Risk Factors for Low Back Pain in Childhood and Adolescence: A Systematic Review.

OBJECTIVES: To identify factors associated with low back pain (LBP) in children and adolescents. MATERIALS AND METHODS: A systematic review was conducted (Prospero CRD42016038186). Observational studies analyzing LBP risk factors among participants aged between 9 and 16 were searched for in 13 electronic databases and 8 specialized journals until March 31, 2016, with no language restrictions. In addition, references in the identified studies were manually tracked. All identified studies that included ≥50 participants aged 9 to 16, were reviewed. Their methodological quality was assessed by 2 reviewers separately, using validated tools, which scored, from worst to best, 0 to 100 for cross-sectional and 0 to 12 for cohort studies. A sensitivity analysis only included studies that had adjusted for confounders, had ≥500 participants, and had a methodological score of ≥50%. RESULTS: A total of 5142 citations were screened and 61 studies, including 137,877 participants from 5 continents, were reviewed. Their mean (range) methodological scores were 74.56 (50 to 100) for cross-sectional studies and 7.36 (5 to 9) for cohort studies. The studies had assessed 35 demographic, clinical, biological, family, psychological, ergonomic, and lifestyle risk factors. The mean (range) prevalence of LBP ranged between 15.25% (3.20 to 57.00) for point prevalence and 38.98% (11.60 to 85.56) for lifetime prevalence. Results on the association between LBP and risk factors were inconsistent. In the sensitivity analysis, "older age" and "participation in competitive sports" showed a consistent association with LBP. DISCUSSION: Future studies should focus on muscle characteristics, the relationship between body and backpack weights, duration of carrying the backpack, characteristics of sport practice, and which are the factors associated with specifically chronic pain.

Patients with neck pain are less likely to improve if they experience poor sleep quality: a prospective study in routine practice.

OBJECTIVE: To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at 3 months. MATERIALS AND METHODS: Four hundred twenty-two subacute and chronic patients with neck pain (NP) were recruited in 32 physiotherapy, primary care, and specialized centers. NP, referred pain, disability, catastrophizing, depression, and SQ were assessed through validated questionnaires, upon recruitment and 3 months later. Correlations between baseline scores were calculated through the Spearman coefficient. Improvements in NP, disability, and SQ were defined as a reduction of ≥30% of baseline score. Six estimative logistic regression models were developed to assess the association between baseline SQ and improvement of NP, baseline SQ and improvement of disability, baseline NP and improvement of SQ, baseline disability and improvement of SQ, the evolutions of NP and SQ, and the evolutions of disability and SQ. RESULTS: Most patients were subacute and mildly impaired. Regression models showed that better SQ at baseline was associated with improvement of NP (odds ratio=0.91 [95% confidence interval, 0.83-0.99]), but not disability (1.04 [0.95-1.13]); the improvement of SQ was associated with more severe NP at baseline (1.26 [1.07-1.49)], but not with baseline disability (0.99 [0.97-1.02]); and that improvement in SQ was associated with improvements in NP (3.48 [1.68-7.20]), and disability (5.02 [2.39-10.11]). DISCUSSION: NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.

Programa de fisioterapia mejora a largo plazo las habilidades motoras en pacientes con enfermedad de Parkinson / Physical therapy program improves motor skills in the long term in patients with Parkinson’s disease

El objetivo es reflejar la influencia que tiene eltratamiento fisioterapéutico en pacientes conenfermedad de Parkinson (EP). Se evaluó a19 pacientes aplicando la Unified Parkinson’s DiseaseRating Scale (UPDRS). La UPDRS es una escalamultidimensional con 4 secciones: estado mental,comportamiento y estado de ánimo; actividades de lavida diaria; examen motor; complicaciones de laterapia. También se aplicó la escala Hoehn-Yahrmodificada. Las complicaciones motoras de la EP sobrela capacidad física y funcional son notables.Los resultados relativos al examen motor en la etapapreintervención y postintervención se presentanmediante regresión lineal, utilizando la herramientainformática SPSS versión 14.0. Las medidas detendencia central de la puntuación global alcanzada enla etapa preintervención y postintervención son: en elestadio on la media ± desviación estándar pasa de64,22 ± 16,383 antes de la intervenciónfisioterapéutica a 50,89 ± 19,499 tras la intervención; en el estadio off el valor de la media ± desviaciónestándar pasa de 85,78 ± 12,549 a 75,78 ± 17,745.La reducción cuantitativa de fuerza muscular en laespalda, la cadera y el tobillo, con daño en lapropiocepción y el sentido visual, y una menor base deapoyo, son las causas principales para la inestabilidadpostural en los pacientes con EP. Observamos que, alincrementar hasta un rango de 7-12 el número desesiones (grupos 3 y 4), las puntuaciones en lasubescala motor son mayores, lo que indica que larigidez de cuello, la postura, el equilibrio y la marchamejoran, y esta mejoría es más duradera(AU)

The objective of this study is to examine the effect physicaltherapy on patients with Parkinson’s Disease (PD).Nineteen patients were evaluated with the UnifiedParkinson’s Disease Rating Scale (UPDRS). UPDRS is amultidimensional scale composed of four sections: 1)mental state, behavior and attitude; 2) daily activities; 3)motor examination; 4) therapeutic complications andmodified Hoehn-Yahr scale. The motor complicationscaused by the PD have an important effect on physicaland functional capacity.The results relative to motor examination in the stagepre-intervention and post-intervention are shown withthe linear regression, using SPSS software version 14.0®.Measurements of central trend of the global punctuationreached in the pre-intervention and post-interventionstages are: in the on stage, the average goes from64.22 ± 16.383 before physical therapy intervention to50.89 ± 19.499 after the intervention; in the off stage,the value of the average goes from 85.78 ± 12.549 to75.78 ± 17.745. Quantitative reduction of muscular strength in the back,hips, ankles, with damage in propioception, visual senseand the lowest support base, are the main causes ofinstability in patients with Parkinson’s Disease.If the number of sessions (groups 3 and 4) are increased toa range of 7-12, the scores on the motor examination arehigher. This indicates that neck stiffness, body posture,balance and gait improve, and this improvement islonger-lasting(AU)