Chronic neck pain, a common cause of disability, seems to be the result of several interacting mechanisms. In addition to degenerative and inflammatory changes and trauma, psychological and psychosocial factors are also involved. One common type of trauma associated with chronic neck pain is whiplash injury; this sometimes results in whiplash-associated disorder (WAD), a controversial condition with largely unknown pathogenetic mechanisms. We studied the prevalence of chronic neck pain of traumatic and non-traumatic origin and compared the prevalence of, sociodemographic data, self-perceived health, workload and chronic lowback pain in these groups. In a ready-made questionnaire (MONICA study), we added questions about cervical spine and low-back complaints. 6,000 (72%) completed a self-administered questionnaire. 43% reported neck pain: 48% of women and 38% of men. Women of working age had more neck pain than retired women, a phenomenon not seen in men. 19% of the studied population suffered from chronic neck pain and it was more frequent in women. A history of neck trauma was common in those with chronic neck pain. Those with a history of neck trauma perceived their health worse and were more often on sick-leave. About 50% of those with traumatic and non-traumatic chronic neck pain also had chronic low-back pain. We assessed the subjective and objective neuropsychological functioning in 42 patients with chronic neck pain, 21 with a whiplash trauma, and 21 without previous neck trauma. Despite cognitive complaints, the WAD patients had normal neuropsychological functioning, but the WAD group especially had deviant MMPI results—indicating impaired coping ability and somatization.WAD patients had no alterations in cerebral blood-flow pattern, as measured by rCBF-SPECT and SPM analysis, compared to healthy controls. This contrasts with the non-traumatic group with chronic neck pain, which showed marked blood-flow changes. The blood-flow changes in the non-traumatic group were similar to those described earlier in pain patients but— remarkably enough—were different from those in the WAD group. Chronic neck pain of whiplash and non-traumatic origin appears to be unique in some respects. A better understanding of the underlying pathological mechanisms is a prerequisite for prevention of the development of such chronic pain syndromes and for improvement of the treatment of patients with severe symptoms.

The project has aimed to develop a new kind of back assistive device to reduce the risk of low back problems, mainly focused to industries and workplaces where manual handling are frequently occurring. The idea for the project was introduced in spring 2010, when Martin Paulsen performed internship at Bioservo Technologies AB located in Stockholm. Bioservo Technologies had developed a force-enhancing glove, which responds to the user's movements and produces an assisting grip force, similar to the user´s own muscles. During the training period Martin Paulsen began to consider other features of the technology, which led to this thesis. This project is owned by Bioservo Technologies, conducted by Herbert Eriksson and Martin Paulsen from the Biomechanical program at Halmstad University. The aim has been to develop an idea for a future product for Bioservo Technologies. The goal of the product that has been to reduce the risk of low back problems, mainly the cases of low back pain associated with manual handling at workplaces. In order to find a solution to such complex problems as low back pain, the project has started with three pilot studies. • Literature Study: As this project´s aim has not been to produce a prototype for testing and validation, the project has instead rested heavily on a literature study. The focus of this study was to educate Herbert Eriksson and Martin Paulsen of the problem and the solutions available on the market today. The pilot study can be found as Attachent A: "A literature study about the problems of low back pain and the solutions of today." • Interviews: As the project has been conducted confidentially, no steering group could participate in the project. However, it was important to let the professions that currently work with back problems affect the project, and let their experience and knowledge influence the project. Interviews was instead introduced, and allowed experts to give valuable insight with their unique knowledge on the subject. The pilot study can be found as Appendix B: "Interviews of experts of interest concerning low back pain." • Motion Capture: A measurement of kinematic data was conducted to capture the spine motion for further analysis in Matlab, and to explore the feet´s load patterns while manually lifting. The pilot study can be found as Appendix C: "A Study of Healthy adult's foot pressure pattern in a symmetrical lifting task." These three pilot studies together form a platform for the development of the product´s function and theoretical content. While design and material has been left open, the product description focuses on the product's functional design, mechanics and electronics. In order to validate the product's mechanics, has an Appendix named Appendix D: "Calculations of how the angle alpha depends on the variable theta and the dimensions of the external spine" been added as an Appendix. / Projektet har syftat till att utveckla ett nytt sorts rygghjälpmedel för att reducera risken för ländryggsproblem, främst åt industrier och arbetsplatser där manuella lyft är frekvent förekommande. Idéen till projektet föddes redan våren 2010, då Martin Paulsen praktiserade hos Bioservo Technologies AB i Stockholm. Bioservo Technologies AB hade utvecklat en kraftförstärkande handske, som svarar på användarens rörelser och producerar en assisternade kraftutveckling, lik den egna muskelaturen. Under praktikperioden började Martin Paulsen att fundera på andra funktioner för tekniken, vilket ledde till detta examensarbete. Detta projekt är ägt av Bioservo Technologies AB, utfört av Herbert Eriksson och Martin Paulsen från Biomekanikprogrammet på Högskolan i Halmstad. Syftet har varit att utveckla en idé för en framtida produkt åt Bioservo Technologies AB. Målet med produkten som har utvecklats är att reducera risken för ländryggsproblem, främst de fall av ländryggproblem som är associerat med manuella lyft på arbetsplatser. För att finna en lösning på ett sådant komplex problem som ländryggsproblem, har projektet inledds med tre pilotstudier. • Litteraturstudie: Då projektet inte har syftat till att producera en prototyp för testning och validering, har projektet istället fått vila tungt på en litteraturstudie. Fokus med litteraturstudien var att utbilda Herbert Eriksson och Martin Paulsen om problemet, och vilka lösningar som finns på marknaden idag. Pilotstudien står att finna som Appendix A: ”A literature study about the problems of low back pain and the solutions of today”. • Intervjuer: Då projektet har bedrivits konfidentiellt har ingen styrgrupp kunnat delta i projektet. Det var dock viktigt att låta de arbetsgrupper som idag arbetar med just ryggproblem påverka projektet, och låta deras erfarenheter och kunskaper adapteras i projektet. Med anledning av detta genomfördes istället intervjuer och samtal med tre personer, som har givits tillåtelse att belysa projektet med sina unika kunskaper inom ämnet. Pilotstudien står att finna som Appendix B: “Interviews of experts of interest concerning lowback pain”. • Motion Capture: En mätning av kinematisk data genomfördes för att fånga ryggens rörelse för vidare analys i Matlab, samt för att utforska fötternas belastningsmönster vid manuella lyft. Pilotstudien står att finna som Appendix C: “A study of healthy adult's foot pressure pattern in a symmetrical lifting task”. Dessa tre pilotstudier skapade gemensamt en platå för att utveckla produkten teoretiska funktion och innehåll. Då designval och materialval har lämnats öppna har produktbeskrivningen fokuserats på produktensfunktionella utformning, mekanik och elektronik. För att validera produktens mekanik, har en bilagavid namn Appendix D: ”Calculations of how the angle alpha depends on the variable theta and the dimensions of the external spine” framställts.

Back pain is the 6th most costly condition in the United States and is responsible for the most workdays lost. Approximately 33 million American adults suffered from back and neck problems in 2005. The societal cost of chronic back pain (CBP) has not been calculated from a US perspective. Longitudinal data files from Panels 12, 13, and 14 of the Medical Expenditure Panel Survey (MEPS) were used to estimate excess direct (ambulatory visits, inpatient admissions, emergency room visits, and prescription medication) costs and indirect (lost productivity) costs for persons 18 years and older reporting CBP compared to those not reporting back pain. Persons were included in the CBP group if they reported back pain (ICD-9-CM codes 720, 721, 722, 723, 724, 737, 805, 806, 839, 846, 847) in at least 3 consecutive interview rounds. The complex sampling design of MEPS was taken into account to get accurate national estimates. All costs were adjusted to 2011 using Consumer Price Indices. All mean costs were computed using age-stratified regression models, after adjusting for demographic and clinical covariates. Utilization of provider-based complementary and alternative medicine (CAM) among CBP patients was studied, and differences in costs between CAM users and non-users examined. Based on this analysis, the prevalence of CBP in the adult US population was estimated to be 3.76%. Total all-cause costs for CBP patients were estimated to be $187 billion over 2 years (direct costs = $176 billion, indirect cost = $11 billion). Overall estimates of excess costs of CBP over 2 years per person for direct medical costs were $37,129 ($25,273 vs. $48,984; p<0.001). This breaks down to $11,711 ($14,929 vs. $3,219; p<0.001) for ambulatory visits; $3,560 ($6,514 vs. $2,914; p<0.001) for inpatient admissions; $300 ($690 vs. $390; p<0.001) for emergency department visits; and $19,849 ($23,873 vs. $4,024; p<0.001) for prescription medications. Excess indirect costs for CBP patients were $1,668 ($2,329 vs. $661; p<0.001). Thirty-seven percent of CBP patients reported at least one CAM visit. There was no significant difference in overall costs between CAM users and non-users. The high cost of chronic back pain in the US population has potential implications for prioritizing policy, and in attempting to improve care and outcomes for these patients. / text

Low back disorders (LBDs) are the most common musculoskeletal problem among farmers, with higher prevalence rates than in other occupations. Operators of tractors and other farm machinery such as combines and all terrain vehicles (ATV) can have considerable accumulation of exposure to whole body vibration (WBV). The causal relationship between LBDs and WBV is not fully clear; however, it may be different among farmers as their work context and exposure is unique. Objectives: The objectives of the two studies which form two manuscripts or chapters in this thesis were to: 1) investigate the associations between WBV and LBDs among farmers using a) systematic review (manuscript 1) and cohort studies (manuscript 2). Methods: Objective 1: Nine databases were searched using groups of terms for two concepts: ‘farming’ and ‘low back disorder’. Screening, data extraction and quality assessment was performed by two reviewers independently. The population was adult farmers or agricultural workers globally irrespective of sex. The intervention was considered to be WBV exposure, such tractor, combine and ATV use. The control was no exposure or low exposure to WBV and the outcome was low back disorders. No limits in date of publication and type of study design were applied in the literature search, and only full text, English language studies were considered. Objective 2: The data source was the Saskatchewan Farm Injury Cohort Study. In 2007, baseline data were collected on accumulated yearly tractor, combine, ATV operation, as well as several biopsychosocial covariates thought to be associated with LBDs. Follow-up data on LBDs and related symptoms were collected during 2013 (6 year follow-up) and 2014 (1-year). This resulted in two datasets for each of two cohorts: 1) the first cohort with 1,149 farm people who had been followed for six years, and 2) the second with 605 participants who had been followed for one year. Generalized estimating equation-modified Poisson regressions were performed with low back and hip symptoms as the outcome. Results: Objective 1: After 276 full texts screened, we found 12 articles which analyzed WBV as a risk factor for LBD. Three were case-control, 6 cross-sectional and 3 retrospective cohorts. Four studies showed no association between WBV and LBDs, 4 studies showed a positive association and for the remaining 4 studies, results were mixed depending on the exposure or the outcome measure. Objective 2: The adjusted model in cohort 1 found LBDs to be associated to tractor operation for 1-150 hrs/year (RR=1.23, 95%CI 1.05-1.44), 151-400 hrs/year (RR=1.32, 95%CI 1.14-1.54) and 401+ hrs/year (RR=1.34, 95%CI 1.15-1.56). In addition, tractor operation for 151-400 hrs/year (RR=1.95, 95%CI 1.45-2.62) and 401+ hrs/year (RR=1.79, 95%CI 1.32-2.45) was also found to be related to hip symptoms. Although combine operation ≥ 61 hrs/year and ATV operation 81+ days/year was related to LBD in the bivariate analysis in cohort 1, this association did not persist after adjustment for confounders. Due to limited power, no significant bivariate association was found between WBV and either LBDs and hip symptoms in cohort 2. Conclusions: Objective 1: A firm conclusion is difficult due to heterogeneity in statistical strategy, LBDs definition, type of farm commodity, and study design. Direct comparisons and synthesis were not possible. Although retrospective cohort studies tended to show a relationship, future studies with a prospective cohort design can help clarify this association further. Objective 2: Although duration of tractor operation and older age showed with both LBDs and hip symptoms in farmers in cohort 1, the true prospective cohort 2 found no significant association between WBV and LBDs.

No description available.

Su juosmeninės stuburo dalies skausmu, populiariai dar vadinamu juosmens skausmu, bent kartą per gyvenimą susiduria apie 80 proc. žmonių. Ši patologija rimtai komplikuoja gyvenimo kokybę – ją dažnai lydi neigiamos tiek ekonominės, socialinės (pvz., nedarbingumas), tiek psichologinės (pvz., depresija) pasekmės. Medicininiu požiūriu didžiausia problema, susijusi su šia patologija, yra ta, kad itin komplikuotas juosmeninės stuburo dalies skausmo atsiradimo priežasties nustatymas (net 90 proc. atvejų ji yra nespecifinė, nenustatoma tiksli mechaninė disfunkcija, lemianti sutrikimą). Tai žymiai apsunkina gydymo bei reabilitacijos procesą. Vienas novatoriškiausių būdų nugaros skausmo diagnostikai mokslo pasaulyje – šlaunies sukamųjų (rotaciniai) judesių amplitudės klubo sąnaryje rodikliai. Mokslininkų požiūriai šiuo klausimu iki šiol gan kontraversiški. Tad atsižvelgiant į problemos aktualumą bei svarbą kineziterapiauto praktikai, buvo bandoma detaliau patikslinti hipotezę, kad egzistuoja ryšys tarp lėtinio juosmenin��s stuburo dalies nugaros skausmo ir šlaunies sukamųjų judesių amplitudės klubo sąnaryje. Atliktas tyrimas, kurio pagrindiniai uždaviniai buvo šie: 1. Nustatyti ir įvertinti klubo sąnario sukamųjų judesių amplitudę, žmonių jaučiančių lėtinį juosmeninės stuburo dalies skausmą ir palyginti juos pagal lytį bei amžių. 2. Nustatyti ir įvertinti klubo sąnario sukamųjų judesių amplitudę, žmonių nejaučiančių lėtinio juosmeninės stuburo dalies skausmo ir palyginti juos pagal... [toliau žr. visą tekstą] / Around 80% of the population encounter pain in low back part of the spine, commonly also known as low back pain, at least once in the lifetime. This pathology seriously complicates the quality of life: it is oftentimes accompanied by negative economic and social consequences (e.g. incapacity for work) as well as psychological consequences (e.g. depression). From medical point of view, the biggest problem associated with this pathology is that the diagnostics of the reason for emergence of low back pain is extremely complicated (in even 90% of the cases, this reason is non-specific, no accurate mechanical dysfunction is detected that would result in the disorder). This significantly aggravates the treatment and rehabilitation process. One of the most novel ways of diagnostics for the back pain worldwide is the establishment of indicators for hip rotation range of motion in the hip joint. So far, the views of scientists on this issue are rather controversial. Therefore, taking into account the relevance of the problem and its importance for the practice of a physicaltherapist, the objective was to adjust the hypothesis that a particular relation exists between the pain in the low back part of the spine and the hip rotation range of motion in the hip joint. A research has been made to fulfill the following tasks: 1. Definition and evaluation of the hip rotation range of motion of the people suffering from chronic low back pain and their comparison by sex and age. 2... [to full text]

No description available.

Recorded on July 27, 2007 by Eugene Barsky, Physiotherapy Outreach Librarian, UBC / N/A

Purpose – to determine students back pain correlation with physical development. In order to reach purpose of the reserach following tasks were set: 1. To determine indicators of students’ physical development and correlations among them; 2. To find out and assess static endurance of subjects’ trunk (back, abdominal, left and right sides) muscles; 3. To find out incidence of back pain in students and physical activity through questionnaire survey. Object of research – students back pain. 132 physical therapy students (109 females and 32 males) participated in the study. First year students − 39 females, 5 males; second year − 28 females, 5 males; third year − 27 females, 4 males; fourth year − 15 females, 9 males. When planning a research the following problematic question was formulated: does the fact that subjects are studying at Lithuanian Academy of Physical education and study in faculty of sports biomedicine where they get medical knowledge allows for ensuring them good health condition? In case of our research anthropometric data, physical activity and fitness of trunk muscles were treated as indicators of health condition. It was hypothesized that because of the specificity of studies students should be physically active what may have a positive effect on data of their physical development and trunk muscles’ fitness and at the same time on the condition of their back. The following conclusions were reached after analysis of research findings: 1. Indicators of... [to full text]

Sammanfattning Syfte och frågeställningar: Syftet med föreliggande studie var att beskriva prevalens av ryggsmärta hos ett slumpmässigt urval av svenska ungdomar ur SIH-studien 2004, Skola-Idrott-Hälsa en nationell studie om barns och ungdomars hälsa och omgivande faktorers betydelse för deras fysiska aktivitet. Dessutom var syftet att beskriva köns- och åldersskillnader samt hur stor andel av de med generell ryggsmärta 2004 som hade rapporterat ryggsmärta 3 år tidigare. Vidare var syftet att koda ryggsmärtan i fyra olika fält markerad på smärtteckning, och undersöka om skillnader förelåg mellan barn och ungdomar med ländryggsbesvär och de utan ryggbesvär i fysisk aktivitet, fysisk inaktivitet samt psykologiska faktorer såsom stress, nedstämdhet och trötthet. Metod: Barn och ungdomar 12, 15 och 18 år svarade i enkät på frågan: har du ont i ryggen idag, och markerade ryggsmärta på en smärtteckning. Denna kodades och smärtan kartlades utifrån 4 anatomiska lokalisationer, eller fält: 1)nacke, 2)bröstrygg, 3)ländrygg och 4)smärta i fler än ett fält på ryggen. Den kodade ryggsmärtan presenterades och köns- och åldersskillnader beskrevs. Fält 3)ländrygg studerades separat och sambandet mellan faktorer i SIH-studiens enkät som representerar fysisk aktivitet och fysisk inaktivitet samt stress, trötthet och nedstämdhet jämfört med individer utan ryggsmärta. Resultat: Ryggsmärta rapporterades av 23%, 274 individer, av alla i studien och fler flickor än pojkar rapporterade ryggsmärta, skillnaden var signifikant p&lt;0,001. Ryggsmärta rapporterades av 23% redan år 2001. Ländryggen var den vanligaste smärt-lokalisationen hos både pojkar och flickor och rapporterades av 46% av individerna som hade ryggsmärta. Fler flickor 60% än pojkar 40% rapporterade ländryggssmärta. Smärtan ökade mest från årskurs 6 till 9 hos individerna med ländryggsmärta och smärta i fler än ett fält på ryggen. Färre individer med ländryggssmärta tävlade i idrott eller deltog i idrottsförening. Större andel individer med ländryggsmärta chattade/surfade och spelade dataspel än individerna utan ryggsmärta (p=0,047). Unga med ländryggsmärta rapporterade mer stress, trötthet och nedstämdhet (p&lt;0,001).  Slutsats: Ryggsmärta rapporterades av 23% av alla individer i SIH-studien 2004. Ländryggen var den vanligaste smärtlokalisationen hos både pojkar och flickor och smärtan ökade främst från årskurs 6 till 9. Fler flickor än pojkar rapporterade ryggsmärta. Mindre andel individer med ländryggssmärta tävlade i drott eller deltog i idrottsförening och de unga med ländryggssmärta uppgav mer stress, trötthet och nedstämdhet än individer utan ryggsmärta. Signifikant fler individer med ländryggssmärta ägnade mer tid att chatta/surfa på internet och spela dataspel på helgerna än individerna utan ryggsmärta (p=0,047). / Abstract. Purpose and Issues: The aim of the present study was to describe the prevalence of back pain in a random sample of Swedish adolescents in the SIH-survey 2004, a national survey about health in children and adolescents and possible factors of importance of physical activity in their surrounding. The aim was also to describe the gender and age distribution and if those with back pain in 2004 had back pain 3 years earlier. Furthermore, the aim was to encode back pain in four different fields, marked on a paindrawing, and examine whether there were differences between children and adolescents with low back pain and those without back pain and physical activity, physical inactivity, and psychological factors such as stress, depression and fatigue.  Method: Children and adolescents 12, 15 and 18 years old answered the question in a questionnaire: Do you have a sore back today, and highlighted back pain on a paindrawing. The coded backpain was mapped by four anatomical locations, or fields: 1) neck, 2) thoracic spine, 3) lumbar and 4) pain in more than one field at the back. The coded back pain and gender and age distribution were described. Field 3) lumbar spine, were studied separately and relationships between factors in the SIH-study questionnaire that represents physical activity and physical inactivity and stress, fatigue and depression compared with individuals without back pain. Results: Back pain was reported by 23%, 274 individuals, of all participating in the study and significantly more girls than boys reported back pain. Back pain was reported by 23% already in 2001. The lower back was the most common location of pain in both boys and girls and was reported by 46% of individuals who reported back pain. More girls 60% than boys 40% reported low back pain. The pain increased most from grades 6 to 9 in individuals with low back pain and pain in more than one field at the back. Less number of individuals with low back pain were competing in sports and participated in a sports-club. Young people with low back pain reported significantly more stress, fatigue and depression (p&lt;0,001). Conclusion: Back pain was reported by 23% of all individuals participating in the SIH-study 2004. The lower back was the most common location of pain in both boys and girls and the pain increased primarily from grades 6 to 9. Less number of individuals with low back pain competed in sports and participated in a sports-club. Individuals with low back pain reported significantly more stress, fatigue and depression than individuals without back pain (p&lt;0,001). Significantly more individuals with low back pain played computer games and chatted/surfed on the internet during weekends than individuals without backpain (p=0,047).