RESUMEN
Low back pain (LBP) continues to be a major health problem causing personal suffering and enormous socioeconomic costs. Evidence suggests that more than 85 % of individuals with LBP suffer from non-specific low back pain. Physiotherapy for non-specific LBP includes educational, physical, manual and movement therapy measures. In the acute phase, it is very important to prevent chronicity by identifying barriers for a full recovery and a quick return to everyday activities. If there is a chronicity of symptoms, the treatment must focus on improvement of the general physical activity despite the pain and promote participation in the social and work context. These aims are more important than pain relief. Therefore in the acute phase educational and activity-promoting measures are the primary treatment options. In the sub-acute and chronic phase a multidimensional treatment approach including exercise therapy with the aim of improving function, including return to work, should be applied. By now, there is scientific evidence that physiotherapy can reduce pain and disability due to LBP, and that return to usual activities including work can be achieved.
Asunto(s)
Terapia por Ejercicio/métodos , Dolor de la Región Lumbar/rehabilitación , Terapia Pasiva Continua de Movimiento/métodos , Manipulaciones Musculoesqueléticas/métodos , Educación del Paciente como Asunto/métodos , Modalidades de Fisioterapia , Terapia Combinada , HumanosRESUMEN
A CE method employing capacitively coupled contactless conductivity (C(4)D) compared to indirect UV-detection was developed for the analysis of phytochemically relevant flavonoids, such as 6-hydroxyflavone, biochanin A, hesperetin and naringenin. To ensure fast separation at highest selectivity, sensitivity and peak symmetry, the pH value and the concentration of the running BGE had to be optimized regarding both co- and counter-EOF mode. Optimum conditions were found to be 1.0 and 5.0 mM chromate BGE (pH 9.50) in the counter- and co-EOF mode, respectively. Validation of the established CE-C(4)D method pointed out to be approximately seven times more sensitive compared to indirect UV-detection applying the same conditions. The lower LOD defined at an S/N of 3:1 was found between 0.12 and 0.21 microg/mL for the analytes of interest using C(4)D and between 0.77 and 1.20 microg/mL using indirect UV-detection. Compared to an earlier published CE method employing direct UV-detection, C(4)D was found to be approximately two times more sensitive. Due to the lower baseline noise, C(4)D showed an excellent regression coefficient >0.99 compared to 0.93 when using indirect UV detection calibrating within a concentration range between 1 and 10 microg/mL. The influence of the sugar moiety on the conductivity of a flavonoid was studied upon the analysis of the aglycon hesperetin and the rutinosid hesperidin. The sugar moiety in hesperedin shows a higher conductivity compared to hesperetin. Finally, the optimized established CE-C(4)D method was applied to the determination and quantification of naringenin in Sinupret.