Rozprawy doktorskie: „Lower back pains”

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Pang, Toh Yen, i tohyen_pang@yahoo com. "The transmission of vibration at the lower lumbar spine due to whole-body vibration: a numerical human model study". RMIT University. Aerospace Mechanical and Manufacturing Engineering, 2006. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20060825.160144.

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Lower back disorders due to whole-body vibration (WBV) are the most common injuries reported by professional drivers. Such injuries often have long-term complications leading to significant personal and societal costs. An improved mathematical model of the whole human body would contribute to a better understanding of the mechanisms of lower back injury and be valuable in injury prevention research. Current biodynamic human models reported in the literature lack detailed information for predicting the non-linearity due to vibration amplitude of transmission of vibration from seat to a human. Therefore, one of the primary objectives of this research has been to develop and validate a detailed threedimensional biodynamic human model, with special attention given to the incorporation of active trunk muscles with non-linear stiffness properties. These muscles have been incorporated into an existing spine and neck model of a MADYMO 50th percentile male occupant model. A detailed multi-body human model has been developed, called MODEL ONE. This thesis shows that incorporating non-linear stiffness functions and energy dissipation using hysteresis or damping into a human model is appropriate for predicting non-linear biodynamic responses in arbitrary excitation functions. A major advantage of MODEL ONE compared to other multi-body models and lumped mass models is its ability to predict nonlinear seat-to-human transmissibility. However MADYMO 50th male occupant models use simplified geometry and rigid bodies to represent the lower lumbar spine. These simplified spinal models have no ability to simulate the internal stresses and deformations of soft tissues, even if these are the apparent cause of lower back pain (LBP). Therefore a detailed finite element human lower lumbar spine model - with appropriate material properties and capable of simulating internal stresses⎯is necessary, in order to better understand spinal injuries under WBV. A three-dimensional finite element model of a lower lumbar spine motion segment - called MODEL TWO - has thus been developed for the present study. MODEL TWO comprises a detailed geometric description of vertebrae, nucleus pulposus, endplates, and intervertebral discs. The intervertebral discs lump together the annulus fibrosus, ground substance and ligaments. The vertebrae have been assumed to be rigid. The material properties of the intervertebral discs of MODEL TWO were obtained from test matrices and from various parameter data reported in the literature. MODEL TWO has been validated against cadaveric experiments reported in the literature. The mechanical behaviour and stress distribution within the MODEL TWO intervertebral disc agree reasonably well with the cadaveric experiments. MODEL TWO was integrated into MODEL ONE to form a new human model, called MODEL THREE, which was subsequently dynamically validated against volunteersï¿½ responses to WBV reported in the literature. MODEL THREE, as presented in this thesis, consists of a multi-body human model with detailed representation of a finite element (FE) lower lumbar spine. As far as the author is aware, MODEL THREE is the first model with detailed representation of a FE lower lumbar spine to successfully demonstrate that it is capable of simulating the stress profile of the entire intervertebral disc and endplate region due to WBV. The simulated results revealed abnormal stress concentrations in both the posterior and xviii the posterolateral annulus. The stresses increased most in the posterolateral intervertebral discs region during WBV, suggesting a possible mechanism for disc mechanical overload leading to fatigue fracture and degeneration. The results from MODEL THREE are promising and lead to a more comprehensive understanding of the behaviour of the intervertebral disc under WBV. MODEL THREE has also provided a good foundation for the development of a bio-fidelity human model. However, implementation of currently unavailable and/or inadequate in vitro and in vivo experimental studies is needed to further validate and develop MODEL THREE. A better understanding of injury mechanisms and the clinical significance of LBP will ultimately be arrived at using a combination of analytical models with in vitro and in vivo experimental data.

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Shojaei, Iman. "LOWER BACK BIOMECHANICS AT NON-CHRONIC STAGE OF LOW BACK PAIN". UKnowledge, 2018. https://uknowledge.uky.edu/cbme_etds/52.

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Prior studies have reported differences in lower back biomechanics during activities of daily living between individuals with and without chronic low back pain (LBP). Nevertheless, the literature on lower back biomechanics of patients with non-chronic LBP is scant. Therefore, the objective of this study, as the first step towards future prospective studies, was to investigate the lower back biomechanics in patients with non-chronic LBP. Case-control studies were conducted wherein measures of lumbo-pelvic coordination during bending and return tasks as well as measures of mechanical demand on the lower back during lifting tasks in the sagittal plane were investigated between patients with non-chronic LBP and matched asymptomatic individuals. Patients were enrolled into the study at the non-chronic stage of their LBP. We found distinct difference in measures of lumbo-pelvic coordination as well as mechanical demands on the lower back between patients with non-chronic LBP and controls. Reduced lumbar range of flexion and slower task pace as well as the more in-phase and less variable lumbo-pelvic coordination observed in patients with non-chronic low back pain, may be the result of a neuromuscular adaptation to reduce the forces and deformation in the lower back tissues and avoid pain aggravation. Such a neuromuscular adaptation, however, resulted in a larger shearing demand on the lower back. Persistent abnormal lumbo-pelvic coordination might play a role in transition to chronic stage or recurrence of LBP. However, such inferences need to be further investigated using prospective studies as well as clinical trials involving a combination of physical and psychological treatments aimed at correction of lumbo-pelvic coordination.

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Gregory, Erik W. "Whole-body vibration and the lower back the effect of whole-body vibration on pain in the lower back /". Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1714.

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Thesis (M.S.)--West Virginia University, 2000.
Title from document title page. Document formatted into pages; contains vii, 81 p. : ill. Includes abstract. Includes bibliographical references (p. 44-46).

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Trevelyan, Fiona Catherine. "The implementation and evaluation of an ergonomics intervention in a health care setting". Thesis, University of Surrey, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326894.

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Marsden, Mandy. "The epidemiology and risk associated with lower back pain in cyclists". Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/12114.

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Includes abstract.
Includes bibliographical references (leaves 89-98).
Aims of this thesis: the research reported in this thesis consists of a literature review and two research parts. In the first research part, a descriptive cross-sectional survey was conducted, to investigate 1) the epidemiology and 2) the nature of LBP in cyclists, and 3) possible risk factors associated with LBP in cyclists. In the second research part, a case control study was conducted, to investigate the association between LBP in cyclists and 1) flexibility and 2) anthropometric measurements, and 3) bicycle set-up parameters.

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Freddolini, Marco. "Dynamic properties of the lumbar spine in people with non-specific low back pain". Thesis, University of Roehampton, 2014. https://pure.roehampton.ac.uk/portal/en/studentthesis/dynamic-properties-of-the-lumbar-spine-in-people-with-non-specific-low-back-pain(9589eabf-ee40-4fa5-843f-86d543332723).html.

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Non-specific low back pain (LBP) has been associated with alterations in the biomechanical properties and muscle activities of the trunk, but it is unclear how these changes are related to the dynamic stability of the trunk. During sitting, the structures of the trunk stabilise the upper body counterbalancing external moments acting on the trunk. The aim of this research was to evaluate a range of biomechanical variables including the hip and lumbar spine joints range of motions, moments and powers the viscoelastic properties of the trunk, and the role of the muscles while a participant was performing a balancing task in sitting and to compare results between healthy and LBP subjects. A custom-made swinging chair was used to perform the balancing task. It was designed to challenge primarily the trunk and to minimise the effect of the lower limbs so that the role of the trunk could be examined in isolation. Twenty-four participants with LBP and thirty healthy participants were requested to sit on the custom-made swinging chair and to regain the balance after tilting the chair backward for 10° and 20º. Electromagnetic motion track system sensors were placed on the participants’ back, one at the sacrum level and one at the first lumbar vertebral level to measure hip and lumbar kinematics. One further sensor was placed on the chair to track its rotation, which was also the rotation of the lower limbs. Forces data were taken from a force-plate which was mounted at the bottom of the chair. Inverse dynamic equations were used to derive the muscle moment acting at the hip and lumbar spine joints using data from the force platform and the motion tracking system. Muscle power was then calculated by multiplying the muscle moment and the corresponding joint angular velocity. Trunk viscoelastic parameters were derived using a second order linear model combine trunk moment and motion. Chair motion and trial duration were used to evaluate dynamic stability and task performance, in particular, the angular displacement of the chair was fitted in an equation describing the underdamped second-order response to a step input to derive natural frequency and damping ratio and to evaluate possible differences between groups. Activities, reaction times and co-contraction of the trunk muscles were evaluated using surface electromyography (EMG). The surface electrodes were placed bilaterally on the erector spinae , rectus abdominus, external and internal oblique. Kinematic analysis showed that the hip range of motion increased whereas spine range of motion angle decreased in participants with LBP for both tilt angles (p. < 0.05). No significant differences were found in muscle moment and power between healthy and LBP subjects (p > 0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p < 0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p<0.05). Trunk stiffness was found increased for LBP subjects (p < .05) while no difference was found for damping coefficient. There were no significant differences between the 2 subject groups in the time required to regain balance, and in the dynamic stability parameters, the natural frequency and damping ratio. The present study showed LBP was associated with alterations in biomechanical variables; in particular stiffness, hip and lumbar spine joints kinematic and muscle responses were altered in subjects with LBP when compared with healthy group. However, these alterations did not affect dynamic stability and moment developed at joints level, suggesting that LBP subjects adopted a different strategy to maintain balance but with the same effectiveness as the healthy subjects without any worsening of the symptoms. This may suggest to clinicians to encourage patients to remain active rather than to avoid movements. On the other hand, compensatory strategies were achieved with increased co-contraction at the expenses of muscle efficiency. This may lead to muscle fatigue and increase in spinal stress. Future research should clarify if the observed biomechanical alterations in this study are consequences or causes of LBP; or if the biomechanical changes and pain operate in a vicious circle, reinforcing each other leading to chronic conditions. This would help achieve our ultimate goal of developing effective treatment strategies, and it is hoped that the work of this thesis has helped us take a significant forward towards this goal.

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Kopinski, Stephan [Verfasser], i Frank [Akademischer Betreuer] Mayer. "The neuromuscular efficiency of lower back muscles in low back pain / Stephan Kopinski ; Betreuer: Frank Mayer". Potsdam : Universität Potsdam, 2016. http://d-nb.info/1218401214/34.

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Barriera, Viruet Heriberto. "Effect of forklift operation on lower back pain an evidence-based approach /". Cincinnati, Ohio : University of Cincinnati, 2006. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1148264126.

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Thesis (Ph. D.)--University of Cincinnati, 2006.
Title from electronic thesis title page (viewed Aug. 4, 2006). Includes abstract. Keywords: lower-back pain, forklift operation, evidence-based, meta-analysis, whole-body vibration. Includes bibliographical references.

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Olson, Daniel A. "An evaluation of aquatic therapy as a treatment for lower back pain". Honors in the Major Thesis, University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/489.

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Lower back pain (LBP) is a medical condition that will affect most of us at some point in our lives. Several medical causes have been identified for LBP, yet the large majority of LBP patients do not receive a specific diagnosis. These patients use up a large majority of health care resources, and accumulate billions of dollars in medical costs in countries throughout the globe. In recent years, an increasing focus has been placed on the idea that aquatic therapy may be an effective therapy for LBP patients. Exercise therapy has already proven itself as an effective means for treating LBP. Thus, combined with the unique properties of water, experts believe that aquatic therapy is the future of LBP treatment. This thesis aims to explore the efficacy of aquatic therapy as a treatment for LBP. Through the analysis of controlled peer-reviewed studies, scholarly information databases, and historical data on LBP treatment, this thesis evaluates the relationship between aquatic therapy and LBP in its entirety. Scientific properties of water have shown its many uses in rehabilitative therapy treatments. Water, in theory, is able to manipulate the exercise environment to allow for more substantial progress to be made. In studies where aquatic therapy was tested versus no treatment, aquatic therapy proved to be a more efficient and effective option. Still, when placed against other therapies, aquatic therapy did not always prove more effective. While the analyzed studies support the idea that aquatic therapy is an effective treatment for LBP, further research is needed to determine how aquatic therapy holds up against other forms of treatment.
B.S.
Bachelors
Health and Public Affairs
Health Sciences

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BARRIERA, VIRUET HERIBERTO. "EFFECT OF FORKLIFT OPERATION ON LOWER BACK PAIN - AN EVIDENCE-BASED APPROACH". University of Cincinnati / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1148264126.

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Lewis, Grant. "Incidence, prevalence and aetiology of chronic exercise induced lower back pain in runners". Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/26924.

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The aim of this study was to determine the prevalence of lower back pain (LBP) in the running population and any initiating or aggravating factors. The aetiology of low back pain in runners was also investigated. A random sample population of 225 roadrunners were interviewed following the completion of six local road races. A further subgroup (n = 52) (LBP group as well as control group) of these runners was evaluated to determine if there were any biomechanical; muscle strength, flexibility and stability measures; as well as any training protocols which were more commonly associated in those runners who complained of LBP. Questionnaires were completed by 225 runners and a detailed clinical evaluation was performed to identify the incidence and aetiology of running-related lower back pain. Attention was focussed on the lumbar-pelvic muscles in terms of their flexibility, strength and coordinating ability as well as static biomechanical measures of the lower limb. LBP in runners was found to be common with an injury risk of 1.42 injuries per 1000 running hours. This running-related LBP seldom forced the athlete to stop running yet did affect running performance. It was associated with any increase in the running load. Hip flexor inflexibility on the left (p = 0.07); short hip adductor muscle length (p = 0.055), hamstring inflexibility (p = 0.09) and iliotibial band inflexibility (p = 0.036) on the right were found to be more common in the LBP group. The abdominal muscles were weaker in the LBP group when assessed in the trunk curl-up test (p = 0.0085) and the stabilising ability (p = 0.032) for this group was judged to be poor. Biomechanically, only a marginal difference was found between those with and without LBP (p = 0.077) with regard to the hindfoot and forefoot postures which were valgus and varus respectively for the lower back pain group. Lumbar intervertebral joints were mostly hypomobile (p = 0.004) in the LBP group. Adherence to a poor training regime (excessive running distances and frequencies) was associated with the LBP group. Attention to correct training patterns and adequate muscle control (strength, coordination and flexibility) is suggested to protect from this running-related LBP. Further research into a comparison of rehabilitation protocols is required to validate these findings.

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Nabar, Sean J. "Modern Techniques of Adjunctive Pain Control Lower Opioid Use, Pain Scores, and Length-of-Stay in Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis". Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/281776.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
Study Design. Retrospective analysis. Objective. To determine if the use of adjunctive pain medications (subcutaneous bupivacaine, dexmedetomidine infusion, and intravenous ketorolac) will reduce the need for opioids, reduce postoperative pain, and shorten length of hospital stay in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion. Methods. Retrospective review of children 10 to 18 years with adolescent idiopathic scoliosis receiving posterior spinal fusion surgery over the past 10 years at Phoenix Children’s Hospital. Physicians managed the patients’ pain postoperatively with adjunctive medications in addition to intravenous and oral opioids. Variables of interest were local anesthetic bupivacaine delivered subcutaneously via elastomeric pain pump, sedative/analgesic dexmedetomidine infused for up to 24 hours postoperatively, and the NSAID ketorolac delivered intravenously. These three medications were used either alone or in some combination determined by the physician’s clinical judgment. Primary outcomes analyzed were normalized opioid requirement after surgery, VAS pain scores, and length of stay in the hospital. Results. One hundred and ninety-six children were analyzed with no significant differences in demographics. Univariate analysis showed that all three adjunct medications improved outcomes. A multivariate regression model of the outcomes with respect to the three medication variables of interest was developed to analyze the effects of the three medications simultaneously. The regression analysis showed that subcutaneous bupivacaine significantly reduced normalized opioid requirement by 0.98 mg/kg (P = 0.001) and reduced VAS pain scores by 0.67 points (P = 0.004). Dexmedetomidine significantly reduced the average VAS pain scores in the first 24 hours by 0.62 points (P = 0.005). Ketorolac had no effect in the multiple regression analysis. Conclusion. The use of subcutaneous bupivacaine provides good analgesia with low pain scores. A reduction in opioid requirement is beneficial and may be directly related to presence of the bupivacaine pump, although this may be limited by potential treatment bias. The three adjunct medications improve our outcomes favorably and should be studied prospectively.

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Nilahi, Crese Damas. "Work-related lower back pain among primary school teachers in Dar es Salaam, Tanzania". University of the Western Cape, 2014. http://hdl.handle.net/11394/4187.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
Lower back pain (LBP) is one of the most common work-related health problems in economically developed countries and the most prevailing musculoskeletal condition that causes disability in the developing nations. School teachers are susceptible to LBP due to the nature of their daily work routine which is physically demanding and include common activities such as long hours of sitting, standing and bending that have been identified as risk factors for LBP. The aim of the study was to determine the role of work-related activities in the prevalence of LBP amongst primary school teachers in the Dar-es-Salaam region of Tanzania. To achieve this goal, the study sought to meet the following three objectives: to determine the prevalence of LBP among primary school teachers; to determine the work-related physical activities contributing to LBP among primary school teachers, and to determine and explore the application of kinetic handling principles in their daily work environment. The study was conducted in eighty randomly selected primary schools from the Temeke, Ilala and Kinondoni districts. A sequential explanatory mixed method approach was utilised. A cross-sectional descriptive design was employed. A self-administered questionnaire consisting of three sections (socio-demographic information; the Nordic Back Pain Questionnaire and the Oswestry Lower back pain Questionnaire) was completed by two hundred and eighty six primary school teachers with a mean age of 41.2 years (SD=9.9), 78.7% female and 21.3% male. Thirty primary school teachers participated in the participant observation of the application of kinetic handling principles in their daily work environment and focus group discussions. Results of the study found that 17.1% of the teachers had LBP during the past week while 82.9% experienced LBP during the past year. In addition, 30.8% of the teachers had referred pain, mostly to the thigh area (43.9%). Less than fifty percent (43.5%) of the participants had severe pain in sitting (76 – 100mm on the VAS scale) while 26.9% was not able to sit for more than an hour while teaching due to LBP. A significant relationship was found for severe functional disability and gender (p=0.032). The study demonstrated poor application of kinetic handling principles at work. Factors impeding teachers’ efforts to implement best practices and back care techniques in their daily teaching activities were work environment (poor facilities and equipment; heavy workload and staff shortage) and uncertainty about desired practice. In order to address the higher prevalence of lower back pain the study recommended, inter alia, improvement of the work environment for teachers by providing proper office furniture, re-assessment of education standards such as students /class ratio, students/desk ratio and number of teachers for schools and lastly, the implementation of health education and health promotion strategies to prevent LBP amongst primary school teachers.

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Figueredo, Ronald. "Back Muscle Endurance as Measure by Ito Test Duration". Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6700.

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Lower back pain remains one of the most common problems in public health throughout the industrialized world (Strine and Hootman) (Shiri, Solovieva and K.). The prevalence is about 39-54% annually and 60-65% in a lifetime (Hillman, Wright and Rajaranam) (Leboeuf-Yde, N. and Lauritzen). In the United States, lower back pain is the second most common cause of disability, and is the highest cause of disability among men (Center for Disease Control, 2009). An individual quantitative physical examination to detect muscle deficiencies would be very useful for proper placement of workers in demanding physical jobs where back injuries are common. Trunk muscle extensor endurance might be the best approach for this issue.

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Wohlman, Michael Avron. "A cognitive behavioural treatment program for chronic lower back pain: a case study approach". Thesis, Rhodes University, 2000. http://hdl.handle.net/10962/d1002596.

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A cognitive behavioural treatment program for chronic lower back pain was designed, implemented and evaluated. The outpatient treatment program included education sessions, goal setting, graded activity training, physical exercise, relaxation training, cognitive techniques, social skills training, and medication reduction. Three participants volunteered to participate in the eightweek treatment program. Of the three participants, only one completed the program successfully. The results were used to critically discuss and evaluate the literature. The successful participant showed significant improvement in activity levels, decrease in subjective levels of pain, as well as decreased levels of anxiety and depression. It was shown that correcting cognitive distortions (e.g. selective abstraction, catastrophising, misattribution) and challenging early maladaptive schemas of abandonment, emotional deprivation and emotional inhibition (Young, 1990) assisted in enhancing coping mechanisms and the belief that the pain episodes would be short-lived and could be controlled. There was considerable improvement for the second participant, although he chose to withdraw from the program prior to its completion. The components of the psycho-education, relaxation and stress management and exercise program were beneficial for him. The third participant failed to accept the treatment formulation, and did not engage collaboratively in the treatment program. The case is presented as a point for examining therapeutic ailures.

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Hegedusova, Nina. "Self-reported Health and Pain Sensitivity in Low Back Pain : Differences between Individuals with and without Pain Radiation to Lower Limbs". Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-36955.

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Background: Low back pain (LBP) is the leading cause of disability and is often accompanied with a back-related leg pain (around 60%), where those with radiating pain show worse overall clinical outcomes. Previous studies comparing these two groups have involved individuals with chronic LBP. It is not known if subjects who currently have LBP differ in pain sensitivity from those who have currently LBP accompanied with pain radiation to lower limbs. Aim: The aim of this study was to investigate whether there are differences in self-reported health and pain sensitivity between individuals currently having LBP with and without pain radiation to lower limbs. Method: Individuals with LBP (n=100) aged 40 to 70 years participated in this study. According the first question of STarT Back Pain Screening Tool about the pain radiation to leg(s), individuals were divided into two groups: radiation group (RG, n=36) and no radiation group (noRG, n=64). To gain the information about self-reported health, following questionnaires were used: Roland-Morris Disability Questionnaire, Fear-Avoidance Beliefs Questionnaire and Hospital Anxiety and Depression Scale. Pressure pain thresholds (PPTs) were measured with algometer (6 sites and 4 points of ’lower body’: gluteal and knee points). Mann-Whitney U-test was used to calculate differences on group and gender level. A logistic regression analyses was calculated (crude model), where belong to RG or not was the dependent variable and all self-reported data and PPTs were independent variables, all data were controlled for gender and age. Results: The RG reported worse disability (p=0.017), higher fear-avoidance beliefs (FAB) about physical activity (p=0.003), worse score in anxiety (p=0.002) and depression (p=0.001), and increased pain sensitivity (p=0.043) in 6 sites PPTs compared to the noRG. Higher score of disability, FAB (physical activity and work), anxiety and depression were associated with an increased risk of belonging to the RG (OR 1.05-1.50, 95% CI 1.01-1.94), controlled for gender and age. Conclusion: Individuals with LBP and pain radiation to lower limbs showed worse self-reported disability and fear-avoidance beliefs about physical activity than those with LBP only. Further, those with pain radiation were more sensitive to pain in general. Worse scores of all studied self-reported data were associated with an increased risk of belonging to the groups with pain radiation. To study gender differences larger sample sizes are needed. Individuals with LBP and pain radiation to lower limbs showed worse outcomes and therefore should receive a different treatment approach than those who have only LBP.

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Ross, Matthew. "Quantification of the Biomechanical Load When Handling Paint Buckets With and Without Assistive Devices". University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1561393389016468.

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Woo, Chuen-hau Alexander. "Association of physical activity during leisure time and pain at the lower back and neck". Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971374.

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胡存孝 i Chuen-hau Alexander Woo. "Association of physical activity during leisure time and pain at the lower back and neck". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31971374.

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Briggs, Virginia G. "Injection Treatment for Lower Back Pain in Older Adults with Lumbar Spinal Stenosis: A Dissertation". eScholarship@UMMS, 2009. https://escholarship.umassmed.edu/gsbs_diss/439.

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Background:Lower back pain is one of the most common health-related complaints in the adult population. Thirty percent of Americans 65 years and older reported symptoms of lower back pain in 2004. With an aging population, the proportion of people over the age of 65 is expected to reach 20% by the year 2030. Because of this increase in older adults, lumbar spinal stenosis (LSS) associated with arthritic changes will also likely increase. In older adults, lower back pain is most often caused by degenerative lumbar spinal stenosis. Stenosis is the narrowing ofthe spinal canal, causing pressure on the nerve roots and is frequently treated surgically. Lumbar spinal stenosis is one of the most common reasons for back surgery in patients 65 years and older 2. However, risks associated with surgery increase with age 3-5 and older patients may choose non-surgical treatment for their lower back pain, including injection treatment. Injection treatment, usually consisting of anti-inflammatory medications and analgesics, has improved since the mid-1990's when fluoroscopic guidance was developed. Information about injection treatment for lower back pain is limited, especially in the older population. An extensive review of published literature regarding injection treatment revealed a paucity of information about older adults diagnosed with lumbar spinal stenosis. In this study, three aims were designed to gain more information about the effectiveness of injection treatment in older patients with lumbar spinal stenosis. In the first (retrospective) study, information about receipt of second injections and time between injections was collected to examine injection usage. In the second and third (prospective) studies, information about pain relief and functional return following injection treatment was collected to examine the effectiveness of injection treatment in patients age 60 and older diagnosed with lumbar spinal stenosis. To our knowledge, such results have not been repolted for this population in the literature. Objective:Injection treatment is a commonly used non-surgical procedure to alleviate lower back pain in older adults. However, older patients do not have enough information about how long pain relief will last after treatment or the amount of pain relief and functional return they will experience. These studies focused on three topics: 1) usage of injection treatment; 2) effectiveness of injection treatment on pain relief; 3) effectiveness of injection treatment on functional return. In addition, the variations of the effectiveness were examined by selected patient attributes. Methods:In a retrospective study, medical records of patients aged 60 years or older from a high volume dedicated spine center at the University of Massachusetts Memorial Hospital were retrospectively reviewed. This study included those diagnosed with degenerative LSS, who had not received an injection for lower back pain within six months, and whom were treated between June I, 2006 and May 31, 2007. In two prospective studies, patients scheduled for lumbar injection treatment between January 1 and June 30, 2008 were selected from the University of Massachusetts Memorial Hospital Spine Center. Selection criteria included patients age 60 and over, diagnosed with degenerative lumbar spinal stenosis and no previous lumbar injection within 6 months or lumbar surgery within 2 years. The Pain sub-score of the SF-36 questionnaire was used to measure pain at baseline and at one and three months post injection. The Physical Component Score (PCS) of the SF-36 questionnaire and the Oswestry Disability Index (ODI) were used to measure function at baseline and at one and three months post injection. Variations in longitudinal changes in scores by patient characteristics were analyzed in both unadjusted (univariate) analyses using one-way analysis of variance (ANOVA), and adjusted (multiple regression) analyses using linear mixed effects models. Results: In the retrospective cohort, the mean age of the cohort was 68, 64% were female, 59% were married, with a mean Body Mass index of 32 kg/m2. Of 92 eligible patients, 57% returned for a second injection within six months of the first. The mean number of months between injections was 4.8 for all patients, ranging from 1 to 22 months. When patient characteristics were examined, the only variable that showed a statistically significant difference was age. Patients aged 70 years and older were found to be 67% less likely to return for a second injection when compared to patients age 60-69 (OR=0.33 (0.12 - 0.94)p In the prospective cohort, information was collected on 62 patients. Mean Pain scores improved significantly from baseline to one month (14.1 points), and from baseline to three months (8.3 points). Post injection changes in Pain scores varied by Body Mass Index (BMI) and baseline emotional health. Based on a linear mixed effects model analysis, higher baseline emotional health, as measured by the SF-36 Mental Component Score (MCS>50), was associated with greater reduction in pain over three months when compared to lower emotional health (MCS Conclusion: Patients over age 70 do not return for repeat injection as frequently as patients age 60-69. In addition, each year a patient ages over age 60, they are 10% less likely to return for a repeat injection. Lower back pain in older adults with LSS is clinically significantly alleviated after injection treatment. In addition, injection treatment for LSS is associated with return of lost function needed for daily living activities in older adults. Pain relief and functional return varies by patient personal and clinical characteristics. Higher emotional health was associated with more pain relief and more functional return experienced over three months following injection treatment. Additional information is needed about why older patients do not return for second injections at the same rate as younger patients and how emotional health affects response to injection treatment in older adults.

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Wanyonyi, Nancy Eileen Nekoye. "The effect of a knowledge-based ergonomic intervention amongst administrators at AGA Khan University Hospital, Nairobi". Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4583.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
Lack of adherence to the correct working conditions exposes workers to ergonomics-related hazards and eventually work-related musculoskeletal disorders (WRMDs) which are estimated at 160 million per year globally. Literature shows that with modernization by use of computers, administrators are exposed to prolonged sitting and long working hours which predisposes them to ergonomic hazards. Low back pain and neck pain are the leading work-related musculoskeletal disorders with a lifetime prevalence of 70 - 80% and 50 - 60% respectively.Both low back pain and neck pain have a multifactorial aetiology that includes work-related and individual related factors. Lack of reporting of work-related injuries has led to paucity of statistical literature with regards to work-related low back pain and neck pain, especially in the developing countries. The aim of this study was to determine the prevalence of ergonomics related low back pain and neck pain, and describe the effect of a knowledge-based ergonomic intervention among administrators in Aga Khan University Hospital, Nairobi (AKUH, N). A mixed method design was used in this study using a survey and two focus group discussions(FGD). A self-administered questionnaire that is in four sections was administered to 208 participants. The questionnaire sought the prevalence of musculoskeletal disorders, the knowledge of participants with regards to low back pain and neck pain as well as the work-related and individual risk factors related to the same. The dissemination of the study results involved a one hour knowledge-based ergonomic session given to all interested participants, based on the information from the survey. Two FGD with purposive selection of eight participants were held to explore their experience on the value of the information provided.The statistical package for social sciences (SPSS) version 20 was used to capture and analyze the quantitative data. Descriptive statistics was used to summarize the study findings in the form of means, frequencies, standard deviations and percentages. Inferential statistics (chi-square) was used to test the associations between different categorical variables (p<0.05). For the qualitative data, the tape recorded interviews were transcribed verbatim, field notes typed, sorting and arranging data was done and themes were generated. Thematic content analysis was used to generate the themes. The aim of the study, confidentiality and the participants‘ freedom to withdraw from the study were explained. Informed consent was also obtained before the survey and FGD and referral was made where necessary. The findings of the current study revealed that the study participants were knowledgeable about ergonomics-related low back pain and neck pain however this knowledge was not directly translated into behaviour. Low back pain (LBP) had the highest twelve month prevalence at 75.5% followed by neck pain at 67.8%, and LBP showed significant associations at p< 0.05 with some work-related and individual risk factors. The results of the FGDs showed that most participants had positive behavioural and attitudinal change post the knowledge-based ergonomic intervention despite the challenges they met in implementing the behavioural change. These results therefore show the need for continual education about ergonomics to create awareness on the predisposing factors to work-related LBP and neck pain, hence promoting a healthier quality of life amongst employees through adherence to healthy work behavioural practice.

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Pretorius, Tammy-Lee. "A combination of a physiotherapy and cognitive behavioural therapy in the treatment of non-specific chronic lower back pain: A systematic review". University of the Western Cape, 2019. http://hdl.handle.net/11394/7054.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
Evidence indicates that the current physiotherapy management of patients with chronic non-specific LBP only offers moderate benefit. Combined treatment programmes, addressing body as well as the mind, shows promising results in developed countries with adequate resources but low evidence in poorly-resourced countries and contexts. This is another gap in the existing knowledge. The study aimed to evaluate the effectiveness of a combined physiotherapy and cognitive-behavioral therapy treatment, compared to physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behavior, in adults with non-specific low back pain. The systematic review included articles published, in English only, between 1985-2018 (July) in the following databases available at the University of The Western Cape: EbscoHost, BioMedCentral, Cambridge Journals Online, CINAHL, Cochrane Library, Medline (EbscoHost), Medline (Pubmed), Sabinet Reference, SAGE Journals Online, ScienceDirect,SciFinder Scholar, SCOPUS, Wiley Online Library, Springerlink and PubMed.Two reviewers independently evaluated the methodological quality of full text articles, using a critical appraisal tool. Fourteen (14) articles were included based on methodological rigour. Five (5) articles were included in the narrative synthesis and nine (9) articles were included in the meta-analyses. Statistically significant improvements in pain, disability and mental health, in favour of combination therapy for patients with chronic lower back pain were found. A small but statistically significant cumulative effect size for mental health (g = -0.26, Z = -4.49, p <.01) , physical disability (g = -0.27, Z = -5.09, p <.01) and pain (g = -.27, Z = -5.05, p <.01) , in favour of a combination of cognitive behavioural therapy and physiotherapy in patients with chronic lower back pain was found. In addition, a medium but statistically significant cumulative effect size (g = -0.50, Z = -6.95, p <.01), in terms of fear avoidance, was found in favour of the combination therapy. In conclusion, physiotherapy in combination with cognitivebehavioral therapy was more effective than physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behaviour, in adults with non-specific low back pain. Ethics: Permission for the study was obtained from the university’s Biomedical Research Ethics Committee.

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Johnson, Alexa. "CONNECTING THE PIECES: HOW LOW BACK PAIN ALTERS LOWER EXTREMITY BIOMECHANICS AND SHOCK ATTENUATION IN ACTIVE INDIVIDUALS". UKnowledge, 2019. https://uknowledge.uky.edu/rehabsci_etds/58.

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Low back pain in collegiate athletes has been reported at a rate of 37% from a wide array of sports including soccer, volleyball, football, swimming, and baseball. Whereas, in a military population the prevalence of low back pain is 70% higher than the general population. Compensatory movement strategies are often used as an attempt to reduce pain. Though compensatory movement strategies may effectively reduce pain, they are often associated with altered lower extremity loading patterns. Those who suffer from chronic low back pain tend to walk and run slower and with less trunk and pelvis coordination and variability. Individuals with low back pain also tend to run with more stiffness in their knees. Moving with less joint coordination and more stiffness are potential compensatory movement patterns acting as a guarding mechanism for pain. Overall the purpose of this project was to determine how chronic low back pain influences lower extremity biomechanics and shock attenuation in active individuals compared to healthy individuals and examine how the altered lower extremity biomechanics are related to clinical outcome measures. We hypothesized that individuals who present with chronic low back pain are more likely to exhibit higher vertical ground reaction forces and less knee flexion excursion during landing, compared to healthy individuals. We also hypothesized that individuals with chronic low back pain will have a reduced ability to attenuate shock during landing compared to the healthy individuals. This study was a case control design in which physically active individuals suffering from chronic low back pain were matched to healthy controls. All participants reported for one testing session to assess self-perceived knee function in the form of the Knee Osteoarthritis Outcomes Score (KOOS), lower extremity strength and mechanics during three landing tasks. Isometric strength was assessed using an isokinetic dynamometer during hip abduction, hip extension, and knee extension. The landing tasks included a drop vertical jump, a single leg hop, and a crossover hop. A three-dimensional motion analysis system with two in-ground force plates and four inertial measurement units were used to assess lower extremity mechanics during the landing tasks. Individuals with low back pain presented with reduced KOOS scores compared to healthy individuals in four of the five subscales, including Symptoms (p=0.007), Pain (p=0.002), Activities of Daily Living (p=0.021), and Quality of Life (p=0.003). Alternatively, while there were some strength, kinematic, and kinetic between limb asymmetries noted in the low back pain group, there were not between group differences with the healthy individuals. In the low back pain group, individuals presented with greater dominant limb knee extension strength (p=0.039) and greater dominant limb ankle plantarflexion at initial contact during the drop vertical jump, compared to the non-dominant limb (p=0.022). Individuals with low back pain also presented with greater non-dominant limb tibia impact during the single limb hop (p=0.008). While we did not identify any mechanical differences between individuals suffering from chronic low back pain and those who do not, we did identify that an active population suffering from low back pain does present with decreased self-perceived knee function compared to active individuals without low back pain. As these groups biomechanically perform similarly, they do not clinically perform the same, specifically, in terms of the KOOS. Such differences should not be overlooked when treating active populations with low back pain. If this population is presenting with altered self-perceived knee function at a young age, it is likely that it will continue to decline and negatively affect their function.

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Snyder, Kristian. "Utilizing Convolutional Neural Networks for Specialized Activity Recognition: Classifying Lower Back Pain Risk Prediction During Manual Lifting". University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1583999458096255.

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Perrotti, Tracy Ann. "An exploration of the lumbar loads and affective responses to lumbar pain on lower limb amputees who use a prosthesis". [Tampa, Fla.] : University of South Florida, 2005. http://purl.fcla.edu/fcla/etd/SFE0001327.

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Frost, Brody A. "Polymer Composite Spinal Disc Implants". Thesis, Virginia Tech, 2017. http://hdl.handle.net/10919/78783.

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The goal of this research study was to create an artificial annulus fibrosus similar to that of the natural intervertebral disc, as well as find preliminary results for vertebral endplate connection and nucleus pulposus internal pressure, for the correction of disc degeneration in the spine. The three-part composite samples needed to demonstrate good shock absorption and load distribution while maintaining strength and flexibility, and removing the need for metal in the body, something of which no current total disc replacement or spinal fusion surgery can offer. For this study, the spinal disc was separated into its three different components, the annulus fibrosus, the nucleus pulposus, and the vertebral endplates, each playing a vital role in the function of the disc. Two low-cost materials were selected, a Covestro polyurethane and cellulose nanocrystals, for the purpose of creating a polymer composite spinal disc implant. A methodology was established for creating the cast composite material for use as an annulus fibrosus, while also investigating its mechanical properties. The same composite material was used to acquire preliminary results for vertebral endplate connection to the synthesized annulus, however no additional material was used to determine or mimic the mechanical properties of these endplates, due to time constraints. Also because of time constraints, the nucleus used in this study was only comprised of water with no other additives for preliminary testing since the natural nucleus is comprised of about 80-90% water. These properties were then compared to the mechanical properties of the natural disc, so that they could be finely tuned to emulate the natural disc. It is shown in this study that the composite material, when swelled in water, was able to mimic the annulus fibrosus in tensile strength and modulus, however showed higher compressive strength and modulus than ideal. The samples also did not undergo any permanent deformation within the realm of force actually introduced to the natural disc. The vertebral endplates showed decent adhesion to the synthesized annulus, however there were slight defects that became failure concentrators during compression testing. The nucleus showed promising results maintaining good internal pressure to the system causing better compressive load distribution, with barreling of the samples.
Master of Science
Spinal disc degeneration is a very prevalent problem in today’s society, effecting anywhere from 12% to 35% of a given population. It usually occurs in the lumbar section of the spine, and when severe enough, can cause bulging and herniation of the intervertebral disc itself. This can cause immense lower back pain in individual’s stricken with this disease, and in the US, medical costs associated with lower back pain to exceed $100 billion. Current solutions to this problem include multiple different treatment options of which, spinal fusion surgery and total disc replacement (TDR) are among the most common. Although these treatments cause pain relief for the majority of patients, there are multiple challenges that come with these options. For example, spinal fusion surgery severely limits the mobility of its patients by fusing two vertebrae together, disallowing any individual movement, and TDR can cause hypermobility in among the vertebrae and offer little to no shock absorption of loads. Therefore, a better treatment option is needed to relieve the pain of the patients, as well as maintain equal motion, shock absorption, and load cushioning to that of the normal intervertebral disc and remaining biocompatible. The goal of this research study was to create a three-component system, like that of the natural intervertebral disc, for the use of spinal disc replacement and to replace current options. The fabricated system was comprised of the three components found in the natural intervertebral disc; the annulus fibrosus, the nucleus pulposus, and the vertebral endplates. Because the system will need to go in-body, the materials used were all characterized as biocompatible materials; the polyurethane currently being used in medical devices and implants, and the cellulose nanocrystals (CNCs) coming from natural cellulose in sources such as wood and plants. The results determined that the mechanical properties of the system can be fine-tuned in order to mimic the natural strength and cushioning capabilities of the natural disc, based on CNC content added to the polyurethane, and when all three components of the system are added together, the compressive stress-strain is most similar to the natural disc in compression. However, the system did show failure in the connection between the annulus fibrosus and vertebral endplates, causing herniation of the nucleus similar to the initial problem attempting to be solved. For this, more ideal fabrication methods should be researched in the future including 3D printing techniques, injection molding, and roll milling. As well as alternate fabrication techniques, cell grow and viability should be determined to show that cells don’t die once the system in implanted.

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Frost, Brody. "Polymer Composite Spinal Disc Implants". Thesis, Virginia Tech, 2008. http://hdl.handle.net/10919/78783.

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The goal of this research study was to create an artificial annulus fibrosus similar to that of the natural intervertebral disc, as well as find preliminary results for vertebral endplate connection and nucleus pulposus internal pressure, for the correction of disc degeneration in the spine. The three-part composite samples needed to demonstrate good shock absorption and load distribution while maintaining strength and flexibility, and removing the need for metal in the body, something of which no current total disc replacement or spinal fusion surgery can offer. For this study, the spinal disc was separated into its three different components, the annulus fibrosus, the nucleus pulposus, and the vertebral endplates, each playing a vital role in the function of the disc. Two low-cost materials were selected, a Covestro polyurethane and cellulose nanocrystals, for the purpose of creating a polymer composite spinal disc implant. A methodology was established for creating the cast composite material for use as an annulus fibrosus, while also investigating its mechanical properties. The same composite material was used to acquire preliminary results for vertebral endplate connection to the synthesized annulus, however no additional material was used to determine or mimic the mechanical properties of these endplates, due to time constraints. Also because of time constraints, the nucleus used in this study was only comprised of water with no other additives for preliminary testing since the natural nucleus is comprised of about 80-90% water. These properties were then compared to the mechanical properties of the natural disc, so that they could be finely tuned to emulate the natural disc. It is shown in this study that the composite material, when swelled in water, was able to mimic the annulus fibrosus in tensile strength and modulus, however showed higher compressive strength and modulus than ideal. The samples also did not undergo any permanent deformation within the realm of force actually introduced to the natural disc. The vertebral endplates showed decent adhesion to the synthesized annulus, however there were slight defects that became failure concentrators during compression testing. The nucleus showed promising results maintaining good internal pressure to the system causing better compressive load distribution, with barreling of the samples.
Master of Science
Spinal disc degeneration is a very prevalent problem in today’s society, effecting anywhere from 12% to 35% of a given population. It usually occurs in the lumbar section of the spine, and when severe enough, can cause bulging and herniation of the intervertebral disc itself. This can cause immense lower back pain in individual’s stricken with this disease, and in the US, medical costs associated with lower back pain to exceed $100 billion. Current solutions to this problem include multiple different treatment options of which, spinal fusion surgery and total disc replacement (TDR) are among the most common. Although these treatments cause pain relief for the majority of patients, there are multiple challenges that come with these options. For example, spinal fusion surgery severely limits the mobility of its patients by fusing two vertebrae together, disallowing any individual movement, and TDR can cause hypermobility in among the vertebrae and offer little to no shock absorption of loads. Therefore, a better treatment option is needed to relieve the pain of the patients, as well as maintain equal motion, shock absorption, and load cushioning to that of the normal intervertebral disc and remaining biocompatible. The goal of this research study was to create a three-component system, like that of the natural intervertebral disc, for the use of spinal disc replacement and to replace current options. The fabricated system was comprised of the three components found in the natural intervertebral disc; the annulus fibrosus, the nucleus pulposus, and the vertebral endplates. Because the system will need to go in-body, the materials used were all characterized as biocompatible materials; the polyurethane currently being used in medical devices and implants, and the cellulose nanocrystals (CNCs) coming from natural cellulose in sources such as wood and plants. The results determined that the mechanical properties of the system can be fine-tuned in order to mimic the natural strength and cushioning capabilities of the natural disc, based on CNC content added to the polyurethane, and when all three components of the system are added together, the compressive stress-strain is most similar to the natural disc in compression. However, the system did show failure in the connection between the annulus fibrosus and vertebral endplates, causing herniation of the nucleus similar to the initial problem attempting to be solved. For this, more ideal fabrication methods should be researched in the future including 3D printing techniques, injection molding, and roll milling. As well as alternate fabrication techniques, cell grow and viability should be determined to show that cells don’t die once the system in implanted.

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Hendershot, Bradford Donald. "Alterations and Asymmetries in Trunk Mechanics and Neuromuscular Control among Persons with Lower-Limb Amputation: Exploring Potential Pathways of Low Back Pain". Diss., Virginia Tech, 2012. http://hdl.handle.net/10919/28668.

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Low back pain (LBP) is a substantial secondary disability among persons with lower-limb amputation (LLA). Abnormal mechanics of movement subsequent to LLA may increase the stability demands on the spinal column, and repetitive exposures to such abnormal movements may alter trunk passive properties and/or the coordination of surrounding trunk muscle responses. Further, preferential use of the sound limb may lead to asymmetries in these behaviors. Spine biomechanics (e.g., loading and stability) are substantially influenced by trunk passive properties and neuromuscular control, and alterations in these behaviors are associated with abnormal mechanics of the spinal column and an increased LBP risk. However, there is limited evidence regarding whether prolonged repeated exposures to abnormal gait and movement resulting from LLA and subsequent repeated use of a prosthetic device affect these trunk behaviors. Eight males with unilateral LLA and a matched sample of non-amputation controls completed three studies in which several measures of trunk passive properties, neuromuscular control, and spine biomechanics were quantified using laboratory experiments and biomechanical analyses. Each study involved a distinct task to investigate potential alterations and/or asymmetries in trunk passive properties and neuromuscular control. The first study used a seated balance task to assess trunk postural control and stability. The second study used multidirectional trunk perturbations to assess trunk mechanical and neuromuscular behaviors. Finally, the third study used controlled quasi-static trunk movements to assess load-sharing mechanisms between active and passive low back tissues. Significant alterations and asymmetries in trunk passive properties and trunk neuromuscular responses were present among participants with LLA, specifically reduced and asymmetric trunk stiffness and reflex response; decreased and asymmetric passive contributions to trunk movements; and increased trunk muscle activities. Significant increases in trunk postural sway and trunk muscle activities were also present during seated stability measures. Such alterations in these behaviors may be a result of repetitive exposures to abnormal gait and movement subsequent to LLA and the use of a prosthetic device, and could play a contributing role in the development of LBP in this population. Future work should investigate the temporal relationship between altered trunk behaviors and repeated exposure to abnormal gait and movement subsequent to LLA, to better identify critical years for rehabilitation and preventative care.
Ph. D.

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Forsell, Albin. "Det blir nog inte bra ändå - Förväntningar på återhämtning, smärtkatastrofiering och vägen till kronisk ryggsmärta". Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-52070.

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Pūraitė, Rūta. "Minkštojo įtvaro poveikis nėščiųjų juosmeninės stuburo dalies skausmui: atvejų analizė". Bachelor's thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130910_100314-21762.

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Vis dažniau yra diskutuojama apie minkštojo įtvaro poveikį nėščiųjų juosmeninės stuburo dalies skausmo mažinimui. Yra skausmo sindromų, būdingų tik moterims. Vienas jų – nėščiųjų juosmens skausmas. Apie 50–80 proc. nėščiųjų vargina juosmens skausmai, kurie dažniausiai prasideda 5–7 nėštumo mėnesį, tačiau skausmai gali prasidėti 8—12 nėštumo savaitę (Samėnienė, 2005). Tikslas. Nustatyti minkštojo įtvaro poveikį nėščiosioms mažinant juosmeninės stuburo dalies skausmą. Objektas. Minkštojo įtvaro poveikis mažinant nėščiųjų juosmeninės stuburo dalies skausmui. Hipotezė. Manome, kad minkštasis įtvaras turės teigiamą poveikį nėščiosioms mažinant juosmeninės stuburo dalies skausmą, kadangi minkštojo įtvaro dėka yra suteikiama atrama ir stabilumas sąnariams ir raumenims netrikdant jų kraujotakos ir nevaržant judesių. Tyrimo metu buvo spėjama, kad minkštasis įtvaras turės teigiamą poveikį nėščiosioms mažinant juosmeninės stuburo dalies skausmą Tyrimo uždaviniai: 1. Įvertinti nėščiųjų juosmeninės stuburo dalies skausmą ir negalią prieš minkštojo įtvaro taikymą ir po. 2. Įvertinti kaip minkštojo įtvaro poveikis turi įtakos gyvenimo kokybei prieš ir po minkštojo įtvaro taikymo. 3. Įvertinti nėščiųjų judesių baimę (kinezifobiją) prieš ir po minkštojo įtvaro taikymo. Tyrimas buvo atliekamas Lietuvos Sporto Universiteto kineziterapijos salytėje. Tyrime iš viso dalyvavo septynios niekada stuburo skausmų neturėjusios nėščiosios. Atliekant tyrimą buvo vertinama nėščiųjų nugaros skausmas... [toliau žr. visą tekstą]
Increasingly there are arguable about kinesiotaping influence pregnant women low back pain reduction. There are pain syndromes appropriate just for women. First – pregnant low back pain. About 50—80  pregnant women suffers from low back pain, which normally begins in the 5-7 pregnancy month, however it can start and 8-12 week of pregnant (Samėnienė, 2005). That study main aim was to determine kinesiotaping influence for pregnant women low back pain reduction. Study object was kinesiotaping influence for pregnant women low back pain. Stydy hypothesis: kinesiotaping will have positive effect for preganant women low back pain reduction. Study tasks were: 1. To assess pregnant women low back pain and disability before and after kinesiotaping. 2. To assess pregnant women low back pain influence for living quality before and after kinesiotaping. 3. To assess pregnant women fear of movements (kinesiophobia) before and after kinesiotaping. Study was performed in Lithunians Sports University‘s physical therapy room. In the study participated seven pregnant women who have never suffered from low back pain. In the study were assessed pregnant women low back pain, influence for quality of living, fear of movements. After kinesiotaping investigative‘s pain decreased significantly (p<0,05). Pain influence for quality of living statsitically reliable diffrence were not found (p>0,05). Fear of movements statistically signficant improve (p<0,05). Kinesiotaping the biggest influence had for... [to full text]

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Loubser, Leigh-Anne. "Anatomical study of superior cluneal nerve and its estimation of prevalence as a cause of lower back pain in a South African population". Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/65834.

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Background Lower back pain (LBP) remains a common ailment among adult populations and a superior cluneal nerve (SCN) entrapment accounts for 10% of reported LBP cases. The diagnostic criteria of SCN entrapment include anaesthesia of the SCN. This entrapment can be caused by bone procurement procedures but tends to happen more spontaneously and particularly to sportsmen. This study aimed to describe the location of all three branches of the SCN as well as to estimate the prevalence of entrapment which causes LBP. Methods The SCN was identified as it pierced the thoracolumbar fascia and crossed over the posterior part of the iliac crest on both sides of 50 adult cadavers. A sliding dial calliper was used to measure the distance from the posterior superior iliac spine (PSIS) to the SCN and from the midline lumbar spinous processes to the nerve. A total of 400 patient files were used to estimate the prevalence of SCN entrapment in a South African population. Results The branches of the SCN were found to be 72.6 ± 4.2 mm, 76.6 ± 4.4 mm and 79.6 ± 4.4 mm from the PSIS to the medial, intermediate and lateral branches respectively. From the midline to the medial, intermediate and lateral branches – the SCN was found to be 77.9 ± 4.2 mm, 79.6 ± 4.4 mm and 89.5 ± 4.5 mm. It was estimated that the SCN being the cause of LBP to be 28%. Discussion The measurements found in this study correlate with the measurements found in previous studies. However, this study failed to show sex differences and this could be attributed to sampling as well as chance due to human variation. This study estimated the prevalence of an SCN entrapment as a cause of LBP to be 28% compared to previous studies which estimate it to be 10%. The difference seen here can be a consequence of the limitation of this study in that it was conducted in a private practice.
Dissertation (MSc)--University of Pretoria, 2017.
Anatomy
MSc
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Harless, Deanna Fredericks. "The impact of computer decision support software by nurse practitioners on functional outcomes for patients with acute lower back pain a DNP project". Thesis, Southeastern Louisiana University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10170522.

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Objective: To evaluate the utilization of computer decision support software by nurse practitioners and the effect on functional outcomes for patients with low back pain.

Design: The DNP project used a cohort study design utilizing a convenience sample of patients with nonspecific low back pain to evaluate the intervention. The study was divided into two phases. During each phase the patients completed the functional tools on initial treatment and then again at approximately six weeks. The initial phase measured outcomes following the clinicians’ current treatment model without benefit of support software. During the second phase, the computerized clinical decision support software was introduced and implemented. The results were compared of Phase I outcomes were compared to the results of Phase II to determine if the software indeed improved functionality with the patient.

Measurements: A change in the patient’s functional outcomes judged whether the treatment plan was effective. The functional tools utilized in the study were the Oswestry Disability Index and the Roland-Morris Questionnaire. The computer decision support software utilized was iOutcomes.

Results: There were 249 patients verbally consenting for this study with 104 individuals electronically signing consent. Of the 249 participants, 104 individuals completed the written consent. Of the 104 individuals giving written consent, only 94 completed the entire registration process. Of the 94 individuals completing the registration process, only 37 completed the initial functional tools assessment. Of the 37 individuals completing the initial functional tools, only 34 completed the 6-week follow up functional tools.

The findings of the pre-treatment and post-treatment did not demonstrate a statistically significant difference with the introduction of the computer decision support software. The mean for the difference in the ODI and the difference of the RDQ was -1.65 (p = 0.177, SD = 6.96). There was no improvement demonstrated between Phase I and Phase II in regards to the introduction of the computer decision support software.

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Lu, Shao-chen, i ILLEGIBLE. "Acupuncture for Quality of Life in Patients Having Pain Associated with the Spine: a Systematic Review". RMIT University. Health Science, 2008. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080724.122432.

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Background: Pain associated with the spine (PAWS) refers to pain in the neck, thorax, lower back or sacrum. It impacts on patients' Quality of Life (QoL), including working ability, daily functioning, sleep and psychological well-being. A number of clinical trials have demonstrated that acupuncture was beneficial for patients with PAWS. However the overall effect of acupuncture on these patients' QoL is unknown. Aims: The current study aimed to conduct a systematic review (SR) of clinical trials to determine the effect of acupuncture on QoL and pain for patients with PAWS. In addition, a narrative review (NR) was conducted to compare patients' perceived changes (PCC) with the standard QoL instruments used in acupuncture clinical trials for pain. Methods: For the SR, PubMed, Embase (via ScienceDirect), CINAHL (Via EBSCO) and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials (RCTs) of acupuncture for PAWS condition(s) that include both QoL and pain assessments with a Jadad score of three or greater were included. For the NR, PubMed was searched to identify studies reporting PPC after acupuncture and/or traditional Chinese medicine. Extracted data were grouped and compared with domains of the QoL instruments. Results: In total, 21 RCTs were included and 17 of them had sufficient data for analysis. QoL was measured using 15 different instruments. Randomisation procedures and dropouts were adequately reported in all 17 studies. Four studies compared acupuncture with wait-list or usual-care. Two demonstrated that acupuncture had a superior effect on improving physical and mental components of QoL measured by Short Form-36 health survey questionnaire and pain at the three month follow-up. Studies comparing acupuncture with sham/placebo acupuncture or placebo-TENS found either no difference between the treatments or conflicting results. When acupuncture was compared with active interventions, there was no difference except that at the intermediate-term follow-up massage was better for disability and pain and physiotherapy was better for Northwick Park Neck Pain Questionnaire. Acupuncture was also better than TENS for pain. The combined therapy of acupuncture and an active intervention showed a superior result than the latter alone in the short-term. Six studies were identified for the NR. Patients reported 11 categories of changes after acupuncture, such as reduced reliance on other therapies, enhanced spirituality, prevention of disease. However, these clinical outcomes were not included in any of the QoL instruments used in the included RCTs. Conclusion: There is moderate to strong evidence that acupuncture is more effective than wait-list or usual-care at the short-term follow-up in improving QoL of patients with PAWS. When acupuncture is combined with another therapy, the combined therapy seems to produce a better outcome. Acupuncture is not better than sham/placebo acupuncture or placebo-TENS. Surprisingly, the commonly used QoL instruments do not measure all the changes perceived by patients as a result of acupuncture and/or traditional Chinese medicine. There is a pressing need to design QoL assessments that are suitable for acupuncture research. Further studies should have larger sample sizes and additional validated outcome assessments are required to detect effects of acupuncture.

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Fernandes, João Luís Gameiro. "Efeitos do suster-relaxar na cinemática tridimensional, função neuromuscular e sintomatologia álgica de um atleta de crossfit com dor lombar: um estudo de caso". Bachelor's thesis, [s.n.], 2016. http://hdl.handle.net/10284/5730.

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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia
Introdução: A lombalgia está associada a alterações da atividade muscular e da cinemática lombo-pélvica provocada, em parte, pela fraqueza da musculatura do core. O teste de Thomas é utilizado nas áreas clínica e desportiva para determinar o encurtamento do ilíopsoas e do reto femoral, músculos constituintes do core. O encurtamento destes músculos é um dos fatores de risco de lesão músculo-esquelética nos membros inferiores e de dor lombar. A técnica de suster-relaxar, aumenta a amplitude de movimento articular, normalizando o tónus muscular. Objetivo: Avaliar o efeito da técnica de suster-relaxar na cinemática tridimensional do teste de Thomas, na função neuromuscular e sintomatologia álgica de um atleta de crossfit com dor lombar à direita. Metodologia: Análise da cinemática tridimensional do teste de Thomas através do sistema de captura e análise de movimento 3D, Qualisys Oqus Camera Series, e força isocinética dos joelhos pela dinamometria isocinética, antes e após a aplicação técnica suster-relaxar num atleta de crossfit de 25 anos. Resultados: Após a análise dos dados obtidos, verificou-se um aumento da amplitude de extensão da anca, do peak torque e diminuição da sintomatologia álgica, no lado afetado do atleta, em resultado da aplicação da técnica de suster-relaxar. Conclusão: A técnica suster-relaxar aumenta a amplitude de movimento articular, e o peak torque e diminui a sintomatologia de dor lombar associado a uma disfunção sacroilíaca num atleta de crossfit.
Introduction: Low back pain is associated with changes in muscle activity and lumbar- pelvic kinematics caused, partly by the weakness of the core musculature. The Thomas test is widely used in clinical and sports areas to determine the shortening of the iliopsoas and rectus femoris, core constituent muscles. The shortening of these muscles is one of the risk factors for musculoskeletal injury in the lower limbs and back pain. The technique of hold-relax, increases range of motion, normalizing muscle tone. Objective: To access the effect of the hold-relax technique in the three-dimensional kinematics of the Thomas test, neuromuscular function and symptoms of a crossfit athlete with right low back pain. Methodology: Analysis of three-dimensional kinematics of the Thomas test through the capture system and 3D motion analysis, Qualisys Oqus Camera Series, and isokinetic strength of the knee by isokinetic dynamometer before and after the hold-relax technique application in a 25 years crossfit athlete. Results: After analysing the data, there was an increase in hip extension range, peak torque and reduction of pain symptoms on the affected side of the athlete, as a result of the technical application of hold-relax. Conclusion: The hold-relax technique increases range of motion andpeak torque and decreases lumbar pain symptoms associated with a sacroiliac dysfunction in a crossfit athlete.
N/A

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Lemaire, Alexandra. "Lombalgies chroniques : évaluation des facteurs mécaniques des membres inférieurs au moyen des relations moment-vitesse". Thesis, Le Mans, 2014. http://www.theses.fr/2014LEMA1024/document.

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La lombalgie est un problème de santé public induisant de nombreuses répercussions sur le plan économique et social. Le passage à la chronicité concerne moins de 10% des lombalgies, mais représente 85% des coûts liés à la prise en charge de cette pathologie. Dans ce contexte, il parait indispensable de pouvoir optimiser les programmes de réentrainement à l’effort du lombalgique chronique afin de les rendre le plus efficace et le plus pertinent possible. Ce travail de thèse a pour objectif d’évaluer les facteurs mécaniques des membres inférieurs au moyen des relations moment-vitesse dans des conditions isocinétiques. Dans une première étude, nous avons évalué les muscles extenseurs du genou et les muscles fléchisseurs et extenseurs du tronc chez des sujets lombalgiques et des sujets sains. Nous avons, ainsi mis en évidence une faiblesse significative au niveau de la force et de la puissance des muscles extenseurs du genou chez les sujets lombalgiques associée à la faiblesse musculaire du tronc classiquement évoquée pour cette population. Après avoir mis en place, dans une seconde étude, un protocole d’évaluation permettant d’établir des relations moment- et puissance-vitesse pour les muscles extenseurs et fléchisseurs de la hanche, nous avons évalué la force et la puissance de ces groupes musculaires chez des sujets lombalgiques. Les résultats ont, comme pour la première étude, mis en avant une faiblesse significative au niveau de la force et de la puissance de ces groupes musculaires, par rapport à des sujets sains, avec un déficit plus marqué au niveau des extenseurs, comme pour le tronc. L’ensemble des résultats obtenus dans le cadre de ce travail de thèse démontre qu’il est important de proposer un travail de force et de puissance au niveau des membres inférieurs pour les patients lombalgiques chroniques afin de mieux lutter contre le syndrome de déconditionnement qui touche l’ensemble des chaines musculaires des patients
Low back pain is a public health problem inducing economical and social consequences. Chronicity involves less than 10% of low back pain, but represents 85% of the total costs related to this pathology. In this context, it seems essential to optimize chronic low back pain rehabilitation programs to make them more effective and relevant. The purpose of this phD was then to evaluate lower limbs mechanical factors using torque- and power-velocity relationships. In a first study, knee extensors muscles and trunk flexor and extensor muscles were evaluated in chronic low back pain and healthy subjects. A significant knee extensor strength and power weakness weas observed for chronic low back pain subjects, associated with the typical trunk weakness referred to this population. The second study focused on establishing a protocol allowing assessing hip flexor and extensor torque- and power-velocity relationships. This protocol was then applied to evaluate flexor and extensor hip muscles in chronic low back pain subjects. Results, in accordance with the first study, highlighted a significant strength and power weakness for hip muscle groups in chronic low back pain relative to healthy subjects, with a greater hip extensor deficit, as it is generally observed for the trunk.In conclusion, these different studies showed the importance of proposing torque and power lower limbs rehabilitation for chronic low back pain patients to better fight against the deconditioning syndrome that affects all muscular chains in this population

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Spilla, Maria Amélia Miquelutti 1979. "Avaliação da efetividade de um programa de preparo para o parto". [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311140.

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Orientadores: Maria Yolanda Makuch, José Guilherme Cecatti
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-20T04:27:59Z (GMT). No. of bitstreams: 1 Spilla_MariaAmeliaMiquelutti_D.pdf: 2533271 bytes, checksum: 737080e4c94c6b1f07963f584eba80f3 (MD5) Previous issue date: 2012
Resumo: Introdução: Programas de preparo para o parto são recomendados mundialmente para que se possa promover uma gravidez saudável, com maior autonomia durante o trabalho de parto e parto, prevenindo desconfortos físicos e altos níveis de ansiedade. Objetivo: Avaliar a efetividade do Programa de Preparo para o Parto (PPP) na prevenção de dor, incontinência urinária, ansiedade na gestação e resultados perinatais de nulíparas, comparativamente a gestantes que não participaram do programa. Métodos: Foi realizado um ensaio controlado aleatorizado com 197 participantes, e um estudo qualitativo baseado em entrevistas semi-estruturadas com 21 participantes. Participaram nulíparas entre 16 e 40 anos, com idade gestacional ?18 semanas, sem contraindicação para realizar exercícios físicos. O PPP consistiu de encontros no pré-natal que incluiu exercícios físicos e informações sobre prevenção de dor na gravidez, papel da musculatura perineal, fisiologia do trabalho de parto e técnicas de alívio da dor. Foram avaliadas: incontinência urinária, prática de atividade física, lombalgia e dor pélvica posterior, ansiedade, variáveis perinatais, controle do trabalho de parto, técnicas de alívio da dor e satisfação com o parto. Resultados: As participantes do PPP tiveram menor risco de apresentar incontinência urinária nas avaliações intermediária (RR 0,69; IC 95% 0,51-0,93) e final (RR 0,60; IC 95% 0,45-0,81), e referiram maior prática de exercício físico (p=0,009). Não houve diferenças em relação ao nível de ansiedade, algias lombopélvicas e dados perinatais. Na análise qualitativa, as participantes do PPP relataram maior controle do trabalho de parto, facilidade no uso das técnicas de alívio da dor, utilizaram maior variedade de posições verticais e relataram uma maior satisfação com o a experiência do trabalho de parto e parto. Conclusão: O PPP foi efetivo no controle da incontinência urinária e na melhora da prática de exercícios físicos, aumentou a autonomia das mulheres no controle do trabalho de parto, promoveu maior satisfação com o parto, e não apresentou efeitos adversos maternos-fetais
Abstract: Introduction: Antenatal preparation programs are recommended worldwide so you can promote a healthy pregnancy and greater autonomy during labor and delivery, preventing physical discomfort and high levels of anxiety. Objective: To evaluate the effectiveness of a Birth Peparation Program (BPP) in the prevention of pain, urinary incontinence and anxiety during pregnancy and perinatal outcomes of nulliparous compared with women who did not participate in the program. Methods: A randomized controlled trial was conducted with 197 participants, and a qualitative study based on semi-structured interviews with 21 participants. Participants was low risk nulliparas between 16 and 40 years, with ? 18 weeks gestational age.The intervention consisted of meetings held on the days of prenatal consultations, and involved physical exercises, educational activities and instructions on exercises to be performed at home. Were assessed: urinary incontinence, physical activity, lumbopelvic pain, anxiety, perinatal variables, labor control, pain relief techniques and satisfaction with childbirth. Results: The participants in the experimental group had a lower risk for urinary incontinence in intermediate (RR 0.69, 95% CI 0.51-0.93) and final assessments (RR 0.60, 95% CI 0.45-0.81), and reported greater physical activity (p = 0.009). There were no differences in the anxiety level, lumbopelvic pain, and perinatal data. Qualitative analysis of the experimental group reported greater control of labor, autonomy in the use of pain-relief techniques and vertical positions and reported greater satisfaction with the the experience of labor and delivery. Conclusion: The PPP was effective in controlling urinary incontinence and improvement in physical exercise, increased women's control of labor, promoted greater satisfaction with childbirth, and showed no adverse maternal and fetal effects
Doutorado
Saúde Materna e Perinatal
Doutor em Ciências da Saúde

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Wan, Simon. "Self-assembling peptide hydrogel for intervertebral disc tissue engineering". Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/selfassembling-peptide-hydrogel-for-intervertebral-disc-tissue-engineering(1f931e1e-6b9b-49a7-bd30-2572ff0338fa).html.

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The intervertebral disc (IVD), situated between adjoining vertebrae, consists of the gelatinous nucleus pulposus (NP) in the centre surrounded by the tougher annulus fibrosus (AF). Its main roles are to distribute loads and to act as joints. With aging, degenerative disc disease (DDD) occurs due to an imbalance in anabolic and catabolic events in the IVD, which results in a loss of function. Lower back pain (LBP) affects 84% of people at some point in their lifetime and is strongly associated with DDD. Current LBP treatments have limited long term efficacy and are symptomatic rather than curative. Cell-based therapies are regarded to hold great potential for the treatment of DDD as it has been hypothesised that they could regenerate the damaged tissue and alleviate LBP. A number of natural and synthetic biomaterials have been investigated as NP tissue engineering scaffolds with varying results. In this study, a self assembling peptide hydrogel (SAPH) was investigated for its potential as a cell carrier and/or scaffold for NP tissue engineering. SAPHs display the advantages of natural polymer hydrogels such as biocompatibility and biodegradability whilst combining the advantages of synthetic materials such as controlled structural and mechanical propertiesCharacterisation determined that the SAPH nanofibrous architecture had features that were of similar scale to extracellular matrix (ECM) components of the human NP. The mechanical properties of the SAPH could be optimised to closely match the native tissue. The system could shear thin and self-heal making the system ideally suited to delivery via minimally invasive procedure. The three dimensional (3D) culture of bovine NP cells (bNPCs) in the SAPH demonstrated that the NP phenotype could be restored after de-differentiation during monolayer culture. Gene expression results demonstrated that ‘traditional’ and ‘novel’ NP markers were highly expressed throughout in vitro culture. Cell viability was high, cell population remained stable and bNPCs adopted the characteristic rounded morphology of native NPCs. Finally, type II collagen and aggrecan, the main ECM components of the NP, were deposited with increasing production over culture period. Growth differentiation factor 6 (GDF-6) has been identified as the most promising current growth factor for inducing discogenic differentiation from human bone marrow mesenchymal stem cell (h-BMMSCs). After samples were stimulated with GDF-6, gene expression results confirmed that a NP-like phenotype could be induced with high expression of ‘traditional’ and ‘novel’ NP markers. Cell viability was high, cell population remained stable and NP associated ECM components were deposited with cells displaying a rounded morphology. Interestingly, when h-BMMSCs were cultured without GDF-6, it was strongly suggested that spontaneous discogenic differentiation occurred after culture in the SAPHs as ‘traditional’ and ‘novel’ NP markers were highly expressed, morphology was comparable to native NPCs and type II collagen and aggrecan were deposited extracellularly. If these findings were accurate then this is the first study to demonstrate that a NP-like phenotype could be induced from MSCs without use of an exogenous growth factor or a discogenic bioactive motif. Despite exciting and novel results, further work is required to confirm the potential of SAPHs for NP tissue engineering scaffolds.

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Maeda, Fernando Lourenço. "Investigando a participação do cônjuge nos cuidados ao paciente com dor lombar crônica". Pontifícia Universidade Católica de São Paulo, 2008. https://tede2.pucsp.br/handle/handle/15728.

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Made available in DSpace on 2016-04-28T20:39:50Z (GMT). No. of bitstreams: 1 Fernando Lourenco Maeda.pdf: 503002 bytes, checksum: 7aa342814a5c45db50d1356bb3f56ffc (MD5) Previous issue date: 2008-05-30
Conselho Nacional de Desenvolvimento Científico e Tecnológico
This study had as general goal investigate the perception of partner s support and the impact of the pain in the relationship as a couple of patients suffering of chronic lower back pain, of both gender, in ambulatory treatment in a big public hospital of São Paulo city. The study was made with 50 patients, where 25 were men and 25 were women, aged 35 to 65 years. The main used instruments were: social-demographic questionnaire, visual analogical scale of pain intensity, medical Outcomes study 36- item short form-health survey and semi directed interviews. The results demonstrated that all the participants of the study had the quality of their lives harmed, and that women showed intensity pain levels considered severe, whereas men obtained intensity pain levels considered moderate. 70% percent of the sample mentioned a negative impact on their sexual relations, due to their functional limitation and intensity of the pain, while the rest mentioned a marital adjustment when facing the symptoms of the pain. 86% of the sample mentioned perceiving their partners as supportive, being the helpful behavior considered the main way of support. The analysis of the results showed that the participants that had received partner s support, obtained better levels in the control of Vitality and Mental Health, when compared to the ones that had had no support. The conclusion of the results indicated that the chronic lower back pain causes a negative impact in the couple s relationship and that the partners support can work as a protection factor for depressive and anxiety symptoms, being this an important aspect to be considered in the health process of individual with chronic pain and in the planning of therapeutic procedures
Este estudo teve como objetivo geral investigar a percepção de apoio conjugal e o impacto da dor no relacionamento de casal de pacientes portadores de dor lombar crônica, de ambos os gêneros, em tratamento ambulatorial em um hospital de grande porte da rede pública da cidade de São Paulo. O trabalho foi realizado com 50 pacientes, sendo 25 homens e 25 mulheres, com faixa etária entre 35 e 65 anos. Os principais instrumentos utilizados foram: Questionário Sócio-demográfico, Escala VAS de intensidade da dor, Questionário de Qualidade de Vida SF 36 e Entrevista Semi-dirigida. Os resultados demonstraram que todos os participantes do estudo obtiveram qualidade de vida prejudicada, sendo que as mulheres apresentaram intensidade de dor considerada severa, enquanto os homens obtiveram intensidade de dor moderada. 70% da amostra relataram impacto negativo no relacionamento sexual, em decorrência da limitação funcional e gravidade da dor, enquanto que o restante referiu um reajustamento conjugal frente aos sintomas da dor. 86% da amostra relataram que percebem seus cônjuges como apoiadores, sendo que o comportamento solícito foi considerado o principal meio de apoio. A análise dos resultados demonstrou que os participantes que receberam apoio do cônjuge, obtiveram melhores índices nos domínios Vitalidade e Saúde Mental, quando comparados com aqueles que não receberam apoio. A conclusão dos resultados indicou que a dor lombar crônica causa impacto negativo no relacionamento de casal e o apoio conjugal pode funcionar como fator de proteção para sintomas depressivos e de ansiedade, sendo este um aspecto importante a ser considerado no processo da saúde dos indivíduos com dor crônica e no planejamento de condutas terapêuticas

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Chen, Ling, i 陳鈴. "The Correlations between the Risk Factors of Dancers’ Lower Back Pain and their Lower Back Pain". Thesis, 2015. http://ndltd.ncl.edu.tw/handle/78715303265615796208.

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碩士
國立體育大學
運動保健學系
103
Purpose: The aim of this study attempts to explore the effects of the pelvic tilt angle, the pelvic stability, the torso mobility, and the core isometric muscular strength on the lower back pain, as well as the correlation between the lower back pain and the years of experience in dance learning, the practice time, and the risk factors of the lower back pain. Methodology: The participants in this study were 50 female students enrolled in the dance class of some high school. The examinations of the risk factors of the lower back pain were conducted by testing the pelvic tilt angle (through the pelvic forward tilt and side tilt), the pelvic stability (through the downward swing of a straight leg), the torso mobility (through the torso front bend, back bend, side bend, and twist), and the core isometric muscular strength (through the abdominal muscular isometric endurance, the back muscular isometric endurance, and the lateral abdominal muscular isometric endurance). The results for the dancers with the lower back pain were compared with those without the lower back pain. The analysis of correlation between the risk factors of the lower back pain and the subjects’ background information in terms of dance learning was also conducted. Results: It was found that the dancers with the lower back pain had greater angels of the pelvic forward tilt and lesser pelvic stability. Since the dancers have greater torso mobility than non-dancers in general, there was no significant difference in the torso mobility between the dancers with and without the lower back pain. The results also indicates that the torso stability is not the main factor that causes the dancers’ lower back pain. The dancers with the lower back pain had lesser abdominal muscular isometric endurance, which shows a significant difference when being compared with that of the dancers without the lower back pain. The relationship between the years of experience in dance learning and the pelvic stability (tested by means of the downward swing of a straight leg) was significantly related but in opposite directions. The dancers with the chronic lower back pain (lasting for more than three months) had greater angle of the pelvic forward tilt. The dancers with the chronic lower back pain (lasting for more than three months) had lesser abdominal muscular isometric strength.

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Van, der Merwe Petronella Dorothea. "A systematic review of exercises used in a workplace setting, for the management of lower back pain". Thesis, 2008. http://hdl.handle.net/10539/4935.

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ABSTRACT Aim: The aim of this study was to determine the most effective exercise program for the management of occupational lower back pain. Background: Occupational lower back pain accounts for 25% of workdays lost. The annual occurrence of occupational related lower back pain among blue collar workers in South Africa has shown to be between 55,7% and 63,9%. Methodology: Primary studies were searched with the use of the Entrez-cross-database search tool. Methodologies were assessed and critiqued. Data which included exercise detail, outcome measures of lower back pain intensity, painful episodes, sick leave and physical measures with statistical p-values was then extracted. Results: Nine primary studies, which included 11 exercise groups, complied to the inclusion and exclusion criteria. These studies proved to be of high methodology quality with quality scoring 70% on the quality assessment checklist. Exercise regimes, which included stretching, strengthening, endurance exercises and the combination use of stretching, strengthening and endurance exercises were identified and grouped according to the corresponding outcome measures. No meta-analysis could be done as no similar exercises with similar outcome measures could be found. Discussion: The limitations in the nine selected studies methodological quality were the lack of blinding of the assessors and subjects, and in six of the nine studies the lack of adequate participation rate among the intervention subjects. The validation process is acknowledged as a weakness within this study. Stretching, dynamic strengthening and endurance exercises were not statistically significant. Isometric exercise was statistically significant for lower back pain relief when the control group (p<0,0001) was compared to the experimental group. Isometric exercise however had no significant effect on abdominal strength at 9 months follow up period. Functionalexercises were statistically significant when the exercise group was compared to the control group with lower back pain intensity relief (p<0,018), painful episodes (p<0,018), sick leave (p< 0,0044). Functional exercises also had a long-term statistically significant effect on back muscle strength. A meta analysis could not be done due to insufficient similar studies. Conclusion: Although the methodology quality of the nine primary studies showed to be of high quality the validation process was a weakness within this study. Functional strengthening exercises were the most effective type of exercise for the management of occupational lower back pain among blue-collar workers. Future similar randomized control trials on exercise as an intervention to occupational lower back pain are needed to conduct a meta analysis. A meta analysis will be able to provide more evidence to establish which exercise regime is most effective for the management of occupational lower back pain.

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Kingston, David. "A GENERALIZED SOFTWARE SOLUTION FOR THE ESTIMATION OF JOINT MOMENTS: AN APPLICATION TO LIFTING". Thesis, 2013. http://hdl.handle.net/1974/8143.

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Objective: To develop modular software to assess angular impulse and to determine the effect of a reduced dataset on the net angular impulse acting at the L5/S1 joint. Background. With the prevalence and incidence of lower back pain increasing annually, accurate assessment of physical job demands is needed. Many lab based approaches exist to measure the moments acting on the lower back, but require advanced and sensitive testing equipment. Of the methodologies currently used in industrial settings, most require significant contributions of time or money to be implemented. There is a need for cost and time effective methods to record a worker’s kinematic data over their whole shift. Methods: Twelve participants performed 12 consecutive lifts under five lifting conditions: SQ00 (squat 0kg); SQ04 (squat 4kg); SQ10 (squat 10kg); FP04 (fast squat 4kg); ST04 (stoop 4kg). Kinematic data of the upper limbs, head, and trunk was recorded with external load data and kinetic analysis was performed by implementing an extension of the Hof (1992) method called the lined-segment engine (LSE) to calculate the angular impulse (N•m•s) acting on the L5/S1 joint. Results: The LSE was sensitive to changes in load, lifting speed, and lifting posture (p < 0.05). There was no difference in dynamic, quasi-static, or static models when calculating angular impulse, but there was a difference in the L5/S1 angular impulse when the upper limbs were removed from the dynamic LSE model (p < 0.05). Conclusion: The LSE requires further refinement, but could be a generic approach to kinetic calculations. A scaled no-arms model for calculating the angular impulse acting on the low back could be used to assess field based lifting studies with 5.8% error.
Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2013-08-03 15:05:03.257

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Huang, Hsiang-chun, i 黃向均. "A virtual reality lower-back pain rehabilitation system: system development and effectiveness analysis". Thesis, 2014. http://ndltd.ncl.edu.tw/handle/23037544668484062278.

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碩士
國立中央大學
資訊工程學系
102
Low back pain affects people of all age, it is a very common health problem worldwide, about 80% of people may have complained about it in their life, and it’s ineffective if we use same treatment to all patient. In addition, rehabilitation therapy takes a long period of time, patient may lacked for motivation or don’t have enough physiotherapists, patients are often unable to finish the entire course of treatment. With the progress in technology and electronic process, makes virtual reality a useful tool in rehabilitation field. Cheaper and more accurate wearable device can also be substitute for motion tracking system in measuring patient’s movement. The system is based on virtual reality and combined wireless sensor which is aim to assist therapist and patient in doing three stages low back pain rehabilitation exercises. The three stages are as follows: Observe and correct patient’s posture which is wrong and will makes them get injury. Therapist adjust proper rehabilitation target for every individual in order to training muscle strength. And in the third stage, the system will set the goal of exercise time and frequency for training endurance. Total of 40 low back pain participate recruited in this study, clinical assessment (include VAS for unpleasantness, VAS for pain and Oswestry Low Back Disability Questionnaire), task performance and user acceptance of technology questionnaires are used to investigate the effectiveness of the system. Experimental result shows that participates using the system for rehabilitation tool have significant improve in clinical assessment compare with traditional therapy group. In task performance, the study group also have great improvement. Finally, the users also have a high degree of technology acceptance and willing to continue to use the system for rehabilitation

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Rademeyer, Johannes Frederik. "The efficacy of using inversion therapy in the treatment of lower back pain". Thesis, 2014. http://hdl.handle.net/10210/9969.

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M.Tech. (Chiropractic)
Purpose: The purpose of this study was to determine if inversion therapy is beneficial for participants with lower back pain and if there is an additive effect when combining it with manipulation. Three treatment approaches were utilized: inversion therapy, lumbar spine manipulations and a combination of inversion therapy with lumbar spine manipulations. Method: Thirty participants who qualified for the study were randomly divided into three equal groups consisting of ten participants each. Depending in which group the participant was allocated, determined if they received lumbar spine manipulation (Group 1), inversion therapy (Group 2), or a combination of inversion therapy performed after the lumbar spine manipulation (Group 3). Procedure: Each participant was treated a total of six times over a course of three weeks, furthermore there was a seventh day of final data collection. The measurements were taken on the first, fourth and seventh visit. Subjective measurements consisted of the numerical pain rating scale (NPRS) and the Oswestry Low Back Pain Disability Index. Objective measurements were done with the inclinometer (lumbar range of motion) and the flexicurve (lumbar lordosis measurement). Results: It is clear that there were statistically significant improvements in all three of the groups in both the NPRS and the Oswestry disability index. The inversion therapy group performed the best with the NPRS and the Oswestry disability index, with the spinal manipulation and combination group following narrowly. However, there were no statistically significant differences on the intergroup analysis with regards to the subjective results. The results of the subjective measurements indicated that there was a relative decrease in lumbar spine lordosis measurements, over the trial period, but with no statistical significance. With the lumbar range of motion-flexion measurements it was clear that the spinal manipulation group and the inversion therapy group had superior results compared to the combination group, with both indicating statistical significance over the trial period. Extension, lateral flexion and rotation did not show any statistical significance over the trial period. Conclusion: There were statistically significant improvements within each of the three groups on intragroup analysis, but no statistically significant differences were found on intergroup analysis. Therefore, none of the groups could be singled out as being the superior treatment for mechanical lower back pain. All three groups’ demonstrated improvement. There was no significant additive effect by combining the two treatments. Therefore there is no benefit to adding inversion therapy to the treatment protocol. Manipulation alone demonstrated to have similar effects. However, should a patient not be able to see a chiropractor for treatment, home based inversion therapy can be beneficial. A concern that should be addressed is that home based treatment wouldn’t be supervised and as such it is not advised to do without some form of professional management. Inversion therapy can definitely be utilized as a home based treatment option for a patient with LBP, patients that can’t make use of regular chiropractic care due too logistical or financial restraints will benefit from inversion therapy home usage. Home usage will provide the patient with regular general traction therapy and can result in patient pain relief, increase overall functioning of the patient and the patient compliance may improve.

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44

Lin, Ying-Yi, i 林穎毅. "Finding Measurable Indicators Related to Clinical Symptoms of Lower-back Pain with Mechanical Device". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/4x52bg.

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碩士
國立交通大學
機械工程系所
107
This study investigates measurable indicators related to clinical symptoms of lower-back pain with the horizontal resistance of lower back by mechanical device. Lower back pain is one of the most common diseases in modern people. About 40% of people have experienced lower-back pain, which can seriously affect the daily life of patients, in their lives. People have been studying the diagnosis of lower-back pain, such as the use of pressure measurement under lower-back muscles to make the standard threshold of pressure, while the value which is very different from the lower back was judged to be abnormal. However, this method is easy to have a gap due to the tolerance range of each person. Some people used EMG and MMG ( Electromyography and Mechanomyography) to determine the status of the lower back muscles. But these two measurement features do not directly correspond to the syptoms of lower back pain. In addition, some people used tomography to observe the patient's lower back muscles compared with normal subjects. But the cost is too high and the machine is not available to everone. These measurements all show the difference in the mechanical properties of the lower back between the patient and the normal subject, but neither can be quantified to justify the result. This study will design and construct a robotic arm to measure muscle tension and mechanical values of the lower back muscles, analyze the measured data and place the results on a tension distribution figure, and finally find out measurable indicators related to clinical symptoms of lower-back pain. This study succeeded in distinguishing the nature of the internals of the phantom and the pig's foot by measuring the resistance of the level. We have invented a machine that measures horizontal resistance, allowing us to measure internal surface conditions by measuring the horizontal resistance of the surface. This method can be used in the future to measure the back of the human body. Keywords: lower-back pain, tissue resistance, lower-back detection.

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Tsheole, Rorisang Primrose. "A disability profile of Impala Platinum Mine workers presenting with nonspecific lower back pain". Thesis, 2017. https://hdl.handle.net/10539/24920.

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A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, in partial fulfilment of the requirements for the degree of Masters of Science in Physiotherapy, 8 September 2017
BACKGROUND: Lower back pain (LBP) due to ergonomic exposure in a work environment is wide spread in most countries and is the leading cause of disability affecting quality of life and work performance of an individual suffering from it. LBP is the most common reason for repeated medical consultation and subsequent absenteeism. It is reported that LBP is responsible for a third of work related disability disorders and it is estimated to cause 21.7 million disability adjusted life years (DALY‘s). In addition to the physical impact, lower back pain can influence psychological issues such as anxiety, depression and fear of job loss. Mining is an ancient occupation characterised by intense physical labour such as lifting, carrying, pulling and pushing heavy materials, operating heavy machinery and working in constricted environment. Despite the fact that ergonomics plays a major role in mining, the element of proper ergonomics is currently ignored or applied in a minimal scale in South African mining.LBP continues to have a high prevalence in mining industries. AIM: To profile the disability level of Impala Mine workers presenting with nonspecific lower back pain. METHODS: A cross-sectional quantitative study using a consecutive sampling method was conducted on mine workers employed at Impala platinum mine as rock drill operators (RDOs) and scraper winch operators (SWOs) aged between 20 and 60 years who had been employed in the current occupation for at least a period of one year. Interviews were conducted using the questionnaires based on Oswestry Disability Index (ODI) assessing disability levels, Who Disability Assessment Schedule II (WHODAS II) for activity limitation and participation restriction and Who Quality of life-Bref (WHOQOL-BREF) to measure quality of life. The study received ethical approval from the University of the Witwatersrand Human Research Ethics Committee: (Medical) (Ethical clearance no.M140813). Consent was sort from participants and Impala hospitals granted permission for the study. Data was analysed using Statistica version12.5. Descriptive data was presented as frequencies expressed in percentages. The Spearman correlation test was applied to establish the association among variables. Further analysis was done by fitting bivariate and multivariate linear regression models to quantify the magnitude of relationship between age, job category, disability, activity limitation, participation restriction and quality of life. Finally data was illustrated by means of tables and a scatter graph.RESULTS: From the study sample, 44% (n=151) of the SWOs reported moderate disability while 36% (n=132) of the RDOs reported moderate disability. Results revealed that disability level was significantly associated with job category (p-value 0.04). Activity limitation level was adversely affected and showed a positive correlation with disability(r=0.831). Only a small proportion of participants reported severe participation restrictions RDOs (0. 76%) and SWOs (1. 99%). Majority of participants reported moderate to good Quality of life (QoL) with only a small proportion reporting poor QoL RDOs (4.55%) and SWOs(3.31%).The findings of the study showed no statistical difference between the two job categories in terms of activity limitation (p=0.20), participation restriction (p=0.31) and QoL (p=0.56). There was a negative correlation between QoL and disability (r=-0.536).The result of the bi-variate linear regression showed a statistical significance between age and years of service with disability (P=0.001). DISCUSSIONS: Disability due to nonspecific lower back pain (NSLBP) was significantly associated with job category, suggesting that SWOs were the category mostly affected than the RDOs. The results revealed no statistical difference between two job categories in relation to activity limitation, participation restrictions and QoL. Furthermore, the results showed a strong positive correlation between disability and activity limitation and a moderate positive correlation between disability and participation restriction while a moderate negative correlation between disability and QoL was noted. The results of the linear regression highlighted that increased age and long years of service predisposes the miners to higher levels of disability and activity limitation, resulting in difficulties with participation in work related or societal activities which subsequently leads to poor QoL. CONCLUSION: Results of the current study revealed that the majority of RDOs and SWOs presented with moderate disability due to NSLBP. This study identified that age, job category and length of service were significantly associated with the severity and functional disability of LBP among RDO‘s and SWO‘s.Activity limitation level was adversely affected among RDO‘s and SWO‘s whereas participation restriction levels and QoL levels were less affected.
DH2018

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46

"Chiropractic and ergonomics for the treatment of lower back pain in the corporate environment". Thesis, 2009. http://hdl.handle.net/10210/2654.

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47

Chen, Shu-Mei, i 陳淑媚. "The Association with Pain,Disability and The Muscle Strength of The Lower Extremities in Chronic Low Back Pain Patients". Thesis, 1998. http://ndltd.ncl.edu.tw/handle/56236585505791131063.

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碩士
高雄醫學院
醫學研究所
86
Most of the biomechanical studies about low back pain on muscle strength have emphasized on the strength of trunk muscle. The attention paid to the changes of the muscle strength of the lower extremities in chronic low back pain( CLBP) patients was quite insufficient by comparison. Pain often cause restrictions on patients'' daily activites. Therefore, the present study will focus on the discussion of the relationship with prolonged pain, patients''daily activities and the muscle strength of the lower extremities. This cross-sectional study was based on 65 CLBP patients with relative symptoms for at least 3 months. Questionnaires concerned with their pain and disabilities in daily life were designed and completed by the subjects. At the same time, physical tests were given to these subjects to examine the muscle strength of their lower extremities, of which the results were compared with 130 normal subjects with matching age and gender. The results of this study have shown that the severity of pain was positively correlated with living disability (r = 0.33, P<0.05).There was also significant difference on the muscle strength of the lower extremities between the CLBP and control group(P<0.05). Furthermore, CLBP patients with leg symptoms had more living disability than those without leg symptoms (P<0.05). The results have also shown that the muscle strength of the lower extremities in the group with CLBP decreased accordingly. This may be due to pain or fear of pain which restricted the daily activities and resulted in the disuse weakness. Therefore, these CLBP patients had suffered from considerable pain and inconvenience in their daily life. The weakened muscle strength of the lower extremities can be improved by special therapy, such as physical therapy, occupational therapy.

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48

Billson, John Henry. "Effect of an aggressive versus conservative, multi-modal rehabilitation programme on chronic lower back pain". Thesis, 2011. http://hdl.handle.net/2263/29008.

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Low back pain has become one of the most influential musculoskeletal diseases of modern society. It is one of most expensive diseases in terms of medical costs and increased worker absenteeism, which can lead to permanent disability and places strain on the economy as a whole. Pain has been recognised as a disease in itself, which has certain consequences when it becomes chronic. Many kinds of treatment options exist with varying degrees of success. The question is thus which treatment option is the most favourable and cost-effective. Conservative treatment is the most recommended form of treatment when no serious underlying diseases are present. Exercise has been shown to be very effective in the treatment of chronic low back pain but there are still questions regarding the use of exercise therapy. The predetermined goal of the study was to ascertain whether an aggressiveprogressive exercise programme, and specifically what kind of exercises, would be more effective in the treatment of chronic low back pain. This was achieved through a number of steps, which included an extensive literature review, the identification of an appropriate test battery with related minimum physical requirements and cut scores, subject recruitment and screening of subjects, the implementation of the intervention and the subsequent re-testing of the subjects. Once the data was completed, the next step was to make use of two case studies to assist in illustrating the effectiveness of individual patients compared to the sample as a whole. These case studies were of patients who completed the entire programme but one took longer to complete the programme. This assists in illustrating the value of maintaining exercise protocol. The results from the present study are extremely positive. The two case studies provided a glimpse of the potential value that could be added through the implementation of more aggressive-progressive exercise interventions in the treatment of chronic low back pain. The final product will greatly assist exercise therapists concerned with the treatment of chronic low back pain along with cognitive-behavioural techniques. Hopefully this study will provide insight into managing chronic low back pain in South Africa from an exercise standpoint. Secondly the study will provide practical techniques to implement in an era in which economic difficulties are rife.AFRIKAANS: Laerugpyn het een van die invloedrykste muskuloskeletale siektes van die moderne samelewing geword. Dit is een van die duurste siektes in terme van mediese koste en verhoogde siekverlof deur werkers, wat kan lei tot permanente ongeskiktheid en ’n verhoogde las plaas op die ekonomie as ’n geheel. Pyn word erken as ’n siekte op sy eie wat sekere gevolge het wanneer dit chronies begin raak. Verskeie soorte behandelingsopsies is beskikbaar met variërende grade van sukses. Die vraag is dus watter behandelingsopsie is die bruikbaarste en koste-doeltreffendste. Konserwatiewe behandeling is die mees aanbevole metode van behandeling wanneer daar geen ernstige onderliggende siektetoestande teenwoordig is nie. Dit is reeds bewys dat oefening baie doeltreffend is in die behandeling van chroniese laerugpyn. Daar bestaan egter steeds vrae rondom die gebruik van oefening as terapie.Die vooropgestelde doelwit van die studie was om te bepaal of ’n aggressiewe-progressiewe inoefeningsprogram doeltreffend sal wees in die behandeling van chroniese laerugpyn, en meer spesifiek watter tipe oefening die doeltreffendste sal wees. Die navorsing het bestaan uit ’n paar stappe wat ingesluit het ’n intensiewe literatuursoektog, die identifisering van ’n gepaste toetsbattery met verwante minimum fisieke vereistes en afsnytellings, die verkryging en evaluering van proefpersone, die implementering van die intervensieprogram en die daaropvolgende hertoetsing van die proefpersone.Nadat die invordering van die data en die gepaardgaande analise van die data voltooi is, was die volgende stap om gebruik te maak van twee gevallestudies ten einde die doeltreffendheid van die intervensieprogram vir individuele proefpersone te ilustreer deur dit te vergelyk met die groep as ’n geheel. Die twee gevallestudies was van proefpersone wat die intervensieprogram volledig voltooi het, alhoewel die een proefpersoon langer geneem het om die intervensieprogram te voltooi. Dit help om die navolgingswaarde van ’n inoefeningsprotokol te illustreer. Die resultate van die huidige studie is uiters positief. Die twee gevallestudies gee ’n mate van insig wat betref die potensiële waarde wat verkry kan word deur die implementering van ’n meer aggressiewe-progressiewe inoefeningsintervensie vir die behandeling van chroniese lae rugpyn. Die finale produk sal die nodige ondersteuning aan oefeningsterapeute bied wat onseker is oor die behandeling van chroniese laerugpyn deur middel van aggressiewe-progressiewe inoefeningsintervensies en kognitiewe gedragstegnieke. Hierdie studie sal dus die begrip en insig van die behandeling van chroniese laerugpyn in Suid-Afrika verhoog vanuit ’n oefeningsuitgangspunt. Tweedens sal die studie die gebruik van praktiese oefentegnieke aanmoedig in ’n era waarin ekonomiese tye moeilik is.
Thesis (DPhil)--University of Pretoria, 2011.
Biokinetics, Sport and Leisure Sciences
unrestricted

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49

Fernandes, Carina. "The effects of chiropractic adjustments compared to stretching in freestyle dancers with lower back pain". Thesis, 2011. http://hdl.handle.net/10210/3718.

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M.Tech.
Dancing, over the years has become a highly competitive sport with demanding levels of fitness and flexibility needed in order to progress to a professional level (DeMann, 1997). With lower back pain becoming a common occurrence in dancers, both physical as well as emotional stress is placed on the dancer and their lower back (DeMann, 1997). The aim of this study was to compare the effectiveness of Chiropractic adjustments on the lumbar spine and Sacroiliac joints, stretching certain muscle groups or the combination of the two treatment protocols on Freestyle dancers with chronic lower back pain with regards to pain, disability and lumbar spine and pelvis range of motion. Thirty female participants between the ages of thirteen and twenty five years were recruited to participate in this study. Successful participants were then randomly placed into one of three groups, of ten participants each, which would receive different treatment protocols according to their group allocation. Group 1 underwent Chiropractic adjustments to the lumbar spine and Sacroiliac joints, Group 2 received stretching exercises to the Quadratus lumborum muscle; gluteal muscles consisting of Gluteus maximus, medius and minimus; Piriformis; Psoas; Hamstring and Multifidus muscles only and Group 3 received a combination of the treatment protocols. Participants in all three groups were assessed using the Numerical Pain Rating Scale and the Roland-Morris Disability Questionnaire for subjective readings; the Digital Inclinometer was used for objective readings of ROM. All treatments were performed at the Riviere Academy of Dance under the supervision of a qualified Chiropractor. The results concluded that the benefits of an adjustment alone, stretching alone as well as the two treatments combined showed a reduction of pain and increase of ROM, when managing a dancer with lower back pain. Not one treatment was shown to be more beneficial than the other.

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Deall, Ashleigh Jane. "The value of isometric and stretch exercises in the management of mechanical lower back pain". Thesis, 1995. http://hdl.handle.net/10321/2843.

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A dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technikon: Chiropractic, Technikon Natal, 1998.
Mechanical low back pain is a common clinical entity which needs professional treatment (Margo 1994). Due to the nature of mechanical low back pain, recurrence of pain is a common entity that can cripple a patient and the ~tate financially. It is for'this reason that the professionals need to establish a cost effective method of treatment that helps maintain the pain free state and prevent recurrences
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