Bakgrund: Ländryggsmärta är en mycket vanligt förekommande smärtproblematik världen över och har stor påverkan på olika faktorer som exempelvis antalet funktionsjusterade levnadsår och förlorade levnadsår till följd av funktionshinder. Ett verktyg som har potential inom fysioterapin är virtual reality (VR), där metoden har testats  vid behandling av bland annat smärtproblematik, rörelserädsla och funktionsnedsättning. I dagsläget saknas enighet inom forskningen om hur upplägget för behandlingsstudier för kroniska ländryggsbesvär ska designas samt hur VR-tekniken med tillhörande applikationer har tillämpats och med vilken målsättning.  Syfte:  Syftet med denna studie var att redogöra för hur behandlingsstudier med VR för kroniska ländryggsbesvär är designade och strukturerade samt hur VR-applikationerna är tillämpade. Metod: Sökningarna utfördes systematiskt och skedde i databaserna Pubmed, Scopus och CINAHL. Arbetet följer PRISMAs riktlinjer för rapportering av scoping reviews.  Resultat: I denna scoping review inkluderades 18 studier.Resultatet tyder på att VR headset med eller utan kontroller, ihop med olika typer av arm-, ben- eller huvudrörelser var det mest använda i studierna. Huvudsakligen användes applikationer som innehöll olika uppgiftsspecifika aktiviteter samt att efterlikna rörelser av en virtuell avatar och racing- och skjutspel med styrning av bålrörelser. Spelen innehöll även patientutbildning om smärta, smärthantering och psykologiska behandlingsprinciper, Vanligast förekommande var ett behandlingsupplägg på 30 minuter per session, fem gånger i veckan, över en interventionsperiod på fyra veckor, där mätning av smärta och mätningstillfällen av utfallsmått sker vid början och slutet av interventionsperioden. Virtual reality som behandlingsmetod har även påvisat en begränsad mängd negativa sidoeffekter som yrsel och illamående/åksjuka. Konklusion: VR har visat potential att vara ett behandlingshjälpmedel för att kunna bidra till att behandla långvariga ryggbesvär. Mer forskning behövs om design och tillämpning av applikationer och interventioner utifrån önskade behandlingseffekter vid användning av VR för kroniska ländsryggsbesvär.

A dor na coluna vertebral é a principal causa de incapacidade no mundo, com altas taxas de prevalência global. A partir de estudos sobre a fisiologia da dor e suas relações com estados psicológicos, tornou-se essencial a avaliação psicológica dos indivíduos com quadros dolorosos, para selecionar os perfis mais favoráveis às diferentes formas de tratamento. O questionário DRAM (Distress Risk Assessment Method) foi desenvolvido como instrumento de triagem para portadores de dor na coluna vertebral subclassificando os indivíduos em quatro grupos distintos (normal, sob risco, somático e depressivo), conforme a pontuação dos dois questionários que compõem o DRAM (MSPQ e Zung). O objetivo desse estudo é traduzir e adaptar o DRAM para o português brasileiro da versão original em inglês, além de analisar a confiabilidade da versão traduzida e adaptada. Segundo a metodologia IQOLA, consagrada em inúmeras publicações, foi desenvolvida uma versão em português brasileiro que foi aplicada a uma amostra inicial de 30 pacientes e a seguir à amostra final de 85 indivíduos dos três centros participantes portadores de dor lombar. Os resultados comprovaram a confiabilidade e reprodutibilidade da versão traduzida e adaptada do questionário DRAM com índice de Cronbach alfa de 0,815 para o MSPQ e 0,794 para o Zung e coeficiente de correlação intraclasse de 0,688 para o MSPQ e 0,659 para o Zung. Tais dados permitiram concluir que a versão do questionário DRAM traduzida e adaptada culturalmente para o português brasileiro é confiável e está disponível para uso na prática clínica / Back pain is the leading disability cause worldwide, with high global prevalence rates. Based on studies regarding pain physiology and its relation to emotional distress conditions, psychological evaluation became essential to determine the most favorable patient profiles to distinct therapeutic approaches. DRAM (Distress Risk Assessment Method) has been developed as screening instrument for patients with lumbar pain, classifying them in subgroups as normal, at risk, distressed somatic and distressed depressive, based on the two components of DRAM scores (MSPQ and Zung questionnaires). The objective of this study is to translate and culturally adapt DRAM to Brazilian Portuguese language, and determine the final version reliability. As proposed by IQOLA method, a Brazilian Portuguese version of DRAM has been applied to an initial sample of 30 patients and finally to a 85 individuals from three participant centers. Results confirmed the reliability and reproducibility of DRAM in its Brazilian Portuguese final version: Cronbach alpha of 0.815 (MSPQ) and 0.794 (Zung) and ICC (intraclass correlation coefficient) of 0.688 (MSPQ) and 0.659 (Zung), thus concluding that the presented DRAM version in Brazilian Portuguese is reliable as available to clinical practice use

INTRODUÇÃO: A incapacidade relacionada à lombalgia crônica é um fenômeno complexo, multideterminado e pouco compreendido. OBJETIVO: Identificar a prevalência, caracterizar a incapacidade e identificar os fatores preditores independentes de incapacidade em pessoas com dor lombar crônica. MÉTODO: Estudo transversal com amostra não probabilística de 215 adultos com dor lombar crônica (idade média 45 anos; DP=11,1, 65% eram mulheres, média de escolaridade de 11 anos, média da intensidade da dor de 7,3; DP=2,3) atendidos em 3 serviços de saúde e trabalhadores de duas indústrias. Os dados foram coletados entre janeiro e novembro de 2008 e os participantes responderam a 8 instrumentos: a Ficha de Caracterização, o Oswestry Disability Index, o Questionário de atividade física habitual de Baecke, a Escala de Auto-eficácia para Dor Crônica, Inventário de Atitudes frente à Dor, a Escala Tampa de Cinesiofobia, Inventário de Depressão de Beck, a Escala de Fadiga de Piper Revisada. Após testes de confiabilidade de todos os instrumentos, o Questionário de atividade física habitual de Baecke foi excluído. Utilizaram-se os pontos de corte previstos nas Escalas e determinaram-se pontos de corte para as variáveis: auto-eficácia, medo e evitação da dor e fadiga. RESULTADOS: A prevalência de incapacidade foi de 53% e a maior parte dos indivíduos apresentou incapacidade de moderada a severa (68%). Na análise univariada, 19 dos 20 fatores investigados apresentaram associação com incapacidade: sexo, idade, escolaridade, situação de trabalho, renda familiar, IMC, intensidade da dor, duração da dor, depressão, fadiga, crença de auto-eficácia, crença de medo e evitação da dor, crença de controle, crença de emoção, crença de que dor incapacita, crença de dano físico, crença de solicitude, crença de medicação e crença de cura médica. Na análise de regressão múltipla identificaram-se quatro fatores associados independentemente à incapacidade: afastamento do trabalho, crença de auto-eficácia frente à dor baixa, crença de medo e evitação da dor alta e dor intensa. CONCLUSÕES: A chance de incapacitação para indivíduos sem trabalho foi 219% maior; aqueles com auto-eficácia baixa apresentaram chance 113% maior de ter incapacidade; os indivíduos com elevado medo e evitação da dor apresentaram chance de incapacidade 41% maior do que para os demais e, para os indivíduos com dor intensa, a chance de ter incapacidade foi 30% maior. Os quatro fatores preditores observados são passíveis de mudança. Intervenções como a recolocação do indivíduo no trabalho, a minimização da intensidade da dor e a reconceituação das crenças de auto-eficácia baixa e de elevado medo e evitação da dor devem ser implementadas nos programas de reabilitação, visando à prevenção e redução da incapacidade em pessoas com dor lombar crônica. / INTRODUCTION: Disability related to chronic low back pain is a complex, multidimensional and misunderstood phenomenon. AIMS: To identify the disability prevalence, its characteristics and independent predictors in chronic low back pain adults. METHOD: Cross-sectional study, non-probabilistic sample of 215 individuals from three health services and two industries: mean age=45 years (SD=11.1), female (65%), 11 years of schooling (SD=3.5) and mean pain intensity=7.3 (SD=2.3). Data collection was from January to November, 2008. Respondents answered 8 instruments: Identification Form, The Oswestry Disability Index, The Baecke Habitual Physical Activity Questionnaire, The Chronic Pain Self-efficacy Scale, Survey of Pain Attitudes, Tampa Scale Kinesiophobia, Beck Depression Inventory, Revised Piper Fatigue Scale. The psychometric properties of the instruments were analyzed and The Baecke Habitual Physical Activity Questionnaire was excluded after unsatisfactory reliability tests results. The instruments that had cut-points previously defined were assumed and specific cut-points were established to self-efficacy, fear-avoidance pain and fatigue for this sample. RESULTS: The prevalence of disability was 53% and it was moderate to severe in 68% of the sample. 19 out of 20 explored variables were associated with disability (p<0.05): sex, age, education, work situation, family income, BMI, pain intensity, pain duration, depression, fatigue, self-efficacy beliefs, fear-avoidance beliefs, control beliefs, emotion beliefs, disability beliefs, physical damage beliefs, solicitude beliefs, medication beliefs and medical cure beliefs. The multiple regression model identified four independent predictors of disability: work situation, low self-efficacy beliefs, high fear-avoidance beliefs and severe pain intensity. CONCLUSIONS: To non-workers the disability chance was 219% higher than for workers; those with low self-efficacy showed 113% higher chance of disability; the individuals with higher fear-avoidance beliefs showed 41% higher chance of disability and the individuals with severe pain showed 30% higher chance of disability. The predictive factors identified are modifiable. Interventions like work relocation, reduction of pain intensity and reconceptualization of self-efficacy and fear-avoidance beliefs must be implemented in rehabilitation programs, aiming to prevent and reduce disability in chronic low back pain patients.

A dor na coluna vertebral é a principal causa de incapacidade no mundo, com altas taxas de prevalência global. A partir de estudos sobre a fisiologia da dor e suas relações com estados psicológicos, tornou-se essencial a avaliação psicológica dos indivíduos com quadros dolorosos, para selecionar os perfis mais favoráveis às diferentes formas de tratamento. O questionário DRAM (Distress Risk Assessment Method) foi desenvolvido como instrumento de triagem para portadores de dor na coluna vertebral subclassificando os indivíduos em quatro grupos distintos (normal, sob risco, somático e depressivo), conforme a pontuação dos dois questionários que compõem o DRAM (MSPQ e Zung). O objetivo desse estudo é traduzir e adaptar o DRAM para o português brasileiro da versão original em inglês, além de analisar a confiabilidade da versão traduzida e adaptada. Segundo a metodologia IQOLA, consagrada em inúmeras publicações, foi desenvolvida uma versão em português brasileiro que foi aplicada a uma amostra inicial de 30 pacientes e a seguir à amostra final de 85 indivíduos dos três centros participantes portadores de dor lombar. Os resultados comprovaram a confiabilidade e reprodutibilidade da versão traduzida e adaptada do questionário DRAM com índice de Cronbach alfa de 0,815 para o MSPQ e 0,794 para o Zung e coeficiente de correlação intraclasse de 0,688 para o MSPQ e 0,659 para o Zung. Tais dados permitiram concluir que a versão do questionário DRAM traduzida e adaptada culturalmente para o português brasileiro é confiável e está disponível para uso na prática clínica / Back pain is the leading disability cause worldwide, with high global prevalence rates. Based on studies regarding pain physiology and its relation to emotional distress conditions, psychological evaluation became essential to determine the most favorable patient profiles to distinct therapeutic approaches. DRAM (Distress Risk Assessment Method) has been developed as screening instrument for patients with lumbar pain, classifying them in subgroups as normal, at risk, distressed somatic and distressed depressive, based on the two components of DRAM scores (MSPQ and Zung questionnaires). The objective of this study is to translate and culturally adapt DRAM to Brazilian Portuguese language, and determine the final version reliability. As proposed by IQOLA method, a Brazilian Portuguese version of DRAM has been applied to an initial sample of 30 patients and finally to a 85 individuals from three participant centers. Results confirmed the reliability and reproducibility of DRAM in its Brazilian Portuguese final version: Cronbach alpha of 0.815 (MSPQ) and 0.794 (Zung) and ICC (intraclass correlation coefficient) of 0.688 (MSPQ) and 0.659 (Zung), thus concluding that the presented DRAM version in Brazilian Portuguese is reliable as available to clinical practice use

INTRODUÇÃO: A incapacidade relacionada à lombalgia crônica é um fenômeno complexo, multideterminado e pouco compreendido. OBJETIVO: Identificar a prevalência, caracterizar a incapacidade e identificar os fatores preditores independentes de incapacidade em pessoas com dor lombar crônica. MÉTODO: Estudo transversal com amostra não probabilística de 215 adultos com dor lombar crônica (idade média 45 anos; DP=11,1, 65% eram mulheres, média de escolaridade de 11 anos, média da intensidade da dor de 7,3; DP=2,3) atendidos em 3 serviços de saúde e trabalhadores de duas indústrias. Os dados foram coletados entre janeiro e novembro de 2008 e os participantes responderam a 8 instrumentos: a Ficha de Caracterização, o Oswestry Disability Index, o Questionário de atividade física habitual de Baecke, a Escala de Auto-eficácia para Dor Crônica, Inventário de Atitudes frente à Dor, a Escala Tampa de Cinesiofobia, Inventário de Depressão de Beck, a Escala de Fadiga de Piper Revisada. Após testes de confiabilidade de todos os instrumentos, o Questionário de atividade física habitual de Baecke foi excluído. Utilizaram-se os pontos de corte previstos nas Escalas e determinaram-se pontos de corte para as variáveis: auto-eficácia, medo e evitação da dor e fadiga. RESULTADOS: A prevalência de incapacidade foi de 53% e a maior parte dos indivíduos apresentou incapacidade de moderada a severa (68%). Na análise univariada, 19 dos 20 fatores investigados apresentaram associação com incapacidade: sexo, idade, escolaridade, situação de trabalho, renda familiar, IMC, intensidade da dor, duração da dor, depressão, fadiga, crença de auto-eficácia, crença de medo e evitação da dor, crença de controle, crença de emoção, crença de que dor incapacita, crença de dano físico, crença de solicitude, crença de medicação e crença de cura médica. Na análise de regressão múltipla identificaram-se quatro fatores associados independentemente à incapacidade: afastamento do trabalho, crença de auto-eficácia frente à dor baixa, crença de medo e evitação da dor alta e dor intensa. CONCLUSÕES: A chance de incapacitação para indivíduos sem trabalho foi 219% maior; aqueles com auto-eficácia baixa apresentaram chance 113% maior de ter incapacidade; os indivíduos com elevado medo e evitação da dor apresentaram chance de incapacidade 41% maior do que para os demais e, para os indivíduos com dor intensa, a chance de ter incapacidade foi 30% maior. Os quatro fatores preditores observados são passíveis de mudança. Intervenções como a recolocação do indivíduo no trabalho, a minimização da intensidade da dor e a reconceituação das crenças de auto-eficácia baixa e de elevado medo e evitação da dor devem ser implementadas nos programas de reabilitação, visando à prevenção e redução da incapacidade em pessoas com dor lombar crônica. / INTRODUCTION: Disability related to chronic low back pain is a complex, multidimensional and misunderstood phenomenon. AIMS: To identify the disability prevalence, its characteristics and independent predictors in chronic low back pain adults. METHOD: Cross-sectional study, non-probabilistic sample of 215 individuals from three health services and two industries: mean age=45 years (SD=11.1), female (65%), 11 years of schooling (SD=3.5) and mean pain intensity=7.3 (SD=2.3). Data collection was from January to November, 2008. Respondents answered 8 instruments: Identification Form, The Oswestry Disability Index, The Baecke Habitual Physical Activity Questionnaire, The Chronic Pain Self-efficacy Scale, Survey of Pain Attitudes, Tampa Scale Kinesiophobia, Beck Depression Inventory, Revised Piper Fatigue Scale. The psychometric properties of the instruments were analyzed and The Baecke Habitual Physical Activity Questionnaire was excluded after unsatisfactory reliability tests results. The instruments that had cut-points previously defined were assumed and specific cut-points were established to self-efficacy, fear-avoidance pain and fatigue for this sample. RESULTS: The prevalence of disability was 53% and it was moderate to severe in 68% of the sample. 19 out of 20 explored variables were associated with disability (p<0.05): sex, age, education, work situation, family income, BMI, pain intensity, pain duration, depression, fatigue, self-efficacy beliefs, fear-avoidance beliefs, control beliefs, emotion beliefs, disability beliefs, physical damage beliefs, solicitude beliefs, medication beliefs and medical cure beliefs. The multiple regression model identified four independent predictors of disability: work situation, low self-efficacy beliefs, high fear-avoidance beliefs and severe pain intensity. CONCLUSIONS: To non-workers the disability chance was 219% higher than for workers; those with low self-efficacy showed 113% higher chance of disability; the individuals with higher fear-avoidance beliefs showed 41% higher chance of disability and the individuals with severe pain showed 30% higher chance of disability. The predictive factors identified are modifiable. Interventions like work relocation, reduction of pain intensity and reconceptualization of self-efficacy and fear-avoidance beliefs must be implemented in rehabilitation programs, aiming to prevent and reduce disability in chronic low back pain patients.

No description available.

Résumé : La douleur lombaire (DL) est l’une des conditions musculosquelettiques les plus fréquentes et coûteuses au Canada. La prévalence annuelle de DL aigüe varierait de 19 % à 57 %, et un patient sur quatre souffrirait de récurrence dans la même année. La présente étude vise donc à produire une analyse descriptive de l’épidémiologie de la DL récurrente à l’échelle de la population. Une nouvelle approche méthodologique est proposée afin d’optimiser l’identification de vrais cas incidents de DL récurrente à partir d’une analyse secondaire de données administratives. Puisque 10 % des patients ayant de la DL seraient responsables de 80 % des coûts qui y sont associés, nous avons également déterminé la tendance séculaire des coûts d’interventions médicales des patients récurrents incidents entre 2003 et 2008. En utilisant le fichier des services médicaux rémunérés à l’acte de la Régie de l’assurance maladie du Québec, des cohortes prévalentes ont été construites à partir de 401 264 dossiers de patients ayant consulté au moins trois fois pour de la DL entre 1999 et 2008. Onze ans d’historique médical des 81 329 patients de la cohorte de 2007 ont ensuite été analysés afin d’exclure les patients ayant eu des consultations antérieures de DL. Une valeur prédictive positive et un coefficient de Kappa élevés ont permis d’identifier une clairance optimale pour récupérer les cas véritablement incidents. Les coûts de consultations ont ensuite été calculés pour tous les patients incidents de 2003 à 2007 à partir des manuels de facturation. Nous avons observé une prévalence annuelle de la DL récurrente de 1,64 % en 2000 chez les hommes diminuant à 1,33 % en 2007. Cette baisse a majoritairement eu lieu dans le groupe d’âge des 35-59 ans. Les femmes âgées (> 65 ans) étaient 1,4 fois plus à risque de consulter un médecin de manière récurrente que les hommes du même âge. L’incidence annuelle de la DL en 2007 était de 242 par 100 000 personnes. Les hommes de 18 à 34 ans étaient 1,2 fois plus à risque que les femmes de développer un premier épisode récurrent et les personnes âgées 1,9 fois plus à risque que les jeunes. L’incidence annuelle a diminué de 12 % entre 2003 et 2007 pendant que les coûts totaux augmentaient de 1,4 %. La médiane des coûts était la plus élevée chez les femmes âgées et tendait à augmenter dans le temps. Ces analyses secondaires suggèrent de s’intéresser particulièrement à la DL chez les personnes très âgées, et de déterminer si la baisse de fréquence de consultations récurrentes observée dans le temps est liée à une meilleure gestion de la DL ou à un problème d’accessibilité. Les coûts devraient faire l’objet d’un suivi continu pour limiter les hausses. // Abstract : Low back pain (LBP) is one of the most frequent and costly musculoskeletal health conditions in Canada. Annual prevalence was found to vary between 19 % and 57 % and likely one out of four patients experience a LBP recurrence within one year. The body of knowledge on the prevalence of recurrent LBP is still limited. This study sought to present a descriptive analysis on the epidemiology of recurrent LBP in a medical population. A new methodology is also proposed to identify true cases of incident recurrent LBP. Since 10 % of LBP patients have been reported to generate 80 % of the costs, we will sought to determine the secular trend of medical costs for the incident cohorts of 2003 to 2008. Using the Canadian province of Quebec medical administrative physicians’ claims database, 401 264 prevalent claims-based recurrent LBP patients were identified between 1999 to 2008 for having consulted at least three times for LBP in a period of 365 days. The medical history of 81 329 prevalent patients in 2007 was screened for a retrospective period of 11 years. High positive predictive values and Kappa statistics were used to determine the optimal clearance period for capturing true incidence cases among patients with no prior encounters for LBP. Physicians’ claims manuals were then used to apply a price for every intervention provided to LBP incident patients in their index year and follow-up years. We observed a decrease from 1.64 % to 1.33 % in the LBP annual prevalence between 2000 and 2007 for men. This decrease was mostly observed between 35 and 59 years of age. Older women (≥ 65 years) were 1.4 times more at risk to consult a physician for LBP in a recurrent manner than older men. The annual incidence in 2007 of adult claims-based recurrent LBP was 242 per 100 000 persons. Males of 18 to 34 years of age were found 1.2 times more at risk than their counterparts. Altogether, elderlies were 1.9 times more at risk than young adults to consult in a recurrent manner for LBP. The annual incidence decreased by 12 % between 2003 and 2007, while the direct costs increase by 1.4 %. The median cost for consultations was highest for elder women and increasing in time. These secondary analyses emphasize the importance to keep the watch on the elders in regards to LBP, and to determine if the timely decrease in morbidity is related to improvements in LBP management or to a medical accessibility issue. Also, costs will need to be surveyed on a regular basis to limit the impact of future increases.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Background: Low back pain (LBP) is the most prevalent musculoskeletal condition experienced by human beings and the most common cause of disability in developed nations. Psychosocial factors, involving aspects of social and psychological behaviour, have previously been documented as potential risk factors in the development of adult LBP. However, more research is required to fully understand the role of psychosocial risk factors on the prevalence of LBP amongst adolescents. Objective: To determine the prevalence of LBP and to identify selected psychosocial risk factors associated with LBP amongst Grade 12 learners in the Greater Durban area. Methods: A population-based study was conducted amongst a stratified random sample of 20 public secondary schools in all three educational districts in the Greater Durban area. Data was collected by means of a structured questionnaire administered to the sample population consisting of Grade 12 learners. Using an exploratory research design, the individuals reported on demographics as well as prevalence, severity, frequency and chronicity of LBP. In addition, data was obtained regarding various psychosocial risk factors including depression, exam stress and anxiety, socio-economic status, family history of LBP, smoking, alcohol and drug abuse amongst the respondents. Results: The prevalence of LBP was 57.42% with a median frequency of 8 times a month. About a third (33.9%) of the respondents experienced difficulty bending whilst 35% reported that their LBP spread down to the legs below their knees. The daily activity most affected by LBP was having a good night‟s sleep (50.6%), followed closely by playing sports (47.4%) and concentrating in class (46.6%). The majority of the respondents that suffered from LBP had taken pain relief medication (47.1%) whilst only 21% of the respondents had missed school because of LBP. With regards to the psychosocial risk factors under investigation, three of the risk factors did not show any association to LBP. They included socio-economic status, smoking and recreational drug use. In contrast, five psychosocial risk factors showed an 6 association to LBP. They included alcohol abuse, family history, exam stress, anxiety and depression. Finally, after adjusting for all other risk factors for adolescent LBP, depression and high exam stress showed the strongest correlation with the occurrence of LBP amongst Grade 12 learners in the Greater Durban area. Conclusion: LBP amongst adolescents is a common problem that increases with age, representing a risk for LBP in adulthood. The researcher is of the opinion, that this illustrates the need for further investigations with more profound studies on the risk factors so that more light can be shed on how to manage this ever-growing problem.

This thesis examines the influence of active exercise according to the concept of the Dynamic Neuromuscular Stabilization on local sensory perception in the mid-thoracic spine in elite athletes - cross-country skiers. It also describes the most common health problems in these athletes and assesses the impact of the integration of active exercise according to the DNS concept into everyday practice of cross-country skiers on the intensity and frequency of pain in cervical, thoracic and lumbar spine. It also presents theoretical knowledge about the concept of the Dynamic Neuromuscular Stabilization and interdependence of quality of sensory and motor functions. Methods: The study included a total of 20 elite athletes - cross-country skiers aged 17- 27, randomly divided into two groups. The training group integrated into their practice selected three exercises according to the Dynamic Neuromuscular Stabilization targeting segmental motion in the thoracic spine. A total of five measurements were performed on the quality of sensory perception during two months for all athletes. Furthermore, we evaluated the immediate effect of the therapy in the test group through the examination of sensory perception before and immediately after the treatment. At the beginning and at the end of the study each athlete...

The main aim of the presented diploma thesis was to record objective and subjective changes after therapy with DNS concept in a group of 13 people with LBP. Moiré projection topography was used to record postural changes after 5.5 week therapeutic intervention. It was not clear, whether DNS exercise would help them to achieve visible postural changes and whether this technique is able to record these changes, which would mean that it is a suitable option for objectivisation of therapies focusing on correction of stabilisation and postural functions. Pedoscan was used for further objectivisation of the effect of DNS concept. The chosen correlate of the mentioned objective evaluation was Oswestry disability index, evaluating limitations of common everyday activities resulting from pain in the lower back, and the Numeric pain scale. Patients underwent 5 hour-long physiotherapeutic lessons, the recommended frequency of exercises in the household environment was 3-4 times per day. The probands exercised with the use of DNS concept according to the individual examination findings, especially in the area of the integrated spine stabilisation system. The data were statistically elaborated by Wilcoxon Signed-Rand test, which a non-parametric variant of the pair T-test. It is obvious from the results that...