Dissertations / Theses on the topic 'Chronic lower back pain'
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1
Shojaei, Iman. "LOWER BACK BIOMECHANICS AT NON-CHRONIC STAGE OF LOW BACK PAIN." UKnowledge, 2018. https://uknowledge.uky.edu/cbme_etds/52.
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Prior studies have reported differences in lower back biomechanics during activities of daily living between individuals with and without chronic low back pain (LBP). Nevertheless, the literature on lower back biomechanics of patients with non-chronic LBP is scant. Therefore, the objective of this study, as the first step towards future prospective studies, was to investigate the lower back biomechanics in patients with non-chronic LBP. Case-control studies were conducted wherein measures of lumbo-pelvic coordination during bending and return tasks as well as measures of mechanical demand on the lower back during lifting tasks in the sagittal plane were investigated between patients with non-chronic LBP and matched asymptomatic individuals. Patients were enrolled into the study at the non-chronic stage of their LBP. We found distinct difference in measures of lumbo-pelvic coordination as well as mechanical demands on the lower back between patients with non-chronic LBP and controls. Reduced lumbar range of flexion and slower task pace as well as the more in-phase and less variable lumbo-pelvic coordination observed in patients with non-chronic low back pain, may be the result of a neuromuscular adaptation to reduce the forces and deformation in the lower back tissues and avoid pain aggravation. Such a neuromuscular adaptation, however, resulted in a larger shearing demand on the lower back. Persistent abnormal lumbo-pelvic coordination might play a role in transition to chronic stage or recurrence of LBP. However, such inferences need to be further investigated using prospective studies as well as clinical trials involving a combination of physical and psychological treatments aimed at correction of lumbo-pelvic coordination.
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Lewis, Grant. "Incidence, prevalence and aetiology of chronic exercise induced lower back pain in runners." Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/26924.
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The aim of this study was to determine the prevalence of lower back pain (LBP) in the running population and any initiating or aggravating factors. The aetiology of low back pain in runners was also investigated. A random sample population of 225 roadrunners were interviewed following the completion of six local road races. A further subgroup (n = 52) (LBP group as well as control group) of these runners was evaluated to determine if there were any biomechanical; muscle strength, flexibility and stability measures; as well as any training protocols which were more commonly associated in those runners who complained of LBP. Questionnaires were completed by 225 runners and a detailed clinical evaluation was performed to identify the incidence and aetiology of running-related lower back pain. Attention was focussed on the lumbar-pelvic muscles in terms of their flexibility, strength and coordinating ability as well as static biomechanical measures of the lower limb. LBP in runners was found to be common with an injury risk of 1.42 injuries per 1000 running hours. This running-related LBP seldom forced the athlete to stop running yet did affect running performance. It was associated with any increase in the running load. Hip flexor inflexibility on the left (p = 0.07); short hip adductor muscle length (p = 0.055), hamstring inflexibility (p = 0.09) and iliotibial band inflexibility (p = 0.036) on the right were found to be more common in the LBP group. The abdominal muscles were weaker in the LBP group when assessed in the trunk curl-up test (p = 0.0085) and the stabilising ability (p = 0.032) for this group was judged to be poor. Biomechanically, only a marginal difference was found between those with and without LBP (p = 0.077) with regard to the hindfoot and forefoot postures which were valgus and varus respectively for the lower back pain group. Lumbar intervertebral joints were mostly hypomobile (p = 0.004) in the LBP group. Adherence to a poor training regime (excessive running distances and frequencies) was associated with the LBP group. Attention to correct training patterns and adequate muscle control (strength, coordination and flexibility) is suggested to protect from this running-related LBP. Further research into a comparison of rehabilitation protocols is required to validate these findings.
3
Wohlman, Michael Avron. "A cognitive behavioural treatment program for chronic lower back pain: a case study approach." Thesis, Rhodes University, 2000. http://hdl.handle.net/10962/d1002596.
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A cognitive behavioural treatment program for chronic lower back pain was designed, implemented and evaluated. The outpatient treatment program included education sessions, goal setting, graded activity training, physical exercise, relaxation training, cognitive techniques, social skills training, and medication reduction. Three participants volunteered to participate in the eightweek treatment program. Of the three participants, only one completed the program successfully. The results were used to critically discuss and evaluate the literature. The successful participant showed significant improvement in activity levels, decrease in subjective levels of pain, as well as decreased levels of anxiety and depression. It was shown that correcting cognitive distortions (e.g. selective abstraction, catastrophising, misattribution) and challenging early maladaptive schemas of abandonment, emotional deprivation and emotional inhibition (Young, 1990) assisted in enhancing coping mechanisms and the belief that the pain episodes would be short-lived and could be controlled. There was considerable improvement for the second participant, although he chose to withdraw from the program prior to its completion. The components of the psycho-education, relaxation and stress management and exercise program were beneficial for him. The third participant failed to accept the treatment formulation, and did not engage collaboratively in the treatment program. The case is presented as a point for examining therapeutic ailures.
4
Pretorius, Tammy-Lee. "A combination of a physiotherapy and cognitive behavioural therapy in the treatment of non-specific chronic lower back pain: A systematic review." University of the Western Cape, 2019. http://hdl.handle.net/11394/7054.
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Magister Scientiae (Physiotherapy) - MSc(Physio)Evidence indicates that the current physiotherapy management of patients with chronic non-specific LBP only offers moderate benefit. Combined treatment programmes, addressing body as well as the mind, shows promising results in developed countries with adequate resources but low evidence in poorly-resourced countries and contexts. This is another gap in the existing knowledge. The study aimed to evaluate the effectiveness of a combined physiotherapy and cognitive-behavioral therapy treatment, compared to physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behavior, in adults with non-specific low back pain. The systematic review included articles published, in English only, between 1985-2018 (July) in the following databases available at the University of The Western Cape: EbscoHost, BioMedCentral, Cambridge Journals Online, CINAHL, Cochrane Library, Medline (EbscoHost), Medline (Pubmed), Sabinet Reference, SAGE Journals Online, ScienceDirect,SciFinder Scholar, SCOPUS, Wiley Online Library, Springerlink and PubMed.Two reviewers independently evaluated the methodological quality of full text articles, using a critical appraisal tool. Fourteen (14) articles were included based on methodological rigour. Five (5) articles were included in the narrative synthesis and nine (9) articles were included in the meta-analyses. Statistically significant improvements in pain, disability and mental health, in favour of combination therapy for patients with chronic lower back pain were found. A small but statistically significant cumulative effect size for mental health (g = -0.26, Z = -4.49, p <.01) , physical disability (g = -0.27, Z = -5.09, p <.01) and pain (g = -.27, Z = -5.05, p <.01) , in favour of a combination of cognitive behavioural therapy and physiotherapy in patients with chronic lower back pain was found. In addition, a medium but statistically significant cumulative effect size (g = -0.50, Z = -6.95, p <.01), in terms of fear avoidance, was found in favour of the combination therapy. In conclusion, physiotherapy in combination with cognitivebehavioral therapy was more effective than physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behaviour, in adults with non-specific low back pain. Ethics: Permission for the study was obtained from the university’s Biomedical Research Ethics Committee.
5
Sritoomma, Netchanok. "The Effectiveness of Swedish Massage with Aromatic Ginger Oil in Treating Chronic Low Back Pain in Older Adults: A Randomised Controlled Trial." Thesis, Griffith University, 2013. http://hdl.handle.net/10072/365714.
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Chronic low back pain is a common and major health issue, with a high rate of chronic low back pain (CLBP) in older adults. This pain has an impact on functioning, health-related quality of life and the cost of healthcare. Complementary and alternative medicine (CAM) therapies have been employed to manage low back pain, with massage the most popular CAM therapy for this purpose. Swedish massage (SM) and Traditional Thai massage (TTM) appear to relieve lower back pain but their relative effectiveness has not been clearly established. In this study, an essential oil was used to prolong the effects of Swedish massage. Ginger is one of the most popular herbal remedies as it is used as an anti-inflammatory and anti-rheumatic for musculoskeletal pain. However, no study has examined the use of aromatic ginger oil to treat CLBP, and there are also a number of limitations in the research design of reported massage and/or aromatic ginger oil studies.
This study aimed to investigate the effectiveness of Swedish massage with aromatic ginger oil (SMGO) in treating CLBP in older adults compared to TTM in terms of reduction of CLBP intensity, disability improvement, reduction of depression and improvement of quality of life among a group of 140 older people in Thailand experiencing CLBP.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Forsell, Albin. "Det blir nog inte bra ändå - Förväntningar på återhämtning, smärtkatastrofiering och vägen till kronisk ryggsmärta." Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-52070.
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Harman, Katherine. "Sleep and chronic low back pain." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ26854.pdf.
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Sudwell, Mark Ian. "Chronic back pain : a narrative analysis." Thesis, University of Exeter, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367457.
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Harman, Katherine (Katherine Maureen) Carleton University Dissertation Psychology. "Sleep and chronic low back pain." Ottawa, 1997.
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Armstrong, Mary P. "Chronic low back pain : effectiveness of pain management programmes." Thesis, University of Ulster, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273038.
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Maeda, Fernando Lourenço. "Investigando a participação do cônjuge nos cuidados ao paciente com dor lombar crônica." Pontifícia Universidade Católica de São Paulo, 2008. https://tede2.pucsp.br/handle/handle/15728.
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This study had as general goal investigate the perception of partner s support and the impact of the pain in the relationship as a couple of patients suffering of chronic lower back pain, of both gender, in ambulatory treatment in a big public hospital of São Paulo city. The study was made with 50 patients, where 25 were men and 25 were women, aged 35 to 65 years. The main used instruments were: social-demographic questionnaire, visual analogical scale of pain intensity, medical Outcomes study 36- item short form-health survey and semi directed interviews. The results demonstrated that all the participants of the study had the quality of their lives harmed, and that women showed intensity pain levels considered severe, whereas men obtained intensity pain levels considered moderate. 70% percent of the sample mentioned a negative impact on their sexual relations, due to their functional limitation and intensity of the pain, while the rest mentioned a marital adjustment when facing the symptoms of the pain. 86% of the sample mentioned perceiving their partners as supportive, being the helpful behavior considered the main way of support. The analysis of the results showed that the participants that had received partner s support, obtained better levels in the control of Vitality and Mental Health, when compared to the ones that had had no support. The conclusion of the results indicated that the chronic lower back pain causes a negative impact in the couple s relationship and that the partners support can work as a protection factor for depressive and anxiety symptoms, being this an important aspect to be considered in the health process of individual with chronic pain and in the planning of therapeutic procedures
Este estudo teve como objetivo geral investigar a percepção de apoio conjugal e o impacto da dor no relacionamento de casal de pacientes portadores de dor lombar crônica, de ambos os gêneros, em tratamento ambulatorial em um hospital de grande porte da rede pública da cidade de São Paulo. O trabalho foi realizado com 50 pacientes, sendo 25 homens e 25 mulheres, com faixa etária entre 35 e 65 anos. Os principais instrumentos utilizados foram: Questionário Sócio-demográfico, Escala VAS de intensidade da dor, Questionário de Qualidade de Vida SF 36 e Entrevista Semi-dirigida. Os resultados demonstraram que todos os participantes do estudo obtiveram qualidade de vida prejudicada, sendo que as mulheres apresentaram intensidade de dor considerada severa, enquanto os homens obtiveram intensidade de dor moderada. 70% da amostra relataram impacto negativo no relacionamento sexual, em decorrência da limitação funcional e gravidade da dor, enquanto que o restante referiu um reajustamento conjugal frente aos sintomas da dor. 86% da amostra relataram que percebem seus cônjuges como apoiadores, sendo que o comportamento solícito foi considerado o principal meio de apoio. A análise dos resultados demonstrou que os participantes que receberam apoio do cônjuge, obtiveram melhores índices nos domínios Vitalidade e Saúde Mental, quando comparados com aqueles que não receberam apoio. A conclusão dos resultados indicou que a dor lombar crônica causa impacto negativo no relacionamento de casal e o apoio conjugal pode funcionar como fator de proteção para sintomas depressivos e de ansiedade, sendo este um aspecto importante a ser considerado no processo da saúde dos indivíduos com dor crônica e no planejamento de condutas terapêuticas
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Seidler, Anna Lene, Constanze Rethberg, Jochen Schmitt, Albert Nienhaus, and Andreas Seidler. "Health utilities for chronic low back pain." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-230878.
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Background
Chronic low back pain (LBP) is a common health problem, with a large potential for primary prevention. Health utilities (HU) reflect which proportion of their expected remaining life time individuals would hypothetically trade to be alleviated of a health condition of interest. A value of 0 means “prefer to die immediately”, a value of 1 means “not willing to trade any life time”. The aim of this cross-sectional study was to assess HU for LBP patients and for healthy participants and to examine whether HU for LBP are useful indicators to substantiate preventive and therapeutic decision making.
Methods
Healthy participants (n = 126) and LBP patients (n = 32) were recruited mainly among the employees of a tertiary care hospital in Germany. Standardized LBP scenarios were presented to all participants and HU values were assessed using the time-trade-off method.
Results
Median HU for LBP were 0.90 (IQR 0.31) for participants and 0.93 (IQR 0.10) for LBP patients. Measurements were consistent across illness severity ratings with HU and with a visual analogue scale (VAS); in the healthy sample the intraclass correlation coefficient (ICC) was 0.61 (95% CI 0.23–1.00, F(1125) = 190, p < .001), in the patient sample the ICC was 0.66 (95% CI = 0.24–1.00, F(1,31) = 62, p < .001). 8% of participants reported HU of 1. There was no statistically significant relation between HU and age, income, or gender.
Conclusion
On average, participants chose a 7 to 10% shorter life expectancy to avoid LBP, but almost 1 in 10 participants were not willing to trade any life years. The results indicate a certain stability of HU due to the comparability of HU ratings across patients and healthy participants, the measurement consistency when comparing VAS and HU ratings, and the lack of association between demographic variables and HU. This underlines the usefulness of HU for measuring illness severity in comparative health economics evaluations of preventive and therapeutic measures that address chronic LBP or other pain-characterized diseases. Future studies should focus on different LBP intensities and derive stratified HU that reflect the distribution of pain intensity in the population.
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Holmes, Steve Anna Louise. "Information processing bias in chronic pain." Thesis, University of Southampton, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369878.
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Newton, Mary. "Assessment and rehabilitation of chronic low back pain." Thesis, University of Glasgow, 1996. http://theses.gla.ac.uk/4250/.
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This thesis presents a set of studies which investigated chronic low back pain. The specific aim of this thesis was to develop reliable methods for the assessment and rehabilitation of chronic low back pain. The two assessment methods tested were a broad based clinical evaluation and an isokinetic assessment of trunk muscle strength. The first part of the thesis describes the reliability and validity studies of the clinical methods for measuring trunk mobility, trunk muscle strength, spinal shape and palpation. A total of 27 physical tests were studied using 70 patients and 10 normal subjects. Twenty-three of these tests were found to be reliable and were incorporated into the isokinetic assessment study. The second part of the study reports the standardisation and reliability studies for the isokinetic assessment of trunk muscle strength in 70 normal subjects and 120 patients with chronic low back pain. The results showed that the main isokinetic measures were reliable for both normal subjects and patients. There was a significant learning effect from test 1 to test 2 in both normal subjects and patients. The magnitude of this learning effect was greater in patients than normal subjects. The normal subjects were followed up by a postal questionnaire in a two year prospective study to predict future back pain using the isokinetic measures. None of the measures used showed any significant differences between those subjects who developed back pain and those who did not. The third part of the thesis describes studies to develop a rehabilitation programme for patients with chronic low back pain using the isokinetic machines, both as a means of monitoring progress and as an exercise regime. The first study of 26 patients indicated that the programme was safe and effective, but also revealed a major problem with adherence to a six week exercise programme. The second study investigated the problem of adherence and examined the time course of response to isokinetic exercise by repeating the tests at three weeks and six weeks.
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Hinnant, Donald Wayne. "Cognitive Coping Strategies with Chronic Back Pain Patients." Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331556/.
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Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients who relied on dramatized coping strategies were less likely to be successful in treatment. Breathing activity and pain acknowledgement were positive coping techniques highly predictive of successful outcome in this study. The use of computers for assessment and other recommendations for future research were discussed.
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Cooper, Nicholas A. "Gluteus medius dysfunction in chronic low back pain." Diss., University of Iowa, 2017. https://ir.uiowa.edu/etd/5445.
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Low back pain is a common but severe health problem. Chronic low back pain accounts for the bulk of the burden of low back pain. Exercise interventions are effective in the management of chronic low back pain. Current clinical thinking in physical therapy treats low back pain as a heterogeneous entity seeking to match specific interventions to subpopulations. None of these subgroups assess the role of gluteus medius dysfunction in chronic low back pain. These projects seek to describe the prevalence of gluteus medius weakness in people with chronic low back pain and test the effectiveness of a gluteus medius strengthening exercise intervention in people with chronic low back pain.
Gluteus medius strength was assessed in 150 people seeking care for chronic low back pain and 75 healthy people without low back pain. Gluteus medius was found to be weaker on affected sides compared to unaffected sides within people with chronic low back pain and weaker than people without low back pain. Gluteus medius weakness was a strong predictor of the presence of low back pain.
A gluteus medius strengthening program was compared with lumbar stabilization exercises in 56 people with chronic low back pain. Although there was a clinically significant improvement in pain in people who performed the gluteus medius strengthening exercise program, this was not significantly different from the stabilization exercise intervention. Adherence to exercise was significantly correlated with reduction in pain and perceived improvement of low back pain.
Although gluteus medius weakness is common in people with low back pain and treating this weakness with a targeted exercise intervention is effective, it is not better than a standard stabilization exercise intervention. Doing exercise is likely more important than what exercise is done.
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Trost, Zina. "Correction of Pain Expectancies Following Exposure to Movement in Chronic Back Pain." Ohio University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1216157547.
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Boyd, Kelly. "Chronic low back pain: exploring trends and potential predictors." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=123222.
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Context: Hundreds of thousands of Quebec residents suffer from chronic pain, for which treatment is far from optimal. Despite low back pain being the second most common reason to visit a primary care physician, management remains challenging. Additionally, chronic low back pain (CLBP) has been found to be the most common reason for patients to be referred to tertiary pain centers. Recently, there has been an increasing acceptance that bio-psycho-social factors play a crucial role the clinical course of CLBP. Objectives: The purpose of this study was to identify subgroups of CLBP patients treated in tertiary care, as defined by their changes in pain and disability over time, and to explore possible characteristics associated with these changes. Specific objectives were: 1) to establish whether there are distinct subgroups of patients with CLBP with different characteristics associated with change in pain and disability at 6, 12, and 24 months following an initial visit in a tertiary pain clinic; and 2) to identify potential social, psychological, biological, and environmental factors that may predict their responses in pain intensity and disability in accordance with the Revised Wilson and Cleary Model for Health-Related Quality of Life. Design: Observational prospective design to follow a cohort of patients who were enrolled in the web-based Quebec Pain Registry. Setting: The Quebec Pain Registry, a research database comprised of close to 5000 chronic pain patients. Eligible participants included all patients who 1) have been diagnosed with lumber without radicular pain, LBP (diagnostic code 3.1), lumbar & radicular pain, LRP (diagnostic code 3.2), or diffuse lumbar pain, DLP (diagnostic code 3.4), 2) who provided written consent for their data to be used for research purposes, and 3) have completed their initial visit to the pain clinic by May 31, 2011. Intervention: The data required for this project had previously been collected and entered in the Quebec Pain Registry. Basic descriptive results were produced using SAS® software 9.2. This analysis described the characteristics of the 917 patients included in the study at baseline. Additional data were explored to examine patterns of changes over two years for certain characteristics. A generalized estimating equations model (GEE) was used to analyze data at 6, 12, and 24 months after the initial visit. Results: 299 (32.6%) patients were diagnosed LBP, 522 (56.9%) with LRP, and 96 (10.4%) with DLP. In general, all patients were relatively comparable in terms of their characteristics with the exception of DLP, where proportions were noticeably different. Patients diagnosed with DLP had a higher pain duration median (6.0 years) and the most frequently current employment status was permanent disability (both in regards to proportions). The most common ethnicity was Caucasian among all diagnoses. Income was similarly distributed among all groups and secondary school was the highest level of education completed for all. The top three medical conditions reported other than CLBP were rheumatoid arthritis/osteoarthritis, hypertension, and depressive disorders. DLP patients reported "accident at work" as the most common circumstance surrounding their onset of pain. DLP also had noticeably different mean scores for average pain, worst pain, depression, catastrophizing, disability, mental and physical summary scores on the health-related quality of life questionnaire at baseline, 6, 12, and 24 months (in regards to proportions). Patients with higher worst pain scores, longer pain duration, and lower physical summary scores at the initial visit were significantly less likely to show improvements in pain intensity and disability at six and 12 months. Conclusions: Although modifying the analysis prohibited conclusions for a two-year follow to be made, characteristics, such as worst pain, pain duration, and lower physical summary scores at both six and 12 months were discovered.Contexte: Des centaines de milliers de résidents du Québec souffrent de douleurs chroniques. En dépit de la douleur au bas du dos étant la deuxième cause la plus fréquente de consulter un médecin de soins primaires. . Récemment, il y a eu une acceptation croissante que les facteurs bio- psychosociale (biologiques, psychologiques et sociaux ) jouent un rôle crucial de l'évolution clinique de la lombalgie chronique , mais peu de recherches concernant la lombalgie chronique ont étés achevé plus d'un an . Objectif: Les objectifs spécifiques sont : 1) d'établir s'il existe des groupes distincts de patients atteints de lombalgie chronique avec des caractéristiques de réponse à 6, 12 et 24 mois après la visite initiale, et 2) pour identifier le potentiel social, psychologique, biologique et environnemental caractéristiques, conformément à la modèle révisée Wilson et Cleary pour la qualité liée à la santé de la vie. Conception: analyse prospective d'une cohorte historique. Cadre: Le Registre québécois de la douleur, une base de données de recherche unique composée de près de 5000 patients souffrant de douleurs chroniques de centres de la douleur tertiaires. Participants: adultes diagnostiqués avec la douleur chronique au bas du dos qui sont inscrits dans le registre de la douleur Québec. Les participants admissibles inclus tous les patients qui ont été diagnostiqués avec le bois sans douleur radiculaire , LBP (code de diagnostic 3.1), lombaire et douleur radiculaire , LRP (code de diagnostic 3.2) , ou une douleur lombaire diffuse , DLP (code de diagnostic 3.4) et ont terminé leur formation initiale visite à la clinique de la douleur avant le 31 mai 2011. Intervention: Les données nécessaires à ce projet avaient déjà été recueillies et consignées sur le registre de la douleur Québec. Résultats descriptives de base ont été produites en utilisant SAS ® 9.2 logiciel. L'analyse descriptive a décrit les 917 patients inclus dans l'échantillon de l'étude au départ, générant des scores moyens. Des données supplémentaires ont été explorées pour observer des modèles sur deux ans pour certaines caractéristiques. Un modèle des équations d'estimation généralisées (GEE) a été utilisé pour analyser des données corrélées à six, 12 et 24 mois. Résultats: 299 (32.6%) patients ont été diagnostiqués LBP, 522 (56.9%) avec LRP, et 96 (10.4%) avec DLP. En général, tous les diagnostics étaient comparables à l'exception de DLP. Les patients diagnostiqués avec DLP avaient une durée médiane de la douleur plus élevé (6,0) et l'invalidité permanente le plus fréquemment rapporté pour le statut actuel de l'emploi. L' ethnie la plus fréquente était de race blanche parmi tous les diagnostics . Le revenu a été distribué similaire dans tous les groupes, et à l'école secondaire était le plus haut niveau de scolarité atteint pour tous. Les trois conditions médicales rapportées étaient la polyarthrite rhumatoïde / arthrose, l'hypertension et les troubles dépressifs. DLP patients ont signalé « accident du travail » comme circonstance la plus courante qui entoure leur apparition de la douleur. DLP a également indiqué sensiblement différents scores moyens pour la douleur moyenne, pire douleur, la dépression, catastrophisme, le handicap, le score résumé mental, et le score résumé physique au départ, 6, 12 et 24 mois. Les patients ayant les plus mauvais scores de la douleur, la durée de la douleur plus élevé, et des scores plus bas sommaires physiques étaient significativement moins susceptibles de montrer des améliorations dans la douleur et le handicap à six et 12 mois. Conclusions: Bien que la modification des conclusions interdites d'analyse pour un suivi de deux ans à faire, des caractéristiques importantes telles que la pire douleur, la durée de la douleur, et les scores sommaires physiques inférieurs aux deux six et 12 mois ont été découverts.
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Renzhofer, Holly T. "Proceeding with Caution: The Medicalization of Chronic Back Pain." University of Toledo / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1279162445.
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Goldby, Lucy. "The physiotherapy management of chronic low back disorder." Thesis, University of Brighton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251746.
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Musculoskeletal physiotherapy is the most common intervention for chronic low back disorder. Any observation on clinical practice or investigation into the clinical and scientific literature indicates that musculoskeletal physiotherapy encompasses a plethora of treatment modalities and approaches. The aim of the present investigation was to determine the most common intervention(s) that comprise musculoskeletal physiotherapy and to critically explore their empirical therapeutic basis. Two components were highlighted as the most frequently employed interventions; namely manually applied therapy (manual therapy) and exercise(s) to rehabilitate the lumbar spine's stabilising system. In the course of an extensive literature search, work was uncovered that suggested that the mechanisms required for spinal stability could be better facilitated using methods other than those in current clinical use. These discoveries culminated in the creation of a ten-week rehabilitation programme which was primarily developed to facilitate rehabilitation of spinal stabilisation but also permitted an empirical analysis of this component of musculoskeletal physiotherapy. The efficacy of the regime was then assessed in comparison to manual therapy and to a control (an education booklet) in a randomised controlled trial. Following a series of pilot studies, 300 patients with chronic low back disorder were randomly assigned to groups and completed their respective management programmes. Data were collected on pain, disability, handicap, impairment and quality of life prior to entry and at three, six, twelve and twenty-four months post intervention. The results indicated a consistent trend for greater improvement in the spinal stabilisation group in the pain, handicap, impairment, disability, dysfunction and medication variables. These trends reached statistical significance at the three-month follow-up stage as evidenced by quality of life (P = 0.025), at the six-month follow-up stage in pain (P = 0.009) and dysfunction (P = 0.042) and at the one-year follow-up stage in medication (P = 0.007), dysfunction (P = 0.048), disability (P = 0.0098) and quality of life (P = 0.003). It was therefore concluded that the spinal stabilisation programme was a more effective component of musculoskeletal physiotherapy (when analysed in isolation) than manually applied therapy or an education booklet in the management of chronic low back disorder. Various sub-analyses of the data were conducted. Subjects who entered the study with high levels of low back pain (greater than 50 numerical rating scale) demonstrated a statistically Significant reduction in pain levels (P = 0.04) in both the manual therapy group and the spinal stabilisation group in comparison to the education control group at the three-month follow-up stage. These data provide empirical evidence towards the efficacy of these two musculoskeletal physiotherapy management regimes as being effective in pain reduction in comparison to an active control intervention. This has not hitherto been demonstrated on patients with chronic low back disorder.
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Gregory, Erik W. "Whole-body vibration and the lower back the effect of whole-body vibration on pain in the lower back /." Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1714.
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Thesis (M.S.)--West Virginia University, 2000.Title from document title page. Document formatted into pages; contains vii, 81 p. : ill. Includes abstract. Includes bibliographical references (p. 44-46).
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White, Susan Patricia, and res cand@acu edu au. "The Inside Story of Living With Chronic Intractable Nonmalignant Back Pain: An autoethnography." Australian Catholic University. School of Nursing and Midwifery, 2007. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp185.28112008.
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The aim of this study was to uncover and understand the reality of living with chronic, intractable nonmalignant back pain, as it is understood by sufferers themselves. A narrative autoethnographic research design was chosen, enabling me to interact with participants during the interview process, as well as have the opportunity to further explore my own experiences, as a long time sufferer of chronic, intractable nonmalignant back pain. Thematic analysis of participant interviews, and a deep, introspective scrutiny of my own journey, resulted in four stories being written. These stories illustrate the startlingly similar experiences we share. Although each story is written around one central character, they are in fact composite characters, representing the participants’ experiences as well as my own. The stories are: ‘The merry-go-round: Searching for a cure’, describing the endless visits to various specialists, in search of the elusive ‘cure’. ‘Mourning the loss’, illustrating the grief-like process we must go through when it becomes apparent that a cure is not possible and pain will be with us for the rest of our lives. ‘Walk a mile in my shoes’, giving a snapshot of issues facing us in our daily lives, and ‘Here we go again’, a description of a ‘typical’ pain management hospital stay. A fifth story, ‘We’re not in Kansas anymore’, was added following a bizarre emergency admission I was forced to endure during the course of my research. It is therefore a story where I am the central character. These stories illustrate the impact chronic back pain has on a sufferer’s life, ranging from loss of mobility to an altered body image. They also illustrate the struggle to maintain normality, including masking the pain and facing labelling and stigma. These stories identify and demonstrate the often hidden aspects of chronic intractable back pain, and have the power to inform practicing nurses, students, teachers and the community of the ‘lived experience’.
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Hyde, Susan Ann. "Facial expressive behaviour of a chronic low back pain population." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/27113.
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Assessment of the subjective experience of pain represents an ongoing concern in clinical, experimental and natural settings (Melzack, 1983). Previous laboratory studies (Craig & Patrick, 1985; Patrick, Craig & Prkachin, in press) using induced pain have suggested that facial expressive behaviour may provide a useful source of information additional to that offered by self-report in assessing the pain experience. There are, however, problems associated with the use of such behaviour, these being related to the issue of the voluntary and involuntary control that individuals have over their facial behaviour.
The present study attempted to extend the findings of the earlier analogue research using a clinical sample of chronic low back pain patients. Self-report of pain was also investigated as were several variables of clinical interest, i.e., duration of complaint and disability status. An attempt was made to overcome the tendency of people to attenuate their facial expressiveness in the presence of others scrutinizing the behaviour. Finally, the ability to control facial expression of pain was also investigated by requesting subjects to mask their facial expression during a painful movement and by requesting them to pose an expression of painful distress.
Subjects (60 male and 60 female patients at the Shaughnessy Hospital Back Pain Clinic) underwent a standardized physiotherapy protocol of four movements designed to induce low back or hip joint pain. Half of the subjects of each sex were given a set of instructions designed to enhance their overall global expressiveness. All subjects rated their acute discomfort as well as their more chronic discomfort as experienced on a "typical" basis. Subjects' facial expressions were videotaped during the standardized protocol and subsequently scored by two independent sets of coders using the Facial Action Coding System (Ekman & Friesen, 1978b) and using a global expressiveness rating system.
It was hypothesized that if the Instructional Set manipulation was successful then those subjects receiving the instructions would be rated as more globally expressive than those who did not receive instruction. It was also hypothesized that greater facial activity would be present in the posed expression of painful distress than in the genuine and masked displays.
A positive, albeit modest, relationship was found to exist between facial activity and self-report. This desynchrony between behaviour and self-report is common in the literature (Fordyce et al. 1984). The manipulation to enhance the global expressiveness of the subjects was unsuccessful. Males and females differed marginally, however, in terms of judges' ratings of global expressiveness with females being rated as more expressive. This difference was also discussed in light of the absence of a sex difference on the FACS variables.
Subjects were somewhat successful in deliberately attenuating their facial activity during a painful movement.
It was concluded that future research should focus on further investigation of the existence of configurations of facial actions expressive of pain, any one or more of which might be-displayed, rather than pursuing the existence of a prototypical pain expression. It was suggested that a prototypic expression might be more characteristic of a posed display and further research could investigate this possibility.Arts, Faculty of
Psychology, Department of
Graduate
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Sokunbi, Oluwaleke Ganiyu. "Effects of stabilisation exercise on subclinical chronic low back pain." Thesis, University of Brighton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.436801.
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This was a mixed method study incorporating a randomized controlled trial (RCf) and focus group interviews to explore the effects of spinal stabilization exercises on sub-clinical chronic low back disorders and participants' perceptions of this type of treatment programme. Eighty four participants (34 males and 50 females) in the RCf were randomly allocated to control (no exercise) or exercise treatment groups in which they carried out stabilization exercises at different frequencies i.e. once weekly, twice weekly or three times weekly. Outcome measures used in the RCT were plasma serotonin concentration measured using an enzyme linked immunoassay technique, multifidus cross sectional area measured with diagnostic ultrasound imaging, pain intensity measured with numeric rating scale, functional disability measured with the Roland- Moris Disability Questionnaire and quality of life measured with Nottingham Health Profile. Data were collected at baseline, after six weeks of intervention and at 18 weeks follow up assessments. The results of the RCf showed that spinal stabilization exercises produced a significant increase in plasma serotonin concentration by 17.8% at all stages of data collection in all the exercise groups. All the participants in the treatment groups experienced significant reduction, by more than SO %, in pain and functional disability and improvement by more than 50% in quality of life scores after six weeks of treatment (P <0.05). The extent of reduction in pain and functional disability scores and improvement in quality oflife showed a clear trend in favour of the three times weekly exercise group at 18 weeks follow up assessments. Significant increase in the size of multifidus cross sectional area was observed only in the three times weekly exercise group (P <0.05). A linear regression analysis showed significant correlation between the changes in plasma serotonin and each of pain, functional disability and quality of life scores. (r values ranged from 0.42 to 0.67, P < 0.05). Following the RCf, nine participants (3 males and 6 females) took part in two focus groups interviews. Open ended questions were used to maximize discussion. Audio recording was used to record participant's opinions during the interview process. Careful checking, reading, and correction of the transcripts was carried out and a thematic analysis was conducted on the data. The main themes that emerged from the data analysis from the focus group interviews were: • Participants' perception of the causes and aggravating factors for their low back disorders. • Physical dimensions of participants' experience of low back disorders. • Emotional and psychological dimensions of participants' experience of low back disorders. • Perceived treatment effects on pain intensity and functional limitation. • Impact of the treatment programme on participants' empowerment and self efficacy. • Impact of information on participants' attitude to treatment. • Relationship with the therapist. • Compliance with the home programme of stabilization exercises. • Suggestion for improvement in future studies involving spinal stabilization exercises. The results of this study have indicated that an increased plasma serotonin concentration gained by the use of stabilization exercises could have a role to play in the outcome of treatment in patients with subclinical chronic LBP. The results generally indicated a better outcome of treatment in the three times weekly exercise group. Participants' explanations for the perceived improvements included major increases in confidence levels and formulation of self help strategies. They also reflected on their ability to exert better control over their own back pain, due to increased empowerment and self efficacy based on better understanding of the spine and how it works.
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Pearce, Julian Mark. "A biographical study of men with chronic low back pain." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/348803/.
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Low back pain is a common condition that will affect 80% of the population at some point in their lives. For the majority of people the pain and associated disability will be resolved and they will resume normal activities. For a small proportion of this group however, the condition will remain unresolved with associated long-term pain and disability; this is termed chronic low back pain (CLBP). The costs associated with CLBP are high both physically and emotionally for the individual, and in terms of the economic burden placed on society pertaining to healthcare costs and lost productivity. CLBP is a multifaceted condition. Whilst a biopsychosocial model of care, as opposed to the traditional biomedical model, is advocated as the best approach for its management it has been suggested that the impact on the self-concept and identity of individuals with this condition has not been fully explored or addressed. This study employed a biographical approach with the aim of understanding the impact on the lives and identities of men living with CLBP. Five men were recruited and in-depth interviews were undertaken which were audio-recorded, transcribed verbatim and analysed thematically. The identity of all the participants in the study had been affected by CLBP. Clear themes emerged that included feeling defined by their CLBP, experiencing feelings of frustration and anger, the inability to retain their masculine role, the impact on fatherhood, public and private identities, physicality and feeling a liability or burden to others. The support received from significant others was also highlighted. The participants detailed how exercise and education were major aspects in the management of their condition whilst resilience and the use of humour were also very apparent in their narratives as mechanisms to enable them to cope with CLBP.
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Oduah, Chukwudi. "Chronic Low Back Pain- A Needs Assessment for Practice Change." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4666.
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There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for evidence-based practice change, the chronic care model, and the middle-range theory of self-care of chronic illness were used. The evidence included the analysis of the Patient Assessment of Chronic Illness Care Survey (PACIC) data from 100 patients treated in this pain clinic. The clinic used the PACIC questionnaire to collect data from its 100 chronic low back pain patients, selected by simple random sampling method. The average weighted scores of these patients' responses were below the norm on all PACIC subscales and summary scores. According to study results, this pain clinic did not meet the self-management support needs of its chronic low back pain patients. Evidence-based recommendations were made for the improvement in the medical model of patient care by including nurse-led patient education and support. The positive social change is the improvement in the health status of this growing health population by meeting their identified education and support needs. Positive results from this nurse-led intervention could lead to the dissemination and widespread implementation of these recommendations in other pain clinics.
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Sato, Kaori D. "Pain medication use by participants in a yoga study for chronic low back pain." Thesis, Boston University, 2013. https://hdl.handle.net/2144/21249.
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Thesis (M.A.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Recent studies have shown the efficacy and practicality of the integration of complementary and alternative therapies and biomedical treatments for various diseases and illnesses, including high blood pressure, diabetes, epilepsy, and cancer. Saper et al. (2013) demonstrated that once-weekly yoga classes were equally as effective for relieving chronic low back pain in low-income, minority populations than twice-weekly yoga classes. Pain medication data collected from this 12-week study was used to examine the effect of yoga on analgesic use. Pain medications were categorized into four major groups: (1) acetaminophen, (2) opiates, (3) non-steroidal anti-inflammatory drugs (NSAIDS), and (4) other. The average number of NSAID pills taken daily decreased from baseline to 12 weeks. In addition, there was no statistically significant difference in the average number of any type of analgesic taken between once- and twice-weekly yoga groups from baseline to 12 weeks. Our findings suggest that yoga is most useful for individuals with mild to moderate chronic low back pain; however, further studies with more powerful sample sizes must be conducted in order to make more precise conclusions.
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MacKenzie, Fiona. "A sociological exploration of the field of chronic back pain : accounting for back pain via processes of boundary-work." Thesis, University of Aberdeen, 2013. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201924.
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This thesis presents an account of a sociological research project exploring the field of Chronic Back Pain (CBP). This medical condition, despite being prevalent worldwide, is extremely problematic and difficult to treat because of its often ambiguous medical status and fluctuating symptoms. These problems of diagnosis and resolution often have a negative impact on sufferers’ daily lives, social relationships, identity and sense of self, and are often characterised by negative encounters with medical professionals. This study explores these themes via academic work from the field of cultural sociology, and in particular, from the French pragmatic approach. My data is analysed via Lamont’s (1992) theory of ‘symbolic boundary making’ and other related work on boundaries. I also utilize work on accounts to explore respondents’ processes of account-making. In addition, I use Gieryn’s (1983) model of ‘boundary-work’ to explore the issues of professional identity and the professional struggles that are apparent in the practitioners’ accounts. The research was carried out using qualitative methods. In total, I conducted forty in-depth semi-structured interviews with patients with CBP, GPs, physiotherapists, chiropractors, osteopaths, and an acupuncturist.
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De, Gagné Théo A. "The evolution of chronic pain, adjustment status following treatment for acute low back pain." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ36801.pdf.
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Reilly, James Phillip. "The efficacy of a pain management programme for people with chronic low back pain." Thesis, University of Liverpool, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.250272.
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Marsden, Mandy. "The epidemiology and risk associated with lower back pain in cyclists." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/12114.
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Includes abstract.Includes bibliographical references (leaves 89-98).
Aims of this thesis: the research reported in this thesis consists of a literature review and two research parts. In the first research part, a descriptive cross-sectional survey was conducted, to investigate 1) the epidemiology and 2) the nature of LBP in cyclists, and 3) possible risk factors associated with LBP in cyclists. In the second research part, a case control study was conducted, to investigate the association between LBP in cyclists and 1) flexibility and 2) anthropometric measurements, and 3) bicycle set-up parameters.
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Neiders, Regine Ilga. "An analysis of indicators in predicting return to work for chronic back pain sufferers /." Thesis, Connect to this title online; UW restricted, 1990. http://hdl.handle.net/1773/11157.
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Newman-Beinart, Naomi Angela. "Non-adherence to prescribed home exercise in chronic low back pain." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/nonadherence-to-prescribed-home-exercise-in-chronic-low-back-pain(e64a992a-e4ba-46c6-8955-81d8f36cf480).html.
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Background: Adherence to prescribed home exercise for chronic low back pain (CLBP) is poor and this remains an under-researched area. There is no standard measure of exercise adherence and traditional health behaviour models are limited in their ability to explain non-adherence. This thesis aims to address these issues. Aim: To undertake a review of CLBP literature (Study 1), to develop a new measure (Study 2) and to investigate the role of psychosocial, clinical and executive function factors in explaining variation in exercise adherence in CLBP (Study 3). Design: Study 1 involved systematically reviewing factors associated with adherence to prescribed home exercise in CLBP. In Study 2, the Exercise Adherence Rating Scale (EARS) was developed. Study 3 was a prospective observational study of exercise adherence in a CLBP sample. Results: Study 1 found nine trials providing moderate evidence that higher health locus of control, supervision, participation in an exercise programme and participation in a behaviour change programme incorporating motivational strategies were associated with better exercise adherence in CLBP samples. In Study 2, a 1-factor solution explained 66% of the variance in adherence to exercise. Internal consistency (α = 0.758) and item-response theory methods indicated that EARS reliability was acceptable. In Study 3, longer duration of pain, higher present pain, lower educational level and being female significantly predicted poor adherence behaviour. Executive functions were not predictive of adherence behaviour. Conclusions: Study 1 highlighted a lack of good quality evidence and standardised measures of adherence. The EARS in Study 2 provided a valid and reliable assessment of adherence behaviour in a CLBP sample and now requires further testing. Results of Study 3 suggested factors influencing adherence to prescribed home exercise in patients with CLBP. The inclusion of these factors within health behaviour models may provide better explanatory models of exercise behaviour in CLBP.
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Kool, Jan Pieter. "Physiotherapy and sick leave in patients with chronic low back pain." [Maastricht] : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 2005. http://arno.unimaas.nl/show.cgi?fid=6532.
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Rofail, Diana. "Treatment satisfaction and dissatisfaction in patients with chronic low back pain." Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/4616.
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This thesis explores treatment satisfaction and dissatisfaction in patients with chronic low back pain (CLBP). Chapters 1 and 2 provide background on CLBP, and treatment satisfaction and dissatisfaction. Chapter 3 presents study 1, the systematic review which identified research concerning treatment satisfaction and dissatisfaction in patients with CLBP. Findings indicated a need to define the concept, and establish appropriate measurement based on patient input and evidence to support the reliability and validity of items. Chapter 4 presents study 2, a qualitative study. Ten patients with CLBP taking medication and/or receiving physiotherapy were interviewed. A conceptual model of CLBP and a thematic map of treatment satisfaction and dissatisfaction were developed. Satisfaction was related to being 'happy' or 'pleased', and maintaining normal functioning. Treatment not working, causing discomfort, or negatively affecting health-related quality of life, as well as inconvenience of medication, lack of information, not feeling involved in treatment decisions, lack of trust and confidence in healthcare professionals, and being misdiagnosed or undiagnosed, were associated with dissatisfaction. Chapter 5 documents the development of the CLBP Treatment Satisfaction Questionnaire, based on patient input from study 2. Cognitive debriefing showed items were relevant and understood by patients. Chapter 6, study 3, explored the psychometric properties of the questionnaire. The longitudinal design involved data collection from 249 patients, some of whom participated in follow-ups. Results indicated that treatment satisfaction/dissatisfaction involves an appraisal of the following seven domains: 'Information Provided about Back Pain and Treatment', 'Burden of Back Pain', 'Impact of Back Pain and Treatment on Relationships', 'Satisfaction with the Treatment Process', 'Problems with Side Effects of Medication', 'Adherence to Physiotherapy', and 'Medication Acceptability'. Some evidence of reliability and validity are presented. This thesis concludes with Chapter 7, a discussion of the main findings of the studies, strengths and limitations, and recommendations for future research.
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O'Neill, Katherine M. "The psychological management of chronic low back pain : a controlled trial." Thesis, University of Surrey, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321037.
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Mathieson, Ian. "Foot-type as a risk marker in chronic low back pain." Thesis, Cardiff Metropolitan University, 2004. http://hdl.handle.net/10369/6438.
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Foot function has been linked with various musculoskeletal pathologies. In recognition of the over-emphasised role of interventional trials and the underdeveloped role of observational studies in investigating such relationships, a case-control study was designed to examine the link with low back pain. Before this could proceed, several critical issues surrounding the validity and reliability of measures of 'foot-type' were examined to identify the optimal technique for use in observational research. Firstly, the ability of static measurements to reflect the dynamic state was investigated for two footprint and a calcaneal motion measure to examine a basic validity dimension. Although all measures differed between states, high correlations revealed a consistent dynamic increase. Subsequent content validity assessment involved examining the response of footprint and navicular motion measures to 50 changes in subtalar joint position. Navicular height was most sensitive (consistently changing value significantly with between 50 & 100 of calcaneal motion), whilst poor performance of footprint measures (requiring >150 of calcaneal motion to induce significant changes) compromised their further use. The original intention to categorise subjects according to subtalar axis orientation to increase the precision of this validity study was abandoned after its reliability was found to be poor. Finally, the optimal, motion-based, measures of foot-type identified were utilised in a case-control study, which recruited 64 cases with low back pain and 57 controls. A significantly higher magnitude of left-right asymmetry of calcaneal and navicular motion, and a significantly reduced score on a foot-health related quality of life assessment tool, the foot health status questionnaire, was found in cases. Despite concerns over the absolute reliability and validity of the motion-based measures used, and several limitations in the case-control design, the study implicates foot function with low back pain and suggests that further study to determine the extent of its involvement is warranted.
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MacRae, Catharine Sian. "The effectiveness of rocker sole shoes in chronic low back pain." Thesis, King's College London (University of London), 2013. https://kclpure.kcl.ac.uk/portal/en/theses/the-effectiveness-of-rocker-sole-shoes-in-chronic-low-back-pain(f5e40434-d684-44a5-9cb4-56349404fd42).html.
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Shoes with a rocker sole are marketed as reducing low back pain. There is minimal evidence to support these claims. This investigation compared rocker sole shoes to flat sole shoes in people with chronic low back pain (CLBP). The thesis reports findings of a randomised clinical trial and a series of biomechanical experiments. Following preparatory pilot and reliability studies, 115 people with CLBP were randomised to wear rocker sole shoes or flat sole shoes; all participants attended an exercise and education programme. Participants were assessed without knowledge of group allocation pre-randomisation, at six weeks, six months, and one year (main outcome point). Primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Analysis was by intention-to-treat. Biomechanical experiments recruited 20 participants from the main study and investigated effects of wearing rocker sole and flat sole shoes on standing balance and gait, immediately and after 6 months of shoe wear, using centre of pressure and motion-analysis derived kinetic, kinematic and spatio-temporal measures. Balance and gait in people with and age-and gender-matched controls without CLBP were compared. Rocker sole shoes were no more beneficial than flat sole shoes for CLBP patients; flat sole shoes were more beneficial in a sub-group of CLBP aggravated by standing or walking. Biomechanical studies found rocker sole shoes introduced immediately greater postural instability than flat sole shoes but neither shoe had long-term training effects on postural control. Furthermore, although both shoes resulted in small immediate changes in kinetic, kinematic and spatio-temporal parameters of shod gait, neither shoe had long-term training effects on these parameters in barefoot gait. Finally, in contrast to some previous research, postural control during standing, and kinetics, kinematic, and spatio-temporal parameters during gait were similar between people with and without CLBP.
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Niler, Eric Richard. "Chronic back pain and its relation to psychological and sociodemographic variables /." The Ohio State University, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487683401440807.
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Adem, Ahmed. "Exploring self-management of chronic low back pain in Saudi Arabia." Thesis, Sheffield Hallam University, 2017. http://shura.shu.ac.uk/19155/.
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Aim: The main purpose of this research project is to explore both patients’ and physiotherapists’ perceptions and understanding of self-management for chronic low back pain (CLBP) in the Kingdom of Saudi Arabia (KSA) and moreover, to explore current physiotherapy practice for managing CLBP in KSA. Methods: This research project used a mixed methods approach with sequential designs. The first section contains a quantitative study and the second section includes two qualitative studies. The quantitative section allowed exploration of current physiotherapy practices for CLBP management using a large population. The qualitative section has provided a more in-depth understanding of both patients' and physiotherapists' perceptions in regards to self-management and physiotherapy management for CLBP. Results: In the current study, physiotherapists acknowledged the importance of exercise and advice. Moreover, these represented the most common treatment methods used in daily practice. However, patients’ preferences for passive approaches, such as rest, massage and modalities were frequently reported. This shows conflict between physiotherapists and patients with CLBP in terms of the preferred approach for managing the disorder. Physiotherapists’ extensive use of modalities where evidence of effectiveness was lacking or insufficient was a common practice for physiotherapy management in patients with CLBP in the current research project. Moreover, physiotherapists and patients showed limited understanding of self-management as a concept. Conclusion: Promoting self-management in daily physiotherapy practice appears to be a complex issue. It involves various factors, such as promoting an evidence-based practice culture among physiotherapists; a patient-centred approach; access to guidelines and evidence; and organisational support through developing policy, local guidelines and CPD training. This research presents a platform of recommendations for future researchers, professionals, educators and policymakers to enhance the quality of care for patients with CLBP in the KSA in general and may increase the adoption of self-management.
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Turesky, Derek Geoffrey. "A descriptive analysis of alexithymia among patients with chronic back pain." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/1272.
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Chronic back pain is a pervasive and debilitating phenomenon contributing to staggering health costs and a host of psychological, medical, vocational, and social consequences. The etiology of chronic back pain remains unclear and traditional biomedical, psychological, and interdisciplinary treatments have not been completely effective at eliminating pain or restoring long-term functionality. Psychodynamic models of chronic back pain have not been fully explored due to methodological difficulties. Explorations of psychodynamic-related constructs such as alexithymia (i.e., lack of emotional awareness) may offer vital clues to help increase the understanding of chronic back pain. The purpose of this study was to serve as a preliminary descriptive analysis of alexithymia among patients seeking interdisciplinary treatment for chronic back pain. First, the prevalence of alexithymia in an interdisciplinary treatment seeking sample of patients with chronic back pain and comparisons to other chronic pain and psychosomatic samples were addressed. Second, the relationship between alexithymia and somatic complaints, pain, anxiety, depression, and health-related quality of life was explored. Finally, a meditational analysis was conducted to examine if the relationship between alexithymia and somatic complaints was mediated by negative affect. Eighty-one patients seeking interdisciplinary treatment for chronic back pain participated in the study. Analyses revealed that 14.8% patients met criteria for alexithymia, which was similar to other chronic pain samples but not significantly different from general medical samples. Higher alexithymia scores were found to be associated with higher levels of somatic complaints, negative affect, and mental-health related quality of life. Unexpectedly, higher alexithymia scores were also associated with better physical-related quality of life. There were no significant relationships between alexithymia and pain. The relationship between alexithymia and somatic complaints was found to be mediated by negative affect, which was consistent with psychodynamic models of chronic back pain. Findings were discussed in relation to clinical implications and future research.
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Bunzli, Samantha. "A prospective, qualitative investigation of pain-related fear in people with chronic low back pain." Thesis, Curtin University, 2015. http://hdl.handle.net/20.500.11937/608.
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This qualitative, prospective study explores the lived experience of pain-related fear in people with chronic non-specific low back pain. Novel insights are provided into the beliefs underlying pain-related fear, how these beliefs evolve and the pathways to fear-reduction. The Common-Sense Model is offered as a framework to understand the study findings. By incorporating a Common-Sense perspective, the Fear Avoidance Model may be extended to account for the multiple pathways into pain-related fear and fear-reduction.
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Kopinski, Stephan [Verfasser], and Frank [Akademischer Betreuer] Mayer. "The neuromuscular efficiency of lower back muscles in low back pain / Stephan Kopinski ; Betreuer: Frank Mayer." Potsdam : Universität Potsdam, 2016. http://d-nb.info/1218401214/34.
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Barriera, Viruet Heriberto. "Effect of forklift operation on lower back pain an evidence-based approach /." Cincinnati, Ohio : University of Cincinnati, 2006. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1148264126.
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Thesis (Ph. D.)--University of Cincinnati, 2006.Title from electronic thesis title page (viewed Aug. 4, 2006). Includes abstract. Keywords: lower-back pain, forklift operation, evidence-based, meta-analysis, whole-body vibration. Includes bibliographical references.
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Olson, Daniel A. "An evaluation of aquatic therapy as a treatment for lower back pain." Honors in the Major Thesis, University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/489.
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Lower back pain (LBP) is a medical condition that will affect most of us at some point in our lives. Several medical causes have been identified for LBP, yet the large majority of LBP patients do not receive a specific diagnosis. These patients use up a large majority of health care resources, and accumulate billions of dollars in medical costs in countries throughout the globe. In recent years, an increasing focus has been placed on the idea that aquatic therapy may be an effective therapy for LBP patients. Exercise therapy has already proven itself as an effective means for treating LBP. Thus, combined with the unique properties of water, experts believe that aquatic therapy is the future of LBP treatment. This thesis aims to explore the efficacy of aquatic therapy as a treatment for LBP. Through the analysis of controlled peer-reviewed studies, scholarly information databases, and historical data on LBP treatment, this thesis evaluates the relationship between aquatic therapy and LBP in its entirety. Scientific properties of water have shown its many uses in rehabilitative therapy treatments. Water, in theory, is able to manipulate the exercise environment to allow for more substantial progress to be made. In studies where aquatic therapy was tested versus no treatment, aquatic therapy proved to be a more efficient and effective option. Still, when placed against other therapies, aquatic therapy did not always prove more effective. While the analyzed studies support the idea that aquatic therapy is an effective treatment for LBP, further research is needed to determine how aquatic therapy holds up against other forms of treatment.B.S.
Bachelors
Health and Public Affairs
Health Sciences
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BARRIERA, VIRUET HERIBERTO. "EFFECT OF FORKLIFT OPERATION ON LOWER BACK PAIN - AN EVIDENCE-BASED APPROACH." University of Cincinnati / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1148264126.
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McGee-Hall, Joanne M. (Joanne Moore). "Factor Analysis of Health Concerns in the Chronic Back Pain Patient-MMPI2." Thesis, University of North Texas, 1991. https://digital.library.unt.edu/ark:/67531/metadc500409/.
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The purpose of this study was to analyze the factor structure of items pertaining to health on the Minnesota Multiphasic Personality Inventory (MMPI2) for chronic back pain patients in comparison to a control group. The results may be used as groundwork for developing an MMPI2 subscale to describe this population.
The groups differed in the sequence of the resulting factors and the percentage of variance accounted for by each factor. The factors extracted when evaluating the control group were titled in order: Poor Physical Health, Digestive Difficulties, Equilibrium, Depression/Malaise, and Multiple Somatic Complaints. Resulting factors for the pain group were: Depression/Malaise, Digestive Difficulties, Multiple Somatic Complaints, Headaches/Dizziness, and Neurological Reaction/Poor Physical Health.
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Vlaeyen, Johannes Wolfgang Silvain. "Chronic low back pain assessment and treatment from a behavioral rehabilitation perspective /." Amsterdam [etc.] : Maastricht : Swets & Zeitlinger ; University Library, Maastricht University [Host], 1991. http://arno.unimaas.nl/show.cgi?fid=6194.
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Smeets, Robert Johannes Elise Marie. "Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both?" [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Universiteit Maastricht [host], 2006. http://arno.unimaas.nl/show.cgi?fid=5954.
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Snidvongs, Saowarat. "Lumbar facet joint injections for the management of chronic low back pain." Thesis, University of Exeter, 2018. http://hdl.handle.net/10871/34334.
Full textAbstract:
Background: Low back pain is a leading cause of disability worldwide and has a significant economic burden. Targeted lumbar facet joint injections may be used to relieve this pain and aid rehabilitation, but high quality clinical evidence to support their use is lacking. The National Institute for Health and Care Excellence (NICE) does not recommend spinal injections for the management of chronic low back pain. Critical appraisal of systematic reviews: A critical appraisal of systematic reviews of randomised controlled trials concluded that the existing evidence to support the use of facet joint injections in low back pain management is equivocal, with methodological variability detected across the studies and reviews. FACET feasibility study: The FACET feasibility study was a blinded parallel two-arm pilot randomised controlled trial to assess the feasibility of carrying out a definitive study evaluating the effectiveness of lumbar facet joint injections compared with a sham procedure, in patients with non-specific low back pain of more than three months’ duration. The study recruited from the pain and spinal orthopaedic clinics at Barts Health NHS Trust only, although a multicentre study was planned. Adult patients referred to the specialist clinics with non-specific low back pain despite NICE-recommended best non-invasive care were randomised and blinded to receive either intra-articular lumbar facet joint injections with steroid or a sham procedure, following a positive response to diagnostic medial branch nerve blocks. Both groups were invited to attend a combined physical and psychological programme. Measures of feasibility included the recruitment and retention rate, and adherence to the study protocol. Questionnaires were used to assess a range of pain- and disability-related issues. Of 628 participants screened for eligibility, nine were randomised to receive the study intervention and eight participants completed the study. Failure to recruit sufficient participants led to early closure of the study by the funder, and no conclusions were drawn on the clinical effectiveness of lumbar facet joint injections for the management of non-specific low back pain in this sub-group of patients. Although the target recruitment rate was not achieved, a robust study protocol was developed and the intended interventions delivered safely, thus addressing many of the feasibility objectives. Conclusions: Further high quality randomised controlled trials and systematic reviews are required to inform decision makers, with implications for both clinical practice and policy. Stronger collaborations with primary care may improve the recruitment of patients earlier in their pain trajectory, suitable for inclusion in a future trial.