Chronic Low Back Pain Sufferers Research Articles

Does movement preparation enhance attending to bodily sensations in the back in people with persistent low back pain?

Attention has been proposed to play an important role in persisting pain, with excessive attentional processes towards pain information leading to worse pain outcomes and maladaptive behaviors. Nevertheless, research on somatosensory attending during the anticipation of pain-related movements is still scarce. This study investigated if individuals with chronic and recurrent lower back pain compared to pain-free controls, show enhanced attending to somatosensory information in the back while anticipating back-recruiting movements. 43 healthy control, 33 recurrent (RLBP) and 33 chronic low back (CLBP) pain sufferers were asked to perform back-recruiting movements. Before the movement initiation cue, a task-irrelevant tactile stimulus was administered to participants' lower back to elicit somatosensory evoked potentials (SEPs), used as an index of somatosensory attending. In contrast to our hypothesis, most identified SEP components did not differ across groups. The only exception was the P175 amplitude which was larger for the CLBP group compared to individuals with RLBP and healthy controls. The current study did not find robust evidence of enhanced somatosensory attending to the back in people with persisting lower back pain. The finding that CLBP, but not RLBP individuals, had larger amplitudes to the P175 component, is discussed as possibly reflecting a higher state of emotional arousal in these patients when having to prepare the back-recruiting movements.

The Association of Psychological Variants with Back Pain, Muscle Endurance, and Functional Limitations in an Individual with Chronic Back Pain.

Chronic low back pain (CLBP) substantially impacts quality of life through a multifarious interplay of physical and psychological elements. A comprehensive understanding of this relationship is imperative for developing effective treatment strategies. This study recruited 64 participants (35 males and 29 females) experiencing chronic low back pain to explore the associations between psychological factors, muscle endurance, and functional impairments. The study was conducted over six months in an outpatient department and a rehabilitation unit. The study utilized established outcome measures, such as the Biering-Sorensen Test and the Roland Morris Disability Questionnaire, and psychological variants as the core dependent variables, including the Beck Depression Inventory (BDI), STAI questionnaire, the FABQ-PA, and the Pain Catastrophizing Scale (PCS). The findings uncovered pronounced gender disparities, with females exhibiting elevated levels of depression (BDI: 27.68 ± 9.43, p < 0.001) and anxiety (STAI: 42.34 ± 8.94, p < 0.001) and diminished muscle endurance (130.47 ± 30.56 sec, p = 0.001). These revelations are congruent with the prevailing literature, emphasizing the need for gender-sensitive and personalized interventions. Bivariate correlations presented robust associations between psychological distress and decreased muscle endurance (r values ranging from -0.82 to -0.88, p < 0.001) alongside elevated functional impairments (r values from 0.89 to 0.94, p < 0.001) for both genders. Additionally, linear regression analyses illuminated the consequential impact of specific psychological variables such as the BDI, FABQ-PA, and PCS on muscle endurance and functional impairments (all p < 0.001). This study reveals gender-specific variations in chronic back pain, highlighting the influence of psychological factors on pain perception. It underscores the necessity for gender-sensitive treatment strategies. Future research is needed to explore these differences further and assess treatment efficacy to improve care and quality of life for chronic low back pain sufferers through personalized treatment plans.

Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study.

Background: Limited hip internal rotation range of motion (IR-ROM) and hip abductor weakness are recognized in low back pain (LBP) sufferers. The main aim was to investigate the effect of a ultrasound (US)-guided percutaneous neuromodulation (PNM) technique on hip strength in people with LBP. A second purpose was to discover whether the location along the sciatic nerve, where percutaneous neuromodulation was applied, could influence the change of strength response in these patients. Methods: Sixty LBP sufferers were recruited and divided randomly into three groups. All participants received an isolated percutaneous electrical stimulation at one of three different locations of the sciatic nerve pathway (proximal, middle, and distal), depending on the assigned group. Pain intensity, hip passive IR-ROM, hip muscle strength, and the Oswestry disability index (ODI) were analyzed. All variables were calculated before the intervention and one week after the intervention. Results: All interventions significantly decreased pain intensity and improved the IR-ROMs, strength, and functionality after one week (p = 0.001). However, between-group (treatment x time) differences were reported for flexion strength in the non-intervention limb (p = 0.029) and ODI (p = 0.021), although the effect size was small (Eta2 = 0.1) in both cases. Conclusions: The application of an isolated intervention of the US-guided PNM technique may be a useful therapeutic tool to increase the hip muscle strength in patients with chronic LBP.

Pain Self-Management Strategies of Chronic Back Pain Sufferers in Thailand: A Qualitative Study (A Doctoral Project)

Background: Chronic low back pain is among the most common chronic musculoskeletal disorders worldwide. It is prevalent in Thailand, affecting up to 30% of the general population, with much higher rates among manual labourers. Pain self-management, including education, exercise, medication and other components, is an effective strategy for reducing pain intensity and disability rates for chronic low back pain sufferers. Objective: To investigate pain self-management strategies among chronic lower back pain sufferers in Thailand. Methods: The study design was a qualitative interview-based technique. The study setting was an orthopaedic outpatient department at a university hospital in Northern Thailand. Participants (n = 19) were selected based on recruitment criteria, and data was collected using demographic forms and in-depth interviews. Thematic analysis was used for qualitative analysis, with Wilcoxon signed-rank test used to assess changes in pain levels. Results: Participants used a combination of pain self-management modalities, including exercise, modified food consumption, increased rest, herbal treatments, hot and cold compression, Thai massage, and acupressure, along with psychological and spiritual coping tools like meditation and making merit. Ability to use these interventions was dependent on medical support from practitioners as well as social and other support. A small, but significant, mean difference in pain was also observed. Conclusion: Findings point to the possibility that there are significant cultural differences in pain self-management modalities and their effectiveness.

Moderate Exercise and the Psycho-Neural and Bio-Mechanical Nature of Chronic Low Back Pain

Low back pain (LBP) is one of the most common health problems, which in 10-15% of patients progresses to develop into a chronic low back pain (CLBP) condition, bringing enormous psychological and financial costs to the affected individuals, their families and society as a whole. There are many theories – pure bio-medical, bio-mechanical, psychological, as well as poly-modal ones, attempting to explain the pathology and aetiology of CLBP and guide its treatment. Although there is a general consensus that CLBP, as many other chronic pain conditions, is heterogeneous in nature, involving both organic (bio-mechanical and physiological) and psycho-social factors, there is still not a definite answer to the exact interactions and causative links between these factors. The present study employed a 15 minutes moderate treadmill exercise intervention in 10 CLBP sufferers and 10 healthy controls in order to further clarify the interactions between these physiological, bio-mechanical and psychological factors. The results from the present study, in accordance with previous research confirmed that CLBP participants are clearly identifiable according to their affective and cognitive profile - CLBP participants reported significantly higher levels of Pain Catastrophising (t = 3.81, p = .003), as well as Depression (t = 2.35, p = .03). Although both Pain Catastrophising and Depression were significantly correlated with the background pain (r = .755, p < .001 and r = .559, p = .010 respectively) in the CLBP group alone, contrary to previous CLBP studies, there were no significant associations between the background pain level and duration, Depression, Anxiety, Stress and even Pain Catastrophising. The Negative affective (NA) state was measured dynamically throughout the experiment and was reduced non-significantly by the exercise in both groups. Surprisingly, The NA was very low – 18 to 20 on a scale of 15 to 75, in both groups (even lower in the CLBP) and there was no significant difference between the NA of the CLBP and Control groups at any time-point of the experiment. The ES and MF back muscles activity was measured using a static standing and fully bent forward ratio, as well as flexion-relaxation ratio (FRR) pre- and post-exercise. The present study's results, although less robust than the results from previous research, confirmed that both standing and fully bent forward ES and MF measures, as well as FRR distinguished CLBP from control participants – CLBP had a higher level of static muscle activity (significant for the pre-exercise right MF in fully bent down position t = -2.48, p = . 044) and reduced FRR (significant for the pre-exercise left ES – t = 3.09, p = .013 and post-exercise left ES and right MF – t = 2.33, p = .038; t = 2.73, p = .032 respectively). Although the exercise produced non significant improvement of the ES and MF muscle activity, it also produced a divergent pain intensity (PPI) response between different CLBP participants – 5 (55.56%) had a decrease in PPI, while 4 (44.44%) had an increase. The pain decrease sub-group exhibited only a mild back muscles dysfunction, characterised by increased activity of the ES and MF in resting state (muscle tension), combined with a higher negative cognitive and affective mental set. The main characteristics of the pain increase sub-group was abnormal ES and MF flexion-relaxation, which pointed to compensatory increased activity of the superficial back muscles due to possible intrinsic spinal instability. In conclusion, the moderate treadmill exercise, utilised in the present study, was capable of identifying the existence of CLBP sub-groups, which were otherwise undistinguishable by the rest of their background pain, psychological or muscle activity characteristics. The low back pain of one of the sub-groups was associated with primary psychological top-down dysfunction of the 'active system' (muscles), while in the second sub-group the principal underlying factor identified was primary organic bio-mechanical dysfunction of the 'passive system'. The possible mechanisms and implications of this dichotomous nature of CLBP in respect to its aetiology, diagnosis, treatment and further research are discussed.

Comparison of muscle activation imbalance following core stability or general exercises in nonspecific low back pain: a quasi-randomized controlled trial

BackgroundLow back pain causes changes in muscle activation patterns. Knowing how different exercises may improve altered muscle activation is useful in the treatment of patients. The aim of the study was to investigate whether there was a difference in the pattern of muscle activation in chronic nonspecific low back pain sufferers following core stability exercise (CSE) and general exercise (GE).MethodsFifty-six non-specific chronic LBP subjects were randomly assigned to either groups (28 participants in CSE and 28 in GE group). Both groups performed 16 sessions of an exercise program for about 5 weeks. Pain, disability and trunk muscle activation patterns (using surface electromyography) were measured at baseline and post-training.ResultsAfter the intervention period, antagonist coactivation ratio did not change in either groups. Though all compensated imbalance ratios (residual unequal muscular activity after cancellation of directionality) decreased towards negative (imbalance to left side) only this change for total muscles ratio in GE was significant (mean difference in GE group, 0.15; 95% CI: 0.02 to 0.28; p-value of paired t-test: 0.022); (mean difference in CSE, 0.02; 95% CI: − 0.07 to 0.11; p-value of paired t-test: 0.614).. No overall significantly decrease in uncompensated imbalance ratio (absolute imbalance values without cancellation directionality) was observed. Pain and disability decreased significantly in both groups. However, there was no difference between two groups in either of the variables after the intervention.ConclusionsBoth exercise programs reduced pain and disability and made or kept trunk muscle activation imbalance to the left side. The effects of two exercises on pain, disability and antagonist coactivation or imbalance ratios were not different.Trial registrationThis study was registered in the Iranian Clinical Trial Center with the code IRCT201111098035N1, Registered Jan 21, 2013.

(329) Pain processing during recalled pain differs in chronic low back pain sufferers and healthy individuals

(329) Pain processing during recalled pain differs in chronic low back pain sufferers and healthy individuals

Effect of Medicinal Cannabis Therapy (Mct) On Severity of Chronic Low Back Pain, Sciatica and Lumbar Range of Motion

Background: Anecdotal evidence indicates the possible efficacy of cannabis use as an adjunctive treatment in chronic low back pain. The purpose of the current study was to assess the results of treatment of patients suffering from chronic low back pain by medicinal cannabis (MCT). Methods: A cohort of 46 patients was followed for a minimum of twelve months. They were evaluated at baseline prior to MCT, 3 months later when MCT was begun and up to 12 months of MCT by patient reported outcome questionnaire (SF-12), visual analogue scale (VAS) and the Brief Pain Inventory (BPI), back specific function was assessed using the Oswestry score, range of motion was measured using the Saunders digital inclinometer. Opiate use was assessed using pharmacy dispensation records at baseline and after 12 months of MCT. Inclusion criteria included: age over 25 years, sciatica with documented treatment for at least 12 months, evidence on CT or MRI scan of disc herniation or spinal stenosis, failure of at least two narcotic drugs, and consent to use medicinal cannabis. Exclusion criteria included evidence of bone cancer, evidence of diabetic neuropathy, and evidence of prior psychotic reactions. Treatment protocol: Cannabis usage was at a fixed dosage of 20 grams per month, dose increase was considered at least after 6 months of treatment. The cannabis was smoked at a recommended rate of 4 dosages per day. Results: After 12 months of MCT BPI VAS decreased from 8.4 ± 1.4 to 2.0 ± 2.0; SF12-PCS improved from 47 ± 14 to 55 ± 12; SF12-MCS improved from 44 ± 6 to 50 ± 10; and sagittal plane active range of motion improved from 34º ± 8º degrees to 48º ± 8º, In conclusion, short term usage of smoked medicinal cannabis appear to improve both physical and mental function while decreasing pain levels of chronic low back pain sufferers.

Efficacy of Duloxetine in Chronic Low Back Pain With a Neuropathic Component

(Abstracted from Anesthesiology, 124:150–158, 2016) Chronic low back pain (CLBP) is a major public health issue. Approximately 37% of CLBP sufferers show signs of neuropathic pain, which is associated with higher pain intensity and health care costs, as well as a lower quality of life.

Effect of Medicinal Cannabis Therapy (MCT) on Severity of Chronic Low Back Pain, Sciatica and Lumbar Range of Motion

Background: Anecdotal evidence indicates the possible efficacy of cannabis use as an adjunctive treatment in chronic low back pain. The purpose of the current study was to assess the results of treatment of patients suffering from chronic low back pain by medicinal cannabis (MCT). Methods: A cohort of 46 patients was followed for a minimum of twelve months. They were evaluated at baseline prior to MCT, 3 months later when MCT was begun and up to 12 months of MCT by patient reported outcome questionnaire (SF-12), visual analogue scale (VAS) and the Brief Pain Inventory (BPI), back specific function was assessed using the Oswestry score, range of motion was measured using the Saunders digital inclinometer. Opiate use was assessed using pharmacy dispensation records at baseline and after 12 months of MCT. Inclusion criteria included: Age over 25 years, sciatica with documented treatment for at least 12 months, evidence on CT or MRI scan of disc herniation or spinal stenosis, failure of at least two narcotic drugs, and consent to use medicinal cannabis. Exclusion criteria included evidence of bone cancer, evidence of diabetic neuropathy, and evidence of prior psychotic reactions. Treatment protocol: Cannabis usage was at a fixed dosage of 20 grams per month, dose increase was considered at least after 6 months of treatment. The cannabis was smoked at a recommended rate of 4 dosages per day. Results: After 12 months of MCT BPI VAS decreased from 8.4 ± 1.4 to 2.0 ± 2.0; SF12-PCS improved from 47 ± 14 to 55 ± 12; SF12-MCS improved from 44 ± 6 to 50 ± 10; and sagittal plane active range of motion improved from 34o ± 8o degrees to 48o ± 8o, Conclusion: Short term usage of smoked medicinal cannabis appear to improve both physical and mental function while decreasing pain levels of chronic low back pain sufferers.

The Contribution of Differential Opioid Responsiveness to Identification of Opioid Risk in Chronic Pain Patients

The Screener and Opioid Assessment for Patients with Pain–Revised (SOAPP-R) predicts increased risk of opioid misuse in chronic pain patients. We evaluated whether higher SOAPP-R scores are associated with greater opioid reinforcing properties, potentially contributing to their predictive utility. Across 2 counterbalanced laboratory sessions, 55 chronic low back pain sufferers completed the SOAPP-R at baseline and measures of back pain intensity, evoked pain responsiveness (thermal, ischemic), and subjective opioid effects after receiving intravenous morphine (.08 mg/kg) or saline placebo. Morphine effect measures were derived for all outcomes, reflecting the difference between morphine and placebo condition values. Higher SOAPP-R scores were significantly associated with greater desire to take morphine again, less feeling down and feeling bad, and greater reductions in sensory low back pain intensity following morphine administration. This latter effect was due primarily to SOAPP-R content assessing medication-specific attitudes and behavior. Individuals exceeding the clinical cutoff (18 or higher) on the SOAPP-R exhibited significantly greater morphine liking, desire to take morphine again, and feeling sedated; less feeling bad; and greater reductions in sensory low back pain following morphine. The SOAPP-R may predict elevated opioid risk in part by tapping into individual differences in opioid reinforcing effects. PerspectiveBased on placebo-controlled morphine responses, associations were observed between higher scores on a common opioid risk screener (SOAPP-R) and greater desire to take morphine again, fewer negative subjective morphine effects, and greater analgesia. Opioids may provide the best analgesia in those patients at greatest risk of opioid misuse.

A Brief Review of Physical and Psychosocial Factors Involved in Chronic Low Back Pain

There is a high incidence of low back pain (LBP) in developed countries. Researchers have investigated potential occupation setting(s) that increase the risk of LBP and have reported numerous job related adaptations to reduce the various identified risks. However, chronic LBP results in approximately 10% of all reported LBP cases which can result in frustrating prolonged disability and extensive financial costs to the healthcare system. In the absence/successful treatment of medical and neurological pathology, biopsychosocial interventions may assist chronic LBP sufferers regain their personal and professional lifestyle. Following the biopsychological intervention model, recent research indicates that following ‘normal’ clinical practice guidelines for LBP and the feedback/recommendations made by healthcare practitioners (physicians’ and therapists’) plays a crucial role in chronic LBP patients treatment and recovery duration.

Chronic low back pain sufferers exhibit freezing-like behaviors when asked to move their trunk as fast as possible

Background contextThe effect of chronic low back pain (CLBP) on the kinematic parameters of trunk motion has received much more interest in this last decade. However, there are no descriptions of the motor strategies that occur when patients perform trunk movements in the three anatomical planes at different pace conditions. PurposeTo investigate motor strategies used by CLBP patients and asymptomatic people while performing different go and back trunk movements in an upright standing position. Study designA comparative study. Patient sampleThe control group (CG, n=33) included 14 men and 19 women with no history of low back pain, and the chronic low back pain group (CLBPG, n=49) included 21 men and 28 women. Outcome measuresKinematic data were analyzed during six trunk movements: flexion, extension, left and right lateral bendings, and rotations under two pace conditions (preferred and fast paces). MethodsA three-dimensional optoelectronic motion analysis system was used to assess static (trunk inclinations and base of support) and dynamic (range of motion [ROM] and mean angular velocity of the trunk) parameters during the go and back phases of trunk movements. ResultsIn the initial position, CLBPG showed a more forward-tilted trunk inclination (2.1°±1.1°, p=.013) compared with CG. The base of support was significantly higher in CG (+22.7 cm2, p=.009) during the fast pace when compared with the preferred pace. Regardless of the pace condition, ROM and mean angular velocity of the trunk were significantly lower in CLBPG for all examined movements and the pace condition did not significantly alter ROM. At the preferred pace, both groups displayed the same motor strategy: they all went faster during the second phase of movement than during the first phase. However, at the fast pace, while CG was going faster during the first phase than during the second, CLBPG maintained the same motor strategy as at the preferred pace. ConclusionsContrary to CG who changed its motor behavior from a preferred pace to a fast pace, CLBPG exhibited freezing-like behaviors. This original result highlights the importance of studying the velocity. The use of this parameter may improve the diagnosis of CLBP patients and could be a key indicator for treatment progress and long-term monitoring.

The effect of pain relief on dynamic changes in lumbar curvature

Lumbar curvature is important in the assessment of low back pain (LBP). It is often reported that changes in curvature seen in LBP sufferers are an adaptive response to pain. Studies investigating this hypothesis employing an experimental pain relief model have failed to isolate pain relief in their interventions. Therefore the purpose of this study was to investigate the immediate effects of pain relief on dynamic lumbar curvature.Twenty acute and 20 chronic LBP sufferers had their dynamic curvature measured using a novel fibre-optic device during flexion, extension and lifting before and after administration of oral analgesics. Peak curvature changes were examined using paired t-tests, numbers of responders to pain relief and changes in lumbar curvature sequencing were compared between groups using Chi-squared testing.A significant reduction in movement evoked pain was achieved. A significant reduction in kyphosis at end range flexion and lifting was identified for the acute LBP group following pain relief. No significant differences were observed for the chronic low back pain (CLBP) group. Neither the acute nor chronic LBP group were more likely to respond to pain relief by demonstrating alterations in peak curvature or in lumbar sequencing behaviour.These results demonstrate simple targeted pain relief did not result in gains in peak curvature challenging the assumption of movement alteration being possible through pain relief. Dynamic changes in curvature as displayed by sequencing showed that neither acute nor chronic LBP sufferers were more likely to respond to pain relief.

Dynamic Lumbar Curvature Measurement in Acute and Chronic Low Back Pain Sufferers

Williams JM, Haq I, Lee RY. Dynamic lumbar curvature measurement in acute and chronic low back pain sufferers. Objectives(1) To determine the reliability of a novel fiber-optic method to dynamically measure lumbar curvature in low back pain (LBP) sufferers, and (2) to investigate the dynamic lumbar curvature in acute and chronic LBP sufferers. DesignCross-sectional study. SettingPhysiotherapy clinic. ParticipantsAcute (n=20) and chronic (n=20) LBP sufferers recruited from general practitioner and therapist referrals. InterventionsNot applicable. Main Outcome MeasuresA fiber-optic device was used to measure curvature through time during flexion, lifting, and extension movements. Repeated-measures reliability for curvature-time curves was tested using coefficients of multiple correlation (CMCs) and root mean square error, and for peak curvature values intraclass correlation coefficients (ICCs) and mean absolute errors were used. Acute and chronic LBP groups were compared using peak curvatures and sequencing of curvature change. ResultsThe fiber-optic method was shown to be highly reliable in measuring both whole lumbar and lower lumbar curvature with CMC values >.81 and ICC values >.99. Chronic LBP sufferers displayed greater peak curvatures during flexion and lifting for the whole lumbar spine and lifting for the lower lumbar spine. The sequencing behavior demonstrated that the quartile of movement associated with the greatest curvature change was the second for flexion and lifting and first and second for extension across both groups. No significant differences in sequencing were demonstrated between the 2 groups. ConclusionsThis method is reliable for dynamic lumbar curvature measurement in back pain sufferers and is a viable option for clinicians. Acute LBP sufferers display less kyphosis during flexion and lifting. Sequencing of curvature change is similar across the 2 groups.

THE PREDICTIVE VALUE OF PAIN EVENT-RELATED POTENTIALS FOR THE CLINICAL EXPERIENCE OF PAIN

Journal of Integrative NeuroscienceVol. 09, No. 01, pp. 1-10 (2010) Short CommunicationNo AccessTHE PREDICTIVE VALUE OF PAIN EVENT-RELATED POTENTIALS FOR THE CLINICAL EXPERIENCE OF PAINHELEN VOSSEN, JIM VAN OS, HERMIE HERMENS, and RICHEL LOUSBERGHELEN VOSSENDepartment of Psychiatry and Psychology, Maastricht University, P.O. Box 5800, 6202 Az Maastricht, The Netherlands Search for more papers by this author , JIM VAN OSDepartment of Psychiatry and Psychology, Maastricht University, P.O. Box 5800, 6202 Az Maastricht, The Netherlands Search for more papers by this author , HERMIE HERMENSRoessigh Research and Development, Roessinghsbleekweg 33b, 7522 AH Enschede, The Netherlands Search for more papers by this author , and RICHEL LOUSBERGDepartment of Psychiatry and Psychology, Maastricht University, P.O. Box 5800, 6202 Az Maastricht, The Netherlands Search for more papers by this author https://doi.org/10.1142/S0219635210002354Cited by:1 Next AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsRecommend to Library ShareShare onFacebookTwitterLinked InRedditEmail AbstractEvent-related potentials (ERPs) have been found to be related to subjective experience of experimental pain. But how are they related to the subjective experience of clinical pain? The current study investigated the predictive value of the pain ERP for the subjective experience of clinical pain. Event-related potentials in response to experimental pain were measured in 75 chronic low back pain sufferers. In addition, a two-week registration to note the amount of pain they experienced in daily life was done. The results demonstrate that the N2-component at Cz and C4 of the pain ERP (contralateral to the side of the stimulation) were significant predictors of clinical pain, and even stronger predictors than the accompanying subjective ratings of experimental pain. Thus, it seems promising to use event-related potentials as a more objective measure to make predictions about a person's likely pain experience in daily life.Keywords:Event-related potentialschronic painpredictive value References P. M. Aslaksen and M. A. Flaten, Psychosom. Med. 70, 811 (2008), DOI: 10.1097/PSY.0b013e31818105ed. Crossref, Medline, ISI, Google ScholarB. Bromm and W. Meier, Meth. Find in Exp. Clin. Pharmacol. 6, 405 (1984). Medline, ISI, Google ScholarB. Bromm, Pain Measurement in Man: Neurophysiological Correlates of Pain, ed. B. Bromm (Elsevier, Amsterdam, 1984) pp. 257–290. Google ScholarD. E. Beckeret al., Pain 84, 37 (2000), DOI: 10.1016/S0304-3959(99)00182-7. Crossref, Medline, ISI, Google ScholarJ. Benvenutoet al., Exp. Neurol. 176, 269 (2002), DOI: 10.1006/exnr.2002.7930. Crossref, Medline, ISI, Google ScholarJ. Daltrozzoet al., Clin. Neurophysiol. 118, 606 (2007), DOI: 10.1016/j.clinph.2006.11.019. Crossref, Medline, ISI, Google ScholarA. Farmanet al., Neuropsychiatr. Dis. Treat. 4, 959 (2008). Medline, Google Scholar Hoekstra HA, Ormel J, de Fruyt F, NEO-PI-R – NEO FFI, Big five persoonlijkheidsvragenlijsten, Handleiding, Lisse, Swets & Zeitlinger, 1996 . Google ScholarE. C. Huskisson, Lancet 9, 1127 (1974). Medline, ISI, Google ScholarH. H. Jasper, J. Electroenceph. Clin. Neurophysiol. 20, 371 (1958). Google ScholarM. Kandaet al., Clin. Neurophysiol. 113, 1013 (2002), DOI: 10.1016/S1388-2457(02)00125-6. Crossref, Medline, ISI, Google ScholarA. H. Kempet al., J. Integr. Neurosci. 5, 89 (2006), DOI: 10.1142/S0219635206001069. Link, Google ScholarF. M. Kovacset al., BMC. Musculoskelet. Disord. 9, 9 (2008). Medline, ISI, Google ScholarE. E. Labbé, L. Murphy and C. O'Brien, Headache 37, 1 (1997). Crossref, Medline, ISI, Google ScholarR. Lousberg, A. J. Schmidt and N. H. Groenman, Pain 51, 75 (1992), DOI: 10.1016/0304-3959(92)90011-Y. Crossref, Medline, ISI, Google ScholarI. Myin-Germeyset al., Psycholog. Med. 12, 1 (2009). Medline, ISI, Google ScholarT. V. Perneger, BMJ 316, 1236 (1998). Crossref, Medline, ISI, Google ScholarL. Schwartz and G. H. Kraft, Am. J. Phys. Med. Rehabil. 78, 525 (1999), DOI: 10.1097/00002060-199911000-00006. Crossref, Medline, ISI, Google ScholarH. Stowell, Brain. Res. Bull. 2, 23 (1977), DOI: 10.1016/0361-9230(77)90021-1. Crossref, Medline, ISI, Google ScholarP. D. Wall, J. Psychophysiol. 188, 403 (1964). Google ScholarR. Zaslanskyet al., Pain 66, 39 (1996), DOI: 10.1016/0304-3959(96)03020-5. Crossref, Medline, ISI, Google Scholar FiguresReferencesRelatedDetailsCited By 1Parameter pattern discovery in nonlinear dynamic model for EEGs analysisSun-Hee Kim, Christos Faloutsos, Hyung-Jeong Yang, and Seong-Whan Lee18 November 2016 | Journal of Integrative Neuroscience, Vol. 15, No. 03 Recommended Vol. 09, No. 01 Metrics History Received 28 October 2009 Accepted 12 January 2010 KeywordsEvent-related potentialschronic painpredictive valuePDF download

Sensitivity to change of the Quebec Back Pain Disability Scale and the Dallas Pain Questionnaire

Objective To study and compare the sensitivities to change of the French versions of the Quebec Back Pain Disability Scale (QBPDS) and the Dallas Pain Questionnaire (DPQ). Method A retrospective study of the medical records of 30 chronic low back pain (LBP) outpatients undergoing a 4-week functional training program in a physical medicine and rehabilitation unit. Physical data (a visual analogue pain scale, the Schöber index, Sorensen and Shirado tests and the finger-to-floor distance) and functional status (QBPDS and DPQ scores) were measured at D0 and D25. Sensitivity to change was assessed in terms of the standardized response mean (SRM) and the effect size (ES). Results With the exception of the DPQ's “social interest” domain, all QBPDS and DPQ scores improved significantly over the course of the rehabilitation programme. Sensitivity to change was high for the QBPDS (SRM = 0.80; ES = 0.62) but only moderate for the DPQ (SRM = 0.59; ES = 0.61). Discussion-Conclusion Our results show that the QBPDS was more sensitive to clinical change than the DPQ in a sample of chronic LBP sufferers. It would be interesting to assess this sensitivity in a population of acute LBP patients and to evaluate the long-term effects of a functional rehabilitation program on the DPQ's “social interest” domain.

Objective and subjective assessment of sleep in chronic low back pain patients compared with healthy age and gender matched controls: a pilot study

BackgroundWhile approximately 70% of chronic low back pain (CLBP) sufferers complain of sleep disturbance, current literature is based on self report measures which can be prone to bias and no objective data of sleep quality, based exclusively on CLBP are available. In accordance with the recommendations of The American Sleep Academy, when measuring sleep, both subjective and objective assessments should be considered as the two are only modestly correlated, suggesting that each modality assesses different aspects of an individual's sleep experience. Therefore, the purpose of this study was to expand previous research into sleep disturbance in CLBP by comparing objective and subjective sleep quality in participants with CLBP and healthy age and gender matched controls, to identify correlates of poor sleep and to test logistics and gather information prior to a larger study.Methods15 CLBP participants (mean age = 43.8 years (SD = 11.5), 53% female) and 15 healthy controls (mean age = 41.5 years (SD = 10.6), 53% female) consented. All participants completed the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Pittsburgh Sleep Diary and the SF36v2. CLBP participants also completed the Oswestry Disability Index. Sleep patterns were assessed over three consecutive nights using actigraphy. Total sleep time (TST), sleep efficiency (SE), sleep latency onset (SL) and number of awakenings after sleep onset (WASO) were derived. Statistical analysis was conducted using unrelated t-tests and Pearson's product moment correlation co-efficients.ResultsCLBP participants demonstrated significantly poorer overall sleep both objectively and subjectively. They demonstrated lower actigraphic SE (p = .002) and increased WASO (p = .027) but no significant differences were found in TST (p = .43) or SL (p = .97). Subjectively, they reported increased insomnia (p =< .001), lower SE (p =< .001) and increased SL (p =< .001) but no difference between TST (p = .827) and WASO (p = .055). Statistically significant associations were found between low back pain (p = .021, r = -.589), physical health (p = .003, r = -.713), disability levels (p = .025, r = .576), and subjective sleep quality in the CLBP participants but not with actigraphy.ConclusionCLBP participants demonstrated poorer overall sleep, increased insomnia symptoms and less efficient sleep. Further investigation using a larger sample size and a longer period of sleep monitoring is ongoing.

Self-management of chronic low back pain: An exploration of the impact of a patient-centered website

Objective This paper examines from a qualitative approach the role of a patient-centered website – named “Oneself” – on patients’ chronic low back pain self-management attitudes and behaviors in the Italian part of Switzerland. Methods In-depth interviews have been conducted with a purposive and convenient sample of 18 chronic low back pain sufferers who had used Oneself during 6 months. Data collection and analysis were driven by grounded theory. Results Reported positive effects of the use of Oneself on self-management attitudes and behaviors include self-comprehension, improvement of argumentative abilities, orientation, development of self-confidence and maintenance of a high level of attention. In some cases, participants affirm to have experienced negative effects such as confusion and discouragement. The individual's previous awareness of cLBP and level of self-management plays a main role in the way people use the website and in its impact. Based on this criterium, a typology of four patterns of use is drawn. Conclusion Patient-centered websites are useful for enhancing self-management of chronic low back pain. However, individuals take advantage of this means differently, based on their stage of advancement in the self-management process. Practice implications Information and supports provided online should be tailored according to people's stage of advancement.

Meeting the ranging of informational needs of chronic low back pain sufferers: Conceptual design and rationale of the interactive website ONESELF

Meeting the ranging of informational needs of chronic low back pain sufferers: Conceptual design and rationale of the interactive website ONESELF