Propósito: Analizar si la adición de un espaciador interespinoso o la fusión intersomática ofrece ventajas en relación con la microdiscetomía aislada en el tratamiento de la hernia discal lumbar. Métodos: Pacientes con hernia de disco lumbar que iban a someterse a cirugía fueron elegidos para participar. En este estudio de cohorte los pacientes se dividieron en 3 grupos; Microdiscectomía sola (MD), microdiscectomía más espaciador interespinoso (IS) y fusión intersomática lumbar posterior (PLIF). La medida de resultado primaria fue la eficacia clínica mediante el índice de discapacidad de Oswestry (ODI). También evaluamos varios otros parámetros de resultado, entre los que se incluyeron: escala analógica visual para el dolor (EVA) de espalda y piernas, duración de la estancia, coste desde el ingreso hasta el alta hospitalaria, tasa de complicaciones de 90 días y tasa de reoperación tras 1 año. Resultados: Se incluyeron un total de 103 pacientes cuya edad media fue de 39,1 (± 8,5) años. En los 3 grupos se detectó una mejora significativa de la puntuación inicial del dolor de espalda y piernas con ODI y EVA. Las puntuaciones del ODI cambiaron de 62.66 a 13.77 en el grupo MD, 62.93 a 13.50 en el grupo IS, y 59.62 a 17.62 en el grupo PLIF (p <0.001). Después de 1 año, no se encontraron diferencias significativas en el ODI, ni en la EVA de espalda y piernas entre los 3 grupos. Hubo un aumento del 169% en el coste hospitalario en el grupo IS y del 287% en el grupo PLIF, en relación con la MD (p <0,001). La duración de la estancia fue un 86% mayor en el grupo IS y un 384% más en el grupo PLIF en comparación con MD (p <0,001). Las tasas de reoperación a 1 año fueron de 5,6%, 10% y 16,2% (p = 0,33) en los grupos MD, IS y PLIF respectivamente. Conclusión: La mejoría clínica parece deberse a la microdiscectomía, sin que el implante (interespinoso o fusión) agregue ningún beneficio. La adición de espaciador interespinoso o fusión no protegió contra la reoperación, y aumentó la duración de la estancia hospitalaria y los gastos quirúrgicos.

Bakgrund: Graviditetsrelaterad bäcken- och/eller ländryggssmärta kan bero på hormonella och biomekaniska förändringar som vanligen efter förlossningen. Dock kan kvinnor få ihållande smärtbesvär vilket kan påverka funktion och livskvalitet. Bäckenbottenträning, statisk bålträning och dynamisk bålstabiliserande träning har liknande effektmekanism för smärtlindring. Riktlinjer kring fysisk träning efter förlossning saknar en uppdaterad evidensbild för dess smärtlindrande effekt. Syfte: Syftet var att sammanställa evidensläget samt bedöma evidensstyrkan för den smärtlindrande effekten av bäckenbottenträning, statisk bålträning samt dynamisk bålstabiliserande träning vid smärta i bäcken- och/eller lumbalregion efter förlossning.  Metod: En systematisk litteraturöversikt genomfördes med artikelsökning på databaserna PubMed, Cinahl, PEDro och Cochrane. Varje artikel granskades enskilt av respektive författare utifrån en granskningsmall innan en gemensam sammanställning utfördes. Evidensgradering utifrån varje träningsform genomfördes med GRADE. Resultat: Nio randomiserade kontrollerade studier inkluderades med 499 kvinnor där fysisk träning visades ge en smärtlindrande effekt på postpartumsmärta i bäcken- och/eller ländrygg med genomsnittlig metodologisk kvalitet på 50 poäng. Dynamisk bålstabiliserande träning inkluderade sex studier och bäckenbottenträning två studier, samtliga med låg tillförlitlighet (⨁⨁◯◯). Statisk bålträning inkluderade en studie med mycket låg tillförlitlighet (⨁◯◯◯) enligt GRADE. Konklusion: Fysisk träning kan användas som behandling vid postpartumsmärta i bäcken- och/eller ländrygg. Evidensgraden behöver höjas genom fler studier, fler deltagare och blindad resultatuppföljning. / Background: Pregnancy-related pelvic girdle pain and/or low back pain is commonly caused by hormonal or biomechanical changes and tends to disappear after giving birth. However, some women are affected by the pain for an extended period, which will affect their functional status and quality of life. Pelvic floor exercises, static core exercises and dynamic core stabilisation exercises have a similar mechanism behind the pain-relieving effect. Guidelines for physical exercise after childbirth lack an updated picture of evidence for the pain-relieving effect. Purpose: The purpose of this review was to gather evidence and evaluate the strength of the evidence in relation to the pain-relieving effect of pelvic floor exercises, static core exercises, and dynamic core stabilisation exercises on pelvic girdle pain and/or low back pain after childbirth. Method: A systematic literature review was carried out and articles were gathered from the databases PubMed, Cinahl, PEDro and Cochrane. Each article was analysed individually by each author using a review template before a collective assessment was made. GRADE was used to rate the evidence for each form of physical exercise.  Results: Nine randomised controlled trials were included with 499 women where physical exercise was used to try and treat postpartum pelvic girdle pain and/or low back pain with a mean methodological quality of 50 points. Six studies evaluated dynamic core stabilisation exercises and two reviewed pelvic floor exercises, all with an overall low reliability (⨁⨁◯◯). Static core exercise was assessed in one study with very low reliability (⨁◯◯◯) according to GRADE. Conclusion: Physical exercise can be used as a treatment for pelvic gridle pain and/or low back pain postpartum. The level of evidence for each form of physical exercise needs to increase through more studies, more participants and blinded outcome follow-up.

The diploma thesis evaluates the morphology of the abdominal wall muscles focusing on the assessment of lateral symmetry in elite female floorball players and its relationship with the occurrence of back pain in these players. The theoretical part of the thesis includes an overview of the physiological mechanisms of postural stabilization in comparison with deviations in patients with back pain and describes the principles of sonographic examination and its use in physiotherapy. The theoretical part is also focused on the imagining of the abdominal muscles and the summary of specific findings in floorball players and other athletes, with a predominant one-sided load related to the biomechanics of movement in these sports. Methodology: A total of 20 female players of the highest floorball competition in the Czech Republic participated in this research. The linear parameters of the abdominal muscles (m. RA, m. TrA, m. OI and m. OE) and the whole lateral abdominal muscles were measured in players on both sides at rest using sonography. The participants also filled in an electronic questionnaire evaluating back pain. Results: Significant lateral asymmetry of linear parameters of abdominal muscles was demonstrated in the work (p = 0,017; d = 0,52). The relationship between the lateral asymmetry and the...

No description available.

Design: A single-blinded, cross-sectional observational study. Objectives: Examine muscle cross-sectional area and symmetry of the lumbar multifidus muscle in elite ballroom dancers with and without low back pain (LBP). Background: The incidence of LBP among elite ballroom dancers is high and at Brigham Young University is 57%. Previous research has linked lumbar multifidus muscle atrophy to low back pain; however this relationship has not been examined in ballroom dancers. Methods and Measures: Lumbar multifidus cross-sectional area was assessed at rest on the right and left side at levels L1-L5. Thirty-seven subjects (age 24 ± 3.2 years; height, 172.8 ± 11.3 cm; mass, 54.6 ± 4.5 kg) were divided into one of three groups. Participants who reported LBP severe enough to interfere with dance training and daily living were allocated to the LBP group (reported pain at rest, during dance, and following dance) (n=15). Subjects who reported LBP that was not strong enough to interfere with training and daily living were allocated to the minimal pain group (reported pain during dance and following dance) (n= 6). And those who reported no back pain were put into the no pain group (n=16). Results: There were no significant difference in demographics between the groups (P>0.05). There was no significant difference between groups in multifidus cross-sectional area (P = .437). Asymmetry was found in all groups with the left side being larger than the right (P < .002). Conclusion: This study provides new information on lumbar multifidus cross-sectional area in elite ballroom dancers. Future research needs to examine other causes of LBP in elite ballroom dancers in an attempt to decrease LBP in these athletes.

Low back pain (LBP) has a global impact on health and is a substantial contributor to long term disability. The economic burden of LBP is immense and it is advancing annually. Costs attributing to LBP in the United States is about $84.1 to $624.8 billion. Physical therapy is commonly recommended for those with LBP since it is linked to improved clinical outcomes. However, patient perceptions can influence how this treatment approach is perceived. It is unclear if these perceptions can influence outcomes for patients suffering from LBP. Therefore, the purpose of this study is to identify the factors associated with positive or negative perceptions of physical therapy care in those with LBP. This was accomplished by developing and administering a comprehensive Qualtrics survey to participants in the Orlando area. Participants who took the survey were screened for eligibility requirements with exclusion criteria being those from vulnerable populations including pregnant women, minors, prisoners, and any person unable to provide informed consent. Screening, demographic, clinical, and perception questions were embedded within the online survey. Those who participated had to be 18 years or older, located within the Orlando area, able to provide informed consent, and speak English. Results from the data identified the five top key indicators which included clear explanation by the physical therapist on the treatment plan, how clear the physical therapist is in explaining the problem, friendliness of the physical therapist, patients perceive physical therapy is very effective in treatment of knee, and patients perceive physical therapy is very effective in treatment of lower back.

No description available.

The purpose of this study was to investigate the effectiveness of Kinesio-Taping (KT) in golf-induced chronic low-back pain management. The golfing population continues to grow each year, and the risks of golf-induced chronic low back pain (CLBP) remain high. The Kinesio-taping technique is a non-invasive treatment intervention utilized in sports injury rehabilitation and prevention. Due to the lack of research on KT in golf-related injuries, this study addresses the injury mechanism of golf-induced CLBP and the proposed physiological mechanism and therapeutic effects on the musculoskeletal system of KT. This study is a comprehensive review of the golf swing, prevalence and risk factors of golf induced CLBP, treatment modalities for non-specific low back pain, and the use of KT in sports medicine and healthcare settings. The target population of this study includes active adults and older adults who are at risk or currently experiencing CLBP and those who may golf professionally or recreationally. The literature search (February- October 2022) was performed using multiple databases, including UCF Libraries, PubMed, GoogleScholar, SagePub, ScienceDirect, and Ebscohost. Keywords employed by this research include "low back*" "golf*" or "golf swing*" "Kinesio-tape*" or "Kinesio-taping*" and "pain*" or "injury*". Search results were carefully screened, and relevant literature was selected for this study. A total of 78 scientific studies were included in this review. This literature review found insufficient empirical evidence to support the application of KT in golf-induced low back pain management. Although the subjects' contextual effects should not be overlooked, the reasoning behind how KT physiologically affects target injury sites remains unclear. Further research is suggested to examine the effectiveness of KT in treating golf induced CLBP.

Bakgrund: Smärta som lokaliseras till ländryggen drabbar upp till 80% av alla människor någon gång under livet och är således ett stort problem för både individ och samhälle. Manuell terapi (MT) och olika typer av träningsinterventioner (TI) är två vanligt förekommande behandlingar som fysioterapeuter världen över använder sig av. Långtidseffekten av manuell terapi är ett relativt outforskat område vilket denna litteraturstudie hoppas kunna bidra med ny kunskap till. Syfte: Att undersöka och sammanställa manuella terapiers långtidseffekter på ospecifik ländryggssmärta (LBP) i jämförelse mot olika träningsinterventioner. Kvalitetsgranska inkluderade studier med PEDro samt bedöma tillförlitligheten med GRADEstud. Metod: Genomförande av en systematisk litteraturöversikt genom formulering av PICO. Systematisk sökning i databaserna Pubmed och PEDro. Totalt inkluderades 7 studier som kvalitetsbedömdes med PEDro och granskades med GRADEstud för bedömning av resultatens tillförlitlighet. Resultat: Kvaliteten enligt PEDro varierade mellan medelgod och hög. Samtliga studier observerade positiva effekter av både manuell terapi och träningsinterventioner. 5 av 7 studier fann en signifikant skillnad vid kortidsuppföljning och 2 av 3 studier fann signifikanta långtidseffekter. Den sammanvägda tillförlitligheten till resultatet enligt GRADEstud ansågs vara av mycket låg (+) till låg (++) kvalitet. Slutsats: Resultatet i studien pekar på att både MT och TI kan ha positiva effekter gällande smärtlindring på både kort och lång sikt med svag evidens. Mer högkvalitativ och homogen forskning behövs inom området innan tydliga och välgrundade rekommendationer kan göras. / Background: Low back pain (LBP) affects up towards 80% of people during their life and constitute a problem for both the individual and society. Manual therapy (MT) and different exercise interventions are two common interventions used by physiotherapists. The long-term effect of manual therapy is a rather unstudied area, which this study aims to contribute to with new information. Objective: To research and compile manual therapy’s long-term effects on non-specific low back pain compared to different types of exercise interventions. Also examine the quality of included studies using PEDro and to assess the reliability using GRADEstud. Method: This systematic review implemented and structured questions according to PICO. A systematic search through two databases, Pubmed and PEDro. A total of 7 studies where included whose quality was assessed using PEDro. GRADEstud was used to assess the reliability. Results: The quality of the studies ranged through average to high quality. All studies observed positive effects of both manual therapy and exercise interventions. 5 out of 7 studies found significant differences on short-term outcomes while 2 out of 3 found significant long-term differences. The reliability was considered low (++) to very low (+). Conclusion: The result of this systematic review indicates that both manual therapy and exercise interventions can produce positive effects on pain in short and long-term outcomes with low quality evidence. More high-quality evidence and homogenous research is needed on this area before any clear or well-grounded recommendations can be made.

The second most common lumbosacral diagnosis in the United States is a herniation or prolapse of the intervertebral disc. Individuals with herniated discs can have a wide variety of clinical presentations, ranging from asymptomatic to severe spinal cord compression and pain. Studies suggest that an individual’s pre-existing perception of a condition is likely to influence their course of recovery. Currently, perceptions the general public holds regarding the consequences of disc herniation is unknown. Therefore, the purpose of this study was to assess current views regarding disc herniations in the general population with their reported prevalence and clinical outcome. This was determined via an electronic Qualtrics survey. This survey included demographic questions, medical history questions, disk herniation perception questions, and coping/resilience questions. Upon conclusion of survey administration, data analysis was performed via JASP. A key finding of this study was that resilience levels play a major role in participant’s views on herniated intervertebral discs (p=0.040). Participants with greater resilience levels had views on disc herniations that were more consistent with the findings in the literature (p=0.018). This may implicate low resilience levels in negative catastrophizing, which can impair the recovery process for patients. Due to this, healthcare providers should further consider a patient’s mental characteristics such as resilience and coping style when administering treatment. By further educating patients on their specific prognosis for a disc herniation, providers may be able to improve their overall perception of herniated discs, leading to a possible improvement in outcome.