Pain Disability Questionnaire Research Articles

Effectiveness of kinesiotherapy in chronic non-specific low back pain

The aim of this study was to evaluate the effectiveness of physical therapy (kinesiotherapy or KT) for chronic non-specific low back pain (CNSLBP) in managing pain, improving functional and emotional state, and overall physical activity.
 Materials and methods. The study included 71 patients (17 men and 54 women) aged 1875 years (mean age 55.09 13.0 years) with CNSLBP, of whom 34 patients received standard KT and 37 patients received enhanced KT. Patients were asked to complete the Numeric Pain Rating Scale (NPRS), the Oswestry Low Back Pain Disability Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ-SF) at baseline, after 7 days and 90 days.
 Results. In patients who received treatment, we observed a reduction in pain intensity as measured by the NPRS, from a score of 8 at baseline (68) to 3 (24) points after 7 days and down to 2 (04) after 3 months (p 0.0001). Depression severity decreased from 7 (59) points to 5 (37) after 7 days (p = 0.002) and 4 (36) points after 90 days (p = 0.002). Anxiety decreased from 7 (510) to 6 (48) after 7 days (p = 0.0003) and 5 (37) points after 90 days (p = 0.0003). The Oswestry Low Back Pain Disability Questionnaire score decreased from 46% (3457.77) to 28% (1235.55) after 7 days (p 0.0001), and then to 11.11% (4.4426) after 90 days (p 0.0001). Physical activity as measured by the IPAQ-SF increased from 11 (716) to 16 (1319) points after 7 days (p = 0.001) and to 23 (1526) points after 90 days (p = 0.0002).
 The patient group receiving enhanced KT had a more significant reduction in pain as measured by the NPRS after 7 days and 3 months (p = 0.02 and p = 0.055, respectively), depression as measured by the HADS (p 0.05), and disability as measured by the Oswestry Questionnaire (p = 0.015), accompanied by an increase in physical activity as measured by the IPAQ-SF after 90 days (p = 0.0002), as compared to the patient group receiving standard KT.
 Conclusion. KT not only reduces pain but also improves the functional and emotional state, and increases physical activity in patients with CNSLBP. Enhancing KT by using a personalized approach and educational programmes improves long-term treatment outcomes.

The effect of elastic therapeutic taping and rigid taping on pain, functionality, and tissue temperature in lumbar radiculopathy: a randomized controlled study

Purpose To compare the therapeutic effects of different taping materials and techniques on pain, functionality, and tissue temperature in patients with lumbar radiculopathy. Methods: Patients with lumbar radiculopathy were included in the study (n = 51). Patients were randomly divided into three groups, which were the elastic taping (n = 17), rigid taping (n = 17), and placebo taping groups (n = 17). All patients were enrolled in a physiotherapy and rehabilitation program that included thermotherapy, electrotherapy, and exercise five times a week for 2 weeks. The pain was measured before and after treatment using the Visual Analogue Scale. Functionality and quality of life were measured using the Oswestry Low Back Pain Disability Questionnaire and Roland-Morris Disability Questionnaire. The tissue temperature of the treated area in the lumbar region was measured by digital electronic infra-red thermography. Results: After the treatment, pain, functionality, and quality of life were improved in all groups (p < 0.05). Elastic taping was more effective in decreasing pain and increasing functionality than placebo taping (p < 0.05), but no difference was observed between placebo taping and rigid tapping. Local tissue temperature did not change before and after treatment in the elastic taping group (p > 0.05). Tissue temperature increased in the rigid and placebo taping groups (p < 0.05). Conclusion: Taping therapy in patients with lumbar radiculopathy has a positive effect on pain and functional status. Elastic taping can be recommended for clinical use because its effect is superior in some recovery parameters and its ease of use.

Corrective Exercises or Ergonomic Principles for Workers with Low Back Pain.

Introduction:Work-related musculoskeletal disorders (WRMSD) are considered the main cause of occupational diseases. Health care workers, nursing assistants, and service forces that perform manual labor are the most vulnerable to musculoskeletal disorders, especially low back pain, due to the nature of their jobs. The purpose of this study was to compare the effectiveness of corrective exercise training to ergonomic principles training on low back pain in nursing assistants and service forces.Methods:A nonrandomized clinical trial study was done on 75 staff (nursing assistants and service forces) with low back pain. The participants were divided into three groups: corrective exercise training, ergonomic principles training, and control group. Pain intensity and disability questionnaires were completed before and after 8 weeks of intervention by each group and analyzed.Results:The mean intensity of pain after intervention in corrective exercises group (3.8 ± 1.5) was markedly less than the ergonomic group (4.7 ± 1.4) and control group (5.5 ± 1.7) (P = 0.001). The mean disability score after intervention in the corrective exercises group (17.3 ± 9.6) was significantly less than the ergonomic group (21.8 ± 12.6) and control group (25.3 ± 11.2) (P < 0.001).Conclusion:While corrective exercises training and ergonomic principles training both have a significant effect on reducing the severity of pain and disability caused by low back pain, corrective exercises training is more effective than ergonomic principle training.

The role of Self-Efficacy in Chronic Pain—A Case Report Relating Motivation During The COVID-19 Pandemic and a Patient With Chronic Pain

Research ObjectivesTo analyze patient outcomes and traditional physical therapy interventions for chronic low back back, and discuss the benefits of incorporating self-efficacy techniques to improve patient independence.DesignRetrospective case report.SettingOutpatient physical therapy setting.Participants48-year-old female with complaints of chronic low back pain that has increased significantly over the last six months due to the societal consequences of COVID-19. The patient's past medical history included mild arthritis of her spine. The medications she was using for pain included Naproxen, and the patient also found relief with Salonpas pain relief patches.Interventions1. Trunk flexion AAROM, x 10 repetitions, by rolling swiss ball forward on plinth to promote a stretch of the lower back and eliminate fear of mobility.2. interferential electrical stimulation to low back to decrease pain x 10 min3. bilateral dynamic hip strengthening on hip abduction machine with 45#, 10 reps x 3 sets each4. Functional training such as proper lifting mechanics, 5 repetitions of box lifting5. physiological components aimed to improve self-efficacyMain Outcome Measures1.numerical pain rating scale2. Modified Oswestry Low Back Pain Disability QuestionnaireResultsThe patient's pain improved throughout the 6 weeks that she was seen at physical therapy. This is reflected on her scores on the NPRS. Her baseline pain rating was 9.5/10 and by 6 weeks her score decreased to 3/10. The patient also showed improvements on the Modified Oswestry Disability Index, as seen by a decrease from 42% disability to 10% disability. Improvements were seen in the patient's bed mobility, lumbar flexion AROM, bilateral hip strength, and lower abdominal strength.ConclusionsThis case is an example of someone with chronic low back pain that prior to the pandemic, had enough self efficacy to manager her condition independently. Interventions during physical therapy focused on traditional manual and therapeutic exercise principles as well as physiological components aimed to improve her self-efficacy.Author(s) DisclosuresI declare that I have no relevant or material financial interests that relate to the research described in this paper”.

Relationship between Low Back Pain and Stress Urinary Incontinance in Middle - Aged Women

Abstract Background: Low back pain (LBP) and stress urinary incontinence (SUI) are common problems in women, there are many factors that associated with the development of LBP, but there are a limited research that evaluate the relationship between LBP and SUI. Aim of Study: To determine the relationship between stress urinary Incomitance and low back pain in middle-aged women. Material and Methods: One hundred multipara women participated in this study. 50 women complained from stress urinary incontinence (diagnosed by physician) and 50 women were free from stress urinary incontinence (diagnosed by physician). They were selected from Al-Hussein University Hospital in Cairo, Al-Azhar University from November 2020 to March 2021. Their ages were ranged from 35 to 45 years old. Their body mass index was not exceeding 30kg/m2. They were multipara women. Patients with corrected SUI, previous low back surgery, spondylolisthesis and chronic low back pain were excluded from the study. They were divided ran-domly into two equal groups (AB p-value=0.151. While in group (B). There was a statistical significant negative correlation between oswestry low back pain disability questionnaire (ODI) and pelvic floor muscle strength (PFMS) (r=–0.281; p-value=0.048) and in all studied cases (group A + B). There was a statistical signif-icant negative correlation between oswestry low back pain disability questionnaire (ODI) and pelvic floor muscle strength (PFMS) (r=–0.419; p-value=0.001). Conclusion: Accordingly, it can be concluded that there is a positive relationship between low back pain and stress urinary incontinence and presence of stress urinary inconti-nence is predisposing factor for low back pain.

Comparison of Patient’s Return to Work Capability between Spinal Injection and Muscle Relaxant Medicine among Patients with Chronic Low Back Pain

Introduction: Low back pain is a very common disorder and often hinders our daily activities. There are several treatment options for LBP management. This study aims to determine differences in patient recovery to return to work evaluated based on VAS, Roland Morris Disability Questionnaire (RMDQ) and Oswestry Low Back Pain Disability Questionnaire (ODI) after spinal injection with oral analgesics and muscle relaxants in patients with chronic low back pain. Methods: This is a randomized controlled trial study on patients with LBP undergoing conservative therapies at the Orthopaedic outpatient clinic from February – March 2019. Inclusion began from when patients were admitted to the clinic in February 2019 until March 2019. Mean scores between two treatment groups were compared. Functional evaluation on patients with low back pain is commonly done using questionnaire. Spinal Injection contained a combination of lidocaine and triamcinolone acetonide. Oral therapy containing a combination of paracetamol 325mg and tramadol 37.5mg were given 3 times daily for 3 weeks, along with Eperisone 50mg which acted as a muscle relaxant. Data then was analysed descriptively and statistically. Result: 32 patiens were included in this study with 16 patients in each treatment groups. The mean age of the patients is 42. Patients VAS, RMDQ, and ODI score were measured before the treatment, after 1 week, 2 weeks and 3 weeks. the results were shown in Table 1. All study parameters were shown improvements with increasing time. LBP treated with Spinal injection were clinically and statistically better compared to oral therapy. Conclusion: Spinal injection method with lidocaine and triamcinoloan acetonide is better than oral analgesic therapy with the parameters used in this study

Synergistic effects of Vitamin D and magnesium in non-specific low back ache (nLBA) – A prospective comparative study

Low back ache constitute a group of symptoms with no clear etiopathogenesis and pose a major difficulty for a health care professional to diagnose and treat the disease per se. Low back ache has become permanent disability for certain individuals and interferes with normal functioning of day-to-day life activities. This study was undertaken to establish the correlation and functional outcome between combination of Vitamin D &amp; magnesium supplementation and Vitamin D supplementation for patients with non-specific low back ache. An observational comparative study was performed with 117 patients of non-specific low back ache from June 2019 to May 2020. Out of 117 patients, a total of 60 patients (Group A) were treated with a combination of Vitamin D supplementation along with magnesium tablets for 3 consecutive months and remaining 57 patients (Group B) were treated with Vitamin D supplementation for 3 consecutive months. Both the groups were followed up for 6 months for pain relief assessed by VAS score and functional improvement in quality of life assessed by Oswestry Low Back Pain Disability Questionnaire. A significant difference was noted in the Group A compared to Group B which demonstrates an additive effect on the combination used in them. When analysing the change in parameters compared to the pre-interventions state both the groups showed significant improvements. However, upon analysis of the correlation between the parameters with regard to the change among the groups, we noted that Group A showed significant correlation with respect to the Calcium and Vit-D level improvement out of the intervention upon the observed results. Treatment of non-specific low back ache with vitamin-D and magnesium shows synergistic effects with significant improvement in the functional outcomes and the pre-intervention metabolic parameters.

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.

Comparison of Core Stability Exercises with Williams’ Flexion Exercises in Patients with Non-Specific low back pain

Low back pain is the most common complaint experienced by the majority of people at some point in their lifetime. Physical therapy has been in favor of effective treatment and prevention of low back pain. However, there is a lack of agreement on the best exercise treatment and abundant studies are in progress. Categorical studies are lacking particularly in this part of the world. This study was designed to compare the effectiveness and efficiency of two specific exercises, core stability exercises with Williams’ flexion exercises, in patients with non-specific low back pain. Objective:The objective of this study was to find out the most effective treatment for patients with non-specific low back pain Methods: This study is a single-blinded randomized clinical trial that was conducted in the physiotherapy outdoor patient department of the public hospital, Jinnah Hospital Lahore (JHL). 20 patients with non-specific low back pain were randomly allocated in two treatment groups, 10 in A (core stability exercises) and 10 in B (Williams’ flexion exercises), after giving informed consent. The conventional treatment of low back pain. e.g. Hot or cold pack, electrotherapeutic modalities was given to the patients of both groups along with their specialized group treatment. The visual analog scale (VAS) and Modified Oswestry Low Back Pain Disability Questionnaire were used before treatment and after the third treatment session during the period of one to two weeks to measure outcomes. The independent samples T-test was used for data analysis. A P-value &lt;0.05 was considered statistically significant Results: The results of this study illustrated that there is a significant difference between the two groups in clinical and therapeutic effect in the reduction of pain as the P-value is &lt;0.05. While the results in the reduction of pain-related disability, measured by the Modified Oswestry Low Back Pain Disability Questionnaire, were not significant as P-value &gt;0.05(P= 0.184). Conclusions: The study indicates that core stability exercises are more effective than Williams’ flexion exercises for the reduction of non-specific low back pain except for a reduction in pain-related disability.

Assessing the Functional Status of Patients with Chronic Pain-Cross Cultural Adaptation and Psychometric Properties of the Serbian Version of the Pain Disability Questionnaire.

The Pain Disability Questionnaire (PDQ) has established itself as a leading patient-reported outcome measure for assessing both mental and physical components of pain-related disability. The current study aimed to translate the PDQ into Serbian and validate its psychometric properties. Following a standard translation process, a total of 554 chronic pain patients (average age 55.37 ± 12.72 years; 375 (67.5%) females) completed the PDQ-Serb, Oswestry Disability Index (ODI), Short Form-36 (SF-36), pain intensity rating and a six-minute walk test (6MWT). Responsiveness was examined in a subsample of 141 patients who completed an inpatient rehabilitation program. The internal consistency of the PDQ-Serb was excellent (Cronbach α = 0.92) and test-retest reliability was favorable (ICC = 0.87). Factor analyses found a bifactor model to be the best fit (CFI = 0.97: TLI = 0.96: RMSEA = 0.05; SRMR = 0.03). Statistically significant Pearson’s coefficient correlations (p < 0.001) were found between the PDQ-Serb and ODI (r = 0.786), SF-36 Physical Components summary (r = −0.659), SF-36 Mental Components summary (r = −0.493), pain intensity rating (r = 0.572), and 6MWT (r = −0.571). Significant post-treatment improvements following inpatient rehabilitation were found with the PDQ-Serb (p < 0.001; effect size 0.431) and other clinical variables (p < 0.001; effect sizes from 0.367 to 0.536). The PDQ-Serb was shown to be a reliable and valid self-report instrument for the evaluation of pain-related disability.

Comparative study of combination therapy with non-steroidal anti inflammatory drugs and different doses of low level laser therapy in acute low back pain

According to various side effects of medication in low back pain, respecting conservative therapy, owing to the widespread use of laser therapy in recent decades, related therapeutic outcomes were different and contradictory. The current study aimed at comparing the effect of non-steroidal drugs and laser therapy with different doses in patients with acute low back pain. MethodsThe current randomized, placebo-controlled study was conducted on 65 patients randomly assigned to four groups. In group 1(N = 20), only drug therapy and in group 2(N = 15), laser therapy (3 J/cm 2) in addition to medication was administrated to the patients. For group 3(N = 15), a therapeutic plan similar to that of group 2 was given; however, the laser dose was 6 J/cm 2. Finally, drug therapy plus placebo laser therapy was applied to group 4(N = 15). Pain was compared among the groups using visual analogue scale and Oswestry low back pain disability questionnaire. ResultsSignificant difference between baseline pain scores and those of the weeks 1, 2, 3, and 4 of laser therapy in all intervention groups. Also, the results of the intergroup analyses showed a significant difference between group 1 compared with groups 2 and 3. There was a significant ODI difference between the groups after laser therapy. ConclusionFindings showed that laser therapy plus drug therapy in comparison with drug therapy alone was a more effective method to relieve pain and disability in patient with acute low back pain; however, evidence to support this finding is still inadequate.

Vitamin D Deficiency and Molecular Changes in Circulating MicroRNAs in Older Adults with Lower Back Pain.

Background MicroRNAs play an essential role in regulating pain processing within a wide range of clinical pain disorders. Objectives The present study aimed to evaluate the role of circulating miRNAs as biomarkers of lower back pain in older adults. In addition, the correlation between miRNAs and other related cofounders such as muscle function, adiposity, malnutrition, and Ca and vitamin D intake was assessed. Methods A total of 110 older subjects with an age range of 40–60 years were included in this study. The participants were classified according to a modified Oswestry lower back pain disability questionnaire (OSW) into subjects with minimal LBP (n = 40; LBP score: 0–20%), moderate LBP (n = 35; LBP score: 20–40%), and severe LBP (n = 35; LBP score: 41–60%). RT-PCR and immunoassays were used to study the circulating miRNA profile, vitamin D status, and CRP, IL-6, TNF-α, s-Ca, s-BAP, s-OC, and s-NTX levels. In addition, malnutrition and muscle performance were estimated in all subjects as other factors related to LBP. Results In this study, normal LBP-OSW cutoff values (8.96 ± 3.6) were reported in 36.4% of the total population, whereas 63.6% of the population had higher LBP-OSW scores, classified as follows: 31.8% with moderate LBP (LBP-OSW score: 31.4 ± 9.1) and 31.8% with severe LBP (LBP-OSW score: 54.9 ± 14.6). Four circulating miRNAs, namely, miR-146a, miR-558, miR-155, and miR-124a, as biomarkers of the intensity of back pain were identified in all participants. In subjects with moderate to severe LBP, the expression levels of miR-146a and miR-558 were significantly reduced and those of miR-155 and miR-124a were significantly increased compared to subjects with minimal LBP scores. Subjects with moderate to severe LBP showed a significant increase in adiposity markers, lower PA, muscle performance, malnutrition, and lower Ca and vitamin D intake compared to normal controls. In addition, serum levels of vitamin D and circulated plasma markers of inflammation and bone metabolism such as CRP, IL-6, TNF-α, s-Ca, s-BAP, s-OC, and s-NTX were significantly reduced in severe LBP cases compared to those with minimal LBP scores. The expressed circulating miRNAs were significantly associated with the measured muscle performance, adiposity, PA score, inflammation, and bone metabolism cofounders in subjects with higher LBP-OSW scores. The expressed miRNAs, along with other LBP cofounders, were significantly associated with ∼63.9–86.4% of the incidence of LBP in older adults. Conclusions In older adults with vitamin D deficiency, the severity of LBP was significantly associated with the expression of circulating miRNAs, adiposity, bone metabolism, inflammation, and muscle performance. In addition, the expressed miRNAs, along with other LBP cofounders, were significantly associated with ∼63.9–86.4% of the incidence of LBP in older adults. These results suggest the possibility of using microRNAs as therapeutics to alleviate established pain and as biomarkers in old adults with painful conditions.

Postoperative Epidural Fibrosis Prevention: Which Is Better-Autologous Fat versus Gelfoam.

Study DesignProspective, randomized study of 100 patients with prolapsed intervertebral disc with an average of 12- to 18-month follow-up postoperatively.PurposeTo compare the role of Gelfoam and autologous fat in the prevention of postoperative epidural fibrosis (EF) after lumbar spine surgery.Overview of LiteratureEF is a possible sequelae of lumbar disc surgery. Different treatments and surgical strategies have been attempted to prevent postoperative fibrosis without providing consistent long-term results.MethodsThe study was conducted on 100 adult patients. The patients were randomly allocated into two groups of 50 patients each: group A, autologous fat group, and group B, Gelfoam group. The postoperative follow-up was conducted at intervals of 6 weeks, 3 months, 6 months, and 12 months. Both groups were evaluated clinically (Oswestry Low Back Pain Disability Questionnaire [ODI], Visual Analog Scale [VAS], Straight Leg Raising Test [SLRT]) and radiologically (using Ross grading by contrast magnetic resonance imaging [MRI]) for development of radicular pain and hence EF.ResultsBased on the analysis, improvement in mean values of ODI score, VAS score, and SLRT were found to be statistically significant postoperatively at intervals of 6 weeks, 3 months, 6 months, and 12 months when compared individually in both groups. However, improvement was greater in the autologous fat group than in the Gelfoam group. Based on contrast-enhanced MRI, the number of patients who developed EF was smaller in the autologous fat group than in the Gelfoam group.ConclusionsIn the present study, on clinical and radiological assessment, we conclude that both groups prevent radicular pain and postoperative EF individually but relatively autologous fat was found to be more effective than Gelfoam in the prevention of EF and hence radicular pain.

Comparative effectiveness of paravertebral Ozone injection and caudal epidural steroid-hyaluronidase injection in lumbosacral spinal stenosis

Background Lumbosacral spinal stenosis (LSS) is the narrowing of the lumbar spinal canal. LSS usually happens in older people who do not have the proper physical condition to undergo surgery. Therefore, minimally invasive methods such as Ozone therapy and epidural injection can be used in these patients. Objective The objective this study was to compare the effect of caudal epidural steroid-hyaluronidase injection with paravertebral intramuscular Ozone injection on reducing pain in patients with LSS. Methods A total of 30 patients suffering from LSS randomized to two groups. Group A (n = 15) received three paravertebral intramuscular infiltrations of the Ozone, Group B (n = 15) received a caudal epidural injection of steroid-hyaluronidase. The effects of the interventions were evaluated by measuring Visual analog scale (VAS), Oswestry Disability index (ODI), Quebec Back Pain Disability (QBPDS) and Roland Morris low back pain questionnaire (RMQ) before the interventions and at 2 weeks, 4 weeks, and 8 weeks after the interventions. Results Within-group changes showed significant improvement in VAS, ODI, RMQ, and QBPDS scores in both groups from pre-treatment to end of follow-up (all p < 0.05). The mean VAS score at all follow-up had significant differences between the two groups (p < 0.01). The mean ODI, RMQ, and QBPDS scores at 2-week and 4-week had significant differences between the two groups (p < 0.01). At the 8-week follow-up, there was no significant difference between groups concerning mean ODI, RMQ, and QBPDS scores (p > 0.05). Conclusion Both intramuscular injection Ozone and caudal epidural injection steroid- hyalaz significantly reduce pain. The existing data suggested 8 weeks improvements in pain severity are more significant for paravertebral Ozone injection, compared to caudal epidural steroid-hyaluronidase injection.

Pain and functional disability after lumbar microdiscectomy and their correlations with gender, depression and recovery expectations

Background/Aim. Among the various factors that can influence continued postoperative back pain and/or leg pain, and functional disability after lumbar microdiscectomy are gender, depression, and pessimism. The aim of this study was to determine the correlations between these factors. Methods. The research was conducted after microdiscectomy on 198 patients (95 men and 103 women), with a mean age of 50.20 ? 10.26 years. The following questionnaires were used for examinations: for assessment of pain and its intensity and character ? PainDETECT Test; for functional disability ? Oswestry Low Back Pain Disability Questionnaire; for the presence and degree of depression ? Beck Depression Inventory-II; and questionnaire for the assessment of personal expectations (pessimistic/optimistic) about the treatment results. These assessments were carried out after microdiscectomy ? just before rehabilitation treatment, one month later, and then 3 and 6 months after a microdiscectomy. Results. Depression (p &lt; 0.01) and pessimism (p &lt; 0.01) had significant negative influences on the pain and functional disability. The subjective sensation of pain was significantly higher in women than in men (p &lt; 0.01), while men had a greater degree of functional disability (p &lt; 0.01) than women. Conclusion. Pain and functional disability of the patients after lumbar microdiscectomy are significantly interconnected with gender, depression, and pessimism. The sensation of pain was higher in women, while men had a greater degree of functional disability. Globally, the intensity of pain and functional disability were significantly greater in patients with a higher degree of depression and pessimism, and, by registering mentioned factors, it is possible to predict the postoperative results.

Assessment of a taping method combined with manual therapy as a treatment of non-specific chronic low back pain \u2013 a randomized controlled trial

BackgroundChronic low back pain is the most frequent medical problem and the condition with the most years lived with disability in Western countries. The objective of this study was to assess a new treatment, Medi-Taping, which aims at reducing complaints by treating pelvic obliquity with a combination of manual treatment of trigger points and kinesio taping in a pragmatic RCT with pilot character.MethodsOne hundred ten patients were randomized at two study centers either to Medi-Taping or to a standard treatment consisting of patient education and physiotherapy as control. Treatment duration was 3 weeks. Measures were taken at baseline, end of treatment and at follow-up after 2 months. Main outcome criteria were low back pain measured with VAS, the Chronic Pain Grade Scale (CPGS) and the Oswestry Low Back Pain Disability Questionnaire (ODQ).ResultsPatients of both groups benefited from the treatment by medium to large effect sizes. All effects were pointing towards the intended direction. While Medi-Taping showed slightly better improvement rates, there were no significant differences for the primary endpoints between groups at the end of treatment (VAS: mean difference in change 0.38, 95-CI [− 0.45; 1.21] p = 0.10; ODQ 2.35 [− 0.77; 5.48] p = 0.14; CPGS − 0.19 [− 0.46; 0.08] p = 0.64) and at follow-up. Health-related quality of life was significantly higher (p = .004) in patients receiving Medi-Taping compared to controls.ConclusionsMedi-Taping, a purported way of correcting pelvic obliquity and chronic tension resulting from it, is a treatment modality similar in effectiveness to complex physiotherapy and patient education.Trial registrationThis trial was registered retrospectively on July 24th, 2019 as Number DRKS00017051 in the German Register of Clinical Trials (Deutsches Register Klinischer Studien).URL of trial registry record: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017051.

Gender based variations of mulligan mobilization with movement on chronic nonspecific low back pain

Objective: To discover the adequacy of mulligan mobilization with movement to lessen the pain to enhance the functional activities, to enhance the ROM of lumbar vertebra and to expand the back muscle function on subjects with chronic nonspecific low back pain.&#x0D; Background of the study: These days, a large portion of the populations are experiencing low back pain comprehensively. It has turned into a main source for inability most likely the population influencing from low back pain has been thought to be understudies and stationary employment laborers. Along these lines investigation goes for diminishing the likelihood of low back pain in those populations by mediating with a method mulligan mobilization with movement (MWM).&#x0D; Materials and methods: This was an experimental examination with sixty subjects between the age group of 18-50 (males and females) with chronic nonspecific low back pain(Natour et al 2015). The length of the examination is thrice a week for four weeks. The examination was hung on Dr.MGR Educational and Research Institute. The subjects in avoidance criteria are specific low back pain (spondylosis, radiculopathy, and spondylolisthesis), intellectual issue, pregnancy. VAS scale, Modified Oswestry Low Back Pain Disability Questionnaire and Finger to Floor test (FFT) were utilized as a result measures.&#x0D; Result: There is vast improvement in the post-test estimations of the VAS Score, MODQ, and FFT of Group A when comparing with Group B. On correlation there is distinction in Group A than Group B. In this way the after effect of the investigation has been found to enhance useful functional activity, ROM and lessens pain.&#x0D; Conclusion: Outcome has been proposed that Mulligan Mobilization with Movement (MWM) with SNAG to the Group A has given huge difference and more noteworthy change when compared with Group B.&#x0D; Bangladesh Journal of Medical Science Vol.20(3) 2021 p.543-549

Lumbar Bracing for Chronic Low Back Pain: A Randomized Controlled Trial.

We performed this study to evaluate the effect of back bracing to treat patients with chronic low back pain. This was a prospective, unblinded, randomized controlled trial of 61 adults with uncomplicated chronic low back pain (>12 wks) and imaging findings of degenerative spondylosis, to assess the effectiveness of a semirigid back brace. All study participants received back school instruction. The treatment group also received a lumbar orthosis and was instructed to wear it as needed for symptom relief. At baseline, 6 wks, 12 wks, and 6 mos after intervention, we collected: Numerical Rating Scale to measure pain intensity, Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EuroQol 5-Dimension (EQ-5D) to measure patient-reported function and quality of life. An interim analysis at the halfway point in enrollment (61 of 120 planned participants) revealed the Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EQ-5D scores in the treatment group to be worse than in the control group, but no significant group differences in Numerical Rating Scale scores. Outcome differences between groups analyzed over time revealed (effect [P]): Pain Disability Questionnaire = 0.84 (0.04); Patient-Reported Outcome Measurement Information System = 0.78 (0.005); EQ-5D = 0.06 (0.01); and Numerical Rating Scale = 0.02 (0.6). We halted the study because continuation was unlikely to produce significant changes to the results. In patients with uncomplicated chronic low back pain, a back brace when combined with education and exercise instruction did not provide any pain relief compared with education and exercise instruction alone. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to: (1) Describe the effect of lumbar back bracing on pain intensity in patients with chronic low back pain; (2) Discuss the effects of lumbar back bracing on pain-related disability, function, and quality of life in patients with chronic low back pain; and (3) Understand the role of lumbar back bracing in the treatment of patients with chronic low back pain. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Does transcutaneous electrical nerve stimulation affect pain, neuropathic pain, and sympathetic skin responses in the treatment of chronic low back pain? A randomized, placebo-controlled study.

BackgroundThe purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain.MethodsSeventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients’ visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3.ResultsA statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05).ConclusionsbTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

Результаты трансфораминального эндоскопического удаления грыжи диска пояснично- крестцового отдела позвоночника, дополненного нуклеопластикой

Introduction Herniated disks are very common. Percutaneous endoscopic lumbar spine surgery for the lumbar disc herniation facilitates minimalized access ports to the operating site with decreased risk of infection, reduced blood loss and less tissue dissection and muscle trauma. The goal was to compare the results of standard transforaminal endoscopic discectomy for lumbosacral herniation and outcomes of the procedure added by nucleoplasty. Material and methods Percutaneous transforaminal endoscopic discectomy was performed for 92 patients and added by nucleoplasty in 43 patients of group I. Preoperative and postoperative evaluation was produced with the Visual Analog Pain Scale (VAS), the Oswestry Low Back Pain Disability Questionnaire (ODI) and the MacNab clinical outcome score. Complication and recurrence rate was reviewed. Microsoft Office Excell and Statistica 8.0 were used to complete data analysis reports. Results VAS scores decreased from 7.9 to 3.1 showing 2.5-fold decrease (p &lt; 0.05), and ODI scores decreased from 71.09 to 18.58) (p &lt; 0.001) demonstrating fourfold decrease at one-year follow-up. There were no significant differences in VAS and ODI scores between the groups preoperatively and postoperatively (p &gt; 0.05). The majority of patients of group I (41.86 %) rated their health status as excellent on the MacNab scale, and the majority of patients of group II (53.06 %) rated their health status as good. Postoperative complication rate was 11.63% in group I and 12.24% in group II (p &gt; 0.05). There was no recurrence in group I with the recurrence rate of 6.1% (p &lt; 0.001) in group II. Conclusion Endoscopic discectomy for lumbosacral herniation supplemented with nucleoplasty can reduce the recurrence rate.