Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits

PubMed Central

Hashmi, Javeria A.; Baliki, Marwan N.; Huang, Lejian; Baria, Alex T.; Torbey, Souraya; Hermann, Kristina M.; Schnitzer, Thomas J.; Apkarian, A. Vania

2013-01-01

Chronic pain conditions are associated with abnormalities in brain structure and function. Moreover, some studies indicate that brain activity related to the subjective perception of chronic pain may be distinct from activity for acute pain. However, the latter are based on observations from cross-sectional studies. How brain activity reorganizes with transition from acute to chronic pain has remained unexplored. Here we study this transition by examining brain activity for rating fluctuations of back pain magnitude. First we compared back pain-related brain activity between subjects who have had the condition for ∼2 months with no prior history of back pain for 1 year (early, acute/subacute back pain group, n = 94), to subjects who have lived with back pain for >10 years (chronic back pain group, n = 59). In a subset of subacute back pain patients, we followed brain activity for back pain longitudinally over a 1-year period, and compared brain activity between those who recover (recovered acute/sub-acute back pain group, n = 19) and those in which the back pain persists (persistent acute/sub-acute back pain group, n = 20; based on a 20% decrease in intensity of back pain in 1 year). We report results in relation to meta-analytic probabilistic maps related to the terms pain, emotion, and reward (each map is based on >200 brain imaging studies, derived from neurosynth.org). We observed that brain activity for back pain in the early, acute/subacute back pain group is limited to regions involved in acute pain, whereas in the chronic back pain group, activity is confined to emotion-related circuitry. Reward circuitry was equally represented in both groups. In the recovered acute/subacute back pain group, brain activity diminished in time, whereas in the persistent acute/subacute back pain group, activity diminished in acute pain regions, increased in emotion-related circuitry, and remained unchanged in reward circuitry. The results demonstrate that brain representation for a constant percept, back pain, can undergo large-scale shifts in brain activity with the transition to chronic pain. These observations challenge long-standing theoretical concepts regarding brain and mind relationships, as well as provide important novel insights regarding definitions and mechanisms of chronic pain. PMID:23983029

Evaluation and management of lower back pain in young athletes

PubMed Central

Kinsella, Elizabeth

2017-01-01

Lower back pain in young athletes is a common problem. The prevalence of back pain from different causes in adolescent age group is between 20% and 30%. However, the incidence of low back pain in young athletes varies widely in different sports. Overuse injuries are the most common cause of low back pain in young athletes. In case of overuse injuries, the cause and effect relationship between back pain and specific condition is often difficult to establish. In adolescent athletes, the most common underlying identified cause of low back pain is lumbar spondylolysis. During adolescent growth spurt, the severity of the pain generally correlates with adolescent growth spurt. Participation in sports starting at an early age and for a longer duration tends to increase the risk for back pain. Numerous conditions cause low back pain in athletes. These include acute trauma, chronic overuse or repetitive trauma, and referred pain. Our focus in here will be on selected conditions that cause recurrent or chronic low back pain. PMID:28795014

Maximal anaerobic power in Indian national hockey players.

PubMed Central

Bhanot, J. L.; Sidhu, L. S.

1983-01-01

Anaerobic power in relation to field position of 90 Indian hockey players has been studied. These players included 10 goalkeepers, 16 backs, 20 half-backs and 44 forwards. The goalkeepers possess maximum and forwards possess minimum anaerobic power while in vertical velocity, the former are the fastest and the latter are the slowest. In body weight the backs are heaviest followed by half-backs, goalkeepers and forwards. Among backs, the lefts are heavier, faster and have more anaerobic power than rights. In half-line players, the centre-half-backs are followed by left-half-backs and right-half-backs both in body weight and anaerobic power, while in vertical velocity, the left-half-backs are the fastest and centre-half-backs are the slowest. Among forwards, the centre-forwards are heaviest with maximum anaerobic power and are followed by inside-forwards and outside-forwards, whereas, in vertical velocity the inside-forwards are fastest followed by centre-forwards and outside-forwards. Images p34-a p34-b PMID:6850203

Back schools for the treatment of chronic low back pain: possibility of benefit but no convincing evidence after 47 years of research—systematic review and meta-analysis

PubMed Central

Straube, Sebastian; Harden, Markus; Schröder, Heiko; Arendacka, Barbora; Fan, Xiangning; Moore, R. Andrew; Friede, Tim

2016-01-01

Abstract Back schools are interventions that comprise exercise and education components. We aimed to systematically review the randomized controlled trial evidence on back schools for the treatment of chronic low back pain. By searching MEDLINE, Embase, and Cochrane Central as well as bibliographies, we identified 31 studies for inclusion in our systematic review and 5 of these for inclusion in meta-analyses. Meta-analyses for pain scores and functional outcomes revealed statistical superiority of back schools vs no intervention for some comparisons but not others. No meta-analysis was feasible for the comparison of back schools vs other active treatments. Adverse events were poorly reported so that no reliable conclusions regarding the safety of back schools can be drawn, although some limited reassurance in this regard may be derived from the fact that few adverse events and no serious adverse events were reported in the back school groups in the studies that did report on safety. Overall, the evidence base for the use of back schools to treat chronic low back pain is weak; in nearly a half-century since back schools were first trialled, no unequivocal evidence of benefit has emerged. PMID:27257858

Back schools for the treatment of chronic low back pain: possibility of benefit but no convincing evidence after 47 years of research-systematic review and meta-analysis.

PubMed

Straube, Sebastian; Harden, Markus; Schröder, Heiko; Arendacka, Barbora; Fan, Xiangning; Moore, R Andrew; Friede, Tim

2016-10-01

Back schools are interventions that comprise exercise and education components. We aimed to systematically review the randomized controlled trial evidence on back schools for the treatment of chronic low back pain. By searching MEDLINE, Embase, and Cochrane Central as well as bibliographies, we identified 31 studies for inclusion in our systematic review and 5 of these for inclusion in meta-analyses. Meta-analyses for pain scores and functional outcomes revealed statistical superiority of back schools vs no intervention for some comparisons but not others. No meta-analysis was feasible for the comparison of back schools vs other active treatments. Adverse events were poorly reported so that no reliable conclusions regarding the safety of back schools can be drawn, although some limited reassurance in this regard may be derived from the fact that few adverse events and no serious adverse events were reported in the back school groups in the studies that did report on safety. Overall, the evidence base for the use of back schools to treat chronic low back pain is weak; in nearly a half-century since back schools were first trialled, no unequivocal evidence of benefit has emerged.

Screen-printed back-to-back electroanalytical sensors.

PubMed

Metters, Jonathan P; Randviir, Edward P; Banks, Craig E

2014-11-07

We introduce the concept of screen-printed back-to-back electroanalytical sensors where in this facile and generic approach, screen-printed electrodes are printed back-to-back with a common electrical connection to the two working electrodes with the counter and reference electrodes for each connected in the same manner as a normal "traditional" screen-printed sensor would be. This approach utilises the usually redundant back of the screen-printed sensor, converting this "dead-space" into a further electrochemical sensor which results in improvements in the analytical performance. In the use of the back-to-back design, the electrode area is consequently doubled with improvements in the analytical performance observed with the analytical sensitivity (gradient of a plot of peak height/analytical signal against concentration) doubling and the corresponding limit-of-detection being reduced. We also demonstrate that through intelligent electrode design, a quadruple in the observed analytical sensitivity can also be realised when double microband electrodes are used in the back-to-back configuration as long as they are placed sufficiently apart such that no diffusional interaction occurs. Such work is generic in nature and can be facilely applied to a plethora of screen-printed (and related) sensors utilising the commonly overlooked redundant back of the electrode providing facile improvements in the electroanalytical performance.

The physical demands of Super 14 rugby union.

PubMed

Austin, Damien; Gabbett, Tim; Jenkins, David

2011-05-01

The purpose of the present study was to describe the match-play demands of professional rugby union players competing in Super 14 matches during the 2008 and 2009 seasons. The movements of 20 players from Super 14 rugby union team during the 2008 and 2009 seasons were video recorded. Using time-motion analysis (TMA), five players from four positional groups (front-row forwards, back-row forwards, inside backs and outside backs) were assessed. Players covered between 4218 m and 6389 m during the games. The maximum distances covered in a game by the four groups were: front row forwards (5139 m), back row forwards, (5422 m), inside backs (6389 m) and outside backs (5489 m). The back row forwards spent the greatest amount of time in high-intensity exercise (1190 s), followed by the front row forwards (1015 s), the inside backs (876 s) and the outside backs (570 s). Average distances covered in individual sprint efforts were: front row forwards (16 m), back row forwards (14 m), inside backs (17 m) and outside backs (18 m). Work to rest ratios of 1:4, 1:4, 1:5, and 1:6 were found for the front row and back row forwards, and inside and outside backs respectively. The Super 14 competition during 2008 and 2009, have resulted in an increase in total high-intensity activities, sprint frequency, and work to rest ratios across all playing positions. For players and teams to remain competitive in Super 14 rugby, training (including recovery practices) should reflect these current demands. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Back pain in lower and upper secondary school pupils living in urban areas of Poland. The case of Poznań.

PubMed

Drozda, Kornelia; Lewandowski, Jacek; Górski, Przemysław

2011-01-01

To determine the lifetime prevalence and characteristics of non-specific back pain (low back pain, upper back pain) and neck pain in adolescents living in urban areas of Poland. We also studied the impact of back/neck pain on adolescents' daily activity as well as the association of back pain with computer use, watching TV, physical work, and physical activity. MATERIAL AND METHODS. A school-based questionnaire survey of back pain and physical activity, computer use, watching TV and functional disorders was distributed among 1475 randomly selected adolescents aged 13 to 20 years attending lower and upper secondary schools in Poznań, Poland. A total of 986 (67%) teenagers reported having experienced one or more episodes of back/neck pain in their lives. Low back pain was the most common presentation. Back/neck pain symptoms appeared mostly between the 14th and 16th year of life. The daily activities mostly impaired by back/neck pain were physical activity, learning/concentration and lifting objects. No significant differences were found in computer use and physical activity between adolescents with and without a history of back/neck pain. Pain-free teenagers watched TV significantly longer. Boys with back/neck pain performed physical work more frequently than pain-free boys. 1. Compared to adolescents and adults in other European countries, the lifetime prevalence of back/neck pain in Polish adolescents living in urban areas is similar. 2. The findings support the hypothesis that physical activity, computer use and watching TV cannot be regarded as risk factors for back/neck pain. 3. Back/neck pain may have a negative influence on the daily activities of adolescents. Nevertheless, this impact is probably temporary and adolescents seem to develop strategies for coping with pain in order to participate normally in daily activities. More detailed studies of these coping strategies are recommended.

An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication.

PubMed

Murthy, Vijayendra; Sibbritt, David W; Adams, Jon

2015-08-01

Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (e.g., acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. The study is based on an integrative literature review. A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is largely based on the research investigating CAM use for back pain among a range of other health conditions. Further rigorous research is needed to investigate the use of a wider range of CAM treatments, particularly self-prescribed CAM for back pain. The review findings provide insights for health-care providers and policy makers on the range of CAM treatments used by back pain sufferers. Conventional medical and CAM practitioners should be aware of back pain sufferers' decision making regarding a range of CAM treatments and be prepared to communicate with patients on safe and effective CAM treatments for back pain. Copyright © 2015 Elsevier Inc. All rights reserved.

Protect Your Back: Guidelines for Safer Lifting.

ERIC Educational Resources Information Center

Cantu, Carolyn O.

2002-01-01

Examines back injury in teachers and child care providers; includes statistics, common causes of back pain (improper alignment, improper posture, improper lifting, and carrying), and types of back pain (acute and chronic). Focuses on preventing back injury, body mechanics for lifting and carrying, and proper lifting and carrying of children. (SD)

Army Back Complaint Program

DTIC Science & Technology

1988-05-13

installation of ABC Programs. It is designed to be an educational tool to prevent injuries to the back, shoulder, or neck areas primarily as a result of...third of all costs are the result of back complaints. Wh)ther the problem stems from traumatic injury or aggravation of a long-term illness, back pain...within a matter of days. The Army Back Complaint (ABC) Program has been developed to prevent back complaints and injuries and to return workers with

Understanding cultural influences on back pain and back pain research.

PubMed

Henschke, Nicholas; Lorenz, Eva; Pokora, Roman; Michaleff, Zoe A; Quartey, Jonathan N A; Oliveira, Vinicius Cunha

2016-12-01

Low back pain is highly prevalent and places a considerable burden on individuals, their families and communities. This back pain burden is unequally distributed around the world and within populations. Clinicians and researchers addressing back pain should be aware of the cultural, social and political context of back pain patients and how this context can influence pain perception, disability and health care use. Culture, which influences the beliefs and behaviour of individuals within a social group, could be considered an important contributor to the unequal distribution of back pain. However, there is paucity of high-quality research exploring the influence of culture on the experience and management of back pain. Further development and testing of specific tools, assessment methods and communication strategies are needed to improve our understanding of how cultural practices, values and identifications affect those dealing with back pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

Normative data on the n-back task for children and young adolescents.

PubMed

Pelegrina, Santiago; Lechuga, M Teresa; García-Madruga, Juan A; Elosúa, M Rosa; Macizo, Pedro; Carreiras, Manuel; Fuentes, Luis J; Bajo, M Teresa

2015-01-01

The n-back task is a frequently used measure of working memory (WM) in cognitive neuroscience research contexts, and it has become widely adopted in other areas over the last decade. This study aimed to obtain normative data for the n-back task from a large sample of children and adolescents. To this end, a computerized verbal n-back task with three levels of WM load (1-back, 2-back, and 3-back) was administered to 3722 Spanish school children aged 7-13 years. Results showed an overall age-related increase in performance for the different levels of difficulty. This trend was less pronounced at 1-back than at 2-back when hits were considered. Gender differences were also observed, with girls outperforming boys although taking more time to respond. The theoretical implications of these results are discussed. Normative data stratified by age and gender for the three WM load levels are provided.

Fitness, motor competence, and body composition are weakly associated with adolescent back pain.

PubMed

Perry, Mark; Straker, Leon; O'Sullivan, Peter; Smith, Anne; Hands, Beth

2009-06-01

Cross-sectional survey. To assess the associations between adolescent back pain and fitness, motor competence, and body composition. Although deficits in physical fitness and motor control have been shown to relate to adult back pain, the evidence in adolescents is less clear. In this cross-sectional study, 1608 "Raine" cohort adolescents (mean age, 14 years) answered questions on lifetime, month, and chronic prevalence of back pain, and participated in a range of physical tests assessing aerobic capacity, muscle performance, flexibility, motor competence, and body composition.A history of any diagnosed back pain in the adolescent was obtained from the primary caregiver. After multivariate logistic regression analysis, increased likelihood of back pain in boys was associated with greater aerobic capacity, greater waist girth, and both reduced and greater flexibility. Back pain in girls was associated with greater abdominal endurance, reduced kinesthetic integration, and both reduced and greater back endurance. Lower likelihood of back pain was associated with greater bimanual dexterity in boys and greater lower extremity power in girls. Physical characteristics are commonly cited as important risk factors in back pain development. Although some factors were associated with adolescent back pain, and these differed between boys and girls, they made only a small contribution to logistic regression models for back pain. The results suggest future work should explore the interaction of multiple domains of risk factors (physical, lifestyle, and psychosocial) and subgroups of adolescent back pain, for whom different risk factors may be important.

Heart rate, blood lactate and kinematic data of elite colts (under-19) rugby union players during competition.

PubMed

Deutsch, M U; Maw, G J; Jenkins, D; Reaburn, P

1998-08-01

Physiological and kinematic data were collected from elite under-19 rugby union players to provide a greater understanding of the physical demands of rugby union. Heart rate, blood lactate and time-motion analysis data were collected from 24 players (mean +/- s(x): body mass 88.7 +/- 9.9 kg, height 185 +/- 7 cm, age 18.4 +/- 0.5 years) during six competitive premiership fixtures. Six players were chosen at random from each of four groups: props and locks, back row forwards, inside backs, outside backs. Heart rate records were classified based on percent time spent in four zones (>95%, 85-95%, 75-84%, <75% HRmax). Blood lactate concentration was measured periodically throughout each match, with movements being classified as standing, walking, jogging, cruising, sprinting, utility, rucking/mauling and scrummaging. The heart rate data indicated that props and locks (58.4%) and back row forwards (56.2%) spent significantly more time in high exertion (85-95% HRmax) than inside backs (40.5%) and outside backs (33.9%) (P < 0.001). Inside backs (36.5%) and outside backs (38.5%) spent significantly more time in moderate exertion (75-84% HRmax) than props and locks (22.6%) and back row forwards (19.8%) (P < 0.05). Outside backs (20.1%) spent significantly more time in low exertion (<75% HRmax) than props and locks (5.8%) and back row forwards (5.6%) (P < 0.05). Mean blood lactate concentration did not differ significantly between groups (range: 4.67 mmol x l(-1) for outside backs to 7.22 mmol x l(-1) for back row forwards; P < 0.05). The motion analysis data indicated that outside backs (5750 m) covered a significantly greater total distance than either props and locks or back row forwards (4400 and 4080 m, respectively; P < 0.05). Inside backs and outside backs covered significantly greater distances walking (1740 and 1780 m, respectively; P < 0.001), in utility movements (417 and 475 m, respectively; P < 0.001) and sprinting (208 and 340 m, respectively; P < 0.001) than either props and locks or back row forwards (walking: 1000 and 991 m; utility movements: 106 and 154 m; sprinting: 72 and 94 m, respectively). Outside backs covered a significantly greater distance sprinting than inside backs (208 and 340 m, respectively; P < 0.001). Forwards maintained a higher level of exertion than backs, due to more constant motion and a large involvement in static high-intensity activities. A mean blood lactate concentration of 4.8-7.2 mmol x l(-1) indicated a need for 'lactate tolerance' training to improve hydrogen ion buffering and facilitate removal following high-intensity efforts. Furthermore, the large distances (4.2-5.6 km) covered during, and intermittent nature of, match-play indicated a need for sound aerobic conditioning in all groups (particularly backs) to minimize fatigue and facilitate recovery between high-intensity efforts.

Back Complaints in the Elders (BACE); design of cohort studies in primary care: an international consortium

PubMed Central

2011-01-01

Background Although back complaints are common among older people, limited information is available in the literature about the clinical course of back pain in older people and the identification of older persons at risk for the transition from acute back complaints to chronic back pain. The aim of this study is to assess the course of back complaints and identify prognostic factors for the transition from acute back complaints to chronic back complaints in older people who visit a primary health care physician. Methods/design The design is a prospective cohort study with one-year follow-up. There will be no interference with usual care. Patients older than 55 years who consult a primary health care physician with a new episode of back complaints will be included in this study. Data will be collected using a questionnaire, physical examination and X-ray at baseline, and follow-up questionnaires after 6 weeks and 3, 6, 9 and 12 months. The study 'Back Complaints in the Elders' (BACE) will take place in different countries: starting in the Netherlands, Brazil and Australia. The research groups collaborate in the BACE consortium. The design and basic objectives of the study will be the same across the studies. Discussion This consortium is a collaboration between different research groups, aiming to provide insight into the course of back complaints in older people and to identify prognostic factors for the transition from acute back complaints to chronic back complaints in older persons. The BACE consortium allows to investigate differences between older people with back complaints and the health care systems in the different countries and to increase the statistical power by enabling meta-analyses using the individual patient data. Additional research groups worldwide are invited to join the BACE consortium. PMID:21854620

Alternative Packaging for Back-Illuminated Imagers

NASA Technical Reports Server (NTRS)

Pain, Bedabrata

2009-01-01

An alternative scheme has been conceived for packaging of silicon-based back-illuminated, back-side-thinned complementary metal oxide/semiconductor (CMOS) and charge-coupled-device image-detector integrated circuits, including an associated fabrication process. This scheme and process are complementary to those described in "Making a Back-Illuminated Imager With Back-Side Connections" (NPO-42839), NASA Tech Briefs, Vol. 32, No. 7 (July 2008), page 38. To avoid misunderstanding, it should be noted that in the terminology of imaging integrated circuits, "front side" or "back side" does not necessarily refer to the side that, during operation, faces toward or away from a source of light or other object to be imaged. Instead, "front side" signifies that side of a semiconductor substrate upon which the pixel pattern and the associated semiconductor devices and metal conductor lines are initially formed during fabrication, and "back side" signifies the opposite side. If the imager is of the type called "back-illuminated," then the back side is the one that faces an object to be imaged. Initially, a back-illuminated, back-side-thinned image-detector is fabricated with its back side bonded to a silicon handle wafer. At a subsequent stage of fabrication, the front side is bonded to a glass wafer (for mechanical support) and the silicon handle wafer is etched away to expose the back side. The frontside integrated circuitry includes metal input/output contact pads, which are rendered inaccessible by the bonding of the front side to the glass wafer. Hence, one of the main problems is to make the input/output contact pads accessible from the back side, which is ultimately to be the side accessible to the external world. The present combination of an alternative packaging scheme and associated fabrication process constitute a solution of the problem.

Neural correlates of working memory in first episode and recurrent depression: An fMRI study.

PubMed

Yüksel, Dilara; Dietsche, Bruno; Konrad, Carsten; Dannlowski, Udo; Kircher, Tilo; Krug, Axel

2018-06-08

Patients suffering from major depressive disorder (MDD) show deficits in working memory (WM) performance accompanied by bilateral fronto-parietal BOLD signal changes. It is unclear whether patients with a first depressive episode (FDE) exhibit the same signal changes as patients with recurrent depressive episodes (RDE). We investigated seventy-four MDD inpatients (48 RDE, 26 FDE) and 74 healthy control (HC) subjects performing an n-back WM task (0-back, 2-back, 3-back condition) in a 3T-fMRI. FMRI analyses revealed deviating BOLD signal in MDD in the thalamus (0-back vs. 2-back), the angular gyrus (0-back vs. 3-back), and the superior frontal gyrus (2-back vs. 3-back). Further effects were observed between RDE vs. FDE. Thus, RDE displayed differing neural activation in the middle frontal gyrus (2-back vs. 3-back), the inferior frontal gyrus, and the precentral gyrus (0-back vs. 2-back). In addition, both HC and FDE indicated a linear activation trend depending on task complexity. Although we failed to find behavioral differences between the groups, results suggest differing BOLD signal in fronto-parietal brain regions in MDD vs. HC, and in RDE vs. FDE. Moreover, both HC and FDE show similar trends in activation shapes. This indicates a link between levels of complexity-dependent activation in fronto-parietal brain regions and the stage of MDD. We therefore assume that load-dependent BOLD signal during WM is impaired in MDD, and that it is particularly affected in RDE. We also suspect neurobiological compensatory mechanisms of the reported brain regions in (working) memory functioning. Copyright © 2018 Elsevier Inc. All rights reserved.

Chronic low back pain in patients with systemic lupus erythematosus: prevalence and predictors of back muscle strength and its correlation with disability.

PubMed

Cezarino, Raíssa Sudré; Cardoso, Jefferson Rosa; Rodrigues, Kedma Neves; Magalhães, Yasmin Santana; Souza, Talita Yokoy de; Mota, Lícia Maria Henrique da; Bonini-Rocha, Ana Clara; McVeigh, Joseph; Martins, Wagner Rodrigues

To determine the prevalence of Chronic Low Back Pain and predictors of Back Muscle Strength in patients with Systemic Lupus Erythematosus. Cross-sectional study. Ninety-six ambulatory patients with lupus were selected by non-probability sampling and interviewed and tested during medical consultation. The outcomes measurements were: Point prevalence of chronic low back pain, Oswestry Disability Index, Tampa Scale of Kinesiophobia, Fatigue Severity Scale and maximal voluntary isometric contractions of handgrip and of the back muscles. Correlation coefficient and multiple linear regression were used in statistical analysis. Of the 96 individuals interviewed, 25 had chronic low back pain, indicating a point prevalence of 26% (92% women). The correlation between the Oswestry Index and maximal voluntary isometric contraction of the back muscles was r=-0.4, 95% CI [-0.68; -0.01] and between the maximal voluntary isometric contraction of handgrip and of the back muscles was r=0.72, 95% CI [0.51; 0.88]. The regression model presented the highest value of R 2 being observed when maximal voluntary isometric contraction of the back muscles was tested with five independent variables (63%). In this model handgrip strength was the only predictive variable (β=0.61, p=0.001). The prevalence of chronic low back pain in individuals with systemic lupus erythematosus was 26%. The maximal voluntary isometric contraction of the back muscles was 63% predicted by five variables of interest, however, only the handgrip strength was a statistically significant predictive variable. The maximal voluntary isometric contraction of the back muscles presented a linear relation directly proportional to handgrip and inversely proportional to Oswestry Index i.e. stronger back muscles are associated with lower disability scores. Copyright © 2017. Published by Elsevier Editora Ltda.

Low back pain and physical activity--A 6.5 year follow-up among young adults in their transition from school to working life.

PubMed

Lunde, Lars-Kristian; Koch, Markus; Hanvold, Therese N; Wærsted, Morten; Veiersted, Kaj B

2015-11-12

The association between leisure time physical activity and low back pain in young adults is unclear and is in the need of prospectively obtained evidence. This study examined the course of low back pain and the association between low back pain and leisure time physical activity in a cohort of young adults in their transition from school to working life. Both low back pain and leisure time physical activity was monitored over a 6.5 year period in 420 subjects starting out as students within hairdressing, electrical installation and media/design. The association between physical activity and low back pain was investigated through the follow-up period by using linear mixed models analysis. Low back pain was significantly influenced by time and overall there was a decreasing trend of low back pain prevalence throughout the follow-up. Analysis showed a weak trend of decreasing low back pain with moderate/high physical activity levels, but this association was not significant. Low back pain decreased during follow-up with baseline as reference. Findings in our study did show non-significant trends of reduced low back pain with increased leisure time physical activity. Still, we could not support the theory of moderate/high levels of physical activity acting protective against low back pain in young adults entering working life. Our results, in combination with previous relevant research, cannot support a clear relationship between physical activity and low back pain for young adults. Thus, recommendations regarding effect of physical activity on reducing low back pain for this group are not clear.

Pessimistic back beliefs and lack of exercise: a longitudinal risk study in relation to shoulder, neck, and back pain.

PubMed

Elfering, Achim; Müller, Urs; Rolli Salathé, Cornelia; Tamcan, Özgür; Mannion, Anne F

2015-01-01

This cross-lagged-panel study tested the validity of the German version of the back beliefs questionnaire (BBQ) in predicting pain in the shoulders, neck, and back. A random sample of 2860 individuals participated at baseline, and 73% responded at one-year follow-up. Structural equation modeling was used to carry out a model comparison to evaluate whether paths differed between individuals with and without initial back pain and between those who exercised at baseline and those who did not. Factor analysis showed eight of the nine original items loaded on the expected common factor. High BBQ scores at baseline significantly predicted an increase in shoulder, neck, and back pain in individuals with current back pain (β = .11, p < .05), but not in other respondents (β = .02, p = .259). Similarly, baseline BBQ scores predicted the increase in shoulder, neck, and back pain among those who did not exercise (β = .15, p < .05), but not in those who did (β = .04, ns). The risk of negative back beliefs preceding an increase in shoulder, neck, and back pain was greatest for those with current back pain who did not exercise (β = .29, p < .05). The findings confirmed the validity of the German BBQ. Cognitive behavioral interventions should address pessimistic back beliefs in high-risk groups.

Relationship between Teach-back and patient-centered communication in primary care pediatric encounters.

PubMed

Badaczewski, Adam; Bauman, Laurie J; Blank, Arthur E; Dreyer, Benard; Abrams, Mary Ann; Stein, Ruth E K; Roter, Debra L; Hossain, Jobayer; Byck, Hal; Sharif, Iman

2017-07-01

We proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter. Audio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness. Teach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p=0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI)=4.97 (4.47-5.53)]and negative affect [AOR (95% CI)=5.39 (1.68-17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it. Teach-back was associated with more patient-centered communication and increased affective engagement of parents. Standardizing Teach-back use may strengthen patient-centered communication. Copyright © 2017 Elsevier B.V. All rights reserved.

Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey.

PubMed

Schmidt, Carsten Oliver; Raspe, Heiner; Pfingsten, Michael; Hasenbring, Monika; Basler, Heinz Dieter; Eich, Wolfgang; Kohlmann, Thomas

2007-08-15

A population-based cross-sectional multiregion postal survey. To provide a descriptive epidemiology of the prevalence and severity of back pain in German adults and to analyze sociodemographic correlates for disabling back pain within and across regions. Back pain is a leading health problem in Germany. However, comprehensive population-based evidence on the severity of back pain is still fragmentary for this country. Despite earlier findings concerning large prevalence differences across regions, systematic explanations remain to be ascertained. Questionnaire data were collected for 9263 subjects in 5 German cities and regions (population-based random samples, postal questionnaire). Point, 1-year, and lifetime prevalence were assessed using direct questions, and graded back pain was determined using the Graded Chronic Pain Scale. Poststratification was applied to adjust for cross-regional sociodemographic differences. Point-prevalence was 37.1%, 1-year prevalence 76.0%, and lifetime prevalence 85.5%. A substantial minority had severe (Grade II, 8.0%) or disabling back pain (Grade III-IV, 11.2%). Subjects with a low educational level reported substantially more disabling back pain. This variable was an important predictor for large cross-regional differences in the burden of back pain. Back pain is a highly prevalent condition in Germany. Disabling back pain in this country may be regarded as part of a social disadvantage syndrome. Educational level should receive greater attention in future cross-regional comparisons of back pain.

Spinal Infections

MedlinePlus

Toggle navigation CONDITIONS Low Back Pain Acute Low Back Pain Chronic Low Back Pain SI Joint Pain Other Scoliosis Back Pain and Emotional Distress Muscle Spasms Pinched Nerve Discitis Degenerative Conditions Bulge vs ...

Blepharoplasty

MedlinePlus

... Marks Sun-damaged Skin Tattoo Removal Varicose Veins Vitiligo Wrinkles Back Skin Treatments Back Ambulatory Phlebectomy Blepharoplasty ... Micropigmentation Back Migropigmentation for Burn Scars Migropigmentation for Vitiligo Back Microwave Thermolysis for Excessive Sweating Mohs Surgery ...

Evaluating Quality Management of Acute Low Back Problems Provided By Air Force Nurse Practitioners

DTIC Science & Technology

1999-05-01

evaluate acute back pain, acute back pain with sciatica , and chronic low back pain. Nine treatments were listed in part one, and physicians were asked to...corsets, trigger point injections, and epidural steroid injections for sciatica are effective for chronic back pain. The study concluded that there

20 CFR 404.1242 - Back pay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Back pay. 404.1242 Section 404.1242 Employees... Prior to 1987 § 404.1242 Back pay. (a) Back pay defined. Back pay is pay received in one period of time... an employer. It includes pay made under Federal or State laws intended to create an employment...

The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial.

PubMed

Heymans, Martijn W; de Vet, Henrica C W; Bongers, Paulien M; Knol, Dirk L; Koes, Bart W; van Mechelen, Willem

2006-05-01

Randomized controlled trial. To compare high- and low-intensity back schools with usual care in occupational health care. The content and intensity of back schools vary widely and the methodologic quality of randomized controlled trials is generally weak. Until now, no back school has proven to be superior for workers sick-listed because of subacute nonspecific low back pain. Workers (n = 299) sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain were recruited by the occupational physician and randomly assigned to a high-intensity back school, a low-intensity back school, or care as usual. Outcome measures were days until return to work, total days of sick-leave, pain, functional status, kinesiophobia, and perceived recovery and were assessed at baseline and at 3 and 6 months of follow-up. Principal analyses were performed according to the intention-to-treat principle. We randomly allocated 299 workers. Workers in the low-intensity back school returned to work faster compared with usual care and the high-intensity back school, with hazard ratios of 1.4 (P = 0.06) and 1.3 (P = 0.09), respectively. The comparison between high-intensity back school and usual care resulted in a hazard ratio of 1.0 (P = 0.83). The median number of sick-leave days was 68, 75, and 85 in the low-intensity back school, usual care, and high-intensity back school, respectively. Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school. No substantial differences on pain and perceived recovery were found between groups. The low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up.

Lumbar (Open) Microscopic Discectomy

MedlinePlus

Toggle navigation CONDITIONS Low Back Pain Acute Low Back Pain Chronic Low Back Pain SI Joint Pain Other Scoliosis Back Pain and Emotional Distress Muscle Spasms Pinched Nerve Discitis Degenerative Conditions Bulge vs ...

Evaluation of Prevalence of Low Back Pain Among Residents of Tabriz University of Medical Sciences in Relation with Their Position in Work.

PubMed

Shams Vahdati, Samad; Sarkhosh Khiavi, Reza; Rajaei Ghafouri, Rouzbeh; Adimi, Ida

2014-09-01

Lower back pain is one of the most common complaints among the general population and among health professionals. Multiple workplace-related risk factors may contribute to back pain among physicians. The aim of this study was to assess the prevalence of lower back pain among medical residents of different medical specialties and to evaluate the relevant risk factors. A Dutch Musculoskeletal Questionnaire (DMQ) was completed by 125 medical residents. Part I concerned general demographic information, part II evaluated workplace-specific factors, and part III assessed the individual characteristics of lower back pain. The overall prevalence of lower back pain among residents was 56.8%, with 45.1% of men and 76.5% of women reporting lower back pain. A total of 94.4% of affected individuals believed that their lower back pain was related to their current job, and 72.6% claimed that the onset of lower back pain occurred after beginning medical work. Statistical analysis revealed a significant correlation between lower back pain and certain risk factors, such as working in the same position for long periods, repetitive movement (bending, twisting) of the lumbar region, working in uncomfortable postures, stress, walking, and standing for long periods. However, no significant relationship was found between lower back pain and heavy lifting, smoking, or prolonged sitting. The role of exercise as a protective factor in reducing the incidence of lower back pain was supported by the statistical analysis. The prevalence of lower back pain among residents is high and is associated with a number of workplace-related risk factors.

A systematic review on the effectiveness of back protectors for motorcyclists.

PubMed

Ekmejian, Rafael; Sarrami, Pooria; Naylor, Justine M; Harris, Ian A

2016-10-04

Motorcyclists are a vulnerable road-user population who are overrepresented in traffic injuries. Utilisation of back protectors may be an effective preventive measure for spine injuries in motorcyclists. Since use of back protectors is increasing it is important that clinical evidence supports their use. The study aimed to investigate the current evidence on the ability of back protectors to reduce the rate of back injuries and patient mortality in motorcycle crashes. A systematic literature search was conducted using various electronic databases. Systematic reviews, randomised controlled trials, controlled clinical trials, cohort studies, case series and case reports were included Opinion pieces and laboratory or biomechanical studies were excluded. Back protectors and spine protectors were included as the intervention; neck braces and speed humps were excluded. The target outcomes were any injuries to the back or death. Only English language studies were included. The search strategy yielded 185 studies. After excluding 183 papers by title and abstract and full-text evaluation, only two small cross-sectional studies were included. Foam inserts in motorcycle jackets and non-standard clothing may possibly be associated with higher risk of injuries, while hard shell and standard back protectors may possibly be associated with a reduced rate of back and spinal injury. This systematic review highlighted lack of appropriate evidence on efficacy of back protectors. Based on limited information, we are uncertain about the effects of back protectors on spinal injuries. Further research is required to substantiate the effects of back protectors on mortality and other injuries to the back.

Analysis of 22,655 presentations with back pain to Perth emergency departments over five years.

PubMed

Lovegrove, Michael T; Jelinek, George A; Gibson, Nicholas P; Jacobs, Ian G

2011-09-17

Back pain is a significant cause of disability in the community, but the impact on Emergency Departments (EDs) has not been formally studied. Patients with back pain often require significant time and resources in the ED. To examine the characteristics of patients presenting with back pain to the ED, including final diagnosis, demographics of those attending and temporal distribution of presentations. Emergency presentations in the metropolitan area of Perth, Western Australia, for 2000-2004 were searched using a linked database covering all the major hospitals (Emergency Care Hospitalisation and Outcome Study database). All presentations with the triage code for back pain were extracted and analysed. A total of 22,655 presentations with back pain were identified, representing 1.9% of total presentations. Simple muscular or non-specific back pain accounted for only 43.8% of presentations, with other causes such as renal colic and pyelonephritis accounting for the majority. The young (<15 years old) and elderly (>75 years old) were more likely to have non-muscular causes for their back pain. Muscular back pain presentations occurred mostly between 0800 and 1600, with high proportions presenting on the weekends. Patients with simple muscular back pain spent a mean of 4.4 h in the ED, representing a significant outlay of resources. Back pain has a significant impact on EDs, and staff should be alert for another pathology presenting as back pain. There is a need for multidisciplinary back pain teams to be available 7 days a week, but only during the day.

Viscoelastic Response of the Human Lower Back to Passive Flexion: The Effects of Age.

PubMed

Shojaei, Iman; Allen-Bryant, Kacy; Bazrgari, Babak

2016-09-01

Low back pain is a leading cause of disability in the elderly. The potential role of spinal instability in increasing risk of low back pain with aging was indirectly investigated via assessment of age-related differences in viscoelastic response of lower back to passive deformation. The passive deformation tests were conducted in upright standing posture to account for the effects of gravity load and corresponding internal tissues responses on the lower back viscoelastic response. Average bending stiffness, viscoelastic relaxation, and dissipated energy were quantified to characterize viscoelastic response of the lower back. Larger average bending stiffness, viscoelastic relaxation and dissipated energy were observed among older vs. younger participants. Furthermore, average bending stiffness of the lower back was found to be the highest around the neutral standing posture and to decrease with increasing the lower back flexion angle. Larger bending stiffness of the lower back at flexion angles where passive contribution of lower back tissues to its bending stiffness was minimal (i.e., around neutral standing posture) highlighted the important role of active vs. passive contribution of tissues to lower back bending stiffness and spinal stability. As a whole our results suggested that a diminishing contribution of passive and volitional active subsystems to spinal stability may not be a reason for higher severity of low back pain in older population. The role of other contributing elements to spinal stability (e.g., active reflexive) as well as equilibrium-based parameters (e.g., compression and shear forces under various activities) in increasing severity of low back pain with aging should be investigated in future.

An Inkjet Printed Piezoresistive Back to Back Tactile Sensor for Endosurgical Palpation Applications (Postprint)

DTIC Science & Technology

2017-02-23

elements linked back-to- back for force and displacement detection, respectively. Experimental results indicate the sensor registers 2.1 and 5.3 mN force...feedback from the fat and muscle tissues of pig, respectively, when pressed to the tissues with the same 100 μm displacement . This difference of ∼2.5...back-to-back for force and displacement detection, respectively. Experimental results indicate the sensor registers 2.1 and 5.3 mN force feedback from

Correlation of Body Composition and Low Back Pain Severity in a Cross-Section of US Veterans.

PubMed

Okamoto, Casey S; Dunn, Andrew S; Green, Bart N; Formolo, Lance R; Chicoine, David

2017-06-01

Back pain is more prevalent in the obese, but whether back pain severity is directly correlated to obesity in veterans is unknown. We sought to determine if there was a correlation between body composition and low back pain severity in a sample of veterans. The hypothesis was that veterans with higher body mass index values would report higher low back pain severity scores. This study was a retrospective chart review of 1768 veterans presenting to a Veterans Affairs chiropractic clinic with a chief complaint of low back pain between January 1, 2009 and December 31, 2014. Spearman's rho was used to test for correlation between body composition as measured by body mass index and low back pain severity as measured by the Back Bournemouth Questionnaire. On average, the sample was predominantly male (91%), older than 50, and overweight (36.5%) or obese (48.9%). There was no correlation between body mass index and Back Bournemouth Questionnaire scores, r = .088, p < .001. The majority of veterans with low back pain in this sample were either overweight or obese. There was no correlation between body composition and low back pain severity in this sample of veterans. Copyright © 2017. Published by Elsevier Inc.

Back pain and sports

MedlinePlus

... Running - back pain; Weightlifting - back pain; Lumbar pain - sports; Sciatica - sports; Low back pain - sports ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: ...

Inversion Therapy: Can It Relieve Back Pain?

MedlinePlus

Inversion therapy: Can it relieve back pain? Does inversion therapy relieve back pain? Is it safe? Answers from Edward R. Laskowski, M.D. Inversion therapy doesn't provide lasting relief from back ...

Physical and functional measures related to low back pain in individuals with lower-limb amputation: an exploratory pilot study.

PubMed

Friel, Karen; Domholdt, Elizabeth; Smith, Douglas G

2005-01-01

For this study, we compared the physical impairments and functional deficits of individuals with lower-limb amputation (LLA) for those with and without low back pain (LBP). Nineteen participants with LLA were placed into two groups based on visual analog scores of LBP. We assessed functional limitations, iliopsoas length, hamstring length, abdominal strength, back extensor strength, and back extensor endurance. Data analysis included correlations and t-tests. We found significant correlations between pain score and functional limitations, iliopsoas length, and back extensor endurance. We also detected significant differences in functional limitations, iliopsoas length, back extensor strength, and back extensor endurance between those with and without LBP. We saw significant differences in back extensor strength and back extensor endurance between those with transtibial and transfemoral amputations. Differences exist in physical measures of individuals with LLA with and without LBP. Clinicians should consider these impairments in individuals with amputation who experience LBP. Because of the participants' characteristics, these findings may be applicable to veterans with LLA.

An assessment of lower back pain in young adults: implications for college health education.

PubMed

Reis, J; Flegel, M; Kennedy, C

1996-05-01

A convenience sample of 243 undergraduates completed a 36-item questionnaire on their knowledge about back care and exercise patterns before they attended lectures and a workshop on back mechanics. At the workshop, the students were individually evaluated for posture, hamstring flexibility, hip flexor flexibility, back and abdominal strength, and lifting technique. Twenty-nine percent of the students reported that they experienced no back pain; 71% experienced lower back pain 1 to 5 days a week. The majority were neglectful of their posture, lifting and carrying techniques, and scored fair-to-poor on the hamstring flexibility test, possibly foreshadowing back problems in later life. The majority of respondents were unsure of what exercises to do for back care. Within the subgroup of students who claimed they were knowledgeable about exercise, more than 50% were performing ineffective and potentially harmful exercises. The results underscored the potential worth of health education on back care offered through didactic instruction and experiential workshops.

Making a Back-Illuminated Imager with Back-Side Contact and Alignment Markers

NASA Technical Reports Server (NTRS)

Pain, Bedabrata

2008-01-01

A design modification and a fabrication process that implements the modification have been conceived to solve two problems encountered in the development of back-illuminated, back-sidethinned complementary metal oxide/ semiconductor (CMOS) image-detector integrated circuits. The two problems are (1) how to form metal electrical-contact pads on the back side that are electrically connected through the thickness in proper alignment with electrical contact points on the front side and (2) how to provide alignment keys on the back side to ensure proper registration of backside optical components (e.g., microlenses and/or color filters) with the front-side pixel pattern. The essence of the design modification is to add metal plugs that extend from the desired front-side locations through the thickness and protrude from the back side of the substrate. The plugs afford the required front-to-back electrical conduction, and the protrusions of the plugs serve as both the alignment keys and the bases upon which the back-side electrical-contact pads can be formed.

A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain

PubMed Central

Gordon, Rebecca; Bloxham, Saul

2016-01-01

Back pain is a major health issue in Western countries and 60%–80% of adults are likely to experience low back pain. This paper explores the impact of back pain on society and the role of physical activity for treatment of non-specific low back pain. A review of the literature was carried out using the databases SPORTDiscuss, Medline and Google Scholar. A general exercise programme that combines muscular strength, flexibility and aerobic fitness is beneficial for rehabilitation of non-specific chronic low back pain. Increasing core muscular strength can assist in supporting the lumbar spine. Improving the flexibility of the muscle-tendons and ligaments in the back increases the range of motion and assists with the patient’s functional movement. Aerobic exercise increases the blood flow and nutrients to the soft tissues in the back, improving the healing process and reducing stiffness that can result in back pain. PMID:27417610

Normative data on the n-back task for children and young adolescents

PubMed Central

Pelegrina, Santiago; Lechuga, M. Teresa; García-Madruga, Juan A.; Elosúa, M. Rosa; Macizo, Pedro; Carreiras, Manuel; Fuentes, Luis J.; Bajo, M. Teresa

2015-01-01

The n-back task is a frequently used measure of working memory (WM) in cognitive neuroscience research contexts, and it has become widely adopted in other areas over the last decade. This study aimed to obtain normative data for the n-back task from a large sample of children and adolescents. To this end, a computerized verbal n-back task with three levels of WM load (1-back, 2-back, and 3-back) was administered to 3722 Spanish school children aged 7–13 years. Results showed an overall age-related increase in performance for the different levels of difficulty. This trend was less pronounced at 1-back than at 2-back when hits were considered. Gender differences were also observed, with girls outperforming boys although taking more time to respond. The theoretical implications of these results are discussed. Normative data stratified by age and gender for the three WM load levels are provided. PMID:26500594

Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia.

PubMed

Morony, Suzanne; Weir, Kristie; Duncan, Gregory; Biggs, Janice; Nutbeam, Don; Mccaffery, Kirsten J

2018-03-07

Telehealth professionals require advanced communication skills, in part to compensate for lack of visual cues. Teach-Back is a best practice communication technique that has been recommended but not previously evaluated for consumer telehealth. We aimed to implement Teach-Back at a national maternal and child health telephone helpline. We describe the intervention and report telenurse experiences learning to use Teach-Back. We identified barriers (time, knowledge, skills, beliefs) and enablers (self-reflection) to using Teach-Back, and developed a novel training program to address these, guided by the Theoretical Domains Framework. We engaged maternal and child health telenurses to participate in a "communication skills" study. The intervention had two key components: guided self-reflection and a Teach-Back skills workshop. For the duration of the 7-week study nurses completed brief online surveys following each call, reflecting on both the effectiveness of their communication and perceived caller understanding. At the end of each shift they reflected on what worked well. Teach-Back knowledge, skills, and beliefs were addressed in a 2-h workshop using videos, discussion, and role play. We explored nurses' experiences of the intervention in focus groups and interviews; and analysed transcripts and comments from the self-reflection surveys using the Framework method. This study forms part of a larger evaluation conducted in 2016. In total 16 nurses participated: 15 were trained in Teach-Back, and 13 participated in focus groups or interviews. All engaged with both self-reflection and Teach-Back, although to differing extents. Those who reported acquiring Teach-Back skills easily limited themselves to one or two Teach-Back phrases. Nurses reported that actively self-reflecting (including on what they did well) was useful both for developing Teach-Back skills and analysing effectiveness of the techniques. Most wanted more opportunity to learn how their colleagues manage Teach-Back in different situations, and more visual reminders to use Teach-Back. Our theory-informed intervention successfully enabled nurses to use Teach-Back. Guided self-reflection is a low-resource method aligned with nurse professional identity that can facilitate Teach-Back skills learning, and could also be applied to other advanced communication skills for telehealth. Listening to multiple workplace-specific examples of Teach-Back is recommended for future training. ACTRN12616000623493 Registered 15 May 2016. Retrospectively registered.

Indoor fitness routine

MedlinePlus

... keep your back straight. Using your front leg, push back into the starting position. Repeat on the other ... your back sag. Press into your arms to push yourself back up. If it is too hard to do ...

National supply-chain survey of drug manufacturer back orders.

PubMed

Wellman, G S

2001-07-01

The impact of manufacturer back orders on the supply chain for pharmaceuticals in the institutional setting was studied. A questionnaire was distributed during May and June 2000 to 600 institutional pharmacies affiliated with a major national drug and supply group purchasing organization. The instrument included questions on basic institutional demographics, perceptions about the frequency of manufacturer back orders for pharmaceuticals, the quality of communication with manufacturers and wholesalers about back orders, the two most significant back orders that had occurred in the 12 months preceding the survey, and the reasons for and impact of back orders. A total of 170 usable surveys were returned (net response rate, 28.3%). Reported manufacturer back orders included an array of drug classes, including blood products, antimicrobials, antiarrhythmics, benzodiazepine antagonists, thrombolytics, corticosteroids, and antihypertensives. Respondents perceived significant back orders as increasing in frequency. Communication by manufacturers and wholesalers about back orders was reported to be relatively poor. A raw-material shortage was the most common reason given by manufacturers for back orders (36.5%), followed by a regulatory issue (23.2%). In most cases (92%), medical staff members had to be contacted, indicating an interruption in the normal drug distribution process. In over a third of instances, respondents stated that the back order resulted in less optimal therapy. A survey found that manufacturer back orders for pharmaceuticals were increasing in frequency and that information flow within the supply chain was insufficient to meet the needs of end users.

Does obesity cause low back pain?

PubMed

Garzillo, M J; Garzillo, T A

1994-01-01

The purpose of this study is to review the recent literature on the association between obesity and low back pain, in an effort to determine whether weight control can be considered an appropriate treatment for low back pain, and whether obesity can be considered a primary etiology of low back pain. We reviewed articles in English from 1970 to present on MEDLINE that listed both obesity and low back pain as key words. Because of the paucity of articles retrieved this way, we also reviewed the bibliographies of each article to draw more studies into our review. Our search generated only seven studies. A standard textbook of obesity was also utilized as a source of basic science of obesity. Our review of these articles revealed a possible association between obesity and low back pain only in the upper quintile of obesity, and no evidence of a temporal relationship between weight change and low back pain change. The studies reviewed failed to differentiate low back pain patients by diagnosis and failed to quantify the possible presence of emotional factors in obese low back pain patients. As an incidental finding, one study documented a significant correlation between smoking history and low back pain. We concluded that there is no evidence in the current literature to support obesity that is not in the highest quintile as a cause of low back pain. We recommended that a longitudinal study be done that subclassified obese low back pain patients by mechanical and psychological diagnosis.

Low back pain in car drivers: A review of studies published 1975 to 2005

NASA Astrophysics Data System (ADS)

Gallais, Lenka; Griffin, Michael J.

2006-12-01

This review investigates whether there is evidence of an association between car driving and low back pain, and evidence that whole-body vibration contributes to low back pain in car drivers. The evidence of an association between various physical, psychosocial and individual factors and low back pain in car drivers was also investigated. From 23 epidemiological studies of low back problems in groups that reported car driving, nine studies fulfilled simple criteria for detailed review: four cross-sectional studies, three case-control studies and two longitudinal studies. The definition of low back pain was often unclear and, mostly, the physiological mechanisms causing low back pain were not considered. Eight of the nine studies concluded that there was an increase in low back pain among car drivers but there was little consideration of the influence of the many physical factors, individual factors and psychosocial factors that might be associated with an increase in low back pain. Consequently, there is insufficient evidence to form a conclusion on whether whole-body vibration, postural stressors or other factors, specific or not specific to driving, are common causes of low back problems in car drivers.

Role of Stress and Smoking as Modifiable Risk Factors for Nonpersistent and Persistent Back Pain in Women.

PubMed

Schmelzer, Amy C; Salt, Elizabeth; Wiggins, Amanda; Crofford, Leslie J; Bush, Heather; Mannino, David M

2016-03-01

The purpose of this study was to examine the association between smoking and stress with nonpersistent and persistent back pain. Participants included 3703 women who took part in the Kentucky Women's Health Registry in 2008 and 2011. Multivariate logistic regression modeling was used to examine whether smoking status and stress levels were predictive of nonpersistent and persistent back pain, controlling for sociodemographic characteristics. Stress level was associated with both nonpersistent and persistent back pain, whereas smoking was associated with only persistent back pain. Current smokers were 1.5 times more likely to report persistent back pain compared with never smokers, controlling for age, race, body mass index, educational attainment, and employment status. Women experiencing large or overwhelming amounts of stress were 1.8 times more likely to have nonpersistent back pain and 1.6 times more likely to report persistent back pain, compared with women experiencing small amounts of stress. This study further substantiates the findings of prior research that describes a significant relationship between back pain, stress, and smoking. Understanding the role of modifiable risk factors (ie, smoking and stress) and their impact on back pain provides an opportunity to offer a comprehensive and tailored treatment plan.

Electrophysiological assessment of piano players' back extensor muscles on a regular piano bench and chair with back rest.

PubMed

Honarmand, Kavan; Minaskanian, Rafael; Maboudi, Seyed Ebrahim; Oskouei, Ali E

2018-01-01

[Purpose] Sitting position is the dominant position for a professional pianist. There are many static and dynamic forces which affect musculoskeletal system during sitting. In prolonged sitting, these forces are harmful. The aim of this study was to compare pianists' back extensor muscles activity during playing piano while sitting on a regular piano bench and a chair with back rest. [Subjects and Methods] Ten professional piano players (mean age 25.4 ± 5.28, 60% male, 40% female) performed similar tasks for 5 hours in two sessions: one session sitting on a regular piano bench and the other sitting on a chair with back rest. In each session, muscular activity was assessed in 3 ways: 1) recording surface electromyography of the back-extensor muscles at the beginning and end of each session, 2) isometric back extension test, and 3) musculoskeletal discomfort questionnaire. [Results] There were significantly lesser muscular activity, more ability to perform isometric back extension and better personal comfort while sitting on a chair with back rest. [Conclusion] Decreased muscular activity and perhaps fatigue during prolonged piano playing on a chair with back rest may reduce acquired musculoskeletal disorders amongst professional pianists.

Electrophysiological assessment of piano players’ back extensor muscles on a regular piano bench and chair with back rest

PubMed Central

Honarmand, Kavan; Minaskanian, Rafael; Maboudi, Seyed Ebrahim; Oskouei, Ali E.

2018-01-01

[Purpose] Sitting position is the dominant position for a professional pianist. There are many static and dynamic forces which affect musculoskeletal system during sitting. In prolonged sitting, these forces are harmful. The aim of this study was to compare pianists’ back extensor muscles activity during playing piano while sitting on a regular piano bench and a chair with back rest. [Subjects and Methods] Ten professional piano players (mean age 25.4 ± 5.28, 60% male, 40% female) performed similar tasks for 5 hours in two sessions: one session sitting on a regular piano bench and the other sitting on a chair with back rest. In each session, muscular activity was assessed in 3 ways: 1) recording surface electromyography of the back-extensor muscles at the beginning and end of each session, 2) isometric back extension test, and 3) musculoskeletal discomfort questionnaire. [Results] There were significantly lesser muscular activity, more ability to perform isometric back extension and better personal comfort while sitting on a chair with back rest. [Conclusion] Decreased muscular activity and perhaps fatigue during prolonged piano playing on a chair with back rest may reduce acquired musculoskeletal disorders amongst professional pianists. PMID:29410569

Top 100 Cited Articles on Back Pain Research: A Citation Analysis.

PubMed

Huang, Weimin; Wang, Lei; Wang, Bing; Yu, Lili; Yu, Xiuchun

2016-11-01

A bibliometric review of the literature. Back pain is a global burden that leads people to seek medical service and results in work disability. Numerous studies are published annually to give new insights into back pain. However, characteristics of the high-impact articles on back pain have not been explored. The current study aimed to identify the 100 most cited articles on back pain and determine their characteristics. Back pain is a globally leading cause of work disability. Numerous studies have been published annually to give new insight to back pain. However, comprehensive analysis to identify the most influential articles is not available until now. The Web of Science core database was searched using the subject terms "back NEAR pain," "dorsalgia," "backache," "lumbar NEAR pain," "lumbago," "back NEAR disorder*," "discitis." The searching results were listed by citation times and the top 100 cited articles on back pain were identified. Important information such as author, journal, publishing year, country, institution, and study type were elicited. A total of 44,460 articles on back pain were displayed. Citation times of the enrolled 100 articles ranged from 249 to 1638 with a mean value of 418. The most productive periods were 1991 to 1995 and 1996 to 2000. The journal Spine holds the largest number of 45 articles, followed by Pain with seven articles. A total of 11 countries contribute to the 100 articles and the United States topped the list. None of the high-impact articles were produced in Asian and African. The current citation analysis demonstrated the essential advances in the history of back pain research and determined the influential authors, institutions, countries, and journals that had outstanding contributions to the studies of back pain. 3.

Back problems, comorbidities, and their association with wealth.

PubMed

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Passey, Megan E; Kelly, Simon J; Percival, Richard

2015-01-01

Studies assessing the economic burden of back problems have given little consideration to the presence of comorbidities. To assess the difference in the value of wealth held by Australians who have back problems and varying numbers of chronic comorbidities. A cross-sectional study. Individuals aged 45 to 64 years in 2009: 4,388 with no chronic health conditions, 1,405 with back problems, and 3,018 with other health conditions. Total wealth (cash, shares, superannuation, investment property, and owner occupied home). Using a microsimulation model (Health&WealthMOD), logistic regression models were used to assess the odds of having any wealth. Linear regression models were used to assess the difference in the value of this wealth. Those with back problems and two comorbidities had 0.16 (95% confidence interval [CI]: 0.06-0.42) times the odds and those with back problems and three or more comorbidities had 0.20 (95% CI: 0.11-0.38) times the odds of having accumulated some wealth than those with no chronic health conditions. Those with back problems and three or more comorbidities had a median value of total wealth of around $150,000, whereas those with back problems only and back problems and one comorbidity had a median value of total wealth of around $250,500. There was no significant difference in the amount of wealth accumulated by those with back problems and at least one comorbidity and those with other health conditions and the same number of comorbidities. However, those with only one health condition (excluding back problems) had 65% more wealth than those with back problems only (95% CI: 5.1-161.2). This study highlights the importance of considering multiple morbidities when discussing the relationship between back problems and economic circumstances. Copyright © 2015 Elsevier Inc. All rights reserved.

Aging Baby Boomers and the Rising Cost of Chronic Back Pain: Secular Trend Analysis of Longitudinal Medical Expenditures Panel Survey Data for Years 2000 to 2007

PubMed Central

Smith, Monica; Davis, Matthew A.; Stano, Miron; Whedon, James M.

2013-01-01

Objectives The purposes of this study were to analyze data from the longitudinal Medical Expenditures Panel Survey (MEPS) to evaluate the impact of an aging population on secular trends in back pain and chronicity and to provide estimates of treatment costs for patients who used only ambulatory services. Methods Using the MEPS 2-year longitudinal data for years 2000 to 2007, we analyzed data from all adult respondents. Of the total number of MEPS respondent records analyzed (N = 71 838), we identified 12 104 respondents with back pain and further categorized 3842 as chronic cases and 8262 as nonchronic cases. Results Secular trends from the MEPS data indicate that the prevalence of back pain has increased by 29%, whereas chronic back pain increased by 64%. The average age among all adults with back pain increased from 45.9 to 48.2 years; the average age among adults with chronic back pain increased from 48.5 to 52.2 years. Inflation-adjusted (to 2010 dollars) biennial expenditures on ambulatory services for chronic back pain increased by 129% over the same period, from $15.6 billion in 2000 to 2001 to $35.7 billion in 2006 to 2007. Conclusion The prevalence of back pain, especially chronic back pain, is increasing. To the extent that the growth in chronic back pain is caused, in part, by an aging population, the growth will likely continue or accelerate. With relatively high cost per adult with chronic back pain, total expenditures associated with back pain will correspondingly accelerate under existing treatment patterns. This carries implications for prioritizing health policy, clinical practice, and research efforts to improve care outcomes, costs, and cost-effectiveness and for health workforce planning. PMID:23380209

Endogenous Opioid Inhibition of Chronic Low Back Pain Influences Degree of Back Pain Relief Following Morphine Administration

PubMed Central

Bruehl, Stephen; Burns, John W.; Gupta, Rajnish; Buvanendran, Asokumar; Chont, Melissa; Schuster, Erik; France, Christopher R.

2014-01-01

Background and Objectives Factors underlying differential responsiveness to opioid analgesic medications used in chronic pain management are poorly understood. We tested whether individual differences in endogenous opioid inhibition of chronic low back pain were associated with magnitude of acute reductions in back pain ratings following morphine administration. Methods In randomized, counterbalanced order over three sessions, 50 chronic low back pain patients received intravenous naloxone (8mg), morphine (0.08 mg/kg), or placebo. Back pain intensity was rated pre-drug and again after peak drug activity was achieved using the McGill Pain Questionnaire-Short Form (Sensory and Affective subscales, VAS intensity measure). Opioid blockade effect measures to index degree of endogenous opioid inhibition of back pain intensity were derived as the difference between pre-to post-drug changes in pain intensity across placebo and naloxone conditions, with similar morphine responsiveness measures derived across placebo and morphine conditions. Results Morphine significantly reduced back pain compared to placebo (MPQ-Sensory, VAS; P < .01). There were no overall effects of opioid blockade on back pain intensity. However, individual differences in opioid blockade effects were significantly associated with degree of acute morphine-related reductions in back pain on all measures, even after controlling for effects of age, sex, and chronic pain duration (P < .03). Individuals exhibiting greater endogenous opioid inhibition of chronic back pain intensity reported less acute relief of back pain with morphine. Conclusions Morphine appears to provide better acute relief of chronic back pain in individuals with lower natural opioidergic inhibition of chronic pain intensity. Possible implications for personalized medicine are discussed. PMID:24553304

NASA CF6 jet engine diagnostics program: Long-term CF6-6D low-pressure turbine deterioration

NASA Technical Reports Server (NTRS)

Smith, J. J.

1979-01-01

Back-to-back performance tests were run on seven airline low pressure turbine (LPT) modules and four new CF6-6D modules. Back-to-back test cell runs, in which an airline LPT module was directly compared to a new production module, were included. The resulting change, measured in fuel burn, equaled the level of LPT module deterioration. Three of the LPT modules were analytically inspected followed by a back-to-back test cell run to evaluate current refurbishment techniques.

Limbus Vertebra Presenting with Inflammatory Low Back Pain: A Case Report

PubMed Central

Özdemir, Tayfun; Öz, Hande Ece

2016-01-01

Limbus vertebra is a condition characterized by marginal interosseous herniation of the nucleus pulposus, and causes non specific symptoms like low back pain, back pain, muscle spasms and radiculopathy. It is frequently confused with vertebral fracture, infection, schmorl nodule or tumour because it has not a spesific symptom. It usually causes mechanical low back pain rather than inflammatory low back pain. We reported a patient presented with inflammatory low back pain and diagnosed with anterior limbus vertebra because it is rare and the patient has atypical clinical presentation. PMID:27134989

The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. A 15-year follow-up study of risk indicators for self-reported sick-listing caused by low back trouble.

PubMed

Müller, C F; Monrad, T; Biering-Sørensen, F; Darre, E; Deis, A; Kryger, P

1999-08-01

A 15-year follow-up study. To find risk indicators for self-reported sick-listing because of low back trouble and to evaluate which variables were the most important indicators of work incapacity resulting from low back trouble during the follow-up period of 15 years. The initial data were obtained from a health survey conducted in a general population from the Municipality of Glostrup, Denmark. The follow-up data included information from the Central Person Register, the Early Retirement Pension Register, and a postal questionnaire regarding self-reported sick-listing because of low back trouble. An epidemiologic study, in which logistic regression analyses were used for evaluation of the data. The model used consisted of the variable in question, age, gender, and previous experience of low back trouble, along with interactions. It was found that 22 of 37 variables were risk indicators for later self-reported sick-listing because of low back trouble during the preceding year or the 7 years before the date of follow-up evaluation. In analyzing the most significant variables simultaneously, it was found that information from the initial investigation about sick-listing in general during the previous 10 years, sciatic pain, use of analgesics for low back trouble, previous sick-listing because of low back trouble, and occupation were the most important risk indicators for self-reported work incapacity resulting from low back trouble during the follow-up period of 15 years. Findings showed that the strongest prognostic indicators of later sick-listing because of low back trouble involve information from the person about previous sick-listing behavior in general and previous experience of low back trouble episodes, especially if these had been accompanied by sciatic pain, use of analgesics, or previous low back trouble sick-listing.

What low back pain is and why we need to pay attention.

PubMed

Hartvigsen, Jan; Hancock, Mark J; Kongsted, Alice; Louw, Quinette; Ferreira, Manuela L; Genevay, Stéphane; Hoy, Damian; Karppinen, Jaro; Pransky, Glenn; Sieper, Joachim; Smeets, Rob J; Underwood, Martin

2018-03-20

Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem. Copyright © 2018 Elsevier Ltd. All rights reserved.

Associations between low back pain and depression and somatization in a Canadian emerging adult population

PubMed Central

Robertson, David; Kumbhare, Dinesh; Nolet, Paul; Srbely, John; Newton, Genevieve

2017-01-01

Introduction The association between depression, somatization and low back pain has been minimally investigated in a Canadian emerging adult population. Methods 1013 first year Canadian university students completed the Modified Zung Depression Index, the Modified Somatic Perception Questionnaire, and a survey about low back pain frequency and intensity. Multinomial logistic regression was used to measure associations between low back pain and depression and somatization, both independently and co-occurring. Results Over 50% of subjects reported low back pain across grades, and both depression and somatization were significantly positively associated with low back pain. Several positive associations between the cooccurrence of somatization and depression with various grades of low back pain were observed. Discussion These results suggest that low back pain, depression and somatization are relatively common at the onset of adulthood, and should be considered an important focus of public health. PMID:28928493

Effects of Inclined Treadmill Walking on Pelvic Anterior Tilt Angle, Hamstring Muscle Length, and Trunk Muscle Endurance of Seated Workers with Flat-back Syndrome.

PubMed

Kim, Min-Hee; Yoo, Won-Gyu

2014-06-01

[Purpose] This study investigated the effects of inclined treadmill walking on pelvic anterior tilt angle, hamstring muscle length, and back muscle endurance of seated workers with flat-back syndrome. [Subjects] Eight seated workers with flat-back syndrome who complained of low-back pain in the L3-5 region participated in this study. [Methods] The subjects performed a walking exercise on a 30° inclined treadmill. We measured the pelvic anterior tilt angle, hamstring muscle length, and back muscle endurance before and after inclined treadmill walking. [Results] Anterior pelvic tilt angle and active knee extension angle significantly increased after inclined treadmill walking. Trunk extensor and flexor muscle endurance times were also significantly increased compared to the baseline. [Conclusion] Inclined treadmill walking may be an effective approach for the prevention or treatment of low-back pain in flat-back syndrome.

Comparison of physical fitness between rice farmers with and without chronic low back pain: a cross-sectional study.

PubMed

Taechasubamorn, Panada; Nopkesorn, Tawesak; Pannarunothai, Supasit

2010-12-01

To compare physical fitness between rice farmers with chronic low back pain (CLBP) and a healthy control group. Sixty-eight rice farmers with CLBP were matched according to age and sex with healthy farmers. All subjects underwent nine physical fitness tests for body composition, lifting capacity, static back extensor endurance, leg strength, static abdominal endurance, handgrip strength, hamstring flexibility, posterior leg and back muscles flexibility and abdominal flexibility. There was no significant difference between CLBP and healthy groups for all tests, except the static back extensor endurance. The back extensor endurance times of the CLBP group was significantly lower than that of the control group (p = 0.002). Static back extensor endurance is the deficient physical fitness in CLBP rice farmers. Back extensor endurance training should be emphasized in both prevention and rehabilitation programs.

Thermal imaging of high power diode lasers subject to back-irradiance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, C.; Pipe, K. P.; Cao, C.

In this study, CCD-based thermoreflectance imaging and finite element modeling are used to study the two-dimensional (2D) temperature profile of a junction-down broad-area diode laser facet subject to back-irradiance. By determining the temperature rise in the active region (ΔΤAR) at different diode laser optical powers, back-irradiance reflectance levels, and back-irradiance spot locations, we find that ΔΤAR increases by nearly a factor of three when the back-irradiance spot is centered in the absorbing substrate approximately 5 μm away from the active region, a distance roughly equal to half of the back-irradiance spot FWHM (9 μm). This corroborates prior work studying themore » relationship between the back-irradiance spot location and catastrophic optical damage, suggesting a strong thermal basis for reduced laser lifetime in the presence of back-irradiance for diode lasers fabricated on absorbing substrates.« less

Effect of Individual Strengthening Exercises for Anterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROMs of a LBP Patient with Flat Back.

PubMed

Yoo, Won-Gyu

2013-10-01

[Purpose] The purpose of this paper is to report the effect of individual strengthening exercises for the anterior pelvic tilt muscles on back pain, pelvic tilt angle, and lumbar ROM of a low back pain (LBP) patient with flat back. [Subject] A 37 year-old male, who complained of LBP pain at L3-5 levels with flat back, participated. [Methods] He performed the individual strengthening exercises for anterior pelvic tilt muscles (erector spinae,iliopsoas, rectus femoris). [Results] Pelvic tilt angles of the right and left sides were recovered to normal ranges. His lumbar ROMs increased, and low back pain decreased. [Conclusion] We suggest that individual resistance exercises are a necessary approach for effective and fast strengthening of pelvic anterior tilt muscles in LBP with flat back.

Thermal imaging of high power diode lasers subject to back-irradiance

DOE PAGES

Li, C.; Pipe, K. P.; Cao, C.; ...

2018-03-07

In this study, CCD-based thermoreflectance imaging and finite element modeling are used to study the two-dimensional (2D) temperature profile of a junction-down broad-area diode laser facet subject to back-irradiance. By determining the temperature rise in the active region (ΔΤAR) at different diode laser optical powers, back-irradiance reflectance levels, and back-irradiance spot locations, we find that ΔΤAR increases by nearly a factor of three when the back-irradiance spot is centered in the absorbing substrate approximately 5 μm away from the active region, a distance roughly equal to half of the back-irradiance spot FWHM (9 μm). This corroborates prior work studying themore » relationship between the back-irradiance spot location and catastrophic optical damage, suggesting a strong thermal basis for reduced laser lifetime in the presence of back-irradiance for diode lasers fabricated on absorbing substrates.« less

Thermal imaging of high power diode lasers subject to back-irradiance

NASA Astrophysics Data System (ADS)

Li, C.; Pipe, K. P.; Cao, C.; Thiagarajan, P.; Deri, R. J.; Leisher, P. O.

2018-03-01

CCD-based thermoreflectance imaging and finite element modeling are used to study the two-dimensional (2D) temperature profile of a junction-down broad-area diode laser facet subject to back-irradiance. By determining the temperature rise in the active region (ΔΤAR) at different diode laser optical powers, back-irradiance reflectance levels, and back-irradiance spot locations, we find that ΔΤAR increases by nearly a factor of three when the back-irradiance spot is centered in the absorbing substrate approximately 5 μm away from the active region, a distance roughly equal to half of the back-irradiance spot FWHM (9 μm). This corroborates prior work studying the relationship between the back-irradiance spot location and catastrophic optical damage, suggesting a strong thermal basis for reduced laser lifetime in the presence of back-irradiance for diode lasers fabricated on absorbing substrates.

Back posture education in elementary schoolchildren: a 2-year follow-up study.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2007-06-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 +/- 0.8 years) and 101 controls (mean age 13.2 +/- 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential.

Back posture education in elementary schoolchildren: a 2-year follow-up study

PubMed Central

Geldhof, Elisabeth; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-01-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13–14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters’ lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 ± 0.8 years) and 101 controls (mean age 13.2 ± 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential. PMID:17013655

Illness perceptions in the context of differing work participation outcomes: exploring the influence of significant others in persistent back pain

PubMed Central

2013-01-01

Background Previous research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes. The aim of this study was to extend previous research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others. The purpose of this research was to explore whether the illness beliefs of significant others differed depending on their relative’s working status, and to make some preliminary identification of how significant others may facilitate or hinder work participation for those with persistent back pain. Methods Interviews structured around the Illness Perception Questionnaire (chronic pain version) were conducted with back pain patients recruited from a hospital pain management clinic along with their significant others. Some patients had remained in work despite their back pain; others had ceased employment. Data were analysed using template analysis. Results There were clear differences between beliefs about, and reported responses to, back pain symptoms amongst the significant others of individuals who had remained in employment compared with the significant others of those who had ceased work. Three overarching themes emerged: perceived consequences of back pain, specific nature of employment and the impact of back pain on patient identity. Conclusions Significant others of employed individuals with back pain focused on the extent to which activity could still be undertaken despite back pain symptoms. Individuals out of work due to persistent back pain apparently self-limited their activity and were supported in their beliefs and behaviours by their significant others. To justify incapacity due to back pain, this group had seemingly become entrenched in a position whereby it was crucial that the individual with back pain was perceived as completely disabled. We suggest that significant others are clearly important, and potentially detrimental, sources of support to individuals with back pain. The inclusion of significant others in vocational rehabilitation programmes could potentially be a valuable way of mobilising readily accessible resources in a way that supports optimal functioning. PMID:23363454

Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain.

PubMed

Ghorbanpour, Arsalan; Azghani, Mahmoud Reza; Taghipour, Mohammad; Salahzadeh, Zahra; Ghaderi, Fariba; Oskouei, Ali E

2018-04-01

[Purpose] The aim of this study was to compare the effects of "McGill stabilization exercises" and "conventional physiotherapy" on pain, functional disability and active back flexion and extension range of motion in patients with chronic non-specific low back pain. [Subjects and Methods] Thirty four patients with chronic non-specific low back pain were randomly assigned to McGill stabilization exercises group (n=17) and conventional physiotherapy group (n=17). In both groups, patients performed the corresponding exercises for six weeks. The visual analog scale (VAS), Quebec Low Back Pain Disability Scale Questionnaire and inclinometer were used to measure pain, functional disability, and active back flexion and extension range of motion, respectively. [Results] Statistically significant improvements were observed in pain, functional disability, and active back extension range of motion in McGill stabilization exercises group. However, active back flexion range of motion was the only clinical symptom that statistically increased in patients who performed conventional physiotherapy. There was no significant difference between the clinical characteristics while compared these two groups of patients. [Conclusion] The results of this study indicated that McGill stabilization exercises and conventional physiotherapy provided approximately similar improvement in pain, functional disability, and active back range of motion in patients with chronic non-specific low back pain. However, it appears that McGill stabilization exercises provide an additional benefit to patients with chronic non-specific low back, especially in pain and functional disability improvement.

Do functional tests predict low back pain?

PubMed

Takala, E P; Viikari-Juntura, E

2000-08-15

A cohort of 307 nonsymptomatic workers and another cohort of 123 workers with previous episodes of low back pain were followed up for 2 years. The outcomes were measured by symptoms, medical consultations, and sick leaves due to low back disorders. To study the predictive value of a set of tests measuring the physical performance of the back in a working population. The hypothesis was that subjects with poor functional capacity are liable to back disorders. Reduced functional performance has been associated with back pain. There are few data to show whether reduced functional capacity is a cause or a consequence of pain. Mobility of the trunk in forward and side bending, maximal isokinetic trunk extension, flexion and lifting strength, and static endurance of back extension were measured. Standing balance and foot reaction time were recorded with a force plate. Clinical tests for the provocation of back or leg pain were performed. Gender, workload, age, and anthropometrics were managed as potential confounders in the analysis. Marked overlapping was seen in the measures of the subjects with different outcomes. Among the nonsymptomatic subjects, low performance in tests of mobility and standing balance was associated with future back disorders. Among workers with previous episodes of back pain, low isokinetic extension strength, poor standing balance, and positive clinical signs predicted future pain. Some associations were found between the functional tests and future low back pain. The wide variation in the results questions the value of the tests in health examinations (e.g., in screening or surveillance of low back disorders).

The influence of fat infiltration of back extensor muscles on osteoporotic vertebral fractures.

PubMed

So, Kwang-Young; Kim, Dae-Hee; Choi, Dong-Hyuk; Kim, Choong-Young; Kim, Jeong-Seok; Choi, Yong-Soo

2013-12-01

Retrospective study. To investigate the influence of fat infiltration at low back extensor muscles on osteoporotic vertebral fracture. In persons with stronger back muscles, the risk of osteoporotic vertebral fractures will likely be lower than in those persons with weaker back muscles. However, the degree of influence of fat infiltration of the back extensor muscle on osteoporotic vertebral fracture remains controversial. Two hundred and thirty-seven patients who had undergone lumbar spine magnetic resonance imaging and bone mineral density (BMD) were enrolled in this study. The amount of low back extensor muscle was determined using the pseudocoloring technique on an axial view of the L3 level. The patients were divided into two groups: osteoporotic vertebral fracture group (group A) and non-fracture group (group B). The amount of low back extensor muscle is compared with BMD, degenerative change of disc, osteophyte grade of facet joint and promontory angle to reveal the association between these factors. A negative correlation is found between age and the amount of low back extensor muscle (p=0.001). The amount of low back extensor muscle in group A and group B was 60.3%±14.5% and 64.2%±9.3% respectively, thus showing a significantly smaller amount of low back extensor muscle in the osteoporotic vertebral fracture group (p=0.015). Fat infiltration of low back extensor muscle was increased in osteoporotic vertebral fracture patients. Therefore, fat infiltration of low back extensor muscle in an elderly person may be a risk factor of osteoporotic vertebral fracture.

Investigation of the performance of backing cameras on NHDOT maintenance vehicles.

DOT National Transportation Integrated Search

2011-02-01

This report details the trial use of backing cameras at the New Hampshire Department of Transportation (NHDOT). Several NHDOT : plow routes require the plow vehicles to perform multiple backing maneuvers. Other day-to-day operations entail backing in...

When Your Back Hurts: Don't Let Back Pain Knock You Flat

MedlinePlus

... Your Back Hurts Don’t Let Back Pain Knock You Flat En español Send us your comments ... Complementary Health Approaches Halt the Hurt! References The SPORT Value Compass: Do the Extra Costs of Undergoing ...

Imaging Tests for Lower Back Pain: When You Need Them -- and When You Don't

MedlinePlus

... Geriatric Imaging Tests for Lower-Back Back Pain Imaging Tests for Lower-Back Pain You probably do ... X-rays, CT scans, and MRIs are called imaging tests because they take pictures, or images, of ...

Method for growing a back surface contact on an imaging detector used in conjunction with back illumination

NASA Technical Reports Server (NTRS)

Blacksberg, Jordana (Inventor); Hoenk, Michael Eugene (Inventor); Nikzad, Shouleh (Inventor)

2010-01-01

A method is provided for growing a back surface contact on an imaging detector used in conjunction with back illumination. In operation, an imaging detector is provided. Additionally, a back surface contact (e.g. a delta-doped layer, etc.) is grown on the imaging detector utilizing a process that is performed at a temperature less than 450 degrees Celsius.

Photovoltaic cell and production thereof

DOEpatents

Narayanan, Srinivasamohan [Gaithersburg, MD; Kumar, Bikash [Bangalore, IN

2008-07-22

An efficient photovoltaic cell, and its process of manufacture, is disclosed wherein the back surface p-n junction is removed from a doped substrate having an oppositely doped emitter layer. A front surface and edges and optionally the back surface periphery are masked and a back surface etch is performed. The mask is not removed and acts as an anti-reflective coating, a passivating agent, or both. The photovoltaic cell retains an untextured back surface whether or not the front is textured and the dopant layer on the back surface is removed to enhance the cell efficiency. Optionally, a back surface field is formed.

Physical activity associate low back pain and intervention program: Review

NASA Astrophysics Data System (ADS)

Ibrahim, Muhamad Aizat Mat; Hasbollah, Hasif Rafidee; Ibrahim, Mohd Asrul Hery; Marican, Nor Dalila; Halim, Muhd Hafzal Abdul; Rashid, Ahmad Faezi Ab.; Yasin, Nurul Hafizah Mohd

2017-10-01

The person who have low back pain often report impaired disability to performance daily activities which passive movement of daily life. The effects of low back pain on daily function of patients can describe as a patients level of disability or reduction in physical function it interferes with the movement of patients for running a daily lives. Therefore, the aim of this study was to conduct a review to examine the relationship between physical activity and low back pain. Besides that, the suggestion prevention program to patient who has low back pain. This systematic review study was used internet to find databases and search engines. Data were collected using Wiley online library, Bioline International, SAGE, Science Direct, NCBI, ProQuest, Biomed central, American Diabetes Association, PLOS One and Springer. The search was performed using keywords of "physical activity", "low back pain", "back pain", "activity level" and "intervention". The study was reviewed the resources and the results were classified in different section The results were classified based on several sections including years of reporting, who were reporting, the origins of articles and their health criteria about physical activity and low back pain. There are positive associate physical activity and low back pain from the systematic review. Future intervention treatment can reduce associate physical activity to low back pain.

Lumbar lordosis angle and trunk and lower-limb electromyographic activity comparison in hip neutral position and external rotation during back squats.

PubMed

Oshikawa, Tomoki; Morimoto, Yasuhiro; Kaneoka, Koji

2018-03-01

[Purpose] To compare the lumbar lordosis angle and electromyographic activities of the trunk and lower-limb muscles in the hip neutral position and external rotation during back squats. [Subjects and Methods] Ten healthy males without severe low back pain or lower-limb injury participated in this study. The lumbar lordosis angle and electromyographic activities were measured using three-dimensional motion-capture systems and surface electrodes during four back squats: parallel back squats in the hip neutral position and external rotation and full back squats in the hip neutral position and external rotation. A paired t-test was used to compare parallel and full back squats measurements in the hip neutral position and external rotation, respectively. [Results] During parallel back squats, the average lumbar lordosis angle was significantly larger in hip external rotation than in the hip neutral position. During full back squats, lumbar erector spinae and multifidus activities were significantly lower in hip external rotation than in the hip neutral position, whereas gluteus maximus activity was significantly higher in hip external rotation than in the hip neutral position. [Conclusion] The back squat in hip external rotation induced improvement of lumbar kyphosis, an increasing of the gluteus maximus activity and a decrease of both lumbar erector spinae and multifidus activities.

Is active participation in specific sport activities linked with back pain?

PubMed

Mogensen, A M; Gausel, A M; Wedderkopp, N; Kjaer, P; Leboeuf-Yde, C

2007-12-01

A cross-sectional survey of 439 children/adolescents aged 12-13, living in Odense, Denmark, in the year 2001. To investigate (1) if there is any difference in back pain reporting among those practising specific sports as compared with non-performers and (2) if there is an association between specific kinds of sports and self-reported back problems. Back pain is a common complaint in young people and physical inactivity is generally thought to contribute to this. However, some specific sport activities may be detrimental or beneficial to the spine. Information was collected through a semi-structured interview, a physical examination, and a questionnaire. Associations for back pain, low back pain, mid back pain and neck pain in the preceding month were investigated in relation to specific sports. Associations were controlled for body mass index, puberty stage and sex. There was no association between back problems and the practising of sports in general. However, some sports were either positively or negatively associated with back pain. Taking into account the relatively small subgroups and multiple testing, some sports seem to be potentially harmful or beneficial. These sports should be investigated in proper longitudinal study designs, in relation to their effects on back problems in the young.

The Impact of Obesity on Back and Core Muscular Endurance in Firefighters

PubMed Central

Mayer, John M.; Nuzzo, James L.; Chen, Ren; Quillen, William S.; Verna, Joe L.; Miro, Rebecca; Dagenais, Simon

2012-01-01

The purpose of this study was to assess the relationships between obesity and measures of back and core muscular endurance in firefighters. Methods. A cross-sectional study was conducted in career firefighters without low back pain. Obesity measures included body mass index (BMI) and body fat percentage assessed with air displacement plethysmography. Muscular endurance was assessed with the Modified Biering Sorensen (back) and Plank (core) tests. Relationships were explored using t-tests and regression analyses. Results. Of the 83 participants enrolled, 24 (29%) were obese (BMI ≥ 30). Back and core muscular endurance was 27% lower for obese participants. Significant negative correlations were observed for BMI and body fat percentage with back and core endurance (r = −0.42 to −0.52). Stepwise regression models including one obesity measure (BMI, body fat percentage, and fat mass/fat-free mass), along with age and self-reported physical exercise, accounted for 17–19% of the variance in back muscular endurance and 29–37% of the variance in core muscular endurance. Conclusions. Obesity is associated with reduced back and core muscular endurance in firefighters, which may increase the risk of musculoskeletal injuries. Obesity should be considered along with back and core muscular endurance when designing exercise programs for back pain prevention in firefighters. PMID:23213491

Comparison of clinical examinations of back disorders and humans' evaluation of back pain in riding school horses.

PubMed

Lesimple, Clémence; Fureix, Carole; Biquand, Véronique; Hausberger, Martine

2013-10-15

Questionnaires are a common tool to assess people's opinion on a large scale or to sound them out about their subjective views. The caretakers' opinion about animals' "personality" has been used in many studies. The aim of the present study was to assess whether the owners' subjective evaluation was effective to detect back disorders. Back disorders have been shown to have a high prevalence in working horses. Caretakers from 17 riding schools (1 caretaker/school, 161 horses) were given a questionnaire about their horses' health status, including back disorders. Out of these 161 horses, 59 were subjected to manual palpation of the spine and 102 were subjected to sEMG examination all along the spine. The results showed that subjective caretaker-reported evaluation via questionnaire survey was not efficient to detect back disorders: only 19 horses (11.8%) were reported as suffering from back pain, whereas the experimenters' evaluation detected 80 of them (49.7%) as suffering from back disorders. While most caretakers under-evaluated back disorders, a few "over-evaluated" it (more horses reported as affected than found via clinical evaluations). Horses were less prone to present back disorders when under the care of these "over-attentive" caretakers. This study showed that back pain is difficult to evaluate, even for professionals, and that subjective evaluations using a questionnaire is not valid in this case. The results also highlighted the real need for observational training (behaviours, postures) outside and during riding.

MRI and low back pain

MedlinePlus

... back pain: Cannot pass urine or stools Cannot control your urine or stools Difficulty with walking and balance Back pain that is severe in children Fever History of cancer Other signs or symptoms of cancer Recent serious fall or injury Back pain that is very severe, ...

Quantification of the tug-back by measuring the pulling force and micro computed tomographic evaluation.

PubMed

Jeon, Su-Jin; Moon, Young-Mi; Seo, Min-Seock

2017-11-01

The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (µCT). Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF ( n = 14). The degree of tug-back was scored after selecting taper-matched GP cones. A novel method using a spring balance was designed to quantify the tug-back by measuring the pulling force. The correlation between tug-back scores, pulling force, and percentage of the gutta-percha occupied area (pGPOA) within apical 3 mm was investigated using µCT. The data were analyzed using Pearson's correlation analysis, one-way analysis of variance (ANOVA) and Tukey's test. Specimens with a strong tug-back had a mean pulling force of 1.24 N (range, 0.15-1.70 N). This study showed a positive correlation between tug-back score, pulling force, and pGPOA. However, there was no significant difference in these factors between the PTN and PF groups. Regardless of the groups, pGPOA and pulling force were significantly higher in the specimens with a higher tug-back score ( p < 0.05). The degree of subjective tug-back was a definitive determinant for master cone adaptation in the root canal. The use of the tug-back scoring system and pulling force allows the interpretation of subjective tug-back in a more objective and quantitative manner.

Back posture education in elementary schoolchildren: stability of two-year intervention effects.

PubMed

Geldhof, E; Cardon, G; De Bourdeaudhuij, I; De Clercq, D

2007-09-01

The study's first objective was to evaluate class teachers' efforts to promote good body mechanics after a structured back education program was finished and to evaluate whether their support during follow-up resulted in better intervention effects at 1-year follow-up. Secondary, the stability of intervention effects on children's back posture knowledge, fear-avoidance beliefs and back pain reports following a 2-school-year multi-factorial back education program was evaluated at 1-year follow-up. An additional focus was put on what young children learned about good body mechanics in the obligatory school curriculum compared to intensive back posture promotion. The quasi-experimental study included at baseline 398 elementary schoolchildren aged 8-11 years. The back education program consisted of 13 h back education and the stimulation of postural dynamism in the class through support and environmental changes lasting 2 school-years. Controls received the obligatory curriculum, not including back education. Evaluation consisted of a questionnaire, which was filled out by 121 intervention children and 124 controls at baseline, post-test and follow-up. Teachers were interviewed at the end of the follow-up school-year. Teachers continued with initiatives to increase postural dynamism in the class when they had been instructed about that matter. However, teachers' efforts to continue the promotion of good body mechanics showed no additional effect on children's knowledge. Improved back posture knowledge demonstrated stability at 1-year follow-up. Whereas the obligatory curriculum provided children with fundamental postural knowledge, the back posture program added important aspects. Fear-avoidance beliefs and self-reported pain were not increased at 1-year follow-up. The stable intervention effects point out that intensive implementation of a structured multifactorial back education program in the elementary school curriculum is effective.

A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women

PubMed Central

Litwack-Harrison, Stephanie; Cawthon, Peggy M.; Kado, Deborah M.; Deyo, Richard A.; Makris, Una E.; Carlson, Hans L.; Nevitt, Michael C.

2016-01-01

Background. Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established. Methods. We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale. Results. Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls. Conclusions. Older community-dwelling women with a recent history of back pain are at increased risk for falls. PMID:26757988

Back pain in children surveyed with weekly text messages - a 2.5 year prospective school cohort study.

PubMed

Franz, Claudia; Wedderkopp, Niels; Jespersen, Eva; Rexen, Christina T; Leboeuf-Yde, Charlotte

2014-01-01

Back pain is reported to occur already in childhood, but its development at that age is not well understood. The aims of this study were to describe BP in children aged 6-12 years, and to investigate any sex and age differences. Data on back pain (defined as pain in the neck, mid back and/or lower back) were collected once a week from parents replying to automated text-messages over 2.5 school years from 2008 till 2011. The prevalence estimates were presented as percentages and 95% confidence intervals. Differences between estimates were considered significant if confidence intervals did not overlap. A test for trend, using a multi-level mixed-effects logistic regression extended to the longitudinal and multilevel setting, was performed to see whether back pain reporting increased with age. Depending on the age group, 13-38% children reported back pain at least once per survey year, and 5-23% at least twice per survey year. The average weekly prevalence estimate ranged between 1% and 5%. In the final survey year more girls than boys reported back pain at least twice. The prevalence estimates did not increase monotonically with age but showed a greater increase in children younger than 9/10, after which they remained relatively stable up to the age of 12 years. We found that back pain was not a common problem in this age group and recommend health professionals be vigilant if a child presents with constant or recurring back pain. Our results need to be supplemented by a better understanding of the severity and consequences of back pain in childhood. It would be productive to study the circumstances surrounding the appearance of back pain in childhood, as well as, how various bio-psycho-social factors affect its onset and later recurrence. Knowledge about the causes of back pain in childhood might allow early prevention.

Risk Factors and Disability Associated with Low Back Pain in Older Adults in Low- and Middle-Income Countries. Results from the WHO Study on Global AGEing and Adult Health (SAGE)

PubMed Central

Stewart Williams, Jennifer; Ng, Nawi; Peltzer, Karl; Yawson, Alfred; Biritwum, Richard; Maximova, Tamara; Wu, Fan; Arokiasamy, Perianayagam; Kowal, Paul; Chatterji, Somnath

2015-01-01

Background Back pain is a common disabling chronic condition that burdens individuals, families and societies. Epidemiological evidence, mainly from high-income countries, shows positive association between back pain prevalence and older age. There is an urgent need for accurate epidemiological data on back pain in adult populations in low- and middle-income countries (LMICs) where populations are ageing rapidly. The objectives of this study are to: measure the prevalence of back pain; identify risk factors and determinants associated with back pain, and describe association between back pain and disability in adults aged 50 years and older, in six LMICs from different regions of the world. The findings provide insights into country-level differences in self-reported back pain and disability in a group of socially, culturally, economically and geographically diverse LMICs. Methods Standardized national survey data collected from adults (50 years and older) participating in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analysed. The weighted sample (n = 30, 146) comprised respondents in China, Ghana, India, Mexico, South Africa and the Russian Federation. Multivariable regressions describe factors associated with back pain prevalence and intensity, and back pain as a determinant of disability. Results Prevalence was highest in the Russian Federation (56%) and lowest in China (22%). In the pooled multi-country analyses, female sex, lower education, lower wealth and multiple chronic morbidities were significant in association with past-month back pain (p<0.01). About 8% of respondents reported that they experienced intense back pain in the previous month. Conclusions Evidence on back pain and its impact on disability is needed in developing countries so that governments can invest in cost-effective education and rehabilitation to reduce the growing social and economic burden imposed by this disabling condition. PMID:26042785

The STarT back tool in chiropractic practice: a narrative review.

PubMed

Khan, Yasmeen

2017-01-01

The Keele STarT Back Tool was designed for primary care medical physicians in the UK to determine the risk for persistent disabling pain in patients with musculoskeletal pain and to tailor treatments accordingly. In medical and physical therapy settings, STarT Back Tool's tailored care plans improved patients' low back pain outcomes and lowered costs. Review studies using the STarT Back Tool in chiropractic patient populations. PubMed, The Cochrane Library, Index to Chiropractic Literature, and Science Direct databases were searched. Articles written in English, published in peer-reviewed journals, that studied the STarT Back Tool in patients seeking chiropractic care were included. Seven articles were selected based on inclusion and exclusion criteria. The STarT Back Tool was feasibly incorporated into 19 chiropractic clinics in Denmark. Total STarT Back 5-item score correlated moderately with total Bournemouth Questionnaire score. Two studies reported that the STarT Back Tool's predictive ability was poor, while another reported that the tool predicted outcomes in patients scoring in the medium and high risk categories who completed the STarT Back 2 days after their initial visit. A study examining Danish chiropractic, medical and physical therapy settings revealed that only baseline episode duration affected STarT Back's prognostic ability across all care settings. The tool predicted pain and disability in chiropractic patients whose episode duration was at least 2 weeks, but not in patients with an episode duration <2 weeks. While the STarT Back Tool can be incorporated into chiropractic settings and correlates with some elements of the Bournemouth Questionnaire, its prognostic ability is sometimes limited by the shorter low back pain episodes with which chiropractic patients often present. It may be a better predictor in patients whose episode duration is at least 2 weeks. Studies examining outcomes of stratified care in chiropractic patients are needed.

Prevalence of low back pain in emergency settings: a systematic review and meta-analysis.

PubMed

Edwards, Jordan; Hayden, Jill; Asbridge, Mark; Gregoire, Bruce; Magee, Kirk

2017-04-04

Low back pain may be having a significant impact on emergency departments around the world. Research suggests low back pain is one of the leading causes of emergency department visits. However, in the peer-reviewed literature, there has been limited focus on the prevalence and management of back pain in the emergency department setting. The aim of the systematic review was to synthesize evidence about the prevalence of low back pain in emergency settings and explore the impact of study characteristics including type of emergency setting and how the study defined low back pain. Studies were identified from PubMed and EMBASE, grey literature search, and other sources. We selected studies that presented prevalence data for adults presenting to an emergency setting with low back pain. Critical appraisal was conducted using a modified tool developed to assess prevalence studies. Meta-analyses and a meta-regression explored the influence of study-level characteristics on prevalence. We screened 1187 citations and included 21 studies, reported between 2000 and 2016 presenting prevalence data from 12 countries. The pooled prevalence estimate from studies of standard emergency settings was 4.39% (95% CI: 3.67-5.18). Prevalence estimates of the included studies ranged from 0.9% to 17.1% and varied with study definition of low back pain and the type of emergency setting. The overall quality of the evidence was judged to be moderate as there was limited generalizability and high heterogeneity in the results. This is the first systematic review to examine the prevalence of low back pain in emergency settings. Our results indicate that low back pain is consistently a top presenting complaint and that the prevalence of low back pain varies with definition of low back pain and emergency setting. Clinicians and policy decisions makers should be aware of the potential impact of low back pain in their emergency settings.

Effect of Upper-Extremity Strengthening Exercises on the Lumbar Strength, Disability and Pain of Patients with Chronic Low Back Pain: A Randomized Controlled Study.

PubMed

Atalay, Erdem; Akova, Bedrettin; Gür, Hakan; Sekir, Ufuk

2017-12-01

The present study aimed to analyze the impacts of a low back rehabilitation program accompanied with neck, shoulder and upper back exercises on pain, disability, and physical characteristics of patients with chronic low back pain. Twenty sedentary male patients with chronic low back pain participated in the study on a voluntary basis. The patients were randomly allocated into two groups: a conventional low back exercise group (CE) and a supported exercise group (SE; CE plus upper back, neck, and shoulder exercises). The Modified Oswestry Disability Questionnaire (MODQ) was used to evaluate the disability status and the Visual Analog Scale (VAS) was used to identify the pain states of the patients. In addition, neck, lumbar and shoulder isokinetic and isometric strengths of the patients were evaluated. The CE group performed lumbar stretching, mobilization and stabilization exercises in addition to low-back and abdominal isometric and concentric strengthening exercises. The SE group performed static stretching and isotonic exercises for the neck, upper-back, and shoulder muscles, in addition to the exercises performed in CE group. The exercises were implemented 3 days a week for 6 weeks in both groups. Following the 6-week exercise periods in both groups, statistically significant (p < 0.01) improvements were observed in the patients' levels of pain and the scores of MODQ reflecting an easing of disability. With respect to the levels of pain and disability, the improvements observed in the SE group was significantly (p < 0.01) greater than the improvement observed in the CE group. Based on the findings of this study, we can conclude that a low back exercise program used in combination with neck, shoulder and upper back exercises reduces the level of pain and disability in patients with chronic low back pain more prominently than conventional low back exercises.

Study on the Ag Nanowire/PDMS Pressure Sensors with Three-Layer and Back-to-Back Structures

NASA Astrophysics Data System (ADS)

Wu, Jianhao; Lan, Qiuming; Yang, Weijia; He, Xin; Yue, Yunting; Jiang, Jiayi; Jiang, Tinghui

2018-01-01

Ag nanowire (NW)/polydimethylsiloxane (PDMS) pressure sensors with the three-layer and back-to-back structures were fabricated by a coating-peeling method. The bending and pressing responses of the sensors were comparably investigated. The results reveal that two kinds of pressure sensors show similar response linearity in the bending test with a bending angle of 0-180°. However, the response sensitivity of the three-layer structured pressure sensor is superior to that of the back-to-back structural one, which exhibits that the relationship between the capacitance value (Y) and the bending angle (X) is: Y = 0.01244X + 2.9763. On the contrary, in the pressing test, the response sensitivity of the back-to-back structural sensor is better than that of the three-layer structural one. The relationship between capacitance value (Y) and the number of paper clips (pressure, X2) is Y = 0.09241X2 + 88.03597.

Effectiveness of back-to-back testing

NASA Technical Reports Server (NTRS)

Vouk, Mladen A.; Mcallister, David F.; Eckhardt, David E.; Caglayan, Alper; Kelly, John P. J.

1987-01-01

Three models of back-to-back testing processes are described. Two models treat the case where there is no intercomponent failure dependence. The third model describes the more realistic case where there is correlation among the failure probabilities of the functionally equivalent components. The theory indicates that back-to-back testing can, under the right conditions, provide a considerable gain in software reliability. The models are used to analyze the data obtained in a fault-tolerant software experiment. It is shown that the expected gain is indeed achieved, and exceeded, provided the intercomponent failure dependence is sufficiently small. However, even with the relatively high correlation the use of several functionally equivalent components coupled with back-to-back testing may provide a considerable reliability gain. Implications of this finding are that the multiversion software development is a feasible and cost effective approach to providing highly reliable software components intended for fault-tolerant software systems, on condition that special attention is directed at early detection and elimination of correlated faults.

Acute care to prevent back disability. Ten years of progress.

PubMed

Bigos, S J; Battié, M C

1987-08-01

Efforts to curb back problems through preemployment screening, safety measures, and educational programs have had little effect on this most expensive musculoskeletal malady. Present knowledge raises doubts about the possibility of preventing back pain. However, recent scientific investigations indicate that chronic back pain disability, which accounts for 80% of the costs for back problems, can be prevented. In Gothenburg, Sweden, the collective use of proven treatment methods during the acute stage of back symptoms markedly reduced the period of time patients were disabled from back problems. Effective early intervention centers around: teaching patients about back care, including how to control symptoms through improved body mechanics; applying these educational principles, specifically to the patient's livelihood; avoiding the debilitation that results from overusing bed rest and medication; recommendations to increase cardiovascular fitness; and the judicious use of orthopedic surgery. This approach targets the few patients who tend to be disabled the longest, suffer the most, and become the most costly to society.

Processing distinct linguistic information types in working memory in aphasia.

PubMed

Wright, Heather Harris; Downey, Ryan A; Gravier, Michelle; Love, Tracy; Shapiro, Lewis P

2007-06-01

BACKGROUND: Recent investigations have suggested that adults with aphasia present with a working memory deficit that may contribute to their language-processing difficulties. Working memory capacity has been conceptualised as a single "resource" pool for attentional, linguistic, and other executive processing-alternatively, it has been suggested that there may be separate working memory abilities for different types of linguistic information. A challenge in this line of research is developing an appropriate measure of working memory ability in adults with aphasia. One candidate measure of working memory ability that may be appropriate for this population is the n-back task. By manipulating stimulus type, the n-back task may be appropriate for tapping linguistic-specific working memory abilities. AIMS: The purposes of this study were (a) to measure working memory ability in adults with aphasia for processing specific types of linguistic information, and (b) to examine whether a relationship exists between participants' performance on working memory and auditory comprehension measures. METHOD #ENTITYSTARTX00026; PROCEDURES: Nine adults with aphasia participated in the study. Participants completed three n-back tasks, each tapping different types of linguistic information. They included the PhonoBack (phonological level), SemBack (semantic level), and SynBack (syntactic level). For all tasks, two n-back levels were administered: a 1-back and 2-back. Each level contained 20 target items; accuracy was recorded by stimulus presentation software. The Subject-relative, Object-relative, Active, Passive Test of Syntactic Complexity (SOAP) was the syntactic sentence comprehension task administered to all participants. OUTCOMES #ENTITYSTARTX00026; RESULTS: Participants' performance declined as n-back task difficulty increased. Overall, participants performed better on the SemBack than PhonoBack and SynBack tasks, but the differences were not statistically significant. Finally, participants who performed poorly on the SynBack also had more difficulty comprehending syntactically complex sentence structures (i.e., passive & object-relative sentences). CONCLUSIONS: Results indicate that working memory ability for different types of linguistic information can be measured in adults with aphasia. Further, our results add to the growing literature that favours separate working memory abilities for different types of linguistic information view.

Risk factors associated with back pain in New Zealand school children.

PubMed

Trevelyan, Fiona C; Legg, Stephen J

2011-03-01

This study investigated risk factors associated with back pain in 245 New Zealand intermediate school children aged 11-14 years in a cross-sectional survey, using a self-completion questionnaire for demographic details, pain prevalence, psychosocial parameters, school and leisure activities and family characteristics. The strongest relationships were between back pain and common childhood complaints (stomach ache, headache and sore throats) (p < 0.01) and psychosocial factors (conduct and hyperactivity) (p < 0.01). For physical factors, there was a significant relationship between neck and low back pain and attributes of chairs. Low back pain was significantly related to low desk height (as reported by students) (p < 0.05). School bag weight was not significantly related to low back pain but carrying the bag on one shoulder was (p < 0.05). It is concluded that, amongst these intermediate school children, psychological, social and emotional factors had a stronger relationship with back pain than physical factors. STATEMENT OF RELEVANCE: This study investigated risk factors associated with back pain amongst New Zealand intermediate school children. It showed that psychological, social and emotional factors may have a stronger relationship with back pain than physical factors.

Wildlife use of back channels associated with islands on the Ohio River

USGS Publications Warehouse

Zadnik, A.K.; Anderson, James T.; Wood, P.B.; Bledsoe, K.

2009-01-01

The back channels of islands on the Ohio River are assumed to provide habitat critical for several wildlife species. However, quantitative information on the wildlife value of back channels is needed by natural resource managers for the conservation of these forested islands and embayments in the face of increasing shoreline development and recreational boating. We compared the relative abundance of waterbirds, turtles, anurans, and riparian furbearing mammals during 2001 and 2002 in back and main channels of the Ohio River in West Virginia. Wood ducks (Aix sponsa), snapping turtles (Chelydra serpentina), beavers (Castor canadensis), and muskrats (Ondatra zibethicus) were more abundant in back than main channels. Spring peepers (Pseudacris crucifer) and American toads (Bufo americanus) occurred more frequently on back than main channels. These results provide quantitative evidence that back channels are important for several wildlife species. The narrowness of the back channels, the protection they provide from the main current of the river, and their ability to support vegetated shorelines and woody debris, are characteristics that appear to benefit these species. As a conservation measure for important riparian wildlife habitat, we suggest limiting building of piers and development of the shoreline in back channel areas. ?? 2009, The Society of Wetland Scientists.

Low back pain in professional golfers: the role of associated hip and low back range-of-motion deficits.

PubMed

Vad, Vijay B; Bhat, Atul L; Basrai, Dilshaad; Gebeh, Ansu; Aspergren, Donald D; Andrews, James R

2004-03-01

Low back pain is fairly prevalent among golfers; however, its precise biomechanical mechanism is often debated. There is a positive correlation between decreased lead hip rotation and lumbar range of motion with a prior history of low back pain in professional golfers. A cross-sectional study. Forty-two consecutive professional male golfers were categorized as group 1 (history of low back pain greater than 2 weeks affecting quality of play within past 1 year) and group 2 (no previous such history). All underwent measurements of hip and lumbar range of motion, FABERE's distance, and finger-to-floor distance. Differences in measurements were analyzed using the Wilcoxon signed rank test. 33% of golfers had previously experienced low back pain. A statistically significant correlation (P <.05) was observed between a history of low back pain with decreased lead hip internal rotation, FABERE's distance, and lumbar extension. No statistically significant difference was noted in nonlead hip range of motion or finger-to-floor distance with history of low back pain. Range-of-motion deficits in the lead hip rotation and lumbar spine extension correlated with a history of low back pain in golfers.

The association between static pelvic asymmetry and low back pain.

PubMed

Levangie, P K

1999-06-15

A cross-sectional case-control approach was used to estimate the association between low back pain of less than 12 months' duration and pelvic asymmetry among 21-50-year-old patients seeking physical therapy services. To evaluate the premise that asymmetrical positioning of the innominates of the pelvis is a source of low back pain. No published studies have been conducted to evaluate systematically the association between low back pain and pelvic asymmetry in a clinic-based sample. Pelvic landmark data were obtained in 144 cases and 138 control subjects. The associations of low back pain with levels of pelvic asymmetry were estimated by use of odds ratios and 95% confidence intervals. Effect modification and confounding of the low back pain-pelvic asymmetry association by several factors was assessed and alternative asymmetry measures considered. Pelvic asymmetry was not positively associated with low back pain in any way that seemed clinically meaningful. Asymmetry of posterior superior iliac spine landmarks showed some evidence of a weak positive association with low back pain. In the absence of meaningful positive association between pelvic asymmetry and low back pain, evaluation and treatment strategies based on this premise should be questioned.

Improvement in automatic postural coordination following alexander technique lessons in a person with low back pain.

PubMed

Cacciatore, Timothy W; Horak, Fay B; Henry, Sharon M

2005-06-01

The relationship between abnormal postural coordination and back pain is unclear. The Alexander Technique (AT) aims to improve postural coordination by using conscious processes to alter automatic postural coordination and ongoing muscular activity, and it has been reported to reduce low back pain. This case report describes the use of the AT with a client with low back pain and the observed changes in automatic postural responses and back pain. The client was a 49-year-old woman with a 25-year history of left-sided, idiopathic, lumbrosacral back pain. Automatic postural coordination was measured using a force plate during horizontal platform translations and one-legged standing. The client was tested monthly for 4 months before AT lessons and for 3 months after lessons. Before lessons, she consistently had laterally asymmetric automatic postural responses to translations. After AT lessons, the magnitude and asymmetry of her responses and balance improved and her low back pain decreased. Further research is warranted to study whether AT lessons improve low back pain-associated abnormalities in automatic postural coordination and whether improving automatic postural coordination helps to reduce low back pain.

Differences in brain structure in patients with distinct sites of chronic pain: A voxel-based morphometric analysis

PubMed Central

Mao, Cuiping; Wei, Longxiao; Zhang, Qiuli; Liao, Xia; Yang, Xiaoli; Zhang, Ming

2013-01-01

A reduction in gray matter volume is common in patients with chronic back pain, and different types of pain are associated with gray matter abnormalities in distinct brain regions. To examine differences in brain morphology in patients with low back pain or neck and upper back pain, we investigated changes in gray matter volume in chronic back pain patients having different sites of pain using voxel-based morphometry. A reduction in cortical gray matter volume was found primarily in the left postcentral gyrus and in the left precuneus and bilateral cuneal cortex of patients with low back pain. In these patients, there was an increase in subcortical gray matter volume in the bilateral putamen and accumbens, right pallidum, right caudate nucleus, and left amygdala. In upper back pain patients, reduced cortical gray matter volume was found in the left precentral and left postcentral cortices. Our findings suggest that regional gray matter volume abnormalities in low back pain patients are more extensive than in upper back pain patients. Subcortical gray matter volume increases are found only in patients with low back pain. PMID:25206618

Back pain and backpacks in school children.

PubMed

Skaggs, David L; Early, Sean D; D'Ambra, Phyllis; Tolo, Vernon T; Kay, Robert M

2006-01-01

Back pain in adults is common and well studied. In contrast, back pain in children has received comparatively little scientific study, despite recent media attention. The purpose of this study is to see what factors influence the prevalence of back pain in middle school children, with particular attention to the weight of children's backpacks and the availability of school lockers. A population-based sample of 1540 children ages 11-14 years in a large metropolitan area was studied. A questionnaire was used to determine presence and severity of back pain, availability of lockers, backpack use, use of 1 or 2 straps to carry backpack, activity limitations due to back pain, and use of pain medication for back pain. Gender, age, weight of the child, and weight of his or her backpack were recorded. Results of scoliosis screening were evaluated with regard to the above information. Data were analyzed using the chi test and univariate or multivariate logistic regression analysis as appropriate. Overall, 37% of the children reported back pain. Backpacks were used by 97% of children, hence there were too few students not using backpacks to treat backpack use as an independent variable. Multivariate analysis found back pain associated with use of a heavier backpack (P=0.001), younger age (P<0.001), female sex (P<0.001), and a positive screening examination for scoliosis (P=0.009). Children with lockers available reported less back pain (P=0.016). The use of 1 or 2 straps to carry the backpack did not have a significant association with back pain (P=0.588). Of the children who reported back pain, 34% limited their activity due to the pain, 14% use medication for pain relief, and 82% believed their backpack either caused or worsened their pain. The incidence of back pain in early adolescence approaches that seen in adults. Recommendations for an "acceptable" weight of backpacks cannot be made from this study, as the weights of students' backpacks seem directly proportional to the likelihood of back pain. This study identifies 2 factors associated with self-reported back pain in early adolescents that are amenable to change: availability of school lockers and lighter backpacks. These findings may be useful in advising families and influencing school policies.

Evaluating back pain in older patients.

PubMed

Mazanec, D J

1999-02-01

Low back pain in the elderly has a much wider range of possible causes than in younger patients. In addition to nonspecific mechanical causes, malignancy presenting as back pain occurs more often in older patients. Other systemic and visceral causes of back pain such as polymyalgia rheumatica, aortic aneurysm, Paget disease, Parkinson disease, and osteoporosis with compression fracture occur almost exclusively in persons over age 50. Keys to diagnosis and management of low back pain in older patients are presented.

Optimization of Tape Winding Process Parameters to Enhance the Performance of Solid Rocket Nozzle Throat Back Up Liners using Taguchi's Robust Design Methodology

NASA Astrophysics Data System (ADS)

Nath, Nayani Kishore

2017-08-01

The throat back up liners is used to protect the nozzle structural members from the severe thermal environment in solid rocket nozzles. The throat back up liners is made with E-glass phenolic prepregs by tape winding process. The objective of this work is to demonstrate the optimization of process parameters of tape winding process to achieve better insulative resistance using Taguchi's robust design methodology. In this method four control factors machine speed, roller pressure, tape tension, tape temperature that were investigated for the tape winding process. The presented work was to study the cogency and acceptability of Taguchi's methodology in manufacturing of throat back up liners. The quality characteristic identified was Back wall temperature. Experiments carried out using L 9 ' (34) orthogonal array with three levels of four different control factors. The test results were analyzed using smaller the better criteria for Signal to Noise ratio in order to optimize the process. The experimental results were analyzed conformed and successfully used to achieve the minimum back wall temperature of the throat back up liners. The enhancement in performance of the throat back up liners was observed by carrying out the oxy-acetylene tests. The influence of back wall temperature on the performance of throat back up liners was verified by ground firing test.

Lumbar lordosis angle and trunk and lower-limb electromyographic activity comparison in hip neutral position and external rotation during back squats

PubMed Central

Oshikawa, Tomoki; Morimoto, Yasuhiro; Kaneoka, Koji

2018-01-01

[Purpose] To compare the lumbar lordosis angle and electromyographic activities of the trunk and lower-limb muscles in the hip neutral position and external rotation during back squats. [Subjects and Methods] Ten healthy males without severe low back pain or lower-limb injury participated in this study. The lumbar lordosis angle and electromyographic activities were measured using three-dimensional motion-capture systems and surface electrodes during four back squats: parallel back squats in the hip neutral position and external rotation and full back squats in the hip neutral position and external rotation. A paired t-test was used to compare parallel and full back squats measurements in the hip neutral position and external rotation, respectively. [Results] During parallel back squats, the average lumbar lordosis angle was significantly larger in hip external rotation than in the hip neutral position. During full back squats, lumbar erector spinae and multifidus activities were significantly lower in hip external rotation than in the hip neutral position, whereas gluteus maximus activity was significantly higher in hip external rotation than in the hip neutral position. [Conclusion] The back squat in hip external rotation induced improvement of lumbar kyphosis, an increasing of the gluteus maximus activity and a decrease of both lumbar erector spinae and multifidus activities. PMID:29581666

Interactive Effects of Southern Rice Black-Streaked Dwarf Virus Infection of Host Plant and Vector on Performance of the Vector, Sogatella furcifera (Homoptera: Delphacidae).

PubMed

Lei, Wenbin; Liu, Danfeng; Li, Pei; Hou, Maolin

2014-10-01

Performance of insect vectors can be influenced by the viruses they transmit, either directly by infection of the vectors or indirectly via infection of the host plants. Southern rice black-streaked dwarf virus (SRBSDV) is a propagative virus transmitted by the white-backed planthopper, Sogatella furcifera (Hovath). To elucidate the influence of SRBSDV on the performance of white-backed planthopper, life parameters of viruliferous and nonviruliferous white-backed planthopper fed rice seedlings infected or noninfected with SRBSDV were measured using a factorial design. Regardless of the infection status of the rice plant host, viruliferous white-backed planthopper nymphs took longer to develop from nymph to adult than did nonviruliferous nymphs. Viruliferous white-backed planthopper females deposited fewer eggs than nonviruliferous females and both viruliferous and nonviruliferous white-backed planthopper females laid fewer eggs on infected than on noninfected plants. Longevity of white-backed planthopper females was also affected by the infection status of the rice plant and white-backed planthopper. Nonviruliferous white-backed planthopper females that fed on infected rice plants lived longer than the other three treatment groups. These results indicate that the performance of white-backed planthopper is affected by SRBSDV either directly (by infection of white-backed planthopper) or indirectly (by infection of rice plant). The extended development of viruliferous nymphs and the prolonged life span of nonviruliferous adults on infected plants may increase their likelihood of transmitting virus, which would increase virus spread. © 2014 Entomological Society of America.

Back pain: a real target for spinal cord stimulation?

PubMed

Rigoard, Philippe; Delmotte, Alexandre; D'Houtaud, Samuel; Misbert, Lorraine; Diallo, Bakari; Roy-Moreau, Aline; Durand, Sylvain; Royoux, Solène; Giot, Jean-Philippe; Bataille, Benoit

2012-03-01

Failed back surgery syndrome represents one of the most frequent etiologies of chronic back pain and is a major public health issue. Neurostimulation has currently not been validated in the treatment of back pain because of technological limitations in implantable spinal cord stimulation (SCS) systems. New-generation leads using several columns of stimulation can generate longitudinal and/or transverse stimulation fields into the spinal cord. To investigate, through extensive stimulation testing, the capacity of multicolumn tripolar leads to achieve back territory paresthesia coverage in refractory failed back surgery syndrome patients. Eleven patients implanted with a 16-contact spinal cord stimulation lead (Specify 5-6-5, Medtronic Inc) were assessed with a systematic exploration of 43 selected stimulation configurations to generate bilateral back paresthesia in addition to leg territory coverage. The tripolar lead successfully generated paresthesia in both bilateral back and leg territories in 9 patients (81.8%). Success rates of multicolumn stimulation patterns were significantly higher than for longitudinal configurations for lombodorsal paresthesia coverage. Six months after implantation, significant pain relief was obtained compared with preoperative evaluation for global pain (Visual Analog Scale, 2.25 vs 8.2 preoperatively; P < .05), leg pain (Visual Analog Scale, 0.5 vs 7.6 preoperatively; P < .05), and back pain (Visual Analog Scale, 1.5 vs 7.8 preoperatively; P < .05). These results suggest that multicolumn leads can reliably generate back pain coverage and favor pain relief outcomes. This may lead physicians to reconsider new indications for spinal cord stimulation. Expanding neurostimulation perspectives to intractable back pain syndromes could become realistic in the near future.

Space Adaptation Back Pain: A Retrospective Study

NASA Technical Reports Server (NTRS)

Kerstman, E. L.; Scheuring, R. A.; Barnes, M. G.; DeKorse, T. B.; Saile, L. G.

2008-01-01

Back pain is frequently reported by astronauts during the early phase of space flight as they adapt to the microgravity environment. However, the epidemiology of space adaptation back pain has not been well defined. The purpose of this retrospective study was to develop a case definition of space adaptation back pain, determine the incidence of space adaptation back pain, and determine the effectiveness of available treatments. Medical records from the Mercury, Apollo, Apollo-Soyuz Test Project (ASTP), Skylab, Mir, International Space Station (ISS), and Shuttle programs were reviewed. All episodes of in-flight back pain that met the criteria for space adaptation back pain were recorded. Pain characteristics, including intensity, location, and duration of the pain were noted. The effectiveness of specific treatments also was recorded. The incidence of space adaptation back pain among astronauts was determined to be 53% (384/722). Most of the affected astronauts reported mild pain (85%). Moderate pain was reported by 11% of the affected astronauts and severe pain was reported by only 4% of the affected astronauts. The most effective treatments were fetal positioning (91% effective) and the use of analgesic medications (85% effective). This retrospective study aids in the development of a case definition of space adaptation back pain and examines the epidemiology of space adaptation back pain. Space adaptation back pain is usually mild and self-limited. However, there is a risk of functional impairment and mission impact in cases of moderate or severe pain that do not respond to currently available treatments. Therefore, the development of preventive measures and more effective treatments should be pursued.

Evaluation of Work-related Psychosocial and Ergonomics Factors in Relation to Low Back Discomfort in Emergency Unit Nurses

PubMed Central

Habibi, Ehsanollah; Pourabdian, Siamak; Atabaki, Azadeh Kianpour; Hoseini, Mohsen

2012-01-01

Background and Aim: High prevalence of low back pain is one of the most common problems among nurses. The aim of this study was to evaluate the relation of the intensity of low back discomfort to two low back pain contributor factors (Ergonomics risk factors and psychosocial factors). Methods: This cross-sectional survey was conducted on 120 emergency unit nurses in Esfahan. Job content, ergonomics hazards and nordic questionnaire were used in that order for daily assessment of Psychosocial and Ergonomics factors and the intensity of low back discomfort. Nurses were questioned during a 5-week period, at the end of each shift work. The final results were analyzed with SPSS software18/PASW by using Spearman, Mann-Whitney and Kolmogorov-Smirnove test. Results: There was a significant relationship between work demand, job content, social support and intensity of low back discomfort (P value <0.05). But, there was not any link between intensity of low back discomfort and job control. Also, there was significant relationship between intensity of low back discomfort and ergonomics risk factors. Conclusion: This study showed an indirect relationship between the intensity of low back discomfort and social support. This study also confirmed a direct relationship between the intensity of low back discomfort and work demand, job content, ergonomics factors (Awkward Postures (rotating and bending), manual patient handling and repetitiveness, standing continuously more than 30 min). So, to decrease work related low back discomfort, psychosocial factors should be attended in addition to ergonomics factors. PMID:22973487

Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study.

PubMed

Granado, Nisara S; Pietrucha, Amanda; Ryan, Margaret; Boyko, Edward J; Hooper, Tomoko I; Smith, Besa; Smith, Tyler C

2016-11-15

A prospective cohort study. Activities performed during military operations vary in complexity and physical demand. The risk for mental illness following military combat deployment has been well documented. However, information regarding the possible contribution of back pain to decreased mental and functional health is scarce. To our knowledge, this is the first study to prospectively assess deployment and self-reported recent back pain in a population-based U.S. military cohort. The study consisted of Millennium Cohort participants who were followed for the development of back pain for an average of 3.9 years. Descriptive statistics and longitudinal analyses were used to assess the temporal relationship of deployment with self-reported recent back pain at follow-up (N = 53,933). Recent back pain was self-reported by 8379 (15.5%) participants at follow-up. After adjusting for covariates, deployers with combat experiences had higher odds [odds ratio (OR) = 1.38, 95% confidence interval (95% CI): 1.28-1.50] of recent back pain than noncombat deployers. There was no association between recent back pain and nondeployers compared with noncombat deployers. Service support/supply handlers were at an increased odds of reporting recent back pain (OR = 1.11, 95% CI: 1.02-1.21) than functional support/administration occupations. Occupations associated with a physically demanding work environment had a higher risk of back pain. Deployers with combat experiences were more likely to report back pain postdeployment. This well-defined group of military personnel may potentially benefit from integrated prevention efforts. 3.

34 CFR 675.18 - Use of funds.

Code of Federal Regulations, 2014 CFR

2014-07-01

... funds carried forward from the previous year. (c) Carry back funds. An institution may carry back and...'s approval to carry back funds. (d) The institution may use the funds carried forward or carried back under paragraphs (c) and (d) of this section, respectively, for activities described in paragraph...

34 CFR 675.18 - Use of funds.

Code of Federal Regulations, 2011 CFR

2011-07-01

... funds carried forward from the previous year. (c) Carry back funds. An institution may carry back and...'s approval to carry back funds. (d) The institution may use the funds carried forward or carried back under paragraphs (c) and (d) of this section, respectively, for activities described in paragraph...

34 CFR 675.18 - Use of funds.

Code of Federal Regulations, 2012 CFR

2012-07-01

... funds carried forward from the previous year. (c) Carry back funds. An institution may carry back and...'s approval to carry back funds. (d) The institution may use the funds carried forward or carried back under paragraphs (c) and (d) of this section, respectively, for activities described in paragraph...

34 CFR 675.18 - Use of funds.

Code of Federal Regulations, 2013 CFR

2013-07-01

... funds carried forward from the previous year. (c) Carry back funds. An institution may carry back and...'s approval to carry back funds. (d) The institution may use the funds carried forward or carried back under paragraphs (c) and (d) of this section, respectively, for activities described in paragraph...

26 CFR 1.460-6 - Look-back method.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) for the redetermination year, as adjusted for past applications of the look-back method and taking... the year in question with respect to other contracts. Notwithstanding the look-back method, the...) INCOME TAXES Taxable Year for Which Items of Gross Income Included § 1.460-6 Look-back method. (a) In...

Back Pain and Endurance Training of Back Muscles: Justification for Further Study in Helicopter Pilots.

DTIC Science & Technology

1997-05-29

osteopenic women. J Am Geriatr Soc 1996 Jul;44(7):756-762. 12. Chaffin DB. Human strength capability and low-back pain. J Occup Med 1974 Apr;16(4... geriatric hospital. Scand J Rehabil Med 1978;10(4):201-209. 16. Donchin M, Woolf O, Kaplan L, Floman Y. Secondary prevention of low-back pain. A...FR, Bendix T, Skov P, Jensen CV, Kristensen JH, Krohn L, Schoeler H. Intensive, dynamic back-muscle exercises, conventional physiotherapy , or

Study of Damped Set-Back Pins for S and A Mechanisms.

DTIC Science & Technology

1976-11-01

arm device for artillery munitions. This damped set-back pin assembly is one of two safety features on a S and A device used in the M739 PD/XM587 ET...The damped set-back pin study program was for the design, testing, fabrication, and delivery and damped set-back pin assemblies for use in a safe and...fuzes for a rotating projectile. A pin, porous disc, return spring, floating O-ring, and sleeve comprise the selected damped set-back pin assembly

Electroluminescence analysis for spatial characterization of parasitic optical losses in silicon heterojunction solar cells

NASA Astrophysics Data System (ADS)

Ahmed, Nuha; Zhang, Lei; Sriramagiri, Gowri; Das, Ujjwal; Hegedus, Steven

2018-04-01

Electroluminescence (EL) coupled with reflection measurements are used to spatially quantify optical losses in silicon heterojunction solar cells due to plasmonic absorption in the metal back contacts. The effect of indium tin oxide back reflector in decreasing this plasmonic absorption is found to increase the reflection from the back nickel (Ni)-aluminum (Al) and Al metals by ˜12% and ˜41%, respectively, in both bifacial and front junction silicon solar cells. Losses due to back reflection are calculated by comparison between the EL emission signals in high and low back reflection samples and are shown to be in agreement with standard reflection measurements. We conclude that the optical properties of the back contact can significantly influence the EL intensity which complicates the interpretation of EL as being primarily due to recombination especially when comparing two different devices with spatially varying back surface structures.

Short-circuit current improvement in thin cells with a gridded back contact

NASA Technical Reports Server (NTRS)

Giuliano, M.; Wohlgemuth, J.

1980-01-01

The use of gridded back contact on thin silicon solar cells 50 micrometers was investigated. An unexpected increase in short circuit current of almost 10 percent was experienced for 2 cm x 2 cm cells. Control cells with the standard continuous contact metallization were fabricated at the same time as the gridded back cells with all processes identical up to the formation of the back contact. The gridded back contact pattern was delineated by evaporation of Ti-Pd over a photo-resist mask applied to the back of the wafer; the Ti-Pd film on the controls was applied in the standard fashion in a continuous layer over the back of the cell. The Ti-Pd contacts were similarly applied to the front of the wafer, and the grid pattern on both sides of the cell was electroplated with 8-10 micrometers of silver.

Low back pain and lumbar angles in Turkish coal miners

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sarikaya, S.; Ozdolap, S.; Gumustas, S.

This study was designed to assess the incidence of low back pain among Turkish coal miners and to investigate the relationship between angles of the lumbar spine and low back pain in coal miners. Fifty underground workers (Group I) and 38 age-matched surface workers (Group II) were included in the study. All the subjects were asked about low back pain in the past 5 years. The prevalence of low back pain was higher in Group I than in Group II (78.0%, 32.4%, respectively, P {lt} 0.001). The results of the study showed that low back pain occurred in 78.0% ofmore » Turkish coal miners. Although the nature of the occupation may have influenced coal miners' lumbar spinal curvature, lumbar angles are not a determinant for low back pain in this population. Further extensive studies involving ergonomic measurements are needed to validate our results for Turkish coal mining industry.« less

Prevalence of low back pain and associated factors among farmers during the rice transplanting process

PubMed Central

Keawduangdee, Petcharat; Puntumetakul, Rungthip; Swangnetr, Manida; Laohasiriwong, Wongsa; Settheetham, Dariwan; Yamauchi, Junichiro; Boucaut, Rose

2015-01-01

[Purpose] The aim of this study was to investigate the prevalence of low back pain and associated factors in Thai rice farmers during the rice transplanting process. [Subjects and Methods] Three hundred and forty-four farmers, aged 20–59 years old, were asked to answer a questionnaire modified from the Standard Nordic Questionnaire (Thai version). The questionnaire sought demographic, back-related, and psychosocial data. [Results] The results showed that the prevalence of low back pain was 83.1%. Farmers younger than 45 years old who worked in the field fewer than six days were more likely to experience low back pain than those who worked for at least six days. Farmers with high stress levels were more likely to have low back pain. [Conclusion] In the rice transplanting process, the low back pain experienced by the farmers was associated with the weekly work duration and stress. PMID:26311961

Profiling of back-scattered electrons in opposed magnetic field of a Twin Electron Beam Gun

NASA Astrophysics Data System (ADS)

Sethi, S.; Gupta, Anchal; Dileep Kumar, V.; Mukherjee, Jaya; Gantayet, L. M.

2012-11-01

Electron gun is extensively used in material processing, physical vapour deposition and atomic vapour based laser processes. In these processes where the electron beam is incident on the substrate, a significant fraction of electron beam gets back-scattered from the target surface. The trajectory of this back scattered electron beam depends on the magnetic field in the vicinity. The fraction of back-scattered depends on the atomic number of the target metal and can be as high as ~40% of the incident beam current. These back-scattered electrons can cause undesired hot spots and also affect the overall process. Hence, the study of the trajectory of these back-scattered electrons is important. This paper provides the details of experimentally mapped back-scattered electrons of a 2×20kW Twin Electron Beam Gun (TEBG) in opposed magnetic field i.e. with these guns placed at 180° to each other.

Estimating the executive demands of a one-back choice reaction time task by means of the selective interference paradigm.

PubMed

Szmalec, Arnaud; Vandierendonck, André

2007-08-01

The present study proposes a new executive task, the one-back choice reaction time (RT) task, and implements the selective interference paradigm to estimate the executive demands of the processing components involved in this task. Based on the similarities between a one-back choice RT task and the n-back updating task, it was hypothesized that one-back delaying of a choice reaction involves executive control. In three experiments, framed within Baddeley's (1986) working-memory model, a one-back choice RT task, a choice RT task, articulatory suppression, and matrix tapping were performed concurrently with primary tasks involving verbal, visuospatial, and executive processing. The results demonstrate that one-back delaying of a choice reaction interferes with tasks requiring executive control, while the potential interference at the level of the verbal or visuospatial working memory slave systems remains minimal.

Effective management of low back pain: it’s time to accept the evidence

PubMed Central

Manga, Pran; Angus, Douglas E; Swan, William R

1993-01-01

Low back pain is a ubiquitous and economically costly problem. Unfortunately, the clinical management of low back pain is not yet well understood. Chiropractic management of back pain, long the black sheep of back care, has undergone a transition and is now a more respected and understood alternative to conservative medical care, itself under increased scrutiny due to unsatisfactory outcomes and unacceptable iatrogenic side effects. The substantial amount of clinical and related research on the effectiveness of manipulation for low back pain is summarized here from a larger study, divided into randomized control trials, case-control trials, meta-analyses and descriptive studies. The chiropractic management of low back pain is found to be a more effective way of dealing with this medical, social and economic problem. It is suggested that greater utilization of chiropractors be encouraged such that the “right people are doing the right things at the right time”.

Analysis of Accuracy and Epoch on Back-propagation BFGS Quasi-Newton

NASA Astrophysics Data System (ADS)

Silaban, Herlan; Zarlis, Muhammad; Sawaluddin

2017-12-01

Back-propagation is one of the learning algorithms on artificial neural networks that have been widely used to solve various problems, such as pattern recognition, prediction and classification. The Back-propagation architecture will affect the outcome of learning processed. BFGS Quasi-Newton is one of the functions that can be used to change the weight of back-propagation. This research tested some back-propagation architectures using classical back-propagation and back-propagation with BFGS. There are 7 architectures that have been tested on glass dataset with various numbers of neurons, 6 architectures with 1 hidden layer and 1 architecture with 2 hidden layers. BP with BFGS improves the convergence of the learning process. The average improvement convergence is 98.34%. BP with BFGS is more optimal on architectures with smaller number of neurons with decreased epoch number is 94.37% with the increase of accuracy about 0.5%.

16 CFR 1632.8 - Glossary of terms.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... The seat slopes, in the sitting position, for added comfort (see fig. 5). (w) Push-back sofa. When... lounge. An upholstered couch chair or a couch with a chair back. It has a permanent back rest, no arms... positions for a chaise lounge effect or a single sleeper. The vertical back support always remains upright...

Promoting Healthy Backs in Schools an Evaluative Study

ERIC Educational Resources Information Center

Springett, Angela G.; Wise, Joyce E. M.

2007-01-01

Purpose: The purpose of this paper is to evaluate the impact of educating adolescents in practical ways of looking after their backs to reduce the incidence of back-pain, with particular focus on the use and carrying method of ergonomically designed schoolbags. Design/methodology/approach: An educational leaflet containing a range of back care…

77 FR 23524 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-19

... Change Relating to Post-Trade Transparency for Agency Pass-Through Mortgage-Backed Securities Traded in Specified Pool Transactions and SBA-Backed Asset- Backed Securities Transactions April 13, 2012. Pursuant to... dissemination of transactions in TRACE- Eligible Securities that are: (1) Agency Pass-Through Mortgage-Backed...

History of Particle Physics

Science.gov Websites

back to history page Back Particle Physics Timeline For over two thousand years people have thought the Standard Model. We invite you to explore this history of particle physics with a focus on the : Quantum Theory 1964 - Present: The Modern View (the Standard Model) back to history page Back Sections of

Back pain prevalence and associated factors in children and adolescents: an epidemiological population study

PubMed Central

Noll, Matias; Candotti, Cláudia Tarragô; da Rosa, Bruna Nichele; Loss, Jefferson Fagundes

2016-01-01

ABSTRACT OBJECTIVE To identify the prevalence of back pain among Brazilian school children and the factors associated with this pain. METHODS All 1,720 schoolchildren from the fifth to the eight grade attending schools from the city of Teutonia, RS, Southern Brazil, were invited to participate in the study. From these, 1,597 children participated. We applied the Back Pain and Body Posture Evaluation Instrument. The dependent variable was back pain, while the independent one were demographic, socioeconomic, behavior and heredity data. The prevalence ratio was estimated by multivariate analysis using the Poisson regression model (α = 0.05). RESULTS The prevalence of back pain in the last three months was 55.7% (n = 802). The multivariate analysis showed that back pain is associated with the variables: sex, parents with back pain, weekly frequency of physical activity, daily time spent watching television, studying in bed, sitting posture to write and use the computer, and way of carrying the backpack. CONCLUSIONS The prevalence of back pain in schoolchildren is high and it is associated with demographic, behavior and heredity aspects. PMID:27305406

Holding back sharing concerns, dispositional emotional expressivity, perceived unsupportive responses and distress among women newly diagnosed with gynecological cancers.

PubMed

Manne, Sharon; Myers, Shannon; Ozga, Melissa; Kissane, David; Kashy, Debby; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norm

2014-01-01

Little attention has been paid to the role of holding back sharing concerns in the psychological adaptation of women newly diagnosed with gynecological cancers. The goal of the present study was to evaluate the role of holding back concerns in psychosocial adjustment and quality of life, as well as a possible moderating role for emotional expressivity and perceived unsupportive responses from family and friends. Two hundred forty-four women diagnosed with gynecological cancer in the past 8 months completed measures of holding back, dispositional emotional expressivity, perceived unsupportive responses from family and friends, cancer-specific distress, depressive symptoms and quality of life. Emotional expressivity moderated the association between holding back and cancer-specific distress and quality of life, but not depressive symptoms. Greater holding back was more strongly associated with higher levels of cancer-related distress among women who were more emotionally expressive than among women who were less expressive. Perceived unsupportive responses did not moderate the associations between holding back and psychosocial outcomes. Holding back sharing concerns was more common in this patient population than other cancer populations. Dispositional expressivity played a role in how harmful holding back concerns was for women, while unsupportive responses from family and friends did not. © 2014.

Effectiveness of a standardized back school program for patients with chronic low back pain after implementation in routine rehabilitation care.

PubMed

Meng, Karin; Peters, Stefan; Faller, Hermann

2017-06-01

To evaluate the effectiveness of a standardized, patient-oriented, biopsychosocial back school after implementation in inpatient orthopedic rehabilitation. A multi-center, quasi-experimental controlled study of patients with low back pain (n=535) was conducted. Patients in the control group received the traditional back school before implementation of the new program (usual care); patients in the intervention group received the new standardized back school after implementation into routine care. Patients' illness knowledge and conduct of back exercises (primary outcomes) and secondary self-management outcomes and treatment satisfaction were obtained at admission, discharge, and 6 and 12 months after rehabilitation. We found a significant small between-group intervention effect on patients' illness knowledge in medium- to long term (6 months: η 2 =0.015; 12 months: η 2 =0.013). There were trends for effects on conduct of back exercises among men (6 and 12 months: η 2 =0.008 both). Furthermore, significant small effects were observed for treatment satisfaction at discharge and physical activity after 6 months. The standardized back school seems to be more effective in certain outcomes than a usual care program despite heterogeneous program implementation. Further dissemination within orthopedic rehabilitation may be encouraged to foster self-management outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Correlates of low back pain in a general population sample: a multidisciplinary perspective.

PubMed

Roncarati, A; McMullen, W

1988-06-01

This study identifies correlates of low back pain in a general population sample and defines a profile of subjects with low back pain. A multidisciplinary approach was employed that required surveying and physically assessing 674 subjects on 105 variables in biographical, anatomical, strength and flexibility measurement categories. No attempt was made to select subjects from specific occupational, age, athletic, psychological and anatomical groups or subjects with specific biographical features, which may have resulted in a sample that was atypical of the general population. The results of this study based on a causal comparative ex post facto research design corroborated selected findings of previous research conducted on nongeneral population samples. These findings include relationships between low back pain and age, body type, sex, stress, smoking, selected types of physical activity, occupation and previous injuries to the neck, shoulders, back and upper legs, as well as previous episodes of low back pain. Additional correlates of low back pain that were identified and have little or controversial review in the back literature include: delayed low back pain syndrome caused by abrupt changes in running frequency, Q angle, pes cavus, leg length (right and left), trunk length, genu recurvatum and multiplane strength and flexibility limitations in the hip joints.

Streamlining the Evaluation of Low Back Pain in Children

PubMed Central

Auerbach, Joshua D.; Ahn, Jaimo; Zgonis, Miltiadis H.; Reddy, Sudheer C.; Ecker, Malcolm L.

2008-01-01

The workup of low back pain in children often results in overimaging so as not to miss organic back pain. The primary goal of this study was to identify which combination of imaging modalities provides the most sensitive and specific screening protocol for children with low back pain. Medical records from 100 consecutive patients between 2 and 18 years of age presenting with low back pain, without night pain or constitutional symptoms, were evaluated. A hyperextension test combined with a radiograph showed a negative predictive value of 0.81 and sensitivity of 0.90. The addition of a bone scan was highly effective in achieving good negative predictive value and sensitivity. Bone scans had perfect negative predictive value and sensitivity when symptom duration was less than 6 weeks. We identified a set of factors that is highly predictive for distinguishing organic back pain from mechanical back pain. Painless hyperextension combined with negative anteroposterior, lateral, and oblique lumbar radiographs and magnetic resonance images predicts mechanical back pain. For patients with nonneurologic back pain of less than 6 weeks duration, bone scan is the most useful screening test because it is accurate, accessible, inexpensive, and unlikely to require sedation. Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18553213

Rehabilitation of Low Back Pain in Golfers

PubMed Central

Finn, Christopher

2013-01-01

Context: Low back injuries are the most common injury in golf. Best practice guidelines for rehabilitation and prevention of these injuries are helpful for health care professionals and all golfers. Objective: To establish a best practice clinical model for low back pain in golfers from diagnosis through treatment and rehabilitation to return to golf. Evidence Acquisition: The PubMed database and Google Scholar were searched from 1993 to 2012 with the following keywords: golf and low back injury, low back injury, golf and low back pain, golf injury prevention, golf modern swing, muscles in golf swing, low back rehabilitation, diaphragm, and core stability. All studies addressed in some manner the rehabilitation, prevention, or return to sport from low back injury, preferably in direct relation to golf, as well as muscle firing patterns used during the golf swing. Results: Best practice for rehabilitation and prevention of low back injury in golf appears to be through a multidisciplinary approach. Conclusion: Movement patterns, muscle imbalances, and type of swing utilized all have a direct effect on the forces applied to the spine during the golf swing and need to be assessed to prevent or rehabilitate injury. Understanding the golf swing and how the body works during the swing is necessary. PMID:24459546

Effects of Carcass Weight and Back-fat Thickness on Carcass Properties of Korean Native Pigs.

PubMed

Kim, Gye-Woong; Kim, Hack-Youn

2017-01-01

Our study analyzed the carcass properties of 170 Korean native pigs in relation to carcass weight and back-fat thickness to provide general data for the production and distribution of high quality pig meat. The 70-74 kg group showed highest yield (73.41%). The ≥80 kg group showed the highest thickest back-fat (24.13 mm) ( p <0.05). The ≥80 kg group showed the best quality grade (1.00). Back-fat thickness showed significant differences in the weight among groups ( p <0.05). The ≥25 mm group showed the highest carcass weight (75.93 kg). The thickest back-fat group (≥25 mm) showed the highest yield (73.03%). There were significant differences in back-fat thickness among groups ( p <0.05), and the ≥25 mm group showed the highest thickness back-fat (27.60 mm). We found a strong positive correlation between carcass weight and back-fat thickness (r=0.346) as well as meat quality grade (r=0.739). Back-fat thickness had a relatively strong positive correlation with meat quality grade (r=0.444). Therefore, there are required to manage the breeding through selection of excellent native species for increasing their carcass weight and enhance meat quality.

Effects of Carcass Weight and Back-fat Thickness on Carcass Properties of Korean Native Pigs

PubMed Central

2017-01-01

Our study analyzed the carcass properties of 170 Korean native pigs in relation to carcass weight and back-fat thickness to provide general data for the production and distribution of high quality pig meat. The 70-74 kg group showed highest yield (73.41%). The ≥80 kg group showed the highest thickest back-fat (24.13 mm) (p<0.05). The ≥80 kg group showed the best quality grade (1.00). Back-fat thickness showed significant differences in the weight among groups (p<0.05). The ≥25 mm group showed the highest carcass weight (75.93 kg). The thickest back-fat group (≥25 mm) showed the highest yield (73.03%). There were significant differences in back-fat thickness among groups (p<0.05), and the ≥25 mm group showed the highest thickness back-fat (27.60 mm). We found a strong positive correlation between carcass weight and back-fat thickness (r=0.346) as well as meat quality grade (r=0.739). Back-fat thickness had a relatively strong positive correlation with meat quality grade (r=0.444). Therefore, there are required to manage the breeding through selection of excellent native species for increasing their carcass weight and enhance meat quality. PMID:28747824

Time reversal for localization of sources of infrasound signals in a windy stratified atmosphere.

PubMed

Lonzaga, Joel B

2016-06-01

Time reversal is used for localizing sources of recorded infrasound signals propagating in a windy, stratified atmosphere. Due to the convective effect of the background flow, the back-azimuths of the recorded signals can be substantially different from the source back-azimuth, posing a significant difficulty in source localization. The back-propagated signals are characterized by negative group velocities from which the source back-azimuth and source-to-receiver (STR) distance can be estimated using the apparent back-azimuths and trace velocities of the signals. The method is applied to several distinct infrasound arrivals recorded by two arrays in the Netherlands. The infrasound signals were generated by the Buncefield oil depot explosion in the U.K. in December 2005. Analyses show that the method can be used to substantially enhance estimates of the source back-azimuth and the STR distance. In one of the arrays, for instance, the deviations between the measured back-azimuths of the signals and the known source back-azimuth are quite large (-1° to -7°), whereas the deviations between the predicted and known source back-azimuths are small with an absolute mean value of <1°. Furthermore, the predicted STR distance is off only by <5% of the known STR distance.

Brain activation and deactivation during location and color working memory tasks in 11-13-year-old children.

PubMed

Vuontela, Virve; Steenari, Maija-Riikka; Aronen, Eeva T; Korvenoja, Antti; Aronen, Hannu J; Carlson, Synnöve

2009-02-01

Using functional magnetic resonance imaging (fMRI) and n-back tasks we investigated whether, in 11-13-year-old children, spatial (location) and nonspatial (color) information is differentially processed during visual attention (0-back) and working memory (WM) (2-back) tasks and whether such cognitive task performance, compared to a resting state, results in regional deactivation. The location 0-back task, compared to the color 0-back task, activated segregated areas in the frontal, parietal and occipital cortices whereas no differentially activated voxels were obtained when location and color 2-back tasks were directly contrasted. Several midline cortical areas were less active during 0- and 2-back task performance than resting state. The task-induced deactivation increased with task difficulty as demonstrated by larger deactivation during 2-back than 0-back tasks. The results suggest that, in 11-13-year-old children, the visual attentional network is differently recruited by spatial and nonspatial information processing, but the functional organization of cortical activation in WM in this age group is not based on the type of information processed. Furthermore, 11-13-year-old children exhibited a similar pattern of cortical deactivation that has been reported in adults during cognitive task performance compared to a resting state.

Systematic review of conservative interventions for subacute low back pain.

PubMed

Pengel, Heloise M; Maher, Chris G; Refshauge, Kathryn M

2002-12-01

To evaluate the effect of conservative interventions on clinically relevant outcome measures for patients with subacute low back pain. This is particularly important because effective treatment for subacute low back pain will prevent the transition to chronic low back pain, a condition that is largely responsible for the high health care costs of low back pain. Systematic review of randomized controlled trials. Methodological quality of each trial was assessed. Effect sizes and 95% confidence intervals were calculated for pain and disability and risk ratios for return to work. Thirteen trials were located, evaluating the following interventions: manipulation, back school, exercise, advice, transcutaneous electrical nerve stimulation (TENS), hydrotherapy, massage, corset, cognitive behavioural treatment and co-ordination of primary health care. Most studies were of low quality and did not show a statistically significant effect of intervention. For the strict duration of low back pain (six weeks to three months), no evidence of high internal validity was found but when other methodological criteria were considered, evidence was found for the efficacy of advice. Furthermore, there is evidence that when a broader view is taken of the duration of subacute low back pain (seven days to six months), other treatments (e.g. manipulation, exercise, TENS) may be effective. Our review identified a major gap in the evidence for interventions that are currently recommended in clinical practice guidelines for the treatment of subacute low back pain. Lack of a uniform definition of subacute low back pain further limited current evidence.

Effects of Lumbar Strengthening Exercise in Lower-Limb Amputees With Chronic Low Back Pain.

PubMed

Shin, Min Kyung; Yang, Hee Seung; Yang, Hea-Eun; Kim, Dae Hyun; Ahn, Bo Ram; Kwon, Hyup; Lee, Ju Hwan; Jung, Suk; Choi, Hyun Chul; Yun, Sun Keaung; Ahn, Dong Young; Sim, Woo Sob

2018-02-01

To analyze the effect of lumbar strengthening exercise in lower-limb amputees with chronic low back pain. We included in this prospective study 19 lower-limb amputees who had experienced low back pain for longer than 6 months. Participants were treated with 30-minute lumbar strengthening exercises, twice weekly, for 8 weeks. We used the visual analog scale (VAS), and Oswestry low back pain disability questionnaire, and measured parameters such as iliopsoas length, abdominal muscle strength, back extensor strength, and back extensor endurance. In addition, we assessed the isometric peak torque and total work of the trunk flexors and extensors using isokinetic dynamometer. The pre- and post-exercise measurements were compared. Compared with the baseline, abdominal muscle strength (from 4.4±0.7 to 4.8±0.6), back extensor strength (from 2.6±0.6 to 3.5±1.2), and back extensor endurance (from 22.3±10.7 to 46.8±35.1) improved significantly after 8 weeks. The VAS decreased significantly from 4.6±2.2 to 2.6±1.6 after treatment. Furthermore, the peak torque and total work of the trunk flexors and extensors increased significantly (p<0.05). Lumbar strengthening exercise in lower-limb amputees with chronic low back pain resulted in decreased pain and increased lumbar extensor strength. The lumbar strengthening exercise program is very effective for lower-limb amputees with chronic low back pain.

Incidence of foot rotation, pelvic crest unleveling, and supine leg length alignment asymmetry and their relationship to self-reported back pain.

PubMed

Knutson, Gary A

2002-02-01

To determine the incidence of pelvic unleveling, foot rotation, and supine leg length alignment asymmetry in a nonclinical population and to examine the validity (sensitivity, specificity, positive and negative predictive values) of these visual tests and their relationship to self-reported back pain. Volunteers answered a questionnaire regarding back pain and were then examined by a chiropractor who was unaware of the status of their back pain. Seventy-four unscreened volunteers answered the questionnaire. The association of visual tests with back pain and their validity indices; Visual Analogue Scale ratings. Fifty-one percent (n = 74) of volunteers examined had supine leg length alignment asymmetry (LLA). Pain intensity on a Visual Analogue Scale was significantly higher (P <.001) for those demonstrating supine LLA than for those without LLA. Those with back pain and recurrent back pain were significantly (P <.001) more likely to have supine LLA. The validity indices of the supine leg check showed acceptable levels for sensitivity (74%), specificity (78%), and positive predictive value (82%) [corrected] in recurrent back pain. Findings also indicated a high incidence of supine LLA in volunteers with chronic back pain (85%). The results indicated that, in this group of volunteers, the supine leg length alignment check had clinical validity as a stand-alone test for recurring back pain. Further testing on a larger, statistically defined cross-section of the population is recommended.

Consistency of a lumbar movement pattern across functional activities in people with low back pain.

PubMed

Marich, Andrej V; Hwang, Ching-Ting; Salsich, Gretchen B; Lang, Catherine E; Van Dillen, Linda R

2017-05-01

Limitation in function is a primary reason people with low back pain seek medical treatment. Specific lumbar movement patterns, repeated throughout the day, have been proposed to contribute to the development and course of low back pain. Varying the demands of a functional activity test may provide some insight into whether people display consistent lumbar movement patterns during functional activities. Our purpose was to examine the consistency of the lumbar movement pattern during variations of a functional activity test in people with low back pain and back-healthy people. 16 back-healthy adults and 32 people with low back pain participated. Low back pain participants were classified based on the level of self-reported functional limitations. Participants performed 5 different conditions of a functional activity test. Lumbar excursion in the early phase of movement was examined. The association between functional limitations and early phase lumbar excursion for each test condition was examined. People with low back pain and high levels of functional limitation demonstrated a consistent pattern of greater early phase lumbar excursion across test conditions (p<0.05). For each test condition, the amount of early phase lumbar excursion was associated with functional limitation (r=0.28-0.62). Our research provides preliminary evidence that people with low back pain adopt consistent movement patterns during the performance of functional activities. Our findings indicate that the lumbar spine consistently moves more readily into its available range in people with low back pain and high levels of functional limitation. How the lumbar spine moves during a functional activity may contribute to functional limitations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Back Pain Prevalence and Its Associated Factors in Brazilian Athletes from Public High Schools: A Cross-Sectional Study.

PubMed

Noll, Matias; de Avelar, Ivan Silveira; Lehnen, Georgia Cristina; Vieira, Marcus Fraga

2016-01-01

Most studies on the prevalence of back pain have evaluated it in developed countries (Human Development Index--HDI > 0.808), and their conclusions may not hold for developing countries. The aim of this study was to identify the prevalence of back pain in representative Brazilian athletes from public high schools. This cross-sectional study was performed during the state phase of the 2015 Jogos dos Institutos Federais (JIF), or Federal Institutes Games, in Brazil (HDI = 0.744), and it enrolled 251 athletes, 173 males and 78 females (14-20 years old). The dependent variable was back pain, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, exercise-level, anthropometric, strength, behavioral, and postural factors. The prevalence ratio (PR) was calculated using multivariable analysis according to the Poisson regression model (α = 0.05). The prevalence of back pain in the three months prior to the study was 43.7% (n = 104), and 26% of the athletes reported feeling back pain only once. Multivariable analysis showed that back pain was associated with demographic (sex), psychosocial (loneliness and loss of sleep in the previous year), hereditary (ethnicity, parental back pain), strength (lumbar and hand forces), anthropometric (body mass index), behavioral (sleeping time per night, reading and studying in bed, smoking habits in the previous month), and postural (sitting posture while writing, while on a bench, and while using a computer) variables. Participants who recorded higher levels of lumbar and manual forces reported a lower prevalence of back pain (PR < 0.79), whereas feeling lonely in the previous year, obesity, and ethnicity exhibited the highest prevalence ratio (PR > 1.30). In conclusion, there is no association between exercise levels and back pain but there is an association between back pain and non-exercise related variables.

Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain.

PubMed

el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

2014-01-01

Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. The study population contained patients with sciatica who underwent a baseline MRI to assess eligibility for a randomized trial designed to compare the efficacy of early surgery with prolonged conservative care for sciatica. Two neuroradiologists and one neurosurgeon independently evaluated all MR images. The MRI readers were blinded to symptom status. The MRI findings were compared between sciatica patients with and without disabling back pain. The presence of disabling back pain at baseline was correlated with perceived recovery at one year. Of 379 included sciatica patients, 158 (42%) had disabling back pain. Of the patients with both sciatica and disabling back pain 68% did reveal a herniated disc with nerve root compression on MRI, compared to 88% of patients with predominantly sciatica (P<0.001). The existence of disabling back pain in sciatica at baseline was negatively associated with perceived recovery at one year (Odds ratio [OR] 0.32, 95% Confidence Interval 0.18-0.56, P<0.001). Sciatica patients with disabling back pain in absence of nerve root compression on MRI at baseline reported less perceived recovery at one year compared to those with predominantly sciatica and nerve root compression on MRI (50% vs 91%, P<0.001). Sciatica patients with disabling low back pain reported an unfavorable outcome at one-year follow-up compared to those with predominantly sciatica. If additionally a clear herniated disc with nerve root compression on MRI was absent, the results were even worse.

Influence of Low Back Pain and Prognostic Value of MRI in Sciatica Patients in Relation to Back Pain

PubMed Central

el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L. A. M.; Lycklama à Nijeholt, Geert J.; Van der Kallen, Bas F.; van den Hout, Wilbert B.; Koes, Bart W.; Peul, Wilco C.

2014-01-01

Background Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. Methods The study population contained patients with sciatica who underwent a baseline MRI to assess eligibility for a randomized trial designed to compare the efficacy of early surgery with prolonged conservative care for sciatica. Two neuroradiologists and one neurosurgeon independently evaluated all MR images. The MRI readers were blinded to symptom status. The MRI findings were compared between sciatica patients with and without disabling back pain. The presence of disabling back pain at baseline was correlated with perceived recovery at one year. Results Of 379 included sciatica patients, 158 (42%) had disabling back pain. Of the patients with both sciatica and disabling back pain 68% did reveal a herniated disc with nerve root compression on MRI, compared to 88% of patients with predominantly sciatica (P<0.001). The existence of disabling back pain in sciatica at baseline was negatively associated with perceived recovery at one year (Odds ratio [OR] 0.32, 95% Confidence Interval 0.18–0.56, P<0.001). Sciatica patients with disabling back pain in absence of nerve root compression on MRI at baseline reported less perceived recovery at one year compared to those with predominantly sciatica and nerve root compression on MRI (50% vs 91%, P<0.001). Conclusion Sciatica patients with disabling low back pain reported an unfavorable outcome at one-year follow-up compared to those with predominantly sciatica. If additionally a clear herniated disc with nerve root compression on MRI was absent, the results were even worse. PMID:24637890

Absence of back disorders in adults and work-related predictive factors in a 5-year perspective.

PubMed

Reigo, T; Tropp, H; Timpka, T

2001-06-01

Factors important for avoiding back disorders in different age-groups have seldom been compared and studied over time. We therefore set out to study age-related differences in socio-economic and work-related factors associated with the absence of back disorders in a 5-year comparative cohort study using a mailed questionnaire. Two subgroups (aged 25-34 and 54-59 years) derived from a representative sample of the Swedish population were followed at baseline, 1 year and 5 years. Questions were asked about the duration of back pain episodes, relapses, work changes and work satisfaction. A work adaptability, partnership, growth, affection, resolve (APGAR) score was included in the final questionnaire. Multivariate logistic regression was used to identify factors predicting the absence of back disorders. Absence of physically heavy work predicted an absence of back disorders [odds ratio (OR), 2.86; 95% confidence interval (CI), 1.3-6.3] in the older group. In the younger age-group, the absence of stressful work predicted absence of back disorders (OR, 2.0; 95% CI, 1.1-3.6). Thirty-seven per cent of the younger age-group and 43% of the older age-group did not experience any back pain episodes during the study period. The exploratory work APGAR scores indicated that back disorders were only associated with lower work satisfaction in the older group. The analyses point out the importance of avoiding perceived psychological stress in the young and avoiding perceived physically heavy work in the older age-group for avoiding back disorders. The results suggest a need for different programmes at workplaces to avoid back disorders depending on the age of the employees concerned.

Comparison of the BackJoy SitSmart Relief and Spine Buddy LT1 H/C Ergonomic Chair Supports on Short-Term Neck and Back Pain.

PubMed

Ward, John; Coats, Jesse

2017-01-01

The purpose of this study was to perform a needs assessment to determine whether short-term use of BackJoy SitSmart Relief and Spine Buddy LT1 H/C chair supports influences neck, upper back, and lower back pain. Forty-eight college students (age, 27.5 ± 6.3 years; height, 1.72 ± 0.08 m; body mass, 78.7 ± 19.8 kg; time seated that day, 4.3 ± 2.8 hours; means ± SD) were recruited for this study. The Nordic Musculoskeletal Questionnaire was used to measure pain for the neck, upper back, and lower back regions. Subjects were randomized to sit in a stationary office chair for a single 12-minute period under 1 of 4 conditions: office chair only (control group), BackJoy SitSmart Relief and chair, freezer-cooled Spine Buddy LT1 H/C and chair, or microwave-heated Spine Buddy LT1 H/C and chair. Participants then completed a posttest Nordic Musculoskeletal Questionnaire. A between-within repeated-measures analysis of variance using the between-subject factor intervention (group) and within-subject factor time (baseline and posttest) was used to analyze study data. The main effect of time across the whole sample was statistically significant for neck (P = .000), upper back (P = .032), and lower back (P = .000) pain; however, there was no statistically significant interaction effect between intervention and time. Thus, as long as participants sat down and rested, symptoms improved similarly across the different groups. In this preliminary study, short-term and single use of a support product for an office chair had no additive effect on reducing neck and back pain. Copyright © 2016. Published by Elsevier Inc.

Long-term effectiveness of a back education programme in elementary schoolchildren: an 8-year follow-up study.

PubMed

Dolphens, Mieke; Cagnie, Barbara; Danneels, Lieven; De Clercq, Dirk; De Bourdeaudhuij, Ilse; Cardon, Greet

2011-12-01

The purpose of this study was to investigate the long-term effectiveness of a spine care education programme conducted in 9- to 11-year-old schoolchildren. The study sample included 96 intervention subjects and 98 controls (9- to 11-year-olds at baseline). Intervention consisted of a 6-week school-based back education programme (predominantly biomechanically oriented) and was implemented by a physical therapist. Self-reported outcomes on back care knowledge, spinal care behaviour, self-efficacy towards favourable back care behaviour, prevalence of back and neck pain during the week and fear-avoidance beliefs were evaluated by the use of questionnaires. Post-tests were performed within 1 week after programme completion, after 1 year and after 8 years. Whereas the educational back care programme resulted in increased back care knowledge up to adulthood (P < 0.001), intervention did not change spinal care behaviour or self-efficacy. Pain prevalence figures increased less in the experimental group compared to the controls over the 8-year time span, yet statistical significance was not reached. Dropout analysis revealed spinal pain prevalence rates to be different in both groups throughout the study, including at baseline. Back education at young age did not reinforce fear-avoidance beliefs up to adulthood. Predominantly biomechanical oriented back education in elementary schoolchildren is effective in improving the cognitive aspect of back care up to adulthood, yet not in changing actual behaviour or self-efficacy. The current study does not provide evidence that educational back care programmes have any impact on spinal pain in adulthood. The true long-term impact of school-based spinal health interventions on clinically relevant outcome measures merits further attention.

Diverse alternative back-splicing and alternative splicing landscape of circular RNAs

PubMed Central

Zhang, Xiao-Ou; Dong, Rui; Zhang, Yang; Zhang, Jia-Lin; Luo, Zheng; Zhang, Jun; Chen, Ling-Ling; Yang, Li

2016-01-01

Circular RNAs (circRNAs) derived from back-spliced exons have been widely identified as being co-expressed with their linear counterparts. A single gene locus can produce multiple circRNAs through alternative back-splice site selection and/or alternative splice site selection; however, a detailed map of alternative back-splicing/splicing in circRNAs is lacking. Here, with the upgraded CIRCexplorer2 pipeline, we systematically annotated different types of alternative back-splicing and alternative splicing events in circRNAs from various cell lines. Compared with their linear cognate RNAs, circRNAs exhibited distinct patterns of alternative back-splicing and alternative splicing. Alternative back-splice site selection was correlated with the competition of putative RNA pairs across introns that bracket alternative back-splice sites. In addition, all four basic types of alternative splicing that have been identified in the (linear) mRNA process were found within circRNAs, and many exons were predominantly spliced in circRNAs. Unexpectedly, thousands of previously unannotated exons were detected in circRNAs from the examined cell lines. Although these novel exons had similar splice site strength, they were much less conserved than known exons in sequences. Finally, both alternative back-splicing and circRNA-predominant alternative splicing were highly diverse among the examined cell lines. All of the identified alternative back-splicing and alternative splicing in circRNAs are available in the CIRCpedia database (http://www.picb.ac.cn/rnomics/circpedia). Collectively, the annotation of alternative back-splicing and alternative splicing in circRNAs provides a valuable resource for depicting the complexity of circRNA biogenesis and for studying the potential functions of circRNAs in different cells. PMID:27365365

Low-Dose Tramadol and Non-Steroidal Anti-Inflammatory Drug Combination Therapy Prevents the Transition to Chronic Low Back Pain.

PubMed

Inage, Kazuhide; Orita, Sumihisa; Yamauchi, Kazuyo; Suzuki, Takane; Suzuki, Miyako; Sakuma, Yoshihiro; Kubota, Go; Oikawa, Yasuhiro; Sainoh, Takeshi; Sato, Jun; Fujimoto, Kazuki; Shiga, Yasuhiro; Abe, Koki; Kanamoto, Hirohito; Inoue, Masahiro; Kinoshita, Hideyuki; Takahashi, Kazuhisa; Ohtori, Seiji

2016-08-01

Retrospective study. To determine whether low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy could prevent the transition of acute low back pain to chronic low back pain. Inadequately treated early low back pain transitions to chronic low back pain occur in approximately 30% of affected individuals. The administration of non-steroidal anti-inflammatory drugs is effective for treatment of low back pain in the early stages. However, the treatment of low back pain that is resistant to non-steroidal anti-inflammatory drugs is challenging. Patients who presented with acute low back pain at our hospital were considered for inclusion in this study. After the diagnosis of acute low back pain, non-steroidal anti-inflammatory drug administration was started. Forty patients with a visual analog scale score of >5 for low back pain 1 month after treatment were finally enrolled. The first 20 patients were included in a non-steroidal anti-inflammatory drug group, and they continued non-steroidal anti-inflammatory drug therapy for 1 month. The next 20 patients were included in a combination group, and they received low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy for 1 month. The incidence of adverse events and the improvement in the visual analog scale score at 2 months after the start of treatment were analyzed. No adverse events were observed in the non-steroidal anti-inflammatory drug group. In the combination group, administration was discontinued in 2 patients (10%) due to adverse events immediately following the start of tramadol administration. At 2 months, the improvement in the visual analog scale score was greater in the combination group than in the non-steroidal anti-inflammatory drug group (p<0.001). Low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy might decrease the incidence of adverse events and prevent the transition of acute low back pain to chronic low back pain.

Predictive risk factors for chronic low back pain in Parkinson's disease.

PubMed

Ozturk, Erhan Arif; Kocer, Bilge Gonenli

2018-01-01

Although previous studies have reported that the prevalence of low back pain in Parkinson's disease was over 50% and low back pain was often classified as chronic, risk factors of chronic low back pain have not been previously investigated. The aim of this study was to determine the predictive risk factors of chronic low back pain in Parkinson's disease. One hundred and sixty-eight patients with Parkinson's disease and 179 controls were consecutively included in the study. Demographic data of the two groups and disease characteristics of Parkinson's disease patient group were recorded. Low back pain lasting for ≥3 months was evaluated as chronic. Firstly, the bivariate correlations were calculated between chronic low back pain and all possible risk factors. Then, a multivariate regression was used to evaluate the impact of the predictors of chronic low back pain. The frequency of chronic low back pain in Parkinson's disease patients and controls were 48.2% and 26.7%, respectively (p < 0.001). The predictive risk factors of chronic low back pain in Parkinson's disease were general factors including age (odds ratio = 1.053, p = 0.032) and Hospital Anxiety and Depression Scale - Depression subscore (odds ratio = 1.218, p = 0.001), and Parkinson's disease-related factors including rigidity (odds ratio = 5.109, p = 0.002) and posture item scores (odds ratio = 5.019, p = 0.0001). The chronic low back pain affects approximately half of the patients with Parkinson's disease. Prevention of depression or treatment recommendations for managing depression, close monitoring of anti- parkinsonian medication to keep motor symptoms under control, and attempts to prevent, correct or reduce abnormal posture may help reduce the frequency of chronic low back pain in Parkinson's disease. Copyright © 2017 Elsevier B.V. All rights reserved.

The development and exploratory analysis of the Back Pain Attitudes Questionnaire (Back-PAQ)

PubMed Central

Darlow, Ben; Perry, Meredith; Mathieson, Fiona; Stanley, James; Melloh, Markus; Marsh, Reginald; Baxter, G David; Dowell, Anthony

2014-01-01

Objectives To develop an instrument to assess attitudes and underlying beliefs about back pain, and subsequently investigate its internal consistency and underlying structures. Design The instrument was developed by a multidisciplinary team of clinicians and researchers based on analysis of qualitative interviews with people experiencing acute and chronic back pain. Exploratory analysis was conducted using data from a population-based cross-sectional survey. Setting Qualitative interviews with community-based participants and subsequent postal survey. Participants Instrument development informed by interviews with 12 participants with acute back pain and 11 participants with chronic back pain. Data for exploratory analysis collected from New Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. 602 valid responses were received. Measures The 34-item Back Pain Attitudes Questionnaire (Back-PAQ) was developed. Internal consistency was evaluated by the Cronbach α coefficient. Exploratory analysis investigated the structure of the data using Principal Component Analysis. Results The 34-item long form of the scale had acceptable internal consistency (α=0.70; 95% CI 0.66 to 0.73). Exploratory analysis identified five two-item principal components which accounted for 74% of the variance in the reduced data set: ‘vulnerability of the back’; ‘relationship between back pain and injury’; ‘activity participation while experiencing back pain’; ‘prognosis of back pain’ and ‘psychological influences on recovery’. Internal consistency was acceptable for the reduced 10-item scale (α=0.61; 95% CI 0.56 to 0.66) and the identified components (α between 0.50 and 0.78). Conclusions The 34-item long form of the scale may be appropriate for use in future cross-sectional studies. The 10-item short form may be appropriate for use as a screening tool, or an outcome assessment instrument. Further testing of the 10-item Back-PAQ's construct validity, reliability, responsiveness to change and predictive ability needs to be conducted. PMID:24860003

Osteopathic Manual Treatment and Ultrasound Therapy for Chronic Low Back Pain: A Randomized Controlled Trial

PubMed Central

Licciardone, John C.; Minotti, Dennis E.; Gatchel, Robert J.; Kearns, Cathleen M.; Singh, Karan P.

2013-01-01

PURPOSE We studied the efficacy of osteopathic manual treatment (OMT) and ultrasound therapy (UST) for chronic low back pain. METHODS A randomized, double-blind, sham-controlled, 2 × 2 factorial design was used to study OMT and UST for short-term relief of nonspecific chronic low back pain. The 455 patients were randomized to OMT (n = 230) or sham OMT (n = 225) main effects groups, and to UST (n = 233) or sham UST (n = 222) main effects groups. Six treatment sessions were provided over 8 weeks. Intention-to-treat analysis was performed to measure moderate and substantial improvements in low back pain at week 12 (30% or greater and 50% or greater pain reductions from baseline, respectively). Five secondary outcomes, safety, and treatment adherence were also assessed. RESULTS There was no statistical interaction between OMT and UST. Patients receiving OMT were more likely than patients receiving sham OMT to achieve moderate (response ratio [RR] = 1.38; 95% CI, 1.16-1.64; P <.001) and substantial (RR = 1.41, 95% CI, 1.13-1.76; P = .002) improvements in low back pain at week 12. These improvements met the Cochrane Back Review Group criterion for a medium effect size. Back-specific functioning, general health, work disability specific to low back pain, safety outcomes, and treatment adherence did not differ between patients receiving OMT and sham OMT. Nevertheless, patients in the OMT group were more likely to be very satisfied with their back care throughout the study (P <.001). Patients receiving OMT used prescription drugs for low back pain less frequently during the 12 weeks than did patients in the sham OMT group (use ratio = 0.66, 95% CI, 0.43-1.00; P = .048). Ultrasound therapy was not efficacious. CONCLUSIONS The OMT regimen met or exceeded the Cochrane Back Review Group criterion for a medium effect size in relieving chronic low back pain. It was safe, parsimonious, and well accepted by patients. PMID:23508598

Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial.

PubMed

Licciardone, John C; Minotti, Dennis E; Gatchel, Robert J; Kearns, Cathleen M; Singh, Karan P

2013-01-01

We studied the efficacy of osteopathic manual treatment (OMT) and ultrasound therapy (UST) for chronic low back pain. A randomized, double-blind, sham-controlled, 2 × 2 factorial design was used to study OMT and UST for short-term relief of nonspecific chronic low back pain. The 455 patients were randomized to OMT (n = 230) or sham OMT (n = 225) main effects groups, and to UST (n = 233) or sham UST (n = 222) main effects groups. Six treatment sessions were provided over 8 weeks. Intention-to-treat analysis was performed to measure moderate and substantial improvements in low back pain at week 12 (30% or greater and 50% or greater pain reductions from baseline, respectively). Five secondary outcomes, safety, and treatment adherence were also assessed. There was no statistical interaction between OMT and UST. Patients receiving OMT were more likely than patients receiving sham OMT to achieve moderate (response ratio [RR] = 1.38; 95% CI, 1.16-1.64; P <.001) and substantial (RR = 1.41, 95% CI, 1.13-1.76; P = .002) improvements in low back pain at week 12. These improvements met the Cochrane Back Review Group criterion for a medium effect size. Back-specific functioning, general health, work disability specific to low back pain, safety outcomes, and treatment adherence did not differ between patients receiving OMT and sham OMT. Nevertheless, patients in the OMT group were more likely to be very satisfied with their back care throughout the study (P <.001). Patients receiving OMT used prescription drugs for low back pain less frequently during the 12 weeks than did patients in the sham OMT group (use ratio = 0.66, 95% CI, 0.43-1.00; P = .048). Ultrasound therapy was not efficacious. The OMT regimen met or exceeded the Cochrane Back Review Group criterion for a medium effect size in relieving chronic low back pain. It was safe, parsimonious, and well accepted by patients.

The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women - A randomised controlled trial.

PubMed

Backhausen, Mette G; Tabor, Ann; Albert, Hanne; Rosthøj, Susanne; Damm, Peter; Hegaard, Hanne K

2017-01-01

Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise-either land or water based-has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16-17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32 weeks. The secondary outcomes were self-reported days spent on sick leave, disability due to low back pain (Roland Morris Disability Questionnaire) and self-rated general health (EQ-5D and EQ-VAS). Low back pain intensity was significantly lower in the water exercise group, with a score of 2.01 (95% CI 1.75-2.26) vs. 2.38 in the control group (95% CI 2.12-2.64) (mean difference = 0.38, 95% CI 0.02-0.74 p = 0.04). No difference was found in the number of days spent on sick leave (median 4 vs. 4, p = 0.83), disability due to low back pain nor self-rated general health. There was a trend towards more women in the water exercise group reporting no low back pain at 32 weeks (21% vs. 14%, p = 0.07). Unsupervised water exercise results in a statistically significant lower intensity of low back pain in healthy pregnant women, but the result was most likely not clinically significant. It did not affect the number of days on sick leave, disability due to low back pain nor self-rated health. ClinicalTrials.gov NCT02354430.

The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women – A randomised controlled trial

PubMed Central

Tabor, Ann; Albert, Hanne; Rosthøj, Susanne; Damm, Peter; Hegaard, Hanne K.

2017-01-01

Background Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise–either land or water based–has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. Methods In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16–17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32 weeks. The secondary outcomes were self-reported days spent on sick leave, disability due to low back pain (Roland Morris Disability Questionnaire) and self-rated general health (EQ-5D and EQ-VAS). Results Low back pain intensity was significantly lower in the water exercise group, with a score of 2.01 (95% CI 1.75–2.26) vs. 2.38 in the control group (95% CI 2.12–2.64) (mean difference = 0.38, 95% CI 0.02–0.74 p = 0.04). No difference was found in the number of days spent on sick leave (median 4 vs. 4, p = 0.83), disability due to low back pain nor self-rated general health. There was a trend towards more women in the water exercise group reporting no low back pain at 32 weeks (21% vs. 14%, p = 0.07). Conclusions Unsupervised water exercise results in a statistically significant lower intensity of low back pain in healthy pregnant women, but the result was most likely not clinically significant. It did not affect the number of days on sick leave, disability due to low back pain nor self-rated health. Trial registration ClinicalTrials.gov NCT02354430 PMID:28877165

An epidemiologic analysis of low back pain in primary care: a hot humid country and global comparison.

PubMed

Bener, Abdulbari; Dafeeah, Elnour E; Alnaqbi, Khalid; Falah, Omar; Aljuhaisi, Taha; Sadeeq, Alhassan; Khan, Shehryar; Schlogl, Josia

2013-07-01

Low back pain is one of the most common conditions for which patients seek medical care. The aim of the study was to study the epidemiology of low back pain in primary care setting with emphasis on frequency, sociodemographic factors, and impact of low back pain on lifestyle habits. This is a cross-sectional study. A representative sample of 2742 patients was approached and 2180 subjects agreed to participate in this study (79.5%). The survey was conducted among primary health care visitors during the period from March to October 2012. The questionnaire collected the sociodemographic characteristics, lifestyle habits, and type of treatment taken for relief from recruited subjects. Of the subjects studied, 52.9% were males and 47.1% were females. The prevalence of low back pain in the study sample was 59.2%. Low back pain was more prevalent among women (67.7%) than among men (51.6%). The proportion of low back pain was highest in the age-group 45 to 55 years in both the genders (37.6% and 36.4%, respectively). Nearly half of the men (45.7%) and women (45.2%) with low back pain were overweight with a significant difference (P < .001). More than half of the women with low back pain were housewives (50.4%), whereas most of the men had clerical jobs (36.8%). There was a significant difference observed between men and women in terms of nationality (P < .001), body mass index (P < .001), and occupation (P < .001). Prolonged standing (41.2% vs 29.5%; P < .001) and use of sponge mattress (50.9% vs 45.8%; P .041) was significantly higher among male patients with low back pain compared with females. Coughing/sneezing/straining (9.7% vs 5.9%; P = .01) were more frequent triggering factors in male patients with low back pain as compared with females. The study findings revealed that the prevalence of low back pain was higher among women than among men. Low back pain was observed more frequently among older people and among those who were overweight.

The role of obesity and physical activity in non-specific and radiating low back pain: the Young Finns study.

PubMed

Shiri, Rahman; Solovieva, Svetlana; Husgafvel-Pursiainen, Kirsti; Telama, Risto; Yang, Xiaolin; Viikari, Jorma; Raitakari, Olli T; Viikari-Juntura, Eira

2013-06-01

To study the effects of obesity, physical activity, and change in physical activity on the incidence of low back pain and explore whether obesity modifies the effects of physical activity. As part of the ongoing Young Finns Study, 1224 subjects aged 24-39 years free from low back pain during the preceding 12 months at baseline in 2001 were included. Obesity was defined based on the body mass index (BMI) and waist circumference, and physical activity was assessed by the metabolic equivalent of task (MET) index in 2001 and 2007. Abdominal obesity, defined by an increased waist circumference, was associated with an increased incidence of radiating low back pain (adjusted odds ratio (OR) = 1.7 and 95% confidence interval (CI) 1.1-2.7), while it had no effect on non-specific low back pain. BMI was associated neither with the incidence of radiating low back pain nor with non-specific low back pain. Compared with subjects who stayed active during follow-up, those with a low level of physical activity (adjusted OR = 2.0 and 95% CI 1.1-3.5) and active subjects who further increased their physical activity during follow-up (OR = 3.1 and 95% CI 1.5-6.7) had a higher incidence of radiating low back pain. Low level of physical activity was associated with an increased incidence of radiating low back pain in obese (OR = 3.3 and 95% 1.1-10.4), but not in non-overweight subjects (OR = 1.1 and 95% CI 0.6-1.9). Physical activity was not associated with non-specific low back pain. Our findings indicate that both obesity and low level of physical activity are independent risk factors of radiating low back pain. The current findings propose a U-shaped relation between physical activity and radiating low back pain. Moderate level of physical activity is recommended for the prevention of low back pain, especially in obese individuals. In all, our findings imply that obese individuals should stay physically active, even if they may not lose weight. Copyright © 2013 Elsevier Inc. All rights reserved.

People with low back pain perceive needs for non-biomedical services in workplace, financial, social and household domains: a systematic review.

PubMed

Chou, Louisa; Cicuttini, Flavia M; Urquhart, Donna M; Anthony, Shane N; Sullivan, Kaye; Seneviwickrama, Maheeka; Briggs, Andrew M; Wluka, Anita E

2018-04-01

What needs of non-biomedical services are perceived by people with low back pain? Systematic review of qualitative and quantitative studies examining perceived needs of non-biomedical services for low back pain, identified through searching of MEDLINE, EMBASE, CINAHL and PsycINFO (1990 to 2016). Adults with low back pain of any duration. Descriptive data regarding study design and methodology were extracted. The preferences, expectations and satisfaction with non-biomedical services reported by people with low back pain were identified and categorised within areas of perceived need. Twenty studies (19 qualitative and one quantitative) involving 522 unique participants (total pool of 590) were included in this systematic review. Four areas emerged. Workplace: people with low back pain experience pressure to return to work despite difficulties with the demands of their occupation. They want their employers to be informed about low back pain and they desire workplace accommodations. Financial: people with low back pain want financial support, but have concerns about the inefficiencies of compensation systems and the stigma associated with financial remuneration. Social: people with low back pain report feeling disconnected from social networks and want back-specific social support. Household: people with low back pain report difficulties with household duties; however, there are few data regarding their need for auxiliary devices and domestic help. People with low back pain identified work place, financial and social pressures, and difficulties with household duties as areas of need beyond their healthcare requirements that affect their ability to comply with management of their condition. Consideration of such needs may inform physiotherapists, the wider health system, social networks and the workplace to provide more relevant and effective services. [Chou L, Cicuttini FM, Urquhart DM, Anthony SN, Sullivan K, Seneviwickrama M, Briggs AM, Wluka AE (2018) People with low back pain perceive needs for non-biomedical services in workplace, financial, social and household domains: a systematic review. Journal of Physiotherapy 64: 74-83]. Copyright © 2018 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

The development and exploratory analysis of the Back Pain Attitudes Questionnaire (Back-PAQ).

PubMed

Darlow, Ben; Perry, Meredith; Mathieson, Fiona; Stanley, James; Melloh, Markus; Marsh, Reginald; Baxter, G David; Dowell, Anthony

2014-05-23

To develop an instrument to assess attitudes and underlying beliefs about back pain, and subsequently investigate its internal consistency and underlying structures. The instrument was developed by a multidisciplinary team of clinicians and researchers based on analysis of qualitative interviews with people experiencing acute and chronic back pain. Exploratory analysis was conducted using data from a population-based cross-sectional survey. Qualitative interviews with community-based participants and subsequent postal survey. Instrument development informed by interviews with 12 participants with acute back pain and 11 participants with chronic back pain. Data for exploratory analysis collected from New Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. 602 valid responses were received. The 34-item Back Pain Attitudes Questionnaire (Back-PAQ) was developed. Internal consistency was evaluated by the Cronbach α coefficient. Exploratory analysis investigated the structure of the data using Principal Component Analysis. The 34-item long form of the scale had acceptable internal consistency (α=0.70; 95% CI 0.66 to 0.73). Exploratory analysis identified five two-item principal components which accounted for 74% of the variance in the reduced data set: 'vulnerability of the back'; 'relationship between back pain and injury'; 'activity participation while experiencing back pain'; 'prognosis of back pain' and 'psychological influences on recovery'. Internal consistency was acceptable for the reduced 10-item scale (α=0.61; 95% CI 0.56 to 0.66) and the identified components (α between 0.50 and 0.78). The 34-item long form of the scale may be appropriate for use in future cross-sectional studies. The 10-item short form may be appropriate for use as a screening tool, or an outcome assessment instrument. Further testing of the 10-item Back-PAQ's construct validity, reliability, responsiveness to change and predictive ability needs to be conducted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey

PubMed Central

Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

2017-01-01

Objectives The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors and to identify worker groups with an increased vulnerability for low back pain in the US. Methods The data used for this study came from the 2010 National Health Interview Survey (NHIS), which was designed to collect data on health conditions and related risk factors obtained from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% Confidence Interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment and job insecurity. Work hours, occupation and other work organizational factors (non-standard work arrangements and alternative shifts) were also examined. Results The prevalence rate of self-reported low back pain in previous three months among workers in the U.S. was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15–1.41), exposure to hostile work (OR 1.39, CI 1.25–1.55), and job insecurity (OR 1.44, CI 1.24–1.67), while controlling for demographic characteristics and other health related factors. Older workers who had non-standard work arrangements were more likely to report low back pain. Females who worked 41–45 hours per week and younger workers who worked over 60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including, male healthcare practitioners, female and younger healthcare support workers, and female farming, fishing and forestry workers had an increased risk of low back pain. Conclusions This study linked low back pain to work-family imbalance, exposure to a hostile work environment, job insecurity, long work hours and certain occupation groups. These factors should be considered by employers, policy makers, and healthcare practitioners who are concerned about the impact of low back pain in workers. PMID:27568831

2001 Volvo Award Winner in Clinical Studies: Effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice.

PubMed

Buchbinder, R; Jolley, D; Wyatt, M

2001-12-01

Quasi-experimental, nonrandomized, nonequivalent, parallel group-controlled study involving before and after telephone surveys of the general population and postal surveys of general practitioners was conducted, with an adjacent state used as a control group. To evaluate the effectiveness of a population-based intervention designed to alter beliefs about back pain, influence medical management, and reduce disability and workers' compensation-related costs. A multimedia campaign begun during 1997 in Victoria, Australia, positively advised patients with back pain to stay active and exercise, not to rest for prolonged periods, and to remain at work. The campaign's impact on population beliefs about back pain and fear-avoidance beliefs was measured in telephone surveys, and the effect of the campaign on the potential management of low back pain by general practitioners was assessed by eliciting their likely approach to two hypothetical scenarios in mailed surveys. Demographically identical population groups in Victoria and the control state, New South Wales, were surveyed at three times: before, during, and after intervention in Victoria. The studies were completed by 4730 individuals in the general population and 2556 general practitioners. There were large statistically significant improvements in back pain beliefs over time in Victoria (mean scores on the Back Beliefs Questionnaire, 26.5, 28.4, and 29.7), but not in New South Wales (26.3, 26.2, and 26.3, respectively). Among those who reported back pain during the previous year, fear-avoidance beliefs about physical activity improved significantly in Victoria (mean scores on the Fear-Avoidance Beliefs Questionnaire for physical activity, 14, 12.5, and 11.6), but not in New South Wales (13.3, 13.6, and 12.7, respectively). General practitioners in Victoria reported significant improvements over time in beliefs about back pain management, as compared with their interstate colleagues. There were statistically significant interactions between state and time for 7 of 10 responses on management of acute low back pain, and for 6 of 10 responses on management of subacute low back pain. A population-based strategy of providing positive messages about back pain improves the beliefs of the general population and general practitioners about back pain and appears to influence medical management.

Subcutaneous stimulation as an additional therapy to spinal cord stimulation for the treatment of lower limb pain and/or back pain: a feasibility study.

PubMed

Hamm-Faber, Tanja E; Aukes, Hans A; de Loos, Frank; Gültuna, Ismail

2012-01-01

The objective of this study was to demonstrate the efficacy of subcutaneous stimulation (SubQ) as an additional therapy in patients with failed back surgery syndrome (FBSS) with chronic refractory pain, for whom spinal cord stimulation (SCS) was unsuccessful in treating low back pain. Case series. FBSS patients with chronic limb and/or low back pain whose conventional therapies had failed received a combination of SCS (8-contact Octad lead) and/or SubQ (4-contact Quad Plus lead(s)). Initially leads were placed in the epidural space for SCS for a trial stimulation to assess response to suppression of limb and low back pain. Where SCS alone was insufficient in treating lower back pain, leads were placed superficially in the subcutaneous tissue of the lower back, directly in the middle of the pain area. A pulse generator was implanted if patients reported more than 50% pain relief during the trial period. Pain intensity for limb and lower back pain was scored separately, using visual analog scale (VAS). Pain and Quebec Back Pain Disability Scale (QBPDS) after 12-month treatment were compared with pain and QBPDS at baseline. Eleven FBSS patients, five male and six female (age: 51 ± 8 years; mean ± SD), in whom SCS alone was insufficient in treating lower back pain, were included. In nine cases, SubQ was used in combination with SCS to treat chronic lower back and lower extremity pain. In two cases only SubQ was used to treat lower back pain. SCS significantly reduced limb pain after 12 months (VAS(bl) : 62 ± 14 vs. VAS(12m) : 20 ± 11; p= 0.001, N= 8). SubQ stimulation significantly reduced low back pain after 12 months (VAS(bl) : 62 ± 13.0 vs. VAS(12m) : 32 ± 16; p= 0.0002, N= 10). Overall pain medication was reduced by more than 70%. QBPDS improved from 61 ± 15 to 49 ± 12 (p= 0.046, N= 10). Furthermore, we observed that two patients returned to work. SubQ may be an effective additional treatment for chronic low back pain in patients with FBSS for whom SCS alone is insufficient in alleviating their pain symptoms. © 2011 International Neuromodulation Society.

Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey.

PubMed

Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

2016-09-01

The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors, and to identify worker groups with an increased vulnerability for low back pain in the United States. The data used for this cross-sectional study came from the 2010 National Health Interview Survey, which was designed to collect data on health conditions and related risk factors from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% confidence interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment, and job insecurity. Work hours, occupation, and other work organizational factors (nonstandard work arrangements and alternative shifts) were also examined. The prevalence of self-reported low back pain in the previous 3 months among workers in the United States was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15-1.41), exposure to hostile work (OR 1.39, CI 1.25-1.55), and job insecurity (OR 1.44, CI 1.24-1.67), while controlling for demographic characteristics and other health-related factors. Older workers who had nonstandard work arrangements were more likely to report low back pain. Women who worked 41 to 45 hours per week and younger workers who worked >60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including male health care practitioners, female and younger health care support workers, and female farming, fishing, and forestry workers, had an increased risk of low back pain. This study linked low back pain to work-family imbalance, exposure to a hostile work environment, job insecurity, long work hours, and certain occupation groups. These factors should be considered by employers, policymakers, and health care practitioners who are concerned about the impact of low back pain in workers. Copyright © 2016. Published by Elsevier Inc.

Epidural injections for back pain

MedlinePlus

... Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. ...

Density and abundance of black-backed woodpeckers in a Ponderosa pine ecosystem

Treesearch

Sean R. Mohren; Mark A. Rumble; Stanley H. Anderson

2014-01-01

Black-backed woodpeckers (Picoides arcticus) are usually associated with forest disturbance resulting in recently killed trees. While black-backed woodpeckers are attracted to areas affected by these disturbances, in the Black Hills they exist during interim disturbance periods in largely undisturbed forests. In 2012, a petition for listing black-backed woodpeckers in...

17 CFR 240.13a-18 - Compliance with servicing criteria for asset-backed securities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... include from each party participating in the servicing function a report regarding its assessment of... function and that are backed by the same asset type backing the class of asset-backed securities (including... section, the annual report on Form 10-K must also include a report by a registered public accounting firm...

Teachers' Perspectives on Hitting Back in School: Between Inexcusable Violence and Self-Defense

ERIC Educational Resources Information Center

Fleischmann, Amos

2015-01-01

Israeli schools expressly forbid a student to hit back after being attacked. In semistructured interviews, 71 Israeli educators were asked for their views on the hitting-back tactic. The interviews compared their attitude toward hitting back as teachers with their take on the matter as parents. The results, analyzed using grounded theory, show…

Analysis of the interaction of an electron beam with back surface field solar cells

NASA Technical Reports Server (NTRS)

Von Roos, O.; Luke, K. L.

1983-01-01

In this paper the short circuit current Isc induced by the electron beam of a scanning electron microscope in a back surface field solar cell will be determined theoretically. It will be shown that, in a configuration used previously for solar cells with an ohmic back surface, the Isc gives a convenient means for estimating the back surface recombination velocities and thus the quality of back surface field cells. Numerical data will be presented applicable to a point source model for the electron-hole pair generation.

Fluorinated tin oxide back contact for AZTSSe photovoltaic devices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gershon, Talia S.; Gunawan, Oki; Haight, Richard A.

A photovoltaic device includes a substrate, a back contact comprising a stable low-work function material, a photovoltaic absorber material layer comprising Ag.sub.2ZnSn(S,Se).sub.4 (AZTSSe) on a side of the back contact opposite the substrate, wherein the back contact forms an Ohmic contact with the photovoltaic absorber material layer, a buffer layer or Schottky contact layer on a side of the absorber layer opposite the back contact, and a top electrode on a side of the buffer layer opposite the absorber layer.

Understanding the Probability of a Disability Resulting from Work-Related Injuries

DTIC Science & Technology

2015-07-15

Injury Sprain 162,819 20.3 12.2* 10.5* 4.0* 3.9* Wound 149,826 18.7 4.2* 6.2* 1.8* 2.6* Back 101,440 12.7 10.6 11.5* 5.4* 5.2* Pain 61,125 7.6...if the nature of the injury is back sprain/strain, back pain , subluxation or back sprain/strain, back pain , or subluxation or invertebratal disc...factors across worker groups. Keywords: work-related injury; disability; lost productivity; work absence; return to work; Federal Employees

Passive Fetal Heart Monitoring System

NASA Technical Reports Server (NTRS)

Bryant, Timothy D. (Inventor); Wynkoop, Mark W. (Inventor); Holloway, Nancy M. H. (Inventor); Zuckerwar, Allan J. (Inventor)

2004-01-01

A fetal heart monitoring system preferably comprising a backing plate having a generally concave front surface and a generally convex back surface, and at least one sensor element attached to the concave front surface for acquiring acoustic fetal heart signals produced by a fetus within a body. The sensor element has a shape that conforms to the generally concave back surface of the backing plate. In one embodiment, the at least one sensor element comprises an inner sensor, and a plurality of outer sensors surrounding the inner sensor. The fetal heart monitoring system can further comprise a web belt, and a web belt guide movably attached to the web belt. The web belt guide being is to the convex back surface of the backing plate.

Disappearance of back-to-back high-pT hadron correlations in central Au+Au collisions at sqrt[s NN ] =200 GeV.

PubMed

Adler, C; Ahammed, Z; Allgower, C; Amonett, J; Anderson, B D; Anderson, M; Averichev, G S; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Boucham, A; Brandin, A; Bravar, A; Cadman, R V; Caines, H; Calderón de la Barca Sánchez, M; Cardenas, A; Carroll, J; Castillo, J; Castro, M; Cebra, D; Chaloupka, P; Chattopadhyay, S; Chen, Y; Chernenko, S P; Cherney, M; Chikanian, A; Choi, B; Christie, W; Coffin, J P; Cormier, T M; Corral, M M; Cramer, J G; Crawford, H J; Derevschikov, A A; Didenko, L; Dietel, T; Draper, J E; Dunin, V B; Dunlop, J C; Eckardt, V; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Fachini, P; Faine, V; Faivre, J; Fatemi, R; Filimonov, K; Finch, E; Fisyak, Y; Flierl, D; Foley, K J; Fu, J; Gagliardi, C A; Gagunashvili, N; Gans, J; Gaudichet, L; Germain, M; Geurts, F; Ghazikhanian, V; Grachov, O; Grigoriev, V; Guedon, M; Gushin, E; Hallman, T J; Hardtke, D; Harris, J W; Henry, T W; Heppelmann, S; Herston, T; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Horsley, M; Huang, H Z; Humanic, T J; Igo, G; Ishihara, A; Ivanshin, Yu I; Jacobs, P; Jacobs, W W; Janik, M; Johnson, I; Jones, P G; Judd, E G; Kaneta, M; Kaplan, M; Keane, D; Kiryluk, J; Kisiel, A; Klay, J; Klein, S R; Klyachko, A; Kollegger, T; Konstantinov, A S; Kopytine, M; Kotchenda, L; Kovalenko, A D; Kramer, M; Kravtsov, P; Krueger, K; Kuhn, C; Kulikov, A I; Kunde, G J; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lakehal-Ayat, L; Lamont, M A C; Landgraf, J M; Lange, S; Lansdell, C P; Lasiuk, B; Laue, F; Lauret, J; Lebedev, A; Lednický, R; Leontiev, V M; LeVine, M J; Li, Q; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Z; Liu, Q J; Ljubicic, T; Llope, W J; LoCurto, G; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Ludlam, T; Lynn, D; Ma, J; Magestro, D; Majka, R; Margetis, S; Markert, C; Martin, L; Marx, J; Matis, H S; Matulenko, Yu A; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Messer, M; Miller, M L; Milosevich, Z; Minaev, N G; Mitchell, J; Moore, C F; Morozov, V; de Moura, M M; Munhoz, M G; Nelson, J M; Nevski, P; Nikitin, V A; Nogach, L V; Norman, B; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Paic, G; Pandey, S U; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Perevoztchikov, V; Peryt, W; Petrov, V A; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potrebenikova, E; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Rykov, V; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schüttauf, A; Schweda, K; Seger, J; Seliverstov, D; Seyboth, P; Shahaliev, E; Shestermanov, K E; Shimanskii, S S; Simon, F; Skoro, G; Smirnov, N; Snellings, R; Sorensen, P; Sowinski, J; Spinka, H M; Srivastava, B; Stephenson, E J; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Struck, C; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Thein, D; Thomas, J H; Thompson, M; Tikhomirov, V; Tokarev, M; Tonjes, M B; Trainor, T A; Trentalange, S; Tribble, R E; Trofimov, V; Tsai, O; Ullrich, T; Underwood, D G; Van Buren, G; VanderMolen, A M; Vasilevski, I M; Vasiliev, A N; Vigdor, S E; Voloshin, S A; Wang, F; Ward, H; Watson, J W; Wells, R; Westfall, G D; Whitten, C; Wieman, H; Willson, R; Wissink, S W; Witt, R; Wood, J; Xu, N; Xu, Z; Yakutin, A E; Yamamoto, E; Yang, J; Yepes, P; Yurevich, V I; Zanevski, Y V; Zborovský, I; Zhang, H; Zhang, W M; Zoulkarneev, R; Zubarev, A N

2003-02-28

Azimuthal correlations for large transverse momentum charged hadrons have been measured over a wide pseudorapidity range and full azimuth in Au+Au and p+p collisions at sqrt[s(NN)]=200 GeV. The small-angle correlations observed in p+p collisions and at all centralities of Au+Au collisions are characteristic of hard-scattering processes previously observed in high-energy collisions. A strong back-to-back correlation exists for p+p and peripheral Au+Au. In contrast, the back-to-back correlations are reduced considerably in the most central Au+Au collisions, indicating substantial interaction as the hard-scattered partons or their fragmentation products traverse the medium.

Backing collisions: a study of drivers' eye and backing behaviour using combined rear-view camera and sensor systems.

PubMed

Hurwitz, David S; Pradhan, Anuj; Fisher, Donald L; Knodler, Michael A; Muttart, Jeffrey W; Menon, Rajiv; Meissner, Uwe

2010-04-01

Backing crash injures can be severe; approximately 200 of the 2,500 reported injuries of this type per year to children under the age of 15 years result in death. Technology for assisting drivers when backing has limited success in preventing backing crashes. Two questions are addressed: Why is the reduction in backing crashes moderate when rear-view cameras are deployed? Could rear-view cameras augment sensor systems? 46 drivers (36 experimental, 10 control) completed 16 parking trials over 2 days (eight trials per day). Experimental participants were provided with a sensor camera system, controls were not. Three crash scenarios were introduced. Parking facility at UMass Amherst, USA. 46 drivers (33 men, 13 women) average age 29 years, who were Massachusetts residents licensed within the USA for an average of 9.3 years. Interventions Vehicles equipped with a rear-view camera and sensor system-based parking aid. Subject's eye fixations while driving and researcher's observation of collision with objects during backing. Only 20% of drivers looked at the rear-view camera before backing, and 88% of those did not crash. Of those who did not look at the rear-view camera before backing, 46% looked after the sensor warned the driver. This study indicates that drivers not only attend to an audible warning, but will look at a rear-view camera if available. Evidence suggests that when used appropriately, rear-view cameras can mitigate the occurrence of backing crashes, particularly when paired with an appropriate sensor system.

Comparison of Low Back Pain Recovery and Persistence: A Descriptive Study of Characteristics at Pain Onset.

PubMed

Starkweather, Angela R; Lyon, Debra E; Kinser, Patricia; Heineman, Amy; Sturgill, Jamie L; Deng, Xiaoyan; Siangphoe, Umaporn; Elswick, R K; Greenspan, Joel; Dorsey, Susan G

2016-07-01

Persistent low back pain is a significant problem worldwide. Early identification and treatment of individuals at high risk for persistent low back pain have been suggested as strategies to decrease the rate of disability associated with this condition. To examine and compare demographic, pain-related, psychological, and somatosensory characteristics in a cohort of participants with acute low back pain who later went on to experience persistent low back pain or whose pain resolved within the first 6 weeks after initial onset. A descriptive study was conducted among men and women 18-50 years of age who had an acute episode of low back pain. Study questionnaires were administered to collect demographic information and measures of pain, coping, reactivity, mood, work history and satisfaction, and disability. A standardized protocol of quantitative sensory testing was performed on each participant at the painful area of their low back and at a remote site on their arm. The sample consisted of 48 participants, of whom 19 went on to develop persistent low back pain and 29 resolved. Compared to the resolved group, the persistent low back pain group was significantly older and had a lower level of educational attainment, a higher body mass index, and higher mean "least" pain score on the Brief Pain Inventory-Short Form. Significantly higher thermal detection thresholds at the painful and remote sites as well as signs of central sensitivity differentiated the persistent pain group from the resolved group during the acute stage of low back pain. © The Author(s) 2016.

Development and Validation of the Behavioral Avoidance Test-Back Pain (BAT-Back) for Patients With Chronic Low Back Pain.

PubMed

Holzapfel, Sebastian; Riecke, Jenny; Rief, Winfried; Schneider, Jessica; Glombiewski, Julia A

2016-11-01

Pain-related fear and avoidance of physical activities are central elements of the fear-avoidance model of musculoskeletal pain. Pain-related fear has typically been measured by self-report instruments. In this study, we developed and validated a Behavioral Avoidance Test (BAT) for chronic low back pain (CLBP) patients with the aim of assessing pain-related avoidance behavior by direct observation. The BAT-Back was administered to a group of CLBP patients (N=97) and pain-free controls (N=31). Furthermore, pain, pain-related fear, disability, catastrophizing, and avoidance behavior were measured using self-report instruments. Reliability was assessed with intraclass correlation coefficient and Cronbach α. Validity was assessed by examining correlation and regression analysis. The intraclass correlation coefficient for the BAT-Back avoidance score was r=0.76. Internal consistency was α=0.95. CLBP patients and controls differed significantly on BAT-Back avoidance scores as well as self-report measures. BAT-Back avoidance scores were significantly correlated with scores on each of the self-report measures (rs=0.27 to 0.54). They were not significantly correlated with general anxiety and depression, age, body mass index, and pain duration. The BAT-Back avoidance score was able to capture unique variance in disability after controlling for other variables (eg, pain intensity and pain-related fear). Results indicate that the BAT-Back is a reliable and valid measure of pain-related avoidance behavior. It may be useful for clinicians in tailoring treatments for chronic pain as well as an outcome measure for exposure treatments.

Work-related stress and quality of life among Iranian blue-collar workers with self-reported low back pain.

PubMed

Kabir-Mokamelkhah, Elaheh; Bahrami-Ahmadi, Amir; Aghili, Negar

2016-01-01

Background: Impairment in quality of life and mental health had been reported in the previous studies as the results of musculoskeletal disorders among workers. Mental health has a wide concept and contains different disorders including anxiety, depression or even decreased quality of life, all of which having challengeable impacts on work- related characters such as work productivity and absensism. The present study aimed at evaluating work- related stress and quality of life among Iranian blue-collar workers of Fars ABFA Company with selfreported low back pain. Methods: In the present study, we focused on the low back pain among 451 blue-collar workers and assessed their work- related stress and quality of life status using DASS-21 and short form questionnaire (SF-36), respectively. Independent sample t-test was used to compare the qualitative variables, and chi-square test was utilized for statistical analysis of the qualitative variables. Results: Mean of the total score of quality of life among workers with low back pain was significantly lower than in those workers without low back pain. The mean of work- related stress score was significantly higher in workers with low back pain than in workers without low back pain. The mean quality of life subdomains in patients with low back pain was significantly lower than in workers without low back pain. Conclusion: Findings of the present study revealed that workers with low back pain had lower quality of life score and higher work- related stress score. These findings should be considered in designing preventive programs rather than controlling the pain.

The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain.

PubMed

Anderson, Barton E; Bliven, Kellie C Huxel

2017-09-01

Clinical Scenario: Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain. Focused Clinical Question: In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life? Summary of Key Findings: Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention. Clinical Bottom Line: Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2-3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician's own judgment and clinical expertise and the patient's preferences and values. Strength of Recommendation: Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.

Backing collisions: a study of drivers’ eye and backing behaviour using combined rear-view camera and sensor systems

PubMed Central

Hurwitz, David S; Pradhan, Anuj; Fisher, Donald L; Knodler, Michael A; Muttart, Jeffrey W; Menon, Rajiv; Meissner, Uwe

2012-01-01

Context Backing crash injures can be severe; approximately 200 of the 2,500 reported injuries of this type per year to children under the age of 15 years result in death. Technology for assisting drivers when backing has limited success in preventing backing crashes. Objectives Two questions are addressed: Why is the reduction in backing crashes moderate when rear-view cameras are deployed? Could rear-view cameras augment sensor systems? Design 46 drivers (36 experimental, 10 control) completed 16 parking trials over 2 days (eight trials per day). Experimental participants were provided with a sensor camera system, controls were not. Three crash scenarios were introduced. Setting Parking facility at UMass Amherst, USA. Subjects 46 drivers (33 men, 13 women) average age 29 years, who were Massachusetts residents licensed within the USA for an average of 9.3 years. Interventions Vehicles equipped with a rear-view camera and sensor system-based parking aid. Main Outcome Measures Subject’s eye fixations while driving and researcher’s observation of collision with objects during backing. Results Only 20% of drivers looked at the rear-view camera before backing, and 88% of those did not crash. Of those who did not look at the rear-view camera before backing, 46% looked after the sensor warned the driver. Conclusions This study indicates that drivers not only attend to an audible warning, but will look at a rear-view camera if available. Evidence suggests that when used appropriately, rear-view cameras can mitigate the occurrence of backing crashes, particularly when paired with an appropriate sensor system. PMID:20363812

A Cross-cultural Study of the Back Pain Beliefs of Female Undergraduate Healthcare Students.

PubMed

Burnett, Angus; Sze, Ching Ching; Tam, Suet May; Yeung, Ka Man; Leong, Michelle; Wang, Wendy Tj; Tan, B-K; O'sullivan, Peter

2009-01-01

To determine if country (Australia, Taiwan, Singapore), undergraduate healthcare course (physiotherapy, nursing), low back pain (LBP) history, and year of course influenced various back pain beliefs in undergraduate female healthcare students. Three hundred and 82 female undergraduate nursing and physiotherapy students completed questionnaires examining; the inevitability of future life with low back trouble, the LBP beliefs held by healthcare providers and fear avoidance beliefs related to physical activity. Also participants completed questionnaires to determine their LBP status. General linear models were used to determine whether differences existed for back beliefs scores. Differences were evident in the future consequence of LBP between countries (P<0.001), undergraduate course (P<0.001), and LBP status (P=0.021). Healthcare provider beliefs were found to be significantly influenced by course only (P<0.001). Fear avoidance beliefs related to physical activity were influenced by country (P=0.002) and undergraduate course (P<0.001). When compared with white Australians, Taiwanese and Singaporean Chinese displayed more negative back beliefs regarding the future consequence of LBP (P<0.001) and more fear avoidant beliefs toward physical activity (P=0.021 and P<0.001, respectively). Further, nursing students had more negative back pain beliefs than physiotherapy students (P<0.001) and, the experience of LBP was associated with more positive beliefs on the future consequence of back trouble (P=0.021). Findings of this study highlight the importance of country, education, and LBP experience on back pain beliefs. The more negative back pain beliefs found in Taiwan and Singapore may reflect current pain beliefs and management attitudes.

Back-neck pain and symptoms of anxiety and depression: a population-based twin study.

PubMed

Reichborn-Kjennerud, T; Stoltenberg, C; Tambs, K; Roysamb, E; Kringlen, E; Torgersen, S; Harris, J R

2002-08-01

Clinical and epidemiological studies have shown an association between anxiety and depression and pain in the back and neck. The nature of this relationship is not clear. This study aimed to investigate the extent to which common genetic and environmental aetiological factors contribute to the covariance between symptoms of anxiety and depression and back-neck pain. Measures of back-neck pain and symptoms of anxiety and depression were part of a self-report questionnaire sent in 1992 to twins born in Norway between 1967 and 1974 (3996 pairs). Structural equation modelling was applied to determine to what extent back-neck pain and symptoms of anxiety and depression share genetic and environmental liability factors. The phenotypic correlation between symptoms of anxiety and depression and back-neck pain was 0.31. Individual differences in both anxiety and depression and back-neck pain were best accounted for by additive genetic and individual environmental factors. Heritability estimates were 0.53 and 0.30 respectively. For back-neck pain, however, a model specifying only shared- and individual environmental effects could not be rejected. Bivariate analyses revealed that the correlation between back-neck pain and symptoms of anxiety and depression was best explained by additive genetic and individual environmental factors. Genetic factors affecting both phenotypes accounted for 60% of the covariation. There were no significant sex differences. The results support previous findings of a moderate association between back-neck pain and symptoms of anxiety and depression, and suggest that this association is primarily due to common genetic effects.

Differences in lumbopelvic control and occupational behaviours in female nurses with and without a recent history of low back pain due to back injury.

PubMed

Babiolakis, Corinne S; Kuk, Jennifer L; Drake, Janessa D M

2015-01-01

Low back pain is highly prevalent in nurses. This study aimed to determine which physical fitness, physical activity (PA) and biomechanical characteristics most clearly distinguish between nurses with [recently injured (RInj)] and without [not recently injured (NRInj)] a recent back injury. Twenty-seven (8 RInj, 19 NRInj) female nurses completed questionnaires (pain, work, PA), physical fitness, biomechanical and low back discomfort measures, and wore an accelerometer for one work shift. Relative to NRInj nurses, RInj nurses exhibited reduced lumbopelvic control (41.4% more displayed a moderate loss of frontal plane position), less active occupational behaviours (less moderate PA; less patient lifts performed alone; more sitting and less standing time) and more than two times higher low back discomfort scores. Despite no physical fitness differences, the lumbopelvic control, occupational behaviours and discomfort measures differed between nurses with and without recent back injuries. It is unclear whether poor lumbopelvic control is causal or adaptive in RInj nurses and may require further investigation. Practitioner Summary: It is unclear which personal modifiable factors are most clearly associated with low back pain in nurses. Lumbopelvic control was the only performance-based measure to distinguish between nurses with and without recent back injuries. Future research may investigate whether reduced lumbopelvic control is causal or adaptive in recently injured nurses.

Prevalence and associations of neuropathic pain in a cohort of multi-ethnic Asian low back pain patients.

PubMed

Kew, Yueting; Tan, Cheng-Yin; Ng, Chong-Jing; Thang, Sue-Sien; Tan, Leong-Hooi; Khoo, Yvonne Khaii; Lim, Jun-Ni; Ng, Jia-Hui; Chan, Chris Yin-Wei; Kwan, Mun-Keong; Goh, Khean-Jin

2017-04-01

The prevalence of neuropathic low back pain differs in different ethnic populations. The aims of the study are to determine its frequency and associations in a multi-ethnic cohort of Asian low back pain patients. This was a cross-sectional study of low back patients seen at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Neuropathic low back pain patients were identified using the painDETECT questionnaire and compared with non-neuropathic (unclear or nociceptive) low back pain patients, in terms of socio-demographic and clinical factors, pain severity (numerical pain rating scale, NPRS), disability (Roland Morris Disability Questionnaire, RMDQ), as well as anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Of 210 patients, 26 (12.4%) have neuropathic low back pain. Neuropathic pain is associated with non-Chinese ethnicity, higher body mass index and pain radiation below the knee. Patients with neuropathic pain have significantly higher NPRS and RMDQ scores, and there are more subjects with anxiety on HADS. However, there are no differences between the groups in age, gender, pain duration or underlying diagnosis of low back pain. The prevalence of neuropathic low back pain in a multi-ethnic Malaysian cohort is lower than previously reported in other populations with possible differences between ethnic groups. It is associated with greater pain severity, disability and anxiety.

Effects of a back-pain-reducing program during pregnancy for Korean women: a non-equivalent control-group pretest-posttest study.

PubMed

Shim, Mi-Jung; Lee, Young-Sook; Oh, Hyun-Ei; Kim, Jin-Sun

2007-01-01

Although many pregnant women experience back pain, it has not considered an important health problem. No study has investigated the effects of a back-pain-reducing program (BPRP) during pregnancy for Korean women. The purpose of this study was to evaluate the effect of a program designed to reduce back pain in pregnant women. A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended an antenatal clinic and experienced back pain during their pregnancy were included in an intervention group (n=29), and their intensity of back pain, functional limitation and anxiety were compared with women in a control group from another antenatal clinic (n=27). The data were collected at three time points: prior to intervention, and 6 and 12 weeks after intervention. At 12 weeks after intervention, the intensity of back pain experienced by the intervention group was significantly lower than that of the control group. However, there were no statistically significant differences between the groups with respect to functional limitations and anxiety. The findings show that the pain-reducing program developed for this study was effective in reducing the intensity of back pain experienced by pregnant women. Promoting good posture and regular exercise can be recommended as a method to relieve back pain in pregnancy women. Further studies are needed to confirm the effect of the BPRP during pregnancy.

Neck/upper back and low back pain in parents and their adult offspring: Family linkage data from the Norwegian HUNT Study.

PubMed

Lier, R; Nilsen, T I L; Vasseljen, O; Mork, P J

2015-07-01

Chronic pain in the neck and low back is highly prevalent. Although heritable components have been identified, knowledge about generational transmission of spinal pain between parents and their adult offspring is sparse. This study examined the intergenerational association of spinal pain using data from 11,081 parent-offspring trios participating in the population-based HUNT Study in Norway. Logistic regression was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for offspring spinal pain associated with parental spinal pain. In total, 3654 (33%) offspring reported spinal pain at participation. Maternal and paternal spinal pain was consistently associated with higher ORs for offspring spinal pain. The results suggest a slightly stronger association for parental multilevel spinal pain (i.e., both neck/upper back pain and low back pain) than for pain localized to the neck/upper back or low back. Multilevel spinal pain in both parents was associated with ORs of 2.6 (95% CI, 2.1-3.3), 2.4 (95% CI, 1.9-3.1) and 3.1 (95% CI, 2.2-4.4) for offspring neck/upper back, low back and multilevel spinal pain, respectively. Parental chronic spinal pain was consistently associated with increased occurrence of chronic spinal pain in their adult offspring, and this association was particularly strong for multilevel spinal pain. © 2014 European Pain Federation - EFIC®

Impact of a supervised worksite exercise program on back and core muscular endurance in firefighters.

PubMed

Mayer, John M; Quillen, William S; Verna, Joe L; Chen, Ren; Lunseth, Paul; Dagenais, Simon

2015-01-01

Low back pain is a leading cause of disability in firefighters and is related to poor muscular endurance. This study examined the impact of supervised worksite exercise on back and core muscular endurance in firefighters. A cluster randomized controlled trial was used for this study. The study occurred in fire stations of a municipal fire department (Tampa, Florida). Subjects were 96 full-duty career firefighters who were randomly assigned by fire station to exercise (n = 54) or control (n = 42) groups. Exercise group participants completed a supervised exercise targeting the back and core muscles while on duty, two times per week for 24 weeks, in addition to their usual fitness regimen. Control group participants continued their usual fitness regimen. Back and core muscular endurance was assessed with the Biering-Sorensen test and plank test, respectively. Changes in back and core muscular endurance from baseline to 24 weeks were compared between groups using analysis of covariance and linear mixed effects models. After 24 weeks, the exercise group had 12% greater (p = .021) back muscular endurance and 21% greater (p = .0006) core muscular endurance than did the control group. The exercise intervention did not disrupt operations or job performance. A supervised worksite exercise program was safe and effective in improving back and core muscular endurance in firefighters, which could protect against future low back pain.

The Relationship of the Sit and Reach Test to Criterion Measures of Hamstring and Back Flexibility in Young Females.

ERIC Educational Resources Information Center

Jackson, Allen W.; Baker, Alice A.

1986-01-01

This study tested 100 female adolescents to determine the relationships of the sit and reach test, a component of the Health Related Fitness Test, with back and hamstring flexibility. Findings indicate the sit and reach test is moderately related to hamstring flexibility but not to back and low back flexibility. (Author/MT)

Back Translating: An Integrated Approach to Focus Learners' Attention on Their L2 Knowledge Gaps

ERIC Educational Resources Information Center

Zhang, Yun; Gao, Cun

2014-01-01

Integration of the four language skills can be enhanced by focusing on back translating--translating an English text into the students' first language and then back into English. This article describes a three-step process for using back translation in reading classes as a way to help students identify gaps in their English competence.

5 CFR Appendix A to Subpart H of... - Information on Computing Certain Common Deductions From Back Pay Awards

Code of Federal Regulations, 2010 CFR

2010-01-01

... Deductions From Back Pay Awards A Appendix A to Subpart H of Part 550 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Back Pay Pt. 550, Subpt. H, App. A Appendix A to Subpart H of Part 550—Information on Computing Certain Common Deductions From Back...

Tweeting back: predicting new cases of back pain with mass social media data.

PubMed

Lee, Hopin; McAuley, James H; Hübscher, Markus; Allen, Heidi G; Kamper, Steven J; Moseley, G Lorimer

2016-05-01

Back pain is a global health problem. Recent research has shown that risk factors that are proximal to the onset of back pain might be important targets for preventive interventions. Rapid communication through social media might be useful for delivering timely interventions that target proximal risk factors. Identifying individuals who are likely to discuss back pain on Twitter could provide useful information to guide online interventions. We used a case-crossover study design for a sample of 742 028 tweets about back pain to quantify the risks associated with a new tweet about back pain. The odds of tweeting about back pain just after tweeting about selected physical, psychological, and general health factors were 1.83 (95% confidence interval [CI], 1.80-1.85), 1.85 (95% CI: 1.83-1.88), and 1.29 (95% CI, 1.27-1.30), respectively. These findings give directions for future research that could use social media for innovative public health interventions. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Low back pain caused by a duodenal ulcer.

PubMed

Weiss, D J; Conliffe, T; Tata, N

1998-09-01

The common diagnoses in low back pain are lumbar strain, lumbosacral radiculopathy, osteoarthritis, degenerative disc disease, spinal stenosis, and sacroiliac joint dysfunction. Unusual causes of low back pain that have been previously identified include abdominal aortic aneurysms, pelvic neoplasms, and retroperitoneal hemorrhages. This report describes a case of back pain that was apparently caused by a duodenal ulcer. A 54-year-old man with no significant medical history presented with a complaint of mid to low back pain (T10-L2), which was diagnosed as joint dysfunction. A comprehensive treatment program was prescribed and the patient was instructed to return to clinic in 4 weeks. Three weeks later, he experienced a syncopal episode followed by coffee ground emesis. He immediately sought medical attention at an emergency room, where he was admitted to the hospital with a diagnosis of upper gastrointestinal bleed. Esophagogastroduodenoscopy showed a large duodenal ulcer, and the patient underwent vagotomy and pyloroplasty. He returned to his physiatrist's office 3 weeks after hospital discharge with minimal back pain. The cause of the back pain proved to be referred visceral pain from his duodenal ulcer. This case is presented to reemphasize the need to include the uncommon phenomena in the differential diagnosis of low back pain.

[Low back pain and associated factors in children and adolescents in a private school in Southern Brazil].

PubMed

Lemos, Adriana Torres de; Santos, Fábio Rosa Dos; Moreira, Rodrigo Baptista; Machado, Débora Teixeira; Braga, Fernando Cesar Camargo; Gaya, Adroaldo Cezar Araujo

2013-11-01

Studies have shown that children and adolescents with low back pain are also similarly affected when they reach adulthood, thus highlighting the importance of investigating causes of low back pain in school-age children. The study examined low back pain and associated factors in 770 schoolchildren 7 to 17 years of age in a private school in Porto Alegre, Rio Grande do Sul State, Brazil. Low back pain was defined as pain or discomfort in the lumbar region in the previous month, assessed by a questionnaire. Low back pain was found in 31.6% of the subjects and was more prevalent in girls (41.9%) than boys (21.4%). Factors associated with lumbar pain were female gender, age 9 to 17 years, hyperactivity (borderline and abnormal categories), and emotional symptoms (abnormal category). Mapping the occurrence of low back pain and associated factors is important for identifying children and adolescents at risk and for developing effective programs for primary prevention.

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti's Syndrome

PubMed Central

Sakai, Toshinori; Higashino, Kosaku; Goda, Yuichiro; Mineta, Kazuaki; Sairyo, Koichi

2014-01-01

Bertolotti's syndrome is characterized by anomalous enlargement of the transverse process of the most caudal lumbar segment, causing chronic and persistent low back pain or sciatica. We describe the case of a 45-year-old woman who presented with left sciatic pain and low back pain due to a recurrent lumbar disc herniation at L4-5 with Bertolotti's syndrome. Selective L5 nerve root block and local injection of lidocaine into the articulation between the transverse process and sacral ala temporarily relieved the left sciatic pain and low back pain, respectively. To confirm the effect of local injection on low back pain, we gave a second local injection, which once again relieved the low back pain. Microendoscopic resection of the pseudoarticulation region and discectomy successfully relieved all symptoms. This report illustrates the effectiveness of minimally invasive resection of the transverse process for the treatment of low back pain with Bertolotti's syndrome. PMID:25045566

Prevalence of neuropathic features of back pain in clinical populations: implications for the diagnostic triage paradigm.

PubMed

Hush, Julia M; Marcuzzi, Anna

2012-07-01

SUMMARY Contemporary clinical assessment of back pain is based on the diagnostic triage paradigm. The most common diagnostic classification is nonspecific back pain, considered to be of nociceptive etiology. A small proportion are diagnosed with radicular pain, of neuropathic origin. In this study we review the body of literature on the prevalence of neuropathic features of back pain, revealing that the point prevalence is 17% in primary care, 34% in mixed clinical settings and 53% in tertiary care. There is evidence that neuropathic features of back pain are not restricted to typical clinical radicular pain phenotypes and may be under-recognized, particularly in primary care. The consequence of this is that in the clinic, diagnostic triage may erroneously classify patients with nonspecific back pain or radicular pain. A promising alternative is the development of mechanism-based pain phenotyping in patients with back pain. Timely identification of contributory pain mechanisms may enable greater opportunity to select appropriate therapeutic targets and improve patient outcomes.

A Comparative Study of AlGaN and InGaN Back-Barriers in Ultrathin-Barrier AlN/GaN Heterostructures

NASA Astrophysics Data System (ADS)

All Abbas, J. M.; Atmaca, G.; Narin, P.; Kutlu, E.; Sarikavak-Lisesivdin, B.; Lisesivdin, S. B.

2017-08-01

Investigations of the effects of back-barrier introduction on the two-dimensional electron gas (2DEG) of ultrathin-barrier AlN/GaN heterostructures with AlGaN and InGaN back-barriers are carried out using self-consistent solutions of 1-dimensional Schrödinger-Poisson equations. Inserted AlGaN and InGaN back-barriers are used to provide a good 2DEG confinement thanks to raising the conduction band edge of GaN buffer with respect to GaN channel layer. Therefore, in this paper the influence of these back-barrier layers on sheet carrier density, 2DEG confinement, and mobility are systematically and comparatively investigated. As a result of calculations, although sheet carrier density is found to decrease with InGaN back-barrier layer, it is not changed with AlGaN back-barrier layer for suggested optimise heterostructures. Obtained results can give some insights for further experimental studies.

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti's Syndrome.

PubMed

Takata, Yoichiro; Sakai, Toshinori; Higashino, Kosaku; Goda, Yuichiro; Mineta, Kazuaki; Sugiura, Kosuke; Sairyo, Koichi

2014-01-01

Bertolotti's syndrome is characterized by anomalous enlargement of the transverse process of the most caudal lumbar segment, causing chronic and persistent low back pain or sciatica. We describe the case of a 45-year-old woman who presented with left sciatic pain and low back pain due to a recurrent lumbar disc herniation at L4-5 with Bertolotti's syndrome. Selective L5 nerve root block and local injection of lidocaine into the articulation between the transverse process and sacral ala temporarily relieved the left sciatic pain and low back pain, respectively. To confirm the effect of local injection on low back pain, we gave a second local injection, which once again relieved the low back pain. Microendoscopic resection of the pseudoarticulation region and discectomy successfully relieved all symptoms. This report illustrates the effectiveness of minimally invasive resection of the transverse process for the treatment of low back pain with Bertolotti's syndrome.

Knowledge and perceptions about back education among elementary school students, teachers, and parents in Belgium.

PubMed

Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2002-03-01

A back education program for Belgian elementary school children was evaluated using self-reported questionnaires before intervention and at three follow-up points during one year. Most children found the program interesting, important, and amusing. Intervention children (n = 347) showed better back care knowledge than control children (n = 359), and knowledge gained was retained over a period of one year. Back education did not result in increased fear-avoidance beliefs about physical activity, and intervention children reported more checking of their book bag weight than controls at all test moments. Self-reported behavior in relation to posture-related and back care related self-efficacy were affected only minimally by the program, possibly due to poor self-judgment. Involvement, fear-avoidance beliefs, and back care knowledge of teachers and parents of the intervention children showed low correlation with the children's perceptions and knowledge. Sufficient promise exists to justify further development and evaluation of early back education.

Back Pain

MedlinePlus

... which may be caused by a fall or heavy lifting. Back pain that lasts more than three ... back pain include: Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement may strain ...

Method for simultaneously making a plurality of acoustic signal sensor elements

NASA Technical Reports Server (NTRS)

Bryant, Timothy D. (Inventor); Wynkoop, Mark W. (Inventor); Holloway, Nancy M. H. (Inventor); Zuckerwar, Allan J. (Inventor)

2005-01-01

A fetal heart monitoring system preferably comprising a backing plate having a generally concave front surface and a generally convex back surface, and at least one sensor element attached to the concave front surface for acquiring acoustic fetal heart signals produced by a fetus within a body. The sensor element has a shape that conforms to the generally concave back surface of the backing plate. In one embodiment, the at least one sensor element comprises an inner sensor, and a plurality of outer sensors surrounding the inner sensor. The fetal heart monitoring system can further comprise a web belt, and a web belt guide movably attached to the web belt. The web belt guide being is to the convex back surface of the backing plate.

Method for Simultaneously Making a Plurality of Acoustic Signal Sensor Elements

NASA Technical Reports Server (NTRS)

Bryant, Timothy D.; Wynkoop, Mark W.; Holloway, Nancy M. H.; Zuckerwar, Allan J.

2005-01-01

A fetal heart monitoring system preferably comprising a backing plate having a generally concave front surface and a generally convex back surface, and at least one sensor element attached to the concave front surface for acquiring acoustic fetal heart signals produced by a fetus within a body. The sensor element has a shape that conforms to the generally concave back surface of the backing plate. In one embodiment, the at least one sensor element comprises an inner sensor, and a plurality of outer sensors surrounding the inner sensor. The fetal heart monitoring system can further comprise a web belt, and a web belt guide movably attached to the web belt. The web belt guide being is to the convex back surface of the backing plate.

Myofascial low back pain treatment.

PubMed

Sharan, Deepak; Rajkumar, Joshua Samuel; Mohandoss, Mathankumar; Ranganathan, Rameshkumar

2014-09-01

Myofascial pain is a common musculoskeletal problem, with the low back being one of the commonest affected regions. Several treatments have been used for myofascial low back pain through physical therapies, pharmacologic agents, injections, and other such therapies. This review will provide an update based on recently published literature in the field of myofascial low back pain along with a brief description of a sequenced, multidisciplinary treatment protocol called Skilled Hands-on Approach for the Release of myofascia, Articular, Neural and Soft tissue mobilization (SHARANS) protocol. A comprehensive multidisciplinary approach is recommended for the successful management of individuals with myofascial low back pain.

Nickel aluminide-copper backing for butt joint welding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Raghavan, S.; Muszynski, M.; Chin, B.A.

1996-12-31

Single-side full penetration welding is the primary welding process in shipbuilding. This process requires the use of a backing to support the molten metal. Conventionally, copper has been used as the backing material in the shop and ceramic tiles for jobs on the field. However, copper has shown to contaminate the weld and produce adverse effects and ceramics have shown to produce porosities in the weld. A new backing with an intermetallic layer (NiAl) on the copper surface has been fabricated. The results indicate that this backing could alleviate the contamination problems and produce quality welds.

Bedsores (Pressure Sores)

MedlinePlus

... over the following sites: Tailbone or buttocks Shoulder blades and spine Backs of arms and legs where ... following: Back or sides of the head Shoulder blades Hip, lower back or tailbone Heels, ankles and ...

Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group.

PubMed

Heymans, M W; van Tulder, M W; Esmail, R; Bombardier, C; Koes, B W

2005-10-01

A systematic review within the Cochrane Collaboration Back Review Group. To assess the effectiveness of back schools for patients with nonspecific low back pain (LBP). Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating patients with LBP. However, the content of back schools has changed and appears to vary widely today. We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials to November 2004 for relevant trials reported in English, Dutch, French, or German. We also screened references from relevant reviews and included trials. Randomized controlled trials that reported on any type of back school for nonspecific LBP were included. Four reviewers, blinded to authors, institution, and journal, independently extracted the data and assessed the quality of the trials. We set the high-quality level, a priori, at a trial meeting six or more of 11 internal validity criteria. Because data were clinically and statistically too heterogeneous to perform a meta-analysis, we used a qualitative review (best evidence synthesis) to summarize the results. The evidence was classified into four levels (strong, moderate, limited, or no evidence), taking into account the methodologic quality of the studies. We also evaluated the clinical relevance of the studies. Nineteen randomized controlled trials (3,584 patients) were included in this updated review. Overall, the methodologic quality was low, with only six trials considered to be high-quality. It was not possible to perform relevant subgroup analyses for LBP with radiation versus LBP without radiation. The results indicate that there is moderate evidence suggesting that back schools have better short- and intermediate-term effects on pain and functional status than other treatments for patients with recurrent and chronic LBP. There is moderate evidence suggesting that back schools for chronic LBP in an occupational setting are more effective than other treatments and placebo or waiting list controls on pain, functional status, and return to work during short- and intermediate-term follow-up. In general, the clinical relevance of the studies was rated as insufficient. There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain and improve function and return-to-work status, in the short- and intermediate-term, compared with exercises, manipulation, myofascial therapy, advice, placebo, or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodologic quality and clinical relevance and evaluate the cost-effectiveness of back schools.

Preference and Expectation for Treatment Assignment in a Randomized Controlled Trial of Once- vs Twice-weekly Yoga for Chronic Low Back Pain

PubMed Central

Weinberg, Janice; Sherman, Karen J.; Saper, Robert B.

2015-01-01

Background: In studies involving nonpharmacological complementary and alternative medicine interventions, participant blinding is very difficult. Participant expectations may affect perceived benefit of therapy. In studies of yoga as treatment for chronic low back pain, little is known about the relationship between patient expectations and preferences on outcomes. This study was designed to identify baseline predictors of preference and to determine if expectations and preferences for different doses of yoga affect back-related function and low back pain intensity. Methods: This was a secondary data analysis of a 12-week randomized controlled trial comparing once-weekly vs twice-weekly yoga for treatment of chronic low back pain in 93 adults from a predominantly low-income minority population. At baseline, participants were asked about back function, back pain, treatment expectations, and treatment preferences. We created a variable “concordance” to describe the matching of participant preference to randomized treatment. Our outcome variables were change in back function and pain intensity after 12 weeks of yoga instruction. We performed logistic regression to identify predictors of preference for once- or twice-weekly yoga instruction. We created linear regression models to identify independent associations between expectations, preference, concordance, and outcomes. Results: Worse back function at baseline was associated with 20% higher odds of preferring twice-weekly yoga (OR 1.2, CI 1.1, 1.3). Individuals with higher expectation scores for twice-weekly yoga had 90% higher odds of preferring twice-weekly vs once-weekly yoga (OR 1.9, CI 1.3, 2.7). Individuals with higher expectation scores for once-weekly yoga had 40% less odds of preferring twice-weekly yoga (OR 0.6, CI 0.5, 0.9). After controlling for baseline characteristics, we found no statistically significant relationship between treatment outcomes, preference, expectation scores, or concordance. Conclusion: In a population of predominantly low-income minority participants with chronic low back pain, worse back function was associated with preference for more frequent yoga classes. Those who preferred more yoga classes had higher expectations for those classes. Twelve-week change in back pain intensity and back function were not affected by dosing preference, expectation score, or concordance. More research is needed to better measure and quantify preference, expectations, and their relationship to outcomes in yoga research. PMID:25694850

Assessment and exercise in low back pain. With special reference to the management of pain and disability following first time lumbar disc surgery.

PubMed

Manniche, C

1995-09-01

Eight articles including 555 low back pain patients have been published. They included the following topics: 1) A ratio interval rating scale (Low Back Pain Rating Scale (RS)) was introduced. The possibility of registering the actual status in low back pain patients including; Back Pain, Sciatica, Functional Disability and Physical Impairment was studied. Methods of evaluating index-scales developed in the field of psychometry were applied in the validation process of RS. RS was found to be both valid and user friendly. 2) Using Low Back Pain Rating Scale the general outcome following first-time lumbar disc surgery was analysed through a survey. The results showed that more than half of the patients still suffered from considerable Back Pain, Sciatica, and Functional Disabilities. Approximately 25% of the patients risked reduced work capabilities, and many receive pensions. 3) By means of a comprehensive statistical analysis of 18 studied preoperative demographic and physical findings, sex, hypoalgesia, smoking and Finneson-index were found to have prognostic value. 4) Attempts at influencing the results obtained from lumbar disc surgery have been tested in 3 randomized trials, including back training and peroperative glucocorticoid administration. 5) Three randomized trials including patients suffering from chronic low back pain (with or without previous lumbar disc surgery) attempted to convey which elements of a training programme provide patients with the greatest effect and the least risk of side-effects. It was concluded that Low Back Pain Rating Scale is a useable assessment instrument in both clinical trials and as a daily quality control instrument of back patients. There is a need of increased patient scrutiny in patient selection prior to lumbar disc surgery. Postoperative rehabilitation should include intensive back training, which has been shown to be of value in behavioural support and restoration of functional deficits. This has resulted in increased work capacities for disc operated patients. The exercise programmes are generally free of side-effects. As regards chronic back pain patients with or without previous lumbar surgery, high dosage exercises with training periods lasting at least 12 to 16 sessions are of crucial importance for success. Exercises should be dynamic and full-range, and carried out following the adage "Don't let the pain be your guide.

Once-Yearly Zoledronic Acid and Days of Disability, Bed Rest, and Back Pain: Randomized, Controlled HORIZON Pivotal Fracture Trial

PubMed Central

Cauley, Jane A.; Black, Dennis; Boonen, Steven; Cummings, Steven R.; Mesenbrink, Peter; Palermo, Lisa; Man, Zulema; Hadji, Peyman; Reid, Ian R.

2016-01-01

The objective of this study was to determine the effect of once-yearly zoledronic acid on the number of days of back pain and the number of days of disability (ie, limited activity and bed rest) owing to back pain or fracture in postmenopausal women with osteoporosis. This was a multicenter, randomized, double-blind, placebo-controlled trial in 240 clinical centers in 27 countries. Participants included 7736 postmenopausal women with osteoporosis. Patients were randomized to receive either a single 15-minute intravenous infusion of zoledronic acid (5 mg) or placebo at baseline, 12 months, and 24 months. The main outcome measures were self-reported number of days with back pain and the number of days of limited activity and bed rest owing to back pain or a fracture, and this was assessed every 3 months over a 3-year period. Our results show that although the incidence of back pain was high in both randomized groups, women randomized to zoledronic acid experienced, on average, 18 fewer days of back pain compared with placebo over the course of the trial (p = .0092). The back pain among women randomized to zoledronic acid versus placebo resulted in 11 fewer days of limited activity (p = .0017). In Cox proportional-hazards models, women randomized to zoledronic acid were about 6% less likely to experience 7 or more days of back pain [relative risk (RR) = 0.94, 95% confidence interval (CI) 0.90–0.99] or limited activity owing to back pain (RR = 0.94, 95% CI 0.87–1.00). Women randomized to zoledronic acid were significantly less likely to experience 7 or more bed-rest days owing to a fracture (RR = 0.58, 95% CI 0.47–0.72) and 7 or more limited-activity days owing to a fracture (RR = 0.67, 95% CI 0.58–0.78). Reductions in back pain with zoledronic acid were independent of incident fracture. Our conclusion is that in women with postmenopausal osteoporosis, a once-yearly infusion with zoledronic acid over a 3-year period significantly reduced the number of days that patients reported back pain, limited activity owing to back pain, and limited activity and bed rest owing to a fracture. PMID:21542001

Back pain in a large Canadian police force.

PubMed

Brown, J J; Wells, G A; Trottier, A J; Bonneau, J; Ferris, B

1998-04-01

A survey of a random sample of 1002 members of the Royal Canadian Mounted Police to determine their experience with low back pain. To determine the prevalence of low back pain among Royal Canadian Mounted Police members and to assess the validity of the perception that the patrol car seat and the duty belt are causing a higher rate of low back pain among members of the Royal Canadian Mounted Police than in the general population. Low back pain is a common problem throughout the industrialized world, with reported 1-year prevalence rates between 25% and 62%. Prevalence of low back pain among people who drive motor vehicles for a significant part of the day appears higher than in the general population. Among police officers, 1-year prevalence rates of between 44% and 62% have been reported. A computerized database of 14,897 serving regular members was used to identify a sample of officers on active duty. A low back pain questionnaire was mailed to each selected member, eliciting information regarding their experience with low back pain, their exposure to known and putative risk factors, and their opinions about the contribution of these potential risk factors. The respondents to the questionnaire remained anonymous. The response rate was 80%. The prevalence of "chronic or recurring low back pain since joining the force" was 54.9%, which is comparable with the lifetime prevalence reported for the general population. Of those who reported having back problems, only 8.5% had such problems before joining the force. Seventy-six percent who had low back pain reported having a problem within the last year, giving an overall 1-year prevalence of 41.8%, which is comparable with that for the general population. The a priori assumption that driving or wearing a duty belt contributed to the problem was shared by most police officers surveyed. However, only about half of the members who replied drove for more than half the working day or wore the duty belt. These members had the same prevalence of low back pain as those who did not drive or wear the duty belt. The prevalence of low back pain in this police force is comparable with that in the general population, and driving a patrol car or wearing the duty belt does not appear to influence the prevalence rate in this population.

Back Pain

MedlinePlus

... for back pain include being overweight, poor physical conditioning, smoking, whole body vibration, and improper lifting technique ... back and abdominal muscles). •Decrease vibrations by installing air cushions or upgrade seat to damper vibrations. • Stay ...

49 CFR 571.202a - Standard No. 202a; Head restraints; Mandatory applicability begins on September 1, 2009.

Code of Federal Regulations, 2011 CFR

2011-10-01

... restraints in rear outboard seats. Measure the height of the top of a rear seat back or the top of any independently adjustable seat component attached to or adjacent to the rear seat back in its highest position of... seat back inclination position less than the design seat back angle. (a)(1) For head restraints in...

Building America Top Innovations 2012: Reduced Call-Backs with High-Performance Production Builders

DOE Office of Scientific and Technical Information (OSTI.GOV)

none,

2013-01-01

This Building America Top Innovations profile describes ways Building America teams have helped builders cut call-backs. Harvard University study found builders who worked with Building America had a 50% drop in call-backs. One builder reported a 50-fold reduction in the incidence of pipe freezing, a 50% reduction in drywall cracking, and a 60% decline in call-backs.

The Efficacy of a Perceptive Rehabilitation on Postural Control in Patients with Chronic Nonspecific Low Back Pain

ERIC Educational Resources Information Center

Paolucci, Teresa; Fusco, Augusto; Iosa, Marco; Grasso, Maria R.; Spadini, Ennio; Paolucci, Stefano; Saraceni, Vincenzo M.; Morone, Giovanni

2012-01-01

Patients with chronic low back pain have a worse posture, probably related to poor control of the back muscles and altered perception of the trunk midline. The aim of this study was to evaluate the efficacy of a perceptive rehabilitation in terms of stability and pain relief in patients with chronic nonspecific low back pain. Thirty patients were…

Maxillary molar distalization: Pendulum and Fast-Back, comparison between two approaches for Class II malocclusion.

PubMed

Caprioglio, Alberto; Beretta, Matteo; Lanteri, Claudio

2011-01-01

To compare the dento-alveolar and skeletal effects produced by two different molar intraoral distalization appliances, Pendulum and Fast-Back, both followed by fixed appliances, in the treatment of Class II malocclusion. 41 patients for Pendulum (18 males and 23 females) and 35 for Fast-Back (14 males and 21 females) were selected, with a mean age at the start of treatment of 12.11 years in the Pendulum group and 13.3 for in the Fast-Back group. The durations of the distalization phase were 8 months in the Pendulum group and 9 months in the Fast-Back group, and the durations of the second phase of treatment with fixed appliances were 19 months in the Pendulum group and 20 months in the Fast-Back group. Lateral cephalograms were analyzed at 3 observation times: before treatment, after distalization and after comprehensive orthodontic treatment. During molar distalization the Pendulum subjects showed greater distal molar movement and less anchorage loss at both the premolars and maxillary incisors than the Fast-Back subjects. Pendulum and Fast-Back produced similar amounts of distal molar movement and overcorrection of molar relationship at the end of distalization though the Fast-Back induced a more bodily movement. Very little change occurred in the inclination of the mandibular plane at the end of the 2-phase treatment in both groups. At the end of treatment the maxillary first molars were on average 1mm more distal in the Pendulum group compared to the Fast-Back group, while the total molar correction was 3.2mm with 3.9° of distal inclination for the Pendulum and 2mm with 1.1° of mesial inclination for the Fast-Back. Both appliance were equally effective in inducing a satisfactory Class I relationship in 97.2% of the cases. The Pendulum and the Fast-Back induce similar dentoskeletal effects. The use of the two distalization devices, therefore, can be considered clinically equivalent. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

Low-Dose Tramadol and Non-Steroidal Anti-Inflammatory Drug Combination Therapy Prevents the Transition to Chronic Low Back Pain

PubMed Central

Orita, Sumihisa; Yamauchi, Kazuyo; Suzuki, Takane; Suzuki, Miyako; Sakuma, Yoshihiro; Kubota, Go; Oikawa, Yasuhiro; Sainoh, Takeshi; Sato, Jun; Fujimoto, Kazuki; Shiga, Yasuhiro; Abe, Koki; Kanamoto, Hirohito; Inoue, Masahiro; Kinoshita, Hideyuki; Takahashi, Kazuhisa; Ohtori, Seiji

2016-01-01

Study Design Retrospective study. Purpose To determine whether low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy could prevent the transition of acute low back pain to chronic low back pain. Overview of Literature Inadequately treated early low back pain transitions to chronic low back pain occur in approximately 30% of affected individuals. The administration of non-steroidal anti-inflammatory drugs is effective for treatment of low back pain in the early stages. However, the treatment of low back pain that is resistant to non-steroidal anti-inflammatory drugs is challenging. Methods Patients who presented with acute low back pain at our hospital were considered for inclusion in this study. After the diagnosis of acute low back pain, non-steroidal anti-inflammatory drug administration was started. Forty patients with a visual analog scale score of >5 for low back pain 1 month after treatment were finally enrolled. The first 20 patients were included in a non-steroidal anti-inflammatory drug group, and they continued non-steroidal anti-inflammatory drug therapy for 1 month. The next 20 patients were included in a combination group, and they received low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy for 1 month. The incidence of adverse events and the improvement in the visual analog scale score at 2 months after the start of treatment were analyzed. Results No adverse events were observed in the non-steroidal anti-inflammatory drug group. In the combination group, administration was discontinued in 2 patients (10%) due to adverse events immediately following the start of tramadol administration. At 2 months, the improvement in the visual analog scale score was greater in the combination group than in the non-steroidal anti-inflammatory drug group (p<0.001). Conclusions Low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy might decrease the incidence of adverse events and prevent the transition of acute low back pain to chronic low back pain. PMID:27559448

Evaluation of the Back College for nursing staff

PubMed Central

2014-01-01

Background Work-related musculoskeletal pain- particularly back pain - is an important individual and socioeconomic problem. The Back College for the insurance holders of the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) is based on a multimodal concept and has been evaluated with respect to pain relief and continuing in the nursing profession. Methods In a retrospective cohort study, the participants in the Back College from 2009 to 2011 were surveyed in writing. Besides demographic data, the survey covered information on qualification, length of employment, institution, employment status, periods of inability to work, applicability of working techniques and continuation in the profession. Back pain was recorded at three time points - T1 (before the Back College), T2 (directly after the Back College) and T3 (at the time of the survey). Pain changes were submitted to tests for paired samples. Multivariate logistic analysis was applied to determine potential factors influencing unfavourable changes in pain or leaving nursing due to back pain. Results The survey covered 1,282 insurance holders, with a response rate of 80%. Statistically significant reductions in pain were found for the whole group and for all subgroups. For persons who predominantly worked in old people’s homes and who did not take part in refresher services, an increased odds ratio was found for unfavourable changes in pain (OR: 1.9 or 1.4, respectively). Persons with a qualification in geriatric nursing or in intensive care/OP/anaesthesia had an increased risk of leaving nursing due to back pain (OR: 2.5 in each case). An increased risk of leaving was also found for persons who did not take part in workplace support (OR: 2.9). Conclusion Within the context of the study design, the multimodal concept of the Back College is clearly related to relief of back pain. The Back College appears to be less successful for geriatric nurses and persons with qualifications in intensive care/OP/anaesthesia. Further studies are needed to ascertain why some participants experience less relief in stress from the working techniques they have learnt. PMID:25512761

The effect of back and feet support on oscillometric blood pressure measurements.

PubMed

Ringrose, Jennifer S; Wong, Jonathan; Yousefi, Farahnaz; Padwal, Raj

2017-08-01

Recommendations to support the back and feet during blood pressure (BP) measurement are not always followed in clinical practice. Our objective was to determine to what extent back and feet support affects mean oscillometric BP measurements. Eighty-five consecutive, consenting participants 18 years or older with systolic BP readings 80-220 mmHg and diastolic BP readings 50-120 mmHg and arm circumferences of 25-43 cm were recruited. BP was measured using an Omron HEM 907 oscillometric device. Back and feet support were examined independently. First, while the feet were supported, two sets of three BP readings were taken in random order: one with the back supported and one with the back unsupported. Next, with the back supported, two sets of three BP readings were taken in random order: one with the feet dangling and one with feet supported. The mean age of the participants was 52.0±20.7 years and the mean arm circumference was 31.0±3.2 cm; 62% were women and 49% had hypertension. The mean BP levels with the back unsupported were slightly higher than those with the back supported (119.8±15.5/69.9±8.9 vs. 119.2±16.4/68.2±8.8 mmHg; difference of 0.7±4.9/1.8±3.0; P=0.21 for systolic and <0.0001 for diastolic comparisons). The mean BP levels with feet dangling were slightly lower than with feet supported (120.3±16.3/72.6±8.9 vs. 121.2±16.1/72.9±8.6 mmHg; difference of -0.9±4.1/-0.3±2.8; P=0.04 for systolic and <0.36 for diastolic comparisons). Systolic BP differences were greater than or equal to 5 mmHg in 34% (back phase) and 23% (feet phase) of the participants. Provision of back and feet support has a small effect on the mean oscillometric BP. The magnitude of effect is greatest on diastolic BP when the back is unsupported.

Back pain was less explained than leg pain: a cross-sectional study using magnetic resonance imaging in low back pain patients with and without radiculopathy.

PubMed

Jensen, Ole Kudsk; Nielsen, Claus Vinther; Sørensen, Joan Solgaard; Stengaard-Pedersen, Kristian

2015-12-03

Cross-sectional studies have shown associations between lumbar degenerative manifestations on magnetic resonance imaging (MRI) and low back pain (LBP). Disc herniations and other degenerative manifestations, however, frequently occur in asymptomatic individuals. The purpose of this cross-sectional study was to analyze for associations between pain intensity and degenerative manifestations and other pain variables in patients for whom prognostic factors have been published previously. Included were 141 consecutive patients with and without radiculopathy, all sick-listed 1-4 months due to low back pain and subsequently examined by MRI of the lumbar spine. Using different methods of grouping the degenerative manifestations, linear regression analyses were performed with the intensity of back + leg pain, back pain and leg pain as dependent variables covering actual pain and pain the preceding 2 weeks. The clinical classification into +/- radiculopathy was established before and independently of the standardised description of MRI findings. Radiculopathy was present in 43 % of the patients. Pain was best explained using rank-ordered degenerative manifestations on MRI. Back pain and leg pain were differently associated, and back pain was less explained than leg pain in the multivariate analyses (15 % vs. 31 % of the variation). Back pain intensity was higher in patients with type 1 Modic changes and in some patients with nerve root touch, but was not associated with disc herniations. Leg pain intensity was well explained by disc herniations causing MRI nerve root compromise and radiculopathy. In patients with radiculopathy, nerve root touch caused as much leg pain as nerve root displacement or compression. High intensity zones and osteophytes were not associated with back pain, but only associated with leg pain in patients with radiculopathy. Tender points explained some of the back pain, and widespread pain explained leg pain in some of the patients without radiculopathy. Back pain was associated with type 1 Modic changes, nerve root touch and tender points, whereas leg pain was associated with osteophytes, HIZ, disc herniation, all sorts of MRI nerve root compromise, radiculopathy and widespread pain.

Early predictors of occupational back reinjury: results from a prospective study of workers in Washington State.

PubMed

Keeney, Benjamin J; Turner, Judith A; Fulton-Kehoe, Deborah; Wickizer, Thomas M; Chan, Kwun Chuen Gary; Franklin, Gary M

2013-01-15

Prospective population-based cohort study. To identify early predictors of self-reported occupational back reinjury within 1 year after work-related back injury. Back injuries are the costliest and most prevalent disabling occupational injuries in the United States. A substantial proportion of workers with back injuries have reinjuries after returning to work, yet there are few studies of risk factors for occupational back reinjuries. We aimed to identify the incidence and early (in the claim) predictors of self-reported back reinjury by approximately 1 year after the index injury among Washington State workers with new work disability claims for back injuries. The Washington Workers' Compensation Disability Risk Identification Study Cohort provided a large, population-based sample with information on variables in 7 domains: sociodemographic, employment-related, pain and function, clinical status, health care, health behavior, and psychological. We conducted telephone interviews with workers 3 weeks and 1 year after submission of a time-loss claim for the injury. We first identified predictors (P < 0.10) of self-reported reinjury within 1 year in bivariate analyses. Those variables were then included in a multivariate logistic regression model predicting occupational back reinjury. A total of 290 (25.8%) of 1123 (70.0% response rate) workers who completed the 1-year follow-up interview and had returned to work reported having reinjured their back at work. Baseline variables significantly associated with reinjury (P < 0.05) in the multivariate model included male sex, constant whole-body vibration at work, previous similar injury, 4 or more previous claims of any type, possessing health insurance, and high fear-avoidance scores. Baseline obesity was associated with reduced odds of reinjury. No other employment-related or psychological variables were significant. One-fourth of the workers who received work disability compensation for a back injury self-reported reinjury after returning to work. Baseline variables in multiple domains predicted occupational back reinjury. Increased knowledge of early risk factors for reinjury may help to lead to interventions, such as efforts to reduce fear avoidance and graded activity to promote recovery, effective in lowering the risk of reinjury.

Systematic review of back schools, brief education, and fear-avoidance training for chronic low back pain.

PubMed

Brox, J I; Storheim, K; Grotle, M; Tveito, T H; Indahl, A; Eriksen, H R

2008-01-01

Seven previous systematic reviews (SRs) have evaluated back schools, and one has evaluated brief education, with the latest SR including studies until November 2004. The effectiveness of fear-avoidance training has not been assessed. To assess the effectiveness of back schools, brief education, and fear-avoidance training for chronic low back pain (CLBP). A SR. We searched the MEDLINE database of randomized controlled trials (RCT) until August 2006 for relevant trials reported in English. Assessment of effectiveness was based on pain, disability, and sick leave. RCTs that reported back schools, or brief education as the main intervention, were included. For fear-avoidance training, evaluation of domain-specific outcome was required. Two reviewers independently reviewed the studies. Eight RCTs including 1,002 patients evaluated back schools, three studies were of high quality. We found conflicting evidence for back schools compared with waiting list, placebo, usual care, and exercises, and a cognitive behavioral back school. Twelve trials including 3,583 patients evaluated brief education. Seven trials, six of high quality, evaluated brief education in the clinical setting. We found strong evidence of effectiveness on sick leave and short-term disability compared with usual care. We found conflicting or limited evidence for back book or Internet discussion (five trials, two of high quality) compared with waiting list, no intervention, massage, yoga, or exercises. Three RCTs of high quality, including 364 patients, evaluated fear-avoidance training. We found moderate evidence that there is no difference between rehabilitation including fear-avoidance training and spinal fusion. Consistent recommendations are given for brief education in the clinical setting, and fear-avoidance training should be considered as an alternative to spinal fusion, and back schools may be considered in the occupational setting. The discordance between reviews can be attributed differences in inclusion criteria and application of evidence rules.

Back Pain Prevalence and Its Associated Factors in Brazilian Athletes from Public High Schools: A Cross-Sectional Study

PubMed Central

Noll, Matias; de Avelar, Ivan Silveira; Lehnen, Georgia Cristina; Vieira, Marcus Fraga

2016-01-01

Most studies on the prevalence of back pain have evaluated it in developed countries (Human Development Index—HDI > 0.808), and their conclusions may not hold for developing countries. The aim of this study was to identify the prevalence of back pain in representative Brazilian athletes from public high schools. This cross-sectional study was performed during the state phase of the 2015 Jogos dos Institutos Federais (JIF), or Federal Institutes Games, in Brazil (HDI = 0.744), and it enrolled 251 athletes, 173 males and 78 females (14–20 years old). The dependent variable was back pain, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, exercise-level, anthropometric, strength, behavioral, and postural factors. The prevalence ratio (PR) was calculated using multivariable analysis according to the Poisson regression model (α = 0.05). The prevalence of back pain in the three months prior to the study was 43.7% (n = 104), and 26% of the athletes reported feeling back pain only once. Multivariable analysis showed that back pain was associated with demographic (sex), psychosocial (loneliness and loss of sleep in the previous year), hereditary (ethnicity, parental back pain), strength (lumbar and hand forces), anthropometric (body mass index), behavioral (sleeping time per night, reading and studying in bed, smoking habits in the previous month), and postural (sitting posture while writing, while on a bench, and while using a computer) variables. Participants who recorded higher levels of lumbar and manual forces reported a lower prevalence of back pain (PR < 0.79), whereas feeling lonely in the previous year, obesity, and ethnicity exhibited the highest prevalence ratio (PR > 1.30). In conclusion, there is no association between exercise levels and back pain but there is an association between back pain and non-exercise related variables. PMID:26938456

Age Determination by Back Length for African Savanna Elephants: Extending Age Assessment Techniques for Aerial-Based Surveys

PubMed Central

Trimble, Morgan J.; van Aarde, Rudi J.; Ferreira, Sam M.; Nørgaard, Camilla F.; Fourie, Johan; Lee, Phyllis C.; Moss, Cynthia J.

2011-01-01

Determining the age of individuals in a population can lead to a better understanding of population dynamics through age structure analysis and estimation of age-specific fecundity and survival rates. Shoulder height has been used to accurately assign age to free-ranging African savanna elephants. However, back length may provide an analog measurable in aerial-based surveys. We assessed the relationship between back length and age for known-age elephants in Amboseli National Park, Kenya, and Addo Elephant National Park, South Africa. We also compared age- and sex-specific back lengths between these populations and compared adult female back lengths across 11 widely dispersed populations in five African countries. Sex-specific Von Bertalanffy growth curves provided a good fit to the back length data of known-age individuals. Based on back length, accurate ages could be assigned relatively precisely for females up to 23 years of age and males up to 17. The female back length curve allowed more precise age assignment to older females than the curve for shoulder height does, probably because of divergence between the respective growth curves. However, this did not appear to be the case for males, but the sample of known-age males was limited to ≤27 years. Age- and sex-specific back lengths were similar in Amboseli National Park and Addo Elephant National Park. Furthermore, while adult female back lengths in the three Zambian populations were generally shorter than in other populations, back lengths in the remaining eight populations did not differ significantly, in support of claims that growth patterns of African savanna elephants are similar over wide geographic regions. Thus, the growth curves presented here should allow researchers to use aerial-based surveys to assign ages to elephants with greater precision than previously possible and, therefore, to estimate population variables. PMID:22028925

The role of physical fitness as risk indicator of increased low back pain intensity among people working with physically and mentally disabled persons: a 30-month prospective study.

PubMed

Strøyer, Jesper; Jensen, Lone Donbaek

2008-03-01

A prospective cohort study. To study if low level of physical fitness was associated with increased low back pain (LBP) intensity at 30-month follow-up. The evidence of low physical fitness as a risk factor for LBP is inconclusive due to contradictory results. Study participants were 327 employees (women = 271, men = 56) at institutions for physically and mentally disabled persons. Physical fitness was measured by tests of: back extension and flexion endurance, flexibility and balance; and by self-assessed aerobic fitness, muscle strength, endurance, flexibility and balance, using visual analogue scales. Low back pain, lifestyle parameters, and physical and psychosocial work factors were assessed by questionnaires at baseline and at follow-up. Outcome was defined as an increase above 2 steps in average LBP intensity during the previous year (0-10). Persons with low level back endurance showed an insignificantly higher risk of increased LBP intensity (OR = 2.4, P = 0.076), whereas persons with medium level back endurance were at significantly higher risk (OR = 2.7, P = 0.034) compared with those with high level back endurance. The general association between isometric back extension endurance and increased LBP intensity was insignificant (P = 0.067). Persons with medium level self-assessed aerobic fitness were at lower risk of increased LBP intensity compared with those with high level (OR = 0.37, P = 0.02), although the general association of aerobic fitness was insignificant (0.066). Performance-based back flexion endurance, flexibility, and balance; and self-assessed muscle strength, endurance, flexibility, and balance were not associated with increased LBP intensity. The significant association between medium level back extension endurance and increased LBP intensity supports the finding of other studies that particularly back extension endurance is an important physical fitness component in preventing LBP and that the subcomponents of physical fitness are related in different ways to LBP.

Selected Aspects of Mental Health of Elderly Patients with Chronic Back Pain Treated in Primary Care Centers

PubMed Central

Cabak, Anna; Dąbrowska-Zimakowska, Anna; Tomaszewski, Paweł; Łyp, Marek; Kaczor, Ryszard; Tomaszewski, Wiesław; Fijałkowska, Barbara; Kotela, Ireneusz

2015-01-01

Background Improvement of the effectiveness and efficiency of chronic back pain therapy is a continuing challenge on an international scale. The aim of the present study was to tentatively assess mental health of patients with chronic back pain treated in primary care centers. Material/Methods The study enrolled 100 persons over 50 years of age. The back pain group consisted of 53 patients with chronic back pain and the control group consisted of 47 pain-free persons. The assessment of mental health used a Polish version of the international Goldberger’s General Health Questionnaire (GHQ-28). ANOVA (1- and 2-factor) analysis of variance, Tukey’s test, and Pearson’s simple correlation were used to analyze the significance of differences, with the significance level set at α=0.05. Results All patients with chronic back pain, regardless of their age and gender, displayed poorer mental well-being compared to the control group: their overall score was higher by over 7 points than in persons without back pain (F1.96=14.8; p<0.001). Men with back pain were significantly more susceptible to depression than women (F2.96=5.5; p<0.05), compared to the control group. The duration of back pain also showed a significant (p<0.05) direct correlation with the overall mental health score from the questionnaire. Mental health was considerably poorer among patients occasionally (p<0.001) and regularly (p<0.05) consuming analgesics than among persons who did not do so. Conclusions The study revealed that mental health was markedly poorer in patients with chronic back pain than in healthy controls. A preliminary assessment of aspects of mental health should be given more attention in the rehabilitation of patients with chronic back pain treated in primary care center outpatient clinics. PMID:26522877

Low Back Pain Fact Sheet

MedlinePlus

... strenuous weekend workout. Most low back pain is acute, or short term, and lasts a few days ... no residual loss of function. The majority of acute low back pain is mechanical in nature, meaning ...

Lumbar extensor muscle force control is associated with disability in people with chronic low back pain.

PubMed

Pranata, Adrian; Perraton, Luke; El-Ansary, Doa; Clark, Ross; Fortin, Karine; Dettmann, Tim; Brandham, Robert; Bryant, Adam

2017-07-01

The ability to control lumbar extensor force output is necessary for daily activities. However, it is unknown whether this ability is impaired in chronic low back pain patients. Similarly, it is unknown whether lumbar extensor force control is related to the disability levels of chronic low back pain patients. Thirty-three chronic low back pain and 20 healthy people performed lumbar extension force-matching task where they increased and decreased their force output to match a variable target force within 20%-50% maximal voluntary isometric contraction. Force control was quantified as the root-mean-square-error between participants' force output and target force across the entire, during the increasing and decreasing portions of the force curve. Within- and between-group differences in force-matching error and the relationship between back pain group's force-matching results and their Oswestry Disability Index scores were assessed using ANCOVA and linear regression respectively. Back pain group demonstrated more overall force-matching error (mean difference=1.60 [0.78, 2.43], P<0.01) and more force-matching error while increasing force output (mean difference=2.19 [1.01, 3.37], P<0.01) than control group. The back pain group demonstrated more force-matching error while increasing than decreasing force output (mean difference=1.74, P<0.001, 95%CI [0.87, 2.61]). A unit increase in force-matching error while decreasing force output is associated with a 47% increase in Oswestry score in back pain group (R 2 =0.19, P=0.006). Lumbar extensor muscle force control is compromised in chronic low back pain patients. Force-matching error predicts disability, confirming the validity of our force control protocol for chronic low back pain patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prognostic psychosocial factors for disabling low back pain in Japanese hospital workers.

PubMed

Yoshimoto, Takahiko; Oka, Hiroyuki; Katsuhira, Junji; Fujii, Tomoko; Masuda, Katsuhiko; Tanaka, Sakae; Matsudaira, Ko

2017-01-01

Although the occupational health field has identified psychosocial factors as risk factors for low back pain that causes disability, the association between disabling low back pain and psychosocial factors has not been examined adequately in Japanese hospital workers. Therefore, this study examined the association between low back pain, which interfered with work, and psychosocial factors in Japanese hospital workers. This cross-sectional study was conducted at a hospital in Japan. In total, 280 hospital workers were recruited from various occupational settings. Of these, 203 completed a self-administered questionnaire that included items concerning individual characteristics, severity of low back pain, fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire), somatic symptoms (Somatic Symptom Scale-8), psychological distress (K6), workaholism, and work-related psychosocial factors (response rate: 72.5%). Logistic regression was used to explore risk factors associated with disabling low back pain. Of the 203 participants who completed questionnaires, 36 (17.7%) reported low back pain that interfered with their work. Multivariate analyses with individual factors and occupations adjusted for showed statistically significant associations between disabling low back pain and fear-avoidance beliefs (adjusted odds ratio [OR]: 2.619, 95% confidence interval [CI]: 1.003-6.538], somatic symptoms (OR: 4.034, 95% CI: 1.819-9.337), and interpersonal stress at work (OR: 2.619, 95% CI: 1.067-6.224). Psychosocial factors, such as fear-avoidance beliefs, somatic symptoms, and interpersonal relationships at work, were important risk factors in low back pain that interfered with work in Japanese hospital workers. With respect to occupational health, consideration of psychosocial factors is required to reduce disability related to low back pain.

Discriminative ability of reflex receptive fields to distinguish patients with acute and chronic low back pain.

PubMed

Müller, Monika; Biurrun Manresa, José A; Treichel, Fabienne; Agten, Christoph A; Heini, Paul; Andersen, Ole K; Curatolo, Michele; Jüni, Peter

2016-12-01

Low back pain has a life time prevalence of 70% to 85%. Approximately 10% to 20% of all patients experience recurrent episodes or develop chronic low back pain. Sociodemographic, clinical, and psychological characteristics explain the transition from acute to chronic low back pain only to a limited extent. Altered central pain processing may be a contributing mechanism. The measurement of reflex receptive fields (RRF) is a novel method to assess altered central pain processing. The RRF area denotes the area of the foot sole from which spinal nociceptive reflexes can be elicited. It was shown to be enlarged in patients with acute and chronic low back pain compared with pain-free individuals. The aim of the study was to explore the discriminative ability of the RRF to distinguish patients with acute and chronic low back pain with the hypothesis that enlarged RRF are associated with chronic low back pain. We included 214 patients with either acute or chronic low back pain and compared RRF between groups in both univariable and multivariable analyses adjusted for different sociodemographic and clinical characteristics possibly associated with the transition to chronic pain. We found a mean difference between patients with acute and chronic low back pain of -0.01 (95% confidence interval [CI], -0.06 to 0.04) in the crude, -0.02 (95% CI, -0.08 to 0.04) in the age and sex adjusted, and -0.02 (95% CI, -0.09 to 0.05) in the fully adjusted model. Our results suggest that the enlargement of RRF area may not be associated with the transition from acute to chronic low back pain.

Low back pain among nurses in Slovenian hospitals: cross-sectional study.

PubMed

Skela-Savič, B; Pesjak, K; Hvalič-Touzery, S

2017-12-01

The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings. © 2017 International Council of Nurses.

[Acute lumbago due to the manual lifting of patients in wards: prevalence and incidence data].

PubMed

Colombini, D; Cianci, E; Panciera, D; Martinelli, M; Venturi, E; Giammartini, P; Ricci, M G; Menoni, O; Battevi, N

1999-01-01

The aim of the study was to measure the occurrence (prevalence and incidence) of episodes of acute low back pain (definite effect) in a wide sample of health workers assisting disabled patients. A questionnaire was used for the study both of true acute low back pain and of episodes of ingravescent low back pain controlled pharmacologically at the onset. The questionnaire identified overall acute and pharmacologically controlled episodes occurring in the previous 12 months, both in the course of work and over the whole life of the subject. Appropriately trained operators administered the questionnaire to 551 subjects; 481 valid answer cards were obtained from 372 females and 109 males working in medical, orthopaedic and geriatric departments. 75.4% of the sample had high exposure index levels for patient lifting. The prevalence of true acute low back pain was 9% in males and 11% in females referred to the previous 12 months. Taking acute true and pharmacologically controlled low back pain together the prevalences rose to 13.8% for males and 26.9% in females. Data from the reference populations showed that acute low back pain did not exceed 3% on average in the previous year. Since work seniority in the hospital wards was known, the incidences were calculated, giving 7.9% in females and 5.29% in males for acute low back pain, and 19% in females and 3.49% in males for pharmacologically controlled low back pain. Considering the number of episodes in 100 workers/year, acute low back pain alone reached prevalences of 13-14%. This therefore appears to confirm the positive ratio between episodes of low back pain and duties involving assistance to disabled patients.

Prognostic psychosocial factors for disabling low back pain in Japanese hospital workers

PubMed Central

Yoshimoto, Takahiko; Oka, Hiroyuki; Katsuhira, Junji; Fujii, Tomoko; Masuda, Katsuhiko; Tanaka, Sakae; Matsudaira, Ko

2017-01-01

Background Although the occupational health field has identified psychosocial factors as risk factors for low back pain that causes disability, the association between disabling low back pain and psychosocial factors has not been examined adequately in Japanese hospital workers. Therefore, this study examined the association between low back pain, which interfered with work, and psychosocial factors in Japanese hospital workers. Method This cross-sectional study was conducted at a hospital in Japan. In total, 280 hospital workers were recruited from various occupational settings. Of these, 203 completed a self-administered questionnaire that included items concerning individual characteristics, severity of low back pain, fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire), somatic symptoms (Somatic Symptom Scale-8), psychological distress (K6), workaholism, and work-related psychosocial factors (response rate: 72.5%). Logistic regression was used to explore risk factors associated with disabling low back pain. Results Of the 203 participants who completed questionnaires, 36 (17.7%) reported low back pain that interfered with their work. Multivariate analyses with individual factors and occupations adjusted for showed statistically significant associations between disabling low back pain and fear-avoidance beliefs (adjusted odds ratio [OR]: 2.619, 95% confidence interval [CI]: 1.003–6.538], somatic symptoms (OR: 4.034, 95% CI: 1.819–9.337), and interpersonal stress at work (OR: 2.619, 95% CI: 1.067–6.224). Conclusions Psychosocial factors, such as fear-avoidance beliefs, somatic symptoms, and interpersonal relationships at work, were important risk factors in low back pain that interfered with work in Japanese hospital workers. With respect to occupational health, consideration of psychosocial factors is required to reduce disability related to low back pain. PMID:28531194

Back pain in aircrew--an initial survey.

PubMed

Sheard, S C; Pethybridge, R J; Wright, J M; McMillan, G H

1996-05-01

In the early 1990's staff at a Royal Naval Air Station formed the view that pilots and observers of the Navy Lynx helicopter fleet appeared to have a higher incidence of back pain, to be seeking medical assistance more frequently and to be spending more time medically "unfit to fly" when compared to their counterparts in other helicopters. To quantify the incidence of low back pain in helicopter aircrew by use of a questionnaire. A questionnaire was used to establish the prevalence and nature of back pain in Naval aircrew (161) compared to a control group of randomly selected non-flying military personnel (310). Results show that aircrew (82%) experience significantly more back pain than controls (52%) (p < 0.01) though the nature of pain was similar in both groups. Significantly more aircrew (73%) than controls (49%) (p < 0.01) reported a previous history of back pain and report pain in shoulders (19%), midback (42%), lower back (72%) and across the buttocks (12%). Ergonomic factors were thought to be causative. Of aircrew surveyed, 11 (8%) had been issued with personal lumbar supports which resulted in major subjective improvements in flight-related symptoms. Helicopter aircrew have a higher incidence of back pain. Crew station design was identified as a major contributor to the prevalence of back pain while personal supports reduced the levels of discomfort. While these findings are not new, no significant steps have been taken to redesign the crew station. It is recommended that personal supports are provided to all aircrew and that a more detailed study of crew station ergonomics is indicated following a more comprehensive study of prevalence of back pain in Royal Navy aircrew.

High-resolution physical and biogeochemical variability from a shallow back reef on Ofu, American Samoa: an end-member perspective

NASA Astrophysics Data System (ADS)

Koweek, David A.; Dunbar, Robert B.; Monismith, Stephen G.; Mucciarone, David A.; Woodson, C. Brock; Samuel, Lianna

2015-09-01

Shallow back reefs commonly experience greater thermal and biogeochemical variability owing to a combination of coral community metabolism, environmental forcing, flow regime, and water depth. We present results from a high-resolution (sub-hourly to sub-daily) hydrodynamic and biogeochemical study, along with a coupled long-term (several months) hydrodynamic study, conducted on the back reefs of Ofu, American Samoa. During the high-resolution study, mean temperature was 29.0 °C with maximum temperatures near 32 °C. Dissolved oxygen concentrations spanned 32-178 % saturation, and pHT spanned the range from 7.80 to 8.39 with diel ranges reaching 0.58 units. Empirical cumulative distribution functions reveal that pHT was between 8.0 and 8.2 during only 30 % of the observational period, with approximately even distribution of the remaining 70 % of the time between pHT values less than 8.0 and greater than 8.2. Thermal and biogeochemical variability in the back reefs is partially controlled by tidal modulation of wave-driven flow, which isolates the back reefs at low tide and brings offshore water into the back reefs at high tide. The ratio of net community calcification to net community production was 0.15 ± 0.01, indicating that metabolism on the back reef was dominated by primary production and respiration. Similar to other back reef systems, the back reefs of Ofu are carbon sinks during the daytime. Shallow back reefs like those in Ofu may provide insights for how coral communities respond to extreme temperatures and acidification and are deserving of continued attention.

Investigating Research Gaps of Pharmaceutical take back Events: An Analysis of take back Program Participants' Socioeconomic, Demographic, and Geographic Characteristics and the Public Health Benefits of take back Programs

NASA Astrophysics Data System (ADS)

Stoddard, K. I.; Hodge, V.; Maxey, G.; Tiwari, C.; Cready, C.; Huggett, D. B.

2017-06-01

Research continues to show that pharmaceutical environmental contamination causes adverse effects to aquatic life. There are also public health risks associated with pharmaceuticals because in-home reserves of medications provide opportunities for accidental poisoning and intentional medication abuse. Pharmaceutical take back programs have been seen as a potential remedy for these issues; however, a thorough review of past programs indicates limited research has been conducted on take back programs. Furthermore, there are significant gaps in take back program research. To address these gaps and ultimately determine if take back programs could improve public health, research was conducted in conjunction with the take back program Denton drug disposal days held in Denton, Texas. Socioeconomic, demographic, and geographic characteristics of Denton drug disposal days participants were investigated using surveys and Geographic Information Systems. Potential impacts of the Denton drug disposal days program on public health were determined by comparing data from Denton drug disposal days events with data supplied by the North Texas Poison Center. Results suggest that Denton drug disposal days events may have prevented accidental poisonings or intentional abuse, however only qualitative comparisons support this statement and there was insufficient empirical evidence to support the conclusion that Denton drug disposal days events were exclusively responsible for public health improvements. An interesting finding was that there was a definitive travel threshold that influenced participation in Denton drug disposal days events. Overall, this study fills some geographic, socioeconomic, and demographic data gaps of take back programs and proposes methods to analyze and improve participation in future take back programs. These methods could also be applied to improve participation in other local environmentally-focused programs such as household hazardous collection events.

Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls

PubMed Central

Luomajoki, Hannu; Kool, Jan; de Bruin, Eling D; Airaksinen, Olavi

2008-01-01

Background To determine whether there is a difference between patients with low back pain and healthy controls in a test battery score for movement control of the lumbar spine. Methods This was a case control study, carried out in five outpatient physiotherapy practices in the German-speaking part of Switzerland. Twelve physiotherapists tested the ability of 210 subjects (108 patients with non-specific low back pain and 102 control subjects without back pain) to control their movements in the lumbar spine using a set of six tests. We observed the number of positive tests out of six (mean, standard deviation and 95% confidence interval of the mean). The significance of the differences between the groups was calculated with Mann-Whitney U test and p was set on <0.05. The effect size (d) between the groups was calculated and d>0.8 was considered a large difference. Results On average, patients with low back pain had 2.21(95%CI 1.94–2.48) positive tests and the healthy controls 0.75 (95%CI 0.55–0.95). The effect size was d = 1.18 (p < 0.001). There was a significant difference between acute and chronic (p < 0.01), as well as between subacute and chronic patient groups (p < 0.03), but not between acute and subacute patient groups (p > 0.7). Conclusion This is the first study demonstrating a significant difference between patients with low back pain and subjects without back pain regarding their ability to actively control the movements of the low back. The effect size between patients with low back pain and healthy controls in movement control is large. PMID:19108735

Back and neck pain prevalence and their association with physical inactivity domains in adolescents.

PubMed

Scarabottolo, Catarina Covolo; Pinto, R Z; Oliveira, C B; Zanuto, E F; Cardoso, J R; Christofaro, D G D

2017-09-01

Back pain affects people of all ages. This may be associated with physical inactivity, and in the case of physical activity in different domains, the relationship with back pain is not clear in the literature. The aim of this study was to estimate the prevalence of low back and neck pain and investigate their association in different domains of physical inactivity. 1011 randomly selected students participated in this study. Neck and back pain were assessed using the Nordic questionnaire, whereas the Baecke Physical Activity questionnaire was used to measure physical activity domains. Separate Binary Logistic Regression models were performed to investigate the association of physical activity domains with neck or back pain. 17.4% of the students reported cervical pain, while 18.0% reported low back pain. Older adolescents had a higher prevalence of cervical pain (24.4%) than younger adolescents (11.9%) (p value <0.001), as well as lumbar pain, being 25.1% in older adolescents and 12.4% in younger (p value <0.001). Adolescents physically inactive in the school environment were less likely to have pain in the cervical region [OR 0.67 (0.44-0.99)] or back pain [OR 0.60 (0.40-0.91)]. Being inactive in occupational activities was associated with cervical pain [OR 1.49 (1.06-2.10)]. Being inactive in the sports environment presented a marginal relationship with pain in the cervical region [OR 1.41 (0.99-2.02)]. The prevalence of neck and low back pain was higher in older adolescents and physical inactivity in the sporting context and occupational activities could be a risk factor to increase the chances of back pain.

Low back pain in young female gymnasts and the effect of specific segmental muscle control exercises of the lumbar spine: a prospective controlled intervention study.

PubMed

Harringe, M L; Nordgren, J S; Arvidsson, I; Werner, S

2007-10-01

Prospective controlled intervention study. To evaluate a specific segmental muscle training program of the lumbar spine in order to prevent and reduce low back pain in young female teamgym gymnasts. Teamgym is a team sport comprising three events: trampette, tumbling and floor programme. In a recent study, it was found that teamgym gymnasts practice and compete despite suffering from back pain. Specific muscle control exercises of the lumbar spine have shown good results in reducing pain intensity and functional disability levels in patients with low back pain. To our knowledge, this type of training has not been studied in an adolescent athletic population before. Fifty-one gymnasts, with and without LBP, 11-16 years old, from three top-level gymnastics team participated in the study comprising 12 weeks. Every day the gymnasts answered a questionnaire regarding low back pain. After baseline (4 weeks) the intervention group performed a specific segmental muscle training program. Twenty-four gymnasts (47%) reported low back pain during baseline. Nine gymnasts failed to answer the questionnaire every day and the following results are based on 42 gymnasts (intervention group, n = 30, and control group, n=12). Gymnasts in the intervention group reported significantly less number of days with low back pain at completion compared to baseline (P=0.02). Gymnasts in the control group showed no difference in terms of days with low back pain or intensity of low back pain between baseline and completion. Eight gymnasts (out of 15) with LBP in the intervention group became pain free. Specific segmental muscle control exercises of the lumbar spine may be of value in preventing and reducing low back pain in young teamgym gymnasts.

Effect of Superimposed Electromyostimulation on Back Extensor Strengthening: A Pilot Study.

PubMed

Park, Jae Hyeon; Seo, Kwan Sik; Lee, Shi-Uk

2016-09-01

Park, JH, Seo, KS, and Lee, S-U. Effect of superimposed electromyostimulation on back extensor strengthening: a pilot study. J Strength Cond Res 30(9): 2470-2475, 2016-Electromyostimulation (EMS) superimposed on voluntary contraction (VC) can increase muscle strength. However, no study has examined the effect of superimposing EMS on back extensor strengthening. The purpose of this study was to determine the effect of superimposed EMS on back extensor strengthening in healthy adults. Twenty healthy men, 20-29 years of age, without low-back pain were recruited. In the EMS group, electrodes were attached to bilateral L2 and L4 paraspinal muscles. Stimulation intensity was set for maximally tolerable intensity. With VC, EMS was superimposed for 10 seconds followed by a 20-second rest period. The same protocol was used in the sham stimulation (SS) group, except that the stimulation intensity was set at the lowest intensity (5 mA). All subjects performed back extension exercise using a Swiss ball, with 10 repetitions per set, 2 sets each day, 5 times a week for 2 weeks. The primary outcome measure was the change in isokinetic strength of the back extensor using an isokinetic dynamometer. Additionally, endurance was measured using the Sorensen test. After 2 weeks of back extension exercise, the peak torque and endurance increased significantly in both groups (p ≤ 0.05). Effect size between the EMS group and the SS group was medium in strength and endurance. However, there was no statistically significant difference between 2 groups. In conclusion, 2 weeks of back extensor strengthening exercise was effective for strength and endurance. Superimposing EMS on back extensor strengthening exercise could provide an additional effect on increasing strength.

Development Of A Multivariate Prognostic Model For Pain And Activity Limitation In People With Low Back Disorders Receiving Physiotherapy.

PubMed

Ford, Jon J; Richards BPhysio, Matt C; Surkitt BPhysio, Luke D; Chan BPhysio, Alexander Yp; Slater, Sarah L; Taylor, Nicholas F; Hahne, Andrew J

2018-05-28

To identify predictors for back pain, leg pain and activity limitation in patients with early persistent low back disorders. Prospective inception cohort study; Setting: primary care private physiotherapy clinics in Melbourne, Australia. 300 adults aged 18-65 years with low back and/or referred leg pain of ≥6-weeks and ≤6-months duration. Not applicable. Numerical rating scales for back pain and leg pain as well as the Oswestry Disability Scale. Prognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (p<0.05) associations with at least one of the three outcomes. There were five indicators of positive outcome (two types of low back disorder subgroups, paresthesia below waist, walking as an easing factor and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity and higher pain drawing percentage coverage). The preliminary model identifying predictors of low back disorders explained up to 37% of the variance in outcome. This study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of low back disorders. The preliminary multivariate model requires further validation before being considered for clinical use. Copyright © 2018. Published by Elsevier Inc.

Investigating Research Gaps of Pharmaceutical take back Events: An Analysis of take back Program Participants' Socioeconomic, Demographic, and Geographic Characteristics and the Public Health Benefits of take back Programs.

PubMed

Stoddard, K I; Hodge, V; Maxey, G; Tiwari, C; Cready, C; Huggett, D B

2017-06-01

Research continues to show that pharmaceutical environmental contamination causes adverse effects to aquatic life. There are also public health risks associated with pharmaceuticals because in-home reserves of medications provide opportunities for accidental poisoning and intentional medication abuse. Pharmaceutical take back programs have been seen as a potential remedy for these issues; however, a thorough review of past programs indicates limited research has been conducted on take back programs. Furthermore, there are significant gaps in take back program research. To address these gaps and ultimately determine if take back programs could improve public health, research was conducted in conjunction with the take back program Denton drug disposal days held in Denton, Texas. Socioeconomic, demographic, and geographic characteristics of Denton drug disposal days participants were investigated using surveys and Geographic Information Systems. Potential impacts of the Denton drug disposal days program on public health were determined by comparing data from Denton drug disposal days events with data supplied by the North Texas Poison Center. Results suggest that Denton drug disposal days events may have prevented accidental poisonings or intentional abuse, however only qualitative comparisons support this statement and there was insufficient empirical evidence to support the conclusion that Denton drug disposal days events were exclusively responsible for public health improvements. An interesting finding was that there was a definitive travel threshold that influenced participation in Denton drug disposal days events. Overall, this study fills some geographic, socioeconomic, and demographic data gaps of take back programs and proposes methods to analyze and improve participation in future take back programs. These methods could also be applied to improve participation in other local environmentally-focused programs such as household hazardous collection events.

Returning to sports after a back injury

MedlinePlus

... medlineplus.gov/ency/patientinstructions/000518.htm Returning to sports after a back injury To use the sharing ... Back pain - returning to sports Which Type of Sport is Best? In deciding when and if to ...

Back reaction effects on the dynamics of heavy probes in heavy quark cloud

NASA Astrophysics Data System (ADS)

Chakrabortty, Shankhadeep; Dey, Tanay K.

2016-05-01

We holographically study the effect of back reaction on the hydrodynamical properties of {N}=4 strongly coupled super Yang-Mills (SYM) thermal plasma. The back reaction we consider arises from the presence of static heavy quarks uniformly distributed over {N}=4 SYM plasma. In order to study the hydrodynamical properties, we use heavy quark as well as heavy quark-antiquark bound state as probes and compute the jet quenching parameter, screening length and binding energy. We also consider the rotational dynamics of heavy probe quark in the back-reacted plasma and analyse associated energy loss. We observe that the presence of back reaction enhances the energy-loss in the thermal plasma. Finally, we show that there is no effect of angular drag on the rotational motion of quark-antiquark bound state probing the back reacted thermal plasma.

Using the Teach-Back Method in Patient Education to Improve Patient Satisfaction.

PubMed

Centrella-Nigro, Andrea M; Alexander, Catherine

2017-01-01

This quasi-experimental research study used two similar nursing units to test the effects of teach back on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. A pretest-posttest design tested 24 nurses' knowledge, attitudes, and beliefs about teach back. Education specialists provided a 1-hour teaching session on teach back to all nurses in the intervention unit. A significant improvement in knowledge scores in the pretest-posttest was found using paired t tests (p = .002). Qualitative analysis of nurses' comments demonstrated strong support for teach back in the post-test. The HCAHPS scores were not significantly improved in the intervention unit when compared with the control unit. More research needs to be conducted to determine the effectiveness of teach back on HCAHPS scores. J Contin Educ Nurs. 2017;48(1):47-52. Copyright 2017, SLACK Incorporated.

Method for formation of high quality back contact with screen-printed local back surface field

DOEpatents

Rohatgi, Ajeet; Meemongkolkiat, Vichai

2010-11-30

A thin silicon solar cell having a back dielectric passivation and rear contact with local back surface field is described. Specifically, the solar cell may be fabricated from a crystalline silicon wafer having a thickness from 50 to 500 micrometers. A barrier layer and a dielectric layer are applied at least to the back surface of the silicon wafer to protect the silicon wafer from deformation when the rear contact is formed. At least one opening is made to the dielectric layer. An aluminum contact that provides a back surface field is formed in the opening and on the dielectric layer. The aluminum contact may be applied by screen printing an aluminum paste having from one to 12 atomic percent silicon and then applying a heat treatment at 750 degrees Celsius.

[Rehabilitation for the patients with low-back pain].

PubMed

Shirado, Osamu; Watanabe, Yasuyuki; Kawase, Masafumi

2005-03-01

The first choice for the treatment of low-back pain should be physical therapy, or rehabilitation. These are mainly divided into two modalities; passive and active modality. The former includes bed rest, hot pack, massage, and brace. The latter includes therapeutic exercise. The modality used should be dependent of the stages in each patient. Bed rest is indicated in the acute stage within a week after the occurrence low-back pain. The rest longer than a week is basically contraindicated, because of disuse syndrome such as muscle weakness, osteoporosis, and soft tissue contracture. Therapeutic exercise is the mainstay in the chronic stage. It includes trunk muscles strengthening exercise and stretching. Lumbar stabilization exercise has currently drawn attention for the treatment of low-back pain. Patient education such as back-school also plays an important role to manage low-back pain.

Contoured Surface Eddy Current Inspection System

DOEpatents

Batzinger, Thomas James; Fulton, James Paul; Rose, Curtis Wayne; Perocchi, Lee Cranford

2003-04-08

Eddy current inspection of a contoured surface of a workpiece is performed by forming a backing piece of flexible, resiliently yieldable material with a contoured exterior surface conforming in shape to the workpiece contoured surface. The backing piece is preferably cast in place so as to conform to the workpiece contoured surface. A flexible eddy current array probe is attached to the contoured exterior surface of the backing piece such that the probe faces the contoured surface of the workpiece to be inspected when the backing piece is disposed adjacent to the workpiece. The backing piece is then expanded volumetrically by inserting at least one shim into a slot in the backing piece to provide sufficient contact pressure between the probe and the workpiece contoured surface to enable the inspection of the workpiece contoured surface to be performed.

Development of a systematic observation protocol of physical exposure of the back: a preliminary study.

PubMed

Tousignant, M; Tougas, G; Rossignol, M; Goulet, L

2002-04-01

At present there is no systematic observation protocol for the assessment of the multi-factorial aspects of physical exposure related to the back used within the constraints of occupational epidemiological research. In this context, a new preliminary systematic observation protocol is proposed to assess exposure to physical loading of the back using nine categories of physical risk factors: the SOPE back protocol. The objective of this study was to investigate whether the new protocol can correctly identify the level of exposure related to measured physical loading of the back. The subjects of this closed cohort study were 451 manual workers at a natural gas distribution company. The assessment of exposure was made with the protocol using groups with different job titles. The workers were followed for a 2 yr period to establish the risk of a new occurrence of complete disability related to the back (NOCD back injury) in each job grouping. Based on the median of the total scores derived from the protocol, two levels of exposure were identified (high and low). Taking into account the limitations of this study, the protocol in development may be a good tool to establish two levels of exposure to physical loading of the back in large epidemiological studies of occupational low back pain. Further research is needed to replicate these results with larger samples and to test the reliability and predictive validity of the protocol.

Economic benefit of back titration in the treatment of hypertension in Jos, Nigeria.

PubMed

Okeahialam, Basil N; Adeniyi, Michael A

2017-01-01

Treatment of hypertension is expensive and cost is one of the reasons for inadequate blood pressure control. Where there are no social cost cushions, the burden is borne by patients. With pervasive poverty and inadequate control, complications are unchecked. Back titration in appropriate circumstances should, therefore, translate to economic benefit. This is an attempt to compute, in economic terms, the benefit of back titration. Thirty-nine patients who entered an antihypertensive back titration program for 12 months and who had been earlier reported on, form the subject of this study. A survey of the cost of antihypertensives in pharmacy outlets in Jos, Nigeria was undertaken. Regimens of antihypertensives that patients were on at the onset and end of the 12 months of back titration were costed in Nigerian currency and compared. Back titration translated to economic benefit in all patients with a cost reduction varying from 2.3% to 100%. This reflected in reduction in mean daily cost of treatment of N107.09-N54.61. The benefit of antihypertensive back titration apart from psychological relief of lower pill burden and side effect profile is in pharmacoeconomics. This permits greater adherence and prevents morbi-mortality consequences of hypertension. In this study, back titration over 12 months translated to average cost reduction of >50%, making treatment more affordable. In appropriate circumstances, back titration of antihypertensives results in economic relief for patients. This should improve adherence, reduce morbi-mortality and is recommended for wider application.

Influence of chronic back pain on kinematic reactions to unpredictable arm pulls.

PubMed

Götze, Martin; Ernst, Michael; Koch, Markus; Blickhan, Reinhard

2015-03-01

There is evidence that muscle reflexes are delayed in patients with chronic low back pain in response to perturbations. It is still unrevealed whether these delays accompanied by an altered kinematic or compensated by adaption of other muscle parameters. The aim of this study was to investigate whether chronic low back pain patients show an altered kinematic reaction and if such data are reliable for the classification of chronic low back pain. In an experiment involving 30 females, sudden lateral perturbations were applied to the arm of a subject in an upright, standing position. Kinematics was used to distinguish between chronic low back pain patients and healthy controls. A calculated model of a stepwise discriminant function analysis correctly predicted 100% of patients and 80% of healthy controls. The estimation of the classification error revealed a constant rate for the classification of the healthy controls and a slightly decreased rate for the patients. Observed reflex delays and identified kinematic differences inside and outside the region of pain during impaired movement indicated that chronic low back pain patients have an altered motor control that is not restricted to the lumbo-pelvic region. This applied paradigm of external perturbations can be used to detect chronic low back pain patients and also persons without chronic low back pain but with an altered motor control. Further investigations are essential to reveal whether healthy persons with changes in motor function have an increased potential to develop chronic back pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

The ties to unbind: age-related differences in feature (un)binding in working memory for emotional faces

PubMed Central

Pehlivanoglu, Didem; Jain, Shivangi; Ariel, Robert; Verhaeghen, Paul

2014-01-01

In the present study, we investigated age-related differences in the processing of emotional stimuli. Specifically, we were interested in whether older adults would show deficits in unbinding emotional expression (i.e., either no emotion, happiness, anger, or disgust) from bound stimuli (i.e., photographs of faces expressing these emotions), as a hyper-binding account of age-related differences in working memory would predict. Younger and older adults completed different N-Back tasks (side-by-side 0-Back, 1-Back, 2-Back) under three conditions: match/mismatch judgments based on either the identity of the face (identity condition), the face’s emotional expression (expression condition), or both identity and expression of the face (both condition). The two age groups performed more slowly and with lower accuracy in the expression condition than in the both condition, indicating the presence of an unbinding process. This unbinding effect was more pronounced in older adults than in younger adults, but only in the 2-Back task. Thus, older adults seemed to have a specific deficit in unbinding in working memory. Additionally, no age-related differences were found in accuracy in the 0-Back task, but such differences emerged in the 1-Back task, and were further magnified in the 2-Back task, indicating independent age-related differences in attention/STM and working memory. Pupil dilation data confirmed that the attention/STM version of the task (1-Back) is more effortful for older adults than younger adults. PMID:24795660

Efficacy of transverse tripolar spinal cord stimulator for the relief of chronic low back pain from failed back surgery.

PubMed

Buvanendran, Asokumar; Lubenow, Timothy J

2008-01-01

Failed back surgery syndrome is a common clinical entity for which spinal cord stimulation has been found to be an effective mode of analgesia, but with variable success rates. To determine if focal stimulation of the dorsal columns with a transverse tripolar lead might achieve deeper penetration of the electrical stimulus into the spinal cord and therefore provide greater analgesia to the back. Case report. We describe a 42-year-old female with failed back surgery syndrome that had greater back pain than leg pain. The tripolar lead configuration was achieved by placing percutaneously an octapolar lead in the spinal midline followed by 2 adjacent quadripolar leads, advanced to the T7-T10 vertebral bodies. Tripolar stimulation pattern resulted in more than 70% pain relief in this patient during the screening trial, while stimulation of one or 2 electrodes only provided 20% pain relief. After implantation of a permanent tripolar electrode system with a single rechargeable battery, the pain relief was maintained for one year. This is case report describing a case of a patient with chronic low back pain with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation and provide analgesia to the lower back.

Foot posture, foot function and low back pain: the Framingham Foot Study

PubMed Central

Menz, Hylton B.; Dufour, Alyssa B.; Riskowski, Jody L.; Hillstrom, Howard J.

2013-01-01

Objective. Abnormal foot posture and function have been proposed as possible risk factors for low back pain, but this has not been examined in detail. The objective of this study was to explore the associations of foot posture and foot function with low back pain in 1930 members of the Framingham Study (2002–05). Methods. Low back pain, aching or stiffness on most days was documented on a body chart. Foot posture was categorized as normal, planus or cavus using static weight-bearing measurements of the arch index. Foot function was categorized as normal, pronated or supinated using the centre of pressure excursion index derived from dynamic foot pressure measurements. Sex-specific multivariate logistic regression models were used to examine the associations of foot posture, foot function and asymmetry with low back pain, adjusting for confounding variables. Results. Foot posture showed no association with low back pain. However, pronated foot function was associated with low back pain in women [odds ratio (OR) = 1.51, 95% CI 1.1, 2.07, P = 0.011] and this remained significant after adjusting for age, weight, smoking and depressive symptoms (OR = 1.48, 95% CI 1.07, 2.05, P = 0.018). Conclusion. These findings suggest that pronated foot function may contribute to low back symptoms in women. Interventions that modify foot function, such as orthoses, may therefore have a role in the prevention and treatment of low back pain. PMID:24049103

The ties to unbind: age-related differences in feature (un)binding in working memory for emotional faces.

PubMed

Pehlivanoglu, Didem; Jain, Shivangi; Ariel, Robert; Verhaeghen, Paul

2014-01-01

In the present study, we investigated age-related differences in the processing of emotional stimuli. Specifically, we were interested in whether older adults would show deficits in unbinding emotional expression (i.e., either no emotion, happiness, anger, or disgust) from bound stimuli (i.e., photographs of faces expressing these emotions), as a hyper-binding account of age-related differences in working memory would predict. Younger and older adults completed different N-Back tasks (side-by-side 0-Back, 1-Back, 2-Back) under three conditions: match/mismatch judgments based on either the identity of the face (identity condition), the face's emotional expression (expression condition), or both identity and expression of the face (both condition). The two age groups performed more slowly and with lower accuracy in the expression condition than in the both condition, indicating the presence of an unbinding process. This unbinding effect was more pronounced in older adults than in younger adults, but only in the 2-Back task. Thus, older adults seemed to have a specific deficit in unbinding in working memory. Additionally, no age-related differences were found in accuracy in the 0-Back task, but such differences emerged in the 1-Back task, and were further magnified in the 2-Back task, indicating independent age-related differences in attention/STM and working memory. Pupil dilation data confirmed that the attention/STM version of the task (1-Back) is more effortful for older adults than younger adults.

The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain.

PubMed

O'Sullivan, Peter B; Mitchell, Tim; Bulich, Paul; Waller, Rob; Holte, Johan

2006-11-01

This preliminary cross-sectional study was undertaken to determine if there were measurable relationships between posture, back muscle endurance and low back pain (LBP) in industrial workers with a reported history of flexion strain injury and flexion pain provocation. Clinical reports state that subjects with flexion pain disorders of the lumbar spine commonly adopt passive flexed postures such as slump sitting and present with associated dysfunction of the spinal postural stabilising musculature. However, to date there is little empirical evidence to support that patients with back pain, posture their spines differently than pain-free subjects. Subjects included 21 healthy industrial workers and 24 industrial workers with flexion-provoked LBP. Lifestyle information, lumbo-pelvic posture in sitting, standing and lifting, and back muscle endurance were measured. LBP subjects had significantly reduced back muscle endurance (P < 0.01). LBP subjects sat with less hip flexion, (P = 0.05), suggesting increased posterior pelvic tilt in sitting. LBP subjects postured their spines significantly closer to their end of range lumbar flexion in 'usual' sitting than the healthy controls (P < 0.05). Correlations between increased time spent sitting, physical inactivity and poorer back muscle endurance were also identified. There were no significant differences found between the groups for the standing and lifting posture measures. These preliminary results support that a relationship may exist between flexed spinal postures, reduced back muscle endurance, physical inactivity and LBP in subjects with a history of flexion injury and pain.

A comparison of muscle activation between back squats and belt squats.

PubMed

Evans, Thomas W; McLester, Cherilyn N; Howard, Jonathan H; McLester, John R; Calloway, Jimmy P

2017-06-08

A machine belt squat is a piece of equipment designed to allow the performance of squats while loading weight on the lifter's hips using a belt. The purpose of this investigation was to determine if belt squats differ from back squats in activation of the primary movers, and to determine the predictive capabilities of back squat load, training status, and anthropometric data on belt squat load. Thirty-one participants (16 males and 15 females) completed anthropometric measurements, a demographic questionnaire, a familiarization visit, and two testing visits, completing a 5 repetition maximum test for back squat and belt squat. Surface electromyography was used to measure muscle activation for the left and right vastus medialis (VMO), vastus lateralis (VLO), rectus femoris (RF), and gluteus maximus (GM). Comparison of muscle activation between the two exercises showed significant differences in the left GM (back squat: 0.84 ± 0.45, belt squat: 0.69 ± 0.22, p=0.015) and right GM (back squat: 0.86 ± 0.45, belt squat: 0.71 ± 0.29, p=0.004). Regression analysis computed significant prediction equations for belt squat load for general population, males, females, and advanced lifters. Overall, results indicate that belt squats may significantly differ in GM activation from back squats. Back squat load, as well as other variables, may be effective in accurately estimating appropriate belt squat load. These findings may help to more appropriately program for training with machine belt squats as a back squat alternative.

Biomechanical, psychosocial and individual risk factors predicting low back functional impairment among furniture distribution employees

PubMed Central

Ferguson, Sue A.; Allread, W. Gary; Burr, Deborah L.; Heaney, Catherine; Marras, William S.

2013-01-01

Background Biomechanical, psychosocial and individual risk factors for low back disorder have been studied extensively however few researchers have examined all three risk factors. The objective of this was to develop a low back disorder risk model in furniture distribution workers using biomechanical, psychosocial and individual risk factors. Methods This was a prospective study with a six month follow-up time. There were 454 subjects at 9 furniture distribution facilities enrolled in the study. Biomechanical exposure was evaluated using the American Conference of Governmental Industrial Hygienists (2001) lifting threshold limit values for low back injury risk. Psychosocial and individual risk factors were evaluated via questionnaires. Low back health functional status was measured using the lumbar motion monitor. Low back disorder cases were defined as a loss of low back functional performance of −0.14 or more. Findings There were 92 cases of meaningful loss in low back functional performance and 185 non cases. A multivariate logistic regression model included baseline functional performance probability, facility, perceived workload, intermediated reach distance number of exertions above threshold limit values, job tenure manual material handling, and age combined to provide a model sensitivity of 68.5% and specificity of 71.9%. Interpretation: The results of this study indicate which biomechanical, individual and psychosocial risk factors are important as well as how much of each risk factor is too much resulting in increased risk of low back disorder among furniture distribution workers. PMID:21955915

Producing thin film photovoltaic modules with high integrity interconnects and dual layer contacts

DOEpatents

Jansen, Kai W.; Maley, Nagi

2000-01-01

High performance photovoltaic modules are produced with improved interconnects by a special process. Advantageously, the photovoltaic modules have a dual layer back (rear) contact and a front contact with at least one layer. The front contact and the inner layer of the back contact can comprise a transparent conductive oxide. The outer layer of the back contact can comprise a metal or metal oxide. The front contact can also have a dielectric layer. In one form, the dual layer back contact comprises a zinc oxide inner layer and an aluminum outer layer and the front contact comprises a tin oxide inner layer and a silicon dioxide dielectric outer layer. One or more amorphous silicon-containing thin film semiconductors can be deposited between the front and back contacts. The contacts can be positioned between a substrate and an optional superstrate. During production, the transparent conductive oxide layer of the front contact is scribed by a laser, then the amorphous silicon-containing semiconductors and inner layer of the dual layer back contact are simultaneously scribed and trenched (drilled) by the laser and the trench is subsequently filled with the same metal as the outer layer of the dual layer back contact to provide a superb mechanical and electrical interconnect between the front contact and the outer layer of the dual layer back contact. The outer layer of the dual layer back contact can then be scribed by the laser. For enhanced environmental protection, the photovoltaic modules can be encapsulated.

Producing thin film photovoltaic modules with high integrity interconnects and dual layer contacts

DOEpatents

Jansen, Kai W.; Maley, Nagi

2001-01-01

High performance photovoltaic modules are produced with improved interconnects by a special process. Advantageously, the photovoltaic modules have a dual layer back (rear) contact and a front contact with at least one layer. The front contact and the inner layer of the back contact can comprise a transparent conductive oxide. The outer layer of the back contact can comprise a metal or metal oxide. The front contact can also have a dielectric layer. In one form, the dual layer back contact comprises a zinc oxide inner layer and an aluminum outer layer and the front contact comprises a tin oxide inner layer and a silicon dioxide dielectric outer layer. One or more amorphous silicon-containing thin film semiconductors can be deposited between the front and back contacts. The contacts can be positioned between a substrate and an optional superstrate. During production, the transparent conductive oxide layer of the front contact is scribed by a laser, then the amorphous silicon-containing semiconductors and inner layer of the dual layer back contact are simultaneously scribed and trenched (drilled) by the laser and the trench is subsequently filled with the same metal as the outer layer of the dual layer back contact to provide a superb mechanical and electrical interconnect between the front contact and the outer layer of the dual layer back contact. The outer layer of the dual layer back contact can then be scribed by the laser. For enhanced environmental protection, the photovoltaic modules can be encapsulated.

Low Back Imaging When Not Indicated: A Descriptive Cross-System Analysis.

PubMed

Gold, Rachel; Esterberg, Elizabeth; Hollombe, Celine; Arkind, Jill; Vakarcs, Patricia A; Tran, Huong; Burdick, Tim; Devoe, Jennifer E; Horberg, Michael A

2016-01-01

Guideline-discordant imaging to evaluate incident low back pain is common. We compared rates of guideline-discordant imaging in patients with low back pain in two care delivery systems with differing abilities to track care through an electronic health record (EHR), and in their patients' insurance status, to measure the association between these factors and rates of ordered low back imaging. We used data from two Kaiser Permanente (KP) Regions and from OCHIN, a community health center network. We extracted data on imaging performed after index visits for low back pain from June 1, 2011, to May 31, 2012, in these systems. Adjusted logistic regression measured associations between system-level factors and imaging rates. Imaging rates for incident low back pain using 2 national quality metrics: Clinical Quality Measure 0052, a measure for assessing Meaningful Use of EHRs, and the Healthcare Effectiveness Data and Information Set measure "Use of Imaging Studies for Low Back Pain." Among 19,503 KP patients and 2694 OCHIN patients with incident low back pain, ordered imaging was higher among men and whites but did not differ across health care systems. OCHIN's publicly insured patients had higher rates of imaging compared with those with private or no insurance. Rates of ordered imaging to evaluate incident low back pain among uninsured OCHIN patients were lower than in KP overall; among insured OCHIN patients, rates were higher than in KP overall. Research is needed to establish causality and develop interventions.

Back schools for acute and subacute non-specific low-back pain.

PubMed

Poquet, Nolwenn; Lin, Chung-Wei Christine; Heymans, Martijn W; van Tulder, Maurits W; Esmail, Rosmin; Koes, Bart W; Maher, Christopher G

2016-04-26

Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating people with low-back pain (LBP). However, the content of back schools has changed and appears to vary widely today. In this review we defined back school as a therapeutic programme given to groups of people, which includes both education and exercise. This is an update of a Cochrane review first published in 1999, and updated in 2004. For this review update, we split the review into two distinct reviews which separated acute from chronic LBP. To assess the effectiveness of back schools on pain and disability for people with acute or subacute non-specific LBP. We also examined the effect on work status and adverse events. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, PubMed and two clinical trials registers up to 4 August 2015. We also checked the reference lists of articles and contacted experts in the field of research on LBP. We included randomised controlled trials (RCTs) or quasi-RCTs that reported on back school for acute or subacute non-specific LBP. The primary outcomes were pain and disability. The secondary outcomes were work status and adverse events. Back school had to be compared with another treatment, a placebo (or sham or attention control) or no treatment. We used the 2009 updated method guidelines for this Cochrane review. Two review authors independently screened the references, assessed the quality of the trials and extracted the data. We set the threshold for low risk of bias, a priori, as six or more of 13 internal validity criteria and no serious flaws (e.g. large drop-out rate). We classified the quality of the evidence into one of four levels (high, moderate, low or very low) using the adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We contacted study authors for additional information. We collected adverse effects information from the trials. The search update identified 273 new references, of which none fulfilled our inclusion criteria. We included four studies (643 participants) in this updated review, which were all included in the previous (2004) update. The quality of the evidence was very low for all outcomes. As data were too clinically heterogeneous to be pooled, we described individual trial results. The results indicate that there is very low quality evidence that back schools are no more effective than a placebo (or sham or attention control) or another treatment (physical therapies, myofascial therapy, joint manipulations, advice) on pain, disability, work status and adverse events at short-term, intermediate-term and long-term follow-up. There is very low quality evidence that shows a statistically significant difference between back schools and a placebo (or sham or attention control) for return to work at short-term follow-up in favour of back school. Very low quality evidence suggests that back school added to a back care programme is more effective than a back care programme alone for disability at short-term follow-up. Very low quality evidence also indicates that there is no difference in terms of adverse events between back school and myofascial therapy, joint manipulation and combined myofascial therapy and joint manipulation. It is uncertain if back schools are effective for acute and subacute non-specific LBP as there is only very low quality evidence available. While large well-conducted studies will likely provide more conclusive findings, back schools are not widely used interventions for acute and subacute LBP and further research into this area may not be a priority.

The Effect of Back Pressure on the Operation of a Diesel Engine

DTIC Science & Technology

2011-02-01

increased back pressure on a turbocharged diesel engine. Steady state and varying back pressure are considered. The results show that high back...a turbocharged diesel engine using the Ricardo Wave engine modelling software, to gain understanding of the problem and provide a good base for...higher pressure. The pressure ratios across the turbocharger compressor and turbine decrease, reducing the mass flow of air through these components

The Effect of Back Pressure on the Operation of a Disel Engine

DTIC Science & Technology

2011-02-01

increased back pressure on a turbocharged diesel engine. Steady state and varying back pressure are considered. The results show that high back...a turbocharged diesel engine using the Ricardo Wave engine modelling software, to gain understanding of the problem and provide a good base for...higher pressure. The pressure ratios across the turbocharger compressor and turbine decrease, reducing the mass flow of air through these components

Prevention of Low Back Pain in the Military: A Randomized Clinical Trial

DTIC Science & Technology

2009-06-01

interventions and strategies that are implemented during the acute episode of low back injury, before chronic symptoms occur.1 Secondary prevention reduces...SERIOUS SPINAL PATHOLOGY IN PATIENTS PRESENTING TO PRIMARY CARE WITH ACUTE LOW BACK PAIN Henschke N, Maher C, Refshauge KM, Herbert RD, Cumming R...physiotherapists, general prac- titioners, chiropractors) for acute low back pain. At the initial consul- tation clinicians recorded responses to 25

Reliability and Validity of a New Method for Isometric Back Extensor Strength Evaluation Using A Hand-Held Dynamometer.

PubMed

Park, Hee-Won; Baek, Sora; Kim, Hong Young; Park, Jung-Gyoo; Kang, Eun Kyoung

2017-10-01

To investigate the reliability and validity of a new method for isometric back extensor strength measurement using a portable dynamometer. A chair equipped with a small portable dynamometer was designed (Power Track II Commander Muscle Tester). A total of 15 men (mean age, 34.8±7.5 years) and 15 women (mean age, 33.1±5.5 years) with no current back problems or previous history of back surgery were recruited. Subjects were asked to push the back of the chair while seated, and their isometric back extensor strength was measured by the portable dynamometer. Test-retest reliability was assessed with intraclass correlation coefficient (ICC). For the validity assessment, isometric back extensor strength of all subjects was measured by a widely used physical performance evaluation instrument, BTE PrimusRS system. The limit of agreement (LoA) from the Bland-Altman plot was evaluated between two methods. The test-retest reliability was excellent (ICC=0.82; 95% confidence interval, 0.65-0.91). The Bland-Altman plots demonstrated acceptable agreement between the two methods: the lower 95% LoA was -63.1 N and the upper 95% LoA was 61.1 N. This study shows that isometric back extensor strength measurement using a portable dynamometer has good reliability and validity.

Triggers for an episode of sudden onset low back pain: study protocol

PubMed Central

2012-01-01

Background Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. The aim of this study is to quantify the transient increase in risk of a sudden episode of low back pain associated with acute exposure to a range of common physical and psychological factors. Methods/design This study uses a case-crossover design. One thousand adults with a sudden onset of low back pain presenting to primary care clinicians will be recruited. Basic demographic and clinical information including exposure to putative triggers will be collected using a questionnaire. These triggers include exposure to hazardous manual tasks, physical activity, a slip/trip or fall, consumption of alcohol, sexual activity, being distracted, and being fatigued or tired. Exposures in the case window (0-2 hours from the time when participants first notice their back pain) will be compared to exposures in two control time-windows (one 24-26 hours and another 48-50 hours before the case window). Discussion The completion of this study will provide the first-research based estimates of the increase in risk of a sudden episode of acute low back pain associated with transient exposure to a range of common factors thought to trigger low back pain. PMID:22273001

Occupational back disability in U.S. Army personnel.

PubMed

Berkowitz, S M; Feuerstein, M; Lopez, M S; Peck, C A

1999-06-01

Musculoskeletal disorders represent a prevalent source of outpatient visits, lost work time, hospitalization, and disability in the military. Recent research has identified patterns among military occupations, gender, and musculoskeletal disability. Although back disorders accounted for a high percentage of all cases, little is known about the relationship between job type and disability in soldiers. The present study analyzed 41,750 disability cases to determine (1) prevalence of work-related back disability diagnoses, (2) specific jobs associated with greater risk of back disability, and (3) association among gender, job type, and disability. The results indicate that (1) lumbosacral strain and intervertebral disc syndrome represent the most prevalent diagnoses for back disability, (2) certain occupations were associated with higher back disability risk, and (3) specific jobs were identified in which females experienced higher rates of back disability than males. The nature of these high-risk jobs, and recent research on work disability factors in U.S. Army soldiers, suggest that a combination of ergonomic and individual/organizational psychosocial factors may play a role in the development, exacerbation, and maintenance of work disability. Future research that identifies specific job factors contributing to increased back disability risk should assist in the development of empirically based work site prevention programs to improve musculoskeletal health and readiness.

Displacement-based back-analysis of the model parameters of the Nuozhadu high earth-rockfill dam.

PubMed

Wu, Yongkang; Yuan, Huina; Zhang, Bingyin; Zhang, Zongliang; Yu, Yuzhen

2014-01-01

The parameters of the constitutive model, the creep model, and the wetting model of materials of the Nuozhadu high earth-rockfill dam were back-analyzed together based on field monitoring displacement data by employing an intelligent back-analysis method. In this method, an artificial neural network is used as a substitute for time-consuming finite element analysis, and an evolutionary algorithm is applied for both network training and parameter optimization. To avoid simultaneous back-analysis of many parameters, the model parameters of the three main dam materials are decoupled and back-analyzed separately in a particular order. Displacement back-analyses were performed at different stages of the construction period, with and without considering the creep and wetting deformations. Good agreement between the numerical results and the monitoring data was obtained for most observation points, which implies that the back-analysis method and decoupling method are effective for solving complex problems with multiple models and parameters. The comparison of calculation results based on different sets of back-analyzed model parameters indicates the necessity of taking the effects of creep and wetting into consideration in the numerical analyses of high earth-rockfill dams. With the resulting model parameters, the stress and deformation distributions at completion are predicted and analyzed.

Looking back at 'looking back': operationalising referential gaze for dingoes in an unsolvable task.

PubMed

Smith, Bradley Philip; Litchfield, Carla Anita

2013-11-01

This paper examined the performance of dingoes (Canis dingo) on the rope-pulling task, previously used by Miklósi et al. (Curr Biol 13:763-766, 2003) to highlight a key distinction in the problem-solving behaviour of wolves compared to dogs when in the company of humans. That is, when dogs were confronted with an unsolvable task, following a solvable version of the task they looked back or gazed at the human, whereas, wolves did not. We replicated the rope-pulling task using 12 sanctuary-housed dingoes and used the Miklósi et al. (Curr Biol 13:763-766, 2003) definition of looking back behaviour to analyse the data. However, at least three different types of look backs were observed in our study. We, then developed a more accurate operational definition of looking back behaviour that was task specific and reanalysed the data. We found that the operational definition employed greatly influences the results, with vague definitions potentially overestimating the prevalence of looking back behaviour. Thus, caution must be taken when interpreting the results of studies utilising looking back as behaviour linked to assistance seeking during problem solving. We present a more stringent definition and make suggestions for future research.

Text mining a self-report back-translation.

PubMed

Blanch, Angel; Aluja, Anton

2016-06-01

There are several recommendations about the routine to undertake when back translating self-report instruments in cross-cultural research. However, text mining methods have been generally ignored within this field. This work describes a text mining innovative application useful to adapt a personality questionnaire to 12 different languages. The method is divided in 3 different stages, a descriptive analysis of the available back-translated instrument versions, a dissimilarity assessment between the source language instrument and the 12 back-translations, and an item assessment of item meaning equivalence. The suggested method contributes to improve the back-translation process of self-report instruments for cross-cultural research in 2 significant intertwined ways. First, it defines a systematic approach to the back translation issue, allowing for a more orderly and informed evaluation concerning the equivalence of different versions of the same instrument in different languages. Second, it provides more accurate instrument back-translations, which has direct implications for the reliability and validity of the instrument's test scores when used in different cultures/languages. In addition, this procedure can be extended to the back-translation of self-reports measuring psychological constructs in clinical assessment. Future research works could refine the suggested methodology and use additional available text mining tools. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The relationship between back pain and lead apron use in radiologists.

PubMed

Moore, B; vanSonnenberg, E; Casola, G; Novelline, R A

1992-01-01

Anecdotal experience has suggested that back pain in radiologists may result from extensive wearing of lead aprons. To investigate this possibility, we sent questionnaires to 688 radiologists in various subspecialties whose use of lead aprons varied from none to moderate to extensive. The questionnaire included both objective items that quantitated apron use and back pain and subjective items that asked, for example, if the respondent believed that lead aprons were responsible for his or her back pain. We received 236 responses (34% response rate). Objective data from those radiologists who had experienced no back pain before wearing a lead apron (179 radiologists, 26% of those surveyed) were tabulated; respondents were grouped according to age, time spent wearing a lead apron, and degree of back pain. Odds ratios were calculated. Answers to subjective questions for all respondents were tabulated. Back pain was reported by 52% of those who estimated their lead apron use at greater than or equal to 10 hr per week, the mean response, as opposed to 46% of those who wore lead aprons fewer than 10 hr a week. These and related results were not statistically significant. Our study does not prove that wearing a lead apron is a significant risk factor for the development of back pain.

Exploring implicit preventive strategies in prehospital emergency workers: a novel approach for preventing back problems.

PubMed

Arial, Marc; Benoît, Damien; Wild, Pascal

2014-07-01

Back problems are a major occupational health issue for prehospital emergency care professionals. The goals of this article are to: 1) provide descriptive data about the prevalence and the severity of lower back and upper back disorders in EMTs and paramedics; 2) identify some individual and collective strategies used by EMTs and paramedics to protect their health as they perform prehospital emergency missions; 3) assess the possible effectiveness of strategies in preventing back problems by exploring associations between the use of strategies and the presence and severity of symptoms. The method includes a questionnaire survey (sample n = 334; paramedics and emergency medical technicians) and ergonomics work practice analysis involving shadowing ambulance crews in 12 medical emergency services (over 400 h). A majority of ambulance professionals had experienced back pain in the twelve-month period before the survey. Work practice analysis revealed strategies and tricks of the trade used by ambulance professionals to reduce the chances of back strain while working. Multiple regression analyses showed that self-reported use of such strategies was associated with fewer back symptoms. Preventive strategies should be integrated into specialised training programs for prehospital medical emergency professionals. This approach could also be used in other work settings. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The reactivity of the back revisited. Are there differences in reactivity in different parts of the back?

PubMed

Björk, Ann-Kristin; Bruze, Magnus; Engfeldt, Malin; Nielsen, Christel; Svedman, Cecilia

2017-01-01

In the contact dermatitis literature, it is regularly stated that the patch test reactivity on various areas of the back differs, which might have a large impact on the reproducibility of patch testing. To investigate the reproducibility of patch testing on the upper back with regard to the left as opposed to the right side, and the medial as opposed to the lateral part of the upper back. The reproducibility over time and with regard to the reactivity pattern was also investigated. Thirty-one subjects with contact allergy to the metals gold (n = 19) or nickel (n = 12) were patch tested with serial dilutions, in triplicate applications, on different locations on the upper back. The Friedman test was used for statistical calculations. No significant differences in the reactivity of the back were found. In all gold-allergic patients and 11 of 12 nickel-allergic patients, the allergy could be reproduced with regard to previous patch testing, but the degree of reactivity differed. When a high level of standardization of the patch test technique with the same test system was used, there were no differences in patch test reactions and sites of application on the upper back. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Method to protect charge recombination in the back-contact dye-sensitized solar cell.

PubMed

Yoo, Beomjin; Kim, Kang-Jin; Lee, Doh-Kwon; Kim, Kyungkon; Ko, Min Jae; Kim, Yong Hyun; Kim, Won Mok; Park, Nam-Gyu

2010-09-13

We prepared a back-contact dye-sensitized solar cell and investigated effect of the sputter deposited thin TiO₂ film on the back-contact ITO electrode on photovoltaic property. The nanocrystalline TiO₂ layer with thickness of about 11 μm formed on a plain glass substrate in the back-contact structure showed higher optical transmittance than that formed on an ITO-coated glass substrate, which led to an improved photocurrent density by about 6.3%. However, photovoltage was found to decrease from 817 mV to 773 mV. The photovoltage recovered after deposition of a 35 nm-thick thin TiO₂ film on the surface of the back-contact ITO electrode. Little difference in time constant for electron transport was found for the back-contact ITO electrodes with and without the sputter deposited thin TiO₂ film. Whereas, time constant for charge recombination increased after introduction of the thin TiO₂ film, indicating that such a thin TiO₂ film protected back electron transfer, associated with the recovery of photovoltage. As the result of the improved photocurrent density without deterioration of photovoltage, the back-contact dye-sensitized solar cell exhibited 13.6% higher efficiency than the ITO-coated glass substrate-based dye-sensitized solar cell.

ANALYTICAL MODELING OF ELECTRON BACK-BOMBARDMENT INDUCED CURRENT INCREASE IN UN-GATED THERMIONIC CATHODE RF GUNS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edelen, J. P.; Sun, Y.; Harris, J. R.

In this paper we derive analytical expressions for the output current of an un-gated thermionic cathode RF gun in the presence of back-bombardment heating. We provide a brief overview of back-bombardment theory and discuss comparisons between the analytical back-bombardment predictions and simulation models. We then derive an expression for the output current as a function of the RF repetition rate and discuss relationships between back-bombardment, fieldenhancement, and output current. We discuss in detail the relevant approximations and then provide predictions about how the output current should vary as a function of repetition rate for some given system configurations.

49 CFR 572.194 - Shoulder.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., while the midsagittal plane of the dummy is in vertical orientation. (4) Push the dummy at the knees and... back until the back of the upper torso is in contact with the seat back. (5) While maintaining the...

Spinal Manipulation for Low-Back Pain

MedlinePlus

... often have limited benefit in managing back and neck pain. The AHRQ analysis also found that spinal manipulation ... manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine ...

76 FR 51048 - Notice of Submission of Proposed Information Collection to OMB Ginnie Mae Mortgage-Backed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

...-Backed Securities programs and to monitor performance and compliance with established rules and... issuers/customers in its Mortgage-Backed Securities programs and to monitor performance and compliance...

Homework for Parents -- Your Child's Back-To-School Health Checklist

MedlinePlus

... Health & Safety Tips Campaigns Share this! EmergencyCareForYou » Health & Safety Tips » Homework for Parents — Your Child's Back-To-School Health Checklist Homework for Parents — Your Child's Back- ...

Back muscle strength, lifting, and stooped working postures.

PubMed

Poulsen, E; Jørgensen, K

1971-09-01

When lifting loads and working in a forward stooped position, the muscles of the back rather than the ligaments and bony structures of the spine should overcome the gravitational forces. Formulae, based on measurements of back muscle strength, for prediction of maximal loads to be lifted, and for the ability to sustain work in a stooped position, have been worked out and tested in practical situations. From tests with 50 male and female subjects the simplest prediction formulae for maximum loads were: max. load = 1.10 x isometric back muscle strength for men; and max. load = 0.95 x isometric back muscle strength - 8 kg for women. Some standard values for maximum lifts and permissible single and repeated lifts have been calculated for men and women separately and are given in Table 1. From tests with 65 rehabilitees it was found that the maximum isometric strength of the back muscles measured at shoulder height should exceed 2/3 of the body weight, if fatigue and/or pain in the back muscles is to be avoided during work in a standing stooped position.

Lower back pain and absenteeism among professional public transport drivers.

PubMed

Kresal, Friderika; Roblek, Vasja; Jerman, Andrej; Meško, Maja

2015-01-01

Drivers in public transport are subjected to lower back pain. The reason for the pain is associated with the characteristics of the physical position imposed on the worker while performing the job. Lower back pain is the main cause of absenteeism among drivers. The present study includes 145 public transport drivers employed as professional drivers for an average of 14.14 years. Analysis of the data obtained in the study includes the basic descriptive statistics, χ(2) test and multiple regression analysis. Analysis of the incidence of lower back pain showed that the majority of our sample population suffered from pain in the lower back. We found that there are no statistically significant differences between the groups formed by the length of service as a professional driver and incidence of lower back pain; we were also interested in whether or not the risk factors of lower back pain affects the absenteeism of city bus drivers. Analysis of the data has shown that the risk factors of pain in the lower part of the spine do affect the absenteeism of city bus drivers.

Postural control and low back pain in elite athletes comparison of static balance in elite athletes with and without low back pain.

PubMed

Oyarzo, Claudio A; Villagrán, Claudio R; Silvestre, Rony E; Carpintero, Pedro; Berral, Francisco J

2014-01-01

Although current research findings suggest that postural control or static balance is impaired in subjects with low back pain, few studies have specifically addressed the effect of low back pain on static balance in elite athletes. Forty-four athletes belonging to Chilean national teams took part in this study; 20 had low back pain and the remaining 24 were healthy controls. Displacement of the centre of pressure was analyzed by computerized platform posturography, using a standardized protocol; subjects were required to stand upright on both feet, with eyes first open then closed. The results showed that, athletes with low back pain used significantly more energy (p< 0.0182) and had a greater displacement of the centre of pressure (p< 0.005) with open eyes to control posture than healthy athletes. It may be concluded that static balance is impaired in elite athletes with low back pain and that analysis of two-footed stance provides a sensitive assessment of static balance in athletes.

Disability pension from back pain among social security beneficiaries, Brazil.

PubMed

Meziat Filho, Ney; Silva, Gulnar Azevedo E

2011-06-01

To describe disability pension from back pain. Descriptive study based on data from the Brazilian Social Security Beneficiary Database and the Social Security Statistics Annual Report in 2007. The incidence rate of disability pension from back pain was estimated according to gender and age by Brazilian states. There were also estimated working days lost due to back pain disability by occupation. Idiopathic back pain was the most common cause of disability among social security pension and accidental retirement. Most pensioners were living in urban areas and were commercial workers. The rate of disability pension from back pain in Brazil was 29.96 per 100,000 beneficiaries. A higher rate was seen among males and older individuals. Rondônia showed the highest rate, four times as high as expected (RR= 4.05) followed by Bahia with a rate about twice as high as expected (RR=2.07). Commercial workers accounted for 96.9% of working days lost due to disability. Back pain was a major cause of disability in 2007 mostly among commercial workers showing great differences between the Brazilian states.

Reanalysis of the occurrence of back pain among construction workers: modelling for the interdependent effects of heavy physical work, earlier back accidents, and aging.

PubMed

Nurminen, M

1997-11-01

To re-examine the relation between heavy physical work and the occurrence of sciatic pain among construction workers reported previously to be absent in an epidemiological study. METHODS-Poisson log linear regression was used to model for the frequency of sciatic pain among concrete reinforcement workers and maintenance house painters with adjustment for the interactive effects of earlier back accidents and aging that modified the relation. Concrete reinforcement work not only had a direct effect on the frequency of sciatic pain, but it also contributed significantly to the risk indirectly through earlier back accidents. The risk of sciatic pain increased from age 25 to 54 in a different manner for a worker depending on his occupational group and record of back accidents. Epidemiological studies on low back pain need to be analysed with sound methodology. This is important in view of future meta-analyses that will be performed for the purpose of providing guidelines on the prevention of back disorders in heavy physical work.

Chronic low back pain and disability in Brazilian jiu-jitsu athletes.

PubMed

Reis, Felipe J J; Dias, Mariana D; Newlands, Flavia; Meziat-Filho, Ney; Macedo, Adriana R

2015-11-01

To identify the prevalence of chronic low back pain (CLBP) and functional disability in Brazilian jiu-jitsu athletes. Cross-sectional, observational. The study was conducted at jiu-jitsu training sites in the State of Rio de Janeiro. Presence of Chronic low back pain and Quebec Back Pain Disability Scale. The sample was composed of 72 athletes (mean age of 26.7), being 36 recreational and 36 professional. Chronic low back pain was present in 80.6% of athletes. Pain was present in 88.9% of professional and 72.2% of recreational athletes. In the professional jiu-jitsu group, the median of the Quebec Back Pain Disability Scale (QBPDS) was 10 (IQR = 16), and in the recreational group the QBPDS result was 6.0 (IQR = 12) (p = .001). Professional athletes had a marginally significant increased risk of developing CLBP [OR = 3.0; CI(95%) 0.8-10.9)]. The prevalence of low back pain in jiu-jitsu practice was high and professional athletes seem to have a high risk of developing CLBP. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Clinical observation on auricular point magnetotherapy for treatment of senile low back pain].

PubMed

Sun, Gui-Ping

2007-02-01

To compare the therapeutic effects of auricular point magnetotherapy and auricular point sticking of Vaccaria seed on senile low back pain. Sixty cases, aged 60 or over 60 years with back pain, were randomly divided into 2 groups, a control group and a test group. The control group were treated with auricular sticking of Vaccaria seed with no pressing, and the test group with sticking magnetic bead of 66 gauss each piece with no pressing. Auricular points, Shenmen, Kidney, Bladder, Yaodizhui, Gluteus, Liver and Spleen were selected. Three weeks constituted one course. The effects before, during and after the course were assessed by questionnaire about back pain. Compared with the control group, in the test group the back pain was more effectively improved, including reducing pain and numbness in the back and the legs, decreasing the disorder of physical strength induced by this disease, and improving daily life quality of the patient. Follow-up survey for 2-4 weeks showed the effects still were kept. Auricular magnetotherapy can effectively improve senile back pain.

[LOW BACK PAIN AT NEW WORKING AMBIENT IN ERA OF NEW ECONOMY: A SYSTEMATIC REVIEW ABOUT OCCUPATIONAL RISK FACTORS].

PubMed

Pranjić, Nurka; Maleš-Bilić, Ljiljana

2015-03-01

Low back pain is the second most common symptom-related reason for physician visits and the first reason of working disability. Low back pain is a ubiquitous complaint, with particularly high prevalence among people in their working years (67%). For many individuals, episodes of back pain are self-limited and resolve without specific therapy. For others, however, back pain is recurrent or chronic, causing significant pain that interferes with employment and quality of life. Many occupations have been anecdotally linked to certain low back pain syndrome. However, the relationship between the work environment and the patient's symptoms, though clearly perceived by the patient to be causative, may be less certain. The injury model of an occupational disorder proposes that specific work activities are the cause of the patient's pain. The injury model for low back pain; implicating a causal connection with specific work activities, is complex and controversial. Determining whether a patient's low back pain is a consequence of his or her occupational activity, and how best to treat symptoms to maximize functionality and potential for a return to full employment capacity, can be challenging. In this systematic review which included patients/employees with low back pain, the following databases were searched: Pub Med, Embase, Medline and Web of science. The role of occupational mechanical exposure e.g. lifting as a risk factors for low back surgery has been debated for several decades. Diagnostic uncertainty exists even for those with back symptoms and well-described findings on scan, as these findings are common even in subjects without back pain, and may be unrelated to the symptoms. As an example, herniated disks can be identified in significant numbers of CT or MRI low back studies in subjects with no back pain. In further analysis, lifestyle factors and occupational psychosocial exposures will be addressed. Many physicians, including those practicing in primary care settings where back pain is most often seen, lack training and confidence in addressing workplace issues. Occupational factors that have a significant influence on the development of low back pain disorders are not only mechanical and postural order but also organisational, social and psychological. Organisational changes and physical and psychological job demands should not be overestimated as causal factors. In the early phase of a work disability more emphasis should be laid however on appropriate information and medication and, in case of persistant impairment, active treatment (after 3 weeks or relapse). There is some evidence that catastrophizing as a stress coping strategy might lead to delayed recovery. Long-term work (sick) absence can be estimated through evaluation and observation of LBP risks and characteristics of the each individual case. An early return at workplace and to activities of daily life is urgent. To reduce LBS and its consequences, employers need to adopt a multifaced approach: concentrate on improving physical conditions as well as the psychosocial and environmental aspects of working environment. In cases at risk for chronification and/or with obstacles to reintegration at work an interdisciplinary work-oriented rehabilitation and occupational rehabilitation interventions (occupational reintegration) should be provided.

Awareness of the German population of common available guidelines of how to cope with lower back pain.

PubMed

Werber, Andreas; Zimmermann-Stenzel, Monique; Moradi, Babak; Neubauer, Eva; Schiltenwolf, Marcus

2014-01-01

Several countries developed guidelines in order to provide a systematic approach for treatment of (chronic) lower back pain. The risk of suffering from (chronic) lower back pain differs significantly within the general population. A serious lack of research exists concerning the risk factor "dysfunctional behavior of the subjects in terms of acute lower back pain." The purpose of this study was to assess the knowledge of the German population regarding the availability of guidelines about managing lower back pain. Prospective observational cohort study. We interviewed 983 subjects by phone. The study population included 50 - 70-year-old men and women with German residency and sufficient language ability. Of all the subjects, 70.2% claimed that they suffered at least once in their lifetime with lower back pain. Lower back pain with radiating symptoms occurred in 28.7%. Women were affected significantly more frequently compared to the epidemiological data. Of all the subjects with lower education, 82.9% suffered from lower back pain at least once in their lifetime compared to only 62.4% of people with university degrees. Education was also a protective factor for lower back pain with radiating pain. People who completed secondary modern school were 42% less likely to suffer from lower back pain than those who did not graduate. Knowing active rules of conduct occurred significantly more often at higher educational levels (i.e. all kinds of sports and exercises requiring physical strength, flexibility, power, agility, coordination, grace, balance and control, in particular stretching exercises) odds ratio = 7.78, physical activities odds ratio = 3.92, relaxation exercises odds ratio = 3.51). Data acquisition was performed by an external company and therefore provided only limited options for external validity. Furthermore data acquisition was restricted to 50 - 70-year-old patients, since this age group is at higher risk of suffering from lower back pain. A conclusion upon the knowledge of the whole population has to be drawn with caution, especially when considering the size of the study population. The life-time prevalence of lower back pain was assessed by interviewing patients about prior episodes of lower back pain. Slightly biased results may have occurred since the memory of prior episodes might result in too many or too few episodes. The study revealed a lack of awareness of common available guidelines and an uneven distribution of existing knowledge throughout the population. Passive coping strategies like taking pain medication or ointment therapy were favored over active coping strategies like gymnastics, physical activities, and relaxation exercises. Respondents with a higher level of education suffered significantly less often from lower back pain and tended toward active treatment strategies. Respondents with lower levels of education more often demanded passive treatment strategies. The general population, especially those with lower education, is not sufficiently aware of behavioral strategies for managing lower back pain as proposed in available guidelines.

18. DETAIL OF BACK (EAST SIDE) OF TECHWOOD DORMITORY, SHOWING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. DETAIL OF BACK (EAST SIDE) OF TECHWOOD DORMITORY, SHOWING BACK EXIT AND BRICK CHIMNEY. GRAFFITI IS EXTENSIVE ALONG THIS FACADE. - Techwood Homes, McDaniel Dormitory, 581-587 Techwood Drive, Atlanta, Fulton County, GA

Prevent Back Pain

MedlinePlus

... a week. Stand and sit up straight. Avoid heavy lifting. If you do lift something heavy, bend your knees and keep your back straight. ... an accident, fall, or lifting something that’s too heavy. Acute back pain usually gets better on its ...

Flexible pile thermal barrier insulator

NASA Technical Reports Server (NTRS)

Anderson, G. E.; Fell, D. M.; Tesinsky, J. S. (Inventor)

1978-01-01

A flexible pile thermal barrier insulator included a plurality of upstanding pile yarns. A generally planar backing section supported the upstanding pile yarns. The backing section included a plurality of filler yarns forming a mesh in a first direction. A plurality of warp yarns were looped around said filler yarns and pile yarns in the backing section and formed a mesh in a second direction. A binder prevented separation of the yarns in the backing section.

High-frequency piezopolymer transducers with a copper-clad polyimide backing layer

PubMed Central

Ketterling, Jeffrey A.; Aristizábal, Orlando; Turnbull, Daniel H.

2006-01-01

The effect of a copper-clad polyimide (CCP) backing layer on piezopolymer transducer performance is evaluated. High-frequency, spherically curved polyvinylidene fluoride (PVDF) transducers with and without a CCP backing layer are electrically and acoustically tested. The results showed very similar operating characteristics. B-mode in vivo images of a mouse embryo also showed no qualitative differences indicating the CCP backing layer does not effect transducer performance. PMID:16889345

A method of Modelling and Simulating the Back-to-Back Modular Multilevel Converter HVDC Transmission System

NASA Astrophysics Data System (ADS)

Wang, Lei; Fan, Youping; Zhang, Dai; Ge, Mengxin; Zou, Xianbin; Li, Jingjiao

2017-09-01

This paper proposes a method to simulate a back-to-back modular multilevel converter (MMC) HVDC transmission system. In this paper we utilize an equivalent networks to simulate the dynamic power system. Moreover, to account for the performance of converter station, core components of model of the converter station gives a basic model of simulation. The proposed method is applied to an equivalent real power system.

Central sensitization in chronic low back pain: A narrative review.

PubMed

Sanzarello, Ilaria; Merlini, Luciano; Rosa, Michele Attilio; Perrone, Mariada; Frugiuele, Jacopo; Borghi, Raffaele; Faldini, Cesare

2016-11-21

Low back pain is one of the four most common disorders in all regions, and the greatest contributor to disability worldwide, adding 10.7% of total years lost due to this health state. The etiology of chronic low back pain is, in most of the cases (up to 85%), unknown or nonspecific, while the specific causes (specific spinal pathology and neuropathic/radicular disorders) are uncommon. Central sensitization has been recently recognized as a potential pathophysiological mechanism underlying a group of chronic pain conditions, and may be a contributory factor for a sub-group of patients with chronic low back pain. The purposes of this narrative review are twofold. First, to describe central sensitization and its symptoms and signs in patients with chronic pain disorders in order to allow its recognition in patients with nonspecific low back pain. Second, to provide general treatment principles of chronic low back pain with particular emphasis on pharmacotherapy targeting central sensitization.

Discussion on back-to-back two-stage centrifugal compressor compact design techniques

NASA Astrophysics Data System (ADS)

Huo, Lei; Liu, Huoxing

2013-12-01

Design a small flow back-to-back two-stage centrifugal compressor in the aviation turbocharger, the compressor is compact structure, small axial length, light weighted. Stationary parts have a great influence on their overall performance decline. Therefore, the stationary part of the back-to-back two-stage centrifugal compressor should pay full attention to the diffuser, bend, return vane and volute design. Volute also impact downstream return vane, making the flow in circumferential direction is not uniformed, and several blade angle of attack is drastically changed in downstream of the volute with the airflow can not be rotated to required angle. Loading of high-pressure rotor blades change due to non-uniformed of flow in circumferential direction, which makes individual blade load distribution changed, and affected blade passage load decreased to reduce the capability of work, the tip low speed range increases.

Power flow controller with a fractionally rated back-to-back converter

DOEpatents

Divan, Deepakraj M.; Kandula, Rajendra Prasad; Prasai, Anish

2016-03-08

A power flow controller with a fractionally rated back-to-back (BTB) converter is provided. The power flow controller provide dynamic control of both active and reactive power of a power system. The power flow controller inserts a voltage with controllable magnitude and phase between two AC sources at the same frequency; thereby effecting control of active and reactive power flows between the two AC sources. A transformer may be augmented with a fractionally rated bi-directional Back to Back (BTB) converter. The fractionally rated BTB converter comprises a transformer side converter (TSC), a direct-current (DC) link, and a line side converter (LSC). By controlling the switches of the BTB converter, the effective phase angle between the two AC source voltages may be regulated, and the amplitude of the voltage inserted by the power flow controller may be adjusted with respect to the AC source voltages.

Aerodynamic Characteristics and Glide-Back Performance of Langley Glide-Back Booster

NASA Technical Reports Server (NTRS)

Pamadi, Bandu N.; Covell, Peter F.; Tartabini, Paul V.; Murphy, Kelly J.

2004-01-01

NASA-Langley Research Center is conducting system level studies on an-house concept of a small launch vehicle to address NASA's needs for rapid deployment of small payloads to Low Earth Orbit. The vehicle concept is a three-stage system with a reusable first stage and expendable upper stages. The reusable first stage booster, which glides back to launch site after staging around Mach 3 is named the Langley Glide-Back Booster (LGBB). This paper discusses the aerodynamic characteristics of the LGBB from subsonic to supersonic speeds, development of the aerodynamic database and application of this database to evaluate the glide back performance of the LGBB. The aerodynamic database was assembled using a combination of wind tunnel test data and engineering level analysis. The glide back performance of the LGBB was evaluated using a trajectory optimization code and subject to constraints on angle of attack, dynamic pressure and normal acceleration.

Computational Investigation of the Performance and Back-Pressure Limits of a Hypersonic Inlet

NASA Technical Reports Server (NTRS)

Smart, Michael K.; White, Jeffery A.

2002-01-01

A computational analysis of Mach 6.2 operation of a hypersonic inlet with rectangular-to-elliptical shape transition has been performed. The results of the computations are compared with experimental data for cases with and without a manually imposed back-pressure. While the no-back-pressure numerical solutions match the general trends of the data, certain features observed in the experiments did not appear in the computational solutions. The reasons for these discrepancies are discussed and possible remedies are suggested. Most importantly, however, the computational analysis increased the understanding of the consequences of certain aspects of the inlet design. This will enable the performance of future inlets of this class to be improved. Computational solutions with back-pressure under-estimated the back-pressure limit observed in the experiments, but did supply significant insight into the character of highly back-pressured inlet flows.

Back pain and leg complaints that revealed non–small cell carcinoma: a case study

PubMed Central

Crisp, Casey A.; Pierce, Angela N.

2011-01-01

Objective The purpose of this case study is to describe the clinical presentation of a patient with a chief complaint of low back and leg pain with no prior diagnosis of lung cancer. Clinical Features A 48-year-old man with a history of back pain presented to a chiropractic office with a complaint of low back and left leg pain. Intervention and Outcome Abnormal examination and radiographic findings were discovered. The patient was immediately referred to the pulmonologist for co-management. Through the use of advanced imaging and biopsy, stage 4 lung cancer was diagnosed. Conclusion Low back pain recurrence in an established patient should constitute a reevaluation of the problem. The cause cannot be assumed to be musculoskeletal in origin even though this may have been the case with the initial complaint. Metastatic disease should be considered with any type of recurrent low back pain. PMID:22014908

The impact of anthropometric parameters on the incidence of low back pain.

PubMed

Celan, Dusan; Turk, Zmago

2005-06-01

Endogenic factors as one of possible reasons for low back pain were investigated and discussed in this study. The study included 122 male bus drivers, average age 44.2 years, average period of active service 24.4 years. The following anthropometric indexes have been calculated: Quetelet's index, percentage of body fat, relative body weight, Olivier's typologic index, Lorenz's constitution index and muscle index. According to inquiry form regarding history of low back pain the subjects were divided in two groups: 36 had no low back pain history and 76 had a history of recurrent low back pain. The results showed statistically nonsignificant differences in the anthropometric parameters and the calculated indexes between these two groups of subjects. The chosen subject sample showed that nutritional status, body build, constitution and muscular development are not associated with the incidence of low back pain.

[Low back pain vs. leg dominant pain].

PubMed

Kovac, Ida

2011-01-01

There are two patterns of back pain: 1) back-dominant pain and 2) leg pain dominant, greater than back pain. The causes of back pain are very different and numerous, but mostly are due to vertebral, mechanical etiology, and rarely because of non vertebral, visceral etiology. Leg pain greater than back pain is mostly disease of spinal nerve root, generally presented by radicular pain in a dermatomal distribution. Mechanical compression of spinal roots, caused by disc herniation or by spinal stenosis, results in radicular symptoms. Rarely, in about 1% of patients, there are some other reasons except vertebral mechanical cause, like infection, tumor or fracture. There are several causes of pseudoradicular pain like periferal neuropathy, myifascial syndromes, vascular diseases, osteoarthritis. Spondylarthropathies should be taken in cosideration as well. A complete history and physical examination is important to determine further diagnostic evaluation and to provide eficient therapy.

System and method for optically locating microchannel positions

DOEpatents

Brewer, Laurence R.; Kimbrough, Joseph; Balch, Joseph; Davidson, J. Courtney

2001-01-01

A system and method is disclosed for optically locating a microchannel position. A laser source generates a primary laser beam which is directed at a microchannel plate. The microchannel plates include microchannels at various locations. A back-reflectance beam detector receives a back-reflected beam from the plate. The back-reflected beam is generated when the primary beam reflects off of the plate. A photodiode circuit generates a trigger signal when the back-reflected beam exceeds a predetermined threshold, indicating a presence of the microchannel. The method of the present invention includes the steps of generating a primary beam, directing the primary beam to a plate containing a microchannel, receiving from the plate a back-reflected beam generated in response to the primary beam, and generating a trigger signal when the back-reflected beam exceeds a predetermined threshold which corresponds to a presence of the microchannel.

Treatment and ergonomics training of work-related lower back pain and body posture problems for nurses.

PubMed

Jaromi, Melinda; Nemeth, Andrea; Kranicz, Janos; Laczko, Tamas; Betlehem, Jozsef

2012-06-01

The purpose of the study was to measure the effectiveness of a spine training programme (Back School) in nurses who have been living with chronic low back pain. It was hypothesised that active therapy, ergonomics and education called Back School will significantly decrease the pain intensity levels and improve the body posture of the study participants. A chronic low back pain is a significant work-related health problem among healthcare workers around the world. Proper body posture is essential for decreasing pain in healthcare workers who have history of chronic low back pain. By teaching proper body posture and with the creation of occupational settings that are 'spine-friendly' hospitals and other healthcare settings can significantly lower the suffering of their nursing staff. Single-blinded randomised controlled trial was utilised with six- and 12-months follow-up. The study was carried out at the University of Pecs, Faculty of Health Sciences from 2007 to 2008 involving 124 nurses with low back pain. Participants were randomly assigned to the study group (who have received ergonomics training and education called Back School) with an intervention conducted once a week for a six-week period. The control group received passive physiotherapy once a week for a six-week period. Further follow-up measurements were conducted at six and 12 months, respectively. The study variables and outcome measures were pain intensity and body posture (angle of thoracic kyphosis and lumbar lordosis). The pain intensity was investigated with the Visual Analogue Scale. Body posture was recorded and analysed with the Zebris biomechanical motion analysis system. The statistical analysis of repeated measures indicated a significant decrease in back pain intensity after the therapy in both groups, compared with measurements before the therapy; however, the BS group showed significantly better results during the six-month and one-year follow-up period. The biomechanical analysis of postures after the therapy in the BS group showed significant improvements over the control group; during the follow-up, the difference was still significant, yet slightly reduced. This study has shown that a significant reduction in the pain intensity and improvement in body posture can be achieved by the usage of the active physical therapy methods (Back School) in nurses who are experiencing chronic lower back pain. The Back School programme when compared with the passive physical therapies (such as massage, ultrasound treatment, etc.) shows significant improvement in reduction in pain and greatly improves the posture of healthcare workers. The adoption of the Back School programme for the treatment of the healthcare workers with chronic low back problems should be a treatment of choice and standard that should be adopted when designing occupational healthcare policies and procedures. © 2012 Blackwell Publishing Ltd.

Low-dose, non-supervised, health insurance initiated exercise for the treatment and prevention of chronic low back pain in employees. Results from a randomized controlled trial

PubMed Central

Haufe, Sven; Wiechmann, Klaus; Stein, Lothar; Kück, Momme; Smith, Andrea; Meineke, Stefan; Zirkelbach, Yvonne; Rodriguez Duarte, Samuel; Drupp, Michael; Tegtbur, Uwe

2017-01-01

Objective Back pain is a major problem requiring pragmatic interventions, low in costs for health care providers and feasible for individuals to perform. Our objective was to test the effectiveness of a low-dose 5-month exercise intervention with small personnel investment on low back strength and self-perceived pain. Methods Two hundred twenty-six employees (age: 42.7±10.2 years) from three mid-size companies were randomized to 5-month non-supervised training at home (3 times/week for 20 minutes) or wait-list-control. Health insurance professionals instructed the participants on trunk exercises at the start and then supervised participants once a month. Results Muscle strength for back extension increased after the 5-month intervention with a significant between-group difference (mean 27.4 Newton [95%CI 2.2; 60.3]) favoring the exercise group (p = 0.035). Low back pain was reduced more in subjects after exercise than control (mean difference –0.74 cm [95%CI –1.17; –0.27], p = 0.002). No between-group differences were observed for back pain related disability and work ability. After stratified analysis only subjects with preexisting chronic low back pain showed a between-group difference (exercise versus controls) after the intervention in their strength for back extension (mean 55.7 Newton [95%CI 2.8; 108.5], p = 0.039), self-perceived pain (mean –1.42 cm [95%CI –2.32; –0.51], p = 0.003) and work ability (mean 2.1 points [95%CI 0.2; 4.0], p = 0.032). Significant between-group differences were not observed in subjects without low back pain: strength for back extension (mean 23.4 Newton [95%CI –11.2; 58.1], p = 0.184), self-perceived pain (mean –0.48 cm [95%CI –0.99; 0.04], p = 0.067) and work ability (mean –0.1 points [95%CI –0.9; 0.9], p = 0.999). An interaction between low back pain subgroups and the study intervention (exercise versus control) was exclusively observed for the work ability index (p = 0.016). Conclusion In middle-aged employees a low-dose, non-supervised exercise program implemented over 20 weeks improved trunk muscle strength and low back pain, and in those with preexisting chronic low back pain improved work ability. PMID:28662094

The effects of lumbar extensor strength on disability and mobility in patients with persistent low back pain.

PubMed

Helmhout, Pieter H; Witjes, Marloes; Nijhuis-VAN DER Sanden, Ria W; Bron, Carel; van Aalst, Michiel; Staal, J Bart

2017-04-01

It is assumed that low back pain patients who use pain-avoiding immobilizing strategies may benefit from specific back flexion and extension exercises aimed at reducing sagittal lumbar hypomobility. The aim of this study was to test this potential working mechanism in chronic low back pain patients undergoing lumbar extensor strengthening training. A single-group prospective cohort design was used in this study. Patients with persistent low back complaints for at least 2 years were recruited at a specialized physical therapy clinics center. They participated in a progressive 11-week lumbar extensor strength training program, once a week. At baseline, sagittal lumbar mobility in flexion and extension was measured with a computer-assisted inclinometer. Self-rated pain intensity was measured using a visual analogue scale, back-specific functional status was assessed with the Quebec Back Pain Disability Scale and the Patient Specific Complains questionnaire. Statistically significant improvements were found in pain (28% decrease) and functional disability (23% to 36% decrease). Most progress was seen in the first 5 treatment weeks. Lumbar mobility in flexion showed non-significant increases over time (+12%). Pre-post treatment changes in flexion and extension mobility did not contribute significantly to the models. The retained factors together explained 15% to 48% of the variation in outcome. Specific lumbar strengthening showed clinically relevant improvements in pain and disability in patients with persistent chronic low back pain. These improvements did not necessarily relate to improvements in lumbar mobility. Parameters representing other domains of adaptations to exercise may be needed to evaluate the effects of back pain management.

Mantle Flow and Melting Processes Beneath Back-Arc Basins

NASA Astrophysics Data System (ADS)

Hall, P. S.

2007-12-01

The chemical systematics of back-arc basin basalts suggest that multiple mechanisms of melt generation and transport operate simultaneously beneath the back-arc, resulting in a continuum of melts ranging from a relatively dry, MORB-like end-member to a wet, slab-influenced end-member [e.g., Kelley et al., 2006; Langmuir et al., 2006]. Potential melting processes at work include adiabatic decompression melting akin to that at mid-ocean ridges, diapiric upwelling of hydrous and/or partially molten mantle from above the subducting lithospheric slab [e.g., Marsh, 1979; Hall and Kincaid, 2001; Gerya and Yuen, 2003], and melting of back-arc mantle due to a continuous flux of slab-derived hydrous fluid [Kelley et al., 2006]. In this study, we examine the potential for each of these melting mechanisms to contribute to the observed distribution of melts in back-arc basins within the context of upper mantle flow (driven by plate motions) beneath back-arcs, which ultimately controls temperatures within the melting region. Mantle velocities and temperatures are derived from numerical geodynamic models of subduction with back-arc spreading that explicitly include adiabatic decompression melting through a Lagrangian particle scheme and a parameterization of hydrous melting. Dynamical feedback from the melting process occurs through latent heating and viscosity increases related to dehydration. A range of parameters, including subduction rate and trench-back-arc separation distances, is explored. The thermal evolution of individual diapirs is modeled numerically as they traverse the mantle, from nucleation above the subducting slab to melting beneath the back-arc spreading center, and a range of diapir sizes and densities and considered.

A 35-year trend analysis for back pain in Austria: the role of obesity.

PubMed

Großschädl, Franziska; Freidl, Wolfgang; Rásky, Eva; Burkert, Nathalie; Muckenhuber, Johanna; Stronegger, Willibald J

2014-01-01

The prevalence of back pain is constantly increasing and a public health problem of high priority. In Austria there is a lack of empirical evidence for the development of back pain and its related factors. The present study aims to investigate trends in the prevalence of back pain across different subpopulations (sex, age, obesity). A secondary data analysis based on five nationally representative cross-sectional health surveys (1973-2007) was carried out. Face-to-face interviews were conducted in private homes in Austria. Subjects aged 20 years and older were included in the study sample (n = 178,818). Obesity was defined as BMI≥30 kg/m2 and adjusted for self-report bias. Back pain was measured as the self-reported presence of the disorder. The age-standardized prevalence of back pain was 32.9% in 2007; it was higher among women than men (p<0.001), higher in older than younger subjects (p<0.001) and higher in obese than non-obese individuals (p<0.001). During the investigation period the absolute change in the prevalence of back pain was +19.4%. Among all subpopulations the prevalence steadily increased. Obese men showed the highest increase of and the greatest risk for back pain. These results help to understand the development of back pain in Austria and can be used to plan controlled promotion programs. Further monitoring is recommended in order to control risk groups and plan target group-specific prevention strategies. In Austria particular emphasis should be on obese individuals. We recommend conducting prospective studies to confirm our results and investigate causal relationships.

Infant carrying methods: Correlates and associated musculoskeletal disorders among nursing mothers in Nigeria.

PubMed

Ojukwu, Chidiebele Petronilla; Anyanwu, Godson Emeka; Anekwu, Emelie Morris; Chukwu, Sylvester Caesar; Fab-Agbo, Chukwubuikem

2017-10-01

Infant carrying is an integral part of the mothering occupation. Paucity of data exists on its correlates and associated musculoskeletal injuries. In this study, factors and musculoskeletal injuries associated with infant carrying were investigated in 227 nursing mothers, using a structured questionnaire. 77.1% utilised the back infant carrying methods (ICM). Maternal comfort was the major factor influencing participants' (37.4%) choices of ICMs. Infant's age (p = .000) and transportation means (p = .045) were significantly associated with ICMs. Low back pain (82.8%) and upper back pain (74.9%) were the most reported musculoskeletal discomforts associated with ICMs, especially among women who utilised back ICM. Back ICM is predominantly used by nursing mothers. Impact statement Infant carrying has been associated with increased energy cost and biomechanical changes. Currently, there is a paucity of data on infant carrying-related musculoskeletal injuries. In this study, investigating factors and musculoskeletal injuries associated with infant carrying, the results showed that back infant carrying method is predominantly used by nursing mothers. Age of the infant and mothers' means of transportation were determinant factors of infant carrying methods. Among the several reported infant carrying-related musculoskeletal disorders, low back and upper back pain were the most prevalent, especially among women who utilised the back infant carrying method. There is need for women's health specialists to introduce appropriate ergonomic training and interventions on infant carrying tasks in order to improve maternal musculoskeletal health during the childbearing years and beyond. Further experimental studies on the effects of various infant carrying methods on the musculoskeletal system are recommended.

Nonspecific lower-back pain: surgical versus nonsurgical treatment.

PubMed

Nordin, Margareta; Balagué, Federico; Cedraschi, Christine

2006-02-01

We review evidence-based treatments for patients seeking care for lower-back pain and patients who have been diagnosed with nonspecific lower-back pain. The review is based on selected systematic reviews and national and international guidelines for the treatment of lower-back pain. Additional randomized controlled trials (ie, possibly those not previously included in the latest systematic reviews) were reviewed and added based on recommended procedures for the evaluation of methodological quality (ie, strong, moderate, and weak). In acute nonspecific lower-back pain (0-4 weeks duration of pain) there is moderate to strong evidence that self-care with over-the-counter medication and maintaining activity as tolerated or treatment with a limited number of sessions of manipulative therapy is effective for pain relief. In subacute nonspecific lower-back pain (4-12 weeks duration of pain) there is weak to moderate evidence that a graded activity program including exercises and cognitive behavioral treatment in combination is more efficient than usual care with regard to return to work. There is strong evidence that these programs reduce work absenteeism. In cases of chronic nonspecific lower-back pain (> 12 weeks duration of pain) a variety of treatments are available with limited and similar efficacy on pain and disability reduction. There is moderate evidence that surgery in chronic nonspecific lower-back pain is as effective as cognitive behavioral treatment with regard to pain, function, mood and return to work. Surgical indications for chronic nonspecific lower-back pain remain ill defined. Level V (expert opinion). See the Guidelines for Authors for a complete description of levels of evidence.

Movement Demands of Elite U20 International Rugby Union Players

PubMed Central

Drawer, Scott; Eager, Robin; Taylor, Neil; Cook, Christian

2016-01-01

The purpose of this study was to quantify movement demands of elite international age grade (U20) rugby union players during competitive tournament match play. Forty elite professional players from an U20 international performance squad were monitored using 10Hz global positioning systems (GPS) during 15 international tournament matches during the 2014/15 and 2015/16 seasons. Data on distances, velocities, accelerations, decelerations, high metabolic load (HML) distance and efforts, and number of sprints were derived. Data files from players who played over 60 min (n = 161) were separated firstly into Forwards and Backs, and more specifically into six positional groups; FR—Front Row (prop & hooker), SR—Second Row, BR—Back Row (Flankers & No.8), HB—Half Backs (scrum half & outside half), MF—Midfield (centres), B3 –Back Three (wings & full back) for match analysis. Analysis revealed significant differences between forwards and backs positions. Backs scored higher on all variables measured with the exception of number of moderate accelerations, decelerations (no difference). The centres covered the greatest total distance with the front row covering the least (6.51 ± 0.71 vs 4.97 ± 0.75 km, p < 0.001). The front row also covered the least high speed running (HSR) distance compared to the back three (211.6 ± 112.7 vs 728.4 ± 150.2 m, p < 0.001) who covered the most HSR distance, affirming that backs cover greater distances but forwards have greater contact loads. These findings highlight for the first time differences in the movement characteristics of elite age grade rugby union players specific to positional roles. PMID:27055230

Movement Demands of Elite U20 International Rugby Union Players.

PubMed

Cunningham, Daniel; Shearer, David A; Drawer, Scott; Eager, Robin; Taylor, Neil; Cook, Christian; Kilduff, Liam P

2016-01-01

The purpose of this study was to quantify movement demands of elite international age grade (U20) rugby union players during competitive tournament match play. Forty elite professional players from an U20 international performance squad were monitored using 10 Hz global positioning systems (GPS) during 15 international tournament matches during the 2014/15 and 2015/16 seasons. Data on distances, velocities, accelerations, decelerations, high metabolic load (HML) distance and efforts, and number of sprints were derived. Data files from players who played over 60 min (n = 161) were separated firstly into Forwards and Backs, and more specifically into six positional groups; FR--Front Row (prop & hooker), SR--Second Row, BR--Back Row (Flankers & No.8), HB--Half Backs (scrum half & outside half), MF--Midfield (centres), B3--Back Three (wings & full back) for match analysis. Analysis revealed significant differences between forwards and backs positions. Backs scored higher on all variables measured with the exception of number of moderate accelerations, decelerations (no difference). The centres covered the greatest total distance with the front row covering the least (6.51 ± 0.71 vs 4.97 ± 0.75 km, p < 0.001). The front row also covered the least high speed running (HSR) distance compared to the back three (211.6 ± 112.7 vs 728.4 ± 150.2 m, p < 0.001) who covered the most HSR distance, affirming that backs cover greater distances but forwards have greater contact loads. These findings highlight for the first time differences in the movement characteristics of elite age grade rugby union players specific to positional roles.

Low Back Imaging When Not Indicated: A Descriptive Cross-System Analysis

PubMed Central

Gold, Rachel; Esterberg, Elizabeth; Hollombe, Celine; Arkind, Jill; Vakarcs, Patricia A; Tran, Huong; Burdick, Tim; DeVoe, Jennifer E; Horberg, Michael A

2016-01-01

Context: Guideline-discordant imaging to evaluate incident low back pain is common. Objective: We compared rates of guideline-discordant imaging in patients with low back pain in two care delivery systems with differing abilities to track care through an electronic health record (EHR), and in their patients’ insurance status, to measure the association between these factors and rates of ordered low back imaging. Design: We used data from two Kaiser Permanente (KP) Regions and from OCHIN, a community health center network. We extracted data on imaging performed after index visits for low back pain from June 1, 2011, to May 31, 2012, in these systems. Adjusted logistic regression measured associations between system-level factors and imaging rates. Main Outcome Measures: Imaging rates for incident low back pain using 2 national quality metrics: Clinical Quality Measure 0052, a measure for assessing Meaningful Use of EHRs, and the Healthcare Effectiveness Data and Information Set measure “Use of Imaging Studies for Low Back Pain.” Results: Among 19,503 KP patients and 2694 OCHIN patients with incident low back pain, ordered imaging was higher among men and whites but did not differ across health care systems. OCHIN’s publicly insured patients had higher rates of imaging compared with those with private or no insurance. Conclusion: Rates of ordered imaging to evaluate incident low back pain among uninsured OCHIN patients were lower than in KP overall; among insured OCHIN patients, rates were higher than in KP overall. Research is needed to establish causality and develop interventions. PMID:26934626

Increased integrity of white matter pathways after dual n-back training.

PubMed

Salminen, Tiina; Mårtensson, Johan; Schubert, Torsten; Kühn, Simone

2016-06-01

Dual n-back WM training has been shown to produce broad transfer effects to different untrained cognitive functions. The task is demanding to the cognitive system because it includes a bi-modal (auditory and visual) dual-task component. A previous WM training study showed increased white matter integrity in the parietal lobe as well as the anterior part of the corpus callosum after visual n-back training. We investigated dual n-back training-related changes in white matter pathways. We anticipated dual n-back training to increase white matter integrity in pathways that connect brain regions related to WM processes. Additionally, we hypothesized that dual n-back training would produce more brain-wide white matter changes than single n-back training because of the involvement of two modalities and the additional dual-task coordination component of the task. The dual n-back training group showed increased white matter integrity (reflected as increased fractional anisotropy, FA) after training. The effects were mostly left lateralized as compared with changes from pretest to posttest in the passive and active control groups. Additionally, significant effects were observed in the anterior part of the corpus callosum, when the training group was compared with the passive control group. There were no changes in pretest to posttest FA changes between the passive and active control groups. The results therefore show that dual n-back training produces increased integrity in white matter pathways connecting different brain regions. The results are discussed in reference to the bi-modal dual-task component of the training task. Copyright © 2016 Elsevier Inc. All rights reserved.

Abnormal brain chemistry in chronic back pain: an in vivo proton magnetic resonance spectroscopy study.

PubMed

Grachev, I D; Fredrickson, B E; Apkarian, A V

2000-12-15

The neurobiology of chronic pain, including chronic back pain, is unknown. Structural imaging studies of the spine cannot explain all cases of chronic back pain. Functional brain imaging studies indicate that the brain activation patterns are different between chronic pain patients and normal subjects, and the thalamus, and prefrontal and cingulate cortices are involved in some types of chronic pain. Animal models of chronic pain suggest abnormal spinal cord chemistry. Does chronic pain cause brain chemistry changes? We examined brain chemistry changes in patients with chronic back pain using in vivo single- voxel proton magnetic resonance spectroscopy ((1)H-MRS). In vivo (1)H-MRS was used to measure relative concentrations of N-acetyl aspartate, creatine, choline, glutamate, glutamine, gamma-aminobutyric acid, inositol, glucose and lactate in relation to the concentration of creatine. These measurements were performed in six brain regions of nine chronic low back pain patients and 11 normal volunteers. All chronic back pain subjects underwent clinical evaluation and perceptual measures of pain and anxiety. We show that chronic back pain alters the human brain chemistry. Reductions of N-acetyl aspartate and glucose were demonstrated in the dorsolateral prefrontal cortex. Cingulate, sensorimotor, and other brain regions showed no chemical concentration differences. In chronic back pain, the interrelationship between chemicals within and across brain regions was abnormal, and there was a specific relationship between regional chemicals and perceptual measures of pain and anxiety. These findings provide direct evidence of abnormal brain chemistry in chronic back pain, which may be useful in diagnosis and future development of more effective pharmacological treatments.

Prolotherapy: An Effective Treatment for Low Back Pain?

MedlinePlus

... pain? Is prolotherapy an effective treatment for chronic low back pain? Answers from Brent A. Bauer, M.D. Prolotherapy is ... reduced pain. Studies of prolotherapy in people with low back pain have had mixed results. A combination of prolotherapy ...

Back Surgery: When Is It a Good Idea?

MedlinePlus

... pain resolves on its own within three months. Low back pain is one of the most common ailments seen ... diagnose and treat. Firestein GS, et al., eds. Low back pain. In: Kelley and Firestein's Textbook of Rheumatology. 10th ...

LABORATORY ANALYSIS OF BACK-CORONA DISCHARGE

EPA Science Inventory

The paper discusses an experimental research program to characterize back-corona generation and behavior in a range of environments and geometries common to electrostatic precipitators (ESPs). A wire-parallel plate device was used to monitor the intensity and distribution of back...

78 FR 68906 - Agency Information Collection (Back (Thoracolumbar Spine) Conditions Disability Benefits...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits... Control No. 2900- NEW (Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire)'' in any... Disability Benefits Questionnaire)''. SUPPLEMENTARY INFORMATION: Title: (Back (Thoracolumbar Spine...

Physical and physiological differences of backs and forwards from the Brazilian National rugby union team.

PubMed

Nakamura, Fábio Y; Pereira, Lucas A; Moraes, José E; Kobal, Ronaldo; Kitamura, Katia; Cal Abad, Cesar C; Teixeira Vaz, Luís M; Loturco, Irineu

2017-12-01

The aim of this study was to compare backs and forwards rugby union players recruited to a National team in the following physical and physiological indicators: anthropometrics, squat jump (SJ), countermovement jump (CMJ), 10- and 30-meter sprint, resting heart rate variability (HRV), Yo-Yo Test and heart rate (HR) at 2 minutes of test. The measurements were performed on the first day of a training camp planned to finely select the players who would participate in the 2016 America's Rugby Championship. The magnitude-based inference was used in the comparisons. Backs demonstrated almost certainly greater distance in the Yo-Yo Test (backs: 2305.9±231.3 meters; forwards: 1802.4±361.2 meters), higher vertical jump height in both SJ and CMJ (SJ: 44.0±5.3 cm vs. 37.6±5.4 cm; CMJ: 46.1±5.0 cm vs. 40.0±5.5 cm, for backs and forwards respectively), and superior sprint velocity in 10- and 30-m (10-m: 6.02±0.23 m.s-1 vs. 5.51±0.34 m.s-1; 30-m: 7.46±0.25 m.s-1 vs. 6.89±0.37 m.s-1, for backs and forwards respectively) than the forwards. In contrast, forwards were almost certainly taller and heavier than backs, and displayed higher sprint momentum in 10- and 30-meters (10 meters: 513.0±51.6 kg.m.s-1 vs. 598.4±53.1 kg.m.s-1; 30 meters: 635.3±56.1 kg.m.s-1 vs. 749.0±70.5 kg.m.s-1, for backs and forwards respectively). The submaximal HR in the first 2-minutes of the Yo-Yo test was likely lower in the backs than in the forwards (77.6±5.1% of the maximal HR vs. 81.3±5.4% of the maximal HR for backs and forwards respectively), while HRV indices were not different between backs and forwards. Playing position appears to be determined by the players' physical and physiological characteristics in top-level rugby union, and the submaximal HR measured during Yo-Yo test can be a simple alternative to discriminate backs and forwards.

Back schools for non-specific low-back pain.

PubMed

Heymans, M W; van Tulder, M W; Esmail, R; Bombardier, C; Koes, B W

2004-10-18

Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating patients with low-back pain (LBP). However, the content of back schools has changed and appears to vary widely today. To assess the effectiveness of back schools for patients with non-specific LBP. We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials to May 2003 for relevant trials reported in English, Dutch, French or German. We also screened references from relevant reviews and included trials. Randomized controlled trials (RCTs) that reported on any type of back school for non-specific LBP were included. Four reviewers, blinded to authors, institution and journal, independently extracted the data and assessed the quality of the trials. We set the high quality level, a priori, at a trial meeting six or more of 11 internal validity criteria. As data were clinically and statistically too heterogeneous to perform a meta-analysis, we used a qualitative review (best evidence synthesis) to summarize the results. The evidence was classified into four levels (strong, moderate, limited or no evidence), taking into account the methodological quality of the studies. We also evaluated the clinical relevance of the studies. Nineteen RCTs (3584 patients) were included in this updated review. Overall, the methodological quality was low, with only six trials considered to be high quality. It was not possible to perform relevant subgroup analyses for LBP with radiation versus LBP without radiation. The results indicate that there is moderate evidence suggesting that back schools have better short and intermediate-term effects on pain and functional status than other treatments for patients with recurrent and chronic LBP. There is moderate evidence suggesting that back schools for chronic LBP in an occupational setting, are more effective than other treatments and placebo or waiting list controls on pain, functional status and return to work during short and intermediate-term follow-up. In general, the clinical relevance of the studies was rated as insufficient. There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain, and improve function and return-to-work status, in the short and intermediate-term, compared to exercises, manipulation, myofascial therapy, advice, placebo or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodological quality and clinical relevance and evaluate the cost-effectiveness of back schools.

Epidemiology of low back pain.

PubMed

Skovron, M L

1992-10-01

At present, although there have been many epidemiological studies of risk factors for low back pain, there are few risk factors established in prospective studies; and our understanding of them remains relatively crude. Individuals in jobs requiring manual materials handling, particularly repeated heavy lifting and lifting while twisting, are at increased risk of back pain leading to work absence. In addition, exposure to whole-body vibration and job requirements for static postures are associated with back pain. Individual trunk strength has not been consistently demonstrated as associated with back pain; although there is some suggestion that when work requirements for heavy lifting exceed individual capacities, back pain is more likely to occur. The pattern of peak age at onset in the 20's is consistent with back pain development early in working life. Among other individual characteristics, only cigarette smoking has consistently been associated with back pain; and the biological mechanism for this finding is not understood. Evidence with respect to spinal flexibility, aerobic capacity, educational attainment and other variables is suggestive but not consistent. There is some evidence that the individual's relation to work, expressed as job satisfaction or supervisor rating, is also related to work absence due to back pain. While it is possible to describe, however crudely, the characteristics placing people at risk for back pain leading to work absence and/or medical attention, the problem of predicting chronicity and thus identifying patients for more intensive clinical intervention remains unresolved. At this time, only age of the patient and certain clinical features of the back pain such as the presence of sciatic symptoms, duration of the current episode, and history of prior episodes are consistently demonstrated predictors. In chronic patients, there is suggestive evidence that spinal flexibility, trunk strength, and certain psychological characteristics such as coping skills, fear and avoidance of pain or movement, job satisfaction, attribution of fault and hysterical or hypochondriacal features are associated with treatment failure. In addition, there is suggestive evidence that the availability of alternative work placement may allow for earlier return to work than otherwise. While the availability of disability compensation in excess of usual wages may serve as a disincentive to return to work. The latter-cited remain to be verified, while findings in chronic patients remain to be tested in acute. Further, the role of physical demands of work in duration of back pain episodes has not been well studied.

Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of SpondyloArthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain.

PubMed

de Winter, Janneke; de Hooge, Manouk; van de Sande, Marleen; de Jong, Henriëtte; van Hoeven, Lonneke; de Koning, Anoek; Berg, Inger Jorid; Ramonda, Roberta; Baeten, Dominique; van der Heijde, Désirée; Weel, Angelique; Landewé, Robert

2018-03-07

To compare magnetic resonance images (MRIs) of the sacroiliac (SI) joints of healthy subjects and individuals with known mechanical strain acting upon the SI joints to those of patients with axial spondyloarthritis (SpA) and patients with chronic back pain. Three readers who had received standardized training and were blinded with regard to study group randomly scored MRIs of the SI joints of 172 subjects, including 47 healthy individuals without current or past back pain, 47 axial SpA patients from the Spondyloarthritis Caught Early (SPACE) cohort (with a previous MRI confirmed positive for sacroiliitis), 47 controls with chronic back pain (irrespective of MRI results) from the SPACE cohort, 7 women with postpartum back pain, and 24 frequent runners. MRIs were scored according to the Assessment of SpondyloArthritis international Society (ASAS) definition and Spondyloarthritis Research Consortium of Canada (SPARCC) index. Of the 47 healthy volunteers, 11 (23.4%) had an MRI positive for sacroiliitis, compared to 43 (91.5%) of 47 axial SpA patients and 3 (6.4%) of 47 patients with chronic back pain. Three (12.5%) of the 24 runners and 4 (57.1%) of the 7 women with postpartum back pain had a positive MRI. Using a SPARCC cutoff of ≥2 for positivity, 12 (25.5%) of 47 healthy volunteers, 46 (97.9%) of 47 positive axial SpA patients, 5 (10.6%) of 47 controls with chronic back pain, 4 (16.7%) of 24 runners, and 4 (57.1%) of 7 women with postpartum back pain had positive MRIs. Deep bone marrow edema (BME) lesions were not found in healthy volunteers, patients with chronic back pain, or runners, but were found in 42 (89.4%) of 47 positive axial SpA patients and in 1 (14.3%) of 7 women with postpartum back pain. A substantial proportion of healthy individuals without current or past back pain has an MRI positive for sacroiliitis according to the ASAS definition. Deep (extensive) BME lesions are almost exclusively found in axial SpA patients. © 2018 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

Meta-analysis: exercise therapy for nonspecific low back pain.

PubMed

Hayden, Jill A; van Tulder, Maurits W; Malmivaara, Antti V; Koes, Bart W

2005-05-03

Exercise therapy is widely used as an intervention in low back pain. To evaluate the effectiveness of exercise therapy in adult nonspecific acute, subacute, and chronic low back pain versus no treatment and other conservative treatments. MEDLINE, EMBASE, PsychInfo, CINAHL, and Cochrane Library databases to October 2004; citation searches and bibliographic reviews of previous systematic reviews. Randomized, controlled trials evaluating exercise therapy for adult nonspecific low back pain and measuring pain, function, return to work or absenteeism, and global improvement outcomes. Two reviewers independently selected studies and extracted data on study characteristics, quality, and outcomes at short-, intermediate-, and long-term follow-up. 61 randomized, controlled trials (6390 participants) met inclusion criteria: acute (11 trials), subacute (6 trials), and chronic (43 trials) low back pain (1 trial was unclear). Evidence suggests that exercise therapy is effective in chronic back pain relative to comparisons at all follow-up periods. Pooled mean improvement (of 100 points) was 7.3 points (95% CI, 3.7 to 10.9 points) for pain and 2.5 points (CI, 1.0 to 3.9 points) for function at earliest follow-up. In studies investigating patients (people seeking care for back pain), mean improvement was 13.3 points (CI, 5.5 to 21.1 points) for pain and 6.9 points (CI, 2.2 to 11.7 points) for function, compared with studies where some participants had been recruited from a general population (for example, with advertisements). Some evidence suggests effectiveness of a graded-activity exercise program in subacute low back pain in occupational settings, although the evidence for other types of exercise therapy in other populations is inconsistent. In acute low back pain, exercise therapy and other programs were equally effective (pain, 0.03 point [CI, -1.3 to 1.4 points]). Limitations of the literature, including low-quality studies with heterogeneous outcome measures inconsistent and poor reporting, and possibility of publication bias. Exercise therapy seems to be slightly effective at decreasing pain and improving function in adults with chronic low back pain, particularly in health care populations. In subacute low back pain populations, some evidence suggests that a graded-activity program improves absenteeism outcomes, although evidence for other types of exercise is unclear. In acute low back pain populations, exercise therapy is as effective as either no treatment or other conservative treatments.

Occupational driving as a risk factor for low back pain in active-duty military service members.

PubMed

Knox, Jeffrey B; Orchowski, Joseph R; Scher, Danielle L; Owens, Brett D; Burks, Robert; Belmont, Philip J

2014-04-01

Although occupational driving has been associated with low back pain, little has been reported on the incidence rates for this disorder. To determine the incidence rate and demographic risk factors of low back pain in an ethnically diverse and physically active population of US military vehicle operators. Retrospective database analysis. All active-duty military service members between 1998 and 2006. Low back pain requiring visit to a health-care provider. A query was performed using the US Defense Medical Epidemiology Database for the International Classification of Diseases, Ninth Revision, Clinical Modification code for low back pain (724.20). Multivariate Poisson regression analysis was used to estimate the rate of low back pain among military vehicle operators and control subjects per 1,000 person-years, while controlling for sex, race, rank, service, age, and marital status. A total of 8,447,167 person-years of data were investigated. The overall unadjusted low back pain incidence rate for military members whose occupation is vehicle operator was 54.2 per 1,000 person-years. Compared with service members with other occupations, motor vehicle operators had a significantly increased adjusted incidence rate ratio (IRR) for low back pain of 1.15 (95% confidence interval [CI] 1.13-1.17). Female motor vehicle operators, compared with males, had a significantly increased adjusted IRR for low back pain of 1.45 (95% CI 1.39-1.52). With senior enlisted as the referent category, the junior enlisted rank group of motor vehicle operators had a significantly increased adjusted IRR for low back pain: 1.60 (95% CI 1.52-1.70). Compared with Marine service members, those motor vehicle operators in both the Army, 2.74 (95% CI 2.60-2.89), and the Air Force, 1.98 (95% CI 1.84-2.14), had a significantly increased adjusted IRR for low back pain. The adjusted IRRs for the less than 20-year and more than 40-year age groups, compared with the 30- to 39-year age group, were 1.24 (1.15-1.36) and 1.23 (1.10-1.38), respectively. Motor vehicle operators have a small but statistically significantly increased rate of low back pain compared with matched control population. Published by Elsevier Inc.

Transcultural adaptation and validation of Hindi version of Quebec Back Pain Disability Scale.

PubMed

Zaidi, Sahar; Verma, Shalini; Moiz, Jamal Ali; Hussain, Mohammed E

2017-08-07

To transculturally adapt the Quebec Back Pain Disability Scale for Hindi-speaking population and examine its psychometric properties in patients with low back pain. The Quebec Back Pain Disability Scale was translated and cross-culturally adapted into Hindi following international guidelines. Hindi version of the scale was completed by 120 patients with low back pain and 60 healthy controls. Patients with low back pain were also administered the Hindi-Roland Morris Disability Questionnaire and Visual Analog Scale. Psychometric evaluation included test-retest reliability, convergent and discriminative validity. Exploratory factor analysis was carried out to determine the factor structure. The factorial analysis revealed a four-factor solution (bending/carrying, ambulation/reach, prolonged postures and rest). Convergent validity was confirmed by high correlation of Hindi Quebec Back Pain Disability Scale to the Hindi version of Roland Morris Disability Questionnaire (r = 0.77 and p < 0.001) as well as Visual Analog Scale (r = 0.682 and p < 0.001) scores. Discriminative validity was established by significantly different scores for patients with low back pain and the healthy controls (35.36 ± 18.6 vs. 9.13 ± 6.08 and p < 0.001). The translated version of the scale showed remarkable internal consistency (Cronbach α = 0.98) and the intraclass correlation coefficient of test-retest reliability was excellent (ICC 2,1 =0.96). MDC 95 and SEM scores obtained were 10.28 and 3.71, respectively. The Hindi version of Quebec Back Pain Disability Scale has good test-retest reliability, discriminative and convergent validity and is appropriate for clinical and research use in Hindi-speaking low back pain patients. Implications for rehabilitation Linguistically and culturally adapted questionnaires help researchers make adequate inferences about instruments measuring health and quality of life. The translated version would serve as a valid research tool allowing comparability of data across cultures thus, providing opportunities for large multicenter, multicountry trials. A Hindi Quebec Back Pain Disability Scale version will help to improve the quality and efficacy of assessment of low back pain by developing in patients, a better understanding of the items which can be easily correlated with the activities of daily living.

Early Predictors of Occupational Back Re-Injury: Results from a Prospective Study of Workers in Washington State

PubMed Central

Keeney, Benjamin J.; Turner, Judith A.; Fulton-Kehoe, Deborah; Wickizer, Thomas M.; Chan, Kwun Chuen Gary; Franklin, Gary M.

2014-01-01

Study Design Prospective population-based cohort study Objective To identify early predictors of self-reported occupational back re-injury within 1 year after work-related back injury Summary of Background Data Back injuries are the costliest and most prevalent disabling occupational injuries in the United States. A substantial proportion of workers with back injuries have re-injuries after returning to work, yet there are few studies of risk factors for occupational back re-injuries. Methods We aimed to identify the incidence and early (in the claim) predictors of self-reported back re-injury by approximately 1 year after the index injury among Washington State workers with new work disability claims for back injuries. The Washington Workers’ Compensation Disability Risk Identification Study Cohort (D-RISC) provided a large, population-based sample with information on variables in seven domains: sociodemographic, employment-related, pain and function, clinical status, health care, health behavior, and psychological. We conducted telephone interviews with workers 3 weeks and 1 year after submission of a time-loss claim for the injury. We first identified predictors (p-values < 0.10) of self-reported re-injury within 1 year in bivariate analyses. Those variables were then included in a multivariate logistic regression model predicting occupational back re-injury. Results 290 (25.8%) of 1,123 (70.0% response rate) workers who completed the one-year follow-up interview and had returned to work reported having re-injured their back at work. Baseline variables significantly associated with re-injury (p-value < 0.05) in the multivariate model included male gender, constant whole body vibration at work, a history of previous similar injury, 4 or more previous claims of any type, possessing health insurance, and high fear-avoidance scores. Baseline obesity was associated with reduced odds of re-injury. No other employment-related or psychological variables were significant. Conclusion One-fourth of workers who received work disability compensation for a back injury self-reported re-injury after returning to work. Baseline variables in multiple domains predicted occupational back re-injury. Increased knowledge of early risk factors for re-injury may help lead to interventions, such as efforts to reduce fear-avoidance and graded activity to promote recovery, effective in lowering the risk of re-injury. PMID:22772568

Magneto-transport study of top- and back-gated LaAlO{sub 3}/SrTiO{sub 3} heterostructures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, W., E-mail: W.Liu@unige.ch; Gariglio, S.; Fête, A.

2015-06-01

We report a detailed analysis of magneto-transport properties of top- and back-gated LaAlO{sub 3}/SrTiO{sub 3} heterostructures. Efficient modulation in magneto-resistance, carrier density, and mobility of the two-dimensional electron liquid present at the interface is achieved by sweeping top and back gate voltages. Analyzing those changes with respect to the carrier density tuning, we observe that the back gate strongly modifies the electron mobility while the top gate mainly varies the carrier density. The evolution of the spin-orbit interaction is also followed as a function of top and back gating.

John F. Kennedy's back: chronic pain, failed surgeries, and the story of its effects on his life and death.

PubMed

Pait, T Glenn; Dowdy, Justin T

2017-09-01

The 35th president of the United States, John F. Kennedy (JFK), experienced chronic back pain beginning in his early 20s. He underwent a total of 4 back operations, including a discectomy, an instrumentation and fusion, and 2 relatively minor surgeries that failed to significantly improve his pain. The authors examined the nature and etiology of JFK's back pain and performed a detailed investigation into the former president's numerous medical evaluations and treatment modalities. This information may lead to a better understanding of the profound effects that JFK's chronic back pain and its treatment had on his life and presidency, and even his death.

Method for manufacturing electrical contacts for a thin-film semiconductor device

DOEpatents

Carlson, David E.; Dickson, Charles R.; D'Aiello, Robert V.

1988-11-08

A method of fabricating spaced-apart back contacts on a thin film of semiconductor material by forming strips of buffer material on top of the semiconductor material in locations corresponding to the desired dividing lines between back contacts, forming a film of metal substantially covering the semiconductor material and buffer strips, and scribing portions of the metal film overlying the buffer strips with a laser without contacting the underlying semiconductor material to separate the metal layer into a plurality of back contacts. The buffer material serves to protect the underlying semiconductor material from being damaged during the laser scribing. Back contacts and multi-cell photovoltaic modules incorporating such back contacts also are disclosed.

Electrical contacts for a thin-film semiconductor device

DOEpatents

Carlson, David E.; Dickson, Charles R.; D'Aiello, Robert V.

1989-08-08

A method of fabricating spaced-apart back contacts on a thin film of semiconductor material by forming strips of buffer material on top of the semiconductor material in locations corresponding to the desired dividing lines between back contacts, forming a film of metal substantially covering the semiconductor material and buffer strips, and scribing portions of the metal film overlying the buffer strips with a laser without contacting the underlying semiconductor material to separate the metal layer into a plurality of back contacts. The buffer material serves to protect the underlying semiconductor material from being damaged during the laser scribing. Back contacts and multi-cell photovoltaic modules incorporating such back contacts also are disclosed.

Standard back-translation procedures may not capture proper emotion concepts: a case study of Chinese disgust terms.

PubMed

Barger, Brian; Nabi, Robin; Hong, Liang Yu

2010-10-01

We present data questioning the adequacy of standard back-translation procedures for investigating emotion states across cultures (Brislin, 1970). Our data indicate that the Chinese back-translation of the term disgust has led cross-cultural researchers to accept terms whose themes, goals, and motivations are more akin to the English term anger. Evidence is presented showing that, compared with the standard back-translation method, a more painstaking interview method found a better translational Chinese equivalent for the English term disgust. Implications for the use of back-translation in cross-cultural research are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Vortex Generators to Control Boundary Layer Interactions

NASA Technical Reports Server (NTRS)

Babinsky, Holger (Inventor); Loth, Eric (Inventor); Lee, Sang (Inventor)

2014-01-01

Devices for generating streamwise vorticity in a boundary includes various forms of vortex generators. One form of a split-ramp vortex generator includes a first ramp element and a second ramp element with front ends and back ends, ramp surfaces extending between the front ends and the back ends, and vertical surfaces extending between the front ends and the back ends adjacent the ramp surfaces. A flow channel is between the first ramp element and the second ramp element. The back ends of the ramp elements have a height greater than a height of the front ends, and the front ends of the ramp elements have a width greater than a width of the back ends.

Fuel cell membrane humidification

DOEpatents

Wilson, Mahlon S.

1999-01-01

A polymer electrolyte membrane fuel cell assembly has an anode side and a cathode side separated by the membrane and generating electrical current by electrochemical reactions between a fuel gas and an oxidant. The anode side comprises a hydrophobic gas diffusion backing contacting one side of the membrane and having hydrophilic areas therein for providing liquid water directly to the one side of the membrane through the hydrophilic areas of the gas diffusion backing. In a preferred embodiment, the hydrophilic areas of the gas diffusion backing are formed by sewing a hydrophilic thread through the backing. Liquid water is distributed over the gas diffusion backing in distribution channels that are separate from the fuel distribution channels.

Exploring N-Back Cognitive Training for Children With ADHD.

PubMed

Jones, Masha R; Katz, Benjamin; Buschkuehl, Martin; Jaeggi, Susanne M; Shah, Priti

2018-06-01

The efficacy of n-back training for children with attention deficit hyperactivity disorder (ADHD) was tested in a randomized controlled trial. 41 children aged 7 to 14 years with ADHD were trained on an n-back task, and their performance was compared with that of an active control group ( n = 39) who were trained on a general knowledge and vocabulary task. The experimental group demonstrated transfer of training to a nontrained n-back task as well as to a measure of inhibitory control. These effects were correlated with the magnitude of training gains. Our results suggest that n-back training may be useful in addressing some of the cognitive and behavioral issues associated with ADHD.

Rate of rotation measurement using back-EMFS associated with windings of a brushless DC motor

NASA Technical Reports Server (NTRS)

Howard, David E. (Inventor)

2000-01-01

A system and method are provided for measuring rate of rotation. A brushless DC motor is rotated and produces a back electromagnetic force (emf) on each winding thereof. Each winding's back-emf is integrated and multiplied by the back-emf associated with an adjacent winding. The multiplied outputs associated with each winding are combined to produce a directionally sensitive DC output proportional only to the rate of rotation of the motor's shaft.

Nursing Care Hour Standards Study. Part 5 thru Part 8

DTIC Science & Technology

1981-09-01

undressing, into shower, with bath and hair shampoo , assist in redressing, and back into the wheelchair. (Must remain with patient and provide assistance...from area. (Buttocks, hips, shoulders , heels.) BACK RUB: Place equipment at patient’s bedside, remove pajama top, 1 turn patient to expose back, rub back...NAIL CARE: Place equipment at bedside, wash hands/feet and 1 nails, trim and clean finger/toe nails, remove equipment from area. SHAMPOO : Place equipment

Rigorously Assessing Whether the Data Backs the Back School

PubMed Central

Vinh, David T.; Johnson, Craig W.; Phelps, Cynthia L.

2003-01-01

A rigorous between-subjects methodology employing independent random samples and having broad clinical applicability was designed and implemented to evaluate the effectiveness of back safety and patient transfer training interventions for both hospital nurses and nursing assistants. Effects upon self-efficacy, cognitive, and affective measures are assessed for each of three back safety procedures. The design solves the problem of obtaining randomly assigned independent controls where all experimental subjects must participate in the training interventions. PMID:14728544

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

PubMed Central

van der Roer, Nicole; van Tulder, Maurits W; Barendse, Johanna M; van Mechelen, Willem; Franken, Willemien K; Ooms, Arjan C; de Vet, Henrica CW

2004-01-01

Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available. PMID:15560843

Muscle Activation Differs Between Partial and Full Back Squat Exercise With External Load Equated.

PubMed

da Silva, Josinaldo J; Schoenfeld, Brad J; Marchetti, Priscyla N; Pecoraro, Silvio L; Greve, Julia M D; Marchetti, Paulo H

2017-06-01

Changes in range of motion affect the magnitude of the load during the squat exercise and, consequently, may influence muscle activation. The purpose of this study was to evaluate muscle activation between the partial and full back squat exercise with external load equated on a relative basis between conditions. Fifteen young, healthy, resistance-trained men (age: 26 ± 5 years, height: 173 ± 6 cm) performed a back squat at their 10 repetition maximum (10RM) using 2 different ranges of motion (partial and full) in a randomized, counterbalanced fashion. Surface electromyography was used to measure muscle activation of the vastus lateralis, vastus medialis, rectus femoris, biceps femoris (BF), semitendinosus, erector spinae, soleus (SL), and gluteus maximus (GM). In general, muscle activity was highest during the partial back squat for GM (p = 0.004), BF (p = 0.009), and SL (p = 0.031) when compared with full-back squat. There was no significant difference for rating of perceived exertion between partial and full back squat exercise at 10RM (8 ± 1 and 9 ± 1, respectively). In conclusion, the range of motion in the back squat alters muscle activation of the prime mover (GM) and stabilizers (SL and BF) when performed with the load equated on a relative basis. Thus, the partial back squat maximizes the level of muscle activation of the GM and associated stabilizer muscles.

Effects of a two-school-year multifactorial back education program in elementary schoolchildren.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-08-01

A quasi-experimental pre/post design. To investigate effects of a 2-school-year multifactorial back education program on back posture knowledge and postural behavior in elementary schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance beliefs were evaluated. Epidemiologic studies report mounting nonspecific back pain prevalence among youngsters, characterized by multifactorial risk factors. Study findings of school-based interventions are promising. Furthermore, biomechanical discomfort is found in the school environment. The study sample included 193 intervention children and 172 controls (baseline, 9-to-11-year-olds). The multifactorial intervention consisted of a back education program and the stimulation of postural dynamism in the class through support and environmental changes. Evaluation consisted of a questionnaire, an observation of postural behavior in the classroom, and an observation of material handling during a movement session. The intervention resulted in increased back posture knowledge (P < 0.001), improved postural behavior during material handling (P < 0.001), and decreased duration of trunk flexion (P < 0.05) and neck torsion (P < 0.05) during lesson time. The intervention did not change fear-avoidance beliefs. There was a trend for decreased pain reports in boys of the intervention group (P < 0.09). The intervention resulted in improved postural aspects related to spinal loading. The long-term effect of improved postural behavior at young age on back pain prevalence later in life is of interest for future research.

Reliability and Validity of a New Method for Isometric Back Extensor Strength Evaluation Using A Hand-Held Dynamometer

PubMed Central

2017-01-01

Objective To investigate the reliability and validity of a new method for isometric back extensor strength measurement using a portable dynamometer. Methods A chair equipped with a small portable dynamometer was designed (Power Track II Commander Muscle Tester). A total of 15 men (mean age, 34.8±7.5 years) and 15 women (mean age, 33.1±5.5 years) with no current back problems or previous history of back surgery were recruited. Subjects were asked to push the back of the chair while seated, and their isometric back extensor strength was measured by the portable dynamometer. Test-retest reliability was assessed with intraclass correlation coefficient (ICC). For the validity assessment, isometric back extensor strength of all subjects was measured by a widely used physical performance evaluation instrument, BTE PrimusRS system. The limit of agreement (LoA) from the Bland-Altman plot was evaluated between two methods. Results The test-retest reliability was excellent (ICC=0.82; 95% confidence interval, 0.65–0.91). The Bland-Altman plots demonstrated acceptable agreement between the two methods: the lower 95% LoA was −63.1 N and the upper 95% LoA was 61.1 N. Conclusion This study shows that isometric back extensor strength measurement using a portable dynamometer has good reliability and validity. PMID:29201818

Late bedtimes, short sleeping time, and longtime video-game playing are associated with low back pain in school-aged athletes.

PubMed

Yabe, Yutaka; Hagiwara, Yoshihiro; Sekiguchi, Takuya; Momma, Haruki; Tsuchiya, Masahiro; Kuroki, Kaoru; Kanazawa, Kenji; Koide, Masashi; Itaya, Nobuyuki; Itoi, Eiji; Nagatomi, Ryoichi

2018-05-01

Low back pain is a significant problem for school-aged athletes. Although some risk factors relating to sports activities have been reported, the effect of lifestyles on low back pain in school-aged athletes is not clear. The purpose of this study was to elucidate the association between lifestyles, such as wake-up time, bedtime, sleeping time, and TV-viewing or video-game-playing time per day and low back pain of school-aged athletes. A cross-sectional study was conducted with school-aged athletes (aged 6-15 years, n = 6441) using a self-reported questionnaire and multivariate logistic regression models were used for analyses. Variables considered in the models were gender, age, body mass index, team levels, number of days in practice per week, number of hours in practice per day, and lifestyles. The frequency of low back pain was 5.0% (n = 322). Late bedtime, short sleeping time, and long video-game-playing time per day were significantly associated with low back pain. There was no significant association between low back pain and wake-up time or TV-viewing time per day. Unhealthy life-style choices, such as late bedtimes, short sleeping time, and longtime video-game playing, were associated with low back pain in school-aged athletes.

[The prevalence of low back pain in hospital staff and its relationship with chronic fatigue syndrome and occupational factors].

PubMed

Terzi, Rabia; Altın, Firuzan

2015-01-01

This study aimed to investigate the occurrence of low back pain in hospital employees during the previous year and its correlation with demographic data, occupational factors and chronic fatigue syndrome. All participants provided information on their socio-demographic background, occupational characteristics, their experience of low back pain during the previous year, and chronic fatigue syndrome. The study included 365 volunteers (221 male and 144 female). The mean age was 33.1 ± 7.2. Of the 365 participants, 218 (59.7%) had experienced low back pain in the last year. No statistically significant difference was detected in age, height, weight, level of education, smoking habits, occupation, professional working hours, shift work or levels of income between the groups with and without low back pain. Low back pain was more frequent (p<0.05) in male workers. Chronic fatigue syndrome was statistically significant in the group suffering from low back pain (p<0.05), of whom 21.5% had chronic fatigue syndrome. We detected a statistically significant relationship (p<0.05) between chronic fatigue syndrome, occupational duration and shift work. To the best of our knowledge, this is the first to show the relationship between low back pain and chronic fatigue syndrome in hospital employees. Shift work and length of time in occupation are risk factors for chronic fatigue syndrome.

Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial.

PubMed

Goertz, Christine M; Salsbury, Stacie A; Long, Cynthia R; Vining, Robert D; Andresen, Andrew A; Hondras, Maria A; Lyons, Kevin J; Killinger, Lisa Z; Wolinsky, Fredric D; Wallace, Robert B

2017-10-13

Low back pain is a debilitating condition for older adults, who may seek healthcare from multiple providers. Few studies have evaluated impacts of different healthcare delivery models on back pain outcomes in this population. The purpose of this study was to compare clinical outcomes of older adults receiving back pain treatment under 3 professional practice models that included primary medical care with or without chiropractic care. We conducted a pilot randomized controlled trial with 131 community-dwelling, ambulatory older adults with subacute or chronic low back pain. Participants were randomly allocated to 12 weeks of individualized primary medical care (Medical Care), concurrent medical and chiropractic care (Dual Care), or medical and chiropractic care with enhanced interprofessional collaboration (Shared Care). Primary outcomes were low back pain intensity rated on the numerical rating scale and back-related disability measured with the Roland-Morris Disability Questionnaire. Secondary outcomes included clinical measures, adverse events, and patient satisfaction. Statistical analyses included mixed-effects regression models and general estimating equations. At 12 weeks, participants in all three treatment groups reported improvements in mean average low back pain intensity [Shared Care: 1.8; 95% confidence interval (CI) 1.0 to 2.6; Dual Care: 3.0; 95% CI 2.3 to 3.8; Medical Care: 2.3; 95% CI 1.5 to 3.2)] and back-related disability (Shared Care: 2.8; 95% CI 1.6 to 4.0; Dual Care: 2.5; 95% CI 1.3 to 3.7; Medical Care: 1.5; 95% CI 0.2 to 2.8). No statistically significant differences were noted between the three groups on the primary measures. Participants in both models that included chiropractic reported significantly better perceived low back pain improvement, overall health and quality of life, and greater satisfaction with healthcare services than patients who received medical care alone. Professional practice models that included primary care and chiropractic care led to modest improvements in low back pain intensity and disability for older adults, with chiropractic-inclusive models resulting in better perceived improvement and patient satisfaction over the primary care model alone. Clinicaltrials.gov, NCT01312233 , 4 March 2011.

Effects of back posture education on elementary schoolchildren's back function.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; Danneels, Lieven; Coorevits, Pascal; Vanderstraeten, Guy; De Clercq, Dirk

2007-06-01

The possible effects of back education on children's back function were never evaluated. Therefore, main aim of the present study was to evaluate the effects of back education in elementary schoolchildren on back function parameters. Since the reliability of back function measurement in children is poorly defined, another objective was to test the selected instruments for reliability in 8-11-year olds. The multi-factorial intervention lasting two school-years consisted of a back education program and the stimulation of postural dynamism in the class. Trunk muscle endurance, leg muscle capacity and spinal curvature were evaluated in a pre-post design including 41 children who received the back education program (mean age at post-test: 11.2 +/- 0.9 years) and 28 controls (mean age at post-test: 11.4 +/- 0.6 years). Besides, test-retest reliability with a 1-week interval was investigated in a separate sample. Therefore, 47 children (mean age: 10.1 +/- 0.5 years) were tested for reliability of trunk muscle endurance and 40 children (mean age: 10.2 +/- 0.7 years) for the assessment of spinal curvatures. Reliability of endurance testing was very good to good for the trunk flexors (ICC = 0.82) and trunk extensors (ICC = 0.63). The assessment of the thoracic (ICC = 0.69) and the lumbar curvature (ICC = 0.52) in seating position showed good to acceptable reliability. Low ICCs were found for the assessment of the thoracic (ICC = 0.39) and the lumbar curvature (ICC = 0.37) in stance. The effects of 2 year back education showed an increase in trunk flexor endurance in the intervention group compared to a decrease in the controls and a trend towards significance for a higher increase in trunk extensor endurance in the intervention group. For leg muscle capacity and spinal curvature no intervention effects were found. The small samples recommend cautious interpretation of intervention effects. However, the present study's findings favor the implementation of back education with focus on postural dynamism in the class as an integral part of the elementary school curriculum in the scope of optimizing spinal loading through the school environment.

The influence of communication and information sources upon decision-making around complementary and alternative medicine use for back pain among Australian women aged 60-65 years.

PubMed

Murthy, Vijayendra; Adams, Jon; Broom, Alex; Kirby, Emma; Refshauge, Kathryn M; Sibbritt, David

2017-01-01

This study examined factors influencing decision-making on complementary and alternative medicine (CAM) use for back pain and back pain sufferers' communication about CAM use. A cross-sectional postal survey was conducted in 2011/2012 as a sub-study of the Australian Longitudinal Study on Women's Health (ALSWH). The sample contained 1620 women from the 1945-1951 cohort of the ALSWH, aged 60-65 years who were eligible for the sub-study, as they had experienced back pain during 12 months prior to the survey. Of these, 1310 (80.9%) returned completed questionnaires. A significant proportion of women consulted a CAM practitioner (76%, n = 1001) and/or had self-prescribed CAM treatment (75%, n = 985). Of the women who used CAM for their back pain, 20% consulted their general practitioner (GP) prior to using CAM and 34% always informed their GP following CAM use. Forty-three per cent of the women were influenced by their doctors, 39% by friends/colleagues, 36% by family/relatives, 33% by their partner, 30% by a CAM practitioner, 20% by a pharmacist, 16% by a book/magazine, 11% by mass media, 10% by an allied health worker and 6% by the Internet. Our results show that information sources used by women for their decision-making on CAM use differed according to the symptoms. While non-professional information sources (e.g. family/relatives) positively influenced women in their decision to use CAM for a range of back pain-related symptoms (e.g. headaches/migraines), doctors and allied health workers (e.g. nurses) negatively influenced women in their decision to consult a CAM practitioner for a range of back pain-related symptoms (e.g. headaches/migraines, neck pain). Women seek information from a wide range of professional and non-professional sources with regard to their decision-making around CAM use for back pain. Back pain care providers need to ensure effective communication with their back pain patients regarding safe, effective and co-ordinated back pain care options. © 2015 John Wiley & Sons Ltd.

Disrupted Self-Perception in People With Chronic Low Back Pain. Further Evaluation of the Fremantle Back Awareness Questionnaire.

PubMed

Wand, Benedict Martin; Catley, Mark Jon; Rabey, Martin Ian; O'Sullivan, Peter Bruce; O'Connell, Neil Edward; Smith, Anne Julia

2016-09-01

Several lines of evidence suggest that body perception is altered in people with chronic back pain. Maladaptive perceptual awareness of the back might contribute to the pain experience as well as serve as a target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) is a simple questionnaire recently developed to assess back-specific altered self-perception. The aims of this study were to present the outcomes of a comprehensive evaluation of the questionnaire's psychometric properties and explore the potential relationships between body perception, nociceptive sensitivity, distress, and beliefs about back pain and the contribution these factors might play in explaining pain and disability. Two hundred fifty-one people with chronic back pain completed the questionnaire as well as a battery of clinical tests. The Rasch model was used to explore the questionnaires' psychometric properties and correlation and multiple linear regression analyses were used to explore the relationship between altered body perception and clinical status. The FreBAQ appears unidimensional with no redundant items, has minimal ceiling and floor effects, acceptable internal consistency, was functional on the category rating scale, and was not biased by demographic or clinical variables. FreBAQ scores were correlated with sensitivity, distress, and beliefs and were uniquely associated with pain and disability. Several lines of evidence suggest that body perception might be disturbed in people with chronic low back pain, possibly contributing to the condition and offering a potential target for treatment. The FreBAQ was developed as a quick and simple way of measuring back-specific body perception in people with chronic low back pain. The questionnaire appears to be a psychometrically sound way of assessing altered self-perception. The level of altered self-perception is positively correlated with pain intensity and disability as well as showing associations with psychological distress, pain catastrophization, fear avoidance beliefs, and lumbar pressure pain threshold. In this sample, it appears that altered self-perception might be a more important determinant of clinical severity than psychological distress, pain catastrophization, fear avoidance beliefs, or lumbar pressure pain threshold. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

"Are We hurting ourselves?" What is the prevalence of back pain in anesthesia providers?

PubMed

Anson, Jonathan A; Mets, Elbert J; Vaida, Sonia J; King, Tonya S; Ochoa, Tim; Gordin, Vitaly

2016-11-01

Back injuries are a highly reported category of occupational injury in the health care setting. The daily clinical activities of an anesthesia provider, including lifting, pushing stretchers, transferring patients, and bending for procedures, are risk factors for developing low back pain. The purpose of this study is to investigate the prevalence of work related low back pain in anesthesia providers. We conducted a cross-sectional survey study of anesthesia providers at an academic institution. The target population included all 141 clinical anesthesia providers employed by the Penn State Milton S. Hershey Medical Center Department of Anesthesia. A survey study was conducted using the Oswestry Disability Index (ODI), a validated scoring system for low back pain. Additional questions related to the daily activities of clinical anesthesia practice were also asked. The survey instrument underwent pretesting and clinical sensibility testing to ensure validity and consistent interpretation. The primary self-reported measures were the prevalence of low back pain in anesthesia providers and an assessment of disability based on the ODI. Secondary functional measures included the impact of low back pain on work flow. Nearly half (46.6%) of respondents suffer from low back pain attributed to clinical practice. In this subset of respondents, 70.1% reported not having back pain prior to their anesthesia training. Of those with low back pain, 44% alter their work flow, and 9.8% reported missing at least one day of work. Six providers (5.3%) required surgical intervention. Using the ODI score interpretation guidelines, 46% of respondents had a "mild disability" and 2% had a "moderate disability." Respondents reporting feeling "burned out" from their job had a significantly higher average ODI score compared to those who did not (6.8 vs 3.3, respectively; P=.01). Nearly half of all anesthesia providers sampled suffer from low back pain subjectively attributed to their clinical practice. This leads to changes in work flow and missed days of work. The results of this study suggest a deficiency in the effectiveness of anesthesia training programs in teaching proper techniques to prevent musculoskeletal injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

Back pain in physically inactive students compared to physical education students with a high and average level of physical activity studying in Poland.

PubMed

Kędra, Agnieszka; Kolwicz-Gańko, Aleksandra; Kędra, Przemysław; Bochenek, Anna; Czaprowski, Dariusz

2017-11-28

The aim of the study was (1) to characterise back pain in physically inactive students as well as in trained (with a high level of physical activity) and untrained (with an average level of physical activity) physical education (PE) students and (2) to find out whether there exist differences regarding the declared incidence of back pain (within the last 12 months) between physically inactive students and PE students as well as between trained (with a high level of physical activity) and untrained (with an average level of physical activity) PE students. The study included 1321 1st-, 2nd- and 3rd-year students (full-time bachelor degree course) of Physical Education, Physiotherapy, Pedagogy as well as Tourism and Recreation from 4 universities in Poland. A questionnaire prepared by the authors was applied as a research tool. The 10-point Visual Analogue Scale (VAS) was used to assess pain intensity. Prior to the study, the reliability of the questionnaire was assessed by conducting it on the group of 20 participants twice with a shorter interval. No significant differences between the results obtained in the two surveys were revealed (p < 0.05). In the group of 1311 study participants, 927 (70.7%) respondents declared having experienced back pain within the last 12 months. Physically inactive students declared back pain frequency similar to the frequency declared by their counterparts studying physical education (p > 0.05). Back pain was more common in the group of trained students than among untrained individuals (p < 0.05). Back pain was mainly located in the lumbar spine. A frequent occurrence of back pain (70.7%) was noted in the examined groups of students. The percentage of students declaring back pain increased in the course of studies (p < 0.05) and, according to the students' declarations, it was located mainly in the lumbar spine. No significant differences regarding the incidence of back pain were found between physically inactive students and physical education students (p > 0.05). The trained students declared back pain more often than their untrained counterparts (p < 0.05).

Homework for Parents -- Your Child's Back-To-School Health Checklist

MedlinePlus

... Tips Share this! Home » Health Tips » Child Emergencies Homework for Parents — Your Child's Back-To-School Health ... do to protect themselves. READ IN CHILD EMERGENCIES Homework for Parents — Your Child's Back-To-School Health ...

Neural Correlates Differ in High and Low Fear-Avoidant Chronic Low Back Pain Patients When Imagining Back-Straining Movements.

PubMed

Barke, Antonia; Preis, Mira A; Schmidt-Samoa, Carsten; Baudewig, Jürgen; Kröner-Herwig, Birgit; Dechent, Peter

2016-08-01

The fear-avoidance model postulates that in an initial acute phase chronic low back pain (CLBP) patients acquire a fear of movement that results in avoidance of physical activity and contributes to the pain becoming chronic. The current functional magnetic resonance imaging study investigated the neural correlates of imagining back-straining and neutral movements in CLBP patients with high (HFA) and low fear avoidance (LFA) and healthy pain-free participants. Ninety-three persons (62 CLBP patients, 31 healthy controls; age 49.7 ± 9.2 years) participated. The CLBP patients were divided into an HFA and an LFA group using the Tampa Scale of Kinesiophobia. The participants viewed pictures of back-straining and neutral movements and were instructed to imagine that they themselves were executing the activity shown. When imagining back-straining movements, HFA patients as well as healthy controls showed stronger anterior hippocampus activity than LFA patients. The neural activations of HFA patients did not differ from those of healthy controls. This may indicate that imagining back-straining movements triggered pain-related evaluations in healthy controls and HFA participants, but not in LFA participants. Although heightened pain expectancy in HFA compared with LFA patients fits well with the fear-avoidance model, the difference between healthy controls and LFA patients was unexpected and contrary to the fear-avoidance model. Possibly, negative evaluations of the back-straining movements are common but the LFA patients use some kind of strategy enabling them to react differently to the back-straining events. It appears that low fear-avoidant back pain patients use some kind of strategy or underlying mechanism that enables them to react with less fear in the face of potentially painful movements. This warrants further investigation because countering fear and avoidance provide an important advantage with respect to disability. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Patients' Attitudes Toward Nonphysician Screening of Low Back and Low Back Related Leg Pain Complaints Referred for Surgical Assessment.

PubMed

Rempel, Joshua; Busse, Jason W; Drew, Brian; Reddy, Kesava; Cenic, Aleksa; Kachur, Edward; Murty, Naresh; Candelaria, Henry; Moore, Ainsley E; Riva, John J

2017-03-01

A questionnaire survey. The aim of this study was to explore patient attitudes toward screening to assess suitability for low back surgery by nonphysician health care providers. Canadian spine surgeons have shown support for nonphysician screening to assess and triage patients with low back pain and low back related leg pain. However, patients' attitudes toward this proposed model are largely unknown. We administered a 19-item cross-sectional survey to adults with low back and/or low back related leg pain who were referred for elective surgical assessment at one of five spine surgeons' clinics in Hamilton, Ontario, Canada. The survey inquired about demographics, expectations regarding wait time for surgical consultation, as well as willingness to pay, travel, and be screened by nonphysician health care providers. Eighty low back patients completed our survey, for a response rate of 86.0% (80 of 93). Most respondents (72.5%; 58 of 80) expected to be seen by a surgeon within 3 months of referral, and 88.8% (71 of 80) indicated willingness to undergo screening with a nonphysician health care provider to establish whether they were potentially a surgical candidate. Half of respondents (40 of 80) were willing to travel >50 km for assessment by a nonphysician health care provider, and 46.2% were willing to pay out-of-pocket (25.6% were unsure). However, most respondents (70.0%; 56 of 80) would still want to see a surgeon if they were ruled out as a surgical candidate, and written comments from respondents revealed concern regarding agreement between surgeons' and nonphysicians' determination of surgical candidates. Patients referred for surgical consultation for low back or low back related leg pain are largely willing to accept screening by nonphysician health care providers. Future research should explore the concordance of screening results between surgeon and nonphysician health care providers. 3.

New low back pain in nurses: work activities, work stress and sedentary lifestyle.

PubMed

Yip, Vera Yin Bing

2004-05-01

Low back pain is common among nurses. Previous studies have shown that the risk of low back pain increases rapidly with greater amounts of physical work and psychological stress, but is inversely related to leisure activities. However, these previous studies were predominantly retrospective in design and not many took account of three factors simultaneously. This 12-month prospective study examined the relationships between work activities, work stress, sedentary lifestyle and new low back pain. A total of 144 nurses from six Hong Kong district hospitals completed a face-to-face baseline interview, which was followed-up by a telephone interview. The main study measures were demographic characteristics, work activities, work stress, physical leisure activities and the nature of new low back pain during the 12-month follow-up period. Level of work stress, quality of relationships at work, level of enjoyment experienced at work, and work satisfaction were self-reported. Fifty-six (38.9%) nurses reported experiencing new low back pain. Sedentary leisure time activity was not associated with new low back pain. Being comparatively new on a ward (adjusted relative risk 2.90), working in bending postures (adjusted relative risk 2.76) and poor work relationships with colleagues (adjusted relative risk 2.52) were independent predictors of new low back pain. The findings of this study suggest that low back pain is a common problem in the population of nurses in Hong Kong. Being comparatively new on a ward, bending frequently during work and having poor work relationships with colleagues are independent predictors of new low back pain. Training for high-risk work activities and ergonomic assessment of awkward work postures are essential. Moreover, relaxation and team-building workshops for nurses, especially those who are less experienced in the type of work on their current ward, are recommended.

The Association Between Obesity and Low Back Pain and Disability Is Affected by Mood Disorders

PubMed Central

Chou, Louisa; Brady, Sharmayne R.E.; Urquhart, Donna M.; Teichtahl, Andrew J.; Cicuttini, Flavia M.; Pasco, Julie A.; Brennan-Olsen, Sharon L.; Wluka, Anita E.

2016-01-01

Abstract Low back pain (LBP) and obesity are major public health problems; however, the relationship between body composition and low back pain in men is unknown. This study aims to examine the association between body composition and LBP and disability in a population-based sample of men, as well as the factors that may affect this relationship. Nine hundred seventy-eight male participants from the Geelong Osteoporosis Study were invited to participate in a follow-up study in 2006. Participants completed questionnaires on sociodemographics and health status. Low back pain was determined using the validated Chronic Back Pain Grade Questionnaire and the presence of an emotional disorder was assessed using the Hospital Anxiety Depression Scale. Body composition was measured using dual energy x-ray absorptiometry. Of the 820 respondents (84% response rate), 124 (15%) had high-intensity low back pain and/or disability (back pain). Low back pain was associated with higher body mass index (28.7 ± 0.4 vs 27.3 ± 0.2 kg/m2, P = 0.02) and waist–hip ratio (0.97 ± 0.006 vs 0.96 ± 0.006, P = 0.04), with increased tendency toward having a higher fat mass index (8.0 vs 7.6 kg/m2, P = 0.08), but not fat-free mass index (P = 0.68). The associations between back pain and measures of obesity were stronger in those with an emotional disorder, particularly for waist–hip ratio (P = 0.05 for interaction) and fat mass index (P = 0.06 for interaction). In a population-based sample of men, high-intensity LBP and/or disability were associated with increased levels of obesity, particularly in those with an emotional disorder. This provides evidence to support a biopsychosocial interaction between emotional disorders and obesity with low back pain. PMID:27082599

Isometric endurance of the back extensors in school-aged adolescents with and without low back pain.

PubMed

Johnson, Olubusola E; Mbada, Chidozie E; Akosile, Christopher O; Agbeja, Oyinade A

2009-01-01

Studies on back extensor endurance in adolescents are scarce. This study sought to establish reference data and pattern of back extensor endurance in school-aged adolescents with and without low-back pain (LBP) from Nigeria. This study recruited 625 adolescents aged 11 to 19 years from eight randomly selected secondary schools. The modified Biering-Sørensen test of Static Muscular Endurance (BSME) was used to assess isometric endurance of the back extensors. Demographic and anthropometric data were collected. A modified LBP questionnaire was used to assess the presence of LBP. Descriptive and inferential analyses were used to analyze data. Significance was set at 0.05 alpha-level. The mean isometric holding time (IHT) of all the participants was 132.9 $\\pm$ 65.6. Males had significantly higher significant (p=0.026) IHT than females. Adolescents without LBP had a higher significant IHT (p=0.042) than those with reported history of previous LBP and those with present LBP (p=0.000) respectively. Using percentile values, poor endurance was defined as IHT that is < 90.0 s and < 67 s for males and females respectively; medium endurance was defined as IHT that ranged between 90 and 193 s and 67 and 170 s for males and females respectively while good endurance was defined as IHT that is > 193 s and > 170 s for males and females respectively. IHT was significantly related to each of body mass index, hip circumference and waist-to-hip ratio (p < 0.05). Isometric back extensors endurance in Nigerian adolescents was comparable to the original Biering-Sørensen mean value. Majority of the participants had medium endurance performance with the back endurance pattern in the ratio 1:2:1. Male had higher isometric back extensors endurance than females. Decreased isometric back extensors endurance was associated with the presence of LBP in adolescents.

Questionnaires to examine Back Pain Beliefs held by health care professionals: a psychometric evaluation of Simplified Chinese versions.

PubMed

Chen, Gang; Tan, B-K; Jia, Hong-Liang; O'Sullivan, Peter; Burnett, Angus

2011-08-15

Observational cross-sectional study. To perform a psychometric evaluation of Simplified Chinese versions of back pain beliefs questionnaires for use in health care professionals living in mainland China. Back pain beliefs are of importance in the development of chronic low back pain (LBP) and disability. Different types of beliefs exist with regard to LBP and these include inevitable consequences of LBP and fear-avoidance beliefs. LBP beliefs held by health care providers are also known to influence their patients' pain beliefs and can contribute to the development of chronic LBP and disability. At present, validated questionnaires such as the Back Beliefs Questionnaire, Health Care Providers' Pain and Impairment Relationship Scale, and Fear-Avoidance Beliefs Questionnaire are commonly used to investigate back pain beliefs held by health care professionals working in western countries. There are no published nor validated Simplified Chinese versions to allow investigation of back pain beliefs in health care professionals living in mainland China. The English versions of the earlier mentioned questionnaires were translated and culturally adapted into Simplified Chinese using the double-back-translation method. A psychometric evaluation of the translated questionnaires was conducted on 65 health care professionals (rehabilitation medicine specialists, osteopaths, and nurses), with and without LBP, practicing in Shanghai, China. The questionnaires were completed twice within 7- to 10-day period. The Back Beliefs Questionnaire, Health Care Providers' Pain and Impairment Relationship Scale, and Fear-Avoidance Beliefs Questionnaire (work and physical subscales) had acceptable internal consistency (Cronbach α range: 0.70-0.87) and construct validity (r = 0.40-0.49, P < 0.05), good reproducibility (Intraclass correlation coefficients, ICC(2,1) range: 0.85-0.93) and an absence of any floor or ceiling effects. This study showed that the Simplified Chinese versions of back pain beliefs questionnaires are valid and reliable. Therefore, these questionnaires can be used in research involving Chinese health care professionals living in mainland China.

[Roof folding and rotary pushing for the treatment of back to back fractures of distal radius and ulna in children].

PubMed

Xu, Ping; Dong, Xiao-jun; Lu, Zhou-tong; Wang, Gongjun; Zhang, Han-qing; Chen, Xuan-ning; Li, Dong

2015-09-01

To evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back". From January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function. All patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist. Using the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

Linear Back-Drive Differentials

NASA Technical Reports Server (NTRS)

Waydo, Peter

2003-01-01

Linear back-drive differentials have been proposed as alternatives to conventional gear differentials for applications in which there is only limited rotational motion (e.g., oscillation). The finite nature of the rotation makes it possible to optimize a linear back-drive differential in ways that would not be possible for gear differentials or other differentials that are required to be capable of unlimited rotation. As a result, relative to gear differentials, linear back-drive differentials could be more compact and less massive, could contain fewer complex parts, and could be less sensitive to variations in the viscosities of lubricants. Linear back-drive differentials would operate according to established principles of power ball screws and linear-motion drives, but would utilize these principles in an innovative way. One major characteristic of such mechanisms that would be exploited in linear back-drive differentials is the possibility of designing them to drive or back-drive with similar efficiency and energy input: in other words, such a mechanism can be designed so that a rotating screw can drive a nut linearly or the linear motion of the nut can cause the screw to rotate. A linear back-drive differential (see figure) would include two collinear shafts connected to two parts that are intended to engage in limited opposing rotations. The linear back-drive differential would also include a nut that would be free to translate along its axis but not to rotate. The inner surface of the nut would be right-hand threaded at one end and left-hand threaded at the opposite end to engage corresponding right- and left-handed threads on the shafts. A rotation and torque introduced into the system via one shaft would drive the nut in linear motion. The nut, in turn, would back-drive the other shaft, creating a reaction torque. Balls would reduce friction, making it possible for the shaft/nut coupling on each side to operate with 90 percent efficiency.

An observational study to assess back pain in patients with severe osteoporosis treated with teriparatide versus antiresorptives: An Indian subpopulation analysis

PubMed Central

Chhabra, Harvinder; Malhotra, Rajesh; Marwah, Sunil; Dave, Bharat; See, Kyoungah; Sohal, Simrat; Gurbuz, Sirel

2015-01-01

Background: One year, prospective, observational study in an Indian subpopulation to assess back pain in patients with severe osteoporosis treated with teriparatide or antiresorptives in a clinical setting. Materials and Methods: One hundred and nineteen teriparatide-naοve Indian men and postmenopausal women (mean age 68.0 years) with previous osteoporotic vertebral fracture participated. Patients were assessed at baseline, 6-and 12-months to evaluate relative risk (RR) of new/worsening back pain using the Back Pain Questionnaire. The incidence of back pain and changes in back pain severity were assessed using the visual analog scale (VAS); Health outcomes were assessed using the euroquol-5 dimensions (EQ-5D) questionnaire. All tests were conducted with a two-sided alpha of 0.05. Results: Of 562 overall patients, 57, 60, and 2 Indian patients received teriparatide, antiresorptive, or teriparatide and antiresorptive, respectively. Baseline disease characteristics were slightly worse for antiresorptive-treated patients, whereas teriparatide-treated patients were older with more comorbidities. At 6-months, the incidence of new/worsening back pain was 5.3% for teriparatide-treated patients versus 4.4% for antiresorptive-treated patients (RR: 1.00, 95% confidence interval: 0.68, 1.48); the incidence of severe back pain was 0% versus 12.5% (P = 0.017); in these treatment groups, respectively. Mean VAS change scores (mean ± standard deviation [SD]) were − 1.9 ± 1.73 versus − 1.4 ± 1.77, and mean EQ-5D change scores were 4.2 ± 27.20 versus 9.9 ± 26.23 at 6-months. At 6 months, more teriparatide-treated patients felt better (89% vs. 61%; P = 0.001) and were at least very satisfied with their treatment (30% vs. 9%; P = 0.011). Conclusion: Teriparatide-treated Indian patients had similar new/worsening back pain risk and minimal risk of severe back pain compared with antiresorptive-treated patients at 6-months. PMID:26180763

Yoga versus education for Veterans with chronic low back pain: study protocol for a randomized controlled trial.

PubMed

Saper, Robert B; Lemaster, Chelsey M; Elwy, A Rani; Paris, Ruth; Herman, Patricia M; Plumb, Dorothy N; Sherman, Karen J; Groessl, Erik J; Lynch, Susan; Wang, Shihwe; Weinberg, Janice

2016-04-29

Chronic low back pain is the most frequent pain condition in Veterans and causes substantial suffering, decreased functional capacity, and lower quality of life. Symptoms of post-traumatic stress, depression, and mild traumatic brain injury are highly prevalent in Veterans with back pain. Yoga for low back pain has been demonstrated to be effective for civilians in randomized controlled trials. However, it is unknown if results from previously published trials generalize to military populations. This study is a parallel randomized controlled trial comparing yoga to education for 120 Veterans with chronic low back pain. Participants are Veterans ≥18 years old with low back pain present on at least half the days in the past six months and a self-reported average pain intensity in the previous week of ≥4 on a 0-10 scale. The 24-week study has an initial 12-week intervention period, where participants are randomized equally into (1) a standardized weekly group yoga class with home practice or (2) education delivered with a self-care book. Primary outcome measures are change at 12 weeks in low back pain intensity measured by the Defense and Veterans Pain Rating Scale (0-10) and back-related function using the 23-point Roland Morris Disability Questionnaire. In the subsequent 12-week follow-up period, yoga participants are encouraged to continue home yoga practice and education participants continue following recommendations from the book. Qualitative interviews with Veterans in the yoga group and their partners explore the impact of chronic low back pain and yoga on family relationships. We also assess cost-effectiveness from three perspectives: the Veteran, the Veterans Health Administration, and society using electronic medical records, self-reported cost data, and study records. This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities. ClinicalTrials.gov: NCT02224183.

Malignant human cell transformation of Marcellus Shale gas drilling flow back water

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yao, Yixin; Department of Environmental Medicine, New York University School of Medicine, Tuxedo, NY 10987; Chen, Tingting

The rapid development of high-volume horizontal hydraulic fracturing for mining natural gas from shale has posed potential impacts on human health and biodiversity. The produced flow back waters after hydraulic stimulation are known to carry high levels of saline and total dissolved solids. To understand the toxicity and potential carcinogenic effects of these wastewaters, flow back waters from five Marcellus hydraulic fracturing oil and gas wells were analyzed. The physicochemical nature of these samples was analyzed by inductively coupled plasma mass spectrometry and scanning electron microscopy/energy dispersive X-ray spectroscopy. A cytotoxicity study using colony formation as the endpoint was carriedmore » out to define the LC{sub 50} values of test samples using human bronchial epithelial cells (BEAS-2B). The BEAS-2B cell transformation assay was employed to assess the carcinogenic potential of the samples. Barium and strontium were among the most abundant metals in these samples and the same metals were found to be elevated in BEAS-2B cells after long-term treatment. BEAS-2B cells treated for 6 weeks with flow back waters produced colony formation in soft agar that was concentration dependent. In addition, flow back water-transformed BEAS-2B cells show better migration capability when compared to control cells. This study provides information needed to assess the potential health impact of post-hydraulic fracturing flow back waters from Marcellus Shale natural gas mining. - Highlights: • This is the first report of potential cytotoxicity and transforming activity of Marcellus shale gas mining flow back to mammalian cells. • Barium and Strontium were elevated in flow back water exposed cells. • Flow back water malignantly transformed cells and formed tumor in athymic nude mice. • Flow back transformed cells exhibited altered transcriptome with dysregulated cell migration pathway and adherent junction pathway.« less

Effectiveness of focused structural massage and relaxation massage for chronic low back pain: protocol for a randomized controlled trial.

PubMed

Cherkin, Daniel C; Sherman, Karen J; Kahn, Janet; Erro, Janet H; Deyo, Richard A; Haneuse, Sebastien J; Cook, Andrea J

2009-10-20

Chronic back pain is a major public health problem and the primary reason patients seek massage treatment. Despite the growing use of massage for chronic low back pain, there have been few studies of its effectiveness. This trial will be the first evaluation of the effectiveness of relaxation massage for chronic back pain and the first large trial of a focused structural form of massage for this condition. A total of 399 participants (133 in each of three arms) between the ages of 20 and 65 years of age who have low back pain lasting at least 3 months will be recruited from an integrated health care delivery system. They will be randomized to one of two types of massage ("focused structural massage" or "relaxation massage"), or continued usual medical care. Ten massage treatments will be provided over 10 weeks. The primary outcomes, standard measures of dysfunction and bothersomeness of low back pain, will be assessed at baseline and after 10, 26, and 52 weeks by telephone interviewers masked to treatment assignment. General health status, satisfaction with back care, days of back-related disability, perceived stress, and use and costs of healthcare services for back pain will also be measured. Outcomes across assigned treatment groups will be compared using generalized estimating equations, accounting for participant correlation and adjusted for baseline value, age, and sex. For both primary outcome measures, this trial will have at least 85% power to detect the presence of a minimal clinically significant difference among the three treatment groups and 91% power for pairwise comparisons. Secondary analyses will compare the proportions of participants in each group that improve by a clinically meaningful amount. Results of this trial will help clarify the value of two types of massage therapy for chronic low back pain.

Prevalence of Back Pain in Sports: A Systematic Review of the Literature.

PubMed

Trompeter, Katharina; Fett, Daniela; Platen, Petra

2017-06-01

Back pain is a frequent health problem in the general population. The epidemiology of back pain in the general population is well researched, but detailed data on the prevalence and risk factors of back pain in athletes are rare. The primary objective was to review articles about back pain in athletes to provide an overview of its prevalence in different sports and compare its prevalence among various types of sports and the general population. A comprehensive search of articles published through May 2015 was conducted. Two independent reviewers searched six databases from inception (PubMed ® , Embase, MEDLINE ® , Cochrane Library, PsycINFO and PSYNDEX), using specifically developed search strategies, for relevant epidemiological research on back pain in 14- to 40-year-old athletes of Olympic disciplines. The reviewers independently evaluated the methodological quality of reviewed articles meeting the inclusion criteria to identify potential sources of bias. Relevant data were extracted from each study. Forty-three articles were judged to meet the inclusion criteria and were included in the assessment of methodological quality. Of these, 25 were assessed to be of high quality. Lifetime prevalence and point prevalence were the most commonly researched episodes and the lower back was the most common localization of pain. In the high-quality studies, lifetime prevalence of low back pain in athletes was 1-94%, (highest prevalence in rowing and cross-country skiing), and point prevalence of low back pain was 18-65% (lowest prevalence in basketball and highest prevalence in rowing). The methodological heterogeneity of the included studies showed a wide range of prevalence rates and did not enable a detailed comparison of data among different sports, within one discipline, or versus the general population. Based on the results of this review, however, it seems obvious that back pain requires further study in some sports.

Association of ACTN3 R577X but not ACE I/D gene variants with elite rugby union player status and playing position.

PubMed

Heffernan, S M; Kilduff, L P; Erskine, R M; Day, S H; McPhee, J S; McMahon, G E; Stebbings, G K; Neale, J P H; Lockey, S J; Ribbans, W J; Cook, C J; Vance, B; Raleigh, S M; Roberts, C; Bennett, M A; Wang, G; Collins, M; Pitsiladis, Y P; Williams, A G

2016-03-01

We aimed to quantify the ACE I/D and ACTN3 R577X (rs1815739) genetic variants in elite rugby athletes (rugby union and league) and compare genotype frequencies to controls and between playing positions. The rugby athlete cohort consisted of 507 Caucasian men, including 431 rugby union athletes that for some analyses were divided into backs and forwards and into specific positional groups: front five, back row, half backs, centers, and back three. Controls were 710 Caucasian men and women. Real-time PCR of genomic DNA was used to determine genotypes using TaqMan probes and groups were compared using χ(2) and odds ratio (OR) statistics. Correction of P values for multiple comparisons was according to Benjamini-Hochberg. There was no difference in ACE I/D genotype between groups. ACTN3 XX genotype tended to be underrepresented in rugby union backs (15.7%) compared with forwards (24.8%, P = 0.06). Interestingly, the 69 back three players (wings and full backs) in rugby union included only six XX genotype individuals (8.7%), with the R allele more common in the back three (68.8%) than controls (58.0%; χ(2) = 6.672, P = 0.04; OR = 1.60) and forwards (47.5%; χ(2) = 11.768, P = 0.01; OR = 2.00). Association of ACTN3 R577X with playing position in elite rugby union athletes suggests inherited fatigue resistance is more prevalent in forwards, while inherited sprint ability is more prevalent in backs, especially wings and full backs. These results also demonstrate the advantage of focusing genetic studies on a large cohort within a single sport, especially when intrasport positional differences exist, instead of combining several sports with varied demands and athlete characteristics. Copyright © 2016 the American Physiological Society.

Association of ACTN3 R577X but not ACE I/D gene variants with elite rugby union player status and playing position

PubMed Central

Kilduff, L. P.; Erskine, R. M.; Day, S. H.; McPhee, J. S.; McMahon, G. E.; Stebbings, G. K.; Neale, J. P. H.; Lockey, S. J.; Ribbans, W. J.; Cook, C. J.; Vance, B.; Raleigh, S. M.; Roberts, C.; Bennett, M. A.; Wang, G.; Collins, M.; Pitsiladis, Y. P.; Williams, A. G.

2016-01-01

We aimed to quantify the ACE I/D and ACTN3 R577X (rs1815739) genetic variants in elite rugby athletes (rugby union and league) and compare genotype frequencies to controls and between playing positions. The rugby athlete cohort consisted of 507 Caucasian men, including 431 rugby union athletes that for some analyses were divided into backs and forwards and into specific positional groups: front five, back row, half backs, centers, and back three. Controls were 710 Caucasian men and women. Real-time PCR of genomic DNA was used to determine genotypes using TaqMan probes and groups were compared using χ2 and odds ratio (OR) statistics. Correction of P values for multiple comparisons was according to Benjamini-Hochberg. There was no difference in ACE I/D genotype between groups. ACTN3 XX genotype tended to be underrepresented in rugby union backs (15.7%) compared with forwards (24.8%, P = 0.06). Interestingly, the 69 back three players (wings and full backs) in rugby union included only six XX genotype individuals (8.7%), with the R allele more common in the back three (68.8%) than controls (58.0%; χ2 = 6.672, P = 0.04; OR = 1.60) and forwards (47.5%; χ2 = 11.768, P = 0.01; OR = 2.00). Association of ACTN3 R577X with playing position in elite rugby union athletes suggests inherited fatigue resistance is more prevalent in forwards, while inherited sprint ability is more prevalent in backs, especially wings and full backs. These results also demonstrate the advantage of focusing genetic studies on a large cohort within a single sport, especially when intrasport positional differences exist, instead of combining several sports with varied demands and athlete characteristics. PMID:26757799

The effects of common medical interventions on pain, back function, and work resumption in patients with chronic low back pain: A prospective 2-year cohort study in six countries.

PubMed

Hansson, T H; Hansson, E K

2000-12-01

A prospective cohort study with identical questionnaires and inclusion criteria was performed. To compare in six different countries the frequencies and effects of the common medical interventions used for patients with low back pain who are work incapacitated. Low back pain is a huge problem with increasing costs for health care, industry, and society. Cohorts of employed men and women ages 18 to 59 years who had been sick-listed (100%) for a minimum of 90 days because of low back pain were recruited in Denmark, Germany, Israel, Sweden, the Netherlands, and the United States. The subjects received three separate questionnaires with identical questions after 90 days, 1 year, and 2 years. The questionnaires included separate questions about background factors, treatment, and the like, as well as validated scales such as the Hannover Activities of Daily Living, von Korff pain score, Short Form-36, and Karasek-Theorell. Working status was obtained from registers. Main outcome measures were working/not working, back function, and pain. All three questionnaires were completed by 2080 subjects in the six countries. With few exceptions, there were great similarities in the appointments, examinations, and treatments in the different countries. Considerable differences were found between the back surgery rates, which ranged from 6% in Sweden to 32% in the United States during the first 90 days of the study. Very few of the interventions had any noticeable positive effects on work resumption, pain, or back function. Back surgery in Sweden was a striking exception, positively affecting all three outcome measures. The frequencies of work resumption within the first year ranged from 73% in the Netherlands to 32% in Denmark. Almost none of the commonly occurring and frequently practiced medical interventions for patients who are sick-listed because of low back pain had any positive effects on either the recorded health measures or work resumption.

Energy absorption of seated occupants exposed to horizontal vibration and role of back support condition.

PubMed

Rakheja, Subhash; Mandapuram, Santosh; Dong, Ren G

2008-12-01

Absorbed power characteristics of seated human subjects under fore-aft (x-axis) and lateral (y-axis) vibration are investigated through measurements of dynamic interactions at the two driving-points formed by the body and the seat pan, and upper body and the backrest. The experiments involved: (i) three back support conditions (no back support, and back supported against a vertical and an inclined backrest); (ii) three seat pan heights (425, 390 and 350 mm); and three magnitudes (0.25, 0.5 and 1.0 m/s2 rms acceleration) of band limited random excitations in 0.5-10 Hz frequency range, applied independently along the x- and y- axes. The force responses, measured at the seat pan and the backrest are applied to characterize total energy transfer reflected on the seat pan and the backrest. The mean responses suggest strong contributions due to back support, and direction and magnitude of vibration. In the absence of a back support, the seat pan responses dominated in lower frequency bands centered at 0.63 and 1.25 Hz under both directions of motion. Most significant interactions of the upper body against the back support was observed under fore-aft vibration. The addition of back support caused the seat pan response to converge to a single primary peak near a higher frequency of 4 Hz under x- axis, with only little effect on the y-axis responses. The back support serves as an additional source of vibration to the occupant and an important constraint to limit the fore-aft movement of the upper body and thus relatively higher energy transfer under. The mean responses were further explored to examine the Wd frequency-weighting used for assessing exposure to horizontal vibration. The results show that the current weighting is suited for assessing the vibration exposure of human subjects seated only without a back support.

Low back pain during pregnancy and Kinesio tape application.

PubMed

Reyhan, Aycan Çakmak; Dereli, Elif Elçin; Çolak, Tuğba Kuru

2017-01-01

Low back pain is a common problem during pregnancy. Although the pain usually occurs in the third trimester, it might be seen in the first trimester, too. There are various types of applications for the treatment of low back pain during pregnancy. However, there is a lack of evidence for the effectiveness of each method. If there is not an obvious deficit, bed rest, exercise, conventional physiotherapy, using protective principles for the lumbar area are recommended, since the main and the only complaint is low back pain. It is aimed in the current review to investigate the use of Kinesio tape in the low back pain seen during pregnancy and to review the literature related to this subject. There are only a few studies investigating the effect of Kinesio tape during pregnancy in the literature and they mostly did not aim to study the low back pain, further evidence and studies are needed to investigate the use of Kinesio tape for the low back pain seen during pregnancy as there is not evidence strong enough. Kinesiotape application aims to increase circulation and mobility, and regarding these gains decreased pain and increased performance are expected.

The treatment effect of hamstring stretching and nerve mobilization for patients with radicular lower back pain

PubMed Central

Lee, Ju-hyun; Kim, Tae-ho

2017-01-01

[Purpose] In this paper, hamstring stretching and nerve mobilization are conducted on patients with radicular lower back pain, and changes to pain levels, pressure thresholds, angles of knee joint extension, and disorder levels of lower back pain were studied. [Subjects and Methods] The subjects were divided into two groups: one group conducted hamstring stretches and was comprised of 6 male and 5 female subjects, and the other group received nerve mobilization treatment and was comprised of 5 male and 6 female subjects. [Results] Pain level and the disorder index of lower back pain were significantly alleviated after the intervention in both groups. Pressure threshold and angles of knee extension were significantly increased after the intervention in both groups. Comparing the two groups, the alleviation of pain was more significant in the nerve mobilization group. [Conclusion] Patients with radicular lower back pain showed significant differences in pain level, pressure threshold, knee extension angle, and disorder index of lower back pain for both the hamstring stretching group and nerve mobilization group after the treatment. Hamstring stretching and nerve mobilization can be usefully applied for the therapy of patients with radicular lower back pain. PMID:28931991

The effect of Kinesio Taping on postural control in subjects with non-specific chronic low back pain.

PubMed

Abbasi, Soheila; Rojhani-Shirazi, Zahra; Shokri, Esmaeil; García-Muro San José, Francisco

2018-04-01

The aim of this study was to investigate the possible alterations in postural control during upright standing in subjects with non-specific chronic low back pain and the effect of Kinesio taping on the postural control. Twenty subjects with non-specific chronic low back pain and twenty healthy subjects participated in this study. The center of pressure excursion was evaluated before the intervention for both groups, and immediately after intervention for the low back pain group. Independent sample t-test, Mann-Whitney test and repeated measure ANOVA were used for the statistical analysis of the data. There were significant differences in the center of pressure excursion between the low back pain group versus the healthy group. The results of the ANOVA demonstrated a statistically significant difference in the mean COP displacement and velocity before Kinesio Taping, immediately after, and 24 h after in the low back pain group. There are poor postural control mechanisms in subjects with non-specific chronic low back pain. Kinesio taping seems to change postural control immediately and have lasting effects until the day after. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of a postpartum back pain relief program for Korean women.

PubMed

Oh, Hyun-Ei; Lee, Young-Sook; Shim, Mi-Jung; Kim, Jin-Sun

2007-03-01

Despite the high prevalence of back pain and its subsequent effects in post-partum women, intervention programs are scarce. The purpose of this study was to test the effects of a back-pain-reducing program on post-partum women who experienced low-back pain during pregnancy. A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended a hospital for prenatal check-ups and experienced back pain participated in an intervention program (n=27), and the results were compared with women in a control group from another hospital (n=25). At 8 weeks post-partum, the pain intensity, functional limitations were lower in the intervention group than in the control group. However, differences in mean change of the pain intensity and functional limitations between 36 and 39 weeks of gestation and at 8 weeks post-partum were not statistically significant between the groups. Moreover, the flexibility, post-partum functional status, and post-partum depression did not differ significantly between the groups. A back-pain-relief program in this study was not effective to reduce the back-pain intensity in post-partum women and to decrease the associated functional limitations. The implications for nursing practice and directions for future research are discussed.

Back pain and exposure to whole body vibration in helicopter pilots.

PubMed

Bongers, P M; Hulshof, C T; Dijkstra, L; Boshuizen, H C; Groenhout, H J; Valken, E

1990-08-01

In a questionnaire survey the prevalence of back pain in 163 helicopter pilots was compared to that in a control group of 297 non-flying air force officers who underwent the same pre-employment medical examination. Since pilots document their hours of flight in a personal flight log, an accurate estimate of the duration of exposure could be made. In addition, vibration levels of the helicopters were measured and an accumulative vibration dose was calculated for each pilot. 'Transient' back pain of a short duration was more frequent amongst the pilots compared to the control group, and the prevalence of 'chronic' back pain of a persistent nature was also higher amongst the helicopter pilots. Transient back pain seemed to be most strongly related to the average hours of flight per day, whereas chronic back pain was more closely related to total hours of flight or the accumulative vibration dose. A significant higher prevalence of this chronic back pain was observed only after 2000 hours of flight or a vibration dose of 400 m2h/s4. The observed health effects may be due to vibration or constrained posture but are most likely due to concomitant exposure to both factors.

Visually induced analgesia during massage treatment in chronic back pain patients.

PubMed

Löffler, A; Trojan, J; Zieglgänsberger, W; Diers, M

2017-11-01

Previous findings suggest that watching sites of experimental and chronic pain can exert an analgesic effect. Our present study investigates whether watching one's back during massage increases the analgesic effect of this treatment in chronic back pain patients. Twenty patients with chronic back pain were treated with a conventional massage therapy. During this treatment, patients received a real-time video feedback of their own back. Watching a neutral object, a video of another person of the same sex being massaged, a picture of the own back, and keeping one's eyes closed were used as controls. These conditions were presented in randomized order on five separate days. All conditions yielded significant decreases in habitual pain intensity. The effect of real-time video feedback of the own back on massage treatment was the strongest and differed significantly from the effect of watching a neutral object, but not from the other control conditions, which may have induced slight effects of their own. Repeated real-time video feedback may be useful during massage treatment of chronic pain. This study shows that inducing visual induced analgesia during massage treatment can be helpful in alleviating chronic pain. © 2017 European Pain Federation - EFIC®.

Worksite back and core exercise in firefighters: Effect on development of lumbar multifidus muscle size.

PubMed

Mayer, John M; Nuzzo, James L

2015-01-01

Firefighting is a dangerous occupation with a high incidence of low back pain and injury. Abnormal back muscle function and morphology has been linked to low back pain and poor physical performance. The effect of exercise training on back muscle size and symmetry has not been investigated in firefighters. The purpose of this study was to assess the effect of worksite exercise training for eliciting lumbar multifidus muscle hypertrophy in firefighters. A cluster randomized controlled trial was conducted with healthy, career firefighters (n=64) from a medium-sized fire department. Participants were randomized by fire station to exercise training (n=36) (supervised back and core exercise performed on duty, 2X/week, 24 weeks) or control (n=28). The cross-sectional area (CSA) of the L4 and L5 lumbar multifidus muscle was assessed with ultrasonography at baseline and following the intervention. At 24 weeks, no significant differences were noted between the groups in the adjusted (by baseline scores and body mass) L4 and L5 lumbar multifidus muscle CSA and asymmetry values. A worksite exercise training program targeting the back and core is not effective for eliciting hypertrophy of the lumbar multifidus muscle in healthy firefighters.

Reciprocal contribution analysis of the left and right hips while walking

NASA Astrophysics Data System (ADS)

Tsuruoka, Yuriko; Tamura, Yoshiyasu; Shibasaki, Ryosuke

2007-10-01

The physical posture of even healthy university students is easy to collapse when walking with textbooks and other heavy loads during university attendance. Consequently, they may experience lower-back pain or knee pain. However, the resulting burden of this stress to the left and right lower-back has not previously been quantitatively analyzed. In this study, we employed a Relative Power Contribution (RPC) analysis approach to quantitatively investigate and compare the reciprocal contribution between the left and right lower-backs while walking with a bag and without a bag. Quantitative data were collected by two accelerometers installed on the subjects. Results for the subjects walking with and without a bag indicated that the contribution of the left and right lower-backs decreased by up to 21% ( p<0.05). Some disorder occurs in the feedback relations of the movement in both lower-backs and as a result, it was understood to cause much discomfort in these areas. This analysis reveals the quantitative relations of left and right lower-backs, which are difficult to discern from the original data. The results can be useful for preventive healthcare for lower-back and knee pains.

Low-cost, high-speed back-end processing system for high-frequency ultrasound B-mode imaging.

PubMed

Chang, Jin Ho; Sun, Lei; Yen, Jesse T; Shung, K Kirk

2009-07-01

For real-time visualization of the mouse heart (6 to 13 beats per second), a back-end processing system involving high-speed signal processing functions to form and display images has been developed. This back-end system was designed with new signal processing algorithms to achieve a frame rate of more than 400 images per second. These algorithms were implemented in a simple and cost-effective manner with a single field-programmable gate array (FPGA) and software programs written in C++. The operating speed of the back-end system was investigated by recording the time required for transferring an image to a personal computer. Experimental results showed that the back-end system is capable of producing 433 images per second. To evaluate the imaging performance of the back-end system, a complete imaging system was built. This imaging system, which consisted of a recently reported high-speed mechanical sector scanner assembled with the back-end system, was tested by imaging a wire phantom, a pig eye (in vitro), and a mouse heart (in vivo). It was shown that this system is capable of providing high spatial resolution images with fast temporal resolution.

Low-Cost, High-Speed Back-End Processing System for High-Frequency Ultrasound B-Mode Imaging

PubMed Central

Chang, Jin Ho; Sun, Lei; Yen, Jesse T.; Shung, K. Kirk

2009-01-01

For real-time visualization of the mouse heart (6 to 13 beats per second), a back-end processing system involving high-speed signal processing functions to form and display images has been developed. This back-end system was designed with new signal processing algorithms to achieve a frame rate of more than 400 images per second. These algorithms were implemented in a simple and cost-effective manner with a single field-programmable gate array (FPGA) and software programs written in C++. The operating speed of the back-end system was investigated by recording the time required for transferring an image to a personal computer. Experimental results showed that the back-end system is capable of producing 433 images per second. To evaluate the imaging performance of the back-end system, a complete imaging system was built. This imaging system, which consisted of a recently reported high-speed mechanical sector scanner assembled with the back-end system, was tested by imaging a wire phantom, a pig eye (in vitro), and a mouse heart (in vivo). It was shown that this system is capable of providing high spatial resolution images with fast temporal resolution. PMID:19574160

Low-back pain during labor.

PubMed

Melzack, R; Schaffelberg, D

1987-04-01

Earlier studies have shown that labor pain is highly variable in intensity and spatial location. Most women feel pain predominantly in the abdominal area whereas others complain about severe back pain. In addition to the pains associated with contractions, many women report continuous low-back pain. This study used the McGill Pain Questionnaire to examine each type of pain. Women during labor also tracked their perceived pain levels at the same time that contractions were registered on cardiotachographic records. The results show that continuous low-back pain is severe and is reported by about 33% of women during labor. It is described as being qualitatively different from the pains associated with uterine contractions. The pain of contractions felt in the back is often reported as "riding on" the continuous low-back pain so that both together may reach "horrible" or "excruciating" intensities. Continuous low-back pain is probably caused by the distention and pressure on adjacent visceral and neural structures in the peritoneum, in contrast to the rhythmic pains that are clearly related to contractions of the uterus. It is possible that each of these major kinds of pain may be controlled by different anesthesiologic and psychologic procedures.

2. JoAnn SieburgBaker, Photographer, September 1977. SECTION SHOWING BACK OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. JoAnn Sieburg-Baker, Photographer, September 1977. SECTION SHOWING BACK OF ROUNDHOUSE AND END OF BACK SHOP WHERE CRANE WAS LOCATED. - Southern Railway Company, Spencer Shops, Salisbury Avenue between Third and Eight Streets, Spencer, Rowan County, NC

Backing warning sensors for tow plows.

DOT National Transportation Integrated Search

2013-06-01

Backup warning system devices were evaluated to determine if they would alert winter maintenance snow : plow drivers to obstacles directly behind the trailer and out of view of the driver when a unit is backed up. : When the sensors on the back of th...

Intracutaneous sterile water for back pain in labour.

PubMed Central

Reynolds, J. L.

1994-01-01

Intracutaneous sterile water appears to be a simple, effective, and harmless technique for relieving back pain. This technique has been used to relieve pain of renal colic, whiplash, and back pain in labour. Family doctors often practise obstetrics in small or isolated units that have limited options for pain relief in labour. This technique is simple, is easy to learn, and appears effective for relieving back pain, which complicates about one third of all labours. Images Figures 1-2 Figures 3-4 PMID:7950471

Bertolotti's syndrome: A commonly missed cause of back pain in young patients.

PubMed

Manmohan, S; Dzulkarnain, A; Nor Azlin, Z A; Fazir, M

2015-01-01

Bertolotti's syndrome must be considered as a differential diagnosis for lower back pain in young people. Treatment, whether conservative or operative, is still debatable. In this paper, we report a case of a 20-year-old girl presenting with lower back pain for 8 years. We administered injection with local anaesthetic and steroid injections within the pseudo-articulation; however, the pain was relieved for 3 weeks. Surgical excision of the pseudo-articulation successfully treated her back pain and the sciatica.

Enhanced light absorption of silicon solar cells with dielectric nanostructured back reflector

NASA Astrophysics Data System (ADS)

Ren, Rui; Zhong, Zheng

2018-06-01

This paper investigates the light absorption property of nanostructured dielectric reflectors in silicon thin film solar cells using numerical simulation. Flat thin film solar cell with ZnO nanostructured back reflector can produce comparable photocurrent to the control model with Ag nanostructured back reflector. Furthermore, when it is integrated with nano-pillar surface decoration, a photocurrent density of 29.5 mA/cm2 can be achieved, demonstrating a photocurrent enhancement of 5% as compared to the model with Ag nanostructured back reflector.

Etiology and Progression of Acute Muscle Tension Related Low Back Pain Occurring During Sustained Activity Including Combat Training Exercises

DTIC Science & Technology

1992-01-31

pattern of paraspinal muscle contraction , and (3) onset of low back pain. (b) That patterns of muscle tension recorded throughout the normal day in the...intensity and duration of activity being performed, (b) the pattern of paraspinal muscle contraction , and (c) onset of low back pain. (2) To determine whether... muscle contraction , and activity by performing continuous recordings of these factors among groups of low back pain subjects in their normal

Making Sense of Low Back Pain and Pain-Related Fear.

PubMed

Bunzli, Samantha; Smith, Anne; Schütze, Robert; Lin, Ivan; O'Sullivan, Peter

2017-09-01

Synopsis Pain-related fear is implicated in the transition from acute to chronic low back pain and the persistence of disabling low back pain, making it a key target for physical therapy intervention. The current understanding of pain-related fear is that it is a psychopathological problem, whereby people who catastrophize about the meaning of pain become trapped in a vicious cycle of avoidance behavior, pain, and disability, as recognized in the fear-avoidance model. However, there is evidence that pain-related fear can also be seen as a common-sense response to deal with low back pain, for example, when one is told that one's back is vulnerable, degenerating, or damaged. In this instance, avoidance is a common-sense response to protect a "damaged" back. While the fear-avoidance model proposes that when someone first develops low back pain, the confrontation of normal activity in the absence of catastrophizing leads to recovery, the pathway to recovery for individuals trapped in the fear-avoidance cycle is less clear. Understanding pain-related fear from a common-sense perspective enables physical therapists to offer individuals with low back pain and high fear a pathway to recovery by altering how they make sense of their pain. Drawing on a body of published work exploring the lived experience of pain-related fear in people with low back pain, this clinical commentary illustrates how Leventhal's common-sense model may assist physical therapists to understand the broader sense-making processes involved in the fear-avoidance cycle, and how they can be altered to facilitate fear reduction by applying strategies established in the behavioral medicine literature. J Orthop Sports Phys Ther 2017;47(9):628-636. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7434.

Whole body vibration exercise for chronic low back pain: study protocol for a single-blind randomized controlled trial.

PubMed

Wang, Xue-Qiang; Pi, Yan-Lin; Chen, Pei-Jie; Chen, Bin-Lin; Liang, Lei-Chao; Li, Xin; Wang, Xiao; Zhang, Juan

2014-04-02

Low back pain affects approximately 80% of people at some stage in their lives. Exercise therapy is the most widely used nonsurgical intervention for low back pain in practice guidelines. Whole body vibration exercise is becoming increasingly popular for relieving musculoskeletal pain and improving health-related quality of life. However, the efficacy of whole body vibration exercise for low back pain is not without dispute. This study aims to estimate the effect of whole body vibration exercise for chronic low back pain. We will conduct a prospective, single-blind, randomized controlled trial of 120 patients with chronic low back pain. Patients will be randomly assigned into an intervention group and a control group. The intervention group will participate in whole body vibration exercise twice a week for 3 months. The control group will receive general exercise twice a week for 3 months. Primary outcome measures will be the visual analog scale for pain, the Oswestry Disability Index and adverse events. The secondary outcome measures will include muscle strength and endurance of spine, trunk proprioception, transversus abdominis activation capacity, and quality of life. We will conduct intention-to-treat analysis if any participants withdraw from the trial. Important features of this study include the randomization procedures, single-blind, large sample size, and a standardized protocol for whole body vibration in chronic low back pain. This study aims to determine whether whole body vibration exercise produces more beneficial effects than general exercise for chronic low back pain. Therefore, our results will be useful for patients with chronic low back pain as well as for medical staff and health-care decision makers. Chinese Clinical Trial Registry: ChiCTR-TRC-13003708.

The influence of self-reported leisure time physical activity and the body mass index on recovery from persistent back pain among men and women: a population-based cohort study.

PubMed

Bohman, Tony; Alfredsson, Lars; Hallqvist, Johan; Vingård, Eva; Skillgate, Eva

2013-04-25

There is limited knowledge about leisure time physical activity and the body mass index (BMI) as prognostic factors for recovery from persistent back pain. The aim of this study was to assess the influence of leisure time physical activity and BMI on recovery from persistent back pain among men and women in a general population. The study population (n=1836) in this longitudinal cohort study consisted of participants reporting persistent back pain in the baseline questionnaire in 2002-2003. Data on leisure time physical activity, BMI and potential confounders were also collected at baseline. Information on recovery from persistent back pain (no back pain periods ≥ 7 days during the last 5 years) was obtained from the follow-up questionnaire in 2007. Log-binomial models were applied to calculate Risk Ratios with 95 percent Confidence Intervals (CI) comparing physically active and normal weight groups versus sedentary and overweight groups. Compared to a sedentary leisure time, all measured levels of leisure time physical activity were associated with a greater chance of recovery from persistent back pain among women. The adjusted Risk Ratios was 1.46 (95% CI: 1.06, 2.01) for low leisure time physical activity, 1.51 (95% CI: 1.02, 2.23) for moderate leisure time physical activity, and 1.67 (95% CI: 1.08, 2.58) for high leisure time physical activity. There were no indications that leisure time physical activity influenced recovery among men, or that BMI was associated with recovery from persistent back pain either among men or among women. Regular leisure time physical activity seems to improve recovery from persistent back pain among women.

Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis.

PubMed

Miyamoto, Gisela Cristiane; Lin, Chung-Wei Christine; Cabral, Cristina Maria Nunes; van Dongen, Johanna M; van Tulder, Maurits W

2018-04-20

To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain. Systematic review of economic evaluations. The search was performed in 5 clinical and 3 economic electronic databases. We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed. Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain. Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed. PROSPERO, CRD42017059025. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Identifying Neck and Back Pain in Administrative Data: Defining the right cohort

PubMed Central

Siroka, Andrew M.; Shane, Andrea C.; Trafton, Jodie A.; Wagner, Todd H.

2017-01-01

Structured Abstract Study design We reviewed existing methods for identifying patients with neck and back pain in administrative data. We compared these methods using data from the Department of Veterans Affairs. Objective To answer the following questions: 1) what diagnosis codes should be used to identify patients with neck and back pain in administrative data; 2) because the majority of complaints are characterized as non-specific or mechanical, what diagnosis codes should be used to identify patients with non-specific or mechanical problems in administrative data; and 3) what procedure and surgical codes should be used to identify patients who have undergone a surgical procedure on the neck or back. Summary of background data Musculoskeletal neck and back pain are pervasive problems, associated with chronic pain, disability, and high rates of healthcare utilization. Administrative data have been widely used in formative research which has largely relied on the original work of Volinn, Cherkin, Deyo and Einstadter and the Back Pain Patient Outcomes Assessment Team first published in 1992. Significant variation in reports of incidence, prevalence, and morbidity associated with these problems may be due to non standard or conflicting methods to define study cohorts. Methods A literature review produced seven methods for identifying neck and back pain in administrative data. These code lists were used to search VA data for patients with back and neck problems, and to further categorize each case by spinal segment involved, as non- specific/mechanical and as surgical or not. Results There is considerable overlap in most algorithms. However, gaps remain. Conclusions Gaps are evident in existing methods and a new framework to identify patients with neck and back pain in administrative data is proposed. PMID:22127268

Back pain and degenerative abnormalities in the spine of young elite divers: a 5-year follow-up magnetic resonance imaging study.

PubMed

Baranto, Adad; Hellström, Mikael; Nyman, Rickard; Lundin, Olof; Swärd, Leif

2006-09-01

Several studies have been published on disc degeneration among young athletes in sports with great demands on the back, but few on competitive divers; however, there are no long-term follow-up studies. Twenty elite divers between 10 and 21 years of age, with the highest possible national ranking, were selected at random without knowledge of previous or present back injuries or symptoms for an MRI study of the thoraco-lumbar spine in a 5-year longitudinal study. The occurrence of MRI abnormalities and their correlation with back pain were evaluated. Eighty-nine percent of the divers had a history of back pain and the median age at the first episode of back pain was 15 years. Sixty-five percent of the divers had MRI abnormalities in the thoraco-lumbar spine already at baseline. Only one diver without abnormalities at baseline had developed abnormalities at follow-up. Deterioration of any type of abnormality was found in 9 of 17 (53%) divers. Including all disc levels in all divers, the total number of abnormalities increased by 29% at follow-up, as compared to baseline. The most common abnormalities were reduced disc signal, Schmorl's nodes, and disc height reduction. Since almost all divers had previous or present back pain, a differentiated analysis of the relationship between pain and MRI findings was not possible. However, the high frequency of both back pain and MRI changes suggests a causal relationship. In conclusion, elite divers had high frequency of back pain at young ages and they run a high risk of developing degenerative abnormalities of the thoraco-lumbar spine, probably due to injuries to the spine during the growth spurt.

Workplace stress, lifestyle and social factors as correlates of back pain: a representative study of the German working population.

PubMed

Schneider, Sven; Schmitt, Holger; Zoller, Silke; Schiltenwolf, Marcus

2005-05-01

To investigate the prevalence of back pain in the German working population and the relationship between back pain and workplace stresses, lifestyle and social factors. The first National Health Survey of the Federal Republic of Germany was carried out between October 1997 and March 1999. It comprised a representative epidemiological cross-sectional study of the working population, with a total sample of 3,488 persons between the ages of 18 and 69 years. The participants took part in a medical examination and answered a self-rating questionnaire. The relationship between subjective back pain and workplace stresses and social and lifestyle factors was investigated with bivariate tests and multiple logistical regression analyses. The 7-day prevalence for back pain in the German working population was found to be 34%, and the 1-year prevalence was 60%. The odds ratios were significantly higher in women, persons of lower socioeconomic status, married and depressed persons and non-athletes. Carrying heavy loads or maintaining a single working posture were the most significant work-related correlates of back pain, for members of both the female and male working population, while environmental stress and psychological stress correlated significantly with back pain in men only. This study reports the first representative epidemiological prevalence data for back pain, and its correlates and potential risk factors, for the German working population. To reduce the negative impact of back pain the most promising behavioural and conditional prevention measures in the workplace would be to reduce carrying stress and to vary working posture. In addition, a more active, athletic lifestyle, plus the avoidance of being overweight, should provide an additional protective or preventive effect.

Review on risk factors related to lower back disorders at workplace

NASA Astrophysics Data System (ADS)

A' Tifah Jaffar, Nur; Nasrull Abdol Rahman, Mohd

2017-08-01

This review examines the evidence of the occurrence of risk exposure on work-related lower back disorders in the workplace. This review also investigates potential interactions between the risk factors in the workplace which include heavy physical work risk factor, static work postures risk factor, frequent bending and twisting risk factor, lifting risk factor, pushing and pulling risk factor, repetitive work risk factor, vibration risk factor, psychological and psychosocial risk factor that may be associated with symptoms of musculoskeletal disorders of lower back. These risk factors can reinforce each other and their influence can also be mediated by cultural or social factors. A systematic review of the literature was carried out by searching using databases and the searching strategy was used combined keyword for risk factors, work-related lower back disorders, heavy physical work, static work postures, frequent bending and twisting, lifting, pushing and pulling, repetitive work, vibration, psychological and psychosocial risk factor. A total of 67 articles were identified and reviewed. The risk factors identified that related for low back disorder are seven which are heavy physical work, static work postures, frequent bending and twisting, lifting, pushing and pulling, repetitive work, vibration, psychological and psychosocial risk factor and the level of evidence supporting the relationship with lower back disorders also described such as strong, moderate, insufficient, limited and no evidence. This result confirms that, existing of higher physical and psychosocial demand related to reported risk factors of low back disorders. The result also showed that previous reviews had evaluated relationship between risk factors of low back disorders and specific types of musculoskeletal disorders. This review also highlights the scarves evidence regarding some of the frequently reported risk factors for work related lower back disorders.

Functional magnetic resonance imaging of working memory in Huntington's disease: cross-sectional data from the IMAGE-HD study.

PubMed

Georgiou-Karistianis, Nellie; Stout, Julie C; Domínguez D, Juan F; Carron, Sarah P; Ando, Ayaka; Churchyard, Andrew; Chua, Phyllis; Bohanna, India; Dymowski, Alicia R; Poudel, Govinda; Egan, Gary F

2014-05-01

We used functional magnetic resonance imaging (fMRI) to investigate spatial working memory (WM) in an N-BACK task (0, 1, and 2-BACK) in premanifest Huntington's disease (pre-HD, n = 35), early symptomatic Huntington's disease (symp-HD, n = 23), and control (n = 32) individuals. Overall, both WM conditions (1-BACK and 2-BACK) activated a large network of regions throughout the brain, common to all groups. However, voxel-wise and time-course analyses revealed significant functional group differences, despite no significant behavioral performance differences. During 1-BACK, voxel-wise blood-oxygen-level-dependent (BOLD) signal activity was significantly reduced in a number of regions from the WM network (inferior frontal gyrus, anterior insula, caudate, putamen, and cerebellum) in pre-HD and symp-HD groups, compared with controls; however, time-course analysis of the BOLD response in the dorsolateral prefrontal cortex (DLPFC) showed increased activation in symp-HD, compared with pre-HD and controls. The pattern of reduced voxel-wise BOLD activity in pre-HD and symp-HD, relative to controls, became more pervasive during 2-BACK affecting the same structures as in 1-BACK, but also incorporated further WM regions (anterior cingulate gyrus, parietal lobe and thalamus). The DLPFC BOLD time-course for 2-BACK showed a reversed pattern to that observed in 1-BACK, with a significantly diminished signal in symp-HD, relative to pre-HD and controls. Our findings provide support for functional brain reorganisation in cortical and subcortical regions in both pre-HD and symp-HD, which are modulated by task difficulty. Moreover, the lack of a robust striatal BOLD signal in pre-HD may represent a very early signature of change observed up to 15 years prior to clinical diagnosis. Copyright © 2013 Wiley Periodicals, Inc.

[Low back pain during pregnancy].

PubMed

Carvalho, Maria Emília Coelho Costa; Lima, Luciana Cavalcanti; de Lira Terceiro, Cristovam Alves; Pinto, Deyvid Ravy Lacerda; Silva, Marcelo Neves; Cozer, Gustavo Araújo; Couceiro, Tania Cursino de Menezes

Low back pain is a common complaint among pregnant women. It is estimated that about 50% of pregnant women complain of some form of back pain at some point in pregnancy or during the postpartum period. The aim of this study was to evaluate the frequency of low back pain during pregnancy and its characteristics. Cross-sectional study with low-risk pregnant women. After approval by the Human Research Ethics Committee and receiving written informed consent, we included pregnant women over 18 years of age and excluded those with psychiatric disorders, previous lumbar pathologies, and receiving treatment for low back pain. We interviewed 97 pregnant women. The frequency of low back pain was 68%. The mean age was 26.2 years and the median gestational age was 30 weeks. Fifty-eight pregnant women declared themselves as brown (58%). Most (88.6%) were married or living in common-law marriage, fifty-six (57.7%) worked outside the home, and 71 (73.2%) had completed high school. Low back pain was more frequent during the second trimester of pregnancy (43.9%), referred to as a "burning" sensation in 37.8% of patients, with intermittent frequency in 96.9% of the women. The symptoms got worse at night (71.2%). Resting reduced low back pain in 43.9% of pregnant women, while the standing position for a long time worsened it in 27.2% of patients. Low back pain is common in pregnant women, has specific characteristics, and is more frequent in the second trimester of pregnancy. This indicates the need for prevention strategies that enable better quality of life for pregnant women. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Physical Therapists' Views and Experiences of Pregnancy-Related Low Back Pain and the Role of Acupuncture: Qualitative Exploration

PubMed Central

Bartlam, Bernadette; Bishop, Annette; Holden, Melanie A.; Barlas, Panos; Foster, Nadine E.

2015-01-01

Background Low back pain is often accepted as a “normal” part of pregnancy. Despite research suggesting that quality of life for women who are pregnant is adversely affected, most are advised to self-manage. Although the use of acupuncture for the management of persistent nonspecific low back pain has been recommended in recent UK national guidelines, its use in the management of pregnancy-related low back pain remains limited. Objectives This study aimed to explore the perceptions and experiences of physical therapists involved in treating women who are pregnant and have low back pain with the objective of informing the pretrial training program for a pilot randomized trial (Evaluating Acupuncture and Standard care for pregnant womEn with Back pain [EASE Back]). Design A qualitative phenomenological method with purposive sampling was used in the study. Methods Three focus groups and 3 individual semistructured interviews were undertaken, and an iterative exploratory thematic analysis was performed. To ensure transparency of the research process and the decisions made, an audit trail was created. Results Twenty-one physical therapists participated, and emergent issues included: a lack of experience in treating pregnancy-related complaints, mixed messages from previous acupuncture education, a mistrust of the current evidence for acupuncture safety and effectiveness, and personal and professional fear of causing harm. Conclusions The findings suggest that UK physical therapists are reluctant to use acupuncture in the management of pregnancy-related low back pain. The explanations for these findings include perceived lack of knowledge and confidence, as well as a pervasive professional culture of caution, particularly fears of inducing early labor and of litigation. These findings have been key to informing the content of the training program for physical therapists delivering acupuncture within the pilot EASE Back trial. PMID:25929530

Task-related and person-related variables influence the effect of low back pain on anticipatory postural adjustments.

PubMed

Jacobs, Jesse V; Lyman, Courtney A; Hitt, Juvena R; Henry, Sharon M

2017-08-01

People with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effect of low back pain on anticipatory postural adjustments. Thirteen subjects with and 13 without low back pain performed seated, rapid arm flexion in self-initiated and cued conditions. Mixed-model ANOVA were used to evaluate group and condition effects on APA onset latencies of trunk muscles, arm-raise velocity, and pre-movement cortical potentials. These measures were evaluated for correlation with pain ratings, Fear Avoidance Beliefs Questionnaire scores, and Modified Oswestry Questionnaire scores. Delayed postural adjustments of subjects with low back pain were greater in the cued condition than in the self-initiated condition. The group with low back pain exhibited larger-amplitude cortical potentials than the group without pain, but also significantly slower arm-raise velocities. With arm-raise velocity as a covariate, the effect of low back pain remained significant for the latencies of postural adjustments but not for cortical potentials. Latencies of the postural adjustments significantly correlated with Oswestry and Fear Avoidance Beliefs scores. Delayed postural adjustments with low back pain appear to be influenced by cueing of movement, pain-related disability and fear of activity. These results highlight the importance of subject characteristics, task condition, and task performance when comparing across studies or when developing treatment of people with low back pain. Copyright © 2017 Elsevier B.V. All rights reserved.

Declining rates of work-related overexertion back injuries among union drywall installers in Washington State, 1989-2008: Improved work safety or shifting of care?

PubMed

Schoenfisch, Ashley L; Lipscomb, Hester J; Marshall, Stephen W; Casteel, Carri; Richardson, David B; Brookhart, M Alan; Cameron, Wilfrid

2014-02-01

Construction workers are at high risk of work-related musculoskeletal back disorders, and research suggests medical care and costs associated with these conditions may be covered by sources other than workers' compensation (WC). Little is known about the back injury experience and care seeking behavior among drywall installers, a high-risk workgroup regularly exposed to repetitive activities, awkward postures, and handling heavy building materials. Among a cohort of 24,830 Washington State union carpenters (1989-2008), including 5,073 drywall installers, we identified WC claims, visits for health care covered through union-provided health insurance and time at risk. Rates of work-related overexertion back injuries (defined using WC claims data) and health care utilization for musculoskeletal back disorders covered by private health insurance were examined and contrasted over time and by worker characteristics, stratified by type of work (drywall installation, other carpentry). Drywall installers' work-related overexertion back injury rates exceeded those of other carpenters (adjusted IRR 1.63, 95% CI 1.48-1.78). For both carpentry groups, rates declined significantly over time. In contrast, rates of private healthcare utilization for musculoskeletal back disorders were similar for drywall installers compared to other carpenters; they increased over time (after the mid-1990s), with increasing years in the union, and with increasing numbers of work-related overexertion back injuries. Observed declines over time in the rate of work-related overexertion back injury, as based on WC claims data, is encouraging. However, results add to the growing literature suggesting care for work-related conditions may be being sought outside of the WC system. © 2013 Wiley Periodicals, Inc.

Is lumbar lordosis related to low back pain development during prolonged standing?

PubMed

Sorensen, Christopher J; Norton, Barbara J; Callaghan, Jack P; Hwang, Ching-Ting; Van Dillen, Linda R

2015-08-01

An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain during prolonged standing. The purposes of this study were to (1) compare baseline lumbar lordosis in back-healthy participants who do (Pain Developers) and do not (Non-Pain Developers) develop low back pain during 2 h of standing, and (2) examine the relationship between lumbar lordosis and low back pain intensity. Cross-sectional. First, participants stood while positions of markers placed superficial to the lumbar vertebrae were recorded using a motion capture system. Following collection of marker positions, participants stood for 2 h while performing light work tasks. At baseline and every 15 min during standing, participants rated their low back pain intensity on a visual analog scale. Lumbar lordosis was calculated using marker positions collected prior to the 2 h standing period. Lumbar lordosis was compared between pain developers and non-pain developers. In pain developers, the relationship between lumbar lordosis and maximum pain was examined. There were 24 (42%) pain developers and 33 (58%) non-pain developers. Lumbar lordosis was significantly larger in pain developers compared to non-pain developers (Mean difference = 4.4°; 95% Confidence Interval = 0.9° to 7.8°, Cohen's d = 0.7). The correlation coefficient between lumbar lordosis and maximum pain was 0.46 (P = 0.02). The results suggest that standing in more lumbar lordosis may be a risk factor for low back pain development during prolonged periods of standing. Identifying risk factors for low back pain development can inform preventative and early intervention strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Promise and Pitfalls of Using Crowdsourcing in Research Prioritization for Back Pain: Cross-Sectional Surveys

PubMed Central

Truitt, Anjali R; Widmer-Rodriguez, Sierra; Tuia, Jordan; Bauer, Zoya A; Comstock, Bryan A; Edwards, Todd C; Lawrence, Sarah O; Monsell, Sarah E; Patrick, Donald L; Jarvik, Jeffrey G; Lavallee, Danielle C

2017-01-01

Background The involvement of patients in research better aligns evidence generation to the gaps that patients themselves face when making decisions about health care. However, obtaining patients’ perspectives is challenging. Amazon’s Mechanical Turk (MTurk) has gained popularity over the past decade as a crowdsourcing platform to reach large numbers of individuals to perform tasks for a small reward for the respondent, at small cost to the investigator. The appropriateness of such crowdsourcing methods in medical research has yet to be clarified. Objective The goals of this study were to (1) understand how those on MTurk who screen positive for back pain prioritize research topics compared with those who screen negative for back pain, and (2) determine the qualitative differences in open-ended comments between groups. Methods We conducted cross-sectional surveys on MTurk to assess participants’ back pain and allow them to prioritize research topics. We paid respondents US $0.10 to complete the 24-point Roland Morris Disability Questionnaire (RMDQ) to categorize participants as those “with back pain” and those “without back pain,” then offered both those with (RMDQ score ≥7) and those without back pain (RMDQ <7) an opportunity to rank their top 5 (of 18) research topics for an additional US $0.75. We compared demographic information and research priorities between the 2 groups and performed qualitative analyses on free-text commentary that participants provided. Results We conducted 2 screening waves. We first screened 2189 individuals for back pain over 33 days and invited 480 (21.93%) who screened positive to complete the prioritization, of whom 350 (72.9% of eligible) did. We later screened 664 individuals over 7 days and invited 474 (71.4%) without back pain to complete the prioritization, of whom 397 (83.7% of eligible) did. Those with back pain who prioritized were comparable with those without in terms of age, education, marital status, and employment. The group with back pain had a higher proportion of women (234, 67.2% vs 229, 57.8%, P=.02). The groups’ rank lists of research priorities were highly correlated: Spearman correlation coefficient was .88 when considering topics ranked in the top 5. The 2 groups agreed on 4 of the top 5 and 9 of the top 10 research priorities. Conclusions Crowdsourcing platforms such as MTurk support efforts to efficiently reach large groups of individuals to obtain input on research activities. In the context of back pain, a prevalent and easily understood condition, the rank list of those with back pain was highly correlated with that of those without back pain. However, subtle differences in the content and quality of free-text comments suggest supplemental efforts may be needed to augment the reach of crowdsourcing in obtaining perspectives from patients, especially from specific populations. PMID:28986339

Low back injuries related to nursing professionals working conditions: a systematic review.

PubMed

Schlossmacher, Roberta; Amaral, Fernando Gonçalves

2012-01-01

Identify the prevalence of low back disorders and associated risks, as well as the characteristics and ergonomic factors present in the work of nursing professionals. Systematic review based on the search of terms such as low back pain, professionals, hospital ergonomics, work organization, nursing found in national and international databases. The prevalence of low back pain symptoms was between 14.7% and 72% and the main cause, that is, the transference of the patient from bed to chair, leaded to the profession abandonment as a main consequence. it was possible to conclude that the prevalence of low back injury is high among nursing professionals and its causes are related to occupational factors - physical or psychological, which are in many cases permanent and disabling.

Evaluation of wheelchair back support crashworthiness: combination wheelchair back support surfaces and attachment hardware.

PubMed

Ha, D; Bertocci, G; Deemer, E; van Roosmalen, L; Karg, P

2000-01-01

Automotive seats are tested for compliance with federal motor vehicle safety standards (FMVSS) to assure safety during impact. Many wheelchair users rely upon their wheelchairs to serve as vehicle seats. However, the crashworthiness of these wheelchairs during impact is often unknown. This study evaluated the crashworthiness of five combinations of wheelchair back support surfaces and attachment hardware using a static test procedure simulating crash loading conditions. The crashworthiness was tested by applying a simulated rearward load to each seat-back system. The magnitude of the applied load was established through computer simulation and biodynamic calculations. None of the five tested wheelchair back supports withstood the simulated crash loads. All failures were associated with attachment hardware.

The development of non-spatial working memory capacity during childhood and adolescence and the role of interference control: an N-Back task study.

PubMed

Schleepen, Tamara M J; Jonkman, Lisa M

2010-01-01

To investigate the role of interference control on the development of working memory (WM) capacity, 6-12-year-old children and adults performed an N-Back task with differing WM-load and interference control demands. Correlation analyses between flanker interference scores and WM-load levels showed that interference control was only required in the 2-back condition. While WM maintenance (1-back task) reached adult accuracy levels at age 10-12, the ability to maintain information in WM during distraction (2-back-task) displayed protracted maturation into adolescence. This is suggested to reflect yet immature connections between prefrontal and posterior association areas, respectively involved in interference control and WM storage.

WS-BP: An efficient wolf search based back-propagation algorithm

NASA Astrophysics Data System (ADS)

Nawi, Nazri Mohd; Rehman, M. Z.; Khan, Abdullah

2015-05-01

Wolf Search (WS) is a heuristic based optimization algorithm. Inspired by the preying and survival capabilities of the wolves, this algorithm is highly capable to search large spaces in the candidate solutions. This paper investigates the use of WS algorithm in combination with back-propagation neural network (BPNN) algorithm to overcome the local minima problem and to improve convergence in gradient descent. The performance of the proposed Wolf Search based Back-Propagation (WS-BP) algorithm is compared with Artificial Bee Colony Back-Propagation (ABC-BP), Bat Based Back-Propagation (Bat-BP), and conventional BPNN algorithms. Specifically, OR and XOR datasets are used for training the network. The simulation results show that the WS-BP algorithm effectively avoids the local minima and converge to global minima.

Back Pain During Pregnancy

MedlinePlus

... your risk of hurting your back when you exercise. How can pregnancy hormones contribute to back pain? To prepare for the passage of the baby through the birth canal, a hormone relaxes the ligaments in the joints of your pelvis. This loosening allows the joints to become more ...

Back Pain at Work: Preventing Pain and Injury

MedlinePlus

Healthy Lifestyle Adult health Heavy lifting, repetitive movements and sitting at a desk all day can take a toll on your back. Get the facts ... your back — such as by lifting or moving heavy objects — can cause injury. Repetition. Repeating certain movements, ...

Local, national, and service component cost variations in the management of low back pain: Considerations for the clinician.

PubMed

Babu, Ashwin N; McCormick, Zachary; Kennedy, David J; Press, Joel

2016-11-21

In the past two decades, the cost associated with managing low back pain has increased significantly. Improved consciousness of how clinicians utilize resources when managing low back pain is necessary in the current economic climate. The goal of this review is to examine the component costs associated with managing low back pain and provide practical solutions for reducing healthcare costs. This is accomplished by utilizing examples from a major metropolitan area with several major academic institutions and private health care centers. It is clear that there is considerable local and national variation in the component costs of managing low back pain, including physician visits, imaging studies, medications, and therapy services. By being well informed about these variations in one's environment, clinicians and patients alike can make strides towards reducing the financial impact of low back pain. Investigation of the cost discrepancies for services within one's community of practice is important. Improved public access to both cost and outcomes data is needed.

Polar Aprotic Modifiers for Chromatographic Separation and Back-Exchange Reduction for Protein Hydrogen/Deuterium Exchange Monitored by Fourier Transform Ion Cyclotron Resonance Mass Spectrometry

NASA Astrophysics Data System (ADS)

Valeja, Santosh G.; Emmett, Mark R.; Marshall, Alan G.

2012-04-01

Hydrogen/deuterium exchange monitored by mass spectrometry is an important non-perturbing tool to study protein structure and protein-protein interactions. However, water in the reversed-phase liquid chromatography mobile phase leads to back-exchange of D for H during chromatographic separation of proteolytic peptides following H/D exchange, resulting in incorrect identification of fast-exchanging hydrogens as unexchanged hydrogens. Previously, fast high-performance liquid chromatography (HPLC) and supercritical fluid chromatography have been shown to decrease back-exchange. Here, we show that replacement of up to 40% of the water in the LC mobile phase by the modifiers, dimethylformamide (DMF) and N-methylpyrrolidone (NMP) (i.e., polar organic modifiers that lack rapid exchanging hydrogens), significantly reduces back-exchange. On-line LC micro-ESI FT-ICR MS resolves overlapped proteolytic peptide isotopic distributions, allowing for quantitative determination of the extent of back-exchange. The DMF modified solvent composition also improves chromatographic separation while reducing back-exchange relative to conventional solvent.

Initial Back-to-Back Fission Chamber Testing in ATRC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benjamin Chase; Troy Unruh; Joy Rempe

2014-06-01

Development and testing of in-pile, real-time neutron sensors for use in Materials Test Reactor experiments is an ongoing project at Idaho National Laboratory. The Advanced Test Reactor National Scientific User Facility has sponsored a series of projects to evaluate neutron detector options in the Advanced Test Reactor Critical Facility (ATRC). Special hardware was designed and fabricated to enable testing of the detectors in the ATRC. Initial testing of Self-Powered Neutron Detectors and miniature fission chambers produced promising results. Follow-on testing required more experiment hardware to be developed. The follow-on testing used a Back-to-Back fission chamber with the intent to providemore » calibration data, and a means of measuring spectral indices. As indicated within this document, this is the first time in decades that BTB fission chambers have been used in INL facilities. Results from these fission chamber measurements provide a baseline reference for future measurements with Back-to-Back fission chambers.« less

Holding Back, Intimacy, and Psychological and Relationship Outcomes Among Couples Coping With Prostate Cancer

PubMed Central

Manne, Sharon L.; Zaider, Talia; Lee, David; Kissane, David; Kashy, Deborah; Heckman, Carolyn; Virtue, Shannon Myers

2016-01-01

The present study evaluated intimacy as a mechanism for the effects of holding back sharing concerns about cancer on couples’ psychological distress, well-being, and marital satisfaction using the actor-partner interdependence model (APIM), and evaluated 2 possible moderators of these associations: the number of patient and spouse cancer concerns. We had 139 men treated for localized prostate cancer in the past year and their spouses complete surveys about holding back sharing cancer concerns, intimacy, distress, and relationship satisfaction, as well as patient and spouse cancer concerns. APIM-indicated that the association between holding back sharing concerns, and patient and spouse distress, well-being, and relationship satisfaction could be partially accounted for by their influence on patient and spouse perceptions of relationship intimacy. The number of cancer concerns did not moderate the mediational model. Holding back has strong associations with both partners’ well-being and distress. Holding back sharing concerns was particularly detrimental for couples’ intimacy and relationship satisfaction. PMID:26192132

Geographic Variation in Diagnostic Ability and Quality of Care Metrics: A Case Study of Ankylosing Spondylitis and Low Back Pain

PubMed Central

Shafrin, Jason; Griffith, Jenny; Shim, Jin Joo; Huber, Caroline; Ganguli, Arijit; Aubry, Wade

2017-01-01

Studies examining geographic variation in care for low back pain often focus on process and outcome measures conditional on patient diagnosis but generally do not take into account a physician’s ability to diagnose the root cause of low back pain. In our case study, we used increased detection of ankylosing spondylitis—a relatively rare inflammatory back disease—as a proxy for diagnostic ability and measured the relationship between ankylosing spondylitis detection, potentially inappropriate low back pain care, and cost. Using 5 years of health insurance claims data, we found significant variation in ankylosing spondylitis detection across metropolitan statistical areas (MSAs), with 8.1% of the variation in detection explained by a region’s racial composition. Furthermore, low back pain patients in MSAs with higher ankylosing spondylitis detection had 7.9% lower use of corticosteroids, 9.0% lower use of opioids, and 8.2% lower pharmacy cost, compared with patients living in low-detection MSAs. PMID:28548005

Influence of structural integration and fascial fitness on body image and the perception of back pain.

PubMed

Baur, Heidi; Gatterer, Hannes; Hotter, Barbara; Kopp, Martin

2017-06-01

[Purpose] The aim of this study was to examine the influence of Structural Integration and Fascial Fitness, a new form of physical exercise, on body image and the perception of back pain. [Subjects and Methods] In total, 33 participants with non-specific back pain were split into two groups and performed three sessions of Structural Integration or Fascial Fitness within a 3-week period. Before and after the interventions, perception of back pain and body image were evaluated using standardized questionnaires. [Results] Structural Integration significantly decreased non-specified back pain and improved both "negative body image" and "vital body dynamics". Fascial Fitness led to a significant improvement on the "negative body image" subscale. Benefits of Structural Integration did not significantly vary in magnitude from those for fascial fitness. [Conclusion] Both Structural Integration and Fascial Fitness can lead to a more positive body image after only three sessions. Moreover, the therapeutic technique of Structural Integration can reduce back pain.

Back pain and leg complaints that revealed non-small cell carcinoma: a case study.

PubMed

Crisp, Casey A; Pierce, Angela N

2011-09-01

The purpose of this case study is to describe the clinical presentation of a patient with a chief complaint of low back and leg pain with no prior diagnosis of lung cancer. A 48-year-old man with a history of back pain presented to a chiropractic office with a complaint of low back and left leg pain. Abnormal examination and radiographic findings were discovered. The patient was immediately referred to the pulmonologist for co-management. Through the use of advanced imaging and biopsy, stage 4 lung cancer was diagnosed. Low back pain recurrence in an established patient should constitute a reevaluation of the problem. The cause cannot be assumed to be musculoskeletal in origin even though this may have been the case with the initial complaint. Metastatic disease should be considered with any type of recurrent low back pain. Copyright © 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Low back cutaneous vibration and its effect on trunk postural control.

PubMed

Cornwall, Adam R; Gregory, Diane E

2017-08-01

The current study investigated the effects of a low back pain (LBP) vibration modality on trunk motor control. Trunk repositioning error and responses to a sudden loading trunk perturbation were evaluated pre- and post-vibration (15min vibration exposure while sitting on a standard chair) as well as when concurrent cutaneous low back vibration was applied. Only minor effects were observed post-vibration when compared to pre-vibration. However, when vibration was applied at the same time as the sudden trunk perturbations, lumbar erector spinae and external oblique muscles were significantly more delayed in activating following the perturbation. In addition, the resting muscle activation prior to the trunk perturbation was higher in both the back extensor and abdominal muscles when concurrent vibration was applied. These findings suggest that cutaneous low back vibration significantly alters motor control responses and this should be considered before implementing cutaneous vibration as a low back pain management strategy. Copyright © 2017. Published by Elsevier B.V.

Magnitude and distribution of trunk stresses in telecommunications engineers.

PubMed Central

Nicholson, A S; David, P R; Sheppard, N J

1981-01-01

The incidence of back injuries has been shown to be greater in occupations as heavy manual work than light manual work. To plan a programme aimed at reducing the incidence of back injuries in industry those workers at high risk of incurring handling accidents and back injuries need to be identified and a knowledge of the specific occupational factors causing such injuries sought. This has been achieved for telecommunications engineers using epidemiological and radio pressure pill methodologies. The results verify the correlation between the back injury rates and physical work stresses of different occupational groups. The magnitude and relative frequency of trunk stresses in hazardous tasks has been determined and compared with those with lower incidences of back disorders. The study has confirmed that in examining manual handling hazards in industrial male populations a critical value of truncal stress can be applied and used to determine the safety of occupational factors in relation to their potential causing or contributing to degenerative back diseases. PMID:7317300

Reducing mechanical cross-coupling in phased array transducers using stop band material as backing

NASA Astrophysics Data System (ADS)

Henneberg, J.; Gerlach, A.; Storck, H.; Cebulla, H.; Marburg, S.

2018-06-01

Phased array transducers are widely used for acoustic imaging and surround sensing applications. A major design challenge is the achievement of low mechanical cross-coupling between the single transducer elements. Cross-coupling induces a loss of imaging resolution. In this work, the mechanical cross-coupling between acoustic transducers is investigated for a generic model. The model contains a common backing with two bending elements bonded on top. The dimensions of the backing are small; thus, wave reflections on the backing edges have to be considered. This is different to other researches. The operating frequency in the generic model is set to a low kHz range. Low operating frequencies are typical for surround sensing applications. The influence of the backing on cross-coupling is investigated numerically. In order to reduce mechanical cross-coupling a stop band material is designed. It is shown numerically that a reduction in mechanical cross-coupling can be achieved by using stop band material as backing. The effect is validated with experimental testing.

Low back pain in physical therapists: a cultural approach to analysis and intervention.

PubMed

Hanson, Heather; Wagner, Mairead; Monopoli, Vanessa; Keysor, Julie

2007-01-01

Low back pain is one of the most prevalent work related injuries in the physical therapy profession. New graduates and therapists working in rehabilitation and acute care hospitals are at the highest risk for developing low back pain [9]. Although physical therapists are trained in maintaining proper body mechanics and preventing work related injuries, between 30% and 63% of therapists will experience low back pain at some point in their careers [2,4,9]. The culture of physical therapy is one of the primary factors contributing to this problem, with many therapists reporting that their decision to use back pain preventive strategies depends on their colleagues' use of these strategies. The authors will use Green and Kreuter's PRECEDE-PROCEED model to identify behavioral, environmental, educational and ecological factors contributing to the problem; then will propose a health promotion intervention using the social action theory at the community level to decrease work-related low back pain in physical therapists while simultaneously addressing the culture of physical therapy.

Clustering of arc volcanoes caused by temperature perturbations in the back-arc mantle

PubMed Central

Lee, Changyeol; Wada, Ikuko

2017-01-01

Clustering of arc volcanoes in subduction zones indicates along-arc variation in the physical condition of the underlying mantle where majority of arc magmas are generated. The sub-arc mantle is brought in from the back-arc largely by slab-driven mantle wedge flow. Dynamic processes in the back-arc, such as small-scale mantle convection, are likely to cause lateral variations in the back-arc mantle temperature. Here we use a simple three-dimensional numerical model to quantify the effects of back-arc temperature perturbations on the mantle wedge flow pattern and sub-arc mantle temperature. Our model calculations show that relatively small temperature perturbations in the back-arc result in vigorous inflow of hotter mantle and subdued inflow of colder mantle beneath the arc due to the temperature dependence of the mantle viscosity. This causes a three-dimensional mantle flow pattern that amplifies the along-arc variations in the sub-arc mantle temperature, providing a simple mechanism for volcano clustering. PMID:28660880

Clustering of arc volcanoes caused by temperature perturbations in the back-arc mantle.

PubMed

Lee, Changyeol; Wada, Ikuko

2017-06-29

Clustering of arc volcanoes in subduction zones indicates along-arc variation in the physical condition of the underlying mantle where majority of arc magmas are generated. The sub-arc mantle is brought in from the back-arc largely by slab-driven mantle wedge flow. Dynamic processes in the back-arc, such as small-scale mantle convection, are likely to cause lateral variations in the back-arc mantle temperature. Here we use a simple three-dimensional numerical model to quantify the effects of back-arc temperature perturbations on the mantle wedge flow pattern and sub-arc mantle temperature. Our model calculations show that relatively small temperature perturbations in the back-arc result in vigorous inflow of hotter mantle and subdued inflow of colder mantle beneath the arc due to the temperature dependence of the mantle viscosity. This causes a three-dimensional mantle flow pattern that amplifies the along-arc variations in the sub-arc mantle temperature, providing a simple mechanism for volcano clustering.

Evaluation of lifestyle risk factors and job status associated with back injuries among employees at a mid-western university.

PubMed

Bidassie, Balmatee; McGlothlin, James D; Mena, Irene; Duffy, Vincent G; Barany, James W

2010-01-01

For decades the literature has shown an association between work-related risk factors and back injuries among employees. However, only recently, there is a growing body of literature that suggests lifestyle risk factors may also be associated with back injuries. The purpose of this research was to determine if selected lifestyle risk factors are associated with a greater risk of back injuries. Further, there may be an association between job status and incident reporting, lost workdays cases and workers' compensation (WC) paid for back injuries among university employees. Aggregate data from a Health Risk Assessment (HRA) questionnaire were used to analyze 6053 university employees for lifestyle risk factors associated with back injuries. Of the total sample, 57% (n=3471) were female; 46% (n=2778) worked as clerical or service staff; and the mean age was 45years. Pearson chi-square (chi(2)) analyses indicate that job status (chi(2)=307.07, df=4, p<.001) and gender (chi(2)=40.14, df=2, p<.001) were associated with high risk back score. An ordinal regression analysis predicted that participants who exercised vigorously for at least 20min, 3 or more days per week, or 3 or more days per week of combined vigorous exercise and moderate-intensity physical activity are almost 30 times less likely to have a high back risk score compared to participants who do not exercise vigorously or participate in less than 3days per week of moderate-intensity physical activity (OR=29.68, 95% CI=25-35.25, p<.001). Participants who have a low risk score for BMI are three times less likely (OR=3.20, 95% CI=2.74-3.75, p<.001) to have a high back risk score when compared to participants who have a high risk score for BMI. A regression tree predicted high back risk scores were participants who: (1) receive an adequate amount of physical activity or vigorous exercise and is a male service or clerical staff; (2) do not receive an adequate amount of physical activity or vigorous exercise, and is not overweight; or (3) who do not receive an adequate amount of physical activity or vigorous exercise, and is overweight. Six years of Occupational Safety and Health Administration (OSHA) 300 logs and WC claims data paid for back injuries supported the finding that clerical or service staff had the greatest risk of back injuries. Based on the results of this study, there appears to be an association between lifestyle risk factors, job status and back injuries among university employees. We believe our evaluation approach may be used to study other work populations to verify the outcomes observed in this study.

Back pain's association with vertebral end-plate signal changes in sciatica.

PubMed

el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; van der Kallen, Bas F; Lycklama à Nijeholt, Geert J; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

2014-02-01

Patients with sciatica frequently experience disabling back pain. One of the proposed causes for back pain is vertebral end-plate signal changes (VESC) as visualized by magnetic resonance imaging (MRI). To report on VESC findings, changes of VESC findings over time, and the correlation between VESC and disabling back pain in patients with sciatica. A randomized clinical trial with 1 year of follow-up. Patients with 6 to 12 weeks of sciatica who participated in a multicenter, randomized clinical trial comparing an early surgery strategy with prolonged conservative care with surgery if needed. Patients were assessed by means of the 100-mm visual analog scale (VAS) for back pain (with 0 representing no pain and 100 the worst pain ever experienced) at baseline and 1 year. Disabling back pain was defined as a VAS score of at least 40 mm. Patients underwent MRI both at baseline and after 1 year follow-up. Presence and change of VESC was correlated with disabling back pain using chi-square tests and logistic regression analysis. At baseline, 39% of patients had disabling back pain. Of the patients with VESC at baseline, 40% had disabling back pain compared with 38% of the patients with no VESC (p=.67). The prevalence of type 1 VESC increased from 1% at baseline to 35% 1 year later in the surgical group compared with an increase from 3% to 11% in the conservative group. The prevalence of type 2 VESC decreased from 40% to 29% in the surgical group while remaining almost stable in the conservative group at 41%. The prevalence of disabling back pain at 1 year was 12% in patients with no VESC at 1 year, 16% in patients with type 1 VESC, 11% in patients with type 2 VESC, and 3% in patients with both types 1 and 2 VESC (p=.36). Undergoing surgery was associated with increase in the extent of VESC (odds ratio [OR], 8.6; 95% confidence interval [CI], 4.7-15.7; p<.001). Patients who showed an increase in the extent of VESC after 1 year did not significantly report more disabling back pain compared with patients who did not show any increase (OR, 1.2; 95% CI, 0.6-2.6; p=.61). In this study, undergoing surgery for sciatica was highly associated with the development of VESC after 1 year. However, in contrast with the intuitive feeling of spine specialists, those with and those without VESC reported disabling back pain in nearly the same proportion. Therefore, VESC does not seem to be responsible for disabling back pain in patients with sciatica. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of lumbo-pelvic kinematics during trunk forward bending and backward return between patients with acute low back pain and asymptomatic controls.

PubMed

Shojaei, Iman; Salt, Elizabeth G; Hooker, Quenten; Van Dillen, Linda R; Bazrgari, Babak

2017-01-01

Prior studies have reported differences in lumbo-pelvic kinematics during a trunk forward bending and backward return task between individuals with and without chronic low back pain; yet, the literature on lumbo-pelvic kinematics of patients with acute low back pain is scant. Therefore, the purpose of this study was set to investigate lumbo-pelvic kinematics in this cohort. A case-control study was conducted to investigate the differences in pelvic and thoracic rotation along with lumbar flexion as well as their first and second time derivatives between females with and without acute low back pain. Participants in each group completed one experimental session wherein they performed trunk forward bending and backward return at self-selected and fast paces. Compared to controls, individuals with acute low back pain had larger pelvic range of rotations and smaller lumbar range of flexions. Patients with acute low back pain also adopted a slower pace compared to asymptomatic controls which was reflected in smaller maximum values for angular velocity, deceleration and acceleration of lumbar flexion. Irrespective of participant group, smaller pelvic range of rotation and larger lumbar range of flexion were observed in younger vs. older participants. Reduced lumbar range of flexion and slower task pace, observed in patients with acute low back pain, may be the result of a neuromuscular adaptation to reduce the forces and deformation in the lower back tissues and avoid pain aggravation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reliability and validity of lumbar and abdominal trunk muscle endurance tests in office workers with nonspecific subacute low back pain.

PubMed

del Pozo-Cruz, Borja; Mocholi, Miguel H; del Pozo-Cruz, Jesus; Parraca, Jose A; Adsuar, Jose C; Gusi, Narcis

2014-01-01

Despite the widespread use of trunk endurance tests, the reliability and validity of these tests in office workers with subacute nonspecific low back pain are unknown. This cross-sectional study involved 190 subjects: 30 men and 42 women without low back pain and 47 men and 71 women with low back pain. All subjects underwent timed prone and supine isometric lumbar and abdominal trunk endurance tests that were performed until subjective fatigue occurred. All subjects also completed the Roland Morris and Oswestry self-reported disability questionnaires. A test-retest study (7 days) was conducted with 31 participants with low back pain from the study. For the abdominal trunk endurance test, males and females with low back pain had mean (SD) values of 62.06 (36.87) and 46.06 (29.28) seconds, respectively, both significantly lower than the asymptomatic workers. For the lumbar test, males and females with low back pain had mean (SD) values of 79.57 (30.66) and 75.49 (28.97) seconds, respectively, again, both significantly lower than the asymptomatic workers. The intraclass correlation coefficients of both tests exceeded 0.90 and the Kappa indices were excellent for both men and women. Receiver-operating curve analyses revealed areas under the curve very close to or exceeding 0.70 for both men and women for both tests. The lumbar and abdominal trunk muscle endurance tests appeared to be reliable and valid measures in office workers with subacute low back pain.

Biological risk indicators for recurrent non-specific low back pain in adolescents.

PubMed

Jones, M A; Stratton, G; Reilly, T; Unnithan, V B

2005-03-01

A matched case-control study was carried out to evaluate biological risk indicators for recurrent non-specific low back pain in adolescents. Adolescents with recurrent non-specific low back pain (symptomatic; n = 28; mean (SD) age 14.9 (0.7) years) and matched controls (asymptomatic; n = 28; age 14.9 (0.7) years) with no history of non-specific low back pain participated. Measures of stature, mass, sitting height, sexual maturity (Tanner self assessment), lateral flexion of the spine, lumbar sagittal plane mobility (modified Schober), hip range of motion (Leighton flexometer), back and hamstring flexibility (sit and reach), and trunk muscle endurance (number of sit ups) were performed using standardised procedures with established reliability. Backward stepwise logistic regression analysis was performed, with the presence/absence of recurrent low back pain as the dependent variable and the biological measures as the independent variables. Hip range of motion, trunk muscle endurance, lumbar sagittal plane mobility, and lateral flexion of the spine were identified as significant risk indicators of recurrent low back pain (p<0.05). Follow up analysis indicated that symptomatic subjects had significantly reduced lateral flexion of the spine, lumbar sagittal plane mobility, and trunk muscle endurance (p<0.05). Hip range of motion, abdominal muscle endurance, lumbar flexibility, and lateral flexion of the spine were risk indicators for recurrent non-specific low back pain in a group of adolescents. These risk indicators identify the potential for exercise as a primary or secondary prevention method.

Developing physical exposure-based back injury risk models applicable to manual handling jobs in distribution centers.

PubMed

Lavender, Steven A; Marras, William S; Ferguson, Sue A; Splittstoesser, Riley E; Yang, Gang

2012-01-01

Using our ultrasound-based "Moment Monitor," exposures to biomechanical low back disorder risk factors were quantified in 195 volunteers who worked in 50 different distribution center jobs. Low back injury rates, determined from a retrospective examination of each company's Occupational Safety and Health Administration (OSHA) 300 records over the 3-year period immediately prior to data collection, were used to classify each job's back injury risk level. The analyses focused on the factors differentiating the high-risk jobs (those having had 12 or more back injuries/200,000 hr of exposure) from the low-risk jobs (those defined as having no back injuries in the preceding 3 years). Univariate analyses indicated that measures of load moment exposure and force application could distinguish between high (n = 15) and low (n = 15) back injury risk distribution center jobs. A three-factor multiple logistic regression model capable of predicting high-risk jobs with very good sensitivity (87%) and specificity (73%) indicated that risk could be assessed using the mean across the sampled lifts of the peak forward and or lateral bending dynamic load moments that occurred during each lift, the mean of the peak push/pull forces across the sampled lifts, and the mean duration of the non-load exposure periods. A surrogate model, one that does not require the Moment Monitor equipment to assess a job's back injury risk, was identified although with some compromise in model sensitivity relative to the original model.

[Evaluation of the German new back school: pain-related and psychological characteristics].

PubMed

Borys, C; Nodop, S; Tutzschke, R; Anders, C; Scholle, H C; Strauß, B

2013-12-01

Results related to the outcome of the classical back schools are inconsistent. Accordingly, a reformulation of the program integrating psychological and social aspects was performed as a necessary step for the development of the new back school in Germany. The aim of this study was to assess the effectiveness and sustainability of the new back school in subjects with non-specific back pain in the prevention setting. In a modified waiting design, individuals were investigated with respect to demographical, pain-related and psychological characteristics 3 months before the start, at the start and at the end of the back school and as well as 12 months after completion. In addition, predictors for a successful participation were analyzed. A total of 88 subjects with back pain initially participated in the study. In the short and long-term course, low to moderate effects were detected; however, during follow-up a reduction of pain showed high effects. Depression as assessed by the hospital anxiety and depression scale (HADS) and passive coping strategies assessed using the coping strategies questionnaire (CSQ) were identified as predictors for response to the intervention. On the basis of the sample studied, the new back school proved to be an effective treatment for short and long-term reduction of pain-related stress and associated psychological aspects. Maladaptive, passive coping strategies and higher depression scores were associated with a higher probability of success in terms of pain reduction and functional improvement.

Adherence to radiography guidelines for low back pain: a survey of chiropractic schools worldwide.

PubMed

Ammendolia, Carlo; Taylor, John A M; Pennick, Victoria; Côté, Pierre; Hogg-Johnson, Sheilah; Bombardier, Claire

2008-01-01

This study describes instruction provided at chiropractic schools worldwide on the use of spine radiography and compares instruction with evidence-based guidelines for low back pain. Individuals responsible for radiology instruction at accredited chiropractic schools throughout the world were contacted and invited to participate in a Web-based survey. The survey included questions on the role of conventional radiography in chiropractic practice and instruction given to students for its use in patients with acute low back pain. Of the 33 chiropractic schools identified worldwide, 32 (97%) participated in the survey. Consistent with the guidelines, 25 (78%) respondents disagreed that "routine radiography should be used prior to spinal manipulative therapy," 29 (91%) disagreed that there "was a role for full spine radiography for assessing patients with low back pain," and 29 (91%) disagreed that "oblique views should be part of a standard radiographic series for low back pain." However, only 14 (44%) respondents concurred with the guidelines and disagreed with the statement that there "is a role for radiography in acute low back pain in the absence of 'red flags' for serious disease." This survey suggests that many aspects of radiology instruction provided by accredited chiropractic schools appear to be evidence based. However, there appears to be a disparity between some schools and existing evidence with respect to the role of radiography for patients with acute low back pain without "red flags" for serious disease. This may contribute to chiropractic overutilization of radiography for low back pain.

Back schools in Brazil: a review of the intervention methodology, assessment tools, and results.

PubMed

Noll, Matias; Vieira, Adriane; Darski, Caroline; Candotti, Cláudia Tarragô

2014-01-01

The Back School is characterized as an educational program aimed at individuals who have chronic pain in spine. In Brazil, a growing number of research studies on the effects of such programs have been observed in the last decades. Thus, the purpose of this systematic review was to identify studies on Back Schools carried out in Brazil with a population of adults and elderlies, and to compare their intervention methodologies, data collection tools, and results. A search for scientific articles and Master's and doctoral theses in several databases was conducted. The keywords used in that search were Postural Program; Postural School; Back School; Back Care Education; Back Education, as well as the respective terms in Portuguese. Eighteen studies were found, being fourteen quantitative and four qualitative studies.The studies showed many differences between them, in both the interventions proposed and the methodological design. However, the use of similar tools for assessing pain intensity, functional capacity, and quality of life between the quantitative studies allowed a partial comparison of the efficacy of those programs.The studies included in this systematic review demonstrated, in general, the immediate efficacy in reducing pain and improving functional capacity and quality of life after the Back School. Results, however, are still conflicting regarding the efficacy in the medium and long terms. Thus, it becomes necessary to conduct further studies that include follow-up assessments in the medium and long terms in order to obtain more accurate conclusions about the efficacy of Back Schools.

Experimental Study of Convective Heating on the Back Face and Payload of a Hypersonic Inflatable Aerodynamic Decelerator (HIAD) Aeroshell

NASA Technical Reports Server (NTRS)

Hollis, Brian R.; Berry, Scott A.; Hollingsworth, Kevin E.; Wright, Sheila A.

2017-01-01

A wind tunnel test program has been conducted to define convective heating environments on the back-face of a Hypersonic Inflatable Aerodynamic Decelerator aeroshell. Wind tunnel testing was conducted at Mach 6 and Mach 10 at unit Reynolds numbers from 0.5×10(exp 6)/ft to 3.9×10(exp 6)/ft on a 6.3088 in diameter aeroshell model. Global heating data were obtained through phosphor thermography on the aeroshell back face, as well as on the payload and the aeroshell front face. For all test conditions, laminar flow was produced on the aeroshell front face, while the separated wake shear layer and aeroshell back-face boundary layer were transitional or turbulent. Along the leeward centerline of the aeroshell back face and payload centerbody, heating levels increased with both free stream Reynolds number and angle of attack. The Reynolds number dependency was due to increasing strength of wake turbulence with Reynolds number. The angle-of-attack dependency was due to movement of the wake-vortex reattachment point on the aeroshell back face. The maximum heating levels on the aeroshell back face and payload were approximately 5% to 6%, respectively, of the aeroshell front-face stagnation point. To allow for extrapolation of the ground test data to flight conditions, the back face and payload heating levels were correlated as a function of aeroshell front-face peak momentum thickness Reynolds numbers.

Back symptoms in aviators flying different aircraft.

PubMed

Grossman, Alon; Nakdimon, Idan; Chapnik, Leah; Levy, Yuval

2012-07-01

Back pain is a common complaint among military aviators of various aircraft. We attempted to define the epidemiologic characteristics of this complaint in military aviators of the Israeli Air Force. Aviators of various aircraft (fighter, attack helicopter, utility helicopter, and transport and cargo) completed 566 questionnaires. The questionnaires included various demographic variables as well as questions specifically addressing type of aircraft, location, and severity of pain. Questionnaires were analyzed according to aircraft type, weekly and total number of flight hours. Back pain was significantly more common among utility and attack helicopter pilots. Compared with only 64.02% of fighter pilots, 89.38% of utility and 74.55% of attack helicopter pilots reported some degree of back pain. Cervical region pain was more common among fighter pilots (47.2%) and utility helicopter pilots (47.3%) compared with attack helicopter (36.4%) and transport (22.3%) pilots. Cervical region pain of moderate-severe degree was more common among utility helicopter pilots (7.1%). Mid and low back pain at all degrees of severity were more common among helicopter pilots. A significant proportion of subjects suffered from pain in multiple regions, particularly among utility helicopter pilots (32.74%). Severity of pain was graded higher in all three regions (cervical, mid, and lower back) in utility helicopter pilots. Utility helicopter pilots have more prevalent and more severe back pain than pilots of other platforms. Yet, it is difficult to make a clear association between type of aircraft and the region of back pain.

10 kHz High-Frequency Spinal Cord Stimulation for Chronic Axial Low Back Pain in Patients With No History of Spinal Surgery: A Preliminary, Prospective, Open Label and Proof-of-Concept Study.

PubMed

Al-Kaisy, Adnan; Palmisani, Stefano; Smith, Thomas E; Pang, David; Lam, Khai; Burgoyne, William; Houghton, Russell; Hudson, Emma; Lucas, Jonathan

2017-01-01

To explore the effectiveness of 10 kHz high frequency spinal cord stimulation (HF10 therapy) treatment of chronic low back pain in patients who have not had spinal surgery. Patients with chronic low back pain without prior spinal surgery were evaluated by a team of spine surgeons to rule out any spinal pathology amenable to surgical interventions and by a multidisciplinary pain team to confirm eligibility for the study. After a successful (>50% back pain reduction) trial of HF10 therapy, enrolled subjects underwent permanent system implantation and were followed-up one year post-implant. About 95% of the enrolled subjects (20/21) received the permanent system. At 12 months post-implant, both back pain VAS score and ODI were significantly reduced compared with baseline values (by 73% and 48%, respectively); an estimated quality-adjusted life year gain of 0.47 and a reduction in opioid use by 64% was observed. Four more patients among those unable to work at baseline due to back pain were employed at 12 months post-implant. There were no serious adverse events. HF10 therapy may provide significant back pain relief, reduction in disability, improvement quality of life, and reduction in opioid use in chronic low back pain not resulting from spinal surgery. © 2016 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals, Inc. on behalf of International Neuromodulation Society.

Wide abdominal rectus plication abdominoplasty for the treatment of chronic intractable low back pain.

PubMed

Oneal, Robert M; Mulka, Joseph P; Shapiro, Paul; Hing, David; Cavaliere, Christi

2011-01-01

A previous report demonstrated that the wide abdominal rectus plication abdominoplasty is an effective treatment modality in select patients with low back pain who failed to achieve relief with conservative therapy. The authors studied eight female patients who presented with chronic low back pain and marked lower abdominal wall muscular laxity. All had failed to respond to conservative management for their chronic back pain. They all underwent wide abdominal rectus plication abdominoplasty. Patient selection and details of the procedure are discussed. There were no significant complications in this series, and all the patients had prompt and prolonged alleviation of their back pain. Length of follow-up ranged from 2 to 11 years. Changes in the biomechanics of the lower abdominal musculature as a result of the wide abdominal rectus plication abdominoplasty are discussed in the context of increasing spinal stability, leading to an alleviation of chronic low back pain. An argument is made that this abdominoplasty procedure produces a spine-stabilizing effect by (1) tightening the muscles of the lateral abdominal complex and thus increasing intraabdominal pressure and (2) increasing the efficiency of these muscles so that their effectiveness as spine stabilizers is increased. Even though this is a small series, the fact that all the patients sustained long-term alleviation of their preoperative chronic back pain suggests that the wide abdominal rectus plication abdominoplasty should be considered as an option for patients with weak lower abdominal muscles and intractable low back pain who have failed conservative management.

Improving client-centred care and services: the role of front/back-office configurations.

PubMed

Broekhuis, Manda; de Blok, Carolien; Meijboom, Bert

2009-05-01

This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases. Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006). The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency. The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.

13 CFR 120.611 - Pools backing Pool Certificates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Pools backing Pool Certificates. 120.611 Section 120.611 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set...

13 CFR 120.612 - Loans eligible to back Certificates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Loans eligible to back Certificates. 120.612 Section 120.612 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Certificates § 120.612 Loans eligible to back Certificates. (a) Pool Certificates...

78 FR 64178 - Drawbridge Operation Regulation; Back Bay of Biloxi, Between Biloxi and D'Iberville, MS

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... deviation from the operating schedule that governs the I-110 Bridge across the Back Bay of Biloxi, mile 3.0... Back Bay of Biloxi, Mile 3.0, between Biloxi and D'Iberville, Harrison County, MS. The bridge has a...

49 CFR 220.49 - Radio communication used in shoving, backing or pushing movements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Radio and Wireless Communication Procedures § 220.49 Radio communication used in shoving, backing or pushing... 49 Transportation 4 2013-10-01 2013-10-01 false Radio communication used in shoving, backing or...

49 CFR 220.49 - Radio communication used in shoving, backing or pushing movements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Radio and Wireless Communication Procedures § 220.49 Radio communication used in shoving, backing or pushing... 49 Transportation 4 2014-10-01 2014-10-01 false Radio communication used in shoving, backing or...

11. INTERIOR OF LIVING ROOM SHOWING BACK WALL ELECTRICAL HEATER, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. INTERIOR OF LIVING ROOM SHOWING BACK WALL ELECTRICAL HEATER, OPEN FIVE-PANELED DOOR TO BACK BEDROOM AT PHOTO RIGHT, AND OPEN DOOR TO KITCHEN AT PHOTO CENTER. VIEW TO NORTHWEST. - Bishop Creek Hydroelectric System, Plant 4, Worker Cottage, Bishop Creek, Bishop, Inyo County, CA

Monitoring Physical and Cognitive Performance During Sustained Military Operations

DTIC Science & Technology

2009-10-01

performances humaines dans les operations militaires de l’OTAN (Science, Technologie et Ethique)). RTO Human Factors and Medicine Panel (HFM) Symposium...Three levels of difficulty (Zero-back, One-back, Two-back) were included. The participants were presented with a series of capital letters on their

77 FR 32591 - Procurement List; Proposed Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... NSN: 5120-00-NIB-0014--Shovel, Round Point, Closed Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0015--Shovel, Round Point, Open Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0016--Shovel, Round Point, Open Back, Industrial Grade, 29...

77 FR 44218 - Procurement List; Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

..., Fiberglass Handle NSN: 5120-00-NIB-0014--Shovel, Round Point, Closed Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0015--Shovel, Round Point, Open Back, Industrial Grade, 48'' Fiberglass Handle, Cushioned Grip NSN: 5120-00-NIB-0016--Shovel, Round Point, Open Back, Industrial Grade, 29...

13 CFR 120.611 - Pools backing Pool Certificates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Pools backing Pool Certificates. 120.611 Section 120.611 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Certificates § 120.611 Pools backing Pool Certificates. (a) Pool characteristics. As set...

13 CFR 120.612 - Loans eligible to back Certificates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Loans eligible to back Certificates. 120.612 Section 120.612 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Certificates § 120.612 Loans eligible to back Certificates. (a) Pool Certificates...

Energy dissipation in thirty-foot broken-back culverts using laboratory models.

DOT National Transportation Integrated Search

2014-09-01

This research investigates the reduction in scour downstream of a broken-back culvert by forming a hydraulic jump : inside the culvert. A broken-back culvert is used in areas of high relief and steep topography as it has one or more breaks in profile...

Studies of corona and back discharges in carbon dioxide

NASA Astrophysics Data System (ADS)

Czech, Tadeusz; Sobczyk, Arkadiusz Tomasz; Jaworek, Anatol; Krupa, Andrzej; Rajch, Eryk

2013-01-01

Results of spectroscopic investigations and current-voltage characteristics of corona and back discharges generated in point-plane electrode geometry in CO2 at atmospheric pressure for positive and negative polarity of the discharge electrode are presented in the paper. Three forms of back discharge, for both polarities, were investigated: glow, streamer and low-current back-arc. To generate the back-discharges for the conditions similar to electrostatic precipitator, the plate electrode was covered with fly ash layer. In order to characterize back discharge processes, the emission spectra were measured and compared with those obtained for normal discharge, generated in the same electrode configuration but without the fly ash layer on the plate electrode. The measurements have shown that optical emission spectral lines of atoms and molecules, excited or ionised in back discharge, depend on the forms of the discharge, the discharge current, and are different in the zones close to needle electrode and fly ash layer. From the comparison of spectral lines of back and normal discharges, an effect of fly ash layer on discharge characteristics and morphology has been determined. In normal corona, the emission spectra are mainly predetermined by the working gas components, but in the case of back discharge, the atomic and molecular lines, resulting from chemical composition of fly ash, are also identified. Differences in the spectra of back discharge for positive and negative polarities of the needle electrode have been explained by considering the kind of ions generated in the crater in fly ash layer. For back arc, the emission of spectral lines of atoms and molecules from fly ash layer can be recorded in the crater zone, but in the needle zone, only the emission lines of CO2 and its decomposition products (CO and C2) can be noticed. The studies of back discharge in CO2, as one of the main components of flue gases, were undertaken because this type of discharge, after unwanted inception, decreases the energy and collection efficiencies of electrostatic precipitator. The second reason behind these studies is that CO2 is the main component of flue gas leaving oxyfuel boiler that re-circulates in the combustion-precipitation cycle. It was shown that discharges in CO2 lead to contamination of discharge electrode with carbonaceous products that can cause severe maintenance problems of electrostatic precipitator. The recognition of the characteristics of electrostatic precipitator operating in the oxyfuel system is, therefore, of crucial importance for exhaust gas cleaning in modern combustion systems.

Parametric Equations: Push 'Em Back, Push 'Em Back, Way Back!

ERIC Educational Resources Information Center

Cieply, Joseph F.

1993-01-01

Stresses using the features of graphing calculators to teach parametric equations much earlier in the curriculum than is presently done. Examples using parametric equations to teach slopes and lines in beginning algebra, inverse functions in advanced algebra, the wrapping function, and simulations of physical phenomena are presented. (MAZ)

26 CFR 54.4980H-3 - Determining full-time employees.

Code of Federal Regulations, 2014 CFR

2014-04-01

...-back measurement method, set forth in paragraph (d) of this section. The monthly measurement method... (except with respect to the weekly rule under the monthly measurement method). The look-back measurement... those employees are not full-time employees under the look-back measurement method or the monthly...

Bereaved Employee: Returning to Work

MedlinePlus

... Out-of-town relatives return home. Children go back to school and grieving adults must get back to work. For some, returning to work is ... one is a long, slow process, but getting back into a routine is an important step in the journey. Share this: ... Copyright Information The materials on this website are ...

49 CFR 220.49 - Radio communication used in shoving, backing or pushing movements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pushing movements. 220.49 Section 220.49 Transportation Other Regulations Relating to Transportation... Wireless Communication Procedures § 220.49 Radio communication used in shoving, backing or pushing movements. When radio communication is used in connection with the shoving, backing or pushing of a train...

Laboratory modeling of energy dissipation in broken-back culverts - phase II.

DOT National Transportation Integrated Search

2011-05-01

This report represents Phase II of broken-back culverts with a drop of 6 feet. The first phase of this research was performed for a drop of 24 feet. This research investigates the reduction in scour downstream of a broken-back culvert by forming a hy...

77 FR 56686 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... Change Relating to Post-Trade Transparency for Agency Pass-Through Mortgage-Backed Securities Traded in... and dissemination of transactions in TRACE- Eligible Securities that are: (1) Agency Pass-Through... Security, Agency Pass-Through Mortgage-Backed Security, Specified Pool Transaction, Asset-Backed Security...

The Scope of Back Pain in Navy Helicopter Pilots

DTIC Science & Technology

2011-03-01

Environmental Medicine 55: 556–7. 40 Frymoyer, J. W., & Cats- Baril W. L. (1991). An overview of the incidences and costs of low back pain. Orthopedic...between individuals. Does back pain affect safety of flight? Frymoyer and Cats- Baril (1991) reported that in the civilian community, at any given

42 CFR 137.304 - May Self-Governance Tribes buy back environmental services from the IHS?

Code of Federal Regulations, 2010 CFR

2010-10-01

... project agreement, including design and construction engineering, and environmental compliance services... 42 Public Health 1 2010-10-01 2010-10-01 false May Self-Governance Tribes buy back environmental...-GOVERNANCE Construction Nepa Process § 137.304 May Self-Governance Tribes buy back environmental services...

Push-Back Leadership.

ERIC Educational Resources Information Center

Tetenbaum, Toby J.; Tetenbaum, Hilary

2003-01-01

Describes push-back leadership, a model of leadership based on the work of Ronald Heifetz and Martin Linksky. Argues that the two key roles of the leader are to give the work back to people and to keep them within a healthy range of disequilibrium that generates creativity and innovation to solve organizational problems. (Author/LRW)

Pseudoneglect in Back Space

ERIC Educational Resources Information Center

Cocchini, Gianna; Watling, Rosamond; Della Sala, Sergio; Jansari, Ashok

2007-01-01

Successful interaction with the environment depends upon our ability to retain and update visuo-spatial information of both front and back egocentric space. Several studies have observed that healthy people tend to show a displacement of the egocentric frame of reference towards the left. However representation of space behind us (back space) has…

7 CFR 981.441 - Credit for market promotion activities, including paid advertising.

Code of Federal Regulations, 2012 CFR

2012-01-01

... relations purposes, including E-commerce (mail ordering through the Internet): Provided, That Credit-Back...-Back is requested. (e) The following requirements shall apply to Credit-Back for all promotional... and Canada, paragraph (e)(5) of this section shall also apply. (2) The clear and evident purpose of...

7 CFR 981.441 - Credit for market promotion activities, including paid advertising.

Code of Federal Regulations, 2010 CFR

2010-01-01

... relations purposes, including E-commerce (mail ordering through the Internet): Provided, That Credit-Back...-Back is requested. (e) The following requirements shall apply to Credit-Back for all promotional... and Canada, paragraph (e)(5) of this section shall also apply. (2) The clear and evident purpose of...

7 CFR 981.441 - Credit for market promotion activities, including paid advertising.

Code of Federal Regulations, 2011 CFR

2011-01-01

... relations purposes, including E-commerce (mail ordering through the Internet): Provided, That Credit-Back...-Back is requested. (e) The following requirements shall apply to Credit-Back for all promotional... and Canada, paragraph (e)(5) of this section shall also apply. (2) The clear and evident purpose of...

7 CFR 981.441 - Credit for market promotion activities, including paid advertising.

Code of Federal Regulations, 2014 CFR

2014-01-01

... relations purposes, including E-commerce (mail ordering through the Internet): Provided, That Credit-Back...-Back is requested. (e) The following requirements shall apply to Credit-Back for all promotional... and Canada, paragraph (e)(5) of this section shall also apply. (2) The clear and evident purpose of...

7 CFR 981.441 - Credit for market promotion activities, including paid advertising.

Code of Federal Regulations, 2013 CFR

2013-01-01

... relations purposes, including E-commerce (mail ordering through the Internet): Provided, That Credit-Back...-Back is requested. (e) The following requirements shall apply to Credit-Back for all promotional... and Canada, paragraph (e)(5) of this section shall also apply. (2) The clear and evident purpose of...

Correlations of hip mobility with degree of back pain and lumbar spinal mobility in chronic low-back pain patients.

PubMed

Mellin, G

1988-06-01

Mobility of hips and lumbar spine were measured in 301 men and 175 women who were in employment but suffered from chronic or recurrent low-back pain. The degree of low-back pain (LBP) was assessed with a questionnaire. Hip flexion, extension, internal rotation, and hamstring flexibility in the men, and hip flexion and extension in the women had statistically significant negative correlations with LBP. Among the correlations between hip and lumbar spinal mobility, hip flexion and extension with lumbar rotation were strongest.

Limitations associated with managing chronic low back pain.

PubMed

Beland, Paul

2016-04-20

Non-specific chronic low back pain is an occupational hazard for nurses. It may result in persistent and disabling pain for some people. There are many techniques for investigating, assessing and treating chronic low back pain. However, research to support some of these interventions and the assumptions that underlie them is limited. Interventions that may be beneficial are not always available to those who need them. Changes to service provision are required to rectify this situation and provide effective treatment for patients with non-specific chronic low back pain.

Squeezed Back-to-Back Correlation of {D}^{0}{\\bar{D}}^{0} in Relativistic Heavy-Ion Collisions

NASA Astrophysics Data System (ADS)

Yang, Ai-Geng; Zhang, Yong; Cheng, Luan; Sun, Hao; Zhang, Wei-Ning

2018-05-01

We investigate the squeezed back-to-back correlation (BBC) of $D^0\\!{\\bar D}^0$ in relativistic heavy-ion collisions, using the in-medium mass modification calculated with a self-energy in hot pion gas and the source space-time distributions provided by the viscous hydrodynamic code VISH2+1. It is found that the BBC of $D^0\\!{\\bar D}^0$ is significant in peripheral Au+Au collisions at the RHIC energy. A possible way to detect the BBC in experiment is presented.

The Elimination of Fire Hazard Due to Back Fires

NASA Technical Reports Server (NTRS)

Theodorsen, Theodore; Freeman, Ira M

1933-01-01

A critical study was made of the operation of a type of back-fire arrester used to reduce the fire hazard of aircraft engines. A flame arrester consisting of a pack or plug of alternate flat and corrugated plates of thin metal was installed in the intake pipe of a gasoline engines; an auxiliary spark plug inserted in the intake manifold permitted the production of artificial back fires at will. It was found possible to design a plug which prevented all back fires from reaching the carburetor.

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

NASA Technical Reports Server (NTRS)

Laughlin, Mitzi S.; Murray, Jocelyn D.; Wear, Mary L.; Van Baalen, Mary

2016-01-01

Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors.

Organizational strategies for protection against back contamination

NASA Technical Reports Server (NTRS)

Mahoney, T. A.

1976-01-01

The organizational issues pertaining to the prevention of inbound contamination associated with possible Viking missions to Mars are considered. The completed Apollo missions, which returned samples from the moon, provide a convenient base for analysis of inbound contamination issues. Despite concern over the threat of inbound contamination from the moon and efforts to prevent back contamination, the back contamination efforts in the Apollo missions were considered ineffective had these missions encountered living organisms. Several alternatives for consideration in the design of future programs dealing with back contamination are examined and proposed for special consideration.

Polarization-insensitive techniques for optical signal processing

NASA Astrophysics Data System (ADS)

Salem, Reza

2006-12-01

This thesis investigates polarization-insensitive methods for optical signal processing. Two signal processing techniques are studied: clock recovery based on two-photon absorption in silicon and demultiplexing based on cross-phase modulation in highly nonlinear fiber. The clock recovery system is tested at an 80 Gb/s data rate for both back-to-back and transmission experiments. The demultiplexer is tested at a 160 Gb/s data rate in a back-to-back experiment. We experimentally demonstrate methods for eliminating polarization dependence in both systems. Our experimental results are confirmed by theoretical and numerical analysis.

Concepts for thin-film GaAs concentrator cells. [for solar photovoltaic space power systems

NASA Technical Reports Server (NTRS)

Spitzer, M. B.; Gale, R. P.; Mcclelland, R.; King, B.; Dingle, J.

1989-01-01

The development of advanced GaAs concentrator solar cells, and in particular, the use of CLEFT (cleavage of lateral epitaxial films for transfer) processes for formation of thin-film structures is reported. The use of CLEFT has made possible processing of the back, and cells with back surface grids are discussed. Data on patterned junction development are presented; such junctions are expected to be useful in back surface applications requiring point contacts, grating structures, and interdigitated back contacts. CLEFT concentrator solar cells with grids on the front and back surfaces are reported here; these cells are 4 microns thick and are bonded to glass covers for support. Air mass zero efficiency of 18.8 percent has been obtained for a CLEFT concentrator operating at 18.5 suns.

A new fabrication technique for back-to-back varactor diodes

NASA Technical Reports Server (NTRS)

Smith, R. Peter; Choudhury, Debabani; Martin, Suzanne; Frerking, Margaret A.; Liu, John K.; Grunthaner, Frank A.

1992-01-01

A new varactor diode process has been developed in which much of the processing is done from the back of an extremely thin semiconductor wafer laminated to a low-dielectric substrate. Back-to-back BNN diodes were fabricated with this technique; excellent DC and low-frequency capacitance measurements were obtained. Advantages of the new technique relative to other techniques include greatly reduced frontside wafer damage from exposure to process chemicals, improved capability to integrate devices (e.g. for antenna patterns, transmission lines, or wafer-scale grids), and higher line yield. BNN diodes fabricated with this technique exhibit approximately the expected capacitance-voltage characteristics while showing leakage currents under 10 mA at voltages three times that needed to deplete the varactor. This leakage is many orders of magnitude better than comparable Schottky diodes.

Back pain and scoliosis in children: When to image, what to consider.

PubMed

Calloni, Sonia F; Huisman, Thierry Agm; Poretti, Andrea; Soares, Bruno P

2017-10-01

Back pain and scoliosis in children most commonly present as benign and self-limited entities. However, persistent back pain and/or progressive scoliosis should always be taken seriously in children. Dedicated diagnostic work-up should exclude etiologies that may result in significant morbidity. Clinical evaluation and management require a comprehensive history and physical and neurological examination. A correct imaging approach is important to define a clear diagnosis and should be reserved for children with persistent symptoms or concerning clinical and laboratory findings. This article reviews the role of different imaging techniques in the diagnostic approach to back pain and scoliosis, and offers a comprehensive review of the main imaging findings associated with common and uncommon causes of back pain and scoliosis in the pediatric population.

Impact of back squat training intensity on strength and flexibility of hamstring muscle group.

PubMed

Shariat, Ardalan; Lam, Eddie T C; Shaw, Brandon S; Shaw, Ina; Kargarfard, Mehdi; Sangelaji, Bahram

2017-01-01

True experimental design. The back squat is an integral aspect of any resistance training program to improve athletic performance. It is also used for injury prevention of the lower limbs. The purpose of this study was to examine the effect of back squat training at different intensities on strength and flexibility of the hamstring muscle group (HMG). Twenty-two male recreational bodybuilders with at least two years of experience in resistance training were recruited to participate in a nine-week training program. They were randomly assigned to a heavy back squat group (90-95% of one repetition maximum) or a moderate-intensity back squat group (60-65% of one repetition maximum). The heavy back squat group resulted in a significantly (p < 0.001) increased in one repetition maximum strength but a significant (p < 0.001) reduction in HMG flexibility when compared to their counterparts. The results of the study indicate that while a heavy back squat training program is effective in improving strength, it has an adverse effect on the flexibility of the HMG. The implication of this study is that there is a tradeoff between strength and flexibility and trainers should select the appropriate training protocols for their athletes to maximize athletic performance.

The effectiveness of a back school program in lowerlimb amputees: a randomized controlled study.

PubMed

Anaforoğlu, Bahar; Erbahçeci, Fatih; Aksekili, Mehmet Atıf Erol

2016-06-23

A few studies have been carried out in lower limb amputees (LLAs) and they examined the incidence of and reasons for low back pain. The aim of this study was to assess the effectiveness of a back school program in LLAs with mechanical low back pain (MLBP). Forty male unilateral transfemoral amputees with MLBP were randomly allocated into two groups. A back school program was applied to Group 1 over 2 weeks. A booklet for home use was given to each participant in Group 2. Pain was assessed using a visual analogue scale. Spinal flexibility measurements were obtained. For the assessment of back pain-related disability, the Oswestry Disability Index was used. Patients were assessed at baseline, at month 1, and at month 3. At the month 1 assessment, a reduction in pain intensity and disability, and increase in spinal flexibility measurements were detected in Group 1 only (P < 0.05). At the month 3 assessment, there were improvements in all measured parameters in both groups(P < 0.05). Group 1 had better results in all parameters compared with Group 2. The back school program, combined with an exercise program, decreased pain and disability and improved the spinal flexibility significantly in LLAs with MLBP.

Experiences of Rehabilitation Professionals with the Implementation of a Back School for Patients with Chronic Low Back Pain: A Qualitative Study.

PubMed

Peters, Stefan; Faller, Hermann; Pfeifer, Klaus; Meng, Karin

2016-01-01

A standardized curriculum back school (CBS) has been recommended for further dissemination in medical rehabilitation in Germany. However, implementation of self-management education programs into practice is challenging. In low back pain care, individual factors of professionals could be decisive regarding implementation fidelity. The study aim was to explore attitudes and experiences of professionals who conducted the back school. Qualitative interviews were led with 45 rehabilitation professionals. The data were examined using thematic analysis. Three central themes were identified: (a) "back school as a common thread," (b) "theory versus practice," and (c) "participation and patient-centeredness." The CBS and its manual were frequently described positively because they provide structure. However, specified time was mentioned critically and there were heterogeneous perceptions regarding flexibility in conducting the CBS. Theory and practice in the CBS were discussed concerning amount, distribution, and conjunction. Participation and patient-centeredness were mainly mentioned in terms of amount and heterogeneity of participation as well as the demand for competences of professionals. Factors were detected that may either positively or negatively influence the implementation fidelity of self-management education programs. The results are explorative and provide potential explanatory mechanisms for behavior and acceptance of rehabilitation professionals regarding the implementation of biopsychosocial back schools.

Low back pain in adolescent and associated factors: A cross sectional study with schoolchildren

PubMed Central

Silva, Mônica R. O. G. C. M.; Badaró, Ana Fátima V.; Dall'Agnol, Marinel M.

2014-01-01

Objective: To determine the prevalence of low back pain nonspecific and associated factors in schoolchildren. Method: This cross-sectional study investigated 343 adolescents, aged between 12 and 15 years, of both sexes of public schools. The questionnaire included questions regarding sociodemographic characteristics, type of school transportation, body mass index and low back pain. The outcome was defined as discomfort localized below the costal margin and above the inferior gluteal folds in the last 12 months. Results : The prevalence of low back pain in the last year was 57% (n=195) among participants, with no significant difference between the sexes (OR 1.13, 95% CI 0.93 to 1.37). Advancing age and body mass index were associated with the presence of low back pain in the bivariate analysis. The remaining seated at school in usual days was considered one of the main activities that trigger symptoms that lasted up to seven days for the majority (80%) of adolescents. Conclusions: The high prevalence of low back pain presented, indicating that it is a common condition among these adolescents. There was no difference between the sexes, but had influence of age and body mass index. Our results point to the need for the development epidemiological studies of low back pain among children and adolescents. PMID:25372002

Schoolbags and back pain in children between 8 and 13 years: a national study

PubMed Central

Spiteri, Karl; Busuttil, Maria-Louisa; Aquilina, Samuel; Gauci, Dorothy; Camilleri, Erin; Grech, Victor

2017-01-01

Schoolbag weight in schoolchildren is a recurrent and contentious issue within the educational and health sphere. Excessive schoolbag weight can lead to back pain in children, which increases the risk of chronic back pain in adulthood. There is limited research regarding this among the Maltese paediatric population. A cross-sectional study was undertaken across all schools in Malta among students aged 8–13 years (inclusive). Data were collected using a questionnaire detailing schoolbag characteristics, self-reported pain and demographic variables, such as age and gender. Structured interviews with participants were also carried out by physiotherapists. A total of 4005 participants were included in the study, with 20% of the total Malta schoolchildren population. Over 70% of the subjects had a schoolbag that exceeded the recommended 10% bag weight to body ratio. A total of 32% of the sample complained of back pain, with 74% of these defining it as low in intensity on the face pain scale–revised. The presence of back pain was statistically related to gender, body mass index (BMI), school and bag weight to body weight ratio. After adjusting for other factors, self-reported back pain in schoolchildren is independently linked to carrying heavy schoolbags. This link should be addressed to decrease the occurrence of back pain in this age group. PMID:28491300

Task and postural factors are related to back pain in helicopter pilots.

PubMed

Bridger, R S; Groom, M R; Jones, H; Pethybridge, R J; Pullinger, N

2002-08-01

A previous survey by Shear et al. revealed a high prevalence of back pain in Royal Navy helicopter aircrew, compared with controls. It was recommended that a second survey be undertaken, taking account of flying tasks and cockpit ergonomics. This was the purpose of the present investigation. A questionnaire containing items on back pain and posture was circulated to all 246 acting pilots, with returns of 75%. The questionnaire sought information on pain in both the flying pilot and co-pilot/instructor roles. The 12-mo prevalence of back pain was 80%. Task-related back pain was greatest in instrument flying (72%) and least in the co-pilot and instructor roles (24%). Self-ratings of posture indicated that forward flexed trunk postures predominated in the flying roles and were most extreme in instrument flying. In non-flying roles, symmetrical, reclining postures were more often reported. No demographic or psychosocial variables were significantly related to back pain prevalence or disability. Much of the back pain experienced by helicopter pilots appears to be due to the posture needed to operate the cyclic and collective controls. In instrument flying, it is suggested that the visual demands of scanning the displays may exacerbate the pain by causing the pilot to lean further forward.

Field-scale forward and back diffusion through low-permeability zones

NASA Astrophysics Data System (ADS)

Yang, Minjune; Annable, Michael D.; Jawitz, James W.

2017-07-01

Understanding the effects of back diffusion of groundwater contaminants from low-permeability zones to aquifers is critical to making site management decisions related to remedial actions. Here, we combine aquifer and aquitard data to develop recommended site characterization strategies using a three-stage classification of plume life cycle based on the solute origins: aquifer source zone dissolution, source zone dissolution combined with back diffusion from an aquitard, and only back diffusion. We use measured aquitard concentration profile data from three field sites to identify signature shapes that are characteristic of these three stages. We find good fits to the measured data with analytical solutions that include the effects of advection and forward and back diffusion through low-permeability zones, and linearly and exponentially decreasing flux resulting from source dissolution in the aquifer. Aquifer contaminant time series data at monitoring wells from a mature site were well described using analytical solutions representing the combined case of source zone and back diffusion, while data from a site where the source had been isolated were well described solely by back diffusion. The modeling approach presented in this study is designed to enable site managers to implement appropriate remediation technologies at a proper timing for high- and low-permeability zones, considering estimated plume life cycle.

Comparison of pain intensity, emotional status and disability level in patients with chronic neck and low back pain.

PubMed

Altuğ, Filiz; Kavlak, Erdoğan; Kurtca, Mine Pekesen; Ünal, Ayşe; Cavlak, Uğur

2015-01-01

This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain. In this study, fifty patients with chronic low back pain (Group I) and fifty patients with chronic neck pain (Group II) at least 6 months were evaluated. A Visual Analog Scale was used to describe pain intensity. To determine emotional status of the subjects, the Beck Depression Scale was used The Oswestry Disability Index and the Neck Disability Index were used to evaluate disability level. The mean age of the patients with low back pain and neck pain were 39.70 ± 9.71 years, 45.44 ± 10.39 years, respectively. It was not found a significant difference between in low back pain (Group I) and neck pain (Group II) in results of pain intensity (p= 0.286) and pain duration (p= 0.382). It was found a significant difference between group I and group II in results of emotional status (p= 0.000) and disability level (p= 0.000). The emotional status and disability level scores were found highest in patient's with low back pain. Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level.

Back transport: exploration of parents' feelings regarding the transition.

PubMed

Kuhnly, J E; Freston, M S

1993-02-01

The purpose of this qualitative study was to explore parents' perceptions and the concepts involved in their preterm infant's back transport from a tertiary neonatal intensive care unit to their home community hospital. A convenience sample of fourteen parents were interviewed five to seven days after the back transport. Following data collection, the analysis of the parents' perceptions regarding the back transport of their premature infant identified a crisis theme that was influenced by several concepts. The subject's positive or negative meaning of the back transport during the pre-crisis phase defined the extent of the crisis during a three day transition period which led to an acceptance of events in the resolution phase. The subjects' perceptions of the previous events of hospitalization and communication of information regarding back transport influenced the meaning of the back transport for them. The extent of crisis during the transition phase was influenced by subjects' perceptions of medical complications, caretaking practice changes, environmental changes, feelings of powerlessness or empowerment, personal coping resources, and support systems available. Resolution in all cases occurred with an acceptance of events. Implications for practice and future research can be identified such as developing and testing education programs to prepare parents for the transition and strengthening the relationship between tertiary and community hospitals.

Individual differences in media multitasking and performance on the n-back.

PubMed

Ralph, Brandon C W; Smilek, Daniel

2017-02-01

A number of studies have recently examined the link between individual differences in media multitasking (using the MMI) and performance on working memory paradigms. However, these studies have yielded mixed results. Here we examine the relation between media multitasking and one particular working memory paradigm-the n-back (2- and 3-back)-improving upon previous research by (a) treating media multitasking as a continuous variable and adopting a correlational approach as well as (b) using a large sample of participants. First, we found that higher scores on the MMI were associated with a greater proportion of omitted trials on both the 2-back and 3-back, indicating that heavier media multitaskers were more disengaged during the n-back. In line with such a claim, heavier media multitaskers were also more likely to confess to responding randomly during various portions of the experiment, and to report media multitasking during the experiment itself. Importantly, when controlling for the relation between MMI scores and omissions, higher scores on the MMI were associated with an increase in false alarms, but not with a change in hits. These findings refine the extant literature on media multitasking and working memory performance (specifically, performance on the n-back), and suggest that media multitasking may be related to the propensity to disengage from ongoing tasks.

Incidence of and risk factors for musculoskeletal symptoms in the neck and low-back during severe flooding in Bangkok in 2011.

PubMed

Sihawong, Rattaporn; Janwantanakul, Prawit; Pensri, Praneet

2012-07-01

To examine whether the incidences of neck and low-back symptoms were elevated during the severe floods that occurred in Bangkok, Thailand in 2011, and to explore flood-related risk factors for neck and low-back symptoms. Prospective cohort design. Severe flooding occurred in Bangkok and surrounding neighbourhoods between October and December, 2011. After the flood had subsided (January 2012), 377 healthy office workers, who were already taking part in a study on musculoskeletal symptoms, were asked about their contact with floodwater. Data were gathered from subjects, who had reported no neck and low-back symptoms at the end of September 2011 and who were affected by the flood. Two regression models for the outcomes of 3-month incidence of neck and low-back symptoms, respectively, were performed. Eighty-two percent of the subjects were affected by the flood. No flood-related factor was found to associate significantly with either neck or low-back symptoms. However, neck symptoms may be associated with commuting frequently through flooded areas, and low-back symptoms may be associated with the subjects' homes or workplaces being flooded. These findings indicate that more attention needs to be paid to the problem of musculoskeletal symptoms during flooding in urban areas, and that preventive measures are required.

Electrophysiological assessment of the effects of obstructive sleep apnea on cognition.

PubMed

Gelir, Ethem; Başaran, Cenk; Bayrak, Sibel; Yağcıoğlu, Süha; Budak, Murat Timur; Fırat, Hikmet; Ungan, Pekcan

2014-01-01

We used electrophysiological measures to investigate the effects of obstructive sleep apnea on attention, learning, and memory. Thirty subjects (OSA group, n = 15, control group n = 15) participated in n-back tests, accompanied by P300 recordings, to investigate working memory and attention. The mirror-drawing test was used to study procedural memory, and the trail-making test (TMT) was used to evaluate divided attention and executive function. No significant group difference in reaction time was found in the 0-back and 1-back tests. In the 2-back test, reaction times of patients were longer than those of the control group. No P300 wave was obtained in the OSA group in any (0-, 1-, or 2-back) n-back test. In contrast, in the control group, significant P300 waves were recorded except for the 2-back test. The mirror-drawing scores were unaffected by sleep apnea. There was no difference between groups in the TMT-A test on any of the trials. Although no group difference was found in the first or second trials of the TMT-B test, OSA patients were less successful in learning on the third trial. According to our study results, OSA affects attention and executive function adversely however, we could not detect a significant effect on working or procedural memory.