Bakgrund: Ospecifik ländryggssmärta är en av de vanligaste orsakerna till att man söker hjälp inom primärvården. För långvarig, ospecifik ländryggssmärta är träning ett förstahandsval och fokus har under det senaste årtiondet legat på bålstabiliserande träning. Psykosociala faktorer som self-efficacy och rörelserädsla kan vara viktiga att beakta vid behandlingen då de spelar en roll i hur ländryggssmärtan utvecklas. Syfte: Att undersöka hur skattad smärta, self-efficacy och rörelserädsla samt funktionsnivå förändrades hos enskilda patienter med långvarig, ospecifik ländryggssmärta under och efter en intervention i grupp med bålstabiliserande träning. Metod: Designen var en A-B-A single-subject design (SSED). Smärtnivå, self-efficacy och rörelserädsla mättes med självskattningsformulär en gång per vecka under fas A-B-A och funktionsnivå före och efter avslutad intervention. Interventionen pågick under åtta veckor, en gång per vecka. Data presenterades visuellt och analys gjordes även av statistisk (2-SD band metod) och klinisk signifikans. Resultat: Analysen visade att skattad smärta, self-efficacy, rörelserädsla och funktionsnivå förändrades i positiv riktning hos flera patienter. Statistisk och klinisk signifikans varierade. Slutsats: Graderad bålstabiliserande träning i grupp under handledning av sjukgymnast verkar för flera av deltagarna ha en positiv effekt på såväl smärtnivå, self-efficacy, rörelserädsla som funktionsnivå. Eftersom SSED har en begränsad generaliserbarhet bör resultaten replikeras i ytterligare studier. / Background: Non-specific low back pain is one of the most common reasons for seeking help in primary care. For chronic, non-specific low back pain exercise rehabilitation is a first choice and focus in the last decade has been on motor control exercises. Psychosocial factors such as self-efficacy and fear of movement may be important to consider in the treatment as they play a role in how low back pain develops. Aim: To investigate how rated pain, self-efficacy and fear of movement as well as level of function changed in individual patients with chronic, nonspecific low back pain during and after an intervention group with motor control exercises. Method: The design was an A-B-A single-subject design (SSED). Pain level, self-efficacy and fear of movement were measured by self-assessment questionnaires once a week during phase A-B-A and level of function before and after the intervention. The intervention lasted for eight weeks, once a week. Data were presented visually and analysis was done to prove statistical (2-SD band method) and clinical significance. Results: The analysis showed that rated pain, self-efficacy, fear of movement and level of function changed in a positive direction for several of the patients. Statistical and clinical significance varied. Conclusion: Graded motor control exercises in a group under the supervision of a physiotherapist seem to have a positive effect for several of the participants with regards to level of pain, self-efficacy, fear of movement as well as level of function. Since SSED has a limited generalizability, results should be replicated in further studies.

Darbo tikslas: įvertinti pacientų su lėtiniu juosmens skausmu, turinčių segmentinį nestabilumą, judėjimo sistemos funkcinę būklę. Pasirinktam darbo tikslui įgyvendinti buvo iškelti šie uždaviniai: 1. Įvertinti tiriamosios ir kontrolinės grupių asmenų juosmens aktyvių judesių amplitudę 2. Įvertinti tiriamosios ir kontrolinės grupių asmenų statinę liemens (pilvo ir nugaros) raumenų jėgos ištvermę. 3. Įvertinti tiriamosios ir kontrolinės grupių asmenų funkcinių judesių atlikties pajėgumą. 4. Įvertinti tiriamosios ir kontrolinės grupių asmenų skausmo kiekybines charakteristikas. Tyrimo metodai. Kontrolinę grupę sudarė 18 pacientų besiskundžiančių juosmens skausmu be stuburo segmentinio nestabilumo požymių. Tiriamąją grupę sudarė 12 pacientų, besiskundžiančių juosmens skausmu ir turinčių stuburo segmentinio nestabilumo požymių. Tyrimo metu pacientams buvo vertinama: skausmo intensyvumas naudojat skaičių analogijos skausmo skalę (SAS), funkcinis apatinės nugaros dalies pajėgumas (Roland – Morris klausimynas), judesio baimės (kinezifobijos) įvertinimo klausimynas (TAMPA), funkciniai judesių atlikties testai, juosmens aktyvių judesių amplitudė, statinė liemens raumenų jėgos ištvermė, stuburo segmentinio nestabilumo įvertinimo testas. Išvados: 1. Tiriamosios ir kontrolinės grupių asmenų juosmens aktyvių judesių amplitudė lenkiantis, tiesiantis, atliekant šoninį lenkimą į kairę statistiškai reikšmingai nesiskyrė (p>0,05), o kontrolinės grupės šoninio lenkimo į dešinę judesių... [toliau žr. visą tekstą] / Purpose of the scientific papper: to evaluate patients with chronical low back pain and segmental instability funcional state. To achieve the goal several tasks were raised: 1. To evaluate the active trunk range of motion of participants (controled group and researche group). 2. To evaluate the endurance of muscle’s static strength of the trunk (back and abdominal) of the controled group and the researche group. 3. To evaluate the ability of a personal functional movement of the controled group and the researche group. 4. To evaluate the quantitative pain characteristics of participants (controled group and researche group). Methods of the research. The control goup was made of eighteen patients complaining of a trunk pain without any spinal segmental instability sings. The researche group was made of twelve patients complaining of a trunk pain with spinal segmental instability sings. During the research patients were evaluated on: intensivity of pain using the numerical analogy pain scale (SAS), functional ability of low back (Roland-Morris questionnaire), fear of movement (kineziophobia) evaluation questionnaire (TAMPA), test of a functional movement ability, active range of motion of the trunk, endurance of static muscles strength of the trunk, prone instability test. Conclusions: 1. Difference between the controled group and the researche group active range of motion while bending, straightening, making the lateral flexion movement to the left was not statisticaly... [to full text]

<p>Low back pain (LBP) is a significant problem among the nursing population worldwide. Manual lifting and shifting of heavy objects and patients are primary contributing factors. Nurses are supposed to be knowledgeable about the risk factors and preventive measures and effectively apply it into practice to prevent them from sustaining back injuries. Strategies to reducing the incidences of LBP in nurses have been previously implemented but with little outcomes. The purpose of this study was to explore the relationship between occupational risk factors and the prevalence of LBP in nurses at MOI, Tanzania. Therefore, the study examined / the prevalence of LBP amongst nurses, work-related risk factors contributing to LBP, knowledge and effectiveness of back care techniques, and barriers to effective back care techniques in clinical nurses.</p>

Darbο tikslas: nustatyti kompiuterizuotos nechirurginės dekοmpresijοs (ND) pοveikį asmenų funkcinei būklei dėl tarpslankstelinės diskο išvaržοs, besiskundžiančių juοsmeninės stuburο dalies (JSD) skausmu bei juοsmeninės stuburο dalies ir kοjοs skausmu. Darbο uždaviniai: 1. Įvertinti pacientų, besiskundžiančių JSD skausmu bei JSD ir kοjοs skausmu, liemens raumenų ištvermės pοkyčius pο ND prοcedūrų. 2. Įvertinti pacientų, besiskundžiančių JSD skausmu bei JSD ir kοjοs skausmu, JSD paslankumο pοkyčius pο ND prοcedūrų. 3. Įvertinti pacientų, besiskundžiančių JSD skausmu bei JSD ir kοjοs skausmu, skausmο intensyvumο pοkyčius pο ND prοcedūrų. 4. Įvertinti pacientų, besiskundžiančių JSD skausmu bei JSD ir kοjοs skausmu, funkcinės negaliοs pοkyčius pο ND prοcedūrų. 5. Palyginti gautus rezultatus tarp pacientų, besiskundžiančių JSD skausmu su pacientų, besiskundžiančių JSD ir kοjοs skausmu. Tyrimο metοdika: 1. Liemenį lenkiančių ir tiesiančių raumenų ištvermė. 2. JSD paslankumas Schοber'ο testu. 3. Skausmο intensyvumas pagal skaičių analοginę skalę (SAS). 4. Funkcinė negalia pagal Οswestry funkcinės negaliοs klausimyną ir Rοland–Mοrris klausimyną. Išvadοs: 1. Pο ND prοcedūrų padidėjο liemenį lenkiančių ir tiesiančių raumenų ištvermė pacientams, besiskundžiantiems JSD skausmu (p<0,001) ir pacientams, besiskundžiantiems JSD ir kοjοs skausmu (p<0,001). 2. Pο ND prοcedūrų padidėjο JSD paslankumas pacientams, besiskundžiantiems JSD skausmu (p<0,001) ir pacientams, besiskundžiantiems JSD... [toliau žr. visą tekstą] / The aim οf the study is tο define the effectiveness οf Nοn-Surgical Spinal Decοmpressiοn (NSSD) οn patients functiοnal status, fοr thοse whο suffers frοm lοw back pain (LBP) and thοse whο suffers frοm lοw back and leg pain, the reasοn οf which is vertebral disc herniatiοn. The tasks οf the study: 1. Estimate the changes in trunk muscle endurance οf patients whο suffers frοm lοw back pain and thοse whο suffers frοm lοw back and leg pain after nοn-surgical spinal decοmpressiοn prοcedures. 2. Estimate the changes οf the lumbar spine mοbility οf patients whο suffers frοm lοw back pain and thοse whο suffers frοm lοw back and leg pain after nοn-surgical spinal decοmpressiοn prοcedures. 3. Estimate the pain intensity changes οf patients whο suffers frοm lοw back pain and thοse whο suffers frοm lοw back and leg pain after nοn-surgical spinal decοmpressiοn prοcedures. 4. Estimate the changes οf disability indicatοrs οf patients whο suffers frοm lοw back pain and thοse whο suffers frοm lοw back and leg pain after nοn-surgical spinal decοmpressiοn prοcedures. 5. Cοmpare the results οf bοth grοups οf patients. The methοds οf the research: 1. The endurance test οf the waist flexing and extending muscles. 2. The lumbar spine mοbility based οn Schοber‘s test. 3. Pain intensity based οn Numeric Analοgue Scale (NAS). 4. Functiοnal status based οn Οwestry Functiοnal Disability Questiοnnaire and Rοlland Mοrris‘s Disability Questiοnnaire. Cοnclusiοns: 1. The imprοvement οf the waist flexing... [to full text]

Nugaros skausmas gydomas taikant kompleksines reabilitacijos priemones, tačiau ir po jų taikymo kai kuriem pacientams išlieka vidutinio intensyvumo skausmas ir gyvenimo kokybė pagerėja ne visose srityse. Šio darbo tikslas yra nustatyti, kuriose sveikatos srityse po sėkmingo II reabilitacijos etapo įveikimo, išlieka tam tikri apribojimai ir nustatyti individualios kineziterapijos programos poveikį su sveikata susijusiai gyvenimo kokybei ir skausmo intensyvumui. / Back pain is treated through complex rehabilitation measures, however, some of health indicators remains unchanged. The goal of this study is to determine which health indicators remains impaired at the end of 2nd stage of rehabilitation, and to determine the effectiveness of individual physical therapy programme for quality of life and pain intensity.

Darbo tikslas: Įvertinti liemens raumenų ištvermės ir statinės pusiausvyros rodiklių sąsajas asmenims, jaučiantiems lėtinį apatinės nugaros dalies skausmą. Darbo uždaviniai: 1. Įvertinti liemens raumenų ištvermę prieš ir po reabilitacinio gydymo taikant stuburo stabilizacinę funkciją gerinančius pratimus. 2. Įvertinti statinę pusiausvyrą ir skausmo intensyvumą prieš ir po reabilitacinio gydymo taikant stuburo stabilizacinę funkciją gerinančius pratimus. 3. Nustatyti liemens raumenų ištvermės, statinės pusiausvyros ir skausmo intensyvumo rodiklių sąsajas prieš ir po reabilitacinio gydymo taikant stuburo stabilizacinę funkciją gerinančius pratimus. Tiriamųjų kontingentas: Tyrime dalyvavo viena tiriamoji grupė, kurios narių skaičius buvo 29 pacientai: 11 vyrų ir 17 moterų; 1 tiriamasis tyrimo neužbaigė, kadangi gydymo eigoje atsisakė jame dalyvauti. Tiriamųjų amžiaus vidurkis buvo 46.32±0,92 metai ir svyravo intervale nuo 38 iki 55 metų. Tyrime taikyti metodai: Statinis nugaros tiesiamųjų raumenų ištvermės vertinimas pagal Ito (1996) ir McIntoch (1998) testus; Statinės pilvo lenkiamųjų raumenų ištvermės vertinimas pagal McIntoch (1998) ir McGill (2002) testus; Statinės šoninių liemens raumenų ištvermės vertinimas pagal McGill (2002) testą; Skausmo intensyvumas vertintas skaitmenine analogijos skale; Statinė pusiausvyra vertinta „Sigma Balance“ platforma. Rezultatai ir išvados: įvertinus liemens raumenų ištvermę, statinę pusiausvyrą ir skausmo intensyvumą prieš ir po... [toliau žr. visą tekstą] / Aim of the thesis is to evaluate correlation between trunk muscle endurance and indicators of static balance for people suffering from chronic low back pain. Goals of the thesis: 1. Assess trunk muscle endurance before and after rehabilitative treatment that involves spine stabilization exercises. 2. Assess static balance and intensity of pain before and after rehabilitative treatment that involves spine stabilization exercises. 3. Determine the correlation between trunk muscle endurance and indicators of static balance and pain intensity before and after rehabilitative treatment that involves spine stabilization exercises. Research group: the research was performed using a single research group that involved 29 patients: 11 men and 17 women; 1 subject refused continuing participation in the research in the course of the treatment. The average age of the subjects was 46.32±0.92 years and varied in the interval from 38 to 55 years. Methods applied in the research: evaluation of static endurance of the trunk extensor muscles applying Ito, (1996) and McIntoch (1998) tests; evaluation of static endurance of the abdominal flexors applying McIntoch (1998) and McGill (2002) tests; evaluation of static endurance of the lateral trunk muscles applying McGill (2002) tests; Pain intensity was evaluated using digital analogue scale; Static balance was assessed using balance platform SIGMA. Results and conclusions: after assessing the endurance of trunk muscles, static balance and pain... [to full text]

No description available.

Objectives. To assess outcome of manual therapy in addition to stay-active care in sub-acute low back pain patients and to investigate the predictive power of pain drawing sketch variables for return to work. Materials and methods. The study was designed as a randomised controlled trial with a factorial design, and included 160 patients with acute or sub-acute low back pain allocated to one of the four treatment groups during 10 weeks. Group 1 received stay-active care only, Group 2 the same treatment as in Group 1 + muscle stretching, Group 3 the same treatment as in Group 2 plus manual therapy, and Group 4 the same treatment as Group 3 plus steroid injections. Outcome included pain intensity, pain extension, functional and health related quality of life variables and return to work. Results. Pain intensity and disability rating improved faster in Groups 3 and 4 than in Groups 1 and 2 (p&lt;0.05 and p&lt;0.05). Also health related quality of life was affected by the treatments given; the more treatment options the better the effect (trend across the groups p&lt;0.05). Pain extension as described on a pain drawing sketch decreased in all groups across the study period. The pain modality ‘numbness’ was the most painful one among patients with no pain radiation. Pain radiation according to the pain drawing sketch was the strongest predictor for return to work (p=0.03, Wald χ2=4.56). Conclusions. The manual therapy concept used in this study reduced pain intensity and disability rating better than the stay active concept. The effects on health related quality of life were greater the larger the number of treatment modalities available. Pain drawing information was significantly correlated with pain and functional variables. Pain radiation according to the pain drawing adds significant information to the prediction of return to work.

Ανασκόπηση βιβλιογραφίας: Όπως υποστηρίζεται από διάφορες έρευνες οι μυς της οσφυϊκής χώρας και συγκεκριμένα ο πολυσχιδής μυς, παίζουν σημαντικό ρόλο στη σταθερότητα της σπονδυλικής στήλης. Προηγούμενες εργασίες που μελέτησαν τα χαρακτηριστικά του πολυσχιδή μυός σε ασθενείς με οσφυαλγία δεν έχουν συμπεριλάβει στο σχεδιασμό τους την παράμετρο της φυσικής δραστηριότητας. Σκοπός της παρούσας έρευνας ήταν να εξετάσει την διάμετρο και την ποσοστιαία αναλογία των μυϊκών ινών του πολυσχιδή μυός μεταξύ ομάδων ασθενών με οσφυαλγία διαφορετικού επιπέδου φυσικής δραστηριότητας και υγιών ατόμων. Μεθοδολογία: Στη μελέτη συμμετείχαν εθελοντικά 64 ασθενείς με οσφυαλγία. Βασιζόμενοι στο επίπεδο φυσικής δραστηριότητας των ασθενών, το οποίο εκτιμήθηκε με την συμπλήρωση συγκεκριμένου ερωτηματολογίου (IPAQ), δημιουργήθηκαν τρεις (3) ερευνητικές ομάδες. Η διαχωρισμός των τριών ομάδων έγινε ανάλογα με το επίπεδο φυσικής δραστηριότητας ως εξής: χαμηλή (ΧΦΔ), μέση (ΜΦΔ), υψηλή (ΥΦΔ). Επίσης στον σχεδιασμό της έρευνας συμπεριελήφθη μια ομάδα ελέγχου αποτελούμενη από 17 άτομα. Βιοπτικό υλικό, διαστάσεων περίπου 5Χ5Χ10 χιλ., ελήφθη από τον πολυσχιδή μυ στο επίπεδο Ο4-Ο5. Αποτελέσματα: Αντίθετα με την ομάδα ελέγχου, οι ομάδες ασθενών με οσφυαλγία παρουσίασαν στατιστικώς μεγαλύτερη ποσοστιαία αναλογία μυϊκών ινών Τύπου ΙΙ καθώς και μικρότερη διάμετρο και στους δύο τύπους ινών (p<0.05). Τα αποτελέσματα έδειξαν ότι το επίπεδο φυσικής δραστηριότητας δεν επηρέασε τα χαρακτηριστικά του πολυσχιδή μυ καθώς δεν παρατηρήθηκαν σημαντικές διαφορές (p>0.05) στη διάμετρο και ποσοστιαία αναλογία των ινών μεταξύ των ομάδων ΥΦΔ, ΜΦΔ και ΧΦΔ. Διάφορες ιστοπαθολογικές αλλοιώσεις που παρατηρήθηκαν ήταν εμφανέστερες στις ομάδες ασθενών με οσφυαλγία συγκριτικά με την ομάδα ελέγχου (p<0.05). Η διάμετρος και των δύο τύπων μυϊκών ινών ήταν μεγαλύτερη στους άνδρες σε σχέση με τις γυναίκες (p<0.05). Συμπεράσματα: Τα αποτελέσματα της έρευνας έδειξαν ότι το επίπεδο φυσικής δραστηριότητας μεταξύ των ομάδων ασθενών με οσφυαλγία δεν επηρέασε την διάμετρο και ποσοστιαία αναλογία των μυικών τους ινών. Συμπερασματικά, βάση αυτών των ευρημάτων η έρευνα προτείνει ότι τόσο η φυσική αδράνεια όσο και η υψηλή φυσική δραστηριότητα μπορούν να επιφέρουν αρνητικές επιπτώσεις στα χαρακτηριστικά των ινών του πολυσχιδή μυός. / Background: Previous studies examining the multifidus fiber characteristics among low back pain (LBP) patients have not considered the variable of physical activity. The present study sought to investigate the muscle fiber size and type distribution of the lumbar multifidus muscle among LBP patient groups with different physical activity levels and healthy controls. Methods: 64 patients were assigned to one of three groups named according to the physical activity level, determined for each patient by the IPAQ questionnaire. These were low (LPA), medium (MPA) and high (HPA) physical activity groups. A control group comprising of 17 healthy individuals was also recruited. Muscle biopsy samples were obtained from the multifidus muscle at the level L4-L5. Results: In contrast with the control group, LBP patient groups showed a significantly higher Type II fiber distribution as well as reduced diameter in both fiber types (p<0.05). The physical activity level did not have an effect on multifidus characteristics since no significant differences were observed in fiber type and diameter (p>0.05) among LPA, MPA and HPA patient groups. Various pathological conditions were detected which were more pronounced in LBP groups compared to the control (p<0.05). Males had a larger fiber diameter compared to females for both fiber types (p<0.05). Conclusion: The results showed that the level of physical activity did not affect muscle fiber size and type distribution among LBP patients groups. These findings suggest that not only inactivity but also high physical activity levels can have an adverse effect on the multifidus muscle fiber characteristics.

Bakgrund Ländryggssmärta är mycket vanligt förekommande i västvärlden. Det innebär stort lidande för individen och stora kostnader för samhället. Idag behandlas ryggsmärta med information om att vara aktiv och vid behov rådgivning om smärtstillande läkemedel. Mer kunskap behövs gällande fysisk träning som prevention och behandling av akut- och subakut ländryggssmärta. Syfte Syftet med studien var att, för patienter med akut- och subakut ländryggsmärta, beskriva den fysiska aktivitetsnivån samt eventuella skillnader i smärtintensitet och funktionsnedsättning mellan grupper med olika aktivitetsnivåer. Syftet var även att undersöka samband mellan aktivitetsnivå och smärtintensitet respektive aktivitetsnivå och funktionsnedsättning. Metod Studien var en enkätstudie med tvärsnittsdesign. Deltagarna var 15 patienter, 9 kvinnor och 6 män, medelålder 49,2 år, som sökt vård för akuta eller subakuta ländryggsbesvär till 4 olika primärvårdsenheter. Fysisk aktivitetsnivå skattades via Socialstyrelsens indikatorfrågor för fysisk aktivitet, smärtan med numerisk skattningsskala 0-10 (NRS) och Roland Morris Disability Questionnaire (RMDQ) besvarades. Data sammanställdes med deskriptiv statistik, skillnader testades med Mann-Whitney U-test och samband analyserades med Spearmans korrelationskoefficient. Resultat Åtta av 15 deltagare uppnådde Världshälsoorganisationens (WHO) rekommendationer för fysisk aktivitet (&gt; 150 minuter i veckan). De som ägnade sig åt fysisk träning minst 90 minuter per vecka hade medianvärde NRS 5,5 och RMDQ 8, för de som tränade mindre var motsvarande värden NRS 7,5 (p=0,153) och RMDQ 11,5 (p=0,175). Ett svagt negativt samband identifierades mellan NRS (r=-0,316,) och nivå av fysisk aktivitet medans sådant samband mellan RMDQ och fysisk aktivitetsnivå var negligerbart (r=-0,158). Slutsats Det var ingen statistiskt signifikant skillnad mellan grupperna som tränade minst 90 minuter per vecka och de som tränade mindre gällande varken smärtintensitet eller funktionsnedsättning. Ett svagt negativt men ej statistiskt signifikant samband kan ses mellan fysisk aktivitetsnivå och smärtintensitet. / Background Lower back pain is very common in the western world. It results in a great suffering for the person and large economic costs for the society. Today lower back pain is treated with information to stay active and medication for pain relief. There is a lack of knowledge with regards to what effect physical training has as prevention and treatment for acute and subacute lower back pain. Aim The aim of this study was to, among patients with acute and subacute non-specific lower back pain, describe their level of physical activity and evaluate differences between groups with different levels of activity. The aim was also to explore the association between pain intensity, disability and level of physical activity. Method The study was conducted as a survey. The participants was 15 patients, 6 men and 9 women with the mean age of 49,2 years old, who had sought care for acute and subacute lower back pain in 6 different primary care clinics. The level of physical activity were estimated using the indicator questions for physical activity by Socialstyrelsen, the pain intensity was measured with the Numeric Rating Scale and the Roland Morris Disability Questionnaire was answered. Data was analyzed with descriptive statistics, differences were tested with Mann-Whitney U-test and correlations analyzed with Spearman correlations coefficient. Results Eight out of 15 participants reached the WHO recommendations of physical activity (&gt; 150 min/week). Those who participated in physical training minimum 90 mins/week had a median value of NRS 5,5 and RMDQ 8. For those who trained less the median values were for NRS 7,5 (p=0,153) and RMDQ 11,5 (p=0,175). A week correlation between NRS (r=-0,136) and level of physical activity was noted while such correlation between RMDQ was negligible (r=-0,158). Conclusion There were no statically significant difference between the groups who trained at least 90 minutes per week and those who trained less neither in regards to pain intensity or disability. A weak but not statistically significant correlation was observed between physical activity and pain intensity.