Ospecifik ländryggssmärta är den vanligaste typen av ländryggssmärta och saknar identifierbar patoanatomisk orsak, därför har det blivit en utmaning att utveckla effektiva behandlingar. Det saknas nationella riktlinjer i Sverige för fysioterapeutisk behandling av ospecifik ländryggssmärta. Det är oklart vilka typer av åtgärder som idag används av svenska fysioterapeuter.  Syftet med studien var att kartlägga vilka fysioterapeutiska åtgärder för ospecifik ländryggssmärta som används av fysioterapeuter i Sverige samt undersöka om det föreligger eventuella skillnader i val av åtgärd mellan offentligt och privat anställda fysioterapeuter och mellan kvinnliga och manliga fysioterapeuter.  Studien var en kvantitativ tvärsnittsstudie av deskriptiv och komparativ design. Urvalet var ett bekvämlighetsurval bestående av yrkesverksamma fysioterapeuter i Sverige. Data samlades in via en enkät som besvarades av 105 fysioterapeuter.  De mest frekvent använda åtgärderna var information och råd kring fysisk aktivitet, sedan följde information om ergonomi, information om smärtmekanismer, muskelstärkande träning samt träning av rörlighet. Privat anställda fysioterapeuter använde laserterapi (p=0.020), massage (p=0.006), samt yoga (p=0.013) oftare i genomsnitt jämfört med offentligt anställda. McKenzie träningsprogram (p=0.010) var mer frekvent använt av offentligt anställda i genomsnitt. Kvinnliga fysioterapeuter använde aerob träning (p=0.012), akupunktur (p=<0.001), information om ergonomi (p=0.023), träning av balans (p=0.013), träning av bålstabilitet med motorisk kontroll (p=0.012), träning av rörlighet (p=0.016) samt TENS (p=<0.001) oftare än manliga.      Studien visade att det i övrigt fanns mycket likhet mellan grupper men att typen av anställning samt kön kan påverka till en viss utsträckning val av åtgärder. / Nonspecific low back pain is the most common type of low back pain and lacks an identifiable pathoanatomical cause, which makes it difficult to develop effective treatments. There are no national guidelines in Sweden for this condition and it is unclear what methods are currently used by Swedish physiotherapists. The purpose of the study was to map physiotherapeutic measures for nonspecific low back pain used by physiotherapists in Sweden and to investigate whether there are differences between public and private physiotherapists and between female and male physiotherapists. The study was a quantitative cross-sectional study of descriptive and comparative design. The sample was a convenience sample and the data were collected via a questionnaire that was answered by 105 physiotherapists.  The most frequently used methods were information and advice on physical activity, followed by information about ergonomy, information on pain mechanisms, muscle-strengthening training and training of mobility. Laser therapy (p=0.020), massage (p=0.006) and yoga (p=0.013) were more often used by public physiotherapists while McKenzie training programme (p=0.010) was more often used by public physiotherapists. Female physiotherapists used aerobic training (p=0.012), acupuncture (p=<0.001), information about ergonomy (p=0.023), training of balance (p=0.013), training of core stability with motorical control (p=0.012), träning of mobility (p=0.016) and TENS (p=<0.001) more often than male physiotherapists.  The study showed that there were strong similarities between groups but that the type of employment and gender can affect to a certain degree the choice of measures.

Le but de cette thèse est d’étudier s’il existe une méthode de récolte d’informations, autre que celle couramment utilisée, permettant de mieux décrire l’histoire naturelle des lombalgies non spécifiques. Pour cela, une revue de la littérature a été effectuée et une étude prospective dans la population générale danoise a été analysée. Deux méthodes de récolte d’informations sont utilisées pour caractériser cette évolution : la méthode usuelle par questionnaires, permettant de classer les douleurs lombaires en fonction du nombre total de jours avec douleurs dans une année, et une nouvelle méthode par suivi SMS prenant en compte la durée et le rythme des épisodes douloureux dans une année. Les résultats de la revue de littérature et l’analyse de la population générale danoise vont dans le même sens. L’évolution des douleurs lombaires est relativement stable, notamment pour ceux qui n’ont pas de douleurs en début d’étude. Les deux systèmes de classification, issus respectivement des deux méthodes de récolte, répartissent les individus en groupes non similaires. De plus, les associations de ces groupes avec des variables biopsychosociales ne sont pas les mêmes, différenciant ainsi cliniquement les groupes de chaque classification. Le suivi SMS permet d’apporter des informations plus détaillées sur le rythme des douleurs lombaires dans le temps et semble plus appropriée pour caractériser l’évolution d’une affection récurrente comme la lombalgie non spécifique. Ces résultats permettent maintenant de prévoir l’évolution des douleurs lombaires et vont faciliter l’étude plus précise de profils d’évolutions des individus afin d’améliorer le diagnostic qui, pour l’instant, reste un diagnostic d’exclusion. / The aim of this thesis is to study if there is information gathering method, other than that commonly used to better describe the natural history of non-specific low back pain. For this, a literature review was performed and a prospective study in the Danish general population was analyzed. Two methods of gathering information are used to characterize this course: the usual method by questionnaires, classifying low back pain based on the total number of days with pain in one year, and a new SMS-Track method taking into account the duration and rhythm of painful episodes in a year. The results of the literature review and analysis of data on the Danish general population go in the same direction. The course of low back pain is fairly stable, especially for those who do not have pain at baseline. Both classification systems, respectively from the two methods of collection, divide individuals into different groups. In addition, associations of these groups with bio-psychosocial variables are not the same, differentiating clinically the groups of each classification. SMS-Track method provide more detailed information on the rhythm of low back pain over time and seems more appropriate to characterize the course of a recurring condition such as non-specific low back pain. These results now predict the natural history of low back pain and will facilitate the study of individual course patterns to improve the diagnosis, which remains, for now, a diagnosis of exclusion.

The Efficacy of Kinesio Taping as an Adjunct Intervention to Traditional Physical Therapy in the Treatment of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial Background: Acute low back pain (LBP) is a significant health problem worldwide and is one of the leading causes of disability. Objective: The purpose of this study was to examine the effect of Kinesio Taping (KT) on disability, fear-avoidance beliefs, and pain intensity in patients with acute, nonspecific LBP. Research Design and Methods: A prospective, randomized controlled study of consecutive patients referred to physical therapy with a primary complaint of LBP. Seventy-eight patients with acute, nonspecific LBP were randomized to an experimental group that received traditional physical therapy plus KT and a control group that received traditional physical therapy alone. Interventions were administered twice a week for 4 weeks. Assessment tools used were Ronald Morris Disability Questionnaire (RMDQ) for disability, Fear-Avoidance Beliefs Questionnaire (FABQ) for fear-avoidance beliefs, and Numerical Pain Rating Scale (NPRS) for pain intensity. Assessments were conducted at baseline, end of week 1, end of week 2, end of week 3, and end of week 4. Analysis: Repeated measures mixed model analysis of variance (ANOVA) was used to examine the effect of treatment on each variable. The group type was the between-subjects variable and the time was the within-subjects variable. A significance level of .05 was used in the analyses. Results: Both groups showed statistically significant lower disability, fear-avoidance beliefs, and pain levels over time compared with baseline scores (p < .0001). The experimental group showed statistically significant lower RMDQ scores at week 2, 3, and 4 (p < .05), statistically significant lower FABQ-physical activity subscale scores at the end of week 1 (p < .01), at the end of week 2 (p < .01), at the end of week 3 (p < .01), and at the end of week 4 (p < .05), statistically significant lower FABQ-work subscale scores at week 3 (p < .05) and week 4 (p < .01), and statistically significant lower NPRS scores at week 1, 2, 3, and 4 (p < .05). Conclusion: Kinesio Taping can be considered a useful adjunct intervention to reduce disability and pain and to modulate fear-avoidance beliefs in patients with acute, nonspecific LBP.

Title: Effect comparison of educational-movement therapy "stabilization function"of a trunk and traditional rehabilitation therapeutic approach for patients with nonspecific low back pain. Nonspecific low back pain is a main cause of disability and the principal cause for injury-related lost work-days. The various therapies for nonspecific low back pain have been elaborated in many studies. The recommended therapeutic guideline for primary care of patients with nonspecific low back pain is early mobilization combined with a specific rehabilitation therapeutic approach. One such specific rehabilitation therapeutic approach is "trunk stabilization" therapy. The objective of this dissertation is to compare a therapeutic approach involving "stabilization exercises" with the traditional clinical approach that has been clinically proven to be most efficacious for patients with acute nonspecific low back pain. This study compares the effects of the prescribed therapies on 24 patients with non- specific acute low back pain. The test subjects (men and women with an average age 41.2 years) were allocated into two simple randomized subgroups. The test subjects received 2 outpatient therapy sessions per week for 4 weeks. Pre-test and post-test spine shape and range of motion examination were determined using...

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2018. / Background: Chronic non-specific low back pain (CNSLBP) is a common ailment treated by chiropractors. Most chiropractors focus on the localised lumbar area of pain. Other chiropractors focus on restoring function to compensating articulations in the ‗full kinematic chain‘ by assessing and treating the lower extremity in conjunction to the low back. Patients with LBP often exhibit decreased hip-related ranges of motion that may result in future LBP, relapse and a prolonged recovery time. Studies investigating the effect of treating the kinematic chain in relation to LBP are limited and the literature, although widely taught and practiced, is largely anecdotal. Chiropractic manipulation has shown to be effective in the treatment of LBP and many lower extremity conditions. Objectives: This study set out to determine if a combination of low back and hip manipulation would result in a more beneficial outcome for the participant, suffering with CNSLBP, than low back manipulation alone in terms of objective and subjective outcomes. Method: The study was a randomised controlled clinical trial which, through purposive sampling, consisted of 50 participants with CNSLBP and hip joint dysfunction. The participants were randomly divided into two groups of 25 each [A and B]. Group A received low back manipulation alone and Group B received combined low back and hip manipulation. Subjective data was obtained through the Oswestry Low Back Pain Disability Index (ODI) and the Numerical Pain Rating Scale (NPRS). Objective data was obtained through the use of a Force Dial Algometer and an Inclinometer. Data collection occurred at the first, third and fifth consultations and was coded and analysed using IBM SPSS version 24.0. A p-value value of less than 0.05 was considered to be statistically relevant. Results: Intra-group testing showed that there was a significant difference over time, within both groups, with regards to internal rotation and external rotation of the hip, flexion of the lumbar spine, increased pain tolerance in Algometer tests, decreased NPRS values and decreased ODI scores. Within Group A, the mean scores for hip flexion reflected a more significant increase over time than those of Group B. Within Group B, the mean scores for left and right rotation of the lumbar spine reflected a more significant change over time than those of Group A. Inter-group testing showed no significantly differential treatment effect for any of the subjective and objective outcomes. This means that both treatments were equally effective and the hypothesis, that suggested that Group B would improve more than Group A, was incorrect. Conclusion: Both treatment groups improved subjectively and objectively with regards to CNSLBP. Inter-group testing showed that statistically, and for all outcome measurements, there were no significant differences between the two treatment group‘s results. This suggested that there was no additional benefit in combining hip joint manipulation with low back manipulation in the treatment of CNSLBP. / M

Title: Effect comparison of educational-movement therapy "stabilization function"of a trunk and traditional rehabilitation therapeutic approach for patients with nonspecific low back pain. Nonspecific low back pain is a main cause of disability and the principal cause for injury-related lost work-days. The various therapies for nonspecific low back pain have been elaborated in many studies. The recommended therapeutic guideline for primary care of patients with nonspecific low back pain is early mobilization combined with a specific rehabilitation therapeutic approach. One such specific rehabilitation therapeutic approach is "trunk stabilization" therapy. The objective of this dissertation is to compare a therapeutic approach involving "stabilization exercises" with the traditional clinical approach that has been clinically proven to be most efficacious for patients with acute nonspecific low back pain. This study compares the effects of the prescribed therapies on 24 patients with non- specific acute low back pain. The test subjects (men and women with an average age 41.2 years) were allocated into two simple randomized subgroups. The test subjects received 2 outpatient therapy sessions per week for 4 weeks. Pre-test and post-test spine shape and range of motion examination were determined using...