INTRODUCTION: While the impact of back pain on morbidity in older adults is well-understood, the influence of back pain on mortality is unclear. Back pain is the leading cause of disability worldwide, and disability is associated with elevated risk of mortality. Thus, we hypothesized that older women with persistent back pain would have a higher risk of mortality over 16-years of follow-up, compared to those with no back pain among participants in the Study of Osteoporotic Fractures (SOF), a large multisite cohort study. Furthermore, we hypothesized that limitations of Instrumental Activities of Daily Living (IADLs) would mediate a greater proportion of the mortality risk, compared to two objective measures of physical function, walking and chair stand speed. METHODS: The analytic sample included 8,321 SOF participants (mean age 71.5, SD=5.1) who answered back pain questions at baseline (1986–87) and visit 2 (1989–90). We created a four-category back pain variable by combining responses at two interviews (baseline and visit 2). Categories included: no back pain (24%), non-persistent back pain (23%), and infrequent (44%) or frequent (9%) persistent back pain. Participants were followed from visit 2 through visit 9 (2006–08). Death was confirmed with receipt of death certificates. Using Cox-proportional hazards, we calculated hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cause-specific mortality with the ‘no back pain’ participants as our reference group. We adjusted for age, sociodemographic characteristics, self-reported general health, smoking status, comorbid conditions (e.g., prevalent vertebral fractures, osteoarthritis, hip pain, diabetes, hypertension), previous stroke, history of breast cancer, hospitalizations and falls in the previous year. We evaluated self-reported IADL limitations, slow walking speed, and slow chair stand time as a priori mediators of back pain and subsequent mortality. RESULTS: A total of 4975 women (55.8%) died over the follow-up period. A higher proportion of women with frequent persistent back pain died (65.8%) compared to those with no back pain (53.5%) (adjusted HR = 1.24; 95% CI 1.11 to 1.39). We observed an increase in cardiovascular (adjusted HR = 1.34; 95% CI 1.12 to 1.62) and cancer (adjusted HR = 1.33; 95% CI 1.03 to 1.71) mortality. No increased risk was observed for other back pain groups. A larger proportion of the association was mediated by IADL limitations (47%), compared to poor performance on chair stand (27%) and walking speed (24%). CONCLUSION: Compared to older women with no back pain, those with frequent persistent back pain had an increased risk of mortality, which underscores the importance of developing safe interventions to address and prevent this condition. Therapies that address IADL limitations or improve physical function (e.g. walking speed, chair stand) may be ideal for preventing early death in individuals with back pain. / 2020-03-17T00:00:00Z

The research was aimed at the effect of kinesitherapy on children aged 4-7 years with spinal disorders in the frontal and sagital plane. The research took place in kindergarten, 30 children were evaluated and separated in two groups: children with spinal disorders in the frontal plane (scoliosis) and children with spinal disorders in the sagital plane (hiperlordosis, hiperkyphosis). Children with selected features were trained with special active and passive exercises 8 months (3 times per week). The change of spinal disorder degree in the frontal and sagital plane were controlled with special measuring device Sabia’s scoliometer. The measurements were evaluated before training and after it. On the grounds of the findings it can be concluded that kinesitherapy was effective on children with spinal disorders in the frontal plane (I° scoliosis). The degree of scoliosis markedly decreased. The kinesitherapy was less effective on children with spinal disorders in the sagital plane. The quantity of hiperlordosis and hiperkyphosis decreased insignificantly.

Book Summary: Serves the needs of advanced practice nurses because it’s written by nurse practitioners for nurse practitioners, in collaboration with a physician. Organizes content around the Circle of Caring framework for nursing-based knowledge and holistic care. Explores complementary and alternative treatments for each disorder. Covers the broadest range of human disease and disorders using a systems-based approach, presenting both common complaints and common problems to help students narrow down the possible differentials to the most likely diagnosis. Considers interactions of pharmaceuticals with alternative medications and nutraceuticals. Features coverage of pathophysiology and diagnostic reasoning as well as up-to-date guidance on laboratory and diagnostic tests. Emphasizes evidence-based practice with information on evidence levels and more references to primary studies. Integrates discussions of health policy and primary care throughout the text.

The Behavioral Medicine Questionnare (BMQ) is a 44- item instrument administered via a computer CRT display or pencil and paper. The BMQ was designed to help primary care physicians treating spinal disorders to screen for emotional factors which warrant further psychological evaluation. The test is composed of three scales: Anxiety, Depression, and Somatization. Concurrent validity for each scale was determined through comparisons with subject (n = 133) scores on clinician judgement ratings, pain drawings, and the MMPI. The psychometric properties of the test were supported through statistical analysis. Significant correlations were found between the BMQ, MMPI, and clinician ratings, with the latter showing relationships of lesser strength. The only significant correlation to subject generated pain drawings was to the BMQ depression scale. Analysis indicated the need for seperate norms for males and females. Further research is needed to facilitate measurement and interpretation of the BMQ.

When implementing a managed healthcare intervention among a working population, evidence-based healthcare is critical. In the current study, the change of work posture of sewing-machine operators from seated to stand-up (the intervention) was managed within a physiotherapy and ergonomics programme (programme) in Johnson Controls Automotive S.A. (Pty) Ltd (company) without local evidence to guide the postural transition. The management of the intervention, implemented over a period of 4.5 years, presented the opportunity for a retrospective longitudinal study. The study determined the impact of the change in work posture on the incidence of work-related musculoskeletal disorders (WRMSDs) from June 2004 to January 2009 (period). The role of the physiotherapist in the programme was to deliver manual therapy to all sewing-machine operators with WRMSDs, and to provide a clinical - ergonomics service, as a member of a multidisciplinary team, to the company. The population of sewing-machine operators (n=123) was described in terms of personal factors (e.g. age, medical history, musculoskeletal history, and body mass index (BMI)), ergonomic risk factors (e.g. work posture, force and duration) and overall incidence of WRMSDs. The associations of risk factors (personal and ergonomic) with WRMSDs, and work posture with WRMSDs among sewing-machine operators were statistically determined. The majority of the population (97.6%) was female, with mean age 42.3± 8 years. At baseline, 17.9% were hypertensive, 3.3% had arthritis, 6.5% were diabetic, and the mean BMI was 29.7 kg/m² (22% of BMIs was normal). The largest proportion of the sewing-machine operators were sewing cloth and leather (79.7%) (compared to sewing cloth and vinyl), and the remainder performed forceful precision stitching (20.3%), including headrest covers, airbags and top stitching on the final product. Job rotation took place between forceful precision stitching and straight stitching (for 36.6% of the sewing-machine operators).p> The intervention was implemented within the study period. At baseline 100% of sewing machine operators were sewing in the seated work posture. Early in the study, 17.9% of them changed their work posture from seated to stand-up, 30.1% changed to the stand-up work posture in January 2007, and 34.9% a year later. The last 17.1% remained seated till the last year of the study period. From July 2008, 100% of the sewing-machine operators were sewing in the stand-up work posture. The results indicated two strong associations of risk factors and a change in work posture with WRMSDs. Obesity (specifically morbid obesity) was a personal risk factor for upper limb disorders and working in the stand-up work posture was protective for spinal disorders, compared to working in the seated work posture. Furthermore, the results indicated a high incidence of disorders (specifically of the spinal area and upper limb) during the first three months of the programme, as well as an increased incidence of lower leg disorders for the first and consecutive month of the change in work posture from seated to standing up. Lower limb disorders were specifically associated with obesity. The increase of lower limb disorders during the postural adaptation phase was temporary, and was addressed within the programme with proper shoe wear, silicone innersoles, supportive stockings and exercises. The combination proved to be effective in preventing and/or managing lower limb disorders. The outcome of the current study provided evidence on the incidence of WRMSDs, and associations between risk factors and work posture, and WRMSDs among sewing machine operators managed within the programme. / Dissertation (MPhysT)--University of Pretoria, 2013. / Physiotherapy / unrestricted