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1.

Objective

To compare clinical pain intensity, exercise performance, pain sensitivity and the effect of aerobic and isometric exercise on local and remote pressure pain thresholds (PPTs) in patients with chronic musculoskeletal pain with high and low levels of kinesiophobia.

Design

An experimental pre–post within-subject study.

Setting

An exercise laboratory in a multidisciplinary pain clinic.

Participants

Fifty-four patients with chronic musculoskeletal pain.

Interventions

Acute aerobic and isometric leg exercises.

Main outcome measures

Clinical pain intensity (numerical rating scale, range 0 to 10), Tampa Scale of Kinesiophobia, aerobic and isometric exercise performances (intensity and maximal voluntary contraction), and PPTs at local and remote body areas before and after exercise conditions.

Results

Patients with a high degree of kinesiophobia demonstrated increased pain intensity compared with patients with a low degree of kinesiophobia [high degree of kinesiophobia: 7.3 (1.6) on NRS; low degree of kinesiophobia: 6.3 (1.6) on NRS; mean difference 1.0 (95% confidence interval 0.08 to 1.9) on NRS]. Aerobic and isometric exercises increased PPTs, but no significant group differences were found in PPTs before and after exercise.

Conclusions

Clinical pain intensity was significantly higher in patients with a high degree of kinesiophobia compared with patients with a low degree of kinesiophobia. Despite a difference in isometric exercise performance, the hypoalgesic responses after cycling and isometric knee exercise were comparable between patients with high and low degrees of kinesiophobia. If replicated in larger studies, these findings indicate that although kinesiophobic beliefs influence pain intensity, they do not significantly influence PPTs and exercise-induced hypoalgesia in patients with chronic musculoskeletal pain.  相似文献   

2.

Background

Physiotherapy is a routine component of postoperative management following total knee arthroplasty (TKA). As the demand for surgery increases it is vital that postoperative physiotherapy interventions are effective and efficient.

Objectives

Determine the most beneficial active physiotherapy interventions in acute hospital and inpatient rehabilitation for improving pain, activity, range of motion and reducing length of stay for adults who have undergone TKA.

Data sources

Electronic databases MEDLINE, CINAHL, PUBMED and EMBASE.

Study eligibility criteria

Randomised controlled trials investigating the effect of active physiotherapy interventions in the acute hospital or inpatient rehabilitation setting for adults who have undergone TKA.

Study appraisal and synthesis methods

Risk of bias for individual studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Standardised Mean Differences (SMD) or Mean Differences (MD) and 95% confidence intervals were calculated and combined in meta-analyses. Quality of meta-analyses was assessed using the Grades of Research, Assessment, Development and Evaluation approach.

Results

Accelerated physiotherapy regimens were effective for reducing acute hospital length of stay (MD ?3.50 days, 95% CI ?5.70 to ?1.30). Technology-assisted physiotherapy did not show any difference for activity (SMD ?0.34, 95% CI ?0.82 to 0.13). From high quality individual studies pain, activity and range of motion improved with accelerated physiotherapy regimens and activity improved with hydrotherapy.

Limitations

Lack of blinding and small sample sizes across the included trials.

Conclusion

After TKA, there is low level evidence that accelerated physiotherapy regimens can reduce acute hospital length of stay.Systematic review registration number PROSPERO (Registration number CRD42014013414) http://www.crd.york.ac.uk/PROSPERO.  相似文献   

3.

Background

The progression through the difficulty levels of Pilates exercises is a subjective criterion, that depends on the therapist's experience and ability to identify the best moment to progress to the next level.

Objective

To identify the factors that interfere in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain.

Methods

Data from 139 patients with chronic nonspecific low back pain from a randomized controlled trial were used for statistical analysis using binary logistic regression. The dependent variable was the progression through the difficulty levels, and the independent variables were age, gender, educational level, low back pain duration, pain intensity, general disability, kinesiophobia, previous physical activity, and number of absences.

Results

The factors that interfered in the progression through the difficulty levels were previous physical inactivity (odds ratio [OR] = 5.14, 95% confidence interval [CI]: 1.53–17.31), low educational level (OR = 2.62, 95% CI: 1.12–6.10), more advanced age (OR = 0.95, 95% CI: 0.92–0.98) and more absences (OR = 0.63, 95% CI: 0.50–0.79). These variables explain 41% of the non-progression through the difficulty level of the exercises.

Conclusion

Physical inactivity, low educational level, more advanced age and greater number of absences can be interfering factors in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain.  相似文献   

4.

Introduction

Worldwide there is a desire to diversify the physiotherapy workforce. However, limited research indicates that some student characteristics linked to under-representation in pre registration physiotherapy education have lower attainment and greater attrition. This study explored the relationship between individual characteristics and success of students in pre registration physiotherapy education within South East England.

Design

A retrospective multi site cohort study including pre registration physiotherapy programmes in the South East of England. Anonymised data included background information (age, gender, ethnicity, socio-economic status) and outcomes (assessment marks, type of award and classification of degree). Analysis involved Bayesian regression models and ordinal logistic regression to examine the association of student characteristics on outcomes.

Results

Data from 1851 student records were collected from four institutions. There were significantly lower assessment scores for Asian (?11% 95% CI: ?13.1 to ?9.2), Black (?7%, 95% CI: ?9.7 to ?4.5) and Other/Mixed ethnicity groups (?5%, 95% CI: ?7.1 to ?2.4), most notable in clinical and observed assessments, compared to their White British colleagues. All BME groups also demonstrated worse odds for a one step lower overall award or no award (Black OR: 3.35, Asian OR: 3.97, Other OR: 2.03). Associations of learning disability, age and non-traditional entry routes with assessment scores and/or degree classification were also noted.

Conclusion

These findings suggest significant attainment gaps in pre registration physiotherapy education in this specific geographical region, particularly for non-White ethnic and disability groups. The association with assessment type challenges educators to look beyond a purely student deficit model to explore all factors that may lead to inequality.  相似文献   

5.

Background

Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population.

Objective

To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD.

Data sources

A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016.

Eligibility criteria

English peer-reviewed articles that utilised CPT before or after cardiac surgery for paediatric CHD. Systematic reviews were excluded.

Data extraction and synthesis

Completed by two independent researchers using the Crowe Critical Appraisal Tool. Data were collated using a piloted data extraction tool. Mix Version 2.0.1.4 was used for meta-analysis, and data were extracted using an odds ratio (with a random effects model).

Results

Eleven studies met the inclusion criteria for the systematic review. Variable results were found regarding the effect of CPT on peripheral oxygen saturation and pain. Meta-analysis showed that CPT did not prevent pneumonia (odds ratio (OR) 2.01; 95% confidence interval (CI) 0.80 to 5.05; P = 0.13), and did not prevent or treat atelectasis (OR 1.27; 95% CI 0.18 to 8.87; P = 0.81).

Limitations

There was a lack of high-quality studies. The included studies were comprised of heterogeneous treatment, limiting external validity.

Conclusion

Active therapies such as mobilisation, deep breathing and incentive spirometry were more effective than passive treatment. Percussion led to oxygen desaturation, and percussion, vibration and suctioning increased the risk of developing atelectasis.
Systematic review registration number CRD42015024768.  相似文献   

6.

Objective

To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD).

Design

Randomised controlled trial.

Setting

Primary care physiotherapy.

Participants

Consecutive patients with stable COPD at Gold Stage II with a score of two or more on the Medical Research Council Dyspnoea Scale.

Intervention

Ten-week combined exercise training and home-based walking programme compared with standard medical care.

Main outcomes

At baseline and after 10 weeks, daily PA was evaluated by accelerometry using three levels of intensity and expressed as metabolic equivalent of task. In addition, daily activities (Physical Activity Scale for the Elderly), functional exercise capacity (6-minute Walk Test), health-related quality of life (Chronic Respiratory Questionnaire) and exercise self-efficacy (Exercise Self-Regulatory Efficacy Scale) were measured.

Results

Fifty-two patients {34 females; mean age 70.2 [standard deviation (SD) 9.5] years; mean forced expiratory volume in 1 second 67% (SD 9.2) of predicted} were randomised. PA, adjusted for baseline differences, increased significantly in the intervention group compared with the control group, by 26.1 minutes/day [95% confidence interval (CI) 7.3 to 44.9]. The increase in functional capacity between groups was clinically relevant (34.0 m, 95% CI 2.3 to 65.6) in favour of the intervention group.

Conclusions

A combined exercise training and home-based walking programme in primary care physiotherapy improved PA in patients with moderate COPD.Clinical trial registration number NL24766.018.08.  相似文献   

7.

Objectives

To determine whether individualised manual therapy plus guideline-based advice results in superior outcomes to advice alone in participants with clinical features potentially indicative of lumbar zygapophyseal joint pain.

Design

Multi centre parallel group randomised controlled trial.

Setting

14 physiotherapy clinics in Melbourne, Australia.

Participants

Sixty-four participants with clinical features potentially indicative of lumbar zygapophyseal joint pain.

Interventions

10-weeks of physiotherapy comprising individualised manual therapy based on pathoanatomical, psychosocial and neurophysiological barriers to recovery plus guideline-based advice (10 sessions) or advice alone (two sessions).

Main outcome measures

Primary outcomes were activity limitation (Oswestry Disability Index), and separate 0 to 10 numerical rating scales for leg pain and back pain. Measures were taken at baseline and 5, 10, 26 and 52-week.

Results

Between-group differences for back pain favoured individualised manual therapy over advice for back pain at 5 (1.0; 95% CI 0.6 to 2.0), 10 (1.5; 95% CI 0.5 to 2.4) and 26-weeks (1.4; 95% CI 0.4 to 2.3) as well as for activity limitation at 26 (8.3; 95% CI 2.6 to 14.2) and 52-weeks (8.2; 95% CI 2.3 to 14.2). There were no significant between-group differences for leg pain. Secondary outcomes and responder analyses also favoured individualised manual therapy at almost all time-points.

Conclusions

In participants with clinical features potentially indicative of lumbar zygapophyseal joint pain, individualised manual therapy led to greater reduction in back pain at 5, 10 and 26-week follow-up as well as activity limitation at 26 and 52-weeks. Between-group differences were likely to be clinically important.

Trial registration

ACTRN12609000334202.  相似文献   

8.
9.

Background

Low back pain (LBP) is a major health and economic problem worldwide. Graded activity and physiotherapy are commonly used interventions for nonspecific low back pain. However, there is currently little evidence to support the use of one intervention over the other in the medium-term.

Objective

To compare the effectiveness of graded activity exercises to physiotherapy-based exercises at mid-term (three and six months’ post intervention) in patients with chronic nonspecific LBP.

Methods

Sixty-six patients were randomly allocated to two groups: graded activity group (n = 33) and physiotherapy group (n = 33). These patients received individual sessions twice a week for six weeks. Follow-up measurements were taken at three and six months. The main outcome measurements were intensity pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire).

Results

No significant differences between groups after three and six month-follow ups were observed. Both groups showed similar outcomes for pain intensity at three months [between group differences: ?0.1 (95% confidence interval [CI] = ?1.5 to 1.2)] and six months [0.1 (95% CI = ?1.1 to 1.5)], disability at three months was [-0.6 (95% CI = ?3.4 to 2.2)] and six months [0.0 (95% CI = ?2.9 to 3.0)].

Conclusion

The results of this study suggest that graded activity and physiotherapy have similar effects in the medium-term for patients with chronic nonspecific low back pain.  相似文献   

10.

Objective

To validate the Rehabilitation Adherence Measure for Athletic Training (RAdMAT) for use in clinic-based physiotherapy.

Design and procedure

Single group, prospective study conducted over the course of the participants’ rehabilitation. Clinic-based adherence was measured by participant attendance at physiotherapy appointments, the 16-item RAdMAT (three subscales) and the three-item SIRAS questionnaire. The SIRAS was evaluated after each physiotherapy treatment and the RAdMAT either at the completion of their treatment or at end of the eight week study period. Both questionnaires were completed by the physiotherapist.

Participants

108 participants with soft tissue injuries of the shoulder.

Results

The percentage of adherence for the three different adherence measures was high ranging from 89% to 95%. Large significant correlations were found between the SIRAS and the RAdMAT total score, and the RAdMAT factor 1; and amongst the RAdMAT total and its three subscales. Medium strength correlations existed between the SIRAS and the other two RAdMAT subscales. Small significant correlations occurred between percentage of attendance, and RAdMAT factors 2 and 3.

Conclusion

The strength of the correlations between the RAdMAT and the SIRAS provide evidence for the RAdMAT and its three subscales comprising a valid and comprehensive assessment tool for measuring patient adherence to clinic-based physiotherapy.Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000611820).  相似文献   

11.

Objective

To determine the factors associated with physical activity participation in adults with chronic cervical spine pain.

Methods

A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE and CINAHL from inception to June 12th, 2016. Grey literature and reference checking was also undertaken. Quantitative studies including factors related to physical activity participation in adults with chronic cervical spine pain were included. Two independent authors conducted the searches, extracted data and completed methodological quality assessment.

Results

A total of seven studies met the selection criteria, however, four papers were finally included in the final review. A modified Downs and Black criteria was used to assess methodological quality, each study included was classed as moderate quality. A total of six factors were assessed against physical activity participation for people with chronic neck pain. These included: pain, fear of movement, smoking habits, socioeconomic status, gender, leisure and work time habits. A significant relationship was demonstrated between pain, leisure and work time habits and physical activity. Subjects were less likely to participate in physical activity if they were in pain. Subjects with neck pain were less likely to participate in physical activity in their leisure and work time.

Conclusion

This review, based on a small number of heterogeneous studies demonstrated key factors that are likely to affect physical activity in people with chronic neck pain, most notably, pain levels, leisure and work habits. This review suggests that more in-depth, high quality studies are required to fully understand the impact of chronic pain on physical activity.

Systematic review registration number

PROSPERO CRD42015027970.  相似文献   

12.

Background

Office workers have the highest incidence of neck pain of all occupations. However, the relationship between symptoms and the risk factors is unclear.

Objective

To examine the relationship between self-reported neck pain with a comprehensive range of individual and work-related risk factors.

Methods

This study utilised a cross-sectional study design. Office workers with and without neck pain (n = 763) were recruited. Participants completed a survey which included a Pain Numerical Rating Scale (dependent variable), and measures of independent variables including demographic, individual, work-related factors, neck/shoulder muscle strength, endurance, and range of motion (ROM). The relationships between the independent and dependent variables were analysed in a logistic regression model.

Results

Neck pain was significantly associated with more senior occupational categories, working more than six hours per day on the computer, female sex, greater fear avoidance beliefs for work, greater psychological distress, and reduced cervical flexion ROM. The low severity of neck pain of the participants in this study may limit a robust determination of their association with the risk factor variables, but the studied sample is a realistic representation of the office worker population.

Conclusion

Several potentially modifiable individual and work-related factors were identified to be associated with the presence of self-reported neck pain in office workers. Future studies will be needed to investigate whether strategies to alter these modifiable risk factors translate to changes in neck pain.Trial registration: ACTRN12612001154897 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363209)  相似文献   

13.

Objective

To determine the feasibility and acceptability of a training programme for peer volunteers to support older adults with chronic low back pain (CLBP) following discharge from physiotherapy.

Design

Feasibility study.

Setting

Community-based.

Participants

17 adults (4 male, 13 female) with CLBP or experience of supporting someone with CLBP enrolled and 12 (2 male, 10 female) completed the volunteer training.

Intervention

Volunteers took part in a face-to-face or blended delivery peer support training programme based on the Mental Health Foundation’s “Principles into Practice” and adapted for CLBP by the study team.

Main outcome measures

Recruitment/retention rates; demographics; time & resources used to deliver training; training evaluation (questionnaire); knowledge questionnaire, and self-efficacy questionnaire.

Results

17 participants enrolled on the training programme (11 face-to-face, 6 blended delivery). 12 (71%) completed the training (73% face-to-face, 67% blended delivery). The training was positively evaluated. All but two participants passed the knowledge quiz at the end of the training, and the majority of self-efficacy scores (90%) were high.

Conclusions

It is feasible to develop, implement and evaluate a peer support training programme for the facilitation of CLBP self-management in older adults following discharge from physiotherapy. Blended delivery of training may facilitate the recruitment of greater numbers of peer support volunteers in future studies. Supported self-management of CLBP pain is widely recommended but can be difficult to achieve. Peer support might be a promising method of facilitating CLBP self-management without additional burden to health services, and should be further evaluated in a larger study.  相似文献   

14.

Background

Over the last few years, telerehabilitation services have developed rapidly, and patients value benefits such as reduced travelling barriers, flexible exercise hours, and the possibility to better integrate skills into daily life. However, the effects of physiotherapy with telerehabilitation on postoperative functional outcomes compared with usual care in surgical populations are still inconclusive.

Objectives

To study the effectiveness of physiotherapy with telerehabilitation on postoperative functional outcomes and quality of life in surgical patients.

Data sources

Relevant studies were obtained from MEDLINE, EMBASE, CINAHL, the Cochrane Library, PEDro, Google Scholar and the World Health Organization International Clinical Trials Registry Platform.

Study selection

Randomised controlled trials, controlled clinical trials, quasi-randomised studies and quasi-experimental studies with comparative controls were included with no restrictions in terms of language or date of publication.

Data extraction and synthesis

Methodological quality was assessed using the Cochrane risk of bias tool. Twenty-three records were included for qualitative synthesis. Seven studies were eligible for quantitative synthesis on quality of life, and the overall pooled standardised mean difference was 1.01 (95% confidence interval 0.18 to 1.84), indicating an increase in favour of telerehabilitation in surgical patients.

Limitations

The variety in contents of intervention and outcome measures restricted the performance of a meta-analysis on all clinical outcome measures.

Conclusions

Physiotherapy with telerehabilitation has the potential to increase quality of life, is feasible, and is at least equally effective as usual care in surgical populations. This may be sufficient reason to choose physiotherapy with telerehabilitation for surgical populations, although the overall effectiveness on physical outcomes remains unclear.
PROSPERO registration number: CRD42015017744.  相似文献   

15.

Objective

This systematic review to aimed to evaluate the effects of orthopaedic manual therapy (OMT) on pain, improving function, and physical performance in patients with knee osteoarthritis (OA).

Data sources

Four databases (PubMed, Web of Science, CENTRAL, and CINAHL) were searched.

Study selection

Trials were required to compare OMT alone or OMT in combination with exercise therapy, with exercise therapy alone or control.

Data extraction

Data extraction and risk assessment were done by two independent reviewers. Outcome measures were visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, WOMAC function score, WOMAC global score, and stairs ascending-descending time.

Results

Eleven randomized controlled trials were included (494 subjects), four of which had a PEDro score of 6 or higher, indicating adequate quality. The results of the meta-analysis indicated that reduction of VAS score in OMT compared with the control group was statistically insignificant (SDM: ?0.59; 95% CI: ?1.54 to ?0.36; P = 0.224). The reduction of VAS score in OMT compared with exercise therapy group was statistically significant (SDM: ?0.78; 95% CI: ?1.42 to ?0.17; P = 0.013). The reduction of WOMAC pain score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.79; 95% CI: ?1.14 to ?0.43; P = 0.001). Similarly, the reduction of WOMAC function score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.85; 95% CI: ?1.20 to ?0.50; P = 0.001). However, the reduction of WOMAC global score in OMT compared with the exercise therapy group was statistically insignificant (SDM: ?0.23; 95% CI: ?0.54 to ?0.09; P = 0.164). The reduction of stairs ascending-descending time in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.88; 95% CI: ?1.48 to ?0.29; P = 0.004).

Conclusions

This review indicated OMT compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee OA.

Review registration

PROSPERO 2016:CRD42016032799.  相似文献   

16.
17.

Objectives

Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is a chronic illness which can cause significant fatigue, pain and disability. Activity pacing is frequently advocated as a beneficial coping strategy, however, it is unclear whether pacing is significantly associated with symptoms in people with CFS/ME. The first aim of this study was therefore to explore the cross-sectional associations between pacing and levels of pain, disability and fatigue. The second aim was to explore whether changes in activity pacing following participation in a symptom management programme were related to changes in clinical outcomes.

Design

Cross-sectional study exploring the relationships between pacing, pain, disability and fatigue (n = 114) and pre–post treatment longitudinal study of a cohort of patients participating in a symptom management programme (n = 35).

Setting

Out-patient physiotherapy CFS/ME service.

Participants

One-hundred and fourteen adult patients with CFS/ME.

Main outcome measures

Pacing was assessed using the chronic pain coping inventory. Pain was measured using a Numeric Pain Rating Scale, fatigue with the Chalder Fatigue Scale and disability with the Fibromyalgia Impact Questionnaire.

Results

No significant associations were observed between activity pacing and levels of pain, disability or fatigue. Likewise, changes in pacing were not significantly associated with changes in pain, disability or fatigue following treatment.

Conclusions

Activity pacing does not appear to be a significant determinant of pain, fatigue or disability in people with CFS/ME when measured with the chronic pain coping index. Consequently, the utility and measurement of pacing require further investigation.  相似文献   

18.

Background

Randomised controlled trials (RCTs) are described as the gold standard of investigative clinical research. Evidence based practice is critical to the physiotherapy profession, and it is therefore important to explore the research underpinning practice by examining published RCTs.

Objectives

The main aims of this review were to profile the quantity and quality of RCTs published in the journal Physiotherapy over the past 50 years.

Data sources

Physiotherapy journal, hand searched (1967 to 1987) and electronically (1988 to 2017).

Study selection or eligibility criteria

Studies identified as RCTs.

Study appraisal and synthesis methods

Quality assessed via PEDRO criteria.

Results

120 RCTs were identified from January 1967 to January 2017. The frequency of RCTs published has increased steadily and the UK was the most common source of RCTs, but the prevalence of non-UK based trials is increasing. The quality of RCTs improved steadily over the decades, with a mean PEDro score of 6.9 in the most recent decade (2017 to 2008), indicative of ‘high quality’. The mean number of trial participants was 60 and the most commonly evaluated area was musculoskeletal physiotherapy.

Limitations

RCTs were not evaluated against CONSORT criteria.

Conclusion and implications of key findings

Frequency of publication of RCTs in the journal Physiotherapy has increased over this time, mirroring trends in the wider medical literature. This highlights the predominance of some areas of research such as musculoskeletal and exercise-based research while other prominent areas such as neurology appear to be less researched.  相似文献   

19.

Objective

To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain.

Methods

Participants (N = 142) in this randomized controlled trial were office workers aged 20–50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention.

Results

There was significant differences in pain scores for neck (MD ?10.55; 95%CI ?14.36 to ?6.74), right shoulder (MD ?12.17; 95%CI ?16.87 to ?7.47), left shoulder (MD ?11.1; 95%CI ?15.1 to ?7.09) and lower back (MD ?7.8; 95%CI ?11.08 to ?4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD ?9.99; 95%CI ?13.63 to ?6.36), right shoulder (MD ?11.12; 95%CI ?15.59 to ?6.65), left shoulder (MD ?10.67; 95%CI ?14.49 to ?6.85) and lower back (MD ?6.87; 95%CI ?10 to ?3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p < 0.05).

Conclusion

To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification.

20.

Objective

Low back pain (LBP) is little explored in the aging population especially when considering age-relevant and culturally dependent outcomes. We aimed to describe socio-demographic and clinical characteristics of Brazilian older people with a new episode of LBP presenting to primary care.

Methods

We sourced baseline information on socio-demographic, pain-related and clinical characteristics from 602 older adults from the Brazilian Back Complaints in the Elders (Brazilian BACE) study. We analyzed differences in pain, disability, functional capacity and psychosocial factors between sub-groups based on age (i.e. participants aged 55–74 or ≥75 years), education (i.e. those with four years or less of schooling or those with more than four years of schooling) and income (i.e. participants who reported earning two or less minimal wages or three and more).

Results

Participants presented severe LBP (7.18/10, SD: 2.59). Younger participants were slightly more disabled (mean difference 1.29 points, 95% confidence interval [CI]: 0.03/5.56), reporting poorer physical health, and less fall-related self-efficacy (mean difference of 2.41, 95% CI 0.35/4.46). Those less educated, and those with income equal or less than two minimum wages had more disability, pain catastrophizing and worse functional capacity.

Conclusions

This was the first study showing that Brazilian older adults with LBP present high levels of functional disability and psychological distress, especially those with low socioeconomic status.  相似文献   

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