Introduction: Low Back Pain Syndrome is commonly classified as a set of signs and symptoms, of multifactorial origin. Rural work has been currently reported in the scientific literature as one of the most harmful labor practices to human health. Objective: Characterizing low back pain syndrome and associated factors in rural workers exposed to short- to long-term pesticides. Methods: This was an observational, cross-sectional and analytical study in which 322 male rural workers aged 18-59 years old have been exposed to pesticides and the parameters evaluated were: anthropometric characteristics, socio-demographic (marital status, alcoholism and smoking) , acute and chronic pain index in the lumbar spine, hip, knee and ankle through Visual Analog Scale (VAS) and Body Map, as well as functional parameters: body balance through the BERG Balance Scale (BBS), Risk of falls: Time Up and Go Test (TUG TEST) and functionality by OSWESTRY (ODI). The statistical approach was analytical descriptive. Results: Regarding the anthropometric parameters observed: age (34.9 ± 8.4 years), weight (72.9 ± 5.3 kg), height (1.69 ± 0.05) and BMI (24.7 ± 1,9 kg / m²). Most workers n=216 (67.1%) were in the age group of 18-39 years, adequate BMI n=179 (41.9%), time of exposure to pesticides =36 months n=202 (62,7%), predominantly single (n=225) (69.9%), low consumption of tobacco and alcohol respectively, n=193 (59.9%) n=183 (56.8%). It was evidenced that a sample presents acute low back pain n = 219 (66.1%), hip pain n =238 (73.9%) and moderate functional disability n=139 (43.2%). There was a strong correlation between TUG TEST vs. ODI (r= 0.8, p=0.01). Acute low back pain. Age (r=0.8, p=0.01), marital status (r=0.75, p=0.01). Conclusion: The data suggest that rural workers present a higher rate of mild acute low back pain and mild to moderate hip pain, low body imbalance, moderate risk of falls and moderate functional disability. / A Síndrome da dor lombar é comumente classificada como um conjunto de sinais e sintomas, de origem multifatorial. Atualmente o trabalho rural tem sido reportado na literatura cientifica como uma das práticas laborais mais lesivas à saúde humana. Objetivo: Caracterizar a Síndrome da dor lombar e fatores associados em trabalhadores rurais das cidades de Lagarto e Salgado, Sergipe expostos a agrotóxicos. Metodologia: Trata-se de um estudo observacional, transversal e analítico, no qual foram incluídos 322 trabalhadores rurais do gênero masculino com idade entre 18 e 59 anos expostos a agrotóxicos e os parâmetros avaliados foram: características antropométricas, sociodemográficas (estado civil, alcoolismo e tabagismo), índice álgico agudo e crônico em coluna lombar, quadril, joelho e tornozelo através da Escala Analógica da Dor (EVA) e Mapa Corporal, além de parâmetros funcionais: equilíbrio corporal através da escala de BERG (EEB), Risco de quedas: Time Up and Go teste (TUG TEST) e funcionalidade pelo OSWESTRY (ODI). A abordagem estatística foi do tipo descritiva analítica. Resultados: Em relação aos parâmetros antropométricos observou-se: idade, (34,9± 8,4 anos), peso (72,9± 5,3 Kg), altura (1,69± 0,05) e IMC (24,7±1,9 Kg/m²). A maioria dos trabalhadores n=216 (67,1%) encontravam-se na faixa etária de 18-39 anos, IMC adequado n=179 (41,9%), tempo de exposição a agrotóxicos =36 meses n=202 (62,7%), predominantemente solteiros n=225 (69,9 %), baixo consumo de tabaco e álcool, respectivamente n=193 (59,9%) n=183 (56,8%). Foi evidenciado que a amostra apresenta lombalgia aguda n=219 (66,1%), dor no quadril n= 238 (73,9%) e incapacidade funcional moderada n=139 (43,2%). Houve correlação forte entre TUG TEST Vs. ODI (r=0,8; p=0,01). Lombalgia aguda Vs. Idade (r=0,8; p=0,01), estado civil (r=0,75; p=0,01). Conclusão: Os dados sugerem que os trabalhadores rurais apresentam, maior índice de lombalgia aguda de forma leve e fatores associados, como do tipo dor no quadril de leve a moderada, baixo desequilíbrio corporal, médio risco de quedas e incapacidade funcional moderada. / Lagarto, SE

Orientador: Neusa Maria Costa Alexandre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T13:14:18Z (GMT). No. of bitstreams: 1 Vigatto_Ricardo_M.pdf: 4076945 bytes, checksum: edca34fee371b306dd3b9984b10e2154 (MD5) Previous issue date: 2006 / Resumo: A literatura tem identificado a necessidade de utilização de instrumentos de medida padronizados e confiáveis que avaliam a dor lombar. O questionário Oswestry tomou-se um dos principais instrumentos utilizados para avaliar os distúrbios da coluna vertebral. O objetivo desse estudo foi traduzir e adaptar a versão do questionário Oswestry para o português e avaliar sua validade e confiabilidade. A adaptação cultural foi realizada de acordo com a metodologia recomendada internacionalmente, usando as seguintes fases: tradução, retro-tradução, revisão por um comitê de especialistas e pré-teste. Primeiramente, o questionário foi traduzido para o português por dois tradutores bilíngües, de uma forma independente. Posteriormente, dois outros tradutores profissionais que possuíam como língua materna o inglês, fizeram a retro-tradução independentemente um do outro. Um comitê composto por seis especialistas revisou as versões obtidas e desenvolveram a versão final do instrumento. Essa versão foi pré-testada em 40 pacientes com lombalgia. A confiabilidade foi avaliada através da estabilidade (teste-resteste) e da consistência interna. A validade foi obtida comparando-se a pontuação do Oswestry com outros instrumentos de medida: o questionário Roland-Morris, o questionário SF-36 e uma escala numérica de dor. As propriedades psicométricas da versão traduzida foram avaliadas aplicando o questionário em 120 sujeitos com dor lombar. Os resultados mostraram uma boa validade e consistência interna (Alfa de Cronbach=0,87). No teste-resteste os resultados apontaram uma alta correlação intraclasse (r=0,99). O questionário Oswestry demonstrou possuir uma moderada correlação com a dor, usando-se uma escala numérica de dor (r=0,66). Uma correlação relativamente alta foi encontrada entre as pontuações do Oswestry e do Roland-Morris (r=0,81). Houve uma correlação significante (p<0,001) entre a pontuação do Oswestry e as oito dimensões do questionário SF-36. Os coeficientes de correlação mais altos foram com a capacidade funcional (r=0,83), com a dor (r=0,58) e com os aspectos físicos (r=0,53). Este estudo demonstrou que o processo usado para a adaptação do questionário Oswestry foi realizado com sucesso e que a versão adaptada possui excelentes propriedades psicométricas / Abstract: Reports in the literature have identified a need for internationally standardized and reliable measurements to analyse back pain. The Oswestry questionnaire has become one of the principal outcome measures used in the management of spinal disorders. The objective of this study was to translate and adapt a version of the Oswestry questionnaire into Brazilian Portuguese and evaluate its reliability. The cross-cultural adaptation was performed according to the internationally recommended methodology, using the following guidelines: translation, back-translation; revision by an expert committee and pretesting. First the questionnaire was independently translated into Portuguese by two bilingual translators. Second, two other professional translators whose mother tongue was English performed a back-translation independently from one another. A committee consisting of six specialists was brought together and developed a final version. This version was pretested on 40 subjects suffering from low back pain. Reliability was estimated through stability (test-retest) and homogeneity assessment. The validity was tested comparing scores of the Oswestry with the following measures: The Roland-Morris Disability Questionnaire, the SF-36 questionnaire and a numerical pain scale. The psychometric properties of the translated version were evaluated by administering the questionnaire to 120 subjects with back pain. Results indicated good content validity and internal consistency (Cronbach alpha = 0.87). Intraclass correlation coefficient for test-retest reliability was r = 0.99. The Oswestry questionnaire showed moderate correlation with pain measure using a numerical pain scale (r = 0 66). Relatively high correlation was also found between the Oswestry and the Roland - Morris scores (r = 0.81). There was significant correlation (p< 0.001) between the Oswestry scores and the eight scales of the SF - 36 questionnaire. The highest correlation coefficients were for physical functioning (r = 0,83); bodily pain (r = 0,58) and role physical (r = 0,53). This study confirmed that the process used for adaptation of the Oswestry questionnaire was well succeeded and that this version had excellent psychometrical properties / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

Orientador: Heleno Rodrigues Correa Filho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-13T00:37:31Z (GMT). No. of bitstreams: 1 Ikari_ThaisEmi_M.pdf: 1806512 bytes, checksum: f29d3f1889bc23c544e659410f7fa26b (MD5) Previous issue date: 2009 / Resumo: A dor lombar é muito comum na população. Entre os trabalhadores é classificada como LER/DORT (Lesões por Esforços Repetitivos/Distúrbios Osteomusculares Relacionados ao Trabalho) e merecem destaque devido aos altos índices de ocorrência e aos custos que geram. A complexidade dos fatores de risco, diagnóstico, tratamento e prevenção também chama a atenção e é objeto de inúmeros estudos. Este trabalho foi realizado com carregadores de alimentos hortifrutigranjeiros da CEASA-Campinas (Central de Abastecimento de Campinas). O estudo foi transversal, realizado através de entrevistas com 289 carregadores. O objetivo foi identificar fatores potencialmente associados à dor lombar, para identificar aspectos do trabalho passíveis de intervenção bem como formas de melhorar a atenção multidisciplinar em saúde para esses trabalhadores. As propostas voltaram-se preferencialmente para sugestões de promoção da saúde, prevenção e reabilitação das lesões já instaladas. Os resultados mostram uma população heterogênea em relação à idade, tempo de trabalho e carga carregada. As crises de dor lombar são freqüentes e predominantemente agudas. Automedicação é amplamente usada em tais crises. Os fatores de risco analisados para associação com dor lombar envolveram características pessoais (idade, hábitos de vida), fatores psicossociais prática de atividades físicas, percepções do trabalho e o esforço físico. As variáveis dor lombar e carga carregadas foram relacionadas com aspectos pessoais e práticas laborais. Foi identificada associação significativa entre esforço físico realizado na função anterior e a presença de dor lombar. Sugere-se neste trabalho que os resultados negativos de associações (análises de OR) e correlações de baixa significância (regressão linear simples) se devem ao fato de que esses trabalhadores desenvolvem mecanismos de autodefesa para se protegerem da dor para poderem permanecer trabalhando apesar das adversidades. Outra possível conclusão seria o afastamento por dor incapacitante permanente. Pesquisas adicionais poderiam esclarecer qual das duas conclusões é mais provável. O trabalho também sugere que a promoção da saúde e prevenção de lesões incapacitantes são necessárias. Assim como um sistema de atendimento na vigência da dor, proporcionando alívio da mesma e orientações de atividades de vida diária. A fisioterapia como um dos campos de saber em saúde, pode inspirar propostas para intervenção e para futuras pesquisas. / Abstract: Low back pain is very common in the population. Among workers is classified as RSI (Repetitive Strain Injury) or WRMD (Work-related musculoskeletal disorders) and deserves attention because of high rates and costs it generates. The complexity of risk factors, diagnosis, treatment and prevention also draws the attention and is currently the subject of numerous studies. This study was carried out with workers who handle products as food, plants, flowers and raw-materials from the CEASA-Campinas, which is the Supply Center of Campinas. The study was cross-sectional, conducted through interviews with 289 workers. The objective was to identify factors that may be associated with low back pain to identify aspects of the work that could be changed as well as ways to improve the multidisciplinary health care for these workers. The proposals are more likely suggestions for health promotion, prevention and rehabilitation of injuries that has been already installed. The results show a very heterogeneous population in terms of age, working time and products carried by them. Low back pain crises are frequent and usually acute. Self-medication is widely used in such crises. The risk factors of low back pain involve psychosocial factors, age, smoking, physical activity and heavy efforts. The variables low back pain and quantity of tons carried by them were related to personal and labor aspects of these workers. There was a significant association between physical effort done on the last job and low back pain. It is suggested in this paper that the results of negative associations and low significance correlations are due to the fact that these workers have been developing mechanisms of self-defense to protect themselves from pain. This way they are able to remain working despite the adversities. Another possible conclusion would be that they are leaving the job because of disabling pain. Only additional research could clarify which of the two conclusions is more likely. The work also suggests that health promotion and prevention are needed. As well as a system of care during the pain, providing relief and orientation for activities of daily living. Physical therapy addresses this field and can inspire proposals for intervention and for future researc / Mestrado / Saude Coletiva / Mestre em Saude Coletiva

Orientador: João Batista de Miranda / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T07:18:16Z (GMT). No. of bitstreams: 1 Cavali_PauloTadeuMaia_D.pdf: 2639722 bytes, checksum: 55b4478f11151611236860d14a52b44f (MD5) Previous issue date: 2012 / Resumo: Existe uma grande variabilidade de resultados nos estudos prévios que analisam os parâmetros do alinhamento sagital (PAS) em indivíduos normais e em pacientes com doenças degenerativas da coluna lombar. A maioria desses estudos relacionam os PAS somente com o sintoma de dor lombar crônica, em grupos de pacientes com diferentes doenças degenerativas lombares, o que dificulta a aplicação clínica desses dados tanto na avaliação diagnóstica como na indicação terapêutica. O objetivo deste estudo caso-controle foi analisar as relações dos PAS com os diferentes sintomas entre um grupo de pacientes com diagnóstico de estenose lombar e um grupo controle e as mesmas relações entre os subgrupos de pacientes diferenciados por sintoma. Foram colhidos os dados da história, exame clínico, ressonância magnética e de exames radiográficos de 23 pacientes com estenose lombar (denominado grupo estenose) e de 17 indivíduos saudáveis (denominado grupo controle). Os PAS utilizados foram: cifose torácica (CT), lordose lombar (LL), eixo sagital vertical (C7-T1), listese anteroposterior (OAP), lordose lombo-pélvica total (LLT) e regional (LLR), eixo sagital em T1, T4 eT9 (ES1, ES4 e ES9 respectivamente), inclinação sagital T1-L5 (IST1-L5), "offset sagital" T1 e T9 (OST1 e OST9), "tilt pélvico" (TP), "slope sacral" (SS), morfologia pélvica (MP), ângulo sacro-femoral (ASF), distância sacro-femoral (DSF) e "overhang" (OVHG). Na Fase 1 do estudo, os dados do PAS foram correlacionados entre os indivíduos do grupo controle e grupo estenose e, na Fase 2, entre os subgrupos do grupo estenose diferenciados por sintomas como lombalgia, radiculopatia, claudicação neurogênica e dor, medida pela Escala Analógica de Dor (EAD). Na Fase 1, observou-se que os pacientes do Grupo Estenose (GE) como um todo tiveram menores valores de LLT (p = 0,006) e LLR em L1, L2 e L3 (p = 0,026) e os pacientes do GE com sintoma de radiculopatia, além dos dados acima, tiveram aumento do TP (p = 0,004), quando comparados ao Grupo Controle (GC). Na Fase 2, o Subgrupo Lombalgia obteve maiores valores de CT (p = 0,035) e LLR (p = 0,028) e uma diminuição do TP (p = 0,029), OST1 (p = 0,022), DSF (p = 0,014) e OVHG (p = 0,035) em relação aos outros pacientes do GE que não se queixavam de lombalgia e, no Subgrupo Radiculopatia, houve a diminuição da LLR (p < 0,047). Este estudo demonstra que há correlações significativas dos sintomas e dos PAS entre o GE e o GC e também entre os Subgrupos do GE diferenciados por sintomas. Estes dados indicam uma melhor interpretação clínica dos PAS, assim como podem sugerir a terapêutica mais adequada / Abstract: There is a great variation in the results of previous studies analyzing sagital alignment parameters (SAP) in normal individuals and in patients with degenerative diseases of the lumbar spine. Most studies associate SAP only with chronic lumbar pain, in groups of patients with different lumbar degenerative diseases, which makes it difficult to apply these data clinically both in diagnostic evaluation and in therapeutics. The objective of this prospective, diagnostic case-control study was to examine the relationship between sagittal balance parameters and different symptoms of spine disease in patients with lumbar canal stenosis (LCS) and controls and the same associations between subgroups of patients with different symptoms. We collected clinical history, clinical exam data from 23 patients with spinal stenosis and 17 healthy volunteers (controls). Magnetic resonance imaging (MRI) and x-rays allowed the measurement of sagittal axis parameters. The SAP analyzed were thoracic kyphosis, lumbar lordosis, sagittal axis, anterior-posterior listesis, total and regional lumbar-pelvic lordosis, sagittal axis in T1, T4 and T9, pelvic tilt, sacral slope, pelvic morphology, sacro-femoral angle, sacro-femoral distance and overhang. In the first phase of the study, SAP data were correlated between controls and patients, and in the second phase, the subgroups inside the group of patients with stenosis were compared for symptoms as lumbar pain, radiculopathy, neurogenic claudication and pain, measure by the visual analogue scale (VAS). In the first phase, it was observed that the stenosis patients presented lower values of total lumbopelvic lordosis (p = 0.006) and regional lordosis L1, L2 and L3 (p < 0.026). Those with stenosis and radiculopathy also had higher values of pelvic tilt (p = 0.004) and lower values for total lumbopelvic lordosis and regional lordosis in L1 and L2 (p < 0.05) than controls. All patients complaining of back pain had higher values of thoracic kyphosis (p = 0.035), regional lumbopelvic lordosis in L1 (p = 0.028), lower values for pelvic tilt (p = 0.029), sagittal T1 offset (p = 0.022), sacro-femoral distance (p = 0.014) and overhang (p = 0.035) compared to patients without the complaint. Patients with stenosis and radiculopathy were less prone to have regional lordosis in L2, L3 and L4 (p = 0.047, p = 0.047 and p = 0.023 respectively). In conclusion, this study shows that there are significant correlations between symptoms and sagittal axis parameters between patients with and without spinal canal stenosis and also in subgroups of the patients with stenosis with different complaints.These data indicate a better clinical interpretation of SAP, as well as suggest a better therapeutic approach / Doutorado / Cirurgia / Doutor em Cirurgia

M.Tech. (Chiropractic) / This study was conducted in order to compare the effectiveness of the lumbar spine manipulation versus the foot manipulation/mobilisation for people suffering with chronic low back pain. This research aims to compare the effects of lumbar spine manipulation alone, foot manipulatioil/mobilisation alone or the combination of the two in people suffering with chronic low back pain. Candidates for the study were recruited from the local surrounding area, and through information pamphlets distributed through the Technikon Witwatersrand Doornfontein. The candidates were asked to participate in the study, which was held at the Technikon Witwatersrand Chiropractic day clinic. Only -those candidates that conformed to the selection criteria were allowed to participate in the study. The candidates were assigned to one of three groups. Eac.h group had ten candidates. Group 1 received lumbar spine manipulation alone. Group 2 received foot manipulation/mobilisation alone. Group 3 candidates received lumbar spine manipulation and foot manipulatioil/mobilisation. Subjective data was collected using the Numerical Pain Rating Scale 101 and the Oswestry Low Back Pain and Disability Questionnaire. Objective data was collected using the electronic inclinometer to measure lumbar spine range of motion in flexion, extension, right and left lateral flexion and right and left anterior rotation. The paired Hest was used for statistical analysis, where a statistically significant difference was found; the Student-Newman-Keuls test was performed to identify which statistically significant difference between the groups was found. The results of this study indicate that lumbar spine manipulation alone would appear to have responded better in terms of lumbar spine range ofmotion...

Abstract Modic changes are vertebral bone marrow signal intensity changes adjacent to the endplates of the degenerated intervertebral discs in magnetic resonance imaging (MRI). This study evaluated the prevalence and the determinants of Modic changes and their association with low back pain symptoms in an occupational cohort of middle-aged Finnish men. The prevalence and the natural course of Modic changes were assessed over a 3-year follow-up period among sciatica patients. Finally, in a patient population, the characteristics of bone marrow changes in MRI were compared to the imaging findings in CT. The prevalence of Modic changes was 56% in an occupational cohort of middle-aged males. Besides age, the determinants of Modic changes and disc degeneration were different. Weight-related factors, which add to the load of the lumbar spine, were associated with Modic changes, whereas whole-body vibration was associated with severe disc degeneration. The prevalence of Modic changes among sciatica patients was 65%, type II change being the most frequent. During the 3-year follow-up, 14% of changes converted to another type, while the incidence of new Modic changes was 6%. Among middle-aged working males, Modic changes located at L5–S1 and type I Modic changes were more likely to be associated with pain symptoms than other types of Modic changes or changes located at other lumbar levels. Thirty-eight percent of the endplates with Modic changes had sclerosis in CT. Of specific Modic types, mixed I/II and II/III associated significantly with endplate sclerosis. Endplate sclerosis was not detected in MRI. In conclusion, Modic changes are a common MRI finding both among patients and middle-aged working males. In addition to age, weight-related factors seem to be important in the pathogenesis of Modic changes. Modic changes can convert from one type to another and type II changes may be less stable than previously assumed. A considerable proportion of Modic changes are sclerotic as observed in CT. Modic changes were always found in combination with a degenerative intervertebral disc and thus they are assumed to be a specific phenotype of degenerative disc disease. Finally, Modic changes may be painful – especially when located at L5–S1 and type I changes.

Abstract Low back pain (LBP) is a significant health problem in all developed countries. The high prevalence of LBP in youth is a cause of concern because a link has been reported between LBP in adolescence and chronic LBP (CLBP) in adulthood. In order to prevent CLBP in adulthood potential protective factors in youth should be identified. The association between trunk muscle strength and LBP has been widely studied but the results are conflicting. The current knowledge on the role of postural balance in relation to LPB is even more controversial. The aims of the thesis were to evaluate 1) the reproducibility of the inclinometric postural balance and maximal isometric trunk muscle strength measurements, 2) the association of low back symptoms with postural balance, trunk muscle strength, and cross-sectional area and fat content of extensor muscles, and 3) muscular fitness in relation to physical activity and television viewing. The study population belongs to the 1986 Northern Finland Birth Cohort (NFBC 1986), originally consisting of 9,479 children with an expected date of birth between July 1, 1985 and June 30, 1986. A total of 874 subjects completed the physical examination at a mean age of 19 years. Of those who participated in the physical examination 554 subjects took part in magnetic resonance imaging (MRI) of the lumbar spine, including extensor muscles, at a mean age of 21 years. Reproducibility of isometric trunk muscle testing was found to be comparable to other methods that are used to measure trunk muscle function. Low back symptoms were not associated with postural balance or trunk muscle strength. Neither was there an association between LBP and the cross-sectional area or fat content of the lumbar muscles. Trunk muscles were significantly stronger in those who participated in regular physical activity and weaker in those who watched TV more than two hours daily. In conclusion, physical activity has an association with muscular fitness whereas association with TV viewing is negative independently of the level of physical activity. Single measurement of trunk muscle strength, and cross-sectional area or fat content of lumbar extensor muscles has little significance in the evaluation of the severity of low back symptoms in young adults. / Tiivistelmä Alaselkäkipu on huomattava kansanterveydellinen ongelma kaikissa kehittyneissä maissa. Erityisen huolestuttavaa on alaselkäkivun yleisyys nuorilla, sillä tällä on todettu olevan yhteyttä krooniseen selkäkipuun aikuisuudessa. Jotta kroonista kipua aikuisiällä voitaisiin ehkäistä, kivulta suojaavat tekijät pitäisi pystyä tunnistamaan jo nuoruudessa. Vartalon lihasvoiman ja alaselkäkivun yhteyttä on tutkittu runsaasti viimeisten vuosikymmenten aikana mutta tulokset ovat ristiriitaisia. Tulokset seisomatasapainon yhteydestä alaselkäkipuun ovat niin ikään ristiriitaisia. Tämän tutkimuksen tavoitteena oli 1) arvioida inklinometrisen tasapainomittauksen ja isometristen lihasvoimamittausten luotettavuutta, 2) arvioida alaselkäoirein yhteyttä vartalon lihasvoimaan, seisomatasapainoon sekä ojentajalihasten rasvoittumiseen ja poikkipinta-alaan ja 3) arvioida lihasvoiman yhteyttä liikunta-aktiivisuuteen ja television katseluun. Tutkimusaineiston perustan muodostavat Pohjois-Suomen 1986 syntymäkohorttiin kuuluvat nuoret Oulun ja Lapin lääneistä, alkuperäiseen kohorttiin kuului 9,479 lasta, joiden laskettu syntymäaika oli heinäkuun 1:n 1986 ja kesäkuun 30:n 1986 välillä. Heistä Oulun Diakonissalaitoksen Liikuntaklinikalla suoritettuihin tutkimuksiin osallistui yhteensä 874 nuorta. Tutkimukseen liittyen Oulun yliopistollisen keskussairaalan radiologian klinikalla suoritettuihin selän magneetti- kuvauksiin osallistui 554 nuorta. Isometrinen lihasvoimatestaus osoittautui luotettavaksi tavaksi mitata vartalon lihasvoimaa. Alaselkäoireilla tai niiden vakavuudella ei todettu olevan yhteyttä vartalon lihasvoimaan tai seisomatasapainoon. Myöskään oireiden ja vartalon ojentajalihasten rasvoittumisen tai poikkipinta-alan välillä ei todettu olevan yhteyttä. Aktiivisemmin liikkuvien lihasvoima oli merkittävästi parempi kuin vähemmän liikkuvilla, toisaalta televisiota runsaasti katsovien lihasvoima oli televisiota vähän katsovia huonompi riippumatta siitä kuinka paljon he harrastivat liikuntaa. Aktiivisella liikunnalla on positiivinen yhteys lihasvoimaan. Toisaalta runsaalla television katsomisella on negatiivinen yhteys lihasvoimaan harrastetun liikunnan määrästä riippumatta. Yksittäisillä mittauksilla, kuten lihaksen poikkipinta-alalla tai vartalon lihasvoimalla ei todettu yhteyttä alaselkäoireiden vakavuuteen nuorilla aikuisilla.

Abstract Aim The aim of the study was to investigate the prevalence of lower back pain in the Greater Stockholm Fire Brigade.   MethodA web-based survey was designed and sent to all operational personnel within the Greater Stockholm Fire Brigade, a total of 530 people. The survey was not validity or reliability tested. The questions in the questionnaire had certain response options and had been modified according to the age group, number of years in the profession, and modified on a validated and reliable questionnaire, the Örebro Musculoskeletal Pain Screening Questionnaire. To strengthen the study's internal validity, a pilot study was conducted. For the statistical analysis, the statistical program SPSS was used and the result was analyzed with Spearman's non-parametric tests and Chisquare-test.   Results A total of 66% of the operating staff responded to the web-based survey, of which 79% reported having lower back pain in the past 12 months. There was not a correlation between lower back pain and age or number of years in the profession. Correlation were found in lower back pain and experienced adverse effects at work (p &lt;0.05). A total of 11 % had reported absence from work due to lower back pain in the past year, and a total of 32% had applied for health care. The most sought after caregivers were naprapaths or chiropractors (p &lt;0.05).   Conclusions: The study shows that the majority of operational personnel in The Greater Stockholm Fire Brigade reported lower back pain over the last 12 months. The result of the study showed no correlation between lower back pain and age or number of years within the profession. There was a correlation between lower back pain and negative impact on the work. There was also a correlation between lower back pain and absence from work. Naprapaths or chiropractors were the most sought caregivers at lower back pain cases. Future studies should include additional factors and causes that affect the presence of lower back pain. / Abstrakt Syfte Syftet med studien var att undersöka förekomsten av ländryggsbesvär inom Storstockholms brandförsvar. Metod En webbaserad enkät utformades och skickades ut till all operativ personal inom Storstockholms brandförsvar, totalt 530 personer. Enkäten var inte validitets- eller reliabilitetstestad. Frågorna i enkäten hade bestämda svarsalternativ och hade modifierats efter urvalsgruppens ålder, antal år i yrket samt utifrån ett validerat och reliabelt frågeformulär, Örebro Musculoskeletal Pain Screening Questionnaire. För att stärka studiens interna validitet gjordes en pilotstudie. Till den statistiska analysen användes programmet SPSS och resultatet analyserades med Spearmans icke parametriska test samt Chitvåtestet. Resultat Totalt 66 % av den operativa personalen besvarade den webbaserade enkäten och av dessa angav 79 % att de upplevt ländryggsbesvär någon gång under de senaste 12 månaderna. Det fanns inget samband mellan ländryggsbesvär och ålder eller antal år i yrket. Samband fanns vid ländryggsbesvär och upplevd negativ påverkan i arbetet (p&lt;0.05). Totalt 11 % hade någon gång under det senaste året rapporterat frånvaro från arbetet på grund av ländryggsbesvär. Totalt 32 % hade under de senaste 12 månaderna sökt vårdgivare för sina ländryggsbesvär. De mest sökta vårdgivarna var naprapater eller kiropraktorer (p&lt;0.05). Slutsats Studien påvisar att majoriteten av den operativa personalen inom Storstockholms brandförsvar upplevt ländryggsbesvär under de senaste 12 månaderna. Studiens resultat visade inget samband mellan ländryggsbesvär och ålder eller antal år inom yrket. Samband fanns vid ländryggsbesvär och upplevd negativ påverkan i arbetet samt vid frånvaro från arbetet. Naprapater eller kiropraktorer var de mest sökta vårdgivarna vid ländryggsbesvär. Framtida studier bör inkludera fler faktorer och orsaker som påverkar förekomsten av ländryggsbesvär.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Low back pain (LBP) is a growing health and socio-economic problem worldwide, affecting humans from adolescent to adult age. In developed countries, more than 80% of adults are at risk of suffering a disabling episode of LBP at one point during their life time. In developing countries, particularly in Africa, the life time prevalence of LBP varies in population groups, but the disability due to LBP is increasing. The aetiology of LBP is multifactorial, and there is still no consensus on the exact cause and contributing factors to LBP. In addition, little is known about patients' knowledge and beliefs on the contributing factors to their LBP. The current study therefore, aimed to identify patients' knowledge, attitudes and beliefs on the contributing factors to LBP, among patients attending physiotherapy outpatient departments in Malawi. / South Africa

Magister Scientiae (Physiotherapy) - MSc(Physio) / Low back pain among high school children is perceived to be uncommon in the clinic setting. However, previous studies have suggested that it may be an important and increasing problem to be managed in this age group. The overall aim of this study was to determine the prevalence, the predisposing factors and management of low back pain among high school children in Nyamasheke district in Rwanda. A cross– sectional descriptive study was conducted using a combination of quantitative and qualitative research methods. The study included a population of 10 330 high school children aged 13- 21 years old registered in high schools of Nyamasheke district. In addition, 13 service providers involved in addressing low back pain were included in the study. The study was conducted in ten schools selected randomly, four schools from nine urban schools and six schools from 15 rural schools. The sample size included 1 000 participants selected by a simple random sampling method and six service providers selected by purposive sampling method. A self-administered questionnaire was given to high school learners. Semi-structured interviews amongst service providers were conducted to validate information given by high school learners. The software SPSS version 19.0 for windows and Microsoft Excel package 2010 were used to analyze the quantitative data. Descriptive statistics using frequencies, percentages, means, and standard deviations and inferential statistics using chi-square and correlation tests were calculated to examine the association between variables. For qualitative findings, audiotaped interviews were transcribed and translated from Kinyarwanda into English, and the expressed ideas were coded and reduced into themes and categories. Permission to conduct this study was obtained from the Senate Research Grants and Study Leave Committee at the University of the Western Cape, and the concerned authorities in Rwanda. Individual participants and their parents/guardians were informed of the study through an information sheet and written informed consent or assent was then obtained from the participants. The mean age of the quantitative study sample was 17 years, and 48.2% were females compared to 51.8% of males. The response rate was 96.2%. The low back pain prevalence was found to be 66.1%. The mean age of the first occurrence of low back pain was 14.5(SD = 2.28). One year prevalence was found to be 25.4% whereas the one month prevalence was 13.7%. Males were the most to report low back pain comparatively to females with 53.1% and 43.9% respectively. There was significant relationship between age group and low back pain (p = 0.000). High school children from the rural region were the most to report low back pain in comparison to those from urban region with 61.5% against 38.5% respectively. Regarding the predisposing factors to low back pain, a strong relationship was found between low back pain and posture (sitting and standing position) (p=0.000) with 83.2%. The findings of the interviews conducted among service providers showed that the main predisposing factors for low back pain could be posture/position in class and psychological factors. The study found that most of the participants do not attend medical services. The study highlighted that the impact of low back pain included medical costs, missing class when attending medical services and difficult to perform normal usual activities. It was found that the level of education in health promotion as preventive measures of low back pain is still at low level.