M.Tech.

Thesis (M.Tech. (Chiropractic))--Technikon Witwatersrand, 2004. / Supervisor: Barrett Losco; co-supervisor: Pauline Moolman. Also available via World Wide Web.

Thesis (M. Phil.)--University of Queensland, 2002. / Includes bibliographical references.

Introduction: Back pain is very prevalent among all sectors of the population. The prevalence varies according to age, sex, occupation, and so forth. Children are regarded as less vulnerable to suffering this kind of musculoskeletal conditions. However, some studies have shown relatively high prevalence among schoolchildren and adolescents. Previous studies failed to conclude any association between back pain and sedentary lifestyle, which has already been categorized as an important factor by the WHO. A new review is required to incorporate the most up-to-date studies in order to give a more comprehensive view of this topic. Method: Several databases were used to retrieve relevant epidemiological studies, including cross-sectional studies, cohort studies and case-control studies, by using predetermined key words and objective selection criteria. The quality of each study was assessed by using several criteria. Results: A total of 12 studies were included in this review, including 5 high-quality studies. Two out of the 5 high-quality studies provided significant evidence of association between back pain and sedentary lifestyle. In total, 8 studies showed some association. There was thus limited evidence to show the effect of sedentary lifestyle on the development of back pain. Discussion: Different study designs (recall duration, age distribution, data collection and so on) were used in each study included in this review. The conclusion of this new review was consistent with some previous ones. The dose-response relation in these studies was not found. There were still not enough local studies to help the policy modification of back health of local children. Conclusion: There is currently some evidence to illustrate the association between back pain and sedentary lifestyle in school children and adolescents, but it is not conclusive. / published_or_final_version / Public Health / Master / Master of Public Health

The management of low back pain (LBP) has long been a challenge as it is a highly prevalent disease worldwide due to the lack of an apparent etiology and a conclusive therapeutic treatment. Heterogeneous groups of LBP patients with diverse medical backgrounds also complicate the problem. A clinical threshold is demanded to match the patients and treatments appropriately in order to maximize the treatment success rate. Besides, the assessments of disability and pain perception due to LBP made by self-evaluated questionnaires in current clinical setting are highly susceptible to subjective feeling and the memory of patients. LBP and spasm are closely related but little is known for the underlying physiology, especially the musculature of LBP patients with spasm. These problems exacerbate the difficulty in LBP rehabilitation further. Surface electromyography (sEMG) topography is a cutting- edge technology to assess the lumbar muscle in vivo non-invasively by illustrating the distribution of global muscle activity visually. sEMG topography has the potential application as an objective assessment tool for LBP rehabilitation. In present study, sEMG topography was used to address 1) the prognostic value of sEMG topography on LBP rehabilitation, 2) the establishment and validation of a clinical classification threshold for identification of LBP patients who are responsive to exercise therapy and 3) the investigation of sEMG topography in accordance with the physiological outcomes (functional disability, pain perception and spasm). Forty-five healthy subjects and fifty patients with chronic non-specific LBP were enrolled to the study. sEMG test was conducted to every subject under the motions of lumbar flexion and extension in order to gather the myoelectric signals by a 16-channel sEMG. Various sEMG topographic parameters (sEMG parameters) were developed for quantitative analysis of sEMG topography. They were Root-Mean-Square-Difference of Relative Area (RMSD RA), Relative Width (RMSD RW) and Relative Height (RMSD RH) at flexion and extension. Results showed that sEMG parameters were of significant prognostic value for LBP patients towards exercise therapy. A clinical threshold of 0.21 was proposed and validated based on the geometric calculation of RMSD RA and RMSD RW at flexion and extension. The threshold was substantiated to increase the success rate of exercise therapy from 46% to 86% when the value measured by sEMG topography was below 0.21. sEMG parameters were found significantly associated with disability and pain perception in a positive manner. Severer disability and pain perception were represented by larger values of sEMG parameters. sEMG topography demonstrated symmetric patterns for patients with or without spasms on bilateral sides of lumbar muscles. The symmetry in sEMG topography evinced the consistency of the musculature of bilateral lumbar muscles while the lost of symmetry might indicate malfunction of lumbar muscles unilaterally. To conclude, this study corroborated versatile roles of sEMG topography in LBP rehabilitation as a prognosis, clinical threshold, and objective measurement. The findings of this study have paved the way of sEMG topography for future application in clinical setting. A study of larger scale would be recommended to complement the present findings. / published_or_final_version / Orthopaedics and Traumatology / Master / Master of Philosophy

There is currently little primary data looking at the epidemiology of back pain in older people and there are few large-scale population based studies which consider the occurrence or aetiology of back pain within this age group. Some evidence suggests that while non-disabling back pain decreases in the oldest old, the prevalence of disabling back pain may continue to increase. However, the aetiology of back pain in this group remains relatively unknown. Therefore, the overall aim of the current thesis was to investigate the epidemiology of back pain in older people, to examine the occurrence of back pain and age-related patterns in prevalence and incidence (descriptive epidemiology) and to identify potential risk factors for predicting back pain onset in those ≥75 years, specifically, to determine the role of social networks (analytical epidemiology). This was done through secondary analysis of a prospective cohort study from Cambridge looking at older people ≥75 years. It has been shown that while the prevalence of non-disabling back pain did not vary significantly across age, the prevalence of disabling back pain increased with age. In addition, it has been demonstrated, firstly, that aspects and indicators of physical health and a prior history of back pain are associated and independent predictors of back pain in older people; and secondly, that while objective measures of social contact are not risk markers for back pain, low mood, feelings of social isolation and depression are more strongly associated. These findings were further verified and confirmed in a second study, a cross-sectional survey of people ≥65 years living in rural Scotland. It can therefore be concluded that back pain is a common problem in the older population and, while mild back pain may remain constant across older age, disabling back pain continues to increase into the oldest old. The risk profile for back pain in older age is multifactorial, while some risk factors evident in younger populations remain; there is greater emphasis on the impact of mood and psychosocial factors.

Introduction. Low back pain is an important public health problem affecting 70-85% of the population worldwide and is a common cause of work-related disability. At Edendale Hospital, the physiotherapy nursing case load related to the management of low back pain increased from 30% to 45% over the past 3 years. The risk factors for low back pain at Edendale Hospital remain unclear and it is not clear whether low back pain is more prevalent in certain wards. Knowing the risk factors contributing to the prevalence of low back pain at the Hospital will assist nursing and hospital managers to plan appropriate interventions to minimize the occurrence. Methods. An observational cross sectional study with an analytic component was implemented. Data was collected utilizing a self- administered questionnaire to determine the prevalence of low back pain amongst nurses at the Hospital. Bivariate analyses and logistic regressions were performed to determine the risk factors associated with low back pain. Results. The point prevalence of current low back pain was 59%, of chronic low back pain was 47% and occupational low back pain was 57%. Logistic regression revealed bending and working in orthopaedic, surgery, paediatrics, obstetrics and gynaecology is significantly associated with low back pain. Conclusion. Occupational factors are strongly associated with low back pain. Thus workplace interventions are required. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2010.

Thesis (Ph. D.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 278-292). Also available in print.

Thesis (M.S.)--Florida State University, 2005. / Advisor: Dr. Jeanne Flannery, Florida State University, School of Nursing. Title and description from dissertation home page (viewed June 16, 2005). Document formatted into pages; contains x, 117 pages. Includes bibliographical references.

Thesis (M.P.H.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 63-72).