Determinants of the intention for using a lumbar support among home care workers with recurrent low back pain.
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SUBMITTER: Roelofs PD
PROVIDER: S-EPMC2989292 | biostudies-literature | 2010 Sep
REPOSITORIES: biostudies-literature
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Determinants of the intention for using a lumbar support among home care workers with recurrent low back pain.
Roelofs Pepijn D D M PD van Poppel Mireille N M MN Bierma-Zeinstra Sita M A SM van Mechelen Willem W
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 20100519 9
In most effectiveness studies on lumbar supports for patients with low back pain, insufficient data are reported about adherence. In a secondary preventive RCT, we found beneficial effects and a good adherence among home care workers with low back pain. To target the use of lumbar supports on those patients who can benefit optimally from usage, we need to know why people are adherent. We used the attitude, social support and self-efficacy model to identify determinants for prolonged adherence to ...[more]
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Project description:Study designTwo-year, prospective cohort data from the Japan epidemiological research of occupation-related back pain study in urban settings were used for this analysis.ObjectiveTo examine the association between aggravated low back pain and psychosocial factors among Japanese workers with mild low back pain.Summary of background dataAlthough psychosocial factors are strongly indicated as yellow flags of low back pain (LBP) leading to disability, the association between aggravated LBP and psychosocial factors has not been well assessed in Japanese workers.MethodsAt baseline, 5,310 participants responded to a self-administered questionnaire including questions about individual characteristics, ergonomic work demands, and work-related psychosocial factors (response rate: 86.5%), with 3,811 respondents completing the 1-year follow-up questionnaire. The target outcome was aggravation of mild LBP into persistent LBP during the follow-up period. Incidence was calculated for the participants with mild LBP during the past year at baseline. Logistic regression was used to explore risk factors associated with persistent LBP.ResultsOf 1,675 participants who had mild LBP during the preceding year, 43 (2.6%) developed persistent LBP during the follow-up year. Multivariate analyses adjusted for individual factors and an ergonomic factor found statistically significant or almost significant associations of the following psychosocial factors with persistent LBP: interpersonal stress at work [adjusted odds ratio (OR): 1.96 and 95% confidence interval (95%CI): 1.00-3.82], job satisfaction (OR: 2.34, 95%CI: 1.21-4.54), depression (OR: 1.92, 95%CI: 1.00-3.69), somatic symptoms (OR: 2.78, 95%CI: 1.44-5.40), support from supervisors (OR: 2.01, 95%CI: 1.05-3.85), previous sick-leave due to LBP (OR: 1.94, 95%CI: 0.98-3.86) and family history of LBP with disability (OR: 1.98, 95%CI: 1.04-3.78).ConclusionsPsychosocial factors are important risk factors for persistent LBP in urban Japanese workers. It may be necessary to take psychosocial factors into account, along with physical work demands, to reduce LBP related disability.
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Project description:Motor control exercise (MCE) is commonly prescribed for patients with low back pain. Although MCE can improve clinical outcomes, lumbar multifidus muscle (LM) activation remains unchanged. Neuromuscular electrical stimulation (NMES) can be used to re-activate motor units prior to MCE which should result in increased LM activation. Therefore, this study aimed to explore the immediate effects of NMES combined with MCE on LM activation and motor performance. Twenty-five participants without low back pain (NoLBP) and 35 participants with movement control impairment (MCI) were recruited. Participants with MCI were further randomized to combined NMES with MCE (COMB) or sham-NMES with MCE (MCE) group. Ultrasound imaging was used to measure LM thickness at rest, maximum voluntary isometric contraction (MVIC), and NMES with MVIC. These data were used to calculate LM activation. Quadruped rocking backward was used to represent motor performance. LM activation and motor performance were measured at baseline and after one-session of intervention. Results showed that both COMB and MCE groups had significantly lower (P < 0.05) LM activation compared with NoLBP group at baseline. Additionally, both COMB and MCE groups demonstrated significant improvement (P < 0.05) in motor performance while COMB group demonstrated significantly greater improvement (P < 0.05) in LM activation compared with MCE group. Individuals with MCI still have persisting LM activation deficit. Our key findings suggest that combined NMES and MCE may have better ability to improve LM activation in individuals with MCI. These findings would support the utility of NMES to induce a priming effect before MCE.
| S-EPMC8292547 | biostudies-literature
Project description:BackgroundChronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility.MethodsWe conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA (FOA) in 3 large studies-the Generalized Osteoarthritis Study, Genetics of Generalized Osteoarthritis Study, and Johnston County Osteoarthritis Project (total n = 5072). Associations of joint hypermobility and Beighton trunk flexion with cLBP and lumbar OA were estimated using separate adjusted logistic regression models. Adjusted pooled odds ratios (pORs) and 95% confidence intervals (CIs) were then summarized-using random effect univariate, multivariate crude, and adjusted models-and heterogeneity was determined (I2 statistic).ResultsIn univariate models, hypermobility was associated with symptomatic FOA (pOR = 0.64 [95% CI 0.44, 0.93]) but this result was not found in the multivariate models. In multivariate adjusted models, hypermobility was not significantly associated with cLBP and lumbar OA, but trunk flexion was inversely associated with cLBP (pOR = 0.40 [95% 0.26, 0.62]), spine OA (pOR = 0.66 [95% CI 0.50, 0.87]), symptomatic spine OA (pOR = 0.39 [95% CI 0.28, 0.53]), and symptomatic FOA (pOR = 0.53 [95% CI 0.37, 0.77]). Generally, between-study heterogeneity was moderate-high.ConclusionsHypermobility was not associated with cLBP or lumbar OA. The inverse association of trunk flexion with cLBP and lumbar OA may indicate a role for a flexible spine in avoiding or managing these conditions.
| S-EPMC6456963 | biostudies-literature
Project description:Study Design Cross-sectional. Background Although low back pain (LBP) occurs commonly in adolescence, little is known about the relationship between objectively measured physical activity and chronic LBP. Objectives To assess the relationship between an objective physical activity measure (accelerometer) and standard clinical measures (pain intensity, disability, and quality of life) in a sample of adolescents with recurrent or chronic LBP. Methods The study included a subsample of 143 adolescents, 12 to 18 years of age, from a randomized clinical trial. Pearson correlations (r) and bivariate linear regression were used to assess the relationship between baseline measures of sedentary, light, and moderate-to-vigorous physical activity using accelerometers and clinical measures of LBP (pain intensity, disability, and quality of life). Results Participants spent an average of 610.5 minutes in sedentary activity, 97.6 minutes in light physical activity, and 35.6 minutes in moderate-to-vigorous physical activity per day. Physical activity was very weakly associated with clinical measures of LBP (r<0.13). None of the assessed correlations were statistically significant, and bivariate regression models showed that physical activity measures explained very little of the variability for clinical measures of LBP (R2<0.02). Conclusion We found no important relationship between objectively measured physical activity and self-reported LBP intensity, disability, or quality of life in adolescents with recurrent or chronic LBP. The parent randomized clinical trial was registered at ClinicalTrials.gov (NCT01096628). J Orthop Sports Phys Ther 2017;47(10):769-774. Epub 12 Sep 2017. doi:10.2519/jospt.2017.7345.
| S-EPMC5639712 | biostudies-literature
Project description:BACKGROUND:A well-known supportive treatment for acute nonspecific back pain, elastic back support belts, are valued for their ability to accelerate natural self-healing, but there are concerns of a deconditioning effect due to their reliance on passive stabilization. METHODS:To evaluate the systematic effects of elastic abdominal belts on the trunk musculature, a total of 36 persons with acute lumbar back pain (no longer than one week) were divided into two groups: an abdominal belt wearing group (B) and a non-abdominal belt wearing control group (C). All were examined over a period of three weeks at three time points: T1 just after assignment, T2 one week later, and T3 further two weeks later. Surface EMG (sEMG) was used to record trunk muscle activation when walking on a treadmill at walking speeds of 2, 3, 4, 5, and 6 km/h. Similarly, pain intensity (VAS) and functional impairment (ODI) over time were recorded in both groups. RESULTS:Over the observation period, a slight advantage for decreased pain intensity (C: p<0.05 T2 vs. T1; B: p<0.01 T2 vs. T1, p<0.05 T3 vs. T1) and decreased functional impairment (Cohen's d vs. T1, C: T2 0.45, T3 0.86; B: T2 1.1, T3 1.0) was observed for the belt group. For the belt group both oblique abdominal muscles exhibited significantly lower sEMG throughout the observation period (external abdominal oblique muscle: (T1), T2, (T3), internal abdominal oblique muscle: T1, (T2), (T3)) and the sEMG for the back muscles ranged from unchanged to slightly elevated for this group, but never reached statistical significance. DISCUSSION:The reduced abdominal amplitude levels in the belt group likely result from the permanent elastic stabilization provided by the belt: the required elevated intra-abdominal pressure to enhance spinal stability is then provided by lessened abdominal muscle activity complemented by the belt's elastic support. With regard to the back muscles, the belt, due to its movement-restricting effect, tends to activate the paravertebral musculature. In this respect, the effect of elastic abdominal belts on the trunk muscles is not uniform. Therefore, the present results suggest that the effect of elastic abdominal belts appears to be more of a temporary neutral alteration of trunk muscle coordination, with some trunk muscles becoming more active and others less, and not a case of uniform deconditioning as is suspected.
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Project description:Study Design We present a patient-specific computer model created to translate two-dimensional (2D) fluoroscopic motion data into three-dimensional (3D) in vivo biomechanical motion data. Objective The aim of this study is to determine the in vivo biomechanical differences in patients with and without acute low back pain. Current dynamic imaging of the lumbar spine consists of flexion-extension static radiographs, which lack sensitivity to out-of-plane motion and provide incomplete information on the overall spinal motion. Using a novel technique, in-plane and coupled out-of-plane rotational motions are quantified in the lumbar spine. Methods A total of 30 participants-10 healthy asymptomatic subjects, 10 patients with low back pain without spondylosis radiologically, and 10 patients with low back pain with radiological spondylosis-underwent dynamic fluoroscopy with a 3D-to-2D image registration technique to create a 3D, patient-specific bone model to analyze in vivo kinematics using the maximal absolute rotational magnitude and the path of rotation. Results Average overall in-plane rotations (L1-L5) in patients with low back pain were less than those asymptomatic, with the dominant loss of motion during extension. Those with low back pain also had significantly greater out-of-plane rotations, with 5.5 degrees (without spondylosis) and 7.1 degrees (with spondylosis) more out-of-plane rotational motion per level compared with asymptomatic subjects. Conclusions Subjects with low back pain exhibited greater out-of-plane intersegmental motion in their lumbar spine than healthy asymptomatic subjects. Conventional flexion-extension radiographs are inadequate for evaluating motion patterns of lumbar strain, and assessment of 3D in vivo spinal motion may elucidate the association of abnormal vertebral motions and clinically significant low back pain.
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Project description:Although the occupational health field has identified psychosocial factors as risk factors for low back pain that causes disability, the association between disabling low back pain and psychosocial factors has not been examined adequately in Japanese hospital workers. Therefore, this study examined the association between low back pain, which interfered with work, and psychosocial factors in Japanese hospital workers.This cross-sectional study was conducted at a hospital in Japan. In total, 280 hospital workers were recruited from various occupational settings. Of these, 203 completed a self-administered questionnaire that included items concerning individual characteristics, severity of low back pain, fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire), somatic symptoms (Somatic Symptom Scale-8), psychological distress (K6), workaholism, and work-related psychosocial factors (response rate: 72.5%). Logistic regression was used to explore risk factors associated with disabling low back pain.Of the 203 participants who completed questionnaires, 36 (17.7%) reported low back pain that interfered with their work. Multivariate analyses with individual factors and occupations adjusted for showed statistically significant associations between disabling low back pain and fear-avoidance beliefs (adjusted odds ratio [OR]: 2.619, 95% confidence interval [CI]: 1.003-6.538], somatic symptoms (OR: 4.034, 95% CI: 1.819-9.337), and interpersonal stress at work (OR: 2.619, 95% CI: 1.067-6.224).Psychosocial factors, such as fear-avoidance beliefs, somatic symptoms, and interpersonal relationships at work, were important risk factors in low back pain that interfered with work in Japanese hospital workers. With respect to occupational health, consideration of psychosocial factors is required to reduce disability related to low back pain.
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Project description:OBJECTIVE:Earlier studies documenting the effect of candidate genes on recovery have seldom taken into consideration the impact of emotional distress. Thus, we aimed to assess the modifying effect of emotional distress on genetic variability as a predictor for pain recovery in lumbar radicular (LRP) and low back pain (LBP). RESULTS:The study population comprised 201 patients and mean age was 41.7 years. The significant association between MMP9 rs17576 (B?=?0.71, 95% CI 0.18 to 1.24, p?=?0.009) and pain recovery remained statistically significant after adjusting for pain intensity at baseline, age, gender, smoking, body mass index, pain localization and emotional distress (B?=?0.68, 95% CI 0.18 to 1.18, p?=?0.008). In contrast, the association between OPRM1 (B?=?-?0.85, 95% CI -?1.66 to -?0.05, p?=?0.038) and pain recovery was abolished in the multivariate analysis (B?=?-?0.72, 95% CI -?1.46 to 0.02, p?=?0.058). Hence, MMP9 rs17576 and emotional distress independently seem to predict persistent back pain. The predictive effect of OPRM1 rs179971 with regard to the same outcome is probably dependent on other factors including emotional processing. Trial registration The Regional Committee for Medical Research and Ethics reference number 2014/1754.
| S-EPMC6712656 | biostudies-literature
Project description:The aim of this observational, cross-sectional study was to analyse lumbar magnetic resonance imaging (MRI) findings in patients with non-specific chronic low back pain (CLBP), and to evaluate any correlation with pain intensity and their capacity to predict neuropathic pain (NP) in these patients.Fifty-two patients with non-specific CLBP, between 21 and 62 years of age, 50% men, were investigated. Lumbar MRI was employed to assess disc degeneration, endplate changes, Modic changes, disc displacement, facet degeneration, foraminal stenosis and central lumbar spinal stenosis. The characteristics of pain were evaluated and patients were divided into 2 subgroups: with NP (24 patients) and without NP (28 patients), based on the results of a DN4-interview. Correlations between particular MRI changes and their relations to the intensity of pain were evaluated. Logistic regression was used to disclose predictors of NP.Lumbar spine degenerative features were frequent in patients with non-specific CLBP, with L4/5 the most affected level. A significant correlation emerged between the severity of degenerative changes in particular lumbar spine structures (correlation coefficient ranging between 0.325 and 0.573), while no correlation was found between severity of degenerative changes and pain. Multivariate logistic regression revealed only 2 independent predictors of NP - female sex (odds ratio [OR]?=?11.9) and a mean pain intensity of ?4.5 in the previous 4 weeks (OR?=?13.1).Degenerative changes in the lumbar spine are frequent MRI findings, but do not correlate with the intensity of pain and do not predict NP. However, female sex and pain intensity do predict NP.
| S-EPMC6831323 | biostudies-literature
Project description:BackgroundLittle information is available on vertebral motion in patients with discogenic low back pain under physiological conditions. We previously validated a combined dual fluoroscopic and magnetic resonance imaging system to investigate in vivo lumbar kinematics. The purpose of the present study was to characterize mechanical dysfunction among patients with confirmed discogenic low back pain, relative to asymptomatic controls without degenerative disc disease, by quantifying abnormal vertebral motion.MethodsTen subjects were recruited for the present study. All patients had discogenic low back pain confirmed clinically and radiographically at L4-L5 and L5-S1. Motions were reproduced with use of the combined imaging technique during flexion-extension, left-to-right bending, and left-to-right twisting movements. From local coordinate systems at the end plates, relative motions of the cephalad vertebrae with respect to caudad vertebrae were calculated at each of the segments from L2 to S1. Range of motion of the primary rotations and coupled translations and rotations were determined.ResultsDuring all three movements, the greatest range of motion was observed at L3-L4. L3-L4 had significantly greater motion than L2-L3 with left-right bending and left-right twisting movements (p < 0.05). The least motion occurred at L5-S1 for all movements; the motion at this level was significantly smaller than that at L3-L4 (p < 0.05). Range of motion during left-right bending and left-right twisting at L3-L4 was significantly larger in the degenerative disc disease group than in the normal group. The range of motion at L4-L5 was significantly larger in the degenerative group than in the normal group during flexion; however, the ranges of motion in both groups were similar during left-to-right bending and left-to-right twisting.ConclusionsThe greatest range of motion in patients with discogenic back pain was observed at L3-L4; this motion was greater than that in normal subjects, suggesting that superior adjacent levels developed segmental hypermobility prior to undergoing fusion. L5-S1 had the least motion, suggesting that segmental hypomobility ensues at this level in patients with discogenic low back pain.
| S-EPMC3004094 | biostudies-literature