Oswestry Low Back Disability Questionnaire Research Articles

THE IMPACT OF IMMERSIVE VIRTUAL REALITY ON PAIN PROCESSING AND PATIENT-REPORTED OUTCOME MEASURES IN PEOPLE WITH PERSISTENT LOW BACK PAIN: PRELIMINARY RESULTS

BackgroundEmbodiment- and distraction-based approaches to immersive virtual reality (IVR) show promise in treating persistent low back pain (PLBP). However, which approach is more effective is unclear. This study aims to evaluate the impact of distraction- and embodiment-based IVR on pain processing and patient-reported outcome measures in PLBP.MethodIndividuals with PLBP were randomised to receive eight sessions of either distraction- or embodiment-based IVR over two weeks. Outcome measures were evaluated at baseline and after the eighth session. Pain processing was evaluated using conditioned pain modulation (CPM) and temporal summation (TS).ResultsThree participants (n=2 embodiment, n=1 distraction) have completed all eight IVR sessions. Preliminary results indicate a decrease from pre to post-intervention in Numerical Pain Rating Scale score (pre: 5/10, 6/10, 5/10; post: 2/10, 5/10, 2/10) and Pain Catastrophising Scale score (pre: 34/52, 11/52, 38/52; post: 11/52, 8/52, 12/52), with no clear trend in other self-reported measures (Hospital Anxiety and Depression scale, Oswestry low back disability questionnaire, fear-avoidance beliefs questionnaire, Tampa scale of kinesiophobia). Preliminary results suggest a potential increase in NPRS absolute values from pre- to post-intervention in CPM (pre: -2.7, -2.3, -2.0; post: -3.3, -2.0, -4.3) and TS (pre-1.2, 2.5, 2.4; post: 1.4, 2.5, 3.1).ConclusionEight sessions of IVR may reduce pain severity and pain catastrophising in people with PLBP and may increase the efficacy of endogenous pain modulatory systems. Data collection is ongoing to compare the effect of distraction- and embodiment-based IVR.Conflicts of InterestThere are no conflicts of interest.Sources of FundingThis project is funded by the Saudi Arabia Cultural Bureau.

Low back pain knowledge and associated disability among nursing staff in Oman

BackgroundLow back pain is a prevalent issue worldwide, impacting all healthcare professionals, in particular nurses, and leading to disability. ObjectiveThis study aimed to explore the predictive contribution of demographic factors, the presence of LBP, and knowledge about LBP in forecasting the level of disability among nurses in Oman. MethodA cross-sectional study was conducted using a paper-based questionnaire comprising two valid tools: the Low Back Pain Knowledge Questionnaire and the Oswestry Low Back Disability Questionnaire. A total of 236 nurses working in two tertiary hospitals in Oman participated in the study. ResultThe findings indicate that 66.8% of nurses had low back pain. The low back pain knowledge score was 13.81(SD 4.42). The mean disability score was 9.13 (SD 8.56), indicating mild disability. There is a negative significant association between low back pain knowledge (r = -0.24, p < .004) and disability level. The low back pain presence was also significantly associated with disability level (t (233) = 4.606, p < .001). The results of the regression indicated the two predictors (i.e., knowledge level and low back pain) explained 13 % of the variation in nurses’ disability level [F (3,230) = 11.447, p = .01]. ConclusionLow back pain is prevalent among nurses in Oman, and it is associated with disability. Preventive strategies need to be implemented.

A Study to Compare the Effect of Interferential Therapy with Ergonomic Changes Versus Core Strengthening Exercise on Low Back Pain Among Desk job workers: An Experimental study

Background: Desk job workers are spending 75% of work hours in high levels of sitting and improperposture causing pain over the low back region.1 Physical exercise is recommended for reducing low back pain andit promotes a healthy lifestyle and quality of life for the workers.2Purpose: The aim of the study was to determine the effect of Interferential therapy with ergonomic changes versuscore strengthening exercises on low back pain among desk job workers.Materials and Methods: This was an Experimental study and the subjects were chosen from the KH shoe company,Ranipet. A total of (N=166) subjects participated in this study based on inclusion and exclusion criteria. The level ofdisability was assessed by using the Oswestry low back disability questionnaire and range of motion by modifiedSchober test and finger to floor test. The strengthening exercise was received by group B for 30 minutes and restfor 30 seconds. The entire study period was from September 2022 to July 2023.Result: This study showed clinically significant reduction of low back pain using interferential therapy. Hence, bythe conventional criteria, this difference is considered to be statistically significant P&lt;0.0001.Conclusion: This study concluded that comparatively the interferential therapy with core strengthening exercisewas more effective than the Interferential therapy with ergonomic changes.

Correlation of Numeric Pain Rating Scale and Oswestry Disability Index of Non-specific Low Back Pain among Nursing Staff

Background: In Pakistan, nurses are pivotal in healthcare, often facing musculoskeletal discomfort, with low back pain being particularly prevalent. Given their vital role in patient care, understanding the extent of this issue is crucial for improving their work conditions and health outcomes. Objective: This study aims to evaluate the prevalence and impact of low back pain among nurses in Pakistani healthcare facilities, particularly focusing on those working in gynecology and obstetrics wards. Methods: A cross-sectional study was conducted over six months, involving 150 nurses from gynecology and obstetrics wards across four major hospitals in Lahore. The Oswestry Low Back Disability Questionnaire and the Numerical Pain Rating Scale were employed for data collection. Analysis was performed using IBM SPSS Statistics 23, with a significance level set at 0.05. Results: The study found that 58.7% of the nurses experienced low back pain, while 41.3% did not. A strong correlation (0.887) was observed between the Numeric Pain Rating Scale and Oswestry Disability Index, with a highly significant p-value of 0.000, indicating statistical significance at the 0.01 level. Conclusion: The study concludes that nurses working morning shifts in gynecology and obstetrics wards are more likely to report higher average pain scores. Additionally, the strong correlation between the Numeric Pain Rating Scale and Oswestry Disability Index underscores the relationship between pain intensity and disability in this group.

Acute effects of Whole Body Electrostimulation combined with stretching on lower back pain.

Data from recent studies suggest that whole-body electromyostimulation (WB-EMS) is a time-effective and tailored intervention for chronic lower back pain (CLBP). The aim of this non-randomized controlled study was to compare the efficacy of a WB-EMS training and the association between WB-EMS specific training with passive stretching (Well Back System, [WBS]) on CLBP. Forty patients with CLBP, 43-81 years old, were assigned to one of the two groups: WB-EMS (n=20) and WB-EMS+WBS (n=20). Both groups completed 12 sessions (8 weeks) WB-EMS protocol (2 x 20 minutes/week). The second group performed core-specific exercises with WB-EMS plus 6 extra stretching sessions (30 minutes each). Primary study endpoints were based on changes on visual analogue scale (VAS) and changes on Oswestry Low Back Disability Questionnaire (ODI). Secondary study endpoints were percentage changes of maximum trunk flexion (Sit & Reach, [SR]) and changes on assumption of painkillers. Both interventions significantly improved VAS, ODI and SR values (p range: 0.04; <0.001). However, the change of VAS (-46% vs -17%, p<0.001), ODI (-53% vs -17%, p<0.001), and SR (+7 vs +3 cm, p=0.001) were significantly higher in the WB-EMS+WBS group compared to the WB-EMS group. The working method with WB-EMS+WBS can be a joint-friendly, individualized form to decrease CLBP.

COMPARISON OF REGIONAL MANUAL THERAPY AND STANDARD PHYSICAL THERAPY INTERVENTION IN FEMALES WITH SACROILIAC JOINT PAIN

Background and Aim: Sacroiliac joint pain is localized in the region of sacroiliac joint which can be increased by stress and provocation tests of the joint. Aim of this study was to compare two interventions for reduction of sacroiliac joint pain. Methodology: Study design was randomized clinical trial. Study was conducted in bajwah hospital and children polyclinic Lahore. Duration of study was six months. The total sample size was 64 patients. Females of 20-50 years old with diagnosed sacroiliac joint pain were included in this study. Compression and distraction objective tests were performed for further confirmation of sacroiliac joint pain. Purposive sampling technique was used. Numeric pain rating scale (NPRS) and Oswestry low back disability questionnaire (ODI) were used to collect the data. Exclusion criteria was females with fractures and other abnormalities of spine. Results: Results showed that both groups were equal when assessed on baseline by normality test colmogorov-smirnova. Independent t test was applied to compare the mean value of NPRS. Pretreatment mean of NPRS scale for both the regional treatment and standard treatment groups was 7.After 4 weeks NPRS of regional treatment group was 4 and of standard treatment group was 7. The mean value of pretreatment ODI for regional treatment group was 33 and for standard treatment group was 34.After 4 weeks ODI of regional treatment group was 24 and mean of standard treatment group was 27. Conclusion: It is concluded that after giving equal sessions to both groups when results were assessed regional treatment is more effective than standard treatment.

Lumbosacral transitional vertebrae: prevalence in a southern European population and its association with low back pain.

Lumbosacral transitional vertebra (LSTV) is a congenital anomaly of the lumbosacral junction. Its prevalence is variable in the literature such as its association with low back pain. The aim of this study was to identify the prevalence of LSTV in a southern European population, and its correlation with low back pain. A retrospective review of 639 thoraco-abdomino-pelvic consecutive CT-scans between January 2019 and November 2020 was performed. The presence of LSTV was classified into type II, III, IV based on Castellvi's classification. To investigate the association with low back pain, Oswestry Low Back Disability Questionnaire (ODI) and the EuroQol-5D-3L questionnaire was applied. The prevalence of LSTV was 24.9% (142 of 571). 37,3% were type IIb, 31,0% were type IIa, 13,4% were type IIIa, 9.9% were type IIIb and 8.5% were type IV. Individuals with LSTV were more likely to report low back pain and have a higher ODI score (OR:0.392, 95% CI:0.192-0.802, p = 0.010), (OR: 1050, 95% CI: 1029-1072, p < 0.01). Castellvi's type IV showed a significantly higher ODI when compared to type II (OR:1059, 95% CI:1019-1100, p = 0,04). There was no statistical difference in the EuroQol-5D-3L score between two groups (OR:1085, 95% CI: 0.459-2.560, p = 0.852). This population-based study adds to the literature the prevalence of LSTV in a southern European population. LSTV was associated with low back pain. However, this difference did not translate into a loss of quality life. Type IV was associated with higher functional disability when compared with type II.

The effect of static stretching exercises on hip range of motion, pain, and disability in patients with non-specific low back pain

PurposeThe benefits of providing static stretching exercise targeting the hips in patients with non-specific Low Back Pain (NSLBP) are not well established. The objective of the study was to verify the effects of static stretching on function, pain and range of motion on patients with non-specific Low Back Pain (NSLBP).MethodsThirty females with NSLBP were randomly assigned to two control (n = 15) and experimental (n = 15) groups. The experimental group received 3 stretch practice sessions per week for a period of 8 weeks. The Oswestry low back pain Disability Questionnaire (ODI), visual analog scale (VAS), and passive hip range of motion (PROM) were employed before and after the intervention.ResultsThe results of mixed model analysis of variance indicate that the group × time interactions was not significant (p > 0.05) for all measurement outcomes. However, there was a main effect for Time (ODI: p = 0.002, VAS: p = 0.001, PROM-R: p = 0.016, PROM-L: p = 0.001). Such that the ODI, VAS, PROM-R, and PROM-L were showed significant differences before and after the intervention in the experimental group.ConclusionsThe results demonstrated a significant difference in PROM, pain, and disability after 8 weeks of stretching exercises in participants with NSLBP and limited hip extension. Therefore, it would be reasonable to infer that NSLBP might be partly related to hip flexors tightness.

Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture.

Background and Objectives: The current options for acute pain control of vertebral compression fracture include hard brace, vertebroplasty, early surgery, and analgesic injection. We hypothesize that the gray ramus communicans nerve block (GRNB) controls the acute pain experienced during vertebral compression fractures. This study assessed the time course of pain control after injection and evaluated the risk factors affecting pain control failure. Materials and methods: Sixty-three patients (24 male, 66.19 ± 15.17 y) with a thoracolumbar vertebral fracture at the T10-L5 spine, who presented to our hospital from November 2018 to October 2019, were included in this retrospective cohort study. GRNB was performed within 1 week of the trauma. The patients were followed up on days 3, 14, 30, 90, and 180 and assessed with the serial visual analog scale (VAS, resting and motion), Oswestry Low Back Disability (ODI) questionnaire, and Roland–Morris Disability Questionnaire (RDQ). The failure group was defined by the need for an additional block or cement injection after a single GRNB. The failure group’s risk factors, such as body mass index, initial thoracolumbar injury classification and severity score, Kummel’s disease, age, bone marrow density (BMD), and underlying disease, were analyzed. Results: The motion VAS score improved from preoperative to three months post-procedure, but the resting VAS was affected by the procedure for only three days. The quality of life index improved at postoperative six months. A lower BMD was the only risk that affected treatment failure in the logistic regression analysis (p = 0.0038). Conclusion: The effect of GRNB was maintained even at three months after trauma based on motion VAS results. The only risk factor identified for GRNB failure was lower BMD.

A multicentre randomized controlled follow-up study of the effects of the underwater traction therapy in chronic low back pain

Low back pain (LBP) is one of the most costly diseases in the developed world. This study aimed to investigate the effects of underwater traction therapy on chronic low back pain. The primary objective was to prove that underwater traction therapy has favorable effects on LBP. Our secondary objective was to evaluate whether it also leads to improvement in the quality of life. This is a prospective, multicenter, follow-up study. A total of 176 patients with more than 3 months of low back pain enrolled from outpatient clinics were randomized into three groups: underwater weight bath traction therapy and non-steroidal anti-inflammatory drugs (NSAIDs); weight bath; and only NSAIDs. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: levels of low back pain in rest and during activity were tested using the visual analogue scale (VAS), the Oswestry Low Back Disability Questionnaire, and the EuroQol-5D-5L Questionnaire.The VAS levels improved significantly (p < 0.05) in both underwater weight bath traction therapy groups by the end of the treatment, whereas the improvement in the third group was not statistically significant. Furthermore, the improvements measured in the groups receiving traction therapy were persistent during the follow-up period. There were no significant changes in the Oswestry Index or the EuroQol-5D-5L without VAS parameters in any of the groups.Based on our results, for patients suffering from LBP pain who underwent underwater weight bath traction therapy, there were favorable impacts on the pain levels at rest or during activity. Clinical trial registration ID: NCT03488498, April 5, 2018

Disability, pain catastrophizing and stress coping of patients with low back pain in rehabilitation practice in Latvia.

It is known that pain has emotional and behavioral consequences that influence the development of problems and outcome of treatment. Patients' attitudes and coping mechanisms seem to play a causal role in the chronification of low back pain (LBP) and augment a cycle of chronic pain and disability. To examine pain catastrophizing, stress coping strategies and disability among patients with low back pain in rehabilitation practice in Latvia. Seventy-four patients participated in the study. We used the Demographic questionnaire, Visual Analogue Scale, The Oswestry Low Back Disability Questionnaire, Pain Catastrophizing Scale and "The Ways of Coping scale". According to our data there is a strong interrelationship of disability and pain catastrophizing. The research data shows significantly higher scores of pain catastrophizing in patients with a more severe disability. Achieved research highlights the importance of a multifactorial approach to pain management and the enormous significance of pain catastrophizing in patients with low back pain.

The Effect of Classical Massage with Different Oils on Nonspecific Chronic Low Back Pain and Function

Research background. Chronic nonspecifc low back pain is one of the most widespread health problems in modern society. Massage together with oils is commonly used for low back pain. However, no studies are available on the effect of classical massage with different oils on functional state and pain in patients with chronic low back pain. The aim of this research was to determine the effects of classical massage with different oils on patients with chronic nonspecifc low back pain. Methods. This study included 14 women. They were randomly assigned into two groups. The experimental group received classical massage using oil of natural components and the control group received massage with Vaseline oil. All participants received seven massage sessions, one session lasted 20 min. Pain intensity (VAS scale), functional disability level (Oswestry Low Back Disability Questionnaire) and measurement of spine flexion range of motion (Modifed Shober test) were evaluated before and after intervention. Results. Both groups showed signifcant improvements in pain intensity (p &lt; 0.05). Massage with oil of natural components was more effective then massage with Vaseline oil in reducing pain (p &lt; 0.05). Functional disability decreased in both groups (p &lt; 0.05), but no signifcant difference was found between groups. The range of motion changes were not signifcant after intervention in two groups. Conclusions. Classical massage with oil of natural components and classical massage with Vaseline oil were found to be effective in relieving pain and decreasing functional disability in patients with chronic low back pain. Massage with oil of natural components was more effective than massage with Vaseline oil in reducing pain.Keywords: chronic nonspecifc low back pain, classical massage, oil.

Immediate analgesic effect of 2KHz interferential current in chronic low back pain: randomized clinical trial

ABSTRACT BACKGROUND AND OBJECTIVES: Interferential current is widely used in clinical practice for the treatment of low back pain, but there is no literature consensus regarding its parameters. The objective of this study was to analyze the immediate effect of the 2KHz interferential current in chronic low back pain. METHODS: This randomized controlled clinical trial was previously approved by the Research Ethics Committee of the Federal University of Parana, with the participation of 105 individuals with chronic low back pain (>12 weeks) of both genders. Participants were randomized in 3 groups: placebo group (PG, n=35), electrical stimulus off; interferential current1 (IG1, n=35), carrier frequency 2KHz, AMF of 2Hz, motor intensity level and IG2, n=35, carrier frequency 2KHz, AMF of 100Hz, sensory intensity level. All groups were subjected to a single application for 30 minutes with 4 electrodes in a crossed-shape position in the lumbar region. RESULTS: The visual analog scale, McGill pain scale, Oswestry Low Back disability questionnaire, Roland Morris disability questionnaire and Algometria of pressure were used for evaluation and revaluation. CONCLUSION: It may be noticed that by the visual analog scale and questionnaires, the interferential current provided an immediate analgesic effect in chronic lumbar pain regardless of the mode of stimulation.

THE COMPARISON OF INTERVENTION OF ULTRASOUND AND MUSCLE ENERGY TECHNIQUE WITH ULTRASOUND AND MCKENZIE EXERCISE INTERVENTION ON INCREASING FUNCTIONAL ABILITY IN NON-SPECIFIC LOW BACK PAIN

This study aims to compare ultrasound interventions and muscle energy techniques more effective than ultrasound and McKenzie exercise in improving functional ability in non-specific low back pain cases. The test used is a modified oswestry low back pain disability questionnaire to measure functional pain. Using experimental design with pre-test and post-test group design involved a sample of 32 people divided into 2 groups. Group 1 with ultrasound treatment and muscle energy technique and group 2 with ultrasound treatment and Mckenzie exercise. Hypothesis test results using the independent sample t-test obtained results p = 0,000 with a mean difference in group 1 22,85 (SB 4,348) while group 2 obtained a mean difference of 12,86 (SB 2,797). These results showed that there was a significant difference in the reduction of significant non-specific LBP functional pain between the treatment groups of the muscle energy technique and the McKenzie exercise treatment group.Keywords: non-specific low back pain, modified oswestry low back pain, disability questionnaire, ultrasound, muscle energy technique, mckenzie exercise

Sexual Functioning and Selected Clinical and Psychosocial Factors Among Individuals with Chronic Non-specific Low Back Pain in Ibadan, Nigeria

Chronic non-specific low back pain (CNLBP) has significant impact on psychosocial life, functional status, and sexual functioning. Prevalence of sexual dysfunction, and influence of selected clinical and psychosocial factors on sexual functioning were investigated in patients with CNLP in Ibadan, Nigeria. Sexual function, pain intensity, pain disability, quality of life were assessed using a modified questionnaire on sexual dysfunction in CNLBP, visual analogue scale, Oswestry low back pain disability questionnaire and quality of life questionnaires respectively. General attitude to sexuality, fear of increased pain at the low back, unwillingness to have sex, expression of sexual feelings, fear of losing the ability to perform sexual activities were assessed with the modified questionnaire. Participants (50 males; 46 females) were aged 46.7 ± 11.8 years. Orgasmic sexual dysfunction (50.0%) was the most prevalent while dysfunction with sexual satisfaction (14.6%) was the least prevalent. Participants with or without sexual dysfunction did not differ significantly in age (p = 0.07), pain duration (p = 0.64), pain disability (p = 0.76) and quality of life (p = 0.64). However, they differed significantly in pain intensity (p = 0.00). Significant associations exist between gender (p = 0.000) and sexual functioning. Participants’ sexual functioning were significantly influenced by psychosocial factors willingness to have sex (p = 0.013), expression of sexual feelings (p = 0.000). Participants’ pain intensity also significantly influenced (p = 0.00) their sexual functioning. Sexual dysfunction is prevalent among individuals with chronic non-specific low back pain and was influenced by clinical factors of pain intensity, pain disability, quality of life and psychosocial factors of general attitude towards sexuality, expression of sexual feelings, and willingness to have sex.

Augmentation of fenestrated pedicle screws with cement in patients with osteoporotic spine.

Background:Backing out and failure of pedicle screws in patients with osteoporosis is becoming a big problem due to wide use of these screws nowadays.Purpose:The aim of this study is to evaluate the purchase of fenestrated pedicle screws augmented with cement in patients with osteoporosis.Study Design:This was retrospective observational study.Patients and Methods:From May 2015 to January 2016, 25 patients with a poor bone stock condition underwent posterior fixation by fenestrated pedicle screws and cement augmentation. Assessment of pain improvement was done by visual analogue score (VAS) score while the long-term clinical outcome was assessed using Oswestry low back disability questionnaire (Oswestry disability index [ODI]). Implant stability was evaluated by plain radiography. Complications were evaluated in all cases.Results:All patients were followed up clinically and radiographically for a mean age of 24.84 months. There was a significant reduction in pain and improvement of the quality of life as detected using VAS scores and ODI questionnaire consecutively (P < 0.001). No radiological loosening or backing out of screws was observed. Cement leakage occurred in five cases.Conclusion:Augmentation of fenestrated screws with cement provided effective and lasting purchase in patients with osteoporosis. The only clinical complication strictly related to this technique was cement leakage.

Low back pain and disability in individuals with plantar heel pain

BackgroundLack of response to plantar heel pain (PHP) treatment may be related to unmanaged low back pain (LBP) and low back dysfunction, but a relationship between LBP and PHP has not been established. The purpose of this investigation was to compare the prevalence of LBP among individuals with and without PHP and to assess the association between low back disability and foot/ankle function. MethodsA cross-sectional study compared the prevalence and likelihood of LBP in individuals with (n=27) and without (n=27) PHP matched to age, sex, BMI, foot posture, and foot mobility. In individuals with PHP, correlations were examined between foot/ankle function using the foot and ankle ability measure (FAAM), low back disability using the Oswestry low back disability questionnaire (OSW), duration of PHP symptoms, body mass index (BMI), and age. ResultsA greater percentage of individuals with PHP had LBP (74% versus 37% of controls, odds ratio=5.2, P=0.009) and higher levels of low back disability (17% higher OSW score than controls, P<0.001). In individuals with PHP, FAAM scores were correlated with OSW scores (ρ=−0.463, P=0.015), but not with duration of PHP symptoms, BMI, or age (P>0.150). ConclusionsIndividuals with PHP had a greater prevalence of LBP and higher low back disability that was correlated to reduced foot and ankle function. Treatment to address both local and proximal impairments, including impairments related to LBP, may be warranted to improve the management of PHP.

EFFECT OF SELECTED YOGIC PRACTICES PHYSICAL EXERCISES AND PHYSIOTHERAPY TREATMENT ON SITTING OF LOW BACK PAIN PATIENTS

The purpose of the study was to investigate the effect of selected yogic practices physical exercises and physiotherapy treatment on sitting of low back pain patients. One hundred low back pain patients are taken from the Thavanur town, Kerala. The age, height and weight of the subjects ranged from 30 to 40 years, 158 to 169 centimetres and 55 to 70 kilograms respectively. The selected subjects were randomly assigned into five equal groups of 20 subjects each. Group I underwent Yogic practices, group II underwent physical exercises, group III underwent physiotherapy treatments, group IV yoga and physiotherapy treatments and group V acted as control. Prior to and after the training the subjects were tested on sitting of low back pain patients through the Oswestry low back pain disability questionnaire. Analysis of covariance was used to determine the significantly difference existing between pretest and posttest on sitting of low back pain patients. The result of the study proved that due to twelve weeks of the experimental training was reduced back pain while sitting for the low back pain patients.

Effect of Combined Brain and Back Muscle Stimulations on Level of Physical Disability among Chronic Low Back Pain Patients

The purpose of this study is to determine the effect of combining anodal cortical and back muscle stimulations in chronic low back pain (CLBP). Forty eight patients divided into four groups participated in the study. The control group received infrared therapy (IRT) and a session soft tissue massage (STM), while those in the other groups received combined dorsolateral prefrontal cortex (DLPFC) and Back muscle stimulation plus IRT and STM, combine primary motor cortex (PMC) and Back muscle stimulations plus IRT and STM and Williams flexion exercise plus IRT and STM respectively. The primary outcome (disability level) was assessed using modified Oswestry low back pain disability questionnaire while bothersome questionnaire (secondary outcome) was used to assess the level of bothersome of the participants. Statistical analysis revealed that participants that received DLPFC/Back muscle stimulation plus IRT and STM (p=0. 046, z=-2.02) have much improvement in disability compare to those that received PMC /Back muscle stimulations plus IRT and STM. In addition, the control intervention (IRT and STM) proves to be more effective (P=0.025, Z=-2.24) compare to other groups. It is concluded that IRT and a session of STM is more effective in the reduction of disability and improvement of the functions in CLBP than the combine stimulations, but the result cannot be generalized because of the small sample size and type of design used in this clinical trial.

EFFECT OF INSTRUMENTAL SURGICAL FUSION ON THE QUALITY OF LIFE IN DEGENERATIVE SPONDYLOLISTHESIS

There is no internationally accepted guideline for treatment of spondylolisthesis in the literature, otherwise this degenerative disease has great social and economical impact. There is no hungarian study examining the efficacy of instrumented fusion procedure in surgical treatment of spondylolisthesis. In current study we examined the effectiveness of fusion technique focusing on the impact of quality of life. Between 1st January, 2011 and 30th June, 2012 we examined a group of patients--who were operated on by instrumented fusion technique because of spondylolisthesis--, in the National Institute of Clinical Neurosciences, using the Oswestry Low Back Disability Questionnaire. All patients were treated after ineffective conservative treatment. The question was wheather how has changed the patients' quality of life after the operation. Paired-sample t-test was used in this study. Eighty-eight of the 97 examined patients reported different levels of impovement in the postoperative period, two patient's condition has not changed in spite of the surgery, seven patient's condition showed progression in average one year after the surgery. The pain improved most significantly (55.5%) (p < 0.0001). Using the 16 point borderline according to the Questionnaire (over moderate disability), significant improvement was detected in 50 patients (51.5%). Succesful surgical result--according to the quality of life--was seen in 77.41% of male and in 50.98% of female patients. According to the different age groups, 72.72% of the younger (before retirement), and 53.06% of the retired patients belonged to this group. At least 15 point improvement was detected 35.05% of the patients, the overall improvement was 10.5 point. Our results proved effectiveness of instrumented surgical fusion procedure in the treatment of degenerative spondylolisthesis. According to our results the younger male population with significant symptoms is the group, where improvement in quality of life is more pronaunced after the surgical procedure. The instrumented fusion surgical technique provides successful clinical and surgical outcome in patients with degenerative spondylolisthesis. It could improve the quality of life. Althought multicentre follow-up studies are needed to determine the exact indication and optimal therapy.