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1.
Appl Ergon ; 98: 103588, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34562781

RESUMO

Through a randomized controlled trial, we evaluated the effects of an electro-magnetic active seat suspension that reduces exposure of a long-haul truck driver to whole body vibration (WBV) on low back pain (LBP) and disability. Among 276 drivers recruited from six trucking terminals of a major US trucking company, 135 eligible drivers were assigned to either having an Active Seat (Intervention: n = 70) - the BoseRide® electro-magnetic active seat - or Passive Seat (reference: n = 65) - a new version of their current seat (passive air suspension seat) - installed in their truck via block (terminal) randomization. Low back pain (LBP) severity, on a 0-10 scale and the Oswestry LBP Disability Index were collected before and 3-, 6-, 12-, 18-, and 24-months post seat installation. LBP severity and LBP disability scores were significantly lower post seat installation in both groups. At 3 months, LBP severity decreased -1.4 [95% CI: -2.1 to -0.7: n = 46] for drivers in the Active Seat arm, and -1.5 [95% CI: -2.3 to -0.8: n = 41] for drivers in the Passive Seat arm. In a subset of drivers, WBV exposures were collected before and after the seat installation. WBV exposures significantly decreased post seat installation for Active Seat (p < 0.01) but not for Passive Seat (p = 0.15). While the new seat-suspension technology reduced WBV exposures, LBP appeared to be improved by multiple factors. These results were limited by the secondary prevention approach and the longer-term loss to follow up due to large rates of driver turnover typical for the industry.


Assuntos
Condução de Veículo , Dor Lombar , Doenças Profissionais , Exposição Ocupacional , Desenho de Equipamento , Humanos , Dor Lombar/etiologia , Dor Lombar/prevenção & controle , Veículos Automotores , Exposição Ocupacional/efeitos adversos , Vibração/efeitos adversos
2.
Neurosurg Focus ; 51(5): E8, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34724641

RESUMO

OBJECTIVE: What is considered "abnormal" in clinical testing is typically defined by simple thresholds derived from normative data. For instance, when testing using the five-repetition sit-to-stand (5R-STS) test, the upper limit of normal (ULN) from a population of spine-healthy volunteers (10.5 seconds) is used to identify objective functional impairment (OFI), but this fails to consider different properties of individuals (e.g., taller and shorter, older and younger). Therefore, the authors developed a personalized testing strategy to quantify patient-specific OFI using machine learning. METHODS: Patients with disc herniation, spinal stenosis, spondylolisthesis, or discogenic chronic low-back pain and a population of spine-healthy volunteers, from two prospective studies, were included. A machine learning model was trained on normative data to predict personalized "expected" test times and their confidence intervals and ULNs (99th percentiles) based on simple demographics. OFI was defined as a test time greater than the personalized ULN. OFI was categorized into types 1 to 3 based on a clustering algorithm. A web app was developed to deploy the model clinically. RESULTS: Overall, 288 patients and 129 spine-healthy individuals were included. The model predicted "expected" test times with a mean absolute error of 1.18 (95% CI 1.13-1.21) seconds and R2 of 0.37 (95% CI 0.34-0.41). Based on the implemented personalized testing strategy, 191 patients (66.3%) exhibited OFI. Type 1, 2, and 3 impairments were seen in 64 (33.5%), 91 (47.6%), and 36 (18.8%) patients, respectively. Increasing detected levels of OFI were associated with statistically significant increases in subjective functional impairment, extreme anxiety and depression symptoms, being bedridden, extreme pain or discomfort, inability to carry out activities of daily living, and a limited ability to work. CONCLUSIONS: In the era of "precision medicine," simple population-based thresholds may eventually not be adequate to monitor quality and safety in neurosurgery. Individualized assessment integrating machine learning techniques provides more detailed and objective clinical assessment. The personalized testing strategy demonstrated concurrent validity with quality-of-life measures, and the freely accessible web app (https://neurosurgery.shinyapps.io/5RSTS/) enabled clinical application.


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Atividades Cotidianas , Humanos , Vértebras Lombares , Aprendizado de Máquina , Estudos Prospectivos
3.
Sensors (Basel) ; 21(21)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34770464

RESUMO

The activities performed by nurses in their daily activities involve frequent forward bending and awkward back postures. These movements contribute to the prevalence and development of low back pain (LBP). In previous studies, it has been shown that modifying their posture by education and training in proper lifting techniques decreases the prevalence of LBP. However, this education and training needs to be implemented daily. Hence, implementing the use of a wearable device to monitor the back posture with haptic feedback would be of importance to prevent LBP. This paper proposes a wearable device to monitor the back posture of the user and provide feedback when the participant is performing a possible hurtful movement. In this study, a group of participants was asked to wear the device while performing three of the most common activities performed by nurses. The study was divided into three sessions: In the first session, the participants performed the activities without feedback (baseline). During the second session, the participants received feedback from the wearable device (training) while performing the three tasks. Finally, for the third session, the participants performed the three tasks again, but the haptic feedback was turned off (validation). We found an improvement in the posture of more than 40% for the pitch (lateral bending) and roll (forward/backward bending) axes and 7% for the yaw (twisting) axis when comparing to the results from session 1 and session 2. The comparison between session 1 and session 3 showed an overall improvement of more than 50% for the pitch (lateral bending) and roll (forward/backward bending) axes and more than 20% for the yaw axis. These results hinted at the impact of the haptic feedback on the participants to correct their posture.


Assuntos
Dor Lombar , Dispositivos Eletrônicos Vestíveis , Retroalimentação , Humanos , Movimento , Postura
4.
MMW Fortschr Med ; 163(20): 12-13, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34767202
5.
MMW Fortschr Med ; 163(20): 71, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34767233
6.
BMC Musculoskelet Disord ; 22(1): 955, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781916

RESUMO

BACKGROUND: Globally, chronic low back pain (CLBP) is the leading cause of disability associated with economic costs. However, it has received little attention in low-and-middle-income countries. This study estimated the prevalence and risk factors of CLBP among adults presenting at selected hospitals in KwaZulu-Natal. METHODOLOGY: This cross-sectional study was conducted among adults aged ≥18 years who attended the selected hospitals in KwaZulu-Natal during the study period. A self-administered questionnaire was used to collect data on socio-demographic, work-related factors, and information about CLBP. The SPSS version 24.0 (IBM SPSS Inc) was used for data analysis. Descriptive statistics were used for demographic characteristics of participants. CLBP risk factors were assessed using multivariate logistic regression analysis. A p-value of ≤0.05 was deemed statistically significant. RESULTS: A total of 678 adults participated in this study. The overall prevalence of CLBP was 18.1% (95% CI: 15.3 - 21.3) with females having a higher prevalence than males, 19.8% (95% CI: 16.0 - 24.1) and 15.85% (95% CI: 11.8 - 20.6), respectively. Using multivariate regression analysis, the following risk factors were identified: overweight (aOR: 3.7, 95% CI: 1.1 - 12.3, p = 0.032), no formal education (aOR: 6.1, 95% CI: 2.1 - 18.1, p = 0.001), lack of regular physical exercises (aOR: 2.2, 95% CI: 1.0 - 4.8, p = 0.044), smoking 1 to 10 (aOR: 4.5, 95% CI: 2.0 - 10.2, p < 0.001) and more than 11 cigarettes per day (aOR: 25.3, 95% CI: 10.4 - 61.2, p < 0.001), occasional and frequent consumption of alcohol, aOR: 2.5, 95% CI: 1.1 - 5.9, p < 0.001 and aOR: 11.3, 95% CI: 4.9 - 25.8, p < 0.001, respectively, a sedentary lifestyle (aOR: 31.8, 95% CI: 11.2 - 90.2, p < 0.001), manual work (aOR: 26.2, 95% CI: 10.1 - 68.4, p < 0.001) and a stooped sitting posture (aOR: 6.0, 95% CI: 2.0 - 17.6, p = 0.001). CONCLUSION: This study concluded that the prevalence of CLBP in KwaZulu-Natal is higher than in other regions, and that it is predicted by a lack of formal education, overweight, lack of regular physical exercises, smoking, alcohol consumption, sedentary lifestyle, manual work, and a stooped posture.


Assuntos
Dor Lombar , Adolescente , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Dor Lombar/diagnóstico , Dor Lombar/epidemiologia , Masculino , Prevalência , Fatores de Risco , África do Sul/epidemiologia
7.
BMC Musculoskelet Disord ; 22(1): 954, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781941

RESUMO

BACKGROUND: Although there are reports on the effectiveness of microendoscopic laminotomy using a spinal endoscope as decompression surgery for lumbar spinal stenosis, predicting the improvement of low back pain (LBP) still poses a challenge, and no clear index has been established. This study aimed to investigate whether microendoscopic laminotomy for lumbar spinal stenosis improves low back pain and determine the preoperative predictors of residual LBP. METHODS: In this single-center retrospective study, we examined 202 consecutive patients who underwent microendoscopic laminotomy for lumbar spinal stenosis with a preoperative visual analog scale (VAS) score for LBP of ≥40 mm. The lumbar spine Japanese Orthopaedic Association (JOA), and VAS scores for LBP, leg pain (LP), and leg numbness (LN) were examined before and at 1 year after surgery. Patients with a 1-year postoperative LBP-VAS of ≥25 mm composed the residual LBP group. The preoperative predictive factors associated with postoperative residual LBP were analyzed. RESULTS: JOA scores improved from 14.1 preoperatively to 20.2 postoperatively (p < 0.001), LBP-VAS improved from 66.7 to 29.7 mm (p < 0.001), LP-VAS improved from 63.8 to 31.2 mm (p < 0.001), and LN-VAS improved from 63.3 to 34.2 mm (p < 0.001). Ninety-eight patients (48.5%) had a postoperative LBP-VAS of ≥25 mm. Multiple logistic regression analysis revealed that Modic type 1 change (odds ratio [OR], 5.61; 95% confidence interval [CI], 1.68-18.68; p = 0.005), preoperative VAS for LBP ≥ 70 mm (OR, 2.19; 95% CI, 1.17-4.08; p = 0.014), and female sex (OR, 1.98; 95% CI, 1.09-3.89; p = 0.047) were preoperative predictors of residual LBP. CONCLUSION: Microendoscopic decompression surgery had an ameliorating effect on LBP in lumbar spinal stenosis. Modic type 1 change, preoperative VAS for LBP, and female sex were predictors of postoperative residual LBP, which may be a useful index for surgical procedure selection.


Assuntos
Dor Lombar , Estenose Espinal , Descompressão Cirúrgica , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Estudos Retrospectivos , Estenose Espinal/complicações , Estenose Espinal/diagnóstico , Estenose Espinal/cirurgia , Resultado do Tratamento
8.
BMC Musculoskelet Disord ; 22(1): 956, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781946

RESUMO

BACKGROUND: In Germany and other European countries, many occupations still involve manual handling of loads (MHL), an activity that puts the musculoskeletal system at risk of low back pain (LBP). This study aims to describe the current prevalence of MHL in different occupational groups stratified by gender in Germany, the association between MHL and LBP and the adjusted prevalence of LBP in different respond-categories of MHL. METHODS: Data was collected in telephone interviews conducted as part of the 2018 BIBB/BAuA Employment Survey, which covers work-related topics like working conditions, education, health status and job satisfaction. The analyses were limited to full-time workers (> 35 h/week) aged between 15 and 67. The frequency of MHL was analysed descriptively. BLOSSFELD classification was used to group the participants in occupational categories. The analysis of the association between MHL and the prevalence of LBP over the last 12 months was based on robust log-linear Poisson regression that results in prevalence ratios (PR). The main regression model was adjusted for gender, age, working hours, and working conditions. Adjusted estimates for the prevalence of LBP were calculated based on regression analysis. RESULTS: The sample consists of n = 14,331 participants (men: n = 8828, 61.6%; women: n = 5503, 38.4%; median age 49 years). Of these, 52.8% say they were exposed to MHL at work. MHL is most common in agricultural occupations, skilled and unskilled occupations. In the regression model, participants who said they were "often" exposed to MHL reported more frequently LBP than those participants who said they were "never" exposed to MHL. The PR as estimate for the association is 1.41 (95%CI [1.32; 1.49]). Postestimation of the prevalence of LBP began with 47.3% (95%CI [43.8%; 51.1%]) for participants who said they were "never" exposed to MHL and rose to 66.5% (95%CI [62.4%; 71.0%]) for participants who indicated they were "often" exposed to MHL. CONCLUSIONS: The 2018 BIBB/BAuA Employment Survey emphasizes that MHL is still common in the German workforce and shows a significant association to LBP. Prevention policies for avoiding MHL remain vital.


Assuntos
Dor Lombar , Doenças Profissionais , Adolescente , Adulto , Idoso , Emprego , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Ocupações , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
9.
J Orthop Sports Phys Ther ; 51(11): 535, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719939

RESUMO

Many people experience low back pain during their lives. Low back pain usually resolves within a couple of weeks or months; however, for some people, it can last for several months or years. Recently, experts developed a guideline for physical therapists to use when treating low back pain. This guideline aims to improve treatment and outcomes for people with back pain, and help you and your physical therapist make decisions that work best for you. J Orthop Sports Phys Ther 2021;51(11):535. doi:10.2519/jospt.2021.0508.


Assuntos
Dor Lombar , Manipulações Musculoesqueléticas , Fisioterapeutas , Exercício Físico , Humanos , Dor Lombar/terapia
10.
J Orthop Sports Phys Ther ; 51(11): 533-534, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719940

RESUMO

Low back pain (LBP) is a common musculoskeletal condition, a leading cause of disability, and one of the costliest medical conditions. Due to the adverse impact of LBP and the rising costs associated with it, there is a great need to implement consistent, evidence-based practice to improve the quality of care for patients suffering from LBP. It is critical that health care practitioners take steps to reduce reliance on pharmacologic interventions, such as opioids, and promote nonpharmacologic interventions for treating and managing LBP. Synthesized and summarized new research in an update to a clinical practice guideline (CPG), published in the November 2021 issue of JOSPT, supports health care providers as they adopt and implement nonpharmacologic interventions. J Orthop Sports Phys Ther 2021;51(11):533-534. doi:10.2519/jospt.2021.0507.


Assuntos
Dor Lombar , Doenças Musculoesqueléticas , Fisioterapeutas , Prática Clínica Baseada em Evidências , Humanos , Dor Lombar/terapia , Exame Físico
11.
J Orthop Sports Phys Ther ; 51(11): CPG1-CPG60, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719942

RESUMO

Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopaedic Section of the American Physical Therapy Association (APTA), clinical practice guideline (CPG) for LBP. The overall objective of this update was to provide recommendations on interventions delivered by physical therapists or studied in care settings that included physical therapy providers. It also focused on synthesizing new evidence, with the purpose of making recommendations for specific nonpharmacologic treatments. J Orthop Sports Phys Ther 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304.


Assuntos
Dor Crônica , Dor Lombar , Fisioterapeutas , Humanos , Dor Lombar/terapia , Modalidades de Fisioterapia
12.
Chiropr Man Therap ; 29(1): 42, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724968

RESUMO

BACKGROUND: Factors that influence utilisation rates of patient reported outcome measures (PROMs) for low back pain (LBP) within the chiropractic profession of Australia are currently unknown. This study aimed to examine whether factors, including age, sex, experience level, clinical title (principal vs associate), or a clinicians' perceived value of PROMs, are predictive of the frequency and/or type of PROMs used by chiropractors in the management of LBP. METHODS: A cross sectional online survey was distributed to members of the Chiropractic Association of Australia (CAA now known as Australian Chiropractors Association-ACA) and Chiropractic Australia (CA). 3,014 CAA members and 930 CA members were invited to participate totaling 3,944, only respondents that were using PROMs were included in the analysis (n = 370). Ordinal logistic regression was used to examine associations between clinician demographics and perceived value of PROMs, and the frequency of pain, health, and functional patient reported outcome measure (PROM) usage by chiropractors. RESULTS: Principal chiropractors were more likely (Wald = 4.101, p = 0.04, OR = 1.4 (1.0-2.1)) than associate chiropractors to frequently use pain-related PROMs for the management of patients with LBP. The remaining demographic factors (age, sex, and experience level) were not associated with the frequency of PROM usage; nor were the perceived value clinicians place on PROMs in clinical practice. CONCLUSION: Principal chiropractors were more likely to frequently use pain-related PROMs for the management of patients with LBP when compared to associate chiropractors. Demographic factors, appear to have little influence on PROM usage. While chiropractors place high value on PROMs, these beliefs are not associated with increased frequency of PROM usage for the management of LBP.


Assuntos
Quiroprática , Dor Lombar , Austrália/epidemiologia , Estudos Transversais , Demografia , Humanos , Dor Lombar/epidemiologia , Dor Lombar/terapia , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários
13.
Chiropr Man Therap ; 29(1): 46, 2021 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-34814923

RESUMO

BACKGROUND: Evidence suggests that diagnostic imaging for low back pain does not improve care in the absence of suspicion of serious pathology. However, the effect of imaging use on clinical outcomes has not been investigated in patients presenting to chiropractors. The aim of this study was to determine if diagnostic imaging affects clinical outcomes in patients with low back pain presenting for chiropractic care. METHODS: A matched observational study using prospective longitudinal observational data with one year follow up was performed in primary care chiropractic clinics in Denmark. Data was collected from November 2016 to December 2019. Participants included low back pain patients presenting for chiropractic care, who were either referred or not referred for diagnostic imaging during their initial visit. Patients were excluded if they were less than 18 years old, had a diagnosis of underlying pathology, or had previous imaging relevant to their current clinical presentation. Coarsened exact matching was used to match participants referred for diagnostic imaging with participants not referred for diagnostic imaging on baseline variables including participant demographics, pain characteristics, and clinical history. Mixed linear and logistic regression models were used to assess the effect of imaging on back pain intensity and disability at two-weeks, three-months, and one-year, and on global perceived effect and satisfaction with care at two-weeks. RESULTS: 2162 patients were included, with 24.1% referred for imaging. Near perfect balance between matched groups was achieved for baseline variables except age and leg pain. Participants referred for imaging had slightly higher back pain intensity at two-weeks (0.4, 95%CI: 0.1, 0.8) and one-year (0.4, 95%CI: 0.0, 0.7), and disability at two-weeks (5.7, 95%CI: 1.4, 10.0), but the changes are unlikely to be clinically meaningful. No difference between groups was found for the other outcome measures. Similar results were found when sensitivity analysis, adjusted for age and leg pain intensity, was performed. CONCLUSIONS: Diagnostic imaging did not result in better clinical outcomes in patients with low back pain presenting for chiropractic care. These results support that current guideline recommendations against routine imaging apply equally to chiropractic practice.


Assuntos
Quiroprática , Dor Lombar , Manipulação Quiroprática , Adolescente , Diagnóstico por Imagem , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/terapia , Estudos Prospectivos
14.
BMC Musculoskelet Disord ; 22(1): 983, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819061

RESUMO

BACKGROUND: Clinical guideline recommendations are against early magnetic resonance imaging (eMRI) within the first 4 to 6 weeks of conservative management of acute low back pain (LBP) without "clinical suspicion" of serious underlying conditions (red flags). There is some limited evidence that a significant proportion of patients with LBP receive eMRI non- indicated by clinical guidelines, which could be associated with increased length of disability (LOD). The aim of this systematic review was to investigate whether eMRI for acute LBP without red flags is associated with increased LOD. The LOD was defined as the number of disability days (absence from work). METHODS: Medline, EMBASE, and CINAHL bibliographic databases were searched from inception until June 5, 2021. Two reviewers independently assessed the methodological quality of included studies using the Newcastle-Ottawa scale and extracted data for the review. The search identified 324 records, in which seven studies met the inclusion criteria. Three of the included studies used the same study population. Owing to between-study heterogeneity, a narrative synthesis of results was used. RESULTS: All included studies were of good methodological quality and consistently reported that patients with acute LBP without red flags who received eMRI had increased LOD compared to those who did not receive eMRI. Three retrospective cohort studies reported that the eMRI groups had a higher mean LOD than the no eMRI groups ranging from 9.4 days (95% CI 8.5, 10.2) to 13.7 days (95% CI 13.0, 14.5) at the end of 1-year follow-up period. The remaining studies reported that the eMRI groups had a higher hazard ratio of work disability ranging between 1.75 (95% CI 1.23, 2.50) and 3.57 (95% CI 2.33, 5.56) as compared to the no eMRI groups. CONCLUSION: eMRI is associated with increased LOD in patients with acute LBP without red flags. Identifying reasons for performing non-indicated eMRI and addressing them with quality improvement interventions may improve adherence to clinical guidelines and improve disability outcomes among patients with LBP.


Assuntos
Dor Aguda , Dor Lombar , Humanos , Dor Lombar/diagnóstico por imagem , Imageamento por Ressonância Magnética , Estudos Retrospectivos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34769823

RESUMO

Low back pain (LBP) is a prevalent musculoskeletal disease that affects a large percentage of the working population, including teachers. The World Health Organization has identified the school as an effective environment for improving child health. For this reason, the figure of the teacher is a fundamental piece in the process of knowledge acquisition about postural education and prevention of LBP among schoolchildren. The present study aims to determine the knowledge of postural education and back pain prevention among primary school teachers. This cross-sectional study evaluated 85 primary school teachers from Majorca (Spain), of whom 17.6% were physical education teachers and 82.4% were classroom teachers. The study was based on two different structured and self-administered questionnaires to investigate into specific knowledge about LBP: Low Back Pain Knowledge Questionnaire (LKQ) and COSACUES-AEF Questionnaire. The results demonstrated a lifetime prevalence of LBP of 96.5% with significant differences determined by sex. The knowledge of participants about LBP was 17.3 in LKQ (range scale 0-24) and 4.3 in COSACUES (range scale 1-10). In conclusion, the teachers knowledge is insufficient to carry out an efficient and useful health promotion program among schoolchildren to prevent LBP.


Assuntos
Dor Lombar , Doenças Profissionais , Criança , Estudos Transversais , Humanos , Dor Lombar/epidemiologia , Dor Lombar/prevenção & controle , Professores Escolares , Instituições Acadêmicas
18.
Arch Argent Pediatr ; 119(6): 364-369, 2021 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34813228

RESUMO

Introduction: Spinal pain is one of the main reasons for seeking care; it usually appears during school age, increases with age, and is related to certain risk factors. The objective of this study is to analyze the prevalence of spinal pain among schoolchildren and examine associated factors. Population and methods: Cross-sectional study with a questionnaire administered to schoolchildren aged 9-11 years. The prevalence of pain, physical activity, spine self-care, backpack use, and electronic device use were analyzed. Results: A total of 329 subjects were analyzed. The prevalence of spinal pain is 34.3%, with no differences observed between sexes. Pain severity is considered mild, with a mean severity of 1.99 ± 2.54 over 10 according to the Wong-Baker FACES® scale; in more than 50% of cases, pain had a short duration (less than 12 hours). Cervical pain was referred by 22.2% of schoolchildren, whereas dorsal and lumbar pain were reported by 14% and 11.9%, respectively. In addition, 47.9% referred pain in more than one region of the spine. Also, 73.3% of schoolchildren did physical activity outside school hours and 90.6% used electronic devices. An association was observed between the presence of pain and adequate postural hygiene habits. Conclusions: Schoolchildren referred spinal pain that was mild and short in duration, often in the cervical region. The association with risk factors indicates that children who referred pain have better postural habits.


Assuntos
Dor Lombar , Coluna Vertebral , Criança , Estudos Transversais , Humanos , Prevalência , Instituições Acadêmicas , Espanha/epidemiologia
19.
J Int Med Res ; 49(11): 3000605211058987, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34812080

RESUMO

Lumbar disc herniation is a common disorder in adults that is accompanied by lower back and radicular pain. A 32-year-old man visited our clinic with 1-week history of persistent lower back pain and weakness in his right big toe. Magnetic resonance imaging (MRI) of his lumbar spine revealed herniated discs at L3/L4, L5/S1 and L4/L5, where a right-sided intraspinal mass lesion deep to the L4 vertebral body was causing compression of the nerve root. The patient underwent conservative treatment and reported no symptoms referrable to his back or leg 4 months later. Follow-up MRI showed no herniation of the nucleus pulposus at the L4/L5 level or lesion deep to the vertebral body of L4, whereas no changes had occurred to the status of the herniated L3/L4 and L5/S1 discs. The present case and a literature review show that a sequestered lumbar disc herniation can regress within a relatively short timeframe without surgery. The authors emphasise the utility of conservative therapy for patients who do not have a definitive surgical indication.


Assuntos
Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Disco Intervertebral , Dor Lombar , Adulto , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Imageamento por Ressonância Magnética , Masculino
20.
Medicina (Kaunas) ; 57(11)2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34833437

RESUMO

Background and objectives: The influence of changes in spinal alignment after total hip arthroplasty (THA) on improvement in lower back pain (LBP) remains controversial. To evaluate how changes in spinal malalignment correlate with improvement in preoperative LBP in patients who underwent THA for hip osteoarthritis. Materials and Methods: From November 2015 to January 2017, 104 consecutive patients who underwent unilateral THA were prospectively registered. Whole spine X-rays and patient-reported outcomes (PROs) were obtained preoperatively and 12 months postoperatively. The PROs used were the Numerical Rating Scale (NRS) for back pain, EuroQol 5 Dimension, and Short Form-12. Results: Seventy-four (71%) patients with complete data were eligible for the analysis. The sagittal parameters changed slightly but significantly. Coronal alignment significantly improved. Twenty-six (37%) patients had LBP preoperatively. These patients had smaller lumbar lordosis (LL), larger PT, and larger PI minus LL than the patients without LBP. Fourteen (54%) of the 26 patients with preoperative LBP showed pain improvement, but there were no significant differences in the radiographic parameters. Conclusions: Although preoperative LBP was likely to be resolved after THA, there were no significant correlations between alignment changes and LBP improvement. The cause of LBP in patients with hip osteoarthritis (OA) patients might be multifactorial.


Assuntos
Artroplastia de Quadril , Lordose , Dor Lombar , Osteoartrite do Quadril , Humanos , Dor Lombar/etiologia , Dor Lombar/cirurgia , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/diagnóstico por imagem , Osteoartrite do Quadril/cirurgia , Coluna Vertebral
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