A descriptive quantitative cross-sectional survey using convenience sampling was used to gather data with a self-administered questionnaire on a sample of 226 nurses. The study population included all registered nurses of Kabgayi District Hospital and Nyanza District Hospitals and their respective health centers. To be included, the nurses had to have suffered from WRLBP during the previous 6 months before data collection. The Nordic Back Pain Questionnaire, the Oswestry Disability Index and an open-ended questionnaire regarding perceived risk factors have been used. Descriptive statistics to summarize data and inferential statistics such as chi- square test to test the relationship between different variables of the study have been studied at 5% levels. Correlation coefficients in terms of cross-tabulation were also studied at 1% level of significance.

A descriptive quantitative cross-sectional survey using convenience sampling was used to gather data with a self-administered questionnaire on a sample of 226 nurses. The study population included all registered nurses of Kabgayi District Hospital and Nyanza District Hospitals and their respective health centers. To be included, the nurses had to have suffered from WRLBP during the previous 6 months before data collection. The Nordic Back Pain Questionnaire, the Oswestry Disability Index and an open-ended questionnaire regarding perceived risk factors have been used. Descriptive statistics to summarize data and inferential statistics such as chi- square test to test the relationship between different variables of the study have been studied at 5% levels. Correlation coefficients in terms of cross-tabulation were also studied at 1% level of significance.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

INTRODUCTION: Low back pain (LBP) is often exacerbated by movement and, during functional movements, people with LBP tend to inherently modify their posture and movement patterns to avoid aggravating their pain further. Therefore, analysis of spinal movement in people with LBP is necessary and may lead to the identification of movement-based clusters for optimal treatment. PURPOSE: The overall purpose of this study was to investigate how movement patterns in people with chronic LBP relate to their subjective level of pain-related disability. First, we determined which spinal movements best discriminate between people with chronic LBP and asymptomatic controls; second, we ascertained whether the level of movement dysfunction in people with chronic LBP correlates with the Oswestry Disability Index (ODI). METHODS: 44 volunteers (26 with current chronic LBP, 15 asymptomatic controls) participated in this study. An OPAL (APDM Wearable Technology) inertial measurement unit (IMU) sensor was attached to the skin over the spinal region of L3-L4, which allowed for transmission of motion data from the lumbar spine. Participants were instructed to perform a series of eleven uniplanar and functional multiplanar spinal movements at a comfortable pace. The median peak angular velocity values from the lumbar spine (measured by the gyroscope component of the IMU) were extracted from MATLAB and Python, and all statistical analyses were subsequently performed in RStudio. RESULTS: From a mixed-direction stepwise regression based on the minimization of the Aikake Information Criterion (AIC), a binomial logistic regression model containing kinematic data from Flexion, Extension-Twist, Axial Rotation, and Sit-to-Stand tasks was selected as the best model to predict chronic LBP status (McFadden’s pseudo-R-squared: 0.310). Moreover, compared to sagittal uniplanar tasks, functional multiplanar movements were better at predicting LBP status (AICmulti-uni = −3.2). Lastly, we found no association between the kinematic data from the movements that best predicted LBP status and ODI scores (p-value = 0.405). CONCLUSION: In this study, we found no correlation between self-reported disability and kinematic median peak angular velocity data from Flexion, Extension-Twist, Axial Rotation, and Sit-to-Stand tasks. Therefore, other factors that may modulate physical function, such as psychosocial factors, should be investigated.

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Magister Scientiae (Physiotherapy) - MSc(Physio) / Low back pain is one of the most frequent health problems and also one of the most prevalent musculoskeletal disorders. It’s the leading reason for activity limitation and job absenteeism which leads to huge economic burden on persons, society, industry and governments. Women are more susceptible to low back pain due to hormonal effects, differences in reporting of somatic symptoms and greater sensitization of pain. The aim of this study was to determine the impact of low back pain on activities of daily living and quality of life of adult women attending Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. The following objectives were addressed, namely to determine pain intensity, functional disability and quality of life of adult women as well as to explore the activities of daily living that may contribute to low back pain. A sequential explanatory mixed method approach, comprising of a cross-sectional descriptive and explorative design for the quantitative and qualitative phases respectively, was employed in the study. A self-administered questionnaire consisting of four sections (socio-demographic information, the Nordic Musculoskeletal Questionnaire, the Oswestry Disability Index Questionnaire and World Health Organization Quality of Life Tool) was completed by two hundred and thirty-four adult women with a mean age of 38.54 years (SD=9.40). Twenty-six women participated in the focus group discussions. Results of the study indicate that 94.6% of the women had experienced low back pain in the past year while 90.1% had low back pain in the past seven days. In addition, more than half of the women (52.3%) experienced moderate pain intensity. Almost three quarters (68.1%) of the participants who experienced pain in the past year reported that low back pain prevented them from carrying out their activities of daily living. Half of the participants (50.2%) had moderate disability. A significant positive correlation was found between pain and disability (r = 0.426; p = 0.000) while a non-significant negative correlation was found between low back pain and quality of life (r = -0.058; p = 0.390). The qualitative results showed that women have difficulty in performing certain activities of daily living i.e. personal hygiene, sitting, standing and housework due to low back pain. A significant correlation was found between pain intensity, disability and quality of life. Such correlations advocate towards the bio-psychosocial model in management of low back pain. There is a need to invest in primary-based health care to include low back pain and its related risk factors, in order to advise the affected population on appropriate and essential prevention strategies. Future interventions should focus on enhancing physical health and psychosocial stress in women with low back pain.

ABSTRACT Specific Exercises as a Secondary Preventative Intervention Programme for Low Back Pain in 12-13 year old Children Gina Lucia Fanucchi Supervisors: Dr Ronél Jordaan, Prof Aimee Stewart Many recent large epidemiological studies have shown that the incidence of non-specific low back pain (LBP) in adolescents is very similar to that in adults, and that LBP in children is predictive of LBP in adults. As a result, it has been suggested that programmes targeting the prevention of LBP should be implemented early. However, there is currently very limited literature available on LBP preventative interventions during childhood. Therefore, this study aimed to determine the efficacy of an eight-week specific exercise programme in reducing self-reported episodes and intensity of LBP, as well as modifying some of the identified risk factors for LBP in children. A randomised control trial was used. Seventy-two 12-13 year old children, who had complained of LBP in the past three months, were included in the study. The intervention group completed an eight week school-based specific exercise programme, whilst the control group continued with normal school activity during this time. Data were collected at baseline, immediately post-intervention and at three months post-intervention, using a valid, reliable questionnaire and physical measurements. Treatment groups were compared with respect to change from baseline to postintervention, using an analysis of covariance (ANCOVA) with baseline values as covariates. Testing was done at the 0.05 level of significance. Significant improvements were observed in the exercise group for LBP prevalence (p=0.02), pain intensity VAS (3 months) (p<0.01) and VAS (1 month) (p=0.01), neural mobility (p<0.00001), hamstring flexibility (p<0.00001), iliopsoas flexibility (p<0.001) and lumbosacral position sense (p=0.01), immediately post-intervention, as well as three months post-intervention. Therefore, it can be concluded that specific exercises are beneficial in the prevention of LBP in 12-13 year old children. In addition, specific exercise programmes should be implemented early, ideally as an integral component of school physical education programmes.

A lombalgia, comum em muitas atividades profissionais acomete principalmente indivíduos que trabalham na condução de veículos motorizados. O objetivo deste estudo foi investigar a prevalência da lombalgia em motoristas de caminhão, bem como os fatores de risco relacionados à sua ocorrência. Para isso foi elaborado um questionário que abordou fatores como: idade, prática de atividade física e esportiva, hábitos gerais de saúde e questões relativas ao exercício profissional. Calculou-se também o índice de massa corpórea através da relação entre o peso corporal e o quadrado da estatura. Foram avaliados 489 caminhoneiros do sexo masculino e selecionados 410 para o estudo. Os resultados obtidos foram: a prevalência da lombalgia em 59% dos caminhoneiros; e dentre as variáveis estudadas apenas o número de horas de trabalho mostrou-se estatisticamente significante, sendo que o risco do caminhoneiro ter dor lombar aumenta 7% para cada hora de trabalho. / Low back pain is common in several kinds of professional activities mainly in people who drive a lot in their job. The aim of this study was to evaluate the prevalence of low back pain in truckers and the risk factors related to the occurrence of lumbar pain. For this, a questionnaire was elaborated including such as: age, physical and sports activities, general health habits and aspects related to the job. Besides, the index of corporal mass has been calculated, based on the relation between the truckers weight and his square height. 489 male truckers were evaluated and 410 have been selected for the study. The results showed that 59% of the truckers have suffered from low back pain, and among the different aspects which have been analysed, only the number of working hours has been more significant: for each working hour, the risk of truck driver in having lumbar pain increases 7%.

Les troubles musculo-squelettiques figurent parmi les principales causes d’arrêt de travail. Le mal de dos appelé aussi lombalgie est une des pathologies les plus fréquentes. La lombalgie est considérée aujourd’hui comme un véritable problème de santé publique. Les répercussions socio-économiques conséquentes résultent des lombalgies persistant plus de trois mois (lombalgies chroniques) qui affectent pourtant une minorité de sujets (moins de 10% des lombalgiques).Face aux coûts aussi importants de la lombalgie chronique et au regard du peu d’efficacité des traitements usuels, la recherche de prises en charge spécifiques se justifie. Aussi, l’objectif principal de ce travail est d’analyser les cinétiques de déconditionnement et de reconditionnement du rachis chez des sujets lombalgiques et, parallèlement, d’apprécier les effets d’un programme intensif et dynamique de restauration fonctionnelle du rachis sur différents profils de sujets lombalgiques (homme et femme, avec ou sans chirurgie, sédentaire ou actif, avec une douleur initiale élevée ou faible à modérée). Ce travail s’intéresse aux effets du temps, de l’entraînement ou du réentraînement et de facteurs spécifiques sur une population de sujets lombalgiques chroniques. Le reconditionnement des sujets lombalgiques chroniques est constaté à l’issue de 5 semaines de prise en charge (175 heures) dans un programme de restauration fonctionnelle du rachis (RFR). L’évaluation de ce type de programme confirme bien l’efficacité sur les plans physique, fonctionnel, psychologique et professionnel d’un programme multidisciplinaire dynamique et intensif de type RFR, proposé pour des sujets lombalgiques chroniques dont le niveau de déconditionnement est avancé mais stabilisé. Cette issue thérapeutique, bien que très coûteuse, conserve ses bénéfices jusqu’à 12 mois post-traitement et peut représenter une alternative intéressante à la chirurgie. La douleur intense prétraitement des sujets lombalgiques chroniques ne constitue ni un frein, ni une variable prédictive des réponses au programme. Des habitudes de vie physique active ou sportive sont recommandées chez les sujets lombalgiques chroniques souhaitant bénéficier d’une prise en charge RFR. / Musculoskeletal disorders are among the leading causes of sick leave or work injuries. Low back pain (LBP) is one of the most frequent disability and remains a public health issue. The consequent socioeconomic impact results from low backpain lasting more than three months (chronic low back pain) which nevertheless affects a minority of people (less than 10 % of the low back pain population). Seeing the importance of chronic low back pain costs and the poor efficiency of usual treatments, the research for specific care is justified. Thus, the main objective of this work is to analyze the kinetics of reconditioning and reconditioning of the spine in chronic low back pain patients and, at the same time, to appreciate the effects of an intensive and dynamic functional restoration program on various profiles of chronic low-back pain patients (male or female, with or without surgery, sedentary or active, with a high or a low to moderate initial pain). Thus, this work deals with the effects of time, of training or retraining and of specific factors on a chronic low-back pain population. The reconditioning of chronic low-back pain patients is noticed at the end of a fiveweek functional restoration program (175 hours). The assessment of this type of program indeed confirms the physical, functional, psychological and professional efficiency of a dynamic and intensive multidisciplinary program such as RFR program, proposed to chronic low back pain patients whose deconditioning level is advanced but stabilized. This therapeutic outcome, though very expensive, is still valid 12 months after the post-treatment and can represent an interesting alternative to the surgery. The pre-treatment of severe pain in chronic low back pain patients, does not constitute either an obstruction, or a predictive variable of the program performances. Having an active, physical and sporting life is recommended for chronic low back pain patients before treatment or to benefit from specific care.