Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

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

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

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.

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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.

Magister Public Health - MPH / Background: Protecting and promoting health in the workplace is imperative, both for individual employee health and workplace productivity. High rates of workplace injuries, particularly in environments where high levels of physical activity are required, point to the need for effective occupational interventions, minimization of workplace inhibitors that increase the risk of developing musculoskeletal disorders (MSDs), and occupational management checks to reduce the onset of MSDs in the workplace. However, for these measures to be successful, it would be important to identify individual and workplace-related factors associated with the development and duration of MSDs. Aim: To determine potential risk and protective factors associated with MSDs among employees in a workplace where heavy lifting is a key job function.

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.

MSc Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 2009 / The use of reliable and valid outcome measures in clinical research as well as clinical practice is very important. Self reported questionnaires are widely used as outcome measures to assess the subjective perception of disability caused by low back pain (LBP). The Roland Morris Disability Questionnaire (RMDQ), Quebec Disability Scale (QDS) and Waddell Disability Index (WDI) have been identified as reliable and valid instruments for assessing disability caused by LPB in English speaking patients. The three questionnaires were translated, back-translated and tested in a final version for use with Tswana speaking subjects. The questionnaires were tested on one hundred respondents, who met the inclusion criteria, at five hospitals in Tswana speaking areas. Of the one hundred respondents 31 were retested 24 hours later. No significant floor or ceiling effects were found for all three questionnaires. There was moderate correlation between the RMDQ, WDI and the DRI (0.74 and 0.63, respectively). The correlation between the QDS and the Disability Rating Index (DRI) was strong (0.85). The RMDQ, QDS and WDI correlated moderately with the VAS (pain) (0.63, 0.68 and 0.74, respectively). The RMDQ, QDS and WDI appeared to be internally consistent scales with Cronbach’s alpha values of 0.92, 0.95 and 0.75, respectively. The RMDQ, QDS and WDI showed excellent test-retest reliability with intra-class correlation coefficient values of 0.93, 0.91 and 0.84, respectively. The results suggest that the Tswana versions of the RMDQ, QDS and WDI validated in this study are easy to understand, valid and reliable instruments for the measurement of functional disability caused by LBP in a Tswana speaking population. Therefore, these translated instruments may be useful clinical methods for collecting standardised data on activity limitations resulting from LBP in a Tswana speaking population.