved statistically significant in Group 1. CONCLUSION: An individual assessment by a knowledgeable physiotherapist and an active treatment model improve how children and adolescents experience their back problems with respect to health and physical function, pain, strength, and mobility, regardless of whether treatment consists of a home exercise program with follow-up or home exercise combined with exercise and treatment supervised by a physiotherapist.
  • Alipour, Akbar, et al. (författare)
  • Four-year incidence of sick leave because of neck and shoulder pain and its association with work and lifestyle
  • 2009
  • Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 34:4, s. 413-418
  • Tidskriftsartikel (refereegranskat)abstract
    • STUDY DESIGN: Four-year prospective cohort study. OBJECTIVE: To find the incidence of sick leave because of neck and shoulder pain (NSP) in industrial workers, and its association with work and lifestyle risk factors. SUMMARY OF BACKGROUND DATA: Longitudinal studies to investigate NSP incidence and risk factors are rare, and even fewer have been conducted in middle- and low-income countries. METHODS: After inviting all full-time employees of an Iranian car manufacturing company with 18,031 employees to participate in a baseline study, they were followed for 4 years. New episodes of sick leave because of NSP have been calculated based on sickness absence registration between the years 2003 and 2007. The incidence was compared for participants and nonparticipants. The association between sick leave, physical, and psychosocial risk factors at work, and previous self-reported NSP, was calculated for the remaining population of baseline participants (12,184 employees) during a 4-year follow-up. RESULTS: During a 4-year follow-up of study subjects for the remaining participants of the baseline study, the incidence of sick leave was 0.8% (98 sick leave cases in 12,184 employees). For nonparticipants this incidence was 4.2% (130 cases in 3127 employees). In the final regression model for sick leave cases, the remaining factors for potential physical risk factors were repetitive work and sitting positions at work; for psychosocial factors unattractive work was the only significant remaining factor. CONCLUSION: The incidence of NSP based on sick leave is definitely very low compared with previous studies in high-income countries. This incidence varies between participants and nonparticipants. Risk factors for sick leave differ from risk factors for self-reported pain. A young population, job security, the insurance system, different health behaviors, and healthy worker bias, are all factors that may affect the results, and sick-leave as an outcome must be interpreted with more caution in middle- and low-income countries.
  • Andersson, Eleonor I., et al. (författare)
  • Performance Tests in People With Chronic Low Back Pain Responsiveness and Minimal Clinically Important Change
  • 2010
  • Ingår i: Spine. - : J B Lippincott Co. - 0362-2436 .- 1528-1159. ; 35:26, s. E1559-E1563
  • Tidskriftsartikel (refereegranskat)abstract
    • Study Design. Cohort study. Objective. To assess the responsiveness and minimal clinically important change (MCIC) of 6 commonly-used performance tests (5-minute walking, 50-ft walking, sit-to-stand, 1 minute stair climbing, loaded forward reach, Progressive Isoinertial Lifting Evaluation). Summary of Background Data. Performance tests are used to evaluate physical function in people with low back pain. Little is known about their clinimetric properties. Methods. Performance tests were administered in people with chronic nonspecific low back pain (n = 198) before and after 10 weeks of treatment. At 10 weeks, the global perceived effect scale was used to determine if participants judged themselves as worsened, unchanged, or improved. The mean change scores for each performance test were calculated. A performance test was considered responsive if the area under the receiver operating characteristic curve (AUC) was equal to or greater than 0.70. We used 2 methods to evaluate MCIC: the optimal cut-off point based on the receiver operating characteristic curve, which takes into account both sensitivity and specificity, and the minimal detectable change for improvement, which considers test specificity only. Results. In general, the mean change scores were the smallest in participants who judged themselves worsened and largest in those reporting to be improved. Sit-to-stand (AUC = 0.75) and stair climbing (AUC = 0.72) were the only performance tests that showed adequate responsiveness. For sit-to-stand, the MCIC ranged from 4.1 to 9.8 seconds (19%-45% of the mean baseline score). For stair climbing, the MCIC ranged from 14.5 to 23.9 steps (19%-31% of the mean baseline score). Conclusion. Only 2 of the 6 performance tests were responsive. Both had acceptable MCIC values. Developing individualized performance tests might partly overcome the general lack of responsiveness of performance tests. Future research should focus on the clinimetric testing of performance tests in subgroups.
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