Risk Of Back Pain Research Articles

The effect of long-term poor sleep quality on risk of back-related disability and the modifying role of physical activity

Sleep problems and regular leisure time physical activity (LTPA) are interrelated and have contrasting effects on risk of back pain. However, no studies have investigated the influence of long-term poor sleep quality on risk of back-related disability, or if LTPA modifies this association. The study comprised data on 8601 people who participated in three consecutive surveys over ~ 22 years, and who reported no chronic back pain at the two first surveys. Adjusted risk ratios (RRs) for back-related disability were calculated at the last survey, associated with the joint effect of changes in sleep quality between the two first surveys and meeting physical activity guidelines at the second survey. Compared to people with long-term good sleep, people with long-term poor sleep had nearly twice the risk of back-related disability (RR 1.92, 95% CI 1.48–2.49). There was no statistical interaction between sleep and LTPA but people who reported long-term poor sleep and meeting the physical activity guidelines had 35% lower risk of back-related disability compared to people with same level of sleep problems, but who not met the guidelines. These findings suggest that long-term poor sleep quality contributes to a substantially increased risk of chronic and disabling back pain irrespective of LTPA.

ROLE OF PHYSICAL THERAPY TREATMENT IN ANTENATAL CARE

BACKGROUND Different types of physical therapy treatment interventions like postural guidance, nutritional guidance, and exercises performed by antenatal patients could have advantageous effects on pregnant women and fetus. OBJECTIVE To evaluate the role of different physical therapy treatments in the antenatal patient. SEARCH STRATEGY A Literature search is done through PubMed, Google Scholar and the Institute for Scientific data (ISI) net of Knowledge on the consequences of physical exertion throughout pregnancy on maternal and baby outcomes was performed. The knowledge about physical exercises during pregnancy is not clear. This review article is designed to explore the interventions of physical exercises during pregnancy in healthy normal women. SUMMARY Physical therapy is very essential for antenatal women to maintain their health during pregnancy. It has been documented that physical exercises are safe for the fetus and in long term by improving the quality of life of pregnant women. Healthy pregnant women should perform and continue regular physical exercises on daily basis by following the recommended guidelines. All pregnant women who are not facing any complications in their pregnancy should be encouraged to contribute to aerobic and strengthening exercises. Antenatal women undergo many body changes during their pregnancy for example weight gain which alters balance and coordination. The goal of physical exercises during pregnancy to maintain good health and fitness. Physical exercises during pregnancy should reduce the risk of back pain, constipation, gestational diabetes, preeclampsia and cesarean delivery. However, physical exercises promote healthy weight gain, improve general fitness, and strengthen heart and blood vessels, and helps to reduce the weight of the baby after pregnancy.

Back-Support Exoskeleton Control Strategy for Pulling Activities: Design and Preliminary Evaluation

The execution of manual material handling activities in the workplace exposes workers to large lumbar loads that increase the risk of musculoskeletal disorders and low back pain. In particular, the redesign of the workplace is making the execution of pulling activities more common, as an alternative to lifting and carrying tasks. The biomechanical analysis of the task revealed a substantial activation of the spinal muscles. This suggests that the user may benefit from the assistance of a back-support exoskeleton that reduces the spinal muscle activity and their contribution to lumbar compression. This work addresses this challenge by exploiting the versatility of an active back-support exoskeleton. A control strategy was specifically designed for assisting pulling that modulates the assistive torques using the forearm muscle activity. These torques are expected to adapt to the user’s assistance needs and the pulled object mass, as forearm muscle activity is considered an indicator of grip strength. We devised laboratory experiments to assess the feasibility and effectiveness of the proposed strategy. We found that, for the majority of the subjects, back muscle activity reductions were associated with the exoskeleton use. Furthermore, subjective measurements reveal advantages in terms of perceived support, comfort, ease of use, and intuitiveness.

Custom-Made Foot Orthoses as Non-Specific Chronic Low Back Pain and Pronated Foot Treatment.

Excessive foot pronation has been reported as being related to chronic low back pain symptoms and risk factors in sports-specific pathologies. Compensating custom-made foot orthotics treatment has not been entirely explored as an effective therapy for chronic low back pain (CLBP). This study aims to observe the effects of custom-made foot orthoses, in subjects with foot pronation suffering from CLBP. A total of 101 patients with nonspecific CLBP and a pronated foot posture index (FPI) were studied. They were randomized in two groups: an experimental one (n = 53) used custom-made foot orthotics, and the control group (n = 48) were treated with non-biomechanical effect orthoses. The CLBP was measured using the Oswestry Disability Index (ODI) Questionnaire and a visual analogue scale (VAS), both for lower back pain. The symptoms were evaluated twice, at first when the subject was included in the study, and later, after 4 weeks of treatment. The analysis of outcomes showed a significant decrease in CLBP in the custom-made foot orthoses participants group (p < 0.001 ODI; p < 0.001 VAS). These findings suggest that controlling excessive foot pronation by using custom-made foot orthoses may significantly contribute to improving CLBP.

Correlation between thoracolumbar disc degeneration and anatomical spinopelvic parameters in supine position on MRI.

ObjectiveThis study aims to investigate the correlation between spinopelvic parameters in supine position (pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL)), disc degeneration and herniation of the thoracolumbar spine, as well as cardiovascular risk factors and back pain in a southern German cohort from the general population.MethodsThis study is a cross-sectional, case–control study drawn from a prospective cohort of the “Cooperative Health Research in the Region of Augsburg/Kooperative Gesundheitsforschung in der Region Augsburg” study (KORA). In total, 374 participants (mean age 56.4 ± 9.2 years; 57.8% male) from the whole-body MRI cohort (FF4) were included. All participants underwent a standardized whole-body MRI on which disc degeneration of the thoracic and lumbar spine was evaluated using a sequence adapted Pfirrmann score. PI, PT, SS and LL were measured according to the description in the literature, using sagittal imaging. Furthermore, disc bulging and protrusion were assessed. Correlations were estimated by logistic regression models providing odds ratios.ResultsMean PI was 54.0° ± 11.1°, PT 13.0° ± 5.8°, SS 40.2° ± 8.8° and LL 36.2° ± 9.6°. SS was greater in men (p<0.05) and lumbar lordosis in women (p<0.001). PT increased by 0.09° per age-year with rising age. Age was not associated with PI, SS and LL. Neither BMI, hypertension, cholesterol, lipid levels, nor physical activity were associated with PI, PT, SS or LL. Diabetes mellitus negatively correlated with SS (β = -4.19; 95%CI -7.31–1.06, p<0.01). Smaller spinopelvic parameters (PI, SS and LL) where significantly (p<0.05) correlated with an increased frequency of disc bulging, as well as a local clustering in the lumbar, but not the thoracic spine.ConclusionIn conclusion, spinopelvic parameters, measured in supine position, are significantly correlated with disc bulging alone; there is no significant correlation between supine spinopelvic parameters and disc degeneration, back pain or cardiovascular risk factors.

Musculoskeletal pain among male faculty members of the College of Medicine and College of Dentistry.

We aimed to establish the local prevalence of musculoskeletal pain among faculty members in Saudi Arabia and describe the patient's risk factors and preventive measures that may reduce its burden.An observational, quantitative, cross-sectional study was carried out to evaluate the prevalence of musculoskeletal pain and its risk factors among male faculty members in the College of Medicine and Dentistry, using a designed questionnaire based on the Standardized Nordic Musculoskeletal Questionnaire. Chi-square testing at a significance level of P < .05, was used for comparative analysis. SPSS version 26 was used for all analyses.Ninety responders participated in the survey analysis. The prevalence of musculoskeletal pain among faculty members was 77.8%, and the most common site of musculoskeletal pain occurred at two different sites of the three (low back, neck, and shoulder), with a prevalence of 38.9%. As for risk factors of musculoskeletal pain, only age group showed a significant correlation with the site of musculoskeletal pain (P = .024), where patients in the younger age group (25–35 years old) were at higher risk of lower back pain, while participants in the older age group (36 to 44 years old and 45 years or older) were at higher risk of musculoskeletal pain in two different sites.Musculoskeletal pain affects more than two-thirds of faculty members. In particular, low back pain is a common problem among faculty members. Age is a significant risk factor for the occurrence of musculoskeletal pain, with more than one site involvement in older age.

The Relationship between Reactive Balance Control and Back and Hamstring Strength in Physiotherapists with Non-Specific Back Pain: Protocol for a Cross-Sectional Study.

Back pain is one of the most costly disorders among the worldwide working population. Within that population, healthcare workers are at a high risk of back pain. Though they often demonstrate awkward postures and impaired balance in comparison with healthy workers, there is no clear relationship between compensatory postural responses to unpredictable stimuli and the strength of related muscle groups, in particular in individuals with mild to moderate back pain. This paper presents a study protocol that aims to evaluate the relationship between peak anterior to peak posterior displacements of the center of pressure (CoP) and corresponding time from peak anterior to peak posterior displacements of the CoP after sudden external perturbations and peak force during a maximum voluntary isometric contraction of the back and hamstring muscles in physiotherapists with non-specific back pain in its early stages. Participants will complete the Oswestry Disability Questionnaire. Those that rate their back pain on the 0–10 Low Back Pain Scale in the ranges 1–3 (mild pain) and 4–6 (moderate pain) will be considered. They will undergo a perturbation-based balance test and a test of the maximal isometric strength of back muscles and hip extensors. We assume that by adding tests of reactive balance and strength of related muscle groups in the functional testing of physiotherapists, we would be able to identify back problems earlier and more efficiently and therefore address them well before chronic back disorders occur.

Relationships Between Spinal Alignment and Muscle Mass in Osteoporosis Patients Over 75 Years of Age Who Were Independent and Maintained Their Activities of Daily Living.

IntroductionElderly patients with osteoporosis often complain of back pain associated with pathological vertebral fractures caused by abnormal spinal alignment. Few reports evaluate the relationships among muscle mass, bone mineral density (BMD), sagittal spinal alignment, and low back pain. We hypothesized that decreasing muscle mass in elderly patients with osteoporosis could cause spinal alignment abnormalities. The aim of the current study were to compare the characteristics between spinal sagittal normal alignment and malalignment and to evaluate the relationships between sagittal spinal alignment and muscle mass in elderly patients with osteoporosis.MethodsFifty patients aged 75 years or more (mean age = 80.5 years) with osteoporosis were included in this study. We evaluated the sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence minus lumbar lordosis (PI-LL), the number of vertebral fractures (N of VFs), BMD by dual-energy X-ray absorptiometry, and trunk and skeletal muscle mass using bioelectrical impedance. Low back pain was evaluated using the Oswestry Disability Index (ODI). Corrected trunk muscle mass (trunk muscle mass index, TMI) and corrected limb muscle mass (skeletal mass index, SMI) also were measured. Patients were divided into two groups for comparison: a ‘normal’ group and a sagittal spinal ‘malalignment’ group. Multiple regression analysis was carried out to evaluate the relationship between spinal sagittal parameters and muscle mass.ResultsComparisons between normal and malalignment groups for SVA, N of VFs, BMI, and SMI showed significantly higher in the malalignment group versus the normal group (p < 0.05). N of VFs, BMI, and TMI, for PT, and BMI, TMI, SMI, and ODI scores for PI-LL showed significantly higher in the malalignment group versus the normal group (p < 0.05). There were significantly more vertebral fractures in the malalignment group than in the normal group (p < 0.05). However, there were no significant differences of pure muscle mass between the two groups. When adjusted by BMD and the number of vertebral fractures, SMI and TMI were positively correlated to PI-LL and SVA (p < 0.05).ConclusionElderly patients with osteoporosis and a sagittal spinal malalignment had more vertebral fractures and a higher risk of low back pain than patients with normal spinal alignment. Patients with a sagittal spinal malalignment who were independent and maintained their activities of daily living (ADL) showed high BMI and maintained muscle mass, independent of BMD and the N of VFs, contrary to our hypothesis.

Effects of back-support exoskeleton use on trunk neuromuscular control during repetitive lifting: A dynamical systems analysis

Back-support exoskeletons (BSEs) are a promising ergonomic intervention to mitigate the risk of occupational low back pain. Although growing evidence points to the beneficial effects of BSEs, specifically in reducing low-back physical demands, there is limited understanding of potential unintended consequences of BSE use on neuromuscular control of the trunk during manual material handling (MMH). We quantified the effects of two passive BSEs (BackX™ AC and Laevo™ V2.5) on trunk dynamic stability and movement coordination during a repetitive lifting task. Eighteen participants (gender-balanced) completed four minutes of repetitive lifting in nine different conditions, involving symmetric and asymmetric postures when using the BSEs (along with no BSE as a control condition). Maximum Lyapunov exponents (short-term: λmax-s; long-term: λmax-l) and Floquet multipliers (FMmax) were respectively calculated to quantify the local dynamic and orbital stability of thorax and pelvis trajectories. Thorax-pelvis segmental coordination was also quantified using the continuous relative phase. Wearing the Laevo™ significantly increased λmax-s for the pelvis (by ~ 8%) and FMmax for the thorax and pelvis (by ~ 5–10%). Use of either BSE decreased the in-phase coordination pattern for the thorax-pelvis coupling (by ~ 15%). These results suggest that BSE use can compromise neuromuscular control of the trunk, and caution should thus be used in selecting a suitable BSE for use in a given MMH task. Future work is needed, however, to assess the generalizability of different BSE design approaches in terms of unintended short-term and long-term effects on trunk neuromuscular control.

Epidemiology of work-related lower back pain among rehabilitation professionals in Saudi Arabia.

Occupational and physical therapists are at risk of musculoskeletal pain and injuries possibly due to their work-related activities, posture and affected body mechanics. To investigate the epidemiology of lower back pain among rehabilitation professionals. A cross-sectional survey of 259 physical and occupational therapists in rehabilitation centres in Saudi Arabia was conducted during July-August 2019, using the Modified Nordic Questionnaire. Data on different measures of lower back pain, and its consequences and risk factors were collected. Logistic regression analysis was done to identify significant predictors of lower back pain. Rehabilitation professionals experienced 73.7% 1-year lower back pain prevalence, 52.5% intense pain that lasted ≥ 1 day, 22.4% chronic lower back pain, 23.9% sick-leave-seeking lower back pain and 18.5% medical-care-seeking lower back pain. Difficult/impossible activities of daily living in standing up (45.5%), employment (44.0%), climbing stairs (33.9%), walking (33.0%), sitting (29.3%), sleeping and travel (29.8% each), awakening (23.0%), social life (26.2%), and personal care (15.7%) were reported. Lower back pain was responsible for stopping work in 32.5% of participants, with a mean 1.38 (±2.96) days off work during the last year. One half of participants (50.3%) were treated by physiotherapy, 25.1% by medical care, and 39.3% requested rest days and/or sick leave. Physical stress and < 10 years' experience were significant predictors of lower back pain. Prevalence of lower back pain was high among rehabilitation professionals, with a high impact on activities of daily living. Physiotherapy was the main management adopted. Educational programmes are necessary to teach proper use of body mechanics, and sports activity programmes to reduce the risk of lower back pain and arrange for proper rest periods.

The lengths of spinal curvature stretch due to the angles of sitting on saddle chair to alleviate back pain: A statistical analysis.

By dividing the burden of one's weight between the shins and the buttocks in the sitting position on an office or saddle chair, a person can avoid back pain. In this 21st century, sitting on a chair for long hours in workplace on office chair is unavoidable necessity and hence, millions in different countries undergo a risk for backpain. Is there a right sitting position? The aim of this article is to find out how much a correlation exists between the angle of sitting and the length of spinal curvature which is the source of backpain. An experiment can be designed and carried out to measure various angles in sitting and the changing length of the person's spinal cord curvature. The usual statistical methodology requires a pair of values namely x and y to quantify the correlation. The data on sitting angles and the length of spinal curvature do not have such pairing, and hence, the traditional approach to find the correlation between the sitting angle and length of spinal curvature is not applicable. Yet, an approach is necessary. This article constructs an innovative statistical approach to fulfil this need. Our approach yields a correlation of 0.998 for sitting on office chair and an increased correlation of 0.999 on saddle chair, according to the Truszczyńska-Baszaka et al.'s data. An adjustment is made in various angles of sitting on office chair to transform the comfortable sitting on a saddle chair. In consequence, the proportional effect on the spinal curvature is estimable with the data and it is phenomenal (that is significantly more than one). No wonder people prefer saddle chair over office chair when it comes to avoid back pain and this article proves the convenience statistically.

Horse-riding simulators in treatment of chronic low back pain: A meta-analysis.

The use of horse-riding simulators in the treatment of chronic low back pain has drawn considerable attention for its efficacy and acceptability to reduce chronic low back pain; because of the similarities in movements provided by equine-assisted therapies and the possible accessibility advantages. However, the results are conflicting. This study aimed to perform a meta-analysis of randomised controlled trials to assess the impact of treatments based on horse-riding simulators on chronic low back pain. A systematic literature search up to January 2021 was performed and 11 studies were detected with 543 subjects with chronic low back pain at the baseline of the study, 257 of them were using horse-riding simulators, and 255 of them were inactive control group who continued their usual care, and similar kind of physical therapy (control). They reported a comparison between horse-riding simulators and control to reduce chronic low back pain. Mean differences (MD) with 95% confidence intervals (CIs) were calculated assessing the impact of treatments based on horse-riding simulators on chronic low back pain using the continuous method with a random or fixed-effect model. Significantly higher change-from-baseline pain outcomes was observed in Visual Analogue Scale (MD, -4.36; 95% CI, -6.24 to -2.30, P<.001), and Roland Morris Disability Questionnaire change-from-baseline (MD, -2.32; 95% CI, -3.52 to -1.12, P<.001) with horse-riding simulators compared with control. Using horse-riding simulators may lower the risk of chronic low back pain. This relationship forces us to recommend the use of horse-riding simulators to avoid any complications that could occur with chronic low back pain.

Changes in risk factors for severe low-back pain among caregivers in care facilities in Japan from 2014 to 2018

In Japan, the practice of the no-lift policy, which states that care recipients should be lifted with care equipment rather than by human power, has been increasing since around 2014. The purpose of this study was to examine whether severe low back pain (LBP) risk factors in caregivers changed between 2014 and 2018. A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted in 2014 and 2018. A total of 612 facilities and 2,712 caregivers responded to the questionnaires in 2014, and 504 facilities and 3,478 caregivers completed the questionnaires in 2018. The percentage of caregivers who experienced severe LBP did not differ significantly between 2014 (37.3%) and 2018 (38.3%). However, the number of facilities that introduced care equipment for transfer increased in 2018. Moreover, the number of participants who received training on care methods and using care equipment increased. Lifting a facility resident using human power and taking an unsuitable posture were associated with severe LBP in 2014, but only taking an unsuitable posture was associated with severe LBP in 2018. As taking an unsuitable posture remains to be a primary risk factor for severe LBP, it needs to be addressed in care facilities.

Determinant Factors of Low Back Pain in Paving Block Workers

Paving block workers are included in the informal sector and have a risk of lower back pain. Documenting the workers’ health status in the informal sector has not been done well so that workers do not get protection from the government. Heavy physical work puts pressure on the spine associated with repeated body twisting. This study aims to determine work attitude, length of employment, and exercise habits related to low back pain in Pontianak paving block workers in 2018. This type of research is observational with a cross-sectional approach. Sampling uses total sampling. The research sample of 56 paving block workers in the city of Pontianak, West Kalimantan. Data is processed with a computer program. Data analysis was performed univariate and bivariate and tested using the Chi-square test, with α = 5%. The results showed that there was a significant relationship between the length of the work (p = 0.013), work attitude (p-value = 0.038), and exercise habits (p = 0.003) with low back pain.

A CROSS-SECTIONAL STUDY OF PREVALENCE OF GASTRIC UPSET AND LOW BACK PAIN IN COMPUTER OPERATORS

Background &amp; Objective:- It has been seen that computer operators work continuously in sitting posture.This leads to low back pain and various gastric problems like acidity, constipation, irregular bowel habits etc. This study aims at finding out the prevalence of these symptoms in computer operators.Methods:- 92 subjects were selected randomly from SKMCH, Newspaper offices, Banks and local markets of Muzaffarpur.A study was conducted with the help of predesigned Questionnaire from October-2019 to February-2020. Data was analysed statistically. Result: - Out of 92 subjects,16 were suffering from gastric upset only,03 were suffering from low back pain only and 08 were suffering from both gastric upset and low back pain.Discussion &amp; Conclusion:- Majority of subjects were knowing the fact that their work profile has risk of low back pain and gastric upset. But lack of knowledge of proper sitting postures and frequent working overtime made them prone to develop gastric upset and low back pain.

Incidence of low back pain and potential risk factors among pharmacists: A population-based cohort study in Taiwan.

Low back pain (LBP) is one of the most common symptoms of work-related musculoskeletal disorders in pharmacists. This can impede the physical functions of the body and lead to incapacitation, resulting in significant social and economic burden. This study aimed to investigate the incidence and risk factors that correlate with LBP in Taiwanese pharmacists.A retrospective cohort study was conducted among all registered pharmacists aged 20 to 40 years using the National Health Insurance Research Database (2000–2013) in Taiwan. The LBP diagnosis was confirmed with one episode of hospitalization or at least three claimed outpatient visits for LBP. Data on workplace characteristics as well as comorbidities were also collected for the analyses. A Cox proportional hazard regression was used to estimate the risk factors for LBP.The incidence rate of LBP among pharmacists was 16.60% in this study. Older pharmacists (28.49%; P < .01) and those who worked at district hospitals (23.51%; P < .01) showed a higher proportion of LBP. Furthermore, after adjustment for selected potential confounding factors, female pharmacists [adjusted hazard ratio (aHR): 1.12, 95% confidence interval (95% CI): 1.01–1.24, P = .0354] and pharmacists with diabetes (aHR: 1.55; 95% CI: 1.20–2.01; P = .0008) and gout (aHR: 1.70; 95% CI: 1.37–2.09; P < .0001) had significantly higher risks of LBP.In conclusion, age was positively correlated with LBP, and the workplace was an important factor in the development of LBP in pharmacists. We suggest that pharmacists who work in district hospitals should pay more attention to the development of LBP.

Prevalence of musculoskeletal disorders and risk factors in recyclable material waste pickers from the dump of the structural city in Brasília, Brazil

Solid waste management is a global challenge impacting the lives of thousands of people, among them the recyclable materials waste pickers, through the separation and sale of these materials, make a living for themselves. These workers face unhealthy working conditions and are exposed to various occupational risks, which predispose the prevalence of musculoskeletal as chronic back problems. MethodExploratory cross-sectional study with a semi-structured questionnaire to investigate the prevalence of back pain and related risk factors. Results1.025 waste pickers were interviewed, and 970 records of chronic back pain were detected. Among them, 660 were women (68.04%), 310 were men (31.96%), the average age of 40.21 years; 597 were single (61.92%); 629 (64.84%) had over 11 years of work; 942 (97.11%) worked exclusively in the open dump, 899 (92.68%) with bags, 922 (95.05%) on dayshift. We found significant associations between gender (p < 0.001); age (p < 0.001); time at work (p < 0.022) and place at work (p < 0.001). After adjusting, there were higher prevalence of chronic back pain women (OR = 1.7), older age (OR = 2.64); working more than 11 years (OR = 1.09); and working on the open dump (OR = 2.8). ConclusionThe prevalence of subjective symptoms of musculoskeletal disorders was high. Women, over 36 years old, who worked more than 11 h a day in the open dump were more exposed to suffer from chronic back problems. The importance of urgently addressing the labor impacts related to solid waste management in developing countries to protect these workers and, especially, women involved in this work is emphasized.

Minimum Seven-Year Follow-Up Outcomes of Percutaneous Endoscopic Lumbar Discectomy for Lumbar Degenerative Disease.

PurposeTo investigate the long-term (> 7 years) clinical outcomes of percutaneous endoscopic lumbar discectomy for lumbar degenerative disease to address postoperative problems including postoperative dysesthesia (POD), residual back pain and segmental instability.MethodsInclusion and exclusion criteria were established. All patients who met the above criteria were treated by PELD using the transforaminal approach. Limited discectomy was performed to preserve the disc material in the intervertebral space as much as possible. The Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score for back pain (VAS-B) and leg pain (VAS-L) and Modified MacNab’s criterion were used for clinical evaluation. Radiographic parameters including height of intervertebral disc and segmental instability were also evaluated.ResultsForty-two patients (24 men and 18 women) who met our inclusion and exclusion criteria were included in our study. The average follow-up period was 95.71±5.63 months (ranging from 87 to 105 months). There were no neurological complications associated with the operation. POD was found in 14.29% of patients, while only 2 patients (4.76%) complained of mild dysesthesia at final follow-up. Two patients (4.76%) required revision surgery during the follow-up period. The final follow-up ODI, JOA score, VAS-B and VAS-L were significantly better than preoperative values. The average disc-height ratio was 84.52±5.66% of the preoperative disc height. No instability at the operation level was noted at final follow-up.ConclusionOur study showed that PELD using the transforaminal approach can provide favorable results after a long-term follow-up period. POD is a common complication at initial prognosis. Limited discectomy can preserve the disc height well and minimize the risk of residual back pain.

A deep learning approach for lower back-pain risk prediction during manual lifting

Occupationally-induced back pain is a leading cause of reduced productivity in industry. Detecting when a worker is lifting incorrectly and at increased risk of back injury presents significant possible benefits. These include increased quality of life for the worker due to lower rates of back injury and fewer workers’ compensation claims and missed time for the employer. However, recognizing lifting risk provides a challenge due to typically small datasets and subtle underlying features in accelerometer and gyroscope data. A novel method to classify a lifting dataset using a 2D convolutional neural network (CNN) and no manual feature extraction is proposed in this paper; the dataset consisted of 10 subjects lifting at various relative distances from the body with 720 total trials. The proposed deep CNN displayed greater accuracy (90.6%) compared to an alternative CNN and multilayer perceptron (MLP). A deep CNN could be adapted to classify many other activities that traditionally pose greater challenges in industrial environments due to their size and complexity.

Description of content, structure and theoretical model of a group-based pain management programme in the treatment of patients with persistent non-specific low back pain and psychological risk factors in a secondary sector setting

Objective: To present the theoretical foundation and methodological considerations for a group-based pain management programme for patients with persistent non-specific low back pain and psychosocial risk factors. Method: The Template for Intervention Description and Replication (TIDieR) checklist was used as a framework for describing the content, structure and context of the program. The theoretical rationale underlying the pain management programme was described using the first three steps of the Intervention Mapping framework. The Fear-avoidance model and the Self-efficacy Theory were identified as the two main theories. These were used to establish specific factors addressed by the pain management programme as well as expected outcomes. Intervention description: A multidisciplinary, group-based programme using a cognitive-behavioural approach was developed. The programme consisting of six sessions of two hours duration, took place at a spine clinic at a regional hospital in Denmark. Psychoeducation and cognitive restructuring were specific strategies hypothesised to induce changes in outcome measures. The outcomes expected to change as a result of the intervention were disability, quality of life, sick leave and physical activity. A pilot study was performed, subsequent adjustments made and the final content and educational materials completed by January 2017. Conclusion: The theoretical foundation and underlying evidence for the hypothesised change mechanisms in the use of a cognitive-behavioural approach was presented. A theoretically sound and practically feasible intervention has been developed and its effectiveness is being determined in a randomised controlled trial, including 130 low back pain patients, which is currently underway.