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1
Grandin, N., and S. I. Reed. "Differential function and expression of Saccharomyces cerevisiae B-type cyclins in mitosis and meiosis." Molecular and Cellular Biology 13, no. 4 (April 1993): 2113–25. http://dx.doi.org/10.1128/mcb.13.4.2113-2125.1993.
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We have studied the patterns of expression of four B-type cyclins (Clbs), Clb1, Clb2, Clb3, and Clb4, and their ability to activate p34cdc28 during the mitotic and meiotic cell cycles of Saccharomyces cerevisiae. During the mitotic cell cycle, Clb3 and Clb4 were expressed and induced a kinase activity in association with p34cdc28 from early S phase up to mitosis. On the other hand, Clb1 and Clb2 were expressed and activated p34cdc28 later in the mitotic cell cycle, starting in late S phase and continuing up to mitosis. The pattern of expression of Clb3 and Clb4 suggests a possible role in the regulation of DNA replication as well as mitosis. Clb1 and Clb2, whose pattern of expression is similar to that of other known Clbs, are likely to have a role predominantly in the regulation of M phase. During the meiotic cell cycle, Clb1, Clb3, and Clb4 were expressed and induced a p34cdc28-associated kinase activity just before the first meiotic division. The fact that Clb3 and Clb4 were not synthesized earlier, in S phase, suggests that these cyclins, which probably have a role in S phase during the mitotic cell cycle, are not implicated in premeiotic S phase. Clb2, the primary mitotic cyclin in S. cerevisiae, was not detectable during meiosis. Sporulation experiments on strains deleted for one, two, or three Clbs indicate, in agreement with the biochemical data, that Clb1 is the primary cyclin for the regulation of meiosis, while Clb2 is not involved at all.
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Grandin, N., and S. I. Reed. "Differential function and expression of Saccharomyces cerevisiae B-type cyclins in mitosis and meiosis." Molecular and Cellular Biology 13, no. 4 (April 1993): 2113–25. http://dx.doi.org/10.1128/mcb.13.4.2113.
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We have studied the patterns of expression of four B-type cyclins (Clbs), Clb1, Clb2, Clb3, and Clb4, and their ability to activate p34cdc28 during the mitotic and meiotic cell cycles of Saccharomyces cerevisiae. During the mitotic cell cycle, Clb3 and Clb4 were expressed and induced a kinase activity in association with p34cdc28 from early S phase up to mitosis. On the other hand, Clb1 and Clb2 were expressed and activated p34cdc28 later in the mitotic cell cycle, starting in late S phase and continuing up to mitosis. The pattern of expression of Clb3 and Clb4 suggests a possible role in the regulation of DNA replication as well as mitosis. Clb1 and Clb2, whose pattern of expression is similar to that of other known Clbs, are likely to have a role predominantly in the regulation of M phase. During the meiotic cell cycle, Clb1, Clb3, and Clb4 were expressed and induced a p34cdc28-associated kinase activity just before the first meiotic division. The fact that Clb3 and Clb4 were not synthesized earlier, in S phase, suggests that these cyclins, which probably have a role in S phase during the mitotic cell cycle, are not implicated in premeiotic S phase. Clb2, the primary mitotic cyclin in S. cerevisiae, was not detectable during meiosis. Sporulation experiments on strains deleted for one, two, or three Clbs indicate, in agreement with the biochemical data, that Clb1 is the primary cyclin for the regulation of meiosis, while Clb2 is not involved at all.
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Revilleza, Jastin Edrian Cocuangco, Megumi Sato, Kaoru Irie, Yasuyuki Suda, Tomoaki Mizuno, and Kenji Irie. "Regulation of CLB6 expression by the cytoplasmic deadenylase Ccr4 through its coding and 3’ UTR regions." PLOS ONE 17, no. 5 (May 6, 2022): e0268283. http://dx.doi.org/10.1371/journal.pone.0268283.
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RNA stability control contributes to the proper expression of gene products. Messenger RNAs (mRNAs) in eukaryotic cells possess a 5’ cap structure and the 3’ poly(A) tail which are important for mRNA stability and efficient translation. The Ccr4-Not complex is a major cytoplasmic deadenylase and functions in mRNA degradation. The CLB1-6 genes in Saccharomyces cerevisiae encode B-type cyclins which are involved in the cell cycle progression together with the cyclin-dependent kinase Cdc28. The CLB genes consist of CLB1/2, CLB3/4, and CLB5/6 whose gene products accumulate at the G2-M, S-G2, and late G1 phase, respectively. These Clb protein levels are thought to be mainly regulated by the transcriptional control and the protein stability control. Here we investigated regulation of CLB1-6 expression by Ccr4. Our results show that all CLB1-6 mRNA levels were significantly increased in the ccr4Δ mutant compared to those in wild-type cells. Clb1, Clb4, and Clb6 protein levels were slightly increased in the ccr4Δ mutant, but the Clb2, Clb3, and Clb5 protein levels were similar to those in wild-type cells. Since both CLB6 mRNA and Clb6 protein levels were most significantly increased in the ccr4Δ mutant, we further analyzed the cis-elements for the Ccr4-mediated regulation within CLB6 mRNA. We found that there were destabilizing sequences in both coding sequence and 3’ untranslated region (3’ UTR). The destabilizing sequences in the coding region were found to be both within and outside the sequences corresponding the cyclin domain. The CLB6 3’ UTR was sufficient for mRNA destabilization and decrease of the reporter GFP gene and this destabilization involved Ccr4. Our results suggest that CLB6 expression is regulated by Ccr4 through the coding sequence and 3’ UTR of CLB6 mRNA.
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Fitch, I., C. Dahmann, U. Surana, A. Amon, K. Nasmyth, L. Goetsch, B. Byers, and B. Futcher. "Characterization of four B-type cyclin genes of the budding yeast Saccharomyces cerevisiae." Molecular Biology of the Cell 3, no. 7 (July 1992): 805–18. http://dx.doi.org/10.1091/mbc.3.7.805.
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The previously described CLB1 and CLB2 genes encode a closely related pair of B-type cyclins. Here we present the sequences of another related pair of B-type cyclin genes, which we term CLB3 and CLB4. Although CLB1 and CLB2 mRNAs rise in abundance at the time of nuclear division, CLB3 and CLB4 are turned on earlier, rising early in S phase and declining near the end of nuclear division. When all possible single and multiple deletion mutants were constructed, some multiple mutations were lethal, whereas all single mutants were viable. All lethal combinations included the clb2 deletion, whereas the clb1 clb3 clb4 triple mutant was viable, suggesting a key role for CLB2. The inviable multiple clb mutants appeared to have a defect in mitosis. Conditional clb mutants arrested as large budded cells with a G2 DNA content but without any mitotic spindle. Electron microscopy showed that the spindle pole bodies had duplicated but not separated, and no spindle had formed. This suggests that the Clb/Cdc28 kinase may have a relatively direct role in spindle formation. The two groups of Clbs may have distinct roles in spindle formation and elongation.
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Segal, Marisa, Duncan J. Clarke, and Steven I. Reed. "Clb5-associated Kinase Activity is Required Early in the Spindle Pathway for Correct Preanaphase Nuclear Positioning in Saccharomyces cerevisiae." Journal of Cell Biology 143, no. 1 (October 5, 1998): 135–45. http://dx.doi.org/10.1083/jcb.143.1.135.
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In Saccharomyces cerevisiae, a single cyclin-dependent kinase, Cdc28, regulates both G1/S and G2/M phase transitions by associating with stage-specific cyclins. During progression through S phase and G2/M, Cdc28 is activated by the B-type cyclins Clb1–6. Because of functional redundancy, specific roles for individual Clbs have been difficult to assign. To help genetically define such roles, strains carrying a cdc28ts allele, combined with single CLB deletions were studied. We assumed that by limiting the activity of the kinase, these strains would be rendered more sensitive to loss of individual Clbs. By this approach, a novel phenotype associated with CLB5 mutation was observed. Homozygous cdc28-4ts clb5 diploids were inviable at room temperature. Cells were defective in spindle positioning, leading to migration of undivided nuclei into the bud. Occasionally, misplaced spindles were observed in cdc28-4 clb5 haploids; additional deletion of CLB6 caused full penetrance. Thus, CLB5 effects proper preanaphase spindle positioning, yet the requirement differs in haploids and diploids. The execution point for the defect corresponded to the time of Clb5-dependent kinase activation. Nevertheless, lethality of cdc28-4 clb5 diploids was not rescued by CLB2 or CLB4 overexpression, indicating a specificity of Clb5 function beyond temporality of expression.
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Dahmann, C., and B. Futcher. "Specialization of B-type cyclins for mitosis or meiosis in S. cerevisiae." Genetics 140, no. 3 (July 1, 1995): 957–63. http://dx.doi.org/10.1093/genetics/140.3.957.
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Abstract The CLB1, CLB2, and CLB3 genes encode B-type cyclins important for mitosis in Saccharomyces cerevisiae, while a fourth B-type cyclin gene, CLB4, has no clear role. The effects of homozygous clb mutations on meiosis were examined. Mutants homozygous for clb1 clb3, or for clb1 clb4, gave high levels of sporulation, but produced mainly two-spored asci instead of four-spored asci. The cells had completed meiosis I but not meiosis II, producing viable diploid ascospores. CLB1 and CLB4 seem to be much more important for meiosis than for mitosis and may play some special role in meiosis II. In contrast, CLB2 is important for mitosis but not meiosis. The level of Cdc28-Clb activity may be important in determining whether meiosis II will occur.
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Bensen, Eric S., Andres Clemente-Blanco, Kenneth R. Finley, Jaime Correa-Bordes, and Judith Berman. "The Mitotic Cyclins Clb2p and Clb4p Affect Morphogenesis inCandida albicans." Molecular Biology of the Cell 16, no. 7 (July 2005): 3387–400. http://dx.doi.org/10.1091/mbc.e04-12-1081.
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The ability of Candida albicans to switch cellular morphologies is crucial for its ability to cause infection. Because the cell cycle machinery participates in Saccharomyces cerevisiae filamentous growth, we characterized in detail the two C. albicans B-type cyclins, CLB2 and CLB4, to better understand the molecular mechanisms that underlie the C. albicans morphogenic switch. Both Clb2p and Clb4p levels are cell cycle regulated, peaking at G2/M and declining before mitotic exit. On hyphal induction, the accumulation of the G1 cyclin Cln1p was prolonged, whereas the accumulation of both Clb proteins was delayed when compared with yeast form cells, indicating that CLB2 and CLB4 are differentially regulated in the two morphologies and that the dynamics of cyclin appearance differs between yeast and hyphal forms of growth. Clb2p-depleted cells were inviable and arrested with hyper-elongated projections containing two nuclei, suggesting that Clb2p is not required for entry into mitosis. Unlike Clb2p-depleted cells, Clb4p-depleted cells were viable and formed constitutive pseudohyphae. Clb proteins lacking destruction box domains blocked cell cycle progression resulting in the formation of long projections, indicating that both Clb2p and Clb4p must be degraded before mitotic exit. In addition, overexpression of either B-type cyclin reduced the extent of filamentous growth. Taken together, these data indicate that Clb2p and Clb4p regulate C. albicans morphogenesis by negatively regulating polarized growth.
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Azour, Adel, Charbel Al-Bayssari, Lucile Pinault, Saïd Azza, Jean-Marc Rolain, and Seydina M. Diene. "clbP Gene, a Potential New Member of the β-Lactamase Family." International Journal of Molecular Sciences 23, no. 24 (December 9, 2022): 15642. http://dx.doi.org/10.3390/ijms232415642.
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The colibactin island (pks) of Escherichia coli formed by 19 genes (55-Kb), encodes non-ribosomal peptide (NRP) and polyketide (PK) synthases, which allow the synthesis of colibactin, a suspected hybrid PK-NRP compound that causes damage to DNA in eukaryotic cells. The clbP, an unusual essential gene, is found in the operon structure with the clbS gene in the pks-encoded machinery. Interestingly, the clbP gene has been annotated as a β-lactamase but no previous study has reported its β-lactamase characteristics. In this study, we (i) investigated the β-lactamase properties of the clbP gene in silico by analysing its phylogenetic relationship with bacterial β-lactamase and peptidase enzymes, (ii) compared its three-dimensional (3D) protein structure with those of bacterial β-lactamase proteins using the Phyr2 database and PyMOL software, and (iii) evaluated in vitro its putative enzymatic activities, including β-lactamase, nuclease, and ribonuclease using protein expression and purification from an E. coli BL21 strain. In this study, we reveal a structural configuration of toxin/antitoxin systems in this island. Thus, similar to the toxin/antitoxin systems, the role of the clbP gene within the pks-island gene group appears as an antitoxin, insofar as it is responsible for the activation of the toxin, which is colibactin. In silico, our analyses revealed that ClbP belonged to the superfamily of β-lactamase, class C. Furthermore, in vitro we were unable to demonstrate its β-lactamase activity, likely due to the fact that the clbP gene requires co-expression with other genes, such as the genes present in the pks-island (19 genes). More research is needed to better understand its actions, particularly with regards to antibiotics, and to discover whether it has any additional functions due to the importance of this gene and its toxicity.
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Rassem, Taha H., and Bee Ee Khoo. "Completed Local Ternary Pattern for Rotation Invariant Texture Classification." Scientific World Journal 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/373254.
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Despite the fact that the two texture descriptors, the completed modeling of Local Binary Pattern (CLBP) and the Completed Local Binary Count (CLBC), have achieved a remarkable accuracy for invariant rotation texture classification, they inherit some Local Binary Pattern (LBP) drawbacks. The LBP is sensitive to noise, and different patterns of LBP may be classified into the same class that reduces its discriminating property. Although, the Local Ternary Pattern (LTP) is proposed to be more robust to noise than LBP, however, the latter’s weakness may appear with the LTP as well as with LBP. In this paper, a novel completed modeling of the Local Ternary Pattern (LTP) operator is proposed to overcome both LBP drawbacks, and an associated completed Local Ternary Pattern (CLTP) scheme is developed for rotation invariant texture classification. The experimental results using four different texture databases show that the proposed CLTP achieved an impressive classification accuracy as compared to the CLBP and CLBC descriptors.
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Cinaroglu, Songul. "Risk factors associated with chronic low back pain: an analysis of Turkey health survey data." International Journal Of Community Medicine And Public Health 5, no. 2 (January 24, 2018): 454. http://dx.doi.org/10.18203/2394-6040.ijcmph20180219.
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Background: Turkey, a developing country has low back disorders as the most common symptom among adults with 33% prevalence in 2014. The patient’s self reports are important to determine the condition as chronic low back pain (CLBP) is a symptom rather than the disease. However, there is a scarcity of knowledge about self-reported CLBP among adults from developing countries. Methods: A community-based cross-sectional population survey study conducted by face-to-face interviews. To identify socio-demographic factors, health, behavior, and comorbidities associated with (CLBP). 6729 adults (≥15 years) with self-reported CLBP and 12400 non-CLBP adults who participated 2014 Turkey Health Survey (THS) were included. Data on smoking, alcohol consumption, physical activity, healthy eating behavior, muscle strengthening activities, and kinesitherapist and psychotherapist visits were collected. Socio-demographic characteristics, comorbidities, and health of CLBP and non-CLBP adults were compared using logistic regression analysis. Results: Age, gender, marital status, occupational status and health insurance were associated with a higher likelihood to report CLBP (p<0.001). The likelihood of diabetes and hypertension was higher in patients with CLBP (p<0.001). Visiting a psychotherapist, smoking and healthy eating were associated with a higher likelihood of CLBP (p<0.001) whereas, alcohol consumption, physical activity, muscle strengthening activities and visiting kinesiotherapist were associated with a lower likelihood of CLBP (p<0.001). Conclusions: Reduced smoking and alcohol consumption, healthy eating, increased physical activity, kinesitherapy and psychotherapy can be employed to manage CLBP.
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Morlion, Bart, Gabriele Finco, Dominic Aldington, Michael Überall, and Ravi Karra. "Severe chronic low back pain: patient journey from onset of symptoms to strong opioid treatments in Europe." Pain Management 11, no. 5 (September 2021): 595–602. http://dx.doi.org/10.2217/pmt-2021-0009.
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Aim: We report the first patient roadmap in severe chronic low back pain (cLBP) in Europe, assessing the views of cLBP patients and general practitioners (GPs) who treat cLBP with regard to current cLBP management. Methodology: Patient journey mapping was conducted in four European countries to assess the views of cLBP patients (n = 20) and GPs (n = 40). Results: Four broad phases of cLBP, subdivided into eight individual steps, were identified as part of the patient journey, showing a disconnect between patients’ and physicians’ treatment goals, and expectations regarding pain relief levels for some patients. Conclusion: Improved communication, with greater involvement of patients in multimodal management decisions, might benefit the GP–patient relationship and overall outcomes for cLBP patients.
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Shakoor, Mohammad Hossein, and Reza Boostani. "Extended Mapping Local Binary Pattern Operator for Texture Classification." International Journal of Pattern Recognition and Artificial Intelligence 31, no. 06 (March 30, 2017): 1750019. http://dx.doi.org/10.1142/s0218001417500197.
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In this paper, an Extended Mapping Local Binary Pattern (EMLBP) method is proposed that is used for texture feature extraction. In this method, by extending nonuniform patterns a new mapping technique is suggested that extracts more discriminative features from textures. This new mapping is tested for some LBP operators such as CLBP, LBP, and LTP to improve the classification rate of them. The proposed approach is used for coding nonuniform patterns into more than one feature. The proposed method is rotation invariant and has all the positive points of previous approaches. By concatenating and joining two or more histograms significant improvement can be made for rotation invariant texture classification. The implementation of proposed mapping on Outex, UIUC and CUReT datasets shows that proposed method can improve the rate of classifications. Furthermore, the introduced mapping can increase the performance of any rotation invariant LBP, especially for large neighborhood. The most accurate result of the proposed technique has been obtained for CLBP. It is higher than that of some state-of-the-art LBP versions such as multiresolution CLBP and CLBC, DLBP, VZ_MR8, VZ_Joint, LTP, and LBPV.
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Singh, Gurpreet, Christopher Newton, Kieran O’Sullivan, Andrew Soundy, and Nicola R. Heneghan. "Exploring the lived experience and chronic low back pain beliefs of English-speaking Punjabi and white British people: a qualitative study within the NHS." BMJ Open 8, no. 2 (February 2018): e020108. http://dx.doi.org/10.1136/bmjopen-2017-020108.
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IntroductionDisabling chronic low back pain (CLBP) is associated with negative beliefs and behaviours, which are influenced by culture, religion and interactions with healthcare practitioners (HCPs). In the UK, HCPs encounter people from different cultures and ethnic backgrounds, with South Asian Indians (including Punjabis) forming the largest ethnic minority group. Better understanding of the beliefs and experiences of ethnic minorities with CLBP might inform effective management.ObjectivesTo explore the CLBP beliefs and experiences of English-speaking Punjabi and white British people living with CLBP, explore how beliefs may influence the lived experience of CLBP and conduct cross-cultural comparisons between the two groups.DesignQualitative study using semistructured interviews set within an interpretive description framework and thematic analysis.SettingA National Health Service hospital physiotherapy department, Leicester, UK.Participants10 CLBP participants (5 English-speaking Punjabi and 5 white British) purposively recruited from physiotherapy waiting lists.ResultsParticipants from both groups held negative biomedical CLBP beliefs such as the ‘spine is weak’, experienced unfulfilling interactions with HCPs commonly due to a perceived lack of support and negative psychosocial dimensions of CLBP with most participants catastrophising about their CLBP. Specific findings to Punjabi participants included (1) disruption to cultural-religious well-being, as well as (2) a perceived lack of understanding and empathy regarding their CLBP from the Punjabi community. In contrast to their white British counterparts, Punjabi participants reported initially using passive coping strategies; however, all participants reported a transition towards active coping strategies.ConclusionCLBP beliefs and experiences, irrespective of ethnicity, were primarily biomedically orientated. However, cross-cultural differences included cultural-religious well-being, the community response to CLBP experienced by Punjabi participants and coping styles. These findings might help inform management of people with CLBP.
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Jacobson, Matthew D., Samantha Gray, Maria Yuste-Rojas, and Frederick R. Cross. "Testing Cyclin Specificity in the Exit from Mitosis." Molecular and Cellular Biology 20, no. 13 (July 1, 2000): 4483–93. http://dx.doi.org/10.1128/mcb.20.13.4483-4493.2000.
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ABSTRACT Cyclical inactivation of B-type cyclins has been proposed to be required for alternating DNA replication and mitosis. Destruction box-dependent Clb5p degradation is strongly increased in mitotic cells, and constitutive overexpression of Clb5p lacking the destruction box resulted in rapid accumulation of inviable cells, frequently multiply budded, with DNA contents ranging from unreplicated to apparently fully replicated. Loss of viability correlated with retention of nuclear Clb5p at the time of nuclear division. CLB2-Δdboverexpression that was quantitatively comparable toCLB5-Δdb overexpression with respect to Clb protein production and Clb-associated kinase activity resulted in a distinct phenotype: reversible mitotic arrest with uniformly replicated DNA. Simultaneous overexpression of CLB2-Δdb andCLB5-Δdb overexpressers similarly resulted in a uniform arrest with replicated DNA, and this arrest was significantly more reversible than that observed with CLB5-Δdboverexpression alone. These results suggest that Clb2p and not Clb5p can efficiently block mitotic completion. We speculate thatCLB5-Δdb overexpression may be lethal, because persistence of high nuclear Clb5p-associated kinase throughout mitosis leads to failure to load origins of replication, thus preventing DNA replication in the succeeding cell cycle.
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Shigetoh, Hayato, Yuki Nishi, Michihiro Osumi, and Shu Morioka. "Combined abnormal muscle activity and pain-related factors affect disability in patients with chronic low back pain: An association rule analysis." PLOS ONE 15, no. 12 (December 17, 2020): e0244111. http://dx.doi.org/10.1371/journal.pone.0244111.
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Objectives In patients with chronic low back pain (CLBP), reduced lumbar flexion-relaxation and reduced variability of muscle activity distribution are reported as abnormal muscle activity. It is not known how abnormal muscle activity and pain-related factors are related to CLBP-based disability. Here, we performed an association rule analysis to investigated how CLBP disability, muscle activity, and pain-related factors in CLBP patients are related. Methods Surface electromyographic signals were recorded from over the bilateral lumbar erector spinae muscle with four-channel electrodes from 24 CLBP patients while they performed a trunk flexion re-extension task. We calculated the average value of muscle activities of all channels and then calculated the flexion relaxation ratio (FRR) and the spatial variability of muscle activities. We also assessed the pain-related factors and CLBP disability by a questionnaire method. A clustering association rules analysis was performed to determine the relationships among pain-related factors, the FRR, and the variability of muscle activity distribution. Results The association rules of severe CLBP disability were divisible into five classes, including ‘low FRR-related rules.’ The rules of the mild CLBP disability were divisible into four classes, including ‘high FRR-related rules’ and ‘high muscle variability-related rules.’ When we combined pain-related factors with the FRR and muscle variability, the relationship between abnormal FRR/muscle variability and CLBP disability became stronger. Discussion Our findings thus highlight the importance of focusing on not only the patients’ pain-related factors but also the abnormal motor control associated with CLBP, which causes CLBP disability.
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Pavelka, K., H. Jarosova, O. Sleglova, R. Svobodova, M. Votavova, L. Milani, Z. Prochazka, et al. "Chronic Low Back Pain: Current Pharmacotherapeutic Therapies and a New Biological Approach." Current Medicinal Chemistry 26, no. 6 (May 13, 2019): 1019–26. http://dx.doi.org/10.2174/0929867325666180514102146.
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Chronic low back pain (CLBP) syndrome represents one of the leading causes of long-term disability worldwide. The prevalence of CLBP has been rising significantly in relation to increasing average life expectancy. CLBP results from chronification of acute low back pain. There are many factors contributing to the CLBP crisis; common etiopathogenetic factors include e.g., functional blockage of intervertebral joints. The treatment of CLBP is complex. An important part of treatment consists of pain pharmacotherapy, for which several groups of drugs are used. The problem lies in the side effects of many of these traditionally used medications. Therefore, new and safer treatment methods are being sought. Innovative options for CLBP pharmacology include injections containing collagen, which can be combined with other traditionally used drugs, which helps reduce dosages and increase the overall safety of CLBP therapy.
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Adnan, Rahmat, Jessica Van Oosterwijck, Lieven Danneels, Tine Willems, Mira Meeus, Geert Crombez, and Dorien Goubert. "Differences in psychological factors, disability and fatigue according to the grade of chronification in non-specific low back pain patients: A cross-sectional study." Journal of Back and Musculoskeletal Rehabilitation 33, no. 6 (November 11, 2020): 919–30. http://dx.doi.org/10.3233/bmr-191548.
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BACKGROUND: Differences in pain processing, muscle structure and function have been reported in patients with low back pain (LBP) with different grades of pain chronicity. OBJECTIVE: The present study aims to examine differences in psychological factors, disability and subjective fatigue between subgroups of LBP based on their chronification grade. METHODS: Twenty-one healthy controls (HC) and 54 LBP patients (categorized based on the grades of chronicity into recurrent LBP (RLBP), non-continuous chronic LBP (CLBP), or continuous (CLBP)) filled out a set of self-reporting questionnaires. RESULTS: The Hospital Anxiety and Depression Scale (HADS) and Multidimensional Pain Inventory (MPI) scores indicated that anxiety, pain severity, pain interference and affective distress were lower in HC and RLBP compared to non-continuous CLBP. Anxiety scores were higher in non-continuous CLBP compared to RLBP, continuous CLBP and HC. The Pain Catastrophizing Scale for Helplessness (PSCH) was higher in non-continuous CLBP compared to HC. The Survey of Pain Attitudes (SOPA) showed no differences in adaptive and maladaptive behaviors across the groups. The Pain Disability Index (PDI) measured a higher disability in both CLBP groups compared to HC. Moreover, the Rolland Morris Disability Questionnaire (RMDQ) showed higher levels of disability in continuous CLBP compared to non-continuous CLBP, RLBP and HC. The Checklist Individual Strength (CIS) revealed that patients with non-continuous CLBP were affected to a higher extent by severe fatigue compared to continuous CLBP, RLBP and HC (subjective fatigue, concentration and physical activity). For all tests, a significance level of 0.05 was used. CONCLUSIONS: RLBP patients are more disabled than HC, but have a tendency towards a general positive psychological state of mind. Non-continuous CLBP patients would most likely present a negative psychological mindset, become more disabled and have prolonged fatigue complaints. Finally, the continuous CLBP patients are characterized by more negative attitudes and believes on pain, enhanced disability and interference of pain in their daily lives.
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Isaikin, A. I., T. I. Nasonova, and A. Kh Mukhametzyanova. "Emotional disorders and their therapy in chronic low back pain." Neurology, Neuropsychiatry, Psychosomatics 14, no. 5 (October 25, 2022): 90–95. http://dx.doi.org/10.14412/2074-2711-2022-5-90-95.
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Chronic low back pain (CLBP) is the most common chronic pain syndrome that causes deterioration of the quality of life and disability. Anxiety and depressive disorders are significantly more common in patients with CLBP. The negative impact of CLBP on cognitive abilities and sleep was revealed. Treatment of patients with CLBP should be started with non-pharmacological methods, including an educational program, kinesiotherapy, and cognitive behavioral therapy. Antidepressants are prescribed for CLBP to reduce the severity of associated anxiety and depressive disorders, improve sleep and relieve pain. The efficacy and safety of sertraline (Serenatа) in CLBP, its additional neurochemical mechanisms of action due to its effect on dopamine reuptake, interaction with sigma receptors, low incidence of side effects, and high adherence of patients to therapy are discussed.
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Oh, Minji, Jongyeon Kim, Suji Lee, Seunghoon Lee, and Jae-Dong Lee. "Association between Fat Distribution and Chronic Low Back Pain among 10,606 Adults: Data from the Korean National Health and Nutrition Examination Survey." International Journal of Environmental Research and Public Health 19, no. 9 (May 5, 2022): 5599. http://dx.doi.org/10.3390/ijerph19095599.
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Obesity is associated with chronic low back pain (CLBP), but the association between fat distribution and CLBP is unclear. This cross-sectional study evaluated the relationship using the Korean National Health and Nutrition Examination Survey data. A total of 10,606 adults (average age: 45.4, female: 57.1%) were included. We estimated the regional fat distribution, waist circumference, and body fat proportion, compared the values in people with and without CLBP, and stratified the estimates by sex and obesity status using a multivariable linear model. There were no statistically significant differences in the average waist circumference between the people with and without CLBP (p = 0.731) and the average fat proportion between those with and without CLBP (p = 0.731). The average regional fat distribution was significantly higher in the people with CLBP than in those without CLBP, in the upper limbs (11.4%, 95% confidence interval [CI]: [11.3, 11.5] vs. 11.2%, 95% CI: [11.1, 11.3], p < 0.05) and in the lower limbs (31.9%, 95% CI: [31.6, 32.2] vs. 31.4%, 95% CI: [31.2, 31.6], p < 0.01). More obvious among men, fat distribution in the lower limbs is higher than in people without obesity (p < 0.001). People with CLBP tend to have a higher fat distribution in the limbs than those without it and obese people with CLBP would need to reduce the fat in the lower limbs.
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Dubois, Damien, Olivier Baron, Antony Cougnoux, Julien Delmas, Nathalie Pradel, Michèle Boury, Bernadette Bouchon, et al. "ClbP Is a Prototype of a Peptidase Subgroup Involved in Biosynthesis of Nonribosomal Peptides." Journal of Biological Chemistry 286, no. 41 (July 27, 2011): 35562–70. http://dx.doi.org/10.1074/jbc.m111.221960.
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The pks genomic island of Escherichia coli encodes polyketide (PK) and nonribosomal peptide (NRP) synthases that allow assembly of a putative hybrid PK-NRP compound named colibactin that induces DNA double-strand breaks in eukaryotic cells. The pks-encoded machinery harbors an atypical essential protein, ClbP. ClbP crystal structure and mutagenesis experiments revealed a serine-active site and original structural features compatible with peptidase activity, which was detected by biochemical assays. Ten ClbP homologs were identified in silico in NRP genomic islands of closely and distantly related bacterial species. All tested ClbP homologs were able to complement a clbP-deficient E. coli mutant. ClbP is therefore a prototype of a new subfamily of extracytoplasmic peptidases probably involved in the maturation of NRP compounds. Such peptidases will be powerful tools for the manipulation of NRP biosynthetic pathways.
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Friedrich, Martin, Julia Hahne, and Florian Wepner. "A Controlled Examination of Medical and Psychosocial Factors Associated With Low Back Pain in Combination With Widespread Musculoskeletal Pain." Physical Therapy 89, no. 8 (August 1, 2009): 786–803. http://dx.doi.org/10.2522/ptj.20080100.
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BackgroundLittle is known about chronic low back pain (CLBP) in combination with widespread musculoskeletal pain (WMP).ObjectiveThis study examined factors that may be common to these conditions, with the objective of detecting factors that could improve the course of these diseases.DesignThis was a prospective case control study.Patients and InterventionA group of patients with CLBP and WMP (CLBP+WMP group, n=97) was compared with a group of individuals who were pain-free and without a history of musculoskeletal problems (control group, n=97) and with a group of patients with CLBP but without WMP (CLBP-only group, n=52). The mean age of the participants was 42.9 years (SD=8.74); 76% were women, and 24% were men.MeasurementsA total of 74 variables were measured, including sociodemographic, physical, and psychosocial variables. After univariate examination for group differences and analyses of variables available for all 3 groups, logistic regression on selected factors was performed. The α level was set at .05, but was adjusted to avoid randomly significant results.ResultsFor a number of variables, significant differences among the 3 groups were observed. For regression model 1 for the CLBP+WMP and control groups, 4 out of 9 variables showed significant likelihood tests: income (lower in the WMP group), depression, anxiety, and fear-avoidance behavior. For regression model 2, 2 out of 13 variables showed significant likelihood tests: endurance capacity (more in the CLBP+WMP group) and balance capability (worse in the CLBP+WMP group). The models predicted at least 91.2% of all cases to the correct group. The regression analysis regarding the CLBP+WMP and CLBP-only groups predicted 86.7% of all cases to the correct group. Three out of 10 variables showed significant likelihood tests: high disability, fear-avoidance behavior, and number of treatments.LimitationsSome variables in testing the patients with WMP and the individuals who were pain-free were not used with the patients with CLBP only.ConclusionsPatients with CLBP and WMP should be examined for indicated physical and psychosocial factors. Therapeutic management should consider them in the early stage of the disease. These findings also might apply to patients with fibromyalgia or myofascial pain.
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Ampiah, Josephine Ahenkorah, Fiona Moffatt, Claire Diver, and Paapa Kwesi Ampiah. "Understanding how patients’ pain beliefs influence chronic low back pain management in Ghana: a grounded theory approach." BMJ Open 12, no. 12 (December 2022): e061062. http://dx.doi.org/10.1136/bmjopen-2022-061062.
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IntroductionChronic low back pain (CLBP) is associated with negative consequences in high and low/middle-income countries. Pain beliefs are important psychosocial factors that affect the occurrence and progression of CLBP and may be influenced by the sociocultural context and interactions with healthcare professionals (HCPs). The pain beliefs of Ghanaian patients with CLBP are unknown and the factors influencing pain beliefs in African contexts are unclear.ObjectivesTo explore the pain beliefs of Ghanaian patients with CLBP, how they influence CLBP management/coping and to identify the mechanisms influencing them.DesignQualitative study using individual semistructured face-to-face interviews, situated within Straussian grounded theory principles and critical realist philosophy.ParticipantsThirty patients with CLBP accessing physiotherapy at two teaching hospitals in Ghana.ResultsParticipants suggested dominant biomedical/mechanical beliefs (related to CLBP causes, posture and activity, and the belief of an endpoint/cure for CLBP). Maladaptive beliefs and practices, in particular fear-avoidance beliefs, and dependence on passive management and coping, were common among participants. These beliefs and practices were mostly influenced by HCPs and sociocultural expectations/norms. Although spirituality, pacing activity and prescribed exercises were commonly mentioned by participants, other active strategies and positive beliefs were expressed by a few participants and influenced by patients’ themselves. Limited physiotherapy involvement, knowledge and awareness were also reported by participants, and this appeared to be influenced by the limited physiotherapy visibility in Ghana.ConclusionParticipants’ narratives suggested the dominant influence of HCPs and the sociocultural environment on their biomedical/mechanical beliefs. These facilitated maladaptive beliefs and adoption of passive coping and management practices. Therefore, incorporation of more positive beliefs and holistic/active strategies by Ghanaian patients and HCPs may be beneficial. Furthermore, patient empowerment and health literacy opportunities to address unhelpful CLBP/sociocultural beliefs and equip patients with management options for CLBP could be beneficial.
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Yeong, Foong May, Hong Hwa Lim, Ya Wang, and Uttam Surana. "Early Expressed Clb Proteins Allow Accumulation of Mitotic Cyclin by Inactivating Proteolytic Machinery during S Phase." Molecular and Cellular Biology 21, no. 15 (August 1, 2001): 5071–81. http://dx.doi.org/10.1128/mcb.21.15.5071-5081.2001.
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ABSTRACT Periodic accumulation and destruction of mitotic cyclins are important for the initiation and termination of M phase. It is known that both APCCdc20 and APCHct1 collaborate to destroy mitotic cyclins during M phase. Here we show that this relationship between anaphase-promoting complex (APC) and Clb proteins is reversed in S phase such that the early Clb kinases (Clb3, Clb4, and Clb5 kinases) inactivate APCHct1 to allow Clb2 accumulation. This alternating antagonism between APC and Clb proteins during S and M phases constitutes an oscillatory system that generates undulations in the levels of mitotic cyclins.
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Budhrani-Shani, Pinky, Donna L. Berry, Patricia Arcari, Helene Langevin, and Peter M. Wayne. "Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review." Nursing Research and Practice 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/9018036.
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Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications.Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms:nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain,and/orrisk factors.Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP.Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.
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Suntsov, Vladislav, Filip Jovanovic, Emilija Knezevic, Kenneth D. Candido, and Nebojsa Nick Knezevic. "Can Implementation of Genetics and Pharmacogenomics Improve Treatment of Chronic Low Back Pain?" Pharmaceutics 12, no. 9 (September 21, 2020): 894. http://dx.doi.org/10.3390/pharmaceutics12090894.
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Etiology of back pain is multifactorial and not completely understood, and for the majority of people who suffer from chronic low back pain (cLBP), the precise cause cannot be determined. We know that back pain is somewhat heritable, chronic pain more so than acute. The aim of this review is to compile the genes identified by numerous genetic association studies of chronic pain conditions, focusing on cLBP specifically. Higher-order neurologic processes involved in pain maintenance and generation may explain genetic contributions and functional predisposition to formation of cLBP that does not involve spine pathology. Several genes have been identified in genetic association studies of cLBP and roughly, these genes could be grouped into several categories, coding for: receptors, enzymes, cytokines and related molecules, and transcription factors. Treatment of cLBP should be multimodal. In this review, we discuss how an individual’s genotype could affect their response to therapy, as well as how genetic polymorphisms in CYP450 and other enzymes are crucial for affecting the metabolic profile of drugs used for the treatment of cLBP. Implementation of gene-focused pharmacotherapy has the potential to deliver select, more efficacious drugs and avoid unnecessary, polypharmacy-related adverse events in many painful conditions, including cLBP.
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Grabli, Florent El, François Quesque, Céline Borg, Michael Witthöft, George A. Michael, Christian Lucas, Florence Pasquier, Thibaud Lebouvier, and Maxime Bertoux. "Interoception and social cognition in chronic low back pain: a common inference disturbance? An exploratory study." Pain Management 12, no. 4 (May 2022): 471–85. http://dx.doi.org/10.2217/pmt-2021-0090.
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Aim: Lower interoceptive abilities are a characteristic of chronic pain conditions. Social support plays an important role in chronic low back pain (cLBP) but social cognitive skills have rarely been investigated. This study aimed to characterize interoceptive and social cognitive abilities in cLBP and to study the relationship between both domains that have been brought closer together by brain predictive coding models. Materials & methods: Twenty-eight patients with cLBP and 74 matched controls were included. Interoceptive accuracy (Heart Beat Perception Task), sensibility/awareness (Multidimensional Assessment of Interoceptive Awareness) and mental-states inference abilities (Mini-Social Cognition and Emotional Assessment) were assessed. Results: cLBP Patients had lower interoceptive accuracy and mentalizing performance. Conclusion: Less efficient interoceptive accuracy and mentalizing abilities were found in cLBP patients without correlation between these performances.
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Nakao, Hidetoshi, Ryota Imai, Taro Hamada, Masakazu Imaoka, Mitsumasa Hida, Takeshi Morifuji, and Masashi Hashimoto. "Factors affecting chronic low back pain among high school baseball players in Japan: A pilot study." PLOS ONE 18, no. 1 (January 26, 2023): e0280453. http://dx.doi.org/10.1371/journal.pone.0280453.
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The prevalence of chronic lower back pain (CLBP) among baseball players is high. CLBP is associated with reduced participation in practice and games. This pilot study examined the factors associated with CLBP among high school baseball players in Fukui, Japan. The participants underwent two health examinations in high school: (1) as first-grade baseball players (baseline) and (2) as second-grade baseball players (follow-up); a total of 59 players who could be followed-up a year later were included in the study. Players were divided into three groups based on whether they had no lower back pain (LBP) (n = 30), improved LBP (n = 17), or CLBP (n = 12) after 1 year of follow-up. Players were evaluated on the physical and cognitive aspects of pain. The Number Rating System, Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Central Sensitization Inventory (CSI), body characteristics (age, height, weight, body mass index, and skeletal mass index), and a medical history questionnaire regarding spondylolysis and baseball loads were used to evaluate the players. Inventory scores were highest in the CLBP group, which indicated that this group had significant pain that affected their willingness to engage in baseball-related activities. The TSK scores in the CLBP group were worse on follow-up. High school baseball players with CLBP were more likely to have lumbar spondylolysis and kinesiophobia, which are also factors related to pain chronicity. Kinesiophobia and the presence of lumbar spondylolysis should be considered when creating an exercise program for high school baseball players with CLBP.
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Da Cuña-Carrera, Iria, Alejandra Alonso-Calvete, Eva M. Lantarón-Caeiro, and Mercedes Soto-González. "Ultrasonographic Changes of Abdominal Muscles in Subjects with and without Chronic Low Back Pain." Healthcare 10, no. 1 (January 8, 2022): 123. http://dx.doi.org/10.3390/healthcare10010123.
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Chronic low back pain (CLBP) is a prevalent disfunction in the spine, affecting both women and men. The implication of the abdominal muscles in this disfunction has been studied, including wrong breathing patterns or inactivity of this area. However, there is a lack of studies examining changes in thickness of abdominal with ultrasonography. Thus, the aim of this study is to analyze the differences in the thickness of abdominal muscles at rest and during breathing between subjects with and without CLBP. A total of 72 subjects were divided in two groups: participants with CLBP (n = 36) and participants without CLBP (n = 36). In both groups, the thickness of the four abdominal muscles was measured and compared at rest and during breathing with ultrasonography. In TrA and IO there were no significant differences between groups, but those subjects with CLBP increased the muscle thickness more than participants without pain during breathing. In EO there were no differences in muscle thickness between groups and between rest and breathing. In RA, subjects with CLBP showed less muscle thickness than subjects without pain during breathing, but no changes were found at rest. In conclusion, the deepest abdominal muscles, TrA and IO, appear to increase their thickness and RA appear to decrease more in subjects with CLBP, in comparison with healthy participants.
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Kahere, Morris, Mbuzeleni Hlongwa, and Themba G. Ginindza. "A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa." International Journal of Environmental Research and Public Health 19, no. 5 (March 3, 2022): 2964. http://dx.doi.org/10.3390/ijerph19052964.
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Background: The global burden of chronic low back pain (CLBP) is a major concern in public health. Several CLBP epidemiological studies have been conducted in high-income-countries (HICs) with little known in low-and-middle-income-countries (LMICs) due to other competing priorities of communicable diseases. The extrapolation of results of studies from HICs for use in LMICs is difficult due to differences in social norms, healthcare systems, and legislations, yet there is urgent need to address this growing burden. It is against this backdrop that we conducted this review to map the current evidence on the distribution of CLBP in Sub-Saharan Africa (SSA). Methods: A comprehensive literature search was conducted from the following databases: PubMed, Google Scholar, Science Direct databases, World Health Organizations library databases, EMBASE, EBSCOhost by searching the following databases within the platform; academic search complete, CINAHL with full text, health sources: nursing/academic and MEDLINE. The title, abstract and the full text screening phases were performed by two independent reviewers with the third reviewer employed to adjudicate discrepancies. The reference list of all included articles was also searched for eligible articles. This scoping review was reported in accordance with the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation, as well as guided by Arksey and O’Malley’s scoping review framework. A thematic content analysis was used to give a narrative account of the review. Results: The electronic search strategy retrieved 21,189 articles. Title/abstract and full text screening only identified 11 articles, which were included in this review. The prevalence of CLBP among the general population ranged from 18.1% to 28.2% and from 22.2% to 59.1% among LBP patients. The prevalence of occupation based CLBP ranged from 30.1% to 55.5%. Identified risk factors for CLBP are multifactorial and included biomechanical, psychological, socioeconomic and lifestyle factors, with psychosocial factors playing a significant role. Hypertension, diabetes mellitus, peptic ulcer disease were the most common comorbidities identified. CLBP disability was significantly associated with psychosocial factors. The management of CLBP in primary care follows the traditional biomedical paradigm and primarily involves pain medication and inconsistent with guidelines. Conclusions: There are limited epidemiological data on CLBP in SSA, however, this study concluded that the prevalence and risk factors of CLBP in SSA are comparable to reports in HICs. Considering the projected increase in the burden of CLBP in LMICs extensive research effort is needed to close this knowledge gap.
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Smith, James Kenneth, and Jack R. Crisler. "Chronic Low Back Pain: The Treatment Dichotomy and Implications for Rehabilitation Counselors." Journal of Applied Rehabilitation Counseling 16, no. 1 (March 1, 1985): 28–31. http://dx.doi.org/10.1891/0047-2220.16.1.28.
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Persons with chronic low back pain (CLBP) are being referred to private and state rehabilitation programs in increasing numbers. The difficulty of rehabilitating the CLBP person is well documented. Treatment approaches to CLBP vary but generally fall into conservative and surgical treatment categories. This paper presents an overview of the treatment approaches and psychological factors, and makes suggestions for rehabilitation counselor strategy.
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Castro-Méndez, Aurora, Inmaculada Concepción Palomo-Toucedo, Manuel Pabón-Carrasco, Javier Ramos-Ortega, Juan Antonio Díaz-Mancha, and Lourdes María Fernández-Seguín. "Custom-Made Foot Orthoses as Non-Specific Chronic Low Back Pain and Pronated Foot Treatment." International Journal of Environmental Research and Public Health 18, no. 13 (June 25, 2021): 6816. http://dx.doi.org/10.3390/ijerph18136816.
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Excessive foot pronation has been reported as being related to chronic low back pain symptoms and risk factors in sports-specific pathologies. Compensating custom-made foot orthotics treatment has not been entirely explored as an effective therapy for chronic low back pain (CLBP). This study aims to observe the effects of custom-made foot orthoses, in subjects with foot pronation suffering from CLBP. A total of 101 patients with nonspecific CLBP and a pronated foot posture index (FPI) were studied. They were randomized in two groups: an experimental one (n = 53) used custom-made foot orthotics, and the control group (n = 48) were treated with non-biomechanical effect orthoses. The CLBP was measured using the Oswestry Disability Index (ODI) Questionnaire and a visual analogue scale (VAS), both for lower back pain. The symptoms were evaluated twice, at first when the subject was included in the study, and later, after 4 weeks of treatment. The analysis of outcomes showed a significant decrease in CLBP in the custom-made foot orthoses participants group (p < 0.001 ODI; p < 0.001 VAS). These findings suggest that controlling excessive foot pronation by using custom-made foot orthoses may significantly contribute to improving CLBP.
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Islam, Mollah Mohammad Muzahidul, Tulshi Chandra Saha, Abu Saleh Mohammad Mainul Hasan, Sarwar Bin Zakir, and Saifur Ahmed. "Assessment of Risk Factors for Chronic Low Back Pain in Adult Male." Faridpur Medical College Journal 15, no. 2 (June 8, 2021): 74–78. http://dx.doi.org/10.3329/fmcj.v15i2.53892.
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Chronic low back pain (CLBP) is an important health problem in Bangladeshi adult males. This case control study was carried out in the department of Physical Medicine and Rehabilitation, BSMMU, Dhaka from January 2015 to December 2015 to determine the association between CLBP and family history, smoking, level of education, level of income, level of exercise, bad posture and BMI in adult male. Total 171 patients with CLBP were taken as cases, and 171 male without CLBP were taken as controls. Data were collected using a structured interviewer-administered questionnaire, enquiring about demographic data and details of risk factors. Heights and weights were measured to calculate body mass index (BMI). Age range was 18 to 60 years. Mean age (± SD) for cases was 35.8±11 years and that of controls was 37.2±13 years. It was found that Bad posture (p value <.001), lack of exercise (p value<.001) and moderate level of education (p value .044) were significant risk factors for CLBP. Family history, smoking, level of income and BMI did not have a significant association with CLBP.
Faridpur Med. Coll. J. 2020;15(2): 74-78
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Champagne, Annick, François Prince, Vicky Bouffard, and Danik Lafond. "Balance, Falls-Related Self-Efficacy, and Psychological Factors amongst Older Women with Chronic Low Back Pain: A Preliminary Case-Control Study." Rehabilitation Research and Practice 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/430374.
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Objective. To investigate balance functions in older women and evaluate the association of the fear-avoidance beliefs model (FABM) factors with balance and mobility performance.Participants. Fifteen older women with CLBP was compared with age-matched pain-free controls (n=15).Main Outcome Measures. Pain intensity, falls-related self-efficacy and intrinsic constructs in the FABM were evaluated. Postural steadiness (centre of pressure (COP)) and mobility functions were assessed. Linear relationships of FABM variables with COP and mobility score were estimated.Results. CLBP showed lower mobility score compared to controls. CLBP presented lower falls-related self-efficacy and it was associated with reduced mobility scores. FABM variables and falls-related self-efficacy were correlated with postural steadiness. Physical activity was reduced in CLBP, but no between-group difference was evident for knee extensor strength. No systematic linkages were observed between FABM variables with mobility score or postural steadiness.Conclusions. Back pain status affects balance and mobility functions in older women. Falls-related self-efficacy is lower in CLBP and is associated with reduced mobility. Disuse syndrome in CLBP elderly is partly supported by the results of this preliminary study.
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Li, Xin, Howe Liu, Le Ge, Yifeng Yan, Wai Leung Ambrose Lo, Le Li, and Chuhuai Wang. "Cortical Representations of Transversus Abdominis and Multifidus Muscles Were Discrete in Patients with Chronic Low Back Pain: Evidence Elicited by TMS." Neural Plasticity 2021 (February 18, 2021): 1–9. http://dx.doi.org/10.1155/2021/6666024.
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Introduction. The transversus abdominis (TVA) and multifidus (MF) muscles are the main segmental spinal stabilizers that are controlled by the primary motor cortex of the brain. However, relocations of the muscle representation in the motor cortex may occur after chronic lower back pain (cLBP); it still needs more evidence to be proven. The current study was aimed at applying transcranial magnetic stimulation (TMS) to investigate the changes of representation of TVA and MF muscles at the cortical network in individuals with cLBP. Methods. Twenty-four patients with cLBP and 12 age-matched healthy individuals were recruited. Responses of TVA and MF to TMS during muscle contraction were monitored and mapped over the contralateral cortex using a standardized grid cap. Maps of the center of gravity (CoG), area, volume, and latency were analyzed, and the asymmetry index was also computed and compared. Results. The locations of MF CoG in cLBP individuals were posterior and lateral to the CoG locations in healthy individuals. In the healthy group, the locations of TVA and MF CoG were closed to each other in both the left and right hemispheres. In the cLBP group, these two locations were next to each other in the right hemisphere but discrete in the left hemisphere. In the cLBP group, the cortical motor map of TVA and MF were mutually symmetric in five out of eleven (45.5%) subjects and leftward asymmetric in four out of ten (40.0%) subjects. Conclusions. Neural representations of TVA and MF muscles were closely organized in both the right and left motor cortices in the healthy group but were discretely organized in the left motor cortex in the cLBP group. This provides strong support for the neural basis of pathokinesiology and clinical treatment of cLBP.
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Simon, Corey B., Trevor A. Lentz, Mark D. Bishop, Joseph L. Riley, Roger B. Fillingim, and Steven Z. George. "Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity." Physical Therapy 96, no. 7 (July 1, 2016): 1049–56. http://dx.doi.org/10.2522/ptj.20150335.
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Abstract Background Because of its high global burden, determining biopsychosocial influences of chronic low back pain (CLBP) is a research priority. Psychological factors such as pain catastrophizing are well established. However, cognitive factors such as working memory warrant further investigation to be clinically useful. Objective The purpose of this study was to determine how working memory and pain catastrophizing are associated with CLBP measures of daily pain intensity and movement-evoked pain intensity. Design This study was a cross-sectional analysis of individuals with ≥3 months of CLBP (n=60) compared with pain-free controls (n=30). Method Participants completed measures of working memory, pain catastrophizing, and daily pain intensity. Movement-evoked pain intensity was assessed using the Back Performance Scale. Outcome measures were compared between individuals with CLBP and those who were pain-free using nonparametric testing. Associations were determined using multivariate regression analyses. Results Participants with CLBP (mean age=47.7 years, 68% female) had lower working memory performance (P=.008) and higher pain catastrophizing (P<.001) compared with pain-free controls (mean age=47.6 years, 63% female). For individuals with CLBP, only working memory remained associated with daily pain intensity (R2=.07, standardized beta=−.308, P=.041) and movement-evoked pain intensity (R2=.14, standardized beta=−.502, P=.001) after accounting for age, sex, education, and interactions between pain catastrophizing and working memory. Limitations The cross-sectional design prevented prospective analysis. Findings also are not indicative of overall working memory (eg, spatial) or cognitive performance. Conclusion Working memory demonstrated the strongest association with daily pain and movement-evoked pain intensity compared with (and after accounting for) established CLBP factors. Future research will elucidate the prognostic value of working memory on prevention and recovery of CLBP.
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Finta, R., I. Polyák, T. Bender, and E. Nagy. "Effects of exercise therapy on postural stability, multifidus thickness, and pain intensity in patients with chronic low-back pain." Developments in Health Sciences 2, no. 1 (March 2019): 15–21. http://dx.doi.org/10.1556/2066.2.2019.003.
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Purpose We examined the effects of exercise therapy on postural stability, multifidus thickness, and pain intensity in patients with low-back pain. Materials and methods Subjects were divided into a chronic low-back pain (CLBP; n = 10) group and a healthy control (C; n = 10) group. Group CLBP took part in an 8-week training programme, whereas group C did not. The thickness of the multifidus in both groups was assessed using ultrasonography before and after 8 weeks, in prone and kneeling positions, in relaxed and contracted states. A standing heel-raising test was used to assess postural stability. Results After the intervention in group CLBP, the thickness of the contracted multifidus increased in the prone position, whereas the thickness of both the contracted and relaxed multifidus decreased in the kneeling position. In group C after 8 weeks, multifidus thickness decreased in both positions, while both relaxed and contracted. Group C performed the standing heel-raising test significantly better than group CLBP before the 8-week period. After the training, group CLBP improved significantly, but no changes were found in group C. Discussion and conclusions Changes in thickness of the multifidus correlate with improved postural stability and decreased pain intensity. Decreasing thickness in healthy individuals may be an early sign of developing CLBP.
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Giesbrecht, R. Jason S., and Michele C. Battié. "A Comparison of Pressure Pain Detection Thresholds in People With Chronic Low Back Pain and Volunteers Without Pain." Physical Therapy 85, no. 10 (October 1, 2005): 1085–92. http://dx.doi.org/10.1093/ptj/85.10.1085.
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Abstract Background and Purpose. Palpation is often utilized in the physical examination of patients with low back pain. The purpose of this study was to compare the pressure pain detection threshold (PPDT) of people with chronic low back pain (CLBP) and subjects without pain. Subjects and Methods. Thirty female subjects with CLBP were recruited from the offices of primary care physicians and physical therapists and compared with 30 female volunteers without pain for differences in PPDT at 6 sites tested bilaterally. Results. A significantly lower mean PPDT was found for all test site groups in subjects with CLBP compared with subjects without pain. A lower global PPDT was found in subjects with CLBP compared with subjects without pain (5.6 lb/cm2 versus 6.9 lb/cm2). This also was the case for PPDT for the group of test sites unrelated to the lumbar spine (5.1 lb/cm2 versus 6.1 lb/cm2) and for PPDT related to the lumbar spine (5.9 lb/cm2 versus 8.0 lb/cm2). Discussion and Conclusion. Neurobiological or biopsychosocial influences may have contributed to the lower PPDT evident in subjects with CLBP. Subjects with CLBP demonstrated a lower global PPDT compared with subjects without pain, which should be taken into account when interpreting findings of pain or tenderness from palpation.
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Jacob, Louis, Wolfgang Rathmann, Ai Koyanagi, Josep Maria Haro, and Karel Kostev. "Association between type 2 diabetes and chronic low back pain in general practices in Germany." BMJ Open Diabetes Research & Care 9, no. 1 (July 2021): e002426. http://dx.doi.org/10.1136/bmjdrc-2021-002426.
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IntroductionThere are conflicting results on the association between type 2 diabetes and chronic low back pain (CLBP). Therefore, the goal was to investigate the relationship between type 2 diabetes and CLBP in individuals followed in general practices in Germany.Research design and methodsAdults diagnosed for the first time with type 2 diabetes in 809 general practices in Germany between 2005 and 2018 (index date) were included. Adults without type 2 diabetes were matched (1:1) to those with type 2 diabetes by sex, age, index year, and the annual number of medical consultations (index date: a randomly selected visit date). The association between type 2 diabetes and the 10-year incidence of CLBP was analyzed in conditional Cox regression models adjusted for a wide range of comorbidities, including hypertension, lipid metabolism disorders, and obesity.ResultsThere were 139 002 individuals included in this study (women: 58.0%; mean (SD) age 62.5 (13.4) years). There was a positive association between type 2 diabetes and the incidence of CLBP in the overall sample (HR=1.23, 95% CI: 1.13 to 1.35). Sex-stratified analyses showed a higher risk of CLBP in women (HR=1.68, 95% CI: 1.43 to 1.90) and a lower risk in men with than in their counterparts without type 2 diabetes (HR=0.83, 95% CI: 0.71 to 0.97).ConclusionsNewly diagnosed type 2 diabetes was associated with an increased risk of CLBP. There were important sex differences in the type 2 diabetes-CLBP relationship, and more research is warranted to investigate the underlying factors explaining these differences.
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Penn, Terence M., Demario S. Overstreet, Edwin N. Aroke, Deanna D. Rumble, Andrew M. Sims, Caroline V. Kehrer, Ava N. Michl, et al. "Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain." Pain Medicine 21, no. 11 (April 24, 2020): 3161–71. http://dx.doi.org/10.1093/pm/pnaa095.
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Abstract Objective For most patients with chronic low back pain (cLBP), the cause is “nonspecific,” meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP. Methods Participants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function. Results Findings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity (indirect effect = 6.64, 95% confidence interval [CI] = 2.041 to 14.913) and physical function (indirect effect = −0.401, 95% CI = −1.029 to −0.052). Greater chronic pain stigma was associated with greater perceived injustice (P = 0.001), which in turn was associated with greater movement-evoked pain severity (P = 0.003). Conclusions These results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.
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Ferrer-Peña, Raúl, César Calvo-Lobo, Ramón Aiguadé, and Josué Fernández-Carnero. "Which Seems to Be Worst? Pain Severity and Quality of Life between Patients with Lateral Hip Pain and Low Back Pain." Pain Research and Management 2018 (October 22, 2018): 1–7. http://dx.doi.org/10.1155/2018/9156247.
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Purpose. The aim of this study was to compare the pain severity, health-related quality of life (HRQoL), and risk of continue having pain with prognostic risk scores (PRS), between patients referring greater trochanteric pain syndrome (GTPS) and chronic low back pain (CLBP). Methods. A descriptive, cross-sectional design using nonprobability convenience sampling was performed. A total sample of 102 patients were recruited from two primary health-care centers and divided into GTPS (n = 51) and CLBP (n = 51) groups. The primary outcome was pain severity which was assessed with the Spanish version of the Graded Chronic Pain Scale (GCPS). The secondary outcome was the HRQoL which was measured using the Spanish version of EuroQoL Five Dimensions and Five Levels (EQ-5D-5L) as well as the PRS. Results. Significant differences (P<0.05) were found within both groups in the pain severity global score with a medium effect size showing greater values for the CLBP group with regards to the GTPS group. The PRS in both groups did not show statistical differences (P>0.05). Nevertheless, subjects referring CLBP showed greater levels in the PRS than patients with GTPS. Comparing both groups, the HRQoL showed statistical differences (P<0.05) in the “pain/discomfort” domain in the CLBP group with respect to the GTPS group, but not in the other domains. Conclusions. Patients who suffered from CLBP showed greater pain severity and HRQoL discomfort with regard to patients with GTPS. Despite greater scores for CLBP, the PRS did not seem to be different between both conditions.
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Torres, Luis Miguel, Antonio Javier Jiménez, Ana Cabezón, and Manuel Jesús Rodríguez. "Prevalence and Characterization of Breakthrough Pain Associated with Chronic Low Back Pain in the South of Spain: A Cross-Sectional, Multicenter, Observational Study." Pain Research and Treatment 2018 (April 23, 2018): 1–7. http://dx.doi.org/10.1155/2018/4325271.
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Chronic low back pain (CLBP) is highly prevalent in industrialized countries, where it is one of the main causes of disability. Patients with CLBP in treatment with opioids often experience episodes of breakthrough pain (BTP), but data on prevalence and treatment preferences are scarce. The objectives of this study were, first, the evaluation of the prevalence of BTP in patients with CLBP in the South of Spain (N=1,868) and, second, the characterization of BTP in these patients (N=295). Data was collected on presence of BTP, type and location of pain, treatment, compliance, and patient satisfaction. We found a prevalence of BTP in patients with CLBP of 37.5% (95% CI: 35.3%–39.7%), similar in men and women. 75% of the patients were older than 50 years. The preferred drug of patients who control BTP with opioids is fentanyl (78.3%) and its most common form of administration is nasal (53.2%). Therapeutic compliance was high and 46.3% of patients considered the control of their BTP very satisfactory. Our study showed that BTP is common in patients with CLBP and that current treatments seem adequate.
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Bhairannawar, Satish S., K. B. Raja, and K. R. Venugopal. "An Efficient Reconfigurable Architecture for Fingerprint Recognition." VLSI Design 2016 (July 28, 2016): 1–22. http://dx.doi.org/10.1155/2016/9532762.
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The fingerprint identification is an efficient biometric technique to authenticate human beings in real-time Big Data Analytics. In this paper, we propose an efficient Finite State Machine (FSM) based reconfigurable architecture for fingerprint recognition. The fingerprint image is resized, and Compound Linear Binary Pattern (CLBP) is applied on fingerprint, followed by histogram to obtain histogram CLBP features. Discrete Wavelet Transform (DWT) Level 2 features are obtained by the same methodology. The novel matching score of CLBP is computed using histogram CLBP features of test image and fingerprint images in the database. Similarly, the DWT matching score is computed using DWT features of test image and fingerprint images in the database. Further, the matching scores of CLBP and DWT are fused with arithmetic equation using improvement factor. The performance parameters such as TSR (Total Success Rate), FAR (False Acceptance Rate), and FRR (False Rejection Rate) are computed using fusion scores with correlation matching technique for FVC2004 DB3 Database. The proposed fusion based VLSI architecture is synthesized on Virtex xc5vlx30T-3 FPGA board using Finite State Machine resulting in optimized parameters.
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Lima Florencio, Lidiane, Ana Lopez-de-Andres, Valentin Hernández-Barrera, Domingo Palacios-Ceña, César Fernández-de-las-Peñas, Rodrigo Jimenez-Garcia, Napoleon Perez-Farinos, David Carabantes-Alarcon, David Martinez-Hernandez, and Romana Albaladejo-Vicente. "Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study." Journal of Clinical Medicine 9, no. 9 (September 4, 2020): 2867. http://dx.doi.org/10.3390/jcm9092867.
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We aimed to assess if subjects with diabetes exhibit higher prevalence of chronic back pain than age-sex-province of residence-matched non-diabetic controls. We also aimed to identify predictors for chronic neck pain (CNP) or chronic low back pain (CLBP) among subjects with diabetes. A case control study was conducted using data obtained from the Spanish National Health Survey 2017. Multivariable conditional and unconditional logistic regression models were constructed. A total of 2095 diabetes sufferers and 2095 non-diabetic matched controls were analyzed. The prevalence of CNP and CLBP was 27.3% and 34.8%, respectively, in diabetes sufferers and 22.1% and 29.0% in non-diabetes controls (both, p < 0.001). After multivariable analysis, the ORs showed significantly higher adjusted risk of CNP (OR 1.34; 95% CI 1.19–1.51) and CLBP (OR 1.19, 95% CI 1.09–1.31) in diabetes cases. Diabetes sufferers with CNP or CLBP showed higher use of pain medication and higher prevalence of migraine/frequent headache than controls. Female sex, worse self-rated health and use of pain medication were predictors for CNP and CLBP in subjects with diabetes. CNP and CLBP are significantly more prevalent in diabetes sufferers than in controls. Current results can help to design better preventive and educational strategies for these highly prevalent and burdensome pains among diabetic patients.
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Wang, Juan, Changcheng Chen, Mengsi Peng, Yizu Wang, Bao Wu, Yili Zheng, and Xueqiang Wang. "Intra- and Inter-Rater Reliability of Three Measurements for Assessing Tactile Acuity in Individuals with Chronic Low Back Pain." Evidence-Based Complementary and Alternative Medicine 2020 (November 24, 2020): 1–14. http://dx.doi.org/10.1155/2020/8367095.
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Objective. To investigate the intra- and inter-rater reliability of three measurements on painful and pain-free sides in participants with chronic low back pain (CLBP) at different ages. Methods. We recruited 60 participants with CLBP and divided them equally into a group of younger participants with chronic low back pain (18 ≤ age ≤ 35, Y-CLBP) and a group of older participants with chronic low back pain (36 ≤ age ≤ 65, O-CLBP). Participants were assessed by two testers within the same day (10 min interval), and one of the testers repeated the assessment program 24 h later. The intraclass correlation coefficient (ICC) was used to assess reliability. The Pearson correlation coefficient was used to analyze the correlation between tactile acuity and age, waistline, and pain-related variables. Results. In the Y-CLBP group, the intra-rater reliability of two-point discrimination (TPD), point-to-point test (PTP), and two-point estimation (TPE) on the painful and pain-free sides was good (ICC range: 0.74–0.85), whereas the inter-rater reliability of TPD, PTP, and TPE on the painful and pain-free sides was moderate to good (ICC range: 0.65–0.76). In the O-CLBP group, the intra-rater reliability of TPD, PTP, and TPE on the painful and pain-free sides was good (ICC range: 0.75–0.85), whereas the inter-rater reliability of TPD, PTP, and TPE on the painful and pain-free sides was moderate to good (ICC range: 0.70–0.85). Age, waistline, duration of pain, maximum pain, general pain, and unpleasant score caused by pain were positively correlated with tactile acuity thresholds (D-TPD, A-TPD, PTP, and TPE) (r > 0.365, p < 0.05 ). When BMI was controlled, age, waistline, and pain-related variables were positively correlated with tactile acuity thresholds (r > 0.388; p < 0.05 ). Conclusion. In the participants of Y-CLBP and O-CLBP groups, TPD, PTP, and TPE have moderate-to-good intra- and inter-rater reliability on the painful and pain-free sides of the fifth lumbar vertebrae.
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Jalalvand, Ali, and Mehrdad Anbarian. "Effect of Lower Limb Muscle Fatigue on Ground Reaction Force Components During Landing in People With Nonspecific Chronic Low Back Pain." Journal of Sport Rehabilitation 28, no. 8 (November 1, 2019): 847–53. http://dx.doi.org/10.1123/jsr.2018-0153.
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Context: The link between landing parameters and lower limb muscle fatigue in association with chronic low back pain (CLBP) is not well understood. Objective: To examine the effects of fatigue on the ground reaction force components during landing in people with nonspecific CLBP. Design: Quasi-experimental study. Setting: Clinical biomechanics laboratory. Participants: A total of 44 subjects were equally divided into a healthy group and a group with CLBP. Main Outcome Measures: The ground reaction force along anterior–posterior (y) and medial–lateral (x) and vertical (z) axes, time to peak (TTP), the rate of force development, and impulses for all axes were calculated. A repeated-measures analysis of variance (group × fatigue) was used to compare the data among groups. Results: In the unfatigued conditions, the amplitudes of Fy3, Fz2, and TTP of Fy1, Fy2, Fz1, Fz2, Fz3, Fz4, rate of force development in Y in the CLBP subjects are significantly different than those in the healthy subjects (P < .05). In the fatigued conditions, the amplitudes of Fz2, Fz3, Fz4, and TTP of Fy2, Fy3, Fy4, Fz2, impulses of X2, Z in the CLBP group were significantly different than those in the healthy subjects (P < .05). Within-group comparisons of measured Fx1, Fy1, Fy2, Fz2, Fz4 and TTP of Fx1, Fy1, Fy2, Fz2, Fz3, Fz4, impulses of X2, z were significantly different from prefatigue to postfatigue in the healthy group (P < .05). Within-group comparisons of measured Fx1, Fy1, Fz1, Fz2 and TTP of Fx5, Fz1, impulses of X2 were significantly differed from prefatigue to postfatigue in the CLBP group (P < .05). Conclusions: It seems that TTP of ground reaction force variables in CLBP may have clinical values for rehabilitation. Muscle fatigue altered landing performance. However, patients with CLBP will respond differently to lower-extremity fatigue. These altered variables in patients with low back pain are the cause of future injuries or lower-extremity injuries that need to be addressed in further studies.
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Ho-A-Tham, Nancy, Niels Struyf, Beverly Ting-A-Kee, Johanna de Almeida Mello, Yves Vanlandewijck, and Wim Dankaerts. "Physical activity, fear avoidance beliefs and level of disability in a multi-ethnic female population with chronic low back pain in Suriname: A population-based study." PLOS ONE 17, no. 10 (October 31, 2022): e0276974. http://dx.doi.org/10.1371/journal.pone.0276974.
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Background Chronic low back pain (CLBP) is an important cause for reduced daily physical activity (PA) and loss of quality of life, especially in women. In Suriname, a middle-income country in South America, the relationship between PA and CLBP is still unknown. Aims To assess the level of PA in women with CLBP of different ethnicity, and to identify whether fear avoidance beliefs (FAB), disability, co-occurring musculoskeletal pain sites and various sociodemographic and lifestyle factors were associated with self-reported PA. Methods A cross-sectional community-based house-to-house survey was conducted between April 2016 and July 2017. The survey followed the Community Oriented Program for Control of Rheumatic Diseases methodology. Selection criteria were being female of Asian-Surinamese, African-Surinamese or of Mixed ethnicity and aged 18 or older, living in an urban area, and reporting CLBP. Data was collected on PA, FAB, disability, co-occurring musculoskeletal pain sites, CLBP intensity and sociodemographic and lifestyle factors. Results Urban adult women with current CLBP (N = 210) were selected. Nearly 57% of the population met the WHO recommendation on PA, with work-related PA as the largest contributor to total self-reported PA. Most women showed low FAB scores (FABQ-Work ≤34 (96.2%) and FABQ-PA ≤14 (57.6%)) and low disability levels (Oswestry Disability Index ≤20 (62.4%)). An inverse association between total PA and FABQ-Work (OR = 0.132, CI: 0.023; 0.750) was found. In contrast, total PA had a significant, positive association with disability (OR = 2.154, CI: 1.044; 4.447) and workload (OR = 2.224, CI: 1.561; 3.167). All other variables showed no association with total PA. Conclusion This was the first study in Suriname reporting that 43.3% of urban adult women with CLBP were physically inactive. Total self-reported PA is influenced by FABQ-Work, average to heavy workload and moderate to severe disability. In this study, PA-Work was the major contributor to total PA. Therefore, future longitudinal studies should evaluate different types and aspects of PA in relation to CLBP management.
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Wells, Cherie, Gregory S. Kolt, Paul Marshall, and Andrea Bialocerkowski. "The Definition and Application of Pilates Exercise to Treat People With Chronic Low Back Pain: A Delphi Survey of Australian Physical Therapists." Physical Therapy 94, no. 6 (June 1, 2014): 792–805. http://dx.doi.org/10.2522/ptj.20130030.
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BackgroundPilates exercise is recommended for people with chronic low back pain (CLBP). In the literature, however, Pilates exercise is described and applied differently to treat people with CLBP. These differences in the definition and application of Pilates exercise make it difficult to evaluate its effectiveness.ObjectiveThe aim of this study was to establish consensus regarding the definition and application of Pilates exercise to treat people with CLBP.MethodsA panel of Australian physical therapists who are experienced in treating people with CLBP using Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect the respondents' opinions. Answers to open-ended questions were analyzed thematically, combined with systematic literature review findings, and translated into statements about Pilates exercise for people with CLBP. Participants then rated their level of agreement with these statements using a 6-point Likert scale. Consensus was achieved when 70% of the panel members strongly agreed, agreed, or somewhat agreed (or strongly disagreed, disagreed, or somewhat disagreed) with an item.ResultsThirty physical therapists completed all 3 questionnaires and reached consensus on the majority of items. Participants agreed that Pilates exercise requires body awareness, breathing, movement control, posture, and education. It was recommended that people with CLBP should undertake supervised sessions for 30 to 60 minutes, twice per week, for 3 to 6 months. Participants also suggested that people with CLBP would benefit from individualized assessment and exercise prescription, supervision and functional integration of exercises, and use of specialized equipment.LimitationsItem consensus does not guarantee the accuracy of findings. This survey reflects the opinion of only 30 physical therapists and requires validation in future trials.ConclusionThese findings contribute to a better understanding of Pilates exercise and how it is utilized by physical therapists to treat people with CLBP. This information provides direction for future research into Pilates exercise, but findings need to be interpreted within the context of study limitations.
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Briggs, Andrew M., Peter B. O'Sullivan, Deryck Foulner, and John D. Wark. "Vertebral Bone Mineral Measures and Psychological Wellbeing among Individuals with Modic Changes." Clinical Medicine Insights: Case Reports 5 (January 2012): CCRep.S9209. http://dx.doi.org/10.4137/ccrep.s9209.
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Purpose This case-control pilot study examined whether vertebral bone mineral measures were associated with the presence of chronic low back pain (CLBP) and Modic changes (MCs), and to compare psychological wellbeing and inflammation among individuals with CLBP and MCs, compared to individuals with no history of low back pain and without MCs. Methods Eleven individuals with MRI-defined MCs in the lumbar spine and CLBP (cases) and 10 individuals with no history of CLBP or MCs (controls) responded to standard questionnaires regarding pain characteristics and psychological health. Bone mineral density (BMD) was measured with postero-anterior and lateral-projection dual energy X-ray absorptiometry (DXA) to estimate areal BMD (aBMD) and apparent volumetric BMD (ap.vBMD). High sensitivity serum C-reactive protein (hsCRP) was measured as an index of inflammation. Results While there was no difference between the groups in measures of depression, anxiety and stress, cases reported significantly greater pain catastrophizing attitudes ( P < 0.01). hsCRP concentrations did not differ between groups ( P = 0.54). Among the 7 cases where MCs were identified between L3–4, significantly higher mean aBMD was observed at the affected vertebral level, compared to the adjacent, unaffected, cephalad level ( P = 0.01–0.04), but not when ap.vBMD was calculated ( P = 0.36). Conclusions Vertebral BMD is not reduced among individuals with CLBP and MCs compared to a control group, although pain catastrophizing attitudes are increased among individuals with CLBP and MCs.
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Gregg, Chris, Chris Hoffman, Hamilton Hall, Greg McIntosh, and Peter Robertson. "Outcomes of an interdisciplinary rehabilitation programme for the management of chronic low back pain." Journal of Primary Health Care 3, no. 3 (2011): 222. http://dx.doi.org/10.1071/hc11222.
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BACKGROUND AND CONTEXT: The health and economic costs associated with chronic low back pain (CLBP) have increased substantially over the past few decades. Despite extensive research, a consistently valid, reliable and effective diagnostic and treatment regime for CLBP is yet to be determined. ASSESSMENT OF PROBLEM: This paper presents an established interdisciplinary rehabilitation model for CLBP initially developed by the Canadian Back Institute. An audit describes the symptomatic, functional and vocational outcomes achieved for patients who attended the programme over three years throughout a national network of primary health care facilities in New Zealand. RESULTS: Over a three-year period, 899 patients with CLBP completed their rehabilitation programme at one of eight affiliated clinics. Of the 899 patients discharged, 780 (86.8%) reported that their back pain had gone or reduced at the end of their rehabilitation. There was a statistically significant, and clinically relevant, improvement in both average pain and subjective functional scores from baseline assessment levels to discharge and follow-up scores (p<0.001). STRATEGIES FOR IMPROVEMENT: Previous studies have shown that functional rehabilitation can improve outcomes in individuals with CLBP. This audit provides further support for the development of interdisciplinary functional rehabilitation programmes to help manage CLBP within the community. LESSONS: The routine measurement of symptomatic, functional and vocational outcomes throughout the rehabilitation process can assist in quantifying the effect of treatment and providing evidence of value for patients, stakeholders and funding groups. KEYWORDS: Low back pain; outcomes; rehabilitation
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Murray, Kyle, Yezhe Lin, Meena M. Makary, Peter G. Whang, and Paul Geha. "Brain Structure and Function of Chronic Low Back Pain Patients on Long-Term Opioid Analgesic Treatment: A Preliminary Study." Molecular Pain 17 (January 2021): 174480692199093. http://dx.doi.org/10.1177/1744806921990938.
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Chronic low back pain (CLBP) is often treated with opioid analgesics (OA), a class of medications associated with a significant risk of misuse. However, little is known about how treatment with OA affect the brain in chronic pain patients. Gaining this knowledge is a necessary first step towards understanding OA associated analgesia and elucidating long-term risk of OA misuse. Here we study CLBP patients chronically medicated with opioids without any evidence of misuse and compare them to CLBP patients not on opioids and to healthy controls using structural and functional brain imaging. CLBP patients medicated with OA showed loss of volume in the nucleus accumbens and thalamus, and an overall significant decrease in signal to noise ratio in their sub-cortical areas. Power spectral density analysis (PSD) of frequency content in the accumbens’ resting state activity revealed that both medicated and unmedicated patients showed loss of PSD within the slow-5 frequency band (0.01–0.027 Hz) while only CLBP patients on OA showed additional density loss within the slow-4 frequency band (0.027–0.073 Hz). We conclude that chronic treatment with OA is associated with altered brain structure and function within sensory limbic areas.