Manipulation: investigation of a proposed mechanism

The purpose of this study was to investigate whether spinal manipulation alters the posteroanterior stiffness of the manipulated region. Thirty subjects with no history of thoracic pain or contraindication to manipulation participated. The manipulation studied was a posteroanterior thrust applied to the T_4–5 spinal level. The effect of the manipulation was compared to a control intervention of supine lying. The posteroanterior stiffness of all subjects was measured at the T₄ and T₅ levels initially, and remeasured after both the manipulation and control interventions. Change scores relating to the change in posteroanterior stiffness due to manipulation and due to the control intervention were computed. A t-test comparing the change scores between interventions revealed no significant difference. However, the posteroanterior stiffness at T₅ was found to be significantly greater than at T₄. It was concluded that in the case of asymptomatic subjects these results did not provide support for the hypothesis that posteroanterior stiffness is altered by manipulation.     

Stressors, coping mechanisms and quality of life among dialysis patients in Australia

The aim of this study was to determine the significant stressors and coping methods which are related to quality of life in dialysis patients A survey was conducted on patients in two dialysis centres in Sydney The response rate was 58% ( n = 64) The results revealed that limitation of physical activity was the most troublesome stressor followed by decrease in social life, uncertainty about the future, fatigue and muscle cramps Although their ranking was not identical to that found in prior studies, these five stressors were considered to be compatible with the high stressors identified in previous studies Problem-solving methods were considered to be more effective than affective measures in dealing with stressors Quality of life was perceived as below average in both haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients However, CAPD patients were experiencing a higher quality of life than haemodialysis patients The length of time on the dialysis programme was not significantly related to coping behaviour The findings of this study can further facilitate nurse practitioners in providing support, information, alternative solutions and in assisting patients to better utilize problem-solving methods to enhance their quality of life on dialysis     

Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women

AIM(S) OF THE STUDY: This study aims to explore the relationship between socio-psychological stress and low back pain (LBP) prevalence among Chinese middle-aged women. BACKGROUND: Women in mid-life experience increasing socio-psychological stress because of midlife transitions, stressful life events and housework or work factors. Encountering socio-psychological stress itself may result in the manifestation of LBP. DESIGN: A case-control study of Hong Kong community-based middle-aged women was conducted. The study subjects were either from the University Family Medicine Clinic or from a previous population-based cross-sectional study of middle-aged women conducted by Department of Community and Family Medicine. Among the 928 potential eligible subjects from both sources, a total of 182 cases and 235 controls participated in this study. Data were collected from face-to-face interviews and included demographic factors, menopausal status, socio-psychological stress and occurrence of LBP. Socio-psychological stress covered social factors, self-reported nature of housework/work, housework/work stress and stressful life events. RESULTS: Among the 182 cases who entered this study, 83 women (45.6%) had experienced 1-<14 days of LBP, and 99 women (54.4%) had at least 14 days of LBP in the previous 12 months. Those who reported that 'their family members, relatives or friends were very sick, died, needed her to take care of them or who they worried about in the past 12 months' had an increased risk of LBP of 67% (95% confidence interval (CI) 1.09-2.55). In addition women with a bad or ordinary relationship with cohabitants had an increased risk of LBP of 70% (95% CI 1.00-3.04). Lastly, women with a high housework or work stress had an increased risk of suffering both types of LBP of nearly two- and half-fold (95% CI 1.61-3.85). CONCLUSIONS: The results indicate that an association exists between high socio-psychological stress and LBP prevalence. Alleviating the impact of housework or work related factors would, however, involve improving both the work and home environment.