Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27.219
Filtrar
1.
Addict Behav ; 136: 107495, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36156453

RESUMO

The opioid epidemic is a significant public health concern, and opioid consumption rates and opioid-related deaths are on the rise. Chronic pain acceptance, or willingness to experience pain and pain-related distress, is one pain-related psychological mechanism that may reduce maladaptive attempts to avoid or control pain using opioids among individuals with chronic lower back pain (CLBP). However, little work has examined chronic pain acceptance as it relates to opioid use and motives for use among adults with CLBP. The current investigation sought to explore the effects of chronic pain acceptance on opioid misuse and motives for opioid use (i.e., pain management and coping motives) among adults with CLBP. Participants were 291 adults (69.1 % female, Mage = 45.77 years, SD = 11.22) self-reporting current mild to severe CLBP and current opioid use who were recruited via an online survey. Results indicated that higher acceptance of pain was related to lower levels of opioid misuse and lower motivation to use opioids to cope with pain. Contrary to hypotheses, chronic pain acceptance did not predict motivation to use opioids to cope with emotional distress (i.e., coping motives). The current findings provide support for chronic pain acceptance as a potential protective mechanism in terms of opioid misuse and motivation to use opioids to manage pain.


Assuntos
Dor Crônica , Dor Lombar , Transtornos Relacionados ao Uso de Opioides , Uso Indevido de Medicamentos sob Prescrição , Adulto , Analgésicos Opioides/uso terapêutico , Dor Crônica/tratamento farmacológico , Dor Crônica/psicologia , Feminino , Humanos , Dor Lombar/tratamento farmacológico , Masculino , Motivação , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Manejo da Dor , Uso Indevido de Medicamentos sob Prescrição/psicologia
2.
Clin Rehabil ; 37(1): 98-108, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36071623

RESUMO

OBJECTIVES: To investigate the effect of integrating an individualized, evidence-based low back pain comprehensive education package on low back pain treatment outcomes. DESIGN: Single-blind, controlled clinical study using the alternate allocation of patients. SETTING: Outpatient clinic. SUBJECTS: In total, 54 participants with chronic low back pain (46.75 ± 11.11 years, 80% females) were randomized to intervention (n = 27) or a control group (n = 27). INTERVENTION: The intervention group received additional four one-hour low back pain-related education sessions to eight 45 minutesstandard physical therapy sessions over 4 weeks. OUTCOME MEASURES: Assessed at baseline, post-intervention, and 3 months. Outcome measures included pain intensity (Visual Analogue Scale), knowledge (Low Back Pain Knowledge Questionnaire), attitude (the Back Pain Attitudes Questionnaire), disability (the Oswestry Disability Index), mental health symptoms (Depression Anxiety Stress Scale, DASS-21 scale), and fear-avoidance (Fear-Avoidance Beliefs Questionnaire). RESULTS: The intervention group showed significantly lower pain intensity ((4 weeks (3.58 ± 1.50 vs. 5.54 ± 1.92), 3 months (3.21 ± 1.74 vs. 5.69 ± 2.51)), higher knowledge ((4 weeks (21.67 ± 2.12 vs. 11.62 ± 3.47), three months (22.08 ± 3.40 vs. 12.23 ± 3.24)), lower negative attitudes ((4 weeks (99.29 ± 11.02 vs. 134.31 ± 12.97), 3 months (102.92 ± 15.58 vs. 132.42 ± 17.79)), lower disability ((4 weeks (26.30 ± 11.37 vs. 45.14 ± 18.67), 3 months (22.83 ± 16.06 vs. 44.13 ± 15.02)), lower stress score ((4 weeks (3.54 ± 3.01 vs. 8.81 ± 5.19), 3 months (3.21 ± 3.22 vs. 7.21 ± 4.36)), lower anxiety ((4 weeks (2.63 ± 3.16 vs. 6.42 ± 4.75), three months (2.63 ± 3.80 vs. 5.73 ± 4.44)), lower depression ((4 weeks (2.42 ± 2.15 vs. 6.42 ± 3.68), three months (2.63 ± 4.18 vs. 7.08 ± 4.41)), and lower fear-avoidance ((4 weeks (13.88 ± 12.32 vs. 50.88 ± 23.25), three months (15.50 ± 16.75 vs. 54.65 ± 31.81)). CONCLUSION: Integrating low back pain comprehensive education into standard physical therapy might optimize the treatment outcomes of low back pain.


Assuntos
Dor Lombar , Feminino , Humanos , Masculino , Dor Lombar/diagnóstico , Dor Lombar/terapia , Dor Lombar/psicologia , Método Simples-Cego , Medição da Dor , Modalidades de Fisioterapia , Inquéritos e Questionários , Resultado do Tratamento , Avaliação da Deficiência
3.
Neurol Clin ; 41(1): 61-76, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36400559

RESUMO

Back pain is a common condition affecting millions of individuals each year. A biopsychosocial approach to back pain provides the best clinical framework. A detailed history and physical examination with a thorough workup are required to exclude emergent or nonoperative etiologies of back pain. The treatment of back pain first uses conventional therapies including lifestyle modifications, nonsteroidal anti-inflammatory drugs, physical therapy, and cognitive behavioral therapy. If these options have been exhausted and pain persists for greater than 6 weeks, imaging and a specialist referral may be indicated.


Assuntos
Terapia Cognitivo-Comportamental , Dor Lombar , Humanos , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Dor Lombar/terapia , Diagnóstico Diferencial , Dor nas Costas/diagnóstico , Dor nas Costas/etiologia , Dor nas Costas/terapia , Anti-Inflamatórios não Esteroides
4.
Ann Anat ; 245: 152000, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36183940

RESUMO

PURPOSE: The existence of the basivertebral nerve and meningeal branch of the spinal nerve has not been proven in dogs to date. The objectives of this study are to 1) determine whether dogs have a meningeal branch of the spinal nerve (MBSN) and a basivertebral nerve (BVN) and to (2) describe anatomical characteristics of these two nerves. Authors also put forward a discussion on the possible clinical relevance of these findings. MATERIAL AND METHODS: Dissections were performed on six embalmed dogs at the Veterinary Faculty of Barcelona with the use of stereomicroscopy and microsurgery equipment. RESULTS: The MBSN (grossly) and BVN (grossly and histologically) were identified in the cervical, thoracic, and lumbar region in all dog specimens. In addition, other small fibers (suspected nerves) entering the vertebral body through small foramina close to the end plates were identified. Histological examination of the tissues confirmed the presence of nerve fibers (myelinated and unmyelinated) in suspected BVN samples. Results of the present study indicated that dogs have BVNs. Also, suspected nerve fibers were identified among the epidural fat, running from the intervertebral foramina, that likely represent the MBSN. CONCLUSION: These findings open up the discussion on extrapolation of treatment options employed in human medicine for "low back pain", such as BVN ablation, which is discussed in this article. Further anatomic and clinical studies of the innervation for the vertebral body, periosteum, vasculature, dorsal longitudinal ligament and anulus fibrosus are necessary to elucidate possible anatomical variants and breed differences as well as potential clinical (e.g., therapeutic) relevance.


Assuntos
Dor Lombar , Nervos Espinhais , Cães , Humanos , Animais , Nervos Espinhais/cirurgia , Dor Lombar/cirurgia , Coluna Vertebral , Dissecação , Região Lombossacral
5.
Patient Educ Couns ; 106: 85-91, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36243600

RESUMO

OBJECTIVE: Existing studies on shared decision-making (SDM) have hardly taken into consideration that patients could have independently developed expectations prior to their consultation with a healthcare provider, nor have studies explored how such expectations affect SDM. Therefore, we explore how pre-consultation expectations affect SDM in patients with low back pain. METHODS: We performed a qualitative study through telephone interviews with 10 patients and seven care professionals (physicians, nurse, physician assistants) and 63 in-person observations of patient-physician consultations in an outpatient clinic in the Netherlands. Transcripts were analyzed through an open coding process. RESULTS: A discrepancy existed between what patients expected and what care professionals could offer. Professionals perceived they had to undertake additional efforts to address patients' 'unrealistic' expectations while attempting SDM. Patients, in turn, were often dissatisfied with the outcomes of the SDM encounter, as they believed their own expectations were not reflected in the final decision. CONCLUSION: Unaddressed pre-consultation expectations form a barrier to constructive SDM encounters. PRACTICAL IMPLICATIONS: Patients' pre-consultation expectations need to be explored during the SDM encounter. To achieve decisions that are truly shared by care professionals and patients, patients' pre-consultation expectations should be better incorporated into SDM models and education.


Assuntos
Dor Lombar , Participação do Paciente , Humanos , Dor Lombar/terapia , Tomada de Decisões , Motivação , Relações Médico-Paciente , Encaminhamento e Consulta
6.
Phys Med Rehabil Clin N Am ; 34(1): 117-133, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36410879

RESUMO

If we could choose a single non-fatal medical condition to find a better solution that would make the greatest impact on global health it would be a solution for degenerative disc disease (DDD) - the number one cause of chronic low back pain (CLBP).


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Plasma Rico em Plaquetas , Humanos , Degeneração do Disco Intervertebral/terapia , Dor Lombar/terapia , Leucócitos
7.
Phys Med Rehabil Clin N Am ; 34(1): 165-180, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36410881

RESUMO

Prolotherapy is a nonsurgical regenerative technique that allows small amounts of irritant solution to be injected into the site of painful tendon and ligament insertions to promote the growth of healthy cells and tissues. The goal of prolotherapy is to stimulate growth factors that may strengthen attachments and reduce pain. Prolotherapy injection technique is centered around a focused physical examination and strong anatomic knowledge for maximized results. Prolotherapy is beneficial in a variety of different musculoskeletal conditions, including, but not limited to, lateral epicondylosis, rotator cuff tendinopathy, plantar fasciitis, Achilles tendinopathy, osteoarthritis, low back pain, sacroiliac joint pain, and TMJ laxity.


Assuntos
Tendão do Calcâneo , Dor Lombar , Dor Musculoesquelética , Proloterapia , Tendinopatia , Humanos , Proloterapia/métodos , Tendinopatia/terapia
10.
Medicine (Baltimore) ; 101(47): e32091, 2022 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-36451480

RESUMO

Failed back surgery syndrome is a challenge. We hypothesized that a multidisciplinary team meeting (MTM) may be useful to select patients who are the most likely to benefit from lumbar surgery. We conducted an observational, prospective, comparative, exploratory study. We aimed to compare core clinical patient-reported outcomes at 2 years after lumbar surgery between patients who attended a MTM and those who did not. Patients who underwent lumbar surgery for a degenerative disease, in a single academic orthopedic department, between January and September 2018, were consecutively screened. Eligible patients were surveyed between April and June 2020. Patient-reported outcomes included lumbar and radicular pain, spine-specific activity limitations and health-related quality of life assessed via self-administered questionnaires. Outcomes were compared between respondents who attended the MTM and those who did not. Overall, 211 patients underwent lumbar surgery, 108 were eligible and 44 included: 11 attended the MTM and 33 did not. Mean participants' age was 57.4 (15.4) years, symptom duration was 14.8 (15.3) months, lumbar pain was 51.3 (18.2) and radicular pain was 53.4 (18.6). At 2 years, we found no evidence that lumbar and radicular pain, activity limitations and health-related quality of life differed between the 2 groups. The decrease was -26.8 (41.1) versus -20.8 (30.4) in lumbar pain and -25.5 (43.0) versus -19.5 (27.5) in radicular pain, in participants who attended the MTM versus those who did not, respectively. We found no evidence that core clinical patient-reported outcomes at 2 years after lumbar surgery differed between participants who attended the MTM and those who did not. However, the exploratory design of our study does not allow concluding that MTMs do not have an impact.


Assuntos
Dor Lombar , Qualidade de Vida , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Medidas de Resultados Relatados pelo Paciente , Equipe de Assistência ao Paciente
11.
BMC Geriatr ; 22(1): 930, 2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36460950

RESUMO

BACKGROUND: Functional disability is a major health issue in an aging population. Low back pain (LBP) is a common health concern that can lead to functional disability in the elderly; nonetheless, their association has not yet been clarified. This study aimed to examine the association between LBP and functional disability in the elderly, with a focus on its dose-dependent effects. METHODS: This study used the 4-year longitudinal data of people living in disaster-affected areas after the Great East Japan Earthquake (aged ≧65, n = 914). LBP and physical function were assessed at 2, 4, and 6 years after the disaster. Multivariate logistic regression analyses were performed to assess the association between LBP and low physical function, as well as the effect of preceding LBP on the onset of low physical function. RESULTS: LBP was significantly associated with low physical function, and the association became stronger as the duration of LBP increased. Adjusted odds ratios (95% confidence intervals) were 1.27 (0.79-2.06) in "< 2 years," 1.95 (1.01-3.77) in "≥2 years and <4 years," and 2.34 (1.35-4.06) in "≥4 years" (p for trend = 0.009). Additionally, preceding LBP was significantly associated with the onset of low physical function, and the effect became prominent as the duration of LBP increased. Adjusted odds ratios (95% confidence intervals) were 2.28 (1.19-4.37) in "< 2 years" and 2.82 (1.35-5.90) in "≥2 years" (p for trend = 0.003). CONCLUSIONS: LBP is associated with physical disability among the elderly in a dose-dependent manner. Therefore, prevention and treatment of LBP are important for preventing functional disability.


Assuntos
Desastres , Terremotos , Dor Lombar , Idoso , Humanos , Estudos Longitudinais , Dor Lombar/diagnóstico , Dor Lombar/epidemiologia , Japão/epidemiologia
12.
BMC Musculoskelet Disord ; 23(1): 1050, 2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36460993

RESUMO

BACKGROUND: Chronic low back pain is a common musculoskeletal disease. With the increasing number of patients, it has become a huge economic and social burden. It is urgent to relieve the burden of patients. There are many common rehabilitation methods, and aquatic physical therapy is one of them. The purpose of this systematic review and meta-analysis is to summarize the existing literature and analyze the impact of aquatic physical therapy on pain intensity, quality of life and disability of patients with chronic low back pain. METHODS: Through 8 databases, we searched randomized controlled trials on the effect of aquatic physical therapy on patients with chronic low back pain. These trials published results on pain intensity, quality of life, and disability. This review is guided by Cochrane Handbook for systematic reviews of interventions version 5.1.0. The level of evidence was assessed through GRADE. RESULTS: A total of 13 articles involving 597 patients were included. The results showed that compared with the control group, aquatic physical therapy alleviated the pain intensity (Visual Analogue Scale: SMD = -0.68, 95%CI:-0.91 to -0.46, Z = 5.92, P < 0.00001) and improved quality of life (physical components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.63, 95%CI:0.36 to 0.90, Ζ = 4.57, P < 0.00001; mental components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.59, 95%CI:0.10 to 1.08, Ζ = 2.35, P = 0.02), and reduced disability (Roland Morris Disability Questionnaire: SMD = -0.42, 95%CI:-0.66 to -0.17, Ζ = 3.34, P = 0.0008; Oswestry Disability Index or Oswestry Low Back Pain Disability Questionnaire: SMD = -0.54, 95%CI:-1.07 to -0.01, Ζ = 1.99, P = 0.05). However, aquatic physical therapy did not improve patients' pain at rest (Visual Analogue Scale at rest: SMD = -0.60, 95%CI:-1.42 to 0.23, Ζ = 1.41, P = 0.16). We found very low or low evidence of effects of aquatic physical therapy on pain intensity, quality of life, and disability in patients with chronic low back pain compared with no aquatic physical therapy. CONCLUSIONS: Our systematic review showed that aquatic physical therapy could benefit patients with chronic low back pain. However, because the articles included in this systematic review have high bias risk or are unclear, more high-quality randomized controlled trials are needed to verify.


Assuntos
Dor Lombar , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Qualidade de Vida , Modalidades de Fisioterapia , Exame Físico , Medição da Dor
13.
BMC Musculoskelet Disord ; 23(1): 1055, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463146

RESUMO

BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal problems affecting daycare (nursery) workers. We aimed to identify the psychosocial factors influencing LBP in daycare workers. METHODS: We conducted a prospective cohort study with a one-year observation period. The baseline sample was a convenience sample of 444 daycare workers from 34 daycare facilities in Nagoya, Japan, and its suburbs. All the data were collected through a questionnaire survey. The question "Where are you currently feeling LBP?" was used to determine whether the subjects suffered from LBP. We examined the prospective relationships of the psychosocial work characteristics, i.e., high job strain, low social support, effort-reward imbalance, and overcommitment, at baseline and LBP after one year. We used multiple logistic regression analyses to calculate the odds ratios of psychosocial work characteristics for the persistence and onset of LBP, adjusted for age, sex, body mass index, smoking, employment status, occupation, and working schedule. RESULTS: At baseline, 270 (60.8%) subjects suffered from LBP. Of 208 who also gave information on LBP one year later, 176 (84.6%) suffered from the persistence of LBP. Low social support at baseline was significantly related to persistent LBP one year later. The incidence of persistent LBP was 89.9% and 80.0% among those with and without low social support at baseline, respectively. The adjusted odds ratio (95% confidence interval) of low social support at baseline for the persistence of LBP was 2.43 (1.01-5.87). Of 150 who were without LBP at baseline and provided information on LBP one year later, 45 (30.0%) suffered from the onset of LBP. None of the psychosocial work characteristics showed significant relationships with the onset of LBP one year later. CONCLUSION: Low social support was related to the persistence, but not to the onset of LBP in a prospective cohort analysis among daycare workers in Japan. High job strain, ERI, or overcommitment did not show a significant prospective effect on LBP.


Assuntos
Dor Lombar , Humanos , Dor Lombar/diagnóstico , Dor Lombar/epidemiologia , Estudos Prospectivos , Japão/epidemiologia , Emprego , Apoio Social
14.
Turk J Med Sci ; 52(4): 1241-1248, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36326376

RESUMO

BACKGROUND: The aim of the study is to identify predictors of treatment success with combined transforaminal epidural steroid injection (TFESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) in patients with lumbar radicular pain (LRP) associated with lumbar disc herniation. METHODS: The study included 48 patients with herniation-related LRP who underwent TFESI and DRG-PRF treatment between November 1, 2020 and April 30, 2021. Patient age, sex, symptom duration, history of lumbar surgery, and numeric rating scale (NRS) pain scores before and at 10 days, 1 month, and 3 months after treatment were evaluated retrospectively. Treatment success was defined as ≥50% improvement or a 4-point decrease in NRS score at 3 months. RESULTS: Twenty-nine female and 19 male patients with a mean age of 51.54 ± 13.31 years were analyzed. The median symptom duration was 6 (interquartile range: 8.50) months. Symptom duration did not affect treatment success (p = 0.105). History of spinal surgery was more common among patients with failed treatment but was not statistically associated with treatment success. A 1-unit increase in pre-treatment NRS score was associated with 72% lower odds of treatment success (p = 0.022), while a 1-unit increase in NRS score on post-treatment day 10 compared to the pre-treatment value was associated with 95% lower odds of treatment success (p = 0.008). DISCUSSION: Symptom duration and history of spinal surgery were not predictive of treatment success with combined TFESI and DRGPRF for herniation-related LRP. However, the 3-month prognosis was significantly better for patients with a marked reduction in NRS score at 10 days.


Assuntos
Dor Lombar , Tratamento por Radiofrequência Pulsada , Radiculopatia , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Recém-Nascido , Gânglios Espinais , Radiculopatia/terapia , Radiculopatia/complicações , Estudos Retrospectivos , Dor Lombar/terapia , Dor nas Costas , Resultado do Tratamento , Esteroides/uso terapêutico , Injeções Epidurais , Vértebras Lombares
15.
Medicine (Baltimore) ; 101(43): e31068, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316867

RESUMO

BACKGROUND: Low back pain refers to pain that occurs mainly in lumbosacral spine, and is a clinically common symptom that 70% to 90% of people experience at least once during their lives. OBJECTIVES: We investigated the effect and safety of orthopedic device (LSM-01) for alleviate back pain caused by muscle tension in a randomized, single-blinded, sham-controlled, parallel-group, pilot trial to establish a basis for large-scale clinical trial. METHODS: A total of 30 subjects were randomly assigned to 2 group: treatment group (LSM-01) and control group (sham device) received treatment with each device 2 to 3 times a week for a total of 6 treatment for 2 weeks. Primary outcome was visual analog scale (VAS); Secondary outcomes were pressure pain threshold (PPT), oswestry disability index (ODI), and patient global impression of change (PGIC). Statistical analysis is performed for full analysis set (FAS) population. Analysis of covariance (ANCOVA) for mean difference of VAS change and Mixed models of repeated measurements (MMRM) for the trend of VAS change were conducted to compare the differences between 2 groups before and after participants got treatment with the clinical trial device. RESULTS: One participant dropped out due to personal reason and 29 participants completed the clinical pilot trial. We found that the degree of low back pain (VAS, PPT, PGIC) significantly decreased and after the trial in the treatment group compared to the control group. Also, there were no any side effects. CONCLUSION: LSM-01 can be effective in improving pain of low back pain. A future large-scale main trial will be conducted based on this pilot study results.


Assuntos
Terapia por Acupuntura , Dor Lombar , Humanos , Dor Lombar/etiologia , Projetos Piloto , Terapia por Acupuntura/métodos , Resultado do Tratamento , Medição da Dor
16.
BMC Med Res Methodol ; 22(1): 285, 2022 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-36333665

RESUMO

OBJECTIVE: Meta-analyses of analgesic medicines for low back pain often rescale measures of pain intensity to use mean difference (MD) instead of standardised mean difference for pooled estimates. Although this improves clinical interpretability, it is not clear whether this method is justified. Our study evaluated the justification for this method. METHODS: We identified randomised clinical trials of analgesic medicines for adults with low back pain that used two scales with different ranges to measure the same construct of pain intensity. We transformed all data to a 0-100 scale, then compared between-group estimates across pairs of scales with different ranges. RESULTS: Twelve trials were included. Overall, differences in means between pain intensity measures that were rescaled to a common 0-100 scale appeared to be small and randomly distributed. For one study that measured pain intensity on a 0-100 scale and a 0-10 scale; when rescaled to 0-100, the difference in MD between the scales was 0.8 points out of 100. For three studies that measured pain intensity on a 0-10 scale and 0-3 scale; when rescaled to 0-100, the average difference in MD between the scales was 0.2 points out of 100 (range 5.5 points lower to 2.7 points higher). For two studies that measured pain intensity on a 0-100 scale and a 0-3 scale; when rescaled to 0-100, the average difference in MD between the scales was 0.7 points out of 100 (range 6.2 points lower to 12.1 points higher). Finally, for six studies that measured pain intensity on a 0-100 scale and a 0-4 scale; when rescaled to 0-100, the average difference in MD between the scales was 0.7 points (range 5.4 points lower to 8.3 points higher). CONCLUSION: Rescaling pain intensity measures may be justified in meta-analyses of analgesic medicines for low back pain. Systematic reviewers may consider this method to improve clinical interpretability and enable more data to be included. STUDY REGISTRATION/DATA AVAILABILITY: Open Science Framework (osf.io/8rq7f).


Assuntos
Analgésicos , Dor Lombar , Adulto , Humanos , Analgésicos/uso terapêutico , Dor Lombar/tratamento farmacológico , Medição da Dor , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
J Tradit Chin Med ; 42(6): 869-876, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36378043

RESUMO

OBJECTIVE: To systematically evaluate the efficacy and safety of blood pricking and cupping in the treatment of nonspecific low back pain (NLBP). METHODS: The China National Knowledge Infrastructure Database (CNKI), Wanfang Med Online Database (Wanfang), China Science and Technology Journal Database (VIP), PubMed, Web of Science, EMBase, and Cochrane Library databases were searched from inception to October 31, 2021, for randomized controlled trials (RCTs) of the treatment of NLBP by blood pricking and cupping. The quality of each included study was evaluated according to the Cochrane Systematic Assessor's Manual evaluation criteria, while the Meta-analysis was performed using RevMan 5.4 software. RESULTS: A total of 13 thirteen RCTs included a total of 1088 subjects. The visual analogue scale scores indicated that blood pricking and cupping was superior to the other treatments at relieving NLBP pain [mean difference () = -1.43; 95% confidence interval (): -2.31 to 0.54; = 3.15; = 0.002). The Oswestry Disability Index score of blood pricking and cupping was superior to that of the control group in terms of improving NLBP dysfunction ( = -6.25; 95%: -8.37 to -4.31); = 5.77; < 0.000 01). 7 RCTs mentioned no adverse reactions, while one study reported mild syncope [7% (3), all in the 17-30 years group] that was gradually relieved after rest. CONCLUSIONS: Blood pricking and cupping therapy can safely and effectively reduce pain and improve functional impairment in patients with NLBP. However, this study included limited high-grade studies with a small overall sample size; therefore, further high-quality large-sample RCTs are needed to improve clinical evidence.


Assuntos
Dor Lombar , Humanos , Dor Lombar/terapia , Medicina Tradicional Chinesa , China
18.
PLoS One ; 17(11): e0276734, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36350802

RESUMO

OBJECTIVE: This study aims to study the effect of mindfulness-based program on the psychological, biomechanical and inflammatory domains of patients with chronic low back pain. METHODS: A multicentre randomized and controlled clinical trial of parallel groups in patients with chronic low back pain between March 2019 to March 2020. Participants with no experience in mindfulness based intervention, were randomized to receive (36 patients) or not (34 patients) mindfulness-based stress reduction program for chronic back pain (MBSR-CBP). The program was performed in 9 sessions. Patients with chronic low back pain due to symptomatic discopathy (degenerative disc disease or herniated disc) were included. The principal outcome was changes in the blood level of cortisol and cytokines (tumor necrosis factor- α (TNF- α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and interleukin-17 (IL-17)). Secondary outcomes (psychological factors, pain, and quality of life) were measured by validated questionnaires. RESULTS: Of the 96 randomized patients, 70 who completed the study were included in the analysis (mean [range] age: 53 [33-73] years; 66% females). MBSR-CBP stopped the increase in cortisol, and reduced pro-inflammatory cytokine IL-1ß (p = 0.05). It reduced depression (p = 0.046) and stress (p = 0.0438), perceived pain (p < 0.0001), and limitations related to health (p < 0.0001). It also increased the physical function (p = 0.002) and sleep quality (p = 0.05). Furthermore, it significantly increased life satisfaction (0.006), well-being (p = 0.001) and vitality (p < 0.0001). It also increased self-compassion (p < 0.0001) and significantly reduced the overidentification (p<0.0001) and catastrophization (p = 0.002). CONCLUSIONS: MBSR-CBP could be part of a multidisciplinary approach in the management of patients suffering from chronic low back pain.


Assuntos
Dor Lombar , Atenção Plena , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Citocinas , Hidrocortisona/análise , Interleucina-6 , Dor Lombar/terapia , Dor Lombar/psicologia , Qualidade de Vida , Estresse Psicológico/terapia , Estresse Psicológico/psicologia , Resultado do Tratamento , Idoso
19.
BMC Musculoskelet Disord ; 23(1): 966, 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36348309

RESUMO

BACKGROUND: A biopsychosocial rehabilitation is recommended for chronic nonspecific low back pain (CNLBP); however, its effectiveness compared to the traditional supervised exercise therapy of CNLBP treatment is still unclear. METHODS: This was a parallel-group randomized controlled clinical trial. The sample consisted of 180 participants of both sexes, aged ≥18 years, with CNLBP for ≥3 months. Using web randomization and concealed allocation, they were assigned to three groups; graded activity receiving cognitive-behavioral therapy, group-based combined exercise therapy and education (GA; n = 59), supervised group-based combined exercise therapy and education (SET; n = 63), and a control group receiving usual care (n = 58). Interventions were administered for 4 weeks (8 sessions). The primary outcome was pain intensity. Outcome measures were collected baseline, after interventions (4 weeks), and during two follow-up periods (3 and 6 months). RESULTS: After the intervention, GA had a significant large effect on pain reduction compared to the control group (MD of 22.64 points; 95% CI = 16.10 to 29.19; p < 0.0001; Cohen's d = 1.70), as well as SET compared with the control group (MD of 21.08 points; 95% CI = 14.64 to 27.52; p < 0.0001; Cohen's d = 1.39), without significant difference between two intervention groups. At 3 and 6 months of follow-up, GA had a statistically significantly better effect in reducing pain, disability and fear-avoidance beliefs, and improving spinal extensor endurance, range of extension and quality of life compared to SET and the control group. A statistically significantly better effect of SET compared with the control group was found in reducing pain, disability, fear-avoidance beliefs, and improving the physical component of quality of life. Harms were not reported. CONCLUSION: This study suggests that graded activity and group-based supervised exercise therapy have beneficial effects over the control group in the treatment of CNLBP. The graded activity was more beneficial than supervised group-based exercise therapy only during the follow-up. TRIAL REGISTRATION: Clinicaltrials.gov (NCT04023162; registration date: 17/07/2019).


Assuntos
Dor Crônica , Dor Lombar , Masculino , Feminino , Humanos , Adolescente , Adulto , Dor Lombar/diagnóstico , Dor Lombar/terapia , Dor Lombar/psicologia , Qualidade de Vida , Terapia por Exercício , Medição da Dor , Exercício Físico , Dor Crônica/diagnóstico , Dor Crônica/terapia
20.
Sci Rep ; 12(1): 19134, 2022 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-36351943

RESUMO

Low back pain among healthcare professionals is associated with the manual handling of patients. Some bed features for turning and repositioning have been developed; however, the load during patient care remains heavy. We developed a device to reduce low back load in caregivers during patient bedside care and evaluated it objectively and subjectively from a caregiver's perspective using a randomised crossover study. Overall, 28 clinical nurses and care workers were randomly assigned to two interventional groups: administering care with (Device method) and without (Manual method) the device in an experimental room. We measured the caregiver's trunk flexion angle using inertial measurement units and video recording during care and then defined a trunk flexion angle of > 45° as the threshold; the variables were analysed using linear mixed models. Subsequently, participants responded to a survey regarding the usability of the device. Trunk flexion time and percentage of time were 26.5 s (95% confidence interval: 14.1 s, 38.9 s) (p < 0.001) and 23.0% (95% confidence interval: 16.4%, 29.6%) (p < 0.001) lower, respectively, in the Device group than in the Manual group. Furthermore, caregivers evaluated the care they could administer with the device as being better than that associated with manual care.


Assuntos
Dor Lombar , Tecnologia Assistiva , Humanos , Cuidadores , Dor Lombar/terapia , Assistência ao Paciente , Pessoal de Saúde
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...