LBP and SIFT based facial expression recognition

NASA Astrophysics Data System (ADS)

Sumer, Omer; Gunes, Ece O.

2015-02-01

This study compares the performance of local binary patterns (LBP) and scale invariant feature transform (SIFT) with support vector machines (SVM) in automatic classification of discrete facial expressions. Facial expression recognition is a multiclass classification problem and seven classes; happiness, anger, sadness, disgust, surprise, fear and comtempt are classified. Using SIFT feature vectors and linear SVM, 93.1% mean accuracy is acquired on CK+ database. On the other hand, the performance of LBP-based classifier with linear SVM is reported on SFEW using strictly person independent (SPI) protocol. Seven-class mean accuracy on SFEW is 59.76%. Experiments on both databases showed that LBP features can be used in a fairly descriptive way if a good localization of facial points and partitioning strategy are followed.

3D face analysis by using Mesh-LBP feature

NASA Astrophysics Data System (ADS)

Wang, Haoyu; Yang, Fumeng; Zhang, Yuming; Wu, Congzhong

2017-11-01

Objective: Face Recognition is one of the widely application of image processing. Corresponding two-dimensional limitations, such as the pose and illumination changes, to a certain extent restricted its accurate rate and further development. How to overcome the pose and illumination changes and the effects of self-occlusion is the research hotspot and difficulty, also attracting more and more domestic and foreign experts and scholars to study it. 3D face recognition fusing shape and texture descriptors has become a very promising research direction. Method: Our paper presents a 3D point cloud based on mesh local binary pattern grid (Mesh-LBP), then feature extraction for 3D face recognition by fusing shape and texture descriptors. 3D Mesh-LBP not only retains the integrity of the 3D geometry, is also reduces the need for recognition process of normalization steps, because the triangle Mesh-LBP descriptor is calculated on 3D grid. On the other hand, in view of multi-modal consistency in face recognition advantage, construction of LBP can fusing shape and texture information on Triangular Mesh. In this paper, some of the operators used to extract Mesh-LBP, Such as the normal vectors of the triangle each face and vertex, the gaussian curvature, the mean curvature, laplace operator and so on. Conclusion: First, Kinect devices obtain 3D point cloud face, after the pretreatment and normalization, then transform it into triangular grid, grid local binary pattern feature extraction from face key significant parts of face. For each local face, calculate its Mesh-LBP feature with Gaussian curvature, mean curvature laplace operator and so on. Experiments on the our research database, change the method is robust and high recognition accuracy.

CNNs flag recognition preprocessing scheme based on gray scale stretching and local binary pattern

NASA Astrophysics Data System (ADS)

Gong, Qian; Qu, Zhiyi; Hao, Kun

2017-07-01

Flag is a rather special recognition target in image recognition because of its non-rigid features with the location, scale and rotation characteristics. The location change can be handled well by the depth learning algorithm Convolutional Neural Networks (CNNs), but the scale and rotation changes are quite a challenge for CNNs. Since it has good rotation and gray scale invariance, the local binary pattern (LBP) is combined with grayscale stretching and CNNs to make LBP and grayscale stretching as CNNs pretreatment, which can not only significantly improve the efficiency of flag recognition, but can also evaluate the recognition effect through ROC, accuracy, MSE and quality factor.

Hyperspectral image classification based on local binary patterns and PCANet

NASA Astrophysics Data System (ADS)

Yang, Huizhen; Gao, Feng; Dong, Junyu; Yang, Yang

2018-04-01

Hyperspectral image classification has been well acknowledged as one of the challenging tasks of hyperspectral data processing. In this paper, we propose a novel hyperspectral image classification framework based on local binary pattern (LBP) features and PCANet. In the proposed method, linear prediction error (LPE) is first employed to select a subset of informative bands, and LBP is utilized to extract texture features. Then, spectral and texture features are stacked into a high dimensional vectors. Next, the extracted features of a specified position are transformed to a 2-D image. The obtained images of all pixels are fed into PCANet for classification. Experimental results on real hyperspectral dataset demonstrate the effectiveness of the proposed method.

Objective grading of facial paralysis using Local Binary Patterns in video processing.

PubMed

He, Shu; Soraghan, John J; O'Reilly, Brian F

2008-01-01

This paper presents a novel framework for objective measurement of facial paralysis in biomedial videos. The motion information in the horizontal and vertical directions and the appearance features on the apex frames are extracted based on the Local Binary Patterns (LBP) on the temporal-spatial domain in each facial region. These features are temporally and spatially enhanced by the application of block schemes. A multi-resolution extension of uniform LBP is proposed to efficiently combine the micro-patterns and large-scale patterns into a feature vector, which increases the algorithmic robustness and reduces noise effects while still retaining computational simplicity. The symmetry of facial movements is measured by the Resistor-Average Distance (RAD) between LBP features extracted from the two sides of the face. Support Vector Machine (SVM) is applied to provide quantitative evaluation of facial paralysis based on the House-Brackmann (H-B) Scale. The proposed method is validated by experiments with 197 subject videos, which demonstrates its accuracy and efficiency.

Spoofing detection on facial images recognition using LBP and GLCM combination

NASA Astrophysics Data System (ADS)

Sthevanie, F.; Ramadhani, K. N.

2018-03-01

The challenge for the facial based security system is how to detect facial image falsification such as facial image spoofing. Spoofing occurs when someone try to pretend as a registered user to obtain illegal access and gain advantage from the protected system. This research implements facial image spoofing detection method by analyzing image texture. The proposed method for texture analysis combines the Local Binary Pattern (LBP) and Gray Level Co-occurrence Matrix (GLCM) method. The experimental results show that spoofing detection using LBP and GLCM combination achieves high detection rate compared to that of using only LBP feature or GLCM feature.

Pollen Image Recognition Based on DGDB-LBP Descriptor

NASA Astrophysics Data System (ADS)

Han, L. P.; Xie, Y. H.

2018-01-01

In this paper, we propose DGDB-LBP, a local binary pattern descriptor based on the pixel blocks in the dominant gradient direction. Differing from traditional LBP and its variants, DGDB-LBP encodes by comparing the main gradient magnitude of each block rather than the single pixel value or the average of pixel blocks, in doing so, it reduces the influence of noise on pollen images and eliminates redundant and non-informative features. In order to fully describe the texture features of pollen images and analyze it under multi-scales, we propose a new sampling strategy, which uses three types of operators to extract the radial, angular and multiple texture features under different scales. Considering that the pollen images have some degree of rotation under the microscope, we propose the adaptive encoding direction, which is determined by the texture distribution of local region. Experimental results on the Pollenmonitor dataset show that the average correct recognition rate of our method is superior to other pollen recognition methods in recent years.

Fusion of LBP and SWLD using spatio-spectral information for hyperspectral face recognition

NASA Astrophysics Data System (ADS)

Xie, Zhihua; Jiang, Peng; Zhang, Shuai; Xiong, Jinquan

2018-01-01

Hyperspectral imaging, recording intrinsic spectral information of the skin cross different spectral bands, become an important issue for robust face recognition. However, the main challenges for hyperspectral face recognition are high data dimensionality, low signal to noise ratio and inter band misalignment. In this paper, hyperspectral face recognition based on LBP (Local binary pattern) and SWLD (Simplified Weber local descriptor) is proposed to extract discriminative local features from spatio-spectral fusion information. Firstly, the spatio-spectral fusion strategy based on statistical information is used to attain discriminative features of hyperspectral face images. Secondly, LBP is applied to extract the orientation of the fusion face edges. Thirdly, SWLD is proposed to encode the intensity information in hyperspectral images. Finally, we adopt a symmetric Kullback-Leibler distance to compute the encoded face images. The hyperspectral face recognition is tested on Hong Kong Polytechnic University Hyperspectral Face database (PolyUHSFD). Experimental results show that the proposed method has higher recognition rate (92.8%) than the state of the art hyperspectral face recognition algorithms.

Finger Vein Recognition Based on Local Directional Code

PubMed Central

Meng, Xianjing; Yang, Gongping; Yin, Yilong; Xiao, Rongyang

2012-01-01

Finger vein patterns are considered as one of the most promising biometric authentication methods for its security and convenience. Most of the current available finger vein recognition methods utilize features from a segmented blood vessel network. As an improperly segmented network may degrade the recognition accuracy, binary pattern based methods are proposed, such as Local Binary Pattern (LBP), Local Derivative Pattern (LDP) and Local Line Binary Pattern (LLBP). However, the rich directional information hidden in the finger vein pattern has not been fully exploited by the existing local patterns. Inspired by the Webber Local Descriptor (WLD), this paper represents a new direction based local descriptor called Local Directional Code (LDC) and applies it to finger vein recognition. In LDC, the local gradient orientation information is coded as an octonary decimal number. Experimental results show that the proposed method using LDC achieves better performance than methods using LLBP. PMID:23202194

Finger vein recognition based on local directional code.

PubMed

Meng, Xianjing; Yang, Gongping; Yin, Yilong; Xiao, Rongyang

2012-11-05

Finger vein patterns are considered as one of the most promising biometric authentication methods for its security and convenience. Most of the current available finger vein recognition methods utilize features from a segmented blood vessel network. As an improperly segmented network may degrade the recognition accuracy, binary pattern based methods are proposed, such as Local Binary Pattern (LBP), Local Derivative Pattern (LDP) and Local Line Binary Pattern (LLBP). However, the rich directional information hidden in the finger vein pattern has not been fully exploited by the existing local patterns. Inspired by the Webber Local Descriptor (WLD), this paper represents a new direction based local descriptor called Local Directional Code (LDC) and applies it to finger vein recognition. In LDC, the local gradient orientation information is coded as an octonary decimal number. Experimental results show that the proposed method using LDC achieves better performance than methods using LLBP.

Hardware-software face detection system based on multi-block local binary patterns

NASA Astrophysics Data System (ADS)

Acasandrei, Laurentiu; Barriga, Angel

2015-03-01

Face detection is an important aspect for biometrics, video surveillance and human computer interaction. Due to the complexity of the detection algorithms any face detection system requires a huge amount of computational and memory resources. In this communication an accelerated implementation of MB LBP face detection algorithm targeting low frequency, low memory and low power embedded system is presented. The resulted implementation is time deterministic and uses a customizable AMBA IP hardware accelerator. The IP implements the kernel operations of the MB-LBP algorithm and can be used as universal accelerator for MB LBP based applications. The IP employs 8 parallel MB-LBP feature evaluators cores, uses a deterministic bandwidth, has a low area profile and the power consumption is ~95 mW on a Virtex5 XC5VLX50T. The resulted implementation acceleration gain is between 5 to 8 times, while the hardware MB-LBP feature evaluation gain is between 69 and 139 times.

Using Fractal and Local Binary Pattern Features for Classification of ECOG Motor Imagery Tasks Obtained from the Right Brain Hemisphere.

PubMed

Xu, Fangzhou; Zhou, Weidong; Zhen, Yilin; Yuan, Qi; Wu, Qi

2016-09-01

The feature extraction and classification of brain signal is very significant in brain-computer interface (BCI). In this study, we describe an algorithm for motor imagery (MI) classification of electrocorticogram (ECoG)-based BCI. The proposed approach employs multi-resolution fractal measures and local binary pattern (LBP) operators to form a combined feature for characterizing an ECoG epoch recording from the right hemisphere of the brain. A classifier is trained by using the gradient boosting in conjunction with ordinary least squares (OLS) method. The fractal intercept, lacunarity and LBP features are extracted to classify imagined movements of either the left small finger or the tongue. Experimental results on dataset I of BCI competition III demonstrate the superior performance of our method. The cross-validation accuracy and accuracy is 90.6% and 95%, respectively. Furthermore, the low computational burden of this method makes it a promising candidate for real-time BCI systems.

Diagnosis of Tempromandibular Disorders Using Local Binary Patterns.

PubMed

Haghnegahdar, A A; Kolahi, S; Khojastepour, L; Tajeripour, F

2018-03-01

Temporomandibular joint disorder (TMD) might be manifested as structural changes in bone through modification, adaptation or direct destruction. We propose to use Local Binary Pattern (LBP) characteristics and histogram-oriented gradients on the recorded images as a diagnostic tool in TMD assessment. CBCT images of 66 patients (132 joints) with TMD and 66 normal cases (132 joints) were collected and 2 coronal cut prepared from each condyle, although images were limited to head of mandibular condyle. In order to extract features of images, first we use LBP and then histogram of oriented gradients. To reduce dimensionality, the linear algebra Singular Value Decomposition (SVD) is applied to the feature vectors matrix of all images. For evaluation, we used K nearest neighbor (K-NN), Support Vector Machine, Naïve Bayesian and Random Forest classifiers. We used Receiver Operating Characteristic (ROC) to evaluate the hypothesis. K nearest neighbor classifier achieves a very good accuracy (0.9242), moreover, it has desirable sensitivity (0.9470) and specificity (0.9015) results, when other classifiers have lower accuracy, sensitivity and specificity. We proposed a fully automatic approach to detect TMD using image processing techniques based on local binary patterns and feature extraction. K-NN has been the best classifier for our experiments in detecting patients from healthy individuals, by 92.42% accuracy, 94.70% sensitivity and 90.15% specificity. The proposed method can help automatically diagnose TMD at its initial stages.

Efficient Spatio-Temporal Local Binary Patterns for Spontaneous Facial Micro-Expression Recognition

PubMed Central

Wang, Yandan; See, John; Phan, Raphael C.-W.; Oh, Yee-Hui

2015-01-01

Micro-expression recognition is still in the preliminary stage, owing much to the numerous difficulties faced in the development of datasets. Since micro-expression is an important affective clue for clinical diagnosis and deceit analysis, much effort has gone into the creation of these datasets for research purposes. There are currently two publicly available spontaneous micro-expression datasets—SMIC and CASME II, both with baseline results released using the widely used dynamic texture descriptor LBP-TOP for feature extraction. Although LBP-TOP is popular and widely used, it is still not compact enough. In this paper, we draw further inspiration from the concept of LBP-TOP that considers three orthogonal planes by proposing two efficient approaches for feature extraction. The compact robust form described by the proposed LBP-Six Intersection Points (SIP) and a super-compact LBP-Three Mean Orthogonal Planes (MOP) not only preserves the essential patterns, but also reduces the redundancy that affects the discriminality of the encoded features. Through a comprehensive set of experiments, we demonstrate the strengths of our approaches in terms of recognition accuracy and efficiency. PMID:25993498

Classification of molecular structure images by using ANN, RF, LBP, HOG, and size reduction methods for early stomach cancer detection

NASA Astrophysics Data System (ADS)

Aytaç Korkmaz, Sevcan; Binol, Hamidullah

2018-03-01

Patients who die from stomach cancer are still present. Early diagnosis is crucial in reducing the mortality rate of cancer patients. Therefore, computer aided methods have been developed for early detection in this article. Stomach cancer images were obtained from Fırat University Medical Faculty Pathology Department. The Local Binary Patterns (LBP) and Histogram of Oriented Gradients (HOG) features of these images are calculated. At the same time, Sammon mapping, Stochastic Neighbor Embedding (SNE), Isomap, Classical multidimensional scaling (MDS), Local Linear Embedding (LLE), Linear Discriminant Analysis (LDA), t-Distributed Stochastic Neighbor Embedding (t-SNE), and Laplacian Eigenmaps methods are used for dimensional the reduction of the features. The high dimension of these features has been reduced to lower dimensions using dimensional reduction methods. Artificial neural networks (ANN) and Random Forest (RF) classifiers were used to classify stomach cancer images with these new lower feature sizes. New medical systems have developed to measure the effects of these dimensions by obtaining features in different dimensional with dimensional reduction methods. When all the methods developed are compared, it has been found that the best accuracy results are obtained with LBP_MDS_ANN and LBP_LLE_ANN methods.

A new texture descriptor based on local micro-pattern for detection of architectural distortion in mammographic images

NASA Astrophysics Data System (ADS)

de Oliveira, Helder C. R.; Moraes, Diego R.; Reche, Gustavo A.; Borges, Lucas R.; Catani, Juliana H.; de Barros, Nestor; Melo, Carlos F. E.; Gonzaga, Adilson; Vieira, Marcelo A. C.

2017-03-01

This paper presents a new local micro-pattern texture descriptor for the detection of Architectural Distortion (AD) in digital mammography images. AD is a subtle contraction of breast parenchyma that may represent an early sign of breast cancer. Due to its subtlety and variability, AD is more difficult to detect compared to microcalcifications and masses, and is commonly found in retrospective evaluations of false-negative mammograms. Several computer-based systems have been proposed for automatic detection of AD, but their performance are still unsatisfactory. The proposed descriptor, Local Mapped Pattern (LMP), is a generalization of the Local Binary Pattern (LBP), which is considered one of the most powerful feature descriptor for texture classification in digital images. Compared to LBP, the LMP descriptor captures more effectively the minor differences between the local image pixels. Moreover, LMP is a parametric model which can be optimized for the desired application. In our work, the LMP performance was compared to the LBP and four Haralick's texture descriptors for the classification of 400 regions of interest (ROIs) extracted from clinical mammograms. ROIs were selected and divided into four classes: AD, normal tissue, microcalcifications and masses. Feature vectors were used as input to a multilayer perceptron neural network, with a single hidden layer. Results showed that LMP is a good descriptor to distinguish AD from other anomalies in digital mammography. LMP performance was slightly better than the LBP and comparable to Haralick's descriptors (mean classification accuracy = 83%).

Uterus segmentation in dynamic MRI using LBP texture descriptors

NASA Astrophysics Data System (ADS)

Namias, R.; Bellemare, M.-E.; Rahim, M.; Pirró, N.

2014-03-01

Pelvic floor disorders cover pathologies of which physiopathology is not well understood. However cases get prevalent with an ageing population. Within the context of a project aiming at modelization of the dynamics of pelvic organs, we have developed an efficient segmentation process. It aims at alleviating the radiologist with a tedious one by one image analysis. From a first contour delineating the uterus-vagina set, the organ border is tracked along a dynamic mri sequence. The process combines movement prediction, local intensity and texture analysis and active contour geometry control. Movement prediction allows a contour intitialization for next image in the sequence. Intensity analysis provides image-based local contour detection enhanced by local binary pattern (lbp) texture descriptors. Geometry control prohibits self intersections and smoothes the contour. Results show the efficiency of the method with images produced in clinical routine.

Quantitative analysis of facial paralysis using local binary patterns in biomedical videos.

PubMed

He, Shu; Soraghan, John J; O'Reilly, Brian F; Xing, Dongshan

2009-07-01

Facial paralysis is the loss of voluntary muscle movement of one side of the face. A quantitative, objective, and reliable assessment system would be an invaluable tool for clinicians treating patients with this condition. This paper presents a novel framework for objective measurement of facial paralysis. The motion information in the horizontal and vertical directions and the appearance features on the apex frames are extracted based on the local binary patterns (LBPs) on the temporal-spatial domain in each facial region. These features are temporally and spatially enhanced by the application of novel block processing schemes. A multiresolution extension of uniform LBP is proposed to efficiently combine the micropatterns and large-scale patterns into a feature vector. The symmetry of facial movements is measured by the resistor-average distance (RAD) between LBP features extracted from the two sides of the face. Support vector machine is applied to provide quantitative evaluation of facial paralysis based on the House-Brackmann (H-B) scale. The proposed method is validated by experiments with 197 subject videos, which demonstrates its accuracy and efficiency.

Topological image texture analysis for quality assessment

NASA Astrophysics Data System (ADS)

Asaad, Aras T.; Rashid, Rasber Dh.; Jassim, Sabah A.

2017-05-01

Image quality is a major factor influencing pattern recognition accuracy and help detect image tampering for forensics. We are concerned with investigating topological image texture analysis techniques to assess different type of degradation. We use Local Binary Pattern (LBP) as a texture feature descriptor. For any image construct simplicial complexes for selected groups of uniform LBP bins and calculate persistent homology invariants (e.g. number of connected components). We investigated image quality discriminating characteristics of these simplicial complexes by computing these models for a large dataset of face images that are affected by the presence of shadows as a result of variation in illumination conditions. Our tests demonstrate that for specific uniform LBP patterns, the number of connected component not only distinguish between different levels of shadow effects but also help detect the infected regions as well.

A change detection method for remote sensing image based on LBP and SURF feature

NASA Astrophysics Data System (ADS)

Hu, Lei; Yang, Hao; Li, Jin; Zhang, Yun

2018-04-01

Finding the change in multi-temporal remote sensing image is important in many the image application. Because of the infection of climate and illumination, the texture of the ground object is more stable relative to the gray in high-resolution remote sensing image. And the texture features of Local Binary Patterns (LBP) and Speeded Up Robust Features (SURF) are outstanding in extracting speed and illumination invariance. A method of change detection for matched remote sensing image pair is present, which compares the similarity by LBP and SURF to detect the change and unchanged of the block after blocking the image. And region growing is adopted to process the block edge zone. The experiment results show that the method can endure some illumination change and slight texture change of the ground object.

Local intensity area descriptor for facial recognition in ideal and noise conditions

NASA Astrophysics Data System (ADS)

Tran, Chi-Kien; Tseng, Chin-Dar; Chao, Pei-Ju; Ting, Hui-Min; Chang, Liyun; Huang, Yu-Jie; Lee, Tsair-Fwu

2017-03-01

We propose a local texture descriptor, local intensity area descriptor (LIAD), which is applied for human facial recognition in ideal and noisy conditions. Each facial image is divided into small regions from which LIAD histograms are extracted and concatenated into a single feature vector to represent the facial image. The recognition is performed using a nearest neighbor classifier with histogram intersection and chi-square statistics as dissimilarity measures. Experiments were conducted with LIAD using the ORL database of faces (Olivetti Research Laboratory, Cambridge), the Face94 face database, the Georgia Tech face database, and the FERET database. The results demonstrated the improvement in accuracy of our proposed descriptor compared to conventional descriptors [local binary pattern (LBP), uniform LBP, local ternary pattern, histogram of oriented gradients, and local directional pattern]. Moreover, the proposed descriptor was less sensitive to noise and had low histogram dimensionality. Thus, it is expected to be a powerful texture descriptor that can be used for various computer vision problems.

New Finger Biometric Method Using Near Infrared Imaging

PubMed Central

Lee, Eui Chul; Jung, Hyunwoo; Kim, Daeyeoul

2011-01-01

In this paper, we propose a new finger biometric method. Infrared finger images are first captured, and then feature extraction is performed using a modified Gaussian high-pass filter through binarization, local binary pattern (LBP), and local derivative pattern (LDP) methods. Infrared finger images include the multimodal features of finger veins and finger geometries. Instead of extracting each feature using different methods, the modified Gaussian high-pass filter is fully convolved. Therefore, the extracted binary patterns of finger images include the multimodal features of veins and finger geometries. Experimental results show that the proposed method has an error rate of 0.13%. PMID:22163741

LBP-based penalized weighted least-squares approach to low-dose cone-beam computed tomography reconstruction

NASA Astrophysics Data System (ADS)

Ma, Ming; Wang, Huafeng; Liu, Yan; Zhang, Hao; Gu, Xianfeng; Liang, Zhengrong

2014-03-01

Cone-beam computed tomography (CBCT) has attracted growing interest of researchers in image reconstruction. The mAs level of the X-ray tube current, in practical application of CBCT, is mitigated in order to reduce the CBCT dose. The lowering of the X-ray tube current, however, results in the degradation of image quality. Thus, low-dose CBCT image reconstruction is in effect a noise problem. To acquire clinically acceptable quality of image, and keep the X-ray tube current as low as achievable in the meanwhile, some penalized weighted least-squares (PWLS)-based image reconstruction algorithms have been developed. One representative strategy in previous work is to model the prior information for solution regularization using an anisotropic penalty term. To enhance the edge preserving and noise suppressing in a finer scale, a novel algorithm combining the local binary pattern (LBP) with penalized weighted leastsquares (PWLS), called LBP-PWLS-based image reconstruction algorithm, is proposed in this work. The proposed LBP-PWLS-based algorithm adaptively encourages strong diffusion on the local spot/flat region around a voxel and less diffusion on edge/corner ones by adjusting the penalty for cost function, after the LBP is utilized to detect the region around the voxel as spot, flat and edge ones. The LBP-PWLS-based reconstruction algorithm was evaluated using the sinogram data acquired by a clinical CT scanner from the CatPhan® 600 phantom. Experimental results on the noiseresolution tradeoff measurement and other quantitative measurements demonstrated its feasibility and effectiveness in edge preserving and noise suppressing in comparison with a previous PWLS reconstruction algorithm.

Diagnosis of Tempromandibular Disorders Using Local Binary Patterns

PubMed Central

Haghnegahdar, A.A.; Kolahi, S.; Khojastepour, L.; Tajeripour, F.

2018-01-01

Background: Temporomandibular joint disorder (TMD) might be manifested as structural changes in bone through modification, adaptation or direct destruction. We propose to use Local Binary Pattern (LBP) characteristics and histogram-oriented gradients on the recorded images as a diagnostic tool in TMD assessment. Material and Methods: CBCT images of 66 patients (132 joints) with TMD and 66 normal cases (132 joints) were collected and 2 coronal cut prepared from each condyle, although images were limited to head of mandibular condyle. In order to extract features of images, first we use LBP and then histogram of oriented gradients. To reduce dimensionality, the linear algebra Singular Value Decomposition (SVD) is applied to the feature vectors matrix of all images. For evaluation, we used K nearest neighbor (K-NN), Support Vector Machine, Naïve Bayesian and Random Forest classifiers. We used Receiver Operating Characteristic (ROC) to evaluate the hypothesis. Results: K nearest neighbor classifier achieves a very good accuracy (0.9242), moreover, it has desirable sensitivity (0.9470) and specificity (0.9015) results, when other classifiers have lower accuracy, sensitivity and specificity. Conclusion: We proposed a fully automatic approach to detect TMD using image processing techniques based on local binary patterns and feature extraction. K-NN has been the best classifier for our experiments in detecting patients from healthy individuals, by 92.42% accuracy, 94.70% sensitivity and 90.15% specificity. The proposed method can help automatically diagnose TMD at its initial stages. PMID:29732343

Local binary pattern texture-based classification of solid masses in ultrasound breast images

NASA Astrophysics Data System (ADS)

Matsumoto, Monica M. S.; Sehgal, Chandra M.; Udupa, Jayaram K.

2012-03-01

Breast cancer is one of the leading causes of cancer mortality among women. Ultrasound examination can be used to assess breast masses, complementarily to mammography. Ultrasound images reveal tissue information in its echoic patterns. Therefore, pattern recognition techniques can facilitate classification of lesions and thereby reduce the number of unnecessary biopsies. Our hypothesis was that image texture features on the boundary of a lesion and its vicinity can be used to classify masses. We have used intensity-independent and rotation-invariant texture features, known as Local Binary Patterns (LBP). The classifier selected was K-nearest neighbors. Our breast ultrasound image database consisted of 100 patient images (50 benign and 50 malignant cases). The determination of whether the mass was benign or malignant was done through biopsy and pathology assessment. The training set consisted of sixty images, randomly chosen from the database of 100 patients. The testing set consisted of forty images to be classified. The results with a multi-fold cross validation of 100 iterations produced a robust evaluation. The highest performance was observed for feature LBP with 24 symmetrically distributed neighbors over a circle of radius 3 (LBP24,3) with an accuracy rate of 81.0%. We also investigated an approach with a score of malignancy assigned to the images in the test set. This approach provided an ROC curve with Az of 0.803. The analysis of texture features over the boundary of solid masses showed promise for malignancy classification in ultrasound breast images.

Low-resolution expression recognition based on central oblique average CS-LBP with adaptive threshold

NASA Astrophysics Data System (ADS)

Han, Sheng; Xi, Shi-qiong; Geng, Wei-dong

2017-11-01

In order to solve the problem of low recognition rate of traditional feature extraction operators under low-resolution images, a novel algorithm of expression recognition is proposed, named central oblique average center-symmetric local binary pattern (CS-LBP) with adaptive threshold (ATCS-LBP). Firstly, the features of face images can be extracted by the proposed operator after pretreatment. Secondly, the obtained feature image is divided into blocks. Thirdly, the histogram of each block is computed independently and all histograms can be connected serially to create a final feature vector. Finally, expression classification is achieved by using support vector machine (SVM) classifier. Experimental results on Japanese female facial expression (JAFFE) database show that the proposed algorithm can achieve a recognition rate of 81.9% when the resolution is as low as 16×16, which is much better than that of the traditional feature extraction operators.

An embedded face-classification system for infrared images on an FPGA

NASA Astrophysics Data System (ADS)

Soto, Javier E.; Figueroa, Miguel

2014-10-01

We present a face-classification architecture for long-wave infrared (IR) images implemented on a Field Programmable Gate Array (FPGA). The circuit is fast, compact and low power, can recognize faces in real time and be embedded in a larger image-processing and computer vision system operating locally on an IR camera. The algorithm uses Local Binary Patterns (LBP) to perform feature extraction on each IR image. First, each pixel in the image is represented as an LBP pattern that encodes the similarity between the pixel and its neighbors. Uniform LBP codes are then used to reduce the number of patterns to 59 while preserving more than 90% of the information contained in the original LBP representation. Then, the image is divided into 64 non-overlapping regions, and each region is represented as a 59-bin histogram of patterns. Finally, the algorithm concatenates all 64 regions to create a 3,776-bin spatially enhanced histogram. We reduce the dimensionality of this histogram using Linear Discriminant Analysis (LDA), which improves clustering and enables us to store an entire database of 53 subjects on-chip. During classification, the circuit applies LBP and LDA to each incoming IR image in real time, and compares the resulting feature vector to each pattern stored in the local database using the Manhattan distance. We implemented the circuit on a Xilinx Artix-7 XC7A100T FPGA and tested it with the UCHThermalFace database, which consists of 28 81 x 150-pixel images of 53 subjects in indoor and outdoor conditions. The circuit achieves a 98.6% hit ratio, trained with 16 images and tested with 12 images of each subject in the database. Using a 100 MHz clock, the circuit classifies 8,230 images per second, and consumes only 309mW.

Glaucoma detection based on local binary patterns in fundus photographs

NASA Astrophysics Data System (ADS)

Alsheh Ali, Maya; Hurtut, Thomas; Faucon, Timothée.; Cheriet, Farida

2014-03-01

Glaucoma, a group of diseases that lead to optic neuropathy, is one of the most common reasons for blindness worldwide. Glaucoma rarely causes symptoms until the later stages of the disease. Early detection of glaucoma is very important to prevent visual loss since optic nerve damages cannot be reversed. To detect glaucoma, purely data-driven techniques have advantages, especially when the disease characteristics are complex and when precise image-based measurements are difficult to obtain. In this paper, we present our preliminary study for glaucoma detection using an automatic method based on local texture features extracted from fundus photographs. It implements the completed modeling of Local Binary Patterns to capture representative texture features from the whole image. A local region is represented by three operators: its central pixel (LBPC) and its local differences as two complementary components, the sign (which is the classical LBP) and the magnitude (LBPM). An image texture is finally described by both the distribution of LBP and the joint-distribution of LBPM and LBPC. Our images are then classified using a nearest-neighbor method with a leave-one-out validation strategy. On a sample set of 41 fundus images (13 glaucomatous, 28 non-glaucomatous), our method achieves 95:1% success rate with a specificity of 92:3% and a sensitivity of 96:4%. This study proposes a reproducible glaucoma detection process that could be used in a low-priced medical screening, thus avoiding the inter-experts variability issue.

Learning Compact Binary Face Descriptor for Face Recognition.

PubMed

Lu, Jiwen; Liong, Venice Erin; Zhou, Xiuzhuang; Zhou, Jie

2015-10-01

Binary feature descriptors such as local binary patterns (LBP) and its variations have been widely used in many face recognition systems due to their excellent robustness and strong discriminative power. However, most existing binary face descriptors are hand-crafted, which require strong prior knowledge to engineer them by hand. In this paper, we propose a compact binary face descriptor (CBFD) feature learning method for face representation and recognition. Given each face image, we first extract pixel difference vectors (PDVs) in local patches by computing the difference between each pixel and its neighboring pixels. Then, we learn a feature mapping to project these pixel difference vectors into low-dimensional binary vectors in an unsupervised manner, where 1) the variance of all binary codes in the training set is maximized, 2) the loss between the original real-valued codes and the learned binary codes is minimized, and 3) binary codes evenly distribute at each learned bin, so that the redundancy information in PDVs is removed and compact binary codes are obtained. Lastly, we cluster and pool these binary codes into a histogram feature as the final representation for each face image. Moreover, we propose a coupled CBFD (C-CBFD) method by reducing the modality gap of heterogeneous faces at the feature level to make our method applicable to heterogeneous face recognition. Extensive experimental results on five widely used face datasets show that our methods outperform state-of-the-art face descriptors.

SU-F-J-207: Non-Small Cell Lung Cancer Patient Survival Prediction with Quantitative Tumor Textures Analysis in Baseline CT

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

Wu, Y; Zou, J; Murillo, P

Purpose: Chemo-radiation therapy (CRT) is widely used in treating patients with locally advanced non-small cell lung cancer (NSCLC). Determination of the likelihood of patient response to treatment and optimization of treatment regime is of clinical significance. Up to date, no imaging biomarker has reliably correlated to NSCLC patient survival rate. This pilot study is to extract CT texture information from tumor regions for patient survival prediction. Methods: Thirteen patients with stage II-III NSCLC were treated using CRT with a median dose of 6210 cGy. Non-contrast-enhanced CT images were acquired for treatment planning and retrospectively collected for this study. Texture analysismore » was applied in segmented tumor regions using the Local Binary Pattern method (LBP). By comparing its HU with neighboring voxels, the LBPs of a voxel were measured in multiple scales with different group radiuses and numbers of neighbors. The LBP histograms formed a multi-dimensional texture vector for each patient, which was then used to establish and test a Support Vector Machine (SVM) model to predict patients’ one year survival. The leave-one-out cross validation strategy was used recursively to enlarge the training set and derive a reliable predictor. The predictions were compared with the true clinical outcomes. Results: A 10-dimensional LBP histogram was extracted from 3D segmented tumor region for each of the 13 patients. Using the SVM model with the leave-one-out strategy, only 1 out of 13 patients was misclassified. The experiments showed an accuracy of 93%, sensitivity of 100%, and specificity of 86%. Conclusion: Within the framework of a Support Vector Machine based model, the Local Binary Pattern method is able to extract a quantitative imaging biomarker in the prediction of NSCLC patient survival. More patients are to be included in the study.« less

Hidden pattern discovery on epileptic EEG with 1-D local binary patterns and epileptic seizures detection by grey relational analysis.

PubMed

Kaya, Yılmaz

2015-09-01

This paper proposes a novel approach to detect epilepsy seizures by using Electroencephalography (EEG), which is one of the most common methods for the diagnosis of epilepsy, based on 1-Dimension Local Binary Pattern (1D-LBP) and grey relational analysis (GRA) methods. The main aim of this paper is to evaluate and validate a novel approach, which is a computer-based quantitative EEG analyzing method and based on grey systems, aimed to help decision-maker. In this study, 1D-LBP, which utilizes all data points, was employed for extracting features in raw EEG signals, Fisher score (FS) was employed to select the representative features, which can also be determined as hidden patterns. Additionally, GRA is performed to classify EEG signals through these Fisher scored features. The experimental results of the proposed approach, which was employed in a public dataset for validation, showed that it has a high accuracy in identifying epileptic EEG signals. For various combinations of epileptic EEG, such as A-E, B-E, C-E, D-E, and A-D clusters, 100, 96, 100, 99.00 and 100% were achieved, respectively. Also, this work presents an attempt to develop a new general-purpose hidden pattern determination scheme, which can be utilized for different categories of time-varying signals.

Scattering features for lung cancer detection in fibered confocal fluorescence microscopy images.

PubMed

Rakotomamonjy, Alain; Petitjean, Caroline; Salaün, Mathieu; Thiberville, Luc

2014-06-01

To assess the feasibility of lung cancer diagnosis using fibered confocal fluorescence microscopy (FCFM) imaging technique and scattering features for pattern recognition. FCFM imaging technique is a new medical imaging technique for which interest has yet to be established for diagnosis. This paper addresses the problem of lung cancer detection using FCFM images and, as a first contribution, assesses the feasibility of computer-aided diagnosis through these images. Towards this aim, we have built a pattern recognition scheme which involves a feature extraction stage and a classification stage. The second contribution relies on the features used for discrimination. Indeed, we have employed the so-called scattering transform for extracting discriminative features, which are robust to small deformations in the images. We have also compared and combined these features with classical yet powerful features like local binary patterns (LBP) and their variants denoted as local quinary patterns (LQP). We show that scattering features yielded to better recognition performances than classical features like LBP and their LQP variants for the FCFM image classification problems. Another finding is that LBP-based and scattering-based features provide complementary discriminative information and, in some situations, we empirically establish that performance can be improved when jointly using LBP, LQP and scattering features. In this work we analyze the joint capability of FCFM images and scattering features for lung cancer diagnosis. The proposed method achieves a good recognition rate for such a diagnosis problem. It also performs well when used in conjunction with other features for other classical medical imaging classification problems. Copyright © 2014 Elsevier B.V. All rights reserved.

Non-specific low back pain: occupational or lifestyle consequences?

PubMed

Stričević, Jadranka; Papež, Breda Jesenšek

2015-12-01

Nursing occupation was identified as a risk occupation for the development of low back pain (LBP). The aim of our study was to find out how much occupational factors influence the development of LBP in hospital nursing personnel. Non-experimental approach with a cross-sectional survey and statistical analysis. Nine hundred questionnaires were distributed among nursing personnel, 663 were returned and 659 (73.2 %) were considered for the analysis. Univariate and multivariate statistics for LBP risk was calculated by the binary logistic regression. The χ(2), influence factor, 95 % confidence interval and P value were calculated. Multivariate binary logistic regression was calculated by the Wald method to omit insignificant variables. Not performing exercises represented the highest risk for the development of LBP (OR 2.8, 95 % CI 1.7-4.4; p < 0.001). The second and third ranked risk factors were frequent manual lifting > 10 kg (OR 2.4, 95 % CI 1.5-3.8; p < 0.001) and duration of employment ≥ 19 years (OR 2.4, 95 % CI 1.6-3.7; p < 0.001). The fourth ranked risk factor was better physical condition by frequent recreation and sports, which reduced the risk for the development of LBP (OR 0.4, 95 % CI 0.3-0.7; p = 0.001). Work with the computer ≥ 2 h per day as last significant risk factor also reduced the risk for the development of LBP (OR 0.6, 95 % CI 0.4-0.1; p = 0.049). Risk factors for LBP established in our study (exercises, duration of employment, frequent manual lifting, recreation and sports and work with the computer) are not specifically linked to the working environment of the nursing personnel. Rather than focusing on mechanical causes and direct workload in the development of non-specific LBP, the complex approach to LBP including genetics, psychosocial environment, lifestyle and quality of life is coming more to the fore.

Binary patterns encoded convolutional neural networks for texture recognition and remote sensing scene classification

NASA Astrophysics Data System (ADS)

Anwer, Rao Muhammad; Khan, Fahad Shahbaz; van de Weijer, Joost; Molinier, Matthieu; Laaksonen, Jorma

2018-04-01

Designing discriminative powerful texture features robust to realistic imaging conditions is a challenging computer vision problem with many applications, including material recognition and analysis of satellite or aerial imagery. In the past, most texture description approaches were based on dense orderless statistical distribution of local features. However, most recent approaches to texture recognition and remote sensing scene classification are based on Convolutional Neural Networks (CNNs). The de facto practice when learning these CNN models is to use RGB patches as input with training performed on large amounts of labeled data (ImageNet). In this paper, we show that Local Binary Patterns (LBP) encoded CNN models, codenamed TEX-Nets, trained using mapped coded images with explicit LBP based texture information provide complementary information to the standard RGB deep models. Additionally, two deep architectures, namely early and late fusion, are investigated to combine the texture and color information. To the best of our knowledge, we are the first to investigate Binary Patterns encoded CNNs and different deep network fusion architectures for texture recognition and remote sensing scene classification. We perform comprehensive experiments on four texture recognition datasets and four remote sensing scene classification benchmarks: UC-Merced with 21 scene categories, WHU-RS19 with 19 scene classes, RSSCN7 with 7 categories and the recently introduced large scale aerial image dataset (AID) with 30 aerial scene types. We demonstrate that TEX-Nets provide complementary information to standard RGB deep model of the same network architecture. Our late fusion TEX-Net architecture always improves the overall performance compared to the standard RGB network on both recognition problems. Furthermore, our final combination leads to consistent improvement over the state-of-the-art for remote sensing scene classification.

Benign-malignant mass classification in mammogram using edge weighted local texture features

NASA Astrophysics Data System (ADS)

Rabidas, Rinku; Midya, Abhishek; Sadhu, Anup; Chakraborty, Jayasree

2016-03-01

This paper introduces novel Discriminative Robust Local Binary Pattern (DRLBP) and Discriminative Robust Local Ternary Pattern (DRLTP) for the classification of mammographic masses as benign or malignant. Mass is one of the common, however, challenging evidence of breast cancer in mammography and diagnosis of masses is a difficult task. Since DRLBP and DRLTP overcome the drawbacks of Local Binary Pattern (LBP) and Local Ternary Pattern (LTP) by discriminating a brighter object against the dark background and vice-versa, in addition to the preservation of the edge information along with the texture information, several edge-preserving texture features are extracted, in this study, from DRLBP and DRLTP. Finally, a Fisher Linear Discriminant Analysis method is incorporated with discriminating features, selected by stepwise logistic regression method, for the classification of benign and malignant masses. The performance characteristics of DRLBP and DRLTP features are evaluated using a ten-fold cross-validation technique with 58 masses from the mini-MIAS database, and the best result is observed with DRLBP having an area under the receiver operating characteristic curve of 0.982.

Face verification system for Android mobile devices using histogram based features

NASA Astrophysics Data System (ADS)

Sato, Sho; Kobayashi, Kazuhiro; Chen, Qiu

2016-07-01

This paper proposes a face verification system that runs on Android mobile devices. In this system, facial image is captured by a built-in camera on the Android device firstly, and then face detection is implemented using Haar-like features and AdaBoost learning algorithm. The proposed system verify the detected face using histogram based features, which are generated by binary Vector Quantization (VQ) histogram using DCT coefficients in low frequency domains, as well as Improved Local Binary Pattern (Improved LBP) histogram in spatial domain. Verification results with different type of histogram based features are first obtained separately and then combined by weighted averaging. We evaluate our proposed algorithm by using publicly available ORL database and facial images captured by an Android tablet.

Composite multi-lobe descriptor for cross spectral face recognition: matching active IR to visible light images

NASA Astrophysics Data System (ADS)

Cao, Zhicheng; Schmid, Natalia A.

2015-05-01

Matching facial images across electromagnetic spectrum presents a challenging problem in the field of biometrics and identity management. An example of this problem includes cross spectral matching of active infrared (IR) face images or thermal IR face images against a dataset of visible light images. This paper describes a new operator named Composite Multi-Lobe Descriptor (CMLD) for facial feature extraction in cross spectral matching of near-infrared (NIR) or short-wave infrared (SWIR) against visible light images. The new operator is inspired by the design of ordinal measures. The operator combines Gaussian-based multi-lobe kernel functions, Local Binary Pattern (LBP), generalized LBP (GLBP) and Weber Local Descriptor (WLD) and modifies them into multi-lobe functions with smoothed neighborhoods. The new operator encodes both the magnitude and phase responses of Gabor filters. The combining of LBP and WLD utilizes both the orientation and intensity information of edges. Introduction of multi-lobe functions with smoothed neighborhoods further makes the proposed operator robust against noise and poor image quality. Output templates are transformed into histograms and then compared by means of a symmetric Kullback-Leibler metric resulting in a matching score. The performance of the multi-lobe descriptor is compared with that of other operators such as LBP, Histogram of Oriented Gradients (HOG), ordinal measures, and their combinations. The experimental results show that in many cases the proposed method, CMLD, outperforms the other operators and their combinations. In addition to different infrared spectra, various standoff distances from close-up (1.5 m) to intermediate (50 m) and long (106 m) are also investigated in this paper. Performance of CMLD is evaluated for of each of the three cases of distances.

A comparison of blood vessel features and local binary patterns for colorectal polyp classification

NASA Astrophysics Data System (ADS)

Gross, Sebastian; Stehle, Thomas; Behrens, Alexander; Auer, Roland; Aach, Til; Winograd, Ron; Trautwein, Christian; Tischendorf, Jens

2009-02-01

Colorectal cancer is the third leading cause of cancer deaths in the United States of America for both women and men. By means of early detection, the five year survival rate can be up to 90%. Polyps can to be grouped into three different classes: hyperplastic, adenomatous, and carcinomatous polyps. Hyperplastic polyps are benign and are not likely to develop into cancer. Adenomas, on the other hand, are known to grow into cancer (adenoma-carcinoma sequence). Carcinomas are fully developed cancers and can be easily distinguished from adenomas and hyperplastic polyps. A recent narrow band imaging (NBI) study by Tischendorf et al. has shown that hyperplastic polyps and adenomas can be discriminated by their blood vessel structure. We designed a computer-aided system for the differentiation between hyperplastic and adenomatous polyps. Our development aim is to provide the medical practitioner with an additional objective interpretation of the available image data as well as a confidence measure for the classification. We propose classification features calculated on the basis of the extracted blood vessel structure. We use the combined length of the detected blood vessels, the average perimeter of the vessels and their average gray level value. We achieve a successful classification rate of more than 90% on 102 polyps from our polyp data base. The classification results based on these features are compared to the results of Local Binary Patterns (LBP). The results indicate that the implemented features are superior to LBP.

A Method of Character Detection and Segmentation for Highway Guide Signs

NASA Astrophysics Data System (ADS)

Xu, Jiawei; Zhang, Chongyang

2018-01-01

In this paper, a method of character detection and segmentation for highway signs in China is proposed. It consists of four steps. Firstly, the highway sign area is detectedby colour and geometric features, andthe possible character region is obtained by multi-level projection strategy. Secondly, pseudo target character region is removed by local binary patterns (LBP) feature. Thirdly, convolutional neural network (CNN)is used to classify target regions. Finally, adaptive projection strategies are used to segment characters strings. Experimental results indicate that the proposed method achieves new state-of-the-art results.

LBP based detection of intestinal motility in WCE images

NASA Astrophysics Data System (ADS)

Gallo, Giovanni; Granata, Eliana

2011-03-01

In this research study, a system to support medical analysis of intestinal contractions by processing WCE images is presented. Small intestine contractions are among the motility patterns which reveal many gastrointestinal disorders, such as functional dyspepsia, paralytic ileus, irritable bowel syndrome, bacterial overgrowth. The images have been obtained using the Wireless Capsule Endoscopy (WCE) technique, a patented, video colorimaging disposable capsule. Manual annotation of contractions is an elaborating task, since the recording device of the capsule stores about 50,000 images and contractions might represent only the 1% of the whole video. In this paper we propose the use of Local Binary Pattern (LBP) combined with the powerful textons statistics to find the frames of the video related to contractions. We achieve a sensitivity of about 80% and a specificity of about 99%. The achieved high detection accuracy of the proposed system has provided thus an indication that such intelligent schemes could be used as a supplementary diagnostic tool in endoscopy.

The Research of Feature Extraction Method of Liver Pathological Image Based on Multispatial Mapping and Statistical Properties

PubMed Central

Liu, Huiling; Xia, Bingbing; Yi, Dehui

2016-01-01

We propose a new feature extraction method of liver pathological image based on multispatial mapping and statistical properties. For liver pathological images of Hematein Eosin staining, the image of R and B channels can reflect the sensitivity of liver pathological images better, while the entropy space and Local Binary Pattern (LBP) space can reflect the texture features of the image better. To obtain the more comprehensive information, we map liver pathological images to the entropy space, LBP space, R space, and B space. The traditional Higher Order Local Autocorrelation Coefficients (HLAC) cannot reflect the overall information of the image, so we propose an average correction HLAC feature. We calculate the statistical properties and the average gray value of pathological images and then update the current pixel value as the absolute value of the difference between the current pixel gray value and the average gray value, which can be more sensitive to the gray value changes of pathological images. Lastly the HLAC template is used to calculate the features of the updated image. The experiment results show that the improved features of the multispatial mapping have the better classification performance for the liver cancer. PMID:27022407

Chronic Low Back Pain in Young Korean Urban Males: The Life-Time Prevalence and Its Impact on Health Related Quality of Life

PubMed Central

Shim, Jae-Hyun; Yoon, Sang-Young; Lee, Chang-Hoon; Doh, Jae-Won; Bae, Hack-Gun

2014-01-01

Objective We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health. PMID:25628807

Convolution Comparison Pattern: An Efficient Local Image Descriptor for Fingerprint Liveness Detection

PubMed Central

Gottschlich, Carsten

2016-01-01

We present a new type of local image descriptor which yields binary patterns from small image patches. For the application to fingerprint liveness detection, we achieve rotation invariant image patches by taking the fingerprint segmentation and orientation field into account. We compute the discrete cosine transform (DCT) for these rotation invariant patches and attain binary patterns by comparing pairs of two DCT coefficients. These patterns are summarized into one or more histograms per image. Each histogram comprises the relative frequencies of pattern occurrences. Multiple histograms are concatenated and the resulting feature vector is used for image classification. We name this novel type of descriptor convolution comparison pattern (CCP). Experimental results show the usefulness of the proposed CCP descriptor for fingerprint liveness detection. CCP outperforms other local image descriptors such as LBP, LPQ and WLD on the LivDet 2013 benchmark. The CCP descriptor is a general type of local image descriptor which we expect to prove useful in areas beyond fingerprint liveness detection such as biological and medical image processing, texture recognition, face recognition and iris recognition, liveness detection for face and iris images, and machine vision for surface inspection and material classification. PMID:26844544

Comparative Evaluation of Pavement Crack Detection Using Kernel-Based Techniques in Asphalt Road Surfaces

NASA Astrophysics Data System (ADS)

Miraliakbari, A.; Sok, S.; Ouma, Y. O.; Hahn, M.

2016-06-01

With the increasing demand for the digital survey and acquisition of road pavement conditions, there is also the parallel growing need for the development of automated techniques for the analysis and evaluation of the actual road conditions. This is due in part to the resulting large volumes of road pavement data captured through digital surveys, and also to the requirements for rapid data processing and evaluations. In this study, the Canon 5D Mark II RGB camera with a resolution of 21 megapixels is used for the road pavement condition mapping. Even though many imaging and mapping sensors are available, the development of automated pavement distress detection, recognition and extraction systems for pavement condition is still a challenge. In order to detect and extract pavement cracks, a comparative evaluation of kernel-based segmentation methods comprising line filtering (LF), local binary pattern (LBP) and high-pass filtering (HPF) is carried out. While the LF and LBP methods are based on the principle of rotation-invariance for pattern matching, the HPF applies the same principle for filtering, but with a rotational invariant matrix. With respect to the processing speeds, HPF is fastest due to the fact that it is based on a single kernel, as compared to LF and LBP which are based on several kernels. Experiments with 20 sample images which contain linear, block and alligator cracks are carried out. On an average a completeness of distress extraction with values of 81.2%, 76.2% and 81.1% have been found for LF, HPF and LBP respectively.

Automated artifact detection and removal for improved tensor estimation in motion-corrupted DTI data sets using the combination of local binary patterns and 2D partial least squares.

PubMed

Zhou, Zhenyu; Liu, Wei; Cui, Jiali; Wang, Xunheng; Arias, Diana; Wen, Ying; Bansal, Ravi; Hao, Xuejun; Wang, Zhishun; Peterson, Bradley S; Xu, Dongrong

2011-02-01

Signal variation in diffusion-weighted images (DWIs) is influenced both by thermal noise and by spatially and temporally varying artifacts, such as rigid-body motion and cardiac pulsation. Motion artifacts are particularly prevalent when scanning difficult patient populations, such as human infants. Although some motion during data acquisition can be corrected using image coregistration procedures, frequently individual DWIs are corrupted beyond repair by sudden, large amplitude motion either within or outside of the imaging plane. We propose a novel approach to identify and reject outlier images automatically using local binary patterns (LBP) and 2D partial least square (2D-PLS) to estimate diffusion tensors robustly. This method uses an enhanced LBP algorithm to extract texture features from a local texture feature of the image matrix from the DWI data. Because the images have been transformed to local texture matrices, we are able to extract discriminating information that identifies outliers in the data set by extending a traditional one-dimensional PLS algorithm to a two-dimension operator. The class-membership matrix in this 2D-PLS algorithm is adapted to process samples that are image matrix, and the membership matrix thus represents varying degrees of importance of local information within the images. We also derive the analytic form of the generalized inverse of the class-membership matrix. We show that this method can effectively extract local features from brain images obtained from a large sample of human infants to identify images that are outliers in their textural features, permitting their exclusion from further processing when estimating tensors using the DWIs. This technique is shown to be superior in performance when compared with visual inspection and other common methods to address motion-related artifacts in DWI data. This technique is applicable to correct motion artifact in other magnetic resonance imaging (MRI) techniques (e.g., the bootstrapping estimation) that use univariate or multivariate regression methods to fit MRI data to a pre-specified model. Copyright © 2011 Elsevier Inc. All rights reserved.

Automated characterisation of ultrasound images of ovarian tumours: the diagnostic accuracy of a support vector machine and image processing with a local binary pattern operator.

PubMed

Khazendar, S; Sayasneh, A; Al-Assam, H; Du, H; Kaijser, J; Ferrara, L; Timmerman, D; Jassim, S; Bourne, T

2015-01-01

Preoperative characterisation of ovarian masses into benign or malignant is of paramount importance to optimise patient management. In this study, we developed and validated a computerised model to characterise ovarian masses as benign or malignant. Transvaginal 2D B mode static ultrasound images of 187 ovarian masses with known histological diagnosis were included. Images were first pre-processed and enhanced, and Local Binary Pattern Histograms were then extracted from 2 × 2 blocks of each image. A Support Vector Machine (SVM) was trained using stratified cross validation with randomised sampling. The process was repeated 15 times and in each round 100 images were randomly selected. The SVM classified the original non-treated static images as benign or malignant masses with an average accuracy of 0.62 (95% CI: 0.59-0.65). This performance significantly improved to an average accuracy of 0.77 (95% CI: 0.75-0.79) when images were pre-processed, enhanced and treated with a Local Binary Pattern operator (mean difference 0.15: 95% 0.11-0.19, p < 0.0001, two-tailed t test). We have shown that an SVM can classify static 2D B mode ultrasound images of ovarian masses into benign and malignant categories. The accuracy improves if texture related LBP features extracted from the images are considered.

Human tracking in thermal images using adaptive particle filters with online random forest learning

NASA Astrophysics Data System (ADS)

Ko, Byoung Chul; Kwak, Joon-Young; Nam, Jae-Yeal

2013-11-01

This paper presents a fast and robust human tracking method to use in a moving long-wave infrared thermal camera under poor illumination with the existence of shadows and cluttered backgrounds. To improve the human tracking performance while minimizing the computation time, this study proposes an online learning of classifiers based on particle filters and combination of a local intensity distribution (LID) with oriented center-symmetric local binary patterns (OCS-LBP). Specifically, we design a real-time random forest (RF), which is the ensemble of decision trees for confidence estimation, and confidences of the RF are converted into a likelihood function of the target state. First, the target model is selected by the user and particles are sampled. Then, RFs are generated using the positive and negative examples with LID and OCS-LBP features by online learning. The learned RF classifiers are used to detect the most likely target position in the subsequent frame in the next stage. Then, the RFs are learned again by means of fast retraining with the tracked object and background appearance in the new frame. The proposed algorithm is successfully applied to various thermal videos as tests and its tracking performance is better than those of other methods.

Multi-Directional Multi-Level Dual-Cross Patterns for Robust Face Recognition.

PubMed

Ding, Changxing; Choi, Jonghyun; Tao, Dacheng; Davis, Larry S

2016-03-01

To perform unconstrained face recognition robust to variations in illumination, pose and expression, this paper presents a new scheme to extract "Multi-Directional Multi-Level Dual-Cross Patterns" (MDML-DCPs) from face images. Specifically, the MDML-DCPs scheme exploits the first derivative of Gaussian operator to reduce the impact of differences in illumination and then computes the DCP feature at both the holistic and component levels. DCP is a novel face image descriptor inspired by the unique textural structure of human faces. It is computationally efficient and only doubles the cost of computing local binary patterns, yet is extremely robust to pose and expression variations. MDML-DCPs comprehensively yet efficiently encodes the invariant characteristics of a face image from multiple levels into patterns that are highly discriminative of inter-personal differences but robust to intra-personal variations. Experimental results on the FERET, CAS-PERL-R1, FRGC 2.0, and LFW databases indicate that DCP outperforms the state-of-the-art local descriptors (e.g., LBP, LTP, LPQ, POEM, tLBP, and LGXP) for both face identification and face verification tasks. More impressively, the best performance is achieved on the challenging LFW and FRGC 2.0 databases by deploying MDML-DCPs in a simple recognition scheme.

Dietary Assessment on a Mobile Phone Using Image Processing and Pattern Recognition Techniques: Algorithm Design and System Prototyping.

PubMed

Probst, Yasmine; Nguyen, Duc Thanh; Tran, Minh Khoi; Li, Wanqing

2015-07-27

Dietary assessment, while traditionally based on pen-and-paper, is rapidly moving towards automatic approaches. This study describes an Australian automatic food record method and its prototype for dietary assessment via the use of a mobile phone and techniques of image processing and pattern recognition. Common visual features including scale invariant feature transformation (SIFT), local binary patterns (LBP), and colour are used for describing food images. The popular bag-of-words (BoW) model is employed for recognizing the images taken by a mobile phone for dietary assessment. Technical details are provided together with discussions on the issues and future work.

Design of biometrics identification system on palm vein using infrared light

NASA Astrophysics Data System (ADS)

Syafiq, Muhammad; Nasution, Aulia M. T.

2016-11-01

Image obtained by the LED with wavelength 740nm and 810nm showed that the contrast gradient of vein pattern is low and palm pattern still exist. It means that 740nm and 810nm are less suitable for the detection of blood vessels in the palm of the hand. At a wavelength of 940nm, the pattern is clearly visible, and the pattern of the palms is mostly gone. Furthermore, the pre-processing performed using smoothing process which include Gaussian filter and median filter and contrast stretching. Image segmentation is done by getting the ROI area that would be obtained its information. The identification process of image features obtained by using MSE (Mean Suare Error) method ,LBP (Local Binary Pattern). Furthermore, we will use a database consists of 5 different palm vein pattern which will be used for testing the tool in the identification process. All the process above are done using Raspberry Pi device. The Obtained MSE parameter is 0.025 and LBP features score are less than 10-3 for image to be matched.

Automated characterisation of ultrasound images of ovarian tumours: the diagnostic accuracy of a support vector machine and image processing with a local binary pattern operator

PubMed Central

Khazendar, S.; Sayasneh, A.; Al-Assam, H.; Du, H.; Kaijser, J.; Ferrara, L.; Timmerman, D.; Jassim, S.; Bourne, T.

2015-01-01

Introduction: Preoperative characterisation of ovarian masses into benign or malignant is of paramount importance to optimise patient management. Objectives: In this study, we developed and validated a computerised model to characterise ovarian masses as benign or malignant. Materials and methods: Transvaginal 2D B mode static ultrasound images of 187 ovarian masses with known histological diagnosis were included. Images were first pre-processed and enhanced, and Local Binary Pattern Histograms were then extracted from 2 × 2 blocks of each image. A Support Vector Machine (SVM) was trained using stratified cross validation with randomised sampling. The process was repeated 15 times and in each round 100 images were randomly selected. Results: The SVM classified the original non-treated static images as benign or malignant masses with an average accuracy of 0.62 (95% CI: 0.59-0.65). This performance significantly improved to an average accuracy of 0.77 (95% CI: 0.75-0.79) when images were pre-processed, enhanced and treated with a Local Binary Pattern operator (mean difference 0.15: 95% 0.11-0.19, p < 0.0001, two-tailed t test). Conclusion: We have shown that an SVM can classify static 2D B mode ultrasound images of ovarian masses into benign and malignant categories. The accuracy improves if texture related LBP features extracted from the images are considered. PMID:25897367

Dietary Assessment on a Mobile Phone Using Image Processing and Pattern Recognition Techniques: Algorithm Design and System Prototyping

PubMed Central

Probst, Yasmine; Nguyen, Duc Thanh; Tran, Minh Khoi; Li, Wanqing

2015-01-01

Dietary assessment, while traditionally based on pen-and-paper, is rapidly moving towards automatic approaches. This study describes an Australian automatic food record method and its prototype for dietary assessment via the use of a mobile phone and techniques of image processing and pattern recognition. Common visual features including scale invariant feature transformation (SIFT), local binary patterns (LBP), and colour are used for describing food images. The popular bag-of-words (BoW) model is employed for recognizing the images taken by a mobile phone for dietary assessment. Technical details are provided together with discussions on the issues and future work. PMID:26225994

Dynamic biometric identification from multiple views using the GLBP-TOP method.

PubMed

Wang, Yu; Shen, Xuanjing; Chen, Haipeng; Zhai, Yujie

2014-01-01

To realize effective and rapid dynamic biometric identification with low computational complexity, a video-based facial texture program that extracts local binary patterns from three orthogonal planes in the frequency domain of the Gabor transform (GLBP-TOP) was proposed. Firstly, each normalized face was transformed by Gabor wavelet to get the enhanced Gabor magnitude map, and then the LBP-TOP operator was applied to the maps to extract video texture. Finally, weighted Chi square statistics based on the Fisher Criterion were used to realize the identification. The proposed algorithm was proved effective through the biometric experiments using the Honda/UCSD database, and was robust against changes of illumination and expressions.

Epidemiological Differences Between Localized and Nonlocalized Low Back Pain.

PubMed

Coggon, David; Ntani, Georgia; Walker-Bone, Karen; Palmer, Keith T; Felli, Vanda E; Harari, Raul; Barrero, Lope H; Felknor, Sarah A; Gimeno, David; Cattrell, Anna; Vargas-Prada, Sergio; Bonzini, Matteo; Solidaki, Eleni; Merisalu, Eda; Habib, Rima R; Sadeghian, Farideh; Kadir, M Masood; Warnakulasuriya, Sudath Sp; Matsudaira, Ko; Nyantumbu, Busisiwe; Sim, Malcolm R; Harcombe, Helen; Cox, Ken; Sarquis, Leila M M; Marziale, Maria H; Harari, Florencia; Freire, Rocio; Harari, Natalia; Monroy, Magda V; Quintana, Leonardo A; Rojas, Marianela; Harris, Elizabeth Clare; Serra, Consol; Martinez, José Miguel; Delclos, George; Benavides, Fernando G; Carugno, Michele; Ferrario, Marco M; Pesatori, Angela C; Chatzi, Leda; Bitsios, Panos; Kogevinas, Manolis; Oha, Kristel; Freimann, Tiina; Sadeghian, Ali; Peiris-John, Roshini J; Sathiakumar, Nalini; Wickremasinghe, A Rajitha; Yoshimura, Noriko; Kelsall, Helen L; Hoe, Victor C W; Urquhart, Donna M; Derrett, Sarah; McBride, David; Herbison, Peter; Gray, Andrew; Salazar Vega, Eduardo J

2017-05-15

A cross-sectional survey with a longitudinal follow-up. The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain. We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries. Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group. Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations. 2.

Early work-related physical exposures and low back pain in midlife: the Cardiovascular Risk in Young Finns Study.

PubMed

Lallukka, T; Viikari-Juntura, E; Viikari, J; Kähönen, M; Lehtimäki, T; Raitakari, O T; Solovieva, S

2017-03-01

To examine whether heavy physical workload in young adulthood increases the risk of local and radiating low back pain (LBP) in midlife. Longitudinal nationally representative Young Finns Study data among women (n=414) and men (n=324), aged 18-24 years in 1986 (baseline), were used. Physical heaviness of work was reported at baseline and follow-up (2007), and local and radiating LBP at follow-up. Covariates were age, smoking and body mass index. Logistic regression was used to examine the associations between physical heaviness of work and LBP. Additionally, the mediating effect of back pain at baseline was examined (the Sobel test). After adjustment for the covariates, and as compared with sedentary/light physical workload, heavy physical workload was associated with radiating LBP among women (OR 4.09, 95% CI 1.62 to 10.31) and men (OR 2.01, 95% CI 1.06 to 3.82). Among men, early back pain mediated the association (p value from the Sobel test=0.006). Among women, early exposure to physically heavy work showed the most consistent associations, while early and late exposures were associated with radiating and local LBP among men. Persistently heavy physical work was associated with radiating LBP among women and men. Physically heavy work at a young age can have a long-lasting effect on the risk of LBP, radiating LBP in particular. These results highlight the need to consider early and persistent exposures to prevent the adverse consequences of physical workload for the low back. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Using evolutionary computation to optimize an SVM used in detecting buried objects in FLIR imagery

NASA Astrophysics Data System (ADS)

Paino, Alex; Popescu, Mihail; Keller, James M.; Stone, Kevin

2013-06-01

In this paper we describe an approach for optimizing the parameters of a Support Vector Machine (SVM) as part of an algorithm used to detect buried objects in forward looking infrared (FLIR) imagery captured by a camera installed on a moving vehicle. The overall algorithm consists of a spot-finding procedure (to look for potential targets) followed by the extraction of several features from the neighborhood of each spot. The features include local binary pattern (LBP) and histogram of oriented gradients (HOG) as these are good at detecting texture classes. Finally, we project and sum each hit into UTM space along with its confidence value (obtained from the SVM), producing a confidence map for ROC analysis. In this work, we use an Evolutionary Computation Algorithm (ECA) to optimize various parameters involved in the system, such as the combination of features used, parameters on the Canny edge detector, the SVM kernel, and various HOG and LBP parameters. To validate our approach, we compare results obtained from an SVM using parameters obtained through our ECA technique with those previously selected by hand through several iterations of "guess and check".

A method of evolving novel feature extraction algorithms for detecting buried objects in FLIR imagery using genetic programming

NASA Astrophysics Data System (ADS)

Paino, A.; Keller, J.; Popescu, M.; Stone, K.

2014-06-01

In this paper we present an approach that uses Genetic Programming (GP) to evolve novel feature extraction algorithms for greyscale images. Our motivation is to create an automated method of building new feature extraction algorithms for images that are competitive with commonly used human-engineered features, such as Local Binary Pattern (LBP) and Histogram of Oriented Gradients (HOG). The evolved feature extraction algorithms are functions defined over the image space, and each produces a real-valued feature vector of variable length. Each evolved feature extractor breaks up the given image into a set of cells centered on every pixel, performs evolved operations on each cell, and then combines the results of those operations for every cell using an evolved operator. Using this method, the algorithm is flexible enough to reproduce both LBP and HOG features. The dataset we use to train and test our approach consists of a large number of pre-segmented image "chips" taken from a Forward Looking Infrared Imagery (FLIR) camera mounted on the hood of a moving vehicle. The goal is to classify each image chip as either containing or not containing a buried object. To this end, we define the fitness of a candidate solution as the cross-fold validation accuracy of the features generated by said candidate solution when used in conjunction with a Support Vector Machine (SVM) classifier. In order to validate our approach, we compare the classification accuracy of an SVM trained using our evolved features with the accuracy of an SVM trained using mainstream feature extraction algorithms, including LBP and HOG.

Research of second harmonic generation images based on texture analysis

NASA Astrophysics Data System (ADS)

Liu, Yao; Li, Yan; Gong, Haiming; Zhu, Xiaoqin; Huang, Zufang; Chen, Guannan

2014-09-01

Texture analysis plays a crucial role in identifying objects or regions of interest in an image. It has been applied to a variety of medical image processing, ranging from the detection of disease and the segmentation of specific anatomical structures, to differentiation between healthy and pathological tissues. Second harmonic generation (SHG) microscopy as a potential noninvasive tool for imaging biological tissues has been widely used in medicine, with reduced phototoxicity and photobleaching. In this paper, we clarified the principles of texture analysis including statistical, transform, structural and model-based methods and gave examples of its applications, reviewing studies of the technique. Moreover, we tried to apply texture analysis to the SHG images for the differentiation of human skin scar tissues. Texture analysis method based on local binary pattern (LBP) and wavelet transform was used to extract texture features of SHG images from collagen in normal and abnormal scars, and then the scar SHG images were classified into normal or abnormal ones. Compared with other texture analysis methods with respect to the receiver operating characteristic analysis, LBP combined with wavelet transform was demonstrated to achieve higher accuracy. It can provide a new way for clinical diagnosis of scar types. At last, future development of texture analysis in SHG images were discussed.

Classification of cardiovascular tissues using LBP based descriptors and a cascade SVM.

PubMed

Mazo, Claudia; Alegre, Enrique; Trujillo, Maria

2017-08-01

Histological images have characteristics, such as texture, shape, colour and spatial structure, that permit the differentiation of each fundamental tissue and organ. Texture is one of the most discriminative features. The automatic classification of tissues and organs based on histology images is an open problem, due to the lack of automatic solutions when treating tissues without pathologies. In this paper, we demonstrate that it is possible to automatically classify cardiovascular tissues using texture information and Support Vector Machines (SVM). Additionally, we realised that it is feasible to recognise several cardiovascular organs following the same process. The texture of histological images was described using Local Binary Patterns (LBP), LBP Rotation Invariant (LBPri), Haralick features and different concatenations between them, representing in this way its content. Using a SVM with linear kernel, we selected the more appropriate descriptor that, for this problem, was a concatenation of LBP and LBPri. Due to the small number of the images available, we could not follow an approach based on deep learning, but we selected the classifier who yielded the higher performance by comparing SVM with Random Forest and Linear Discriminant Analysis. Once SVM was selected as the classifier with a higher area under the curve that represents both higher recall and precision, we tuned it evaluating different kernels, finding that a linear SVM allowed us to accurately separate four classes of tissues: (i) cardiac muscle of the heart, (ii) smooth muscle of the muscular artery, (iii) loose connective tissue, and (iv) smooth muscle of the large vein and the elastic artery. The experimental validation was conducted using 3000 blocks of 100 × 100 sized pixels, with 600 blocks per class and the classification was assessed using a 10-fold cross-validation. using LBP as the descriptor, concatenated with LBPri and a SVM with linear kernel, the main four classes of tissues were recognised with an AUC higher than 0.98. A polynomial kernel was then used to separate the elastic artery and vein, yielding an AUC in both cases superior to 0.98. Following the proposed approach, it is possible to separate with very high precision (AUC greater than 0.98) the fundamental tissues of the cardiovascular system along with some organs, such as the heart, arteries and veins. Copyright © 2017 Elsevier B.V. All rights reserved.

Method for secure electronic voting system: face recognition based approach

NASA Astrophysics Data System (ADS)

Alim, M. Affan; Baig, Misbah M.; Mehboob, Shahzain; Naseem, Imran

2017-06-01

In this paper, we propose a framework for low cost secure electronic voting system based on face recognition. Essentially Local Binary Pattern (LBP) is used for face feature characterization in texture format followed by chi-square distribution is used for image classification. Two parallel systems are developed based on smart phone and web applications for face learning and verification modules. The proposed system has two tire security levels by using person ID followed by face verification. Essentially class specific threshold is associated for controlling the security level of face verification. Our system is evaluated three standard databases and one real home based database and achieve the satisfactory recognition accuracies. Consequently our propose system provides secure, hassle free voting system and less intrusive compare with other biometrics.

Mutual information-based facial expression recognition

NASA Astrophysics Data System (ADS)

Hazar, Mliki; Hammami, Mohamed; Hanêne, Ben-Abdallah

2013-12-01

This paper introduces a novel low-computation discriminative regions representation for expression analysis task. The proposed approach relies on interesting studies in psychology which show that most of the descriptive and responsible regions for facial expression are located around some face parts. The contributions of this work lie in the proposition of new approach which supports automatic facial expression recognition based on automatic regions selection. The regions selection step aims to select the descriptive regions responsible or facial expression and was performed using Mutual Information (MI) technique. For facial feature extraction, we have applied Local Binary Patterns Pattern (LBP) on Gradient image to encode salient micro-patterns of facial expressions. Experimental studies have shown that using discriminative regions provide better results than using the whole face regions whilst reducing features vector dimension.

Image Description with Local Patterns: An Application to Face Recognition

NASA Astrophysics Data System (ADS)

Zhou, Wei; Ahrary, Alireza; Kamata, Sei-Ichiro

In this paper, we propose a novel approach for presenting the local features of digital image using 1D Local Patterns by Multi-Scans (1DLPMS). We also consider the extentions and simplifications of the proposed approach into facial images analysis. The proposed approach consists of three steps. At the first step, the gray values of pixels in image are represented as a vector giving the local neighborhood intensity distrubutions of the pixels. Then, multi-scans are applied to capture different spatial information on the image with advantage of less computation than other traditional ways, such as Local Binary Patterns (LBP). The second step is encoding the local features based on different encoding rules using 1D local patterns. This transformation is expected to be less sensitive to illumination variations besides preserving the appearance of images embedded in the original gray scale. At the final step, Grouped 1D Local Patterns by Multi-Scans (G1DLPMS) is applied to make the proposed approach computationally simpler and easy to extend. Next, we further formulate boosted algorithm to extract the most discriminant local features. The evaluated results demonstrate that the proposed approach outperforms the conventional approaches in terms of accuracy in applications of face recognition, gender estimation and facial expression.

Approach to explosive hazard detection using sensor fusion and multiple kernel learning with downward-looking GPR and EMI sensor data

NASA Astrophysics Data System (ADS)

Pinar, Anthony; Masarik, Matthew; Havens, Timothy C.; Burns, Joseph; Thelen, Brian; Becker, John

2015-05-01

This paper explores the effectiveness of an anomaly detection algorithm for downward-looking ground penetrating radar (GPR) and electromagnetic inductance (EMI) data. Threat detection with GPR is challenged by high responses to non-target/clutter objects, leading to a large number of false alarms (FAs), and since the responses of target and clutter signatures are so similar, classifier design is not trivial. We suggest a method based on a Run Packing (RP) algorithm to fuse GPR and EMI data into a composite confidence map to improve detection as measured by the area-under-ROC (NAUC) metric. We examine the value of a multiple kernel learning (MKL) support vector machine (SVM) classifier using image features such as histogram of oriented gradients (HOG), local binary patterns (LBP), and local statistics. Experimental results on government furnished data show that use of our proposed fusion and classification methods improves the NAUC when compared with the results from individual sensors and a single kernel SVM classifier.

Moving Object Detection Using Scanning Camera on a High-Precision Intelligent Holder.

PubMed

Chen, Shuoyang; Xu, Tingfa; Li, Daqun; Zhang, Jizhou; Jiang, Shenwang

2016-10-21

During the process of moving object detection in an intelligent visual surveillance system, a scenario with complex background is sure to appear. The traditional methods, such as "frame difference" and "optical flow", may not able to deal with the problem very well. In such scenarios, we use a modified algorithm to do the background modeling work. In this paper, we use edge detection to get an edge difference image just to enhance the ability of resistance illumination variation. Then we use a "multi-block temporal-analyzing LBP (Local Binary Pattern)" algorithm to do the segmentation. In the end, a connected component is used to locate the object. We also produce a hardware platform, the core of which consists of the DSP (Digital Signal Processor) and FPGA (Field Programmable Gate Array) platforms and the high-precision intelligent holder.

Perceptually relevant grouping of image tokens on the basis of constraint propagation from local binary patterns

NASA Astrophysics Data System (ADS)

Behlim, Sadaf Iqbal; Syed, Tahir Qasim; Malik, Muhammad Yameen; Vigneron, Vincent

2016-11-01

Grouping image tokens is an intermediate step needed to arrive at meaningful image representation and summarization. Usually, perceptual cues, for instance, gestalt properties inform token grouping. However, they do not take into account structural continuities that could be derived from other tokens belonging to similar structures irrespective of their location. We propose an image representation that encodes structural constraints emerging from local binary patterns (LBP), which provides a long-distance measure of similarity but in a structurally connected way. Our representation provides a grouping of pixels or larger image tokens that is free of numeric similarity measures and could therefore be extended to nonmetric spaces. The representation lends itself nicely to ubiquitous image processing applications such as connected component labeling and segmentation. We test our proposed representation on the perceptual grouping or segmentation task on the popular Berkeley segmentation dataset (BSD500) that with respect to human segmented images achieves an average F-measure of 0.559. Our algorithm achieves a high average recall of 0.787 and is therefore well-suited to other applications such as object retrieval and category-independent object recognition. The proposed merging heuristic based on levels of singular tree component has shown promising results on the BSD500 dataset and currently ranks 12th among all benchmarked algorithms, but contrary to the others, it requires no data-driven training or specialized preprocessing.

Infrared and visible fusion face recognition based on NSCT domain

NASA Astrophysics Data System (ADS)

Xie, Zhihua; Zhang, Shuai; Liu, Guodong; Xiong, Jinquan

2018-01-01

Visible face recognition systems, being vulnerable to illumination, expression, and pose, can not achieve robust performance in unconstrained situations. Meanwhile, near infrared face images, being light- independent, can avoid or limit the drawbacks of face recognition in visible light, but its main challenges are low resolution and signal noise ratio (SNR). Therefore, near infrared and visible fusion face recognition has become an important direction in the field of unconstrained face recognition research. In this paper, a novel fusion algorithm in non-subsampled contourlet transform (NSCT) domain is proposed for Infrared and visible face fusion recognition. Firstly, NSCT is used respectively to process the infrared and visible face images, which exploits the image information at multiple scales, orientations, and frequency bands. Then, to exploit the effective discriminant feature and balance the power of high-low frequency band of NSCT coefficients, the local Gabor binary pattern (LGBP) and Local Binary Pattern (LBP) are applied respectively in different frequency parts to obtain the robust representation of infrared and visible face images. Finally, the score-level fusion is used to fuse the all the features for final classification. The visible and near infrared face recognition is tested on HITSZ Lab2 visible and near infrared face database. Experiments results show that the proposed method extracts the complementary features of near-infrared and visible-light images and improves the robustness of unconstrained face recognition.

Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study.

PubMed

Gupta, Nidhi; Christiansen, Caroline Stordal; Hallman, David M; Korshøj, Mette; Carneiro, Isabella Gomes; Holtermann, Andreas

2015-01-01

Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis. To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers. Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤ 5) or high (> 5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time). The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR = 1.43, 95%CI = 1.15-1.77, P = 0.01). Similar results were obtained for leisure-time sitting (OR = 1.45, 95%CI = 1.10-1.91, P = 0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR = 1.34, 95%CI 0.99-1.82, P = 0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR = 3.31, 95%CI = 1.18-9.28, P = 0.03), leisure (OR = 5.31, 95%CI = 1.57-17.90, P = 0.01), and occupational (OR = 3.26, 95%CI = 0.89-11.98, P = 0.08) periods, referencing those with low sitting time. Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended.

Is Objectively Measured Sitting Time Associated with Low Back Pain? A Cross-Sectional Investigation in the NOMAD study

PubMed Central

Gupta, Nidhi; Christiansen, Caroline Stordal; Hallman, David M.; Korshøj, Mette; Carneiro, Isabella Gomes; Holtermann, Andreas

2015-01-01

Background Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis. Objectives To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers. Methods Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤5) or high (>5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time). Results The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR=1.43, 95%CI=1.15-1.77, P=0.01). Similar results were obtained for leisure-time sitting (OR=1.45, 95%CI=1.10-1.91, P=0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR=1.34, 95%CI 0.99-1.82, P=0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR=3.31, 95%CI=1.18-9.28, P=0.03), leisure (OR=5.31, 95%CI=1.57-17.90, P=0.01), and occupational (OR=3.26, 95%CI=0.89-11.98, P=0.08) periods, referencing those with low sitting time. Conclusion Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended. PMID:25806808

Development and Validation of a Job Exposure Matrix for Physical Risk Factors in Low Back Pain

PubMed Central

Solovieva, Svetlana; Pehkonen, Irmeli; Kausto, Johanna; Miranda, Helena; Shiri, Rahman; Kauppinen, Timo; Heliövaara, Markku; Burdorf, Alex; Husgafvel-Pursiainen, Kirsti; Viikari-Juntura, Eira

2012-01-01

Objectives The aim was to construct and validate a gender-specific job exposure matrix (JEM) for physical exposures to be used in epidemiological studies of low back pain (LBP). Materials and Methods We utilized two large Finnish population surveys, one to construct the JEM and another to test matrix validity. The exposure axis of the matrix included exposures relevant to LBP (heavy physical work, heavy lifting, awkward trunk posture and whole body vibration) and exposures that increase the biomechanical load on the low back (arm elevation) or those that in combination with other known risk factors could be related to LBP (kneeling or squatting). Job titles with similar work tasks and exposures were grouped. Exposure information was based on face-to-face interviews. Validity of the matrix was explored by comparing the JEM (group-based) binary measures with individual-based measures. The predictive validity of the matrix against LBP was evaluated by comparing the associations of the group-based (JEM) exposures with those of individual-based exposures. Results The matrix includes 348 job titles, representing 81% of all Finnish job titles in the early 2000s. The specificity of the constructed matrix was good, especially in women. The validity measured with kappa-statistic ranged from good to poor, being fair for most exposures. In men, all group-based (JEM) exposures were statistically significantly associated with one-month prevalence of LBP. In women, four out of six group-based exposures showed an association with LBP. Conclusions The gender-specific JEM for physical exposures showed relatively high specificity without compromising sensitivity. The matrix can therefore be considered as a valid instrument for exposure assessment in large-scale epidemiological studies, when more precise but more labour-intensive methods are not feasible. Although the matrix was based on Finnish data we foresee that it could be applicable, with some modifications, in other countries with a similar level of technology. PMID:23152793

Surgical treatment of middle cluneal nerve entrapment neuropathy: technical note.

PubMed

Matsumoto, Juntaro; Isu, Toyohiko; Kim, Kyongsong; Iwamoto, Naotaka; Morimoto, Daijiro; Isobe, Masanori

2018-05-18

OBJECTIVE The etiology of low-back pain (LBP) is heterogeneous and is unknown in some patients with chronic pain. Superior cluneal nerve entrapment has been proposed as a causative factor, and some patients suffer severe symptoms. The middle cluneal nerve (MCN) is also implicated in the elicitation of LBP, and its clinical course and etiology remain unclear. The authors report the preliminary outcomes of a less invasive microsurgical release procedure to address MCN entrapment (MCN-E). METHODS The authors enrolled 11 patients (13 sites) with intractable LBP judged to be due to MCN-E. The group included 3 men and 8 women ranging in age from 52 to 86 years. Microscopic MCN neurolysis was performed under local anesthesia with the patient in the prone position. Postoperatively, all patients were allowed to walk freely with no restrictions. The mean follow-up period was 10.5 months. LBP severity was evaluated on the numerical rating scale (NRS) and by the Japanese Orthopaedic Association (JOA) and the Roland-Morris Disability Questionnaire (RDQ) scores. RESULTS All patients suffered buttock pain, and 9 also had leg symptoms. The symptoms were aggravated by standing, lumbar flexion, rolling over, prolonged sitting, and especially by walking. The numbers of nerve branches addressed during MCN neurolysis were 1 in 9 patients, 2 in 1 patient, and 3 in 1 patient. One patient required reoperation due to insufficient decompression originally. There were no local or systemic complications during or after surgery. Postoperatively, the symptoms of all patients improved statistically significantly; the mean NRS score fell from 7.0 to 1.4, the mean RDQ from 10.8 to 1.4, and the mean JOA score rose from 13.7 to 23.6. CONCLUSIONS Less invasive MCN neurolysis performed under local anesthesia is useful for LBP caused by MCN-E. In patients with intractable LBP, MCN-E should be considered.

Gender Recognition from Human-Body Images Using Visible-Light and Thermal Camera Videos Based on a Convolutional Neural Network for Image Feature Extraction

PubMed Central

Nguyen, Dat Tien; Kim, Ki Wan; Hong, Hyung Gil; Koo, Ja Hyung; Kim, Min Cheol; Park, Kang Ryoung

2017-01-01

Extracting powerful image features plays an important role in computer vision systems. Many methods have previously been proposed to extract image features for various computer vision applications, such as the scale-invariant feature transform (SIFT), speed-up robust feature (SURF), local binary patterns (LBP), histogram of oriented gradients (HOG), and weighted HOG. Recently, the convolutional neural network (CNN) method for image feature extraction and classification in computer vision has been used in various applications. In this research, we propose a new gender recognition method for recognizing males and females in observation scenes of surveillance systems based on feature extraction from visible-light and thermal camera videos through CNN. Experimental results confirm the superiority of our proposed method over state-of-the-art recognition methods for the gender recognition problem using human body images. PMID:28335510

Gender Recognition from Human-Body Images Using Visible-Light and Thermal Camera Videos Based on a Convolutional Neural Network for Image Feature Extraction.

PubMed

Nguyen, Dat Tien; Kim, Ki Wan; Hong, Hyung Gil; Koo, Ja Hyung; Kim, Min Cheol; Park, Kang Ryoung

2017-03-20

Extracting powerful image features plays an important role in computer vision systems. Many methods have previously been proposed to extract image features for various computer vision applications, such as the scale-invariant feature transform (SIFT), speed-up robust feature (SURF), local binary patterns (LBP), histogram of oriented gradients (HOG), and weighted HOG. Recently, the convolutional neural network (CNN) method for image feature extraction and classification in computer vision has been used in various applications. In this research, we propose a new gender recognition method for recognizing males and females in observation scenes of surveillance systems based on feature extraction from visible-light and thermal camera videos through CNN. Experimental results confirm the superiority of our proposed method over state-of-the-art recognition methods for the gender recognition problem using human body images.

Moving Object Detection Using Scanning Camera on a High-Precision Intelligent Holder

PubMed Central

Chen, Shuoyang; Xu, Tingfa; Li, Daqun; Zhang, Jizhou; Jiang, Shenwang

2016-01-01

During the process of moving object detection in an intelligent visual surveillance system, a scenario with complex background is sure to appear. The traditional methods, such as “frame difference” and “optical flow”, may not able to deal with the problem very well. In such scenarios, we use a modified algorithm to do the background modeling work. In this paper, we use edge detection to get an edge difference image just to enhance the ability of resistance illumination variation. Then we use a “multi-block temporal-analyzing LBP (Local Binary Pattern)” algorithm to do the segmentation. In the end, a connected component is used to locate the object. We also produce a hardware platform, the core of which consists of the DSP (Digital Signal Processor) and FPGA (Field Programmable Gate Array) platforms and the high-precision intelligent holder. PMID:27775671

A Multi-Modal Face Recognition Method Using Complete Local Derivative Patterns and Depth Maps

PubMed Central

Yin, Shouyi; Dai, Xu; Ouyang, Peng; Liu, Leibo; Wei, Shaojun

2014-01-01

In this paper, we propose a multi-modal 2D + 3D face recognition method for a smart city application based on a Wireless Sensor Network (WSN) and various kinds of sensors. Depth maps are exploited for the 3D face representation. As for feature extraction, we propose a new feature called Complete Local Derivative Pattern (CLDP). It adopts the idea of layering and has four layers. In the whole system, we apply CLDP separately on Gabor features extracted from a 2D image and depth map. Then, we obtain two features: CLDP-Gabor and CLDP-Depth. The two features weighted by the corresponding coefficients are combined together in the decision level to compute the total classification distance. At last, the probe face is assigned the identity with the smallest classification distance. Extensive experiments are conducted on three different databases. The results demonstrate the robustness and superiority of the new approach. The experimental results also prove that the proposed multi-modal 2D + 3D method is superior to other multi-modal ones and CLDP performs better than other Local Binary Pattern (LBP) based features. PMID:25333290

a Novel Ship Detection Method for Large-Scale Optical Satellite Images Based on Visual Lbp Feature and Visual Attention Model

NASA Astrophysics Data System (ADS)

Haigang, Sui; Zhina, Song

2016-06-01

Reliably ship detection in optical satellite images has a wide application in both military and civil fields. However, this problem is very difficult in complex backgrounds, such as waves, clouds, and small islands. Aiming at these issues, this paper explores an automatic and robust model for ship detection in large-scale optical satellite images, which relies on detecting statistical signatures of ship targets, in terms of biologically-inspired visual features. This model first selects salient candidate regions across large-scale images by using a mechanism based on biologically-inspired visual features, combined with visual attention model with local binary pattern (CVLBP). Different from traditional studies, the proposed algorithm is high-speed and helpful to focus on the suspected ship areas avoiding the separation step of land and sea. Largearea images are cut into small image chips and analyzed in two complementary ways: Sparse saliency using visual attention model and detail signatures using LBP features, thus accordant with sparseness of ship distribution on images. Then these features are employed to classify each chip as containing ship targets or not, using a support vector machine (SVM). After getting the suspicious areas, there are still some false alarms such as microwaves and small ribbon clouds, thus simple shape and texture analysis are adopted to distinguish between ships and nonships in suspicious areas. Experimental results show the proposed method is insensitive to waves, clouds, illumination and ship size.

The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients

PubMed Central

Abboud, Jacques; Nougarou, François; Normand, Martin C.

2015-01-01

Introduction Changes in sensorimotor function and increased trunk muscle fatigability have been identified in patients with chronic low back pain (cLBP). This study assessed the control of trunk force production in conditions with and without local erector spinae muscle vibration and evaluated the influence of muscle fatigue on trunk sensorimotor control. Methods Twenty non-specific cLBP patients and 20 healthy participants were asked to perform submaximal isometric trunk extension torque with and without local vibration stimulation, before and after a trunk extensor muscle fatigue protocol. Constant error (CE), variable error (VE) as well as absolute error (AE) in peak torque were computed and compared across conditions. Trunk extensor muscle activation during isometric contractions and during the fatigue protocol was measured using surface electromyography (sEMG). Results Force reproduction accuracy of the trunk was significantly lower in the patient group (CE = 9.81 ± 2.23 Nm; AE = 18.16 ± 3.97 Nm) than in healthy participants (CE = 4.44 ± 1.68 Nm; AE = 12.23 ± 2.44 Nm). Local erector spinae vibration induced a significant reduction in CE (4.33 ± 2.14 Nm) and AE (13.71 ± 3.45 Nm) mean scores in the patient group. Healthy participants conversely showed a significant increase in CE (8.17 ± 2.10 Nm) and AE (16.29 ± 2.82 Nm) mean scores under vibration conditions. The fatigue protocol induced erector spinae muscle fatigue as illustrated by a significant decrease in sEMG median time-frequency slopes. Following the fatigue protocol, patients with cLBP showed significant decrease in sEMG root mean square activity at L4-5 level and responded in similar manner with and without vibration stimulation in regard to CE mean scores. Conclusions Patients with cLBP have a less accurate force reproduction sense than healthy participants. Local muscle vibration led to significant trunk neuromuscular control improvements in the cLBP patients before and after a muscle fatigue protocol. Muscle vibration stimulation during motor control exercises is likely to influence motor adaptation and could be considered in the treatment of cLBP. Further work is needed to clearly identify at what levels of the sensorimotor system these gains are achievable. PMID:26308725

The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients.

PubMed

Boucher, Jean-Alexandre; Abboud, Jacques; Nougarou, François; Normand, Martin C; Descarreaux, Martin

2015-01-01

Changes in sensorimotor function and increased trunk muscle fatigability have been identified in patients with chronic low back pain (cLBP). This study assessed the control of trunk force production in conditions with and without local erector spinae muscle vibration and evaluated the influence of muscle fatigue on trunk sensorimotor control. Twenty non-specific cLBP patients and 20 healthy participants were asked to perform submaximal isometric trunk extension torque with and without local vibration stimulation, before and after a trunk extensor muscle fatigue protocol. Constant error (CE), variable error (VE) as well as absolute error (AE) in peak torque were computed and compared across conditions. Trunk extensor muscle activation during isometric contractions and during the fatigue protocol was measured using surface electromyography (sEMG). Force reproduction accuracy of the trunk was significantly lower in the patient group (CE = 9.81 ± 2.23 Nm; AE = 18.16 ± 3.97 Nm) than in healthy participants (CE = 4.44 ± 1.68 Nm; AE = 12.23 ± 2.44 Nm). Local erector spinae vibration induced a significant reduction in CE (4.33 ± 2.14 Nm) and AE (13.71 ± 3.45 Nm) mean scores in the patient group. Healthy participants conversely showed a significant increase in CE (8.17 ± 2.10 Nm) and AE (16.29 ± 2.82 Nm) mean scores under vibration conditions. The fatigue protocol induced erector spinae muscle fatigue as illustrated by a significant decrease in sEMG median time-frequency slopes. Following the fatigue protocol, patients with cLBP showed significant decrease in sEMG root mean square activity at L4-5 level and responded in similar manner with and without vibration stimulation in regard to CE mean scores. Patients with cLBP have a less accurate force reproduction sense than healthy participants. Local muscle vibration led to significant trunk neuromuscular control improvements in the cLBP patients before and after a muscle fatigue protocol. Muscle vibration stimulation during motor control exercises is likely to influence motor adaptation and could be considered in the treatment of cLBP. Further work is needed to clearly identify at what levels of the sensorimotor system these gains are achievable.

Fear of movement, passive coping, manual handling, and severe or radiating pain increase the likelihood of sick leave due to low back pain.

PubMed

Dawson, Anna P; Schluter, Philip J; Hodges, Paul W; Stewart, Simon; Turner, Catherine

2011-07-01

Sick leave due to low back pain (LBP-SL) is costly and compromises workforce productivity. The fear-avoidance model asserts that maladaptive pain-related cognitions lead to avoidance and disuse, which can perpetuate ongoing pain. Staying home from work is an avoidant behavior, and hence pain-related psychological features may help explain LBP-SL. We examined the relative contribution of pain catastrophizing, fear of movement, and pain coping (active and passive) in LBP-SL in addition to pain characteristics and other psychosocial, occupational, general health, and demographic factors. Two-way interactions between age and gender and candidate exposures were also considered. Our sample comprised 2164 working nurses and midwives with low back pain in the preceding year. Binary logistic regression was performed on cross-sectional data by manual backward stepwise elimination of nonsignificant terms to generate a parsimonious multivariable model. From an extensive array of exposures assessed, fear of movement (women, odds ratio [OR]=1.05, 95% confidence interval [CI] 1.02-1.08; men, OR=1.17, 95% CI 1.05-1.29), passive coping (OR=1.07, 95% CI 1.04-1.11), pain severity (OR=1.61, 95% CI 1.50-1.72), pain radiation (women, OR=1.45, 95% CI 1.10-1.92; men, OR=4.13, 95% CI 2.15-7.95), and manual handling frequency (OR=1.03, 95% CI 1.01-1.05) increased the likelihood of LBP-SL in the preceding 12 months. Administrators and managers were less likely to report LBP-SL (OR=0.44, 95% CI 0.27-0.71), and age had a protective effect in individuals in a married or de facto relationship (OR=0.97, 95% CI 0.95-0.98). In summary, fear of movement, passive coping, frequent manual handling, and severe or radiating pain increase the likelihood of LBP-SL. Gender-specific responses to pain radiation and fear of movement are evident. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Prevalence of Low Back Pain in Health Care Workers and Comparison with Other Occupational Categories in Iran: A Systematic Review

PubMed Central

Mehrdad, Ramin; Shams-Hosseini, Narges Sadat; Aghdaei, Sara; Yousefian, Mina

2016-01-01

Background: There are few research studies evaluating the significance of low back pain (LBP) in Iran, even though the majority of locally published surveys are written in the Persian language. In the present review study, we aimed at appraising published articles related to the burden of LBP and its divergence among different jobs. Methods: A comprehensive search was conducted in all accessible national and international electronic databases from 1948 to mid-2012. The international electronic databases were MEDLINE (PubMed), Web of Sciences, Google Scholar, Scopus, CINAHL, and the Iranian equivalents were SID, IRANDOC, IranMedex, and Magiran. The main search terms were musculoskeletal disorders, musculoskeletal symptoms, low back pain, back pain, and Iran. All keywords were searched electronically by three Boolean operators. The inclusion criteria were age ≥10 years, study focus on LBP prevalence, inclusion of both genders, and no limitation to the study design. A dedicated STROBE questionnaire was developed as a critical appraisal tool and the quality of the identified literature was examined according to the 5-point Linker scale. Articles scoring ≥3 on the Linker scale were appraised. Each literature was screened by four reviewers independently and possible disagreements were streamlined in a joint review meeting. The extracted data were entered into a dedicated table using Microsoft Office Excel program. Data were analyzed for homogeneity using the STATA software (version 11). Results: Of the 51 articles that were included in the present review study, 35 articles reported 1-year LBP with Nordic questionnaire and 3 articles reported point prevalence of LBP. The calculated global prevalence of 1-year LBP in workers was 25% and LBP was the most prevalent issue among health care workers. There was no association between the prevalence of LBP and job classification among workers. Conclusion: LBP is the most common issue among health care workers. It is recommended that future research should focus on this job category for investigating LBP prevalence. This allows parameters that increase the frequency of LBP to be assessed and subsequently permits the reduction or elimination of such factors. PMID:27853326

Prevalence of Low Back Pain in Health Care Workers and Comparison with Other Occupational Categories in Iran: A Systematic Review.

PubMed

Mehrdad, Ramin; Shams-Hosseini, Narges Sadat; Aghdaei, Sara; Yousefian, Mina

2016-11-01

There are few research studies evaluating the significance of low back pain (LBP) in Iran, even though the majority of locally published surveys are written in the Persian language. In the present review study, we aimed at appraising published articles related to the burden of LBP and its divergence among different jobs. A comprehensive search was conducted in all accessible national and international electronic databases from 1948 to mid-2012. The international electronic databases were MEDLINE (PubMed), Web of Sciences, Google Scholar, Scopus, CINAHL, and the Iranian equivalents were SID, IRANDOC, IranMedex, and Magiran. The main search terms were musculoskeletal disorders, musculoskeletal symptoms, low back pain, back pain, and Iran. All keywords were searched electronically by three Boolean operators. The inclusion criteria were age ≥10 years, study focus on LBP prevalence, inclusion of both genders, and no limitation to the study design. A dedicated STROBE questionnaire was developed as a critical appraisal tool and the quality of the identified literature was examined according to the 5-point Linker scale. Articles scoring ≥3 on the Linker scale were appraised. Each literature was screened by four reviewers independently and possible disagreements were streamlined in a joint review meeting. The extracted data were entered into a dedicated table using Microsoft Office Excel program. Data were analyzed for homogeneity using the STATA software (version 11). Of the 51 articles that were included in the present review study, 35 articles reported 1-year LBP with Nordic questionnaire and 3 articles reported point prevalence of LBP. The calculated global prevalence of 1-year LBP in workers was 25% and LBP was the most prevalent issue among health care workers. There was no association between the prevalence of LBP and job classification among workers. LBP is the most common issue among health care workers. It is recommended that future research should focus on this job category for investigating LBP prevalence. This allows parameters that increase the frequency of LBP to be assessed and subsequently permits the reduction or elimination of such factors.

Combining Deep and Handcrafted Image Features for Presentation Attack Detection in Face Recognition Systems Using Visible-Light Camera Sensors

PubMed Central

Nguyen, Dat Tien; Pham, Tuyen Danh; Baek, Na Rae; Park, Kang Ryoung

2018-01-01

Although face recognition systems have wide application, they are vulnerable to presentation attack samples (fake samples). Therefore, a presentation attack detection (PAD) method is required to enhance the security level of face recognition systems. Most of the previously proposed PAD methods for face recognition systems have focused on using handcrafted image features, which are designed by expert knowledge of designers, such as Gabor filter, local binary pattern (LBP), local ternary pattern (LTP), and histogram of oriented gradients (HOG). As a result, the extracted features reflect limited aspects of the problem, yielding a detection accuracy that is low and varies with the characteristics of presentation attack face images. The deep learning method has been developed in the computer vision research community, which is proven to be suitable for automatically training a feature extractor that can be used to enhance the ability of handcrafted features. To overcome the limitations of previously proposed PAD methods, we propose a new PAD method that uses a combination of deep and handcrafted features extracted from the images by visible-light camera sensor. Our proposed method uses the convolutional neural network (CNN) method to extract deep image features and the multi-level local binary pattern (MLBP) method to extract skin detail features from face images to discriminate the real and presentation attack face images. By combining the two types of image features, we form a new type of image features, called hybrid features, which has stronger discrimination ability than single image features. Finally, we use the support vector machine (SVM) method to classify the image features into real or presentation attack class. Our experimental results indicate that our proposed method outperforms previous PAD methods by yielding the smallest error rates on the same image databases. PMID:29495417

Combining Deep and Handcrafted Image Features for Presentation Attack Detection in Face Recognition Systems Using Visible-Light Camera Sensors.

PubMed

Nguyen, Dat Tien; Pham, Tuyen Danh; Baek, Na Rae; Park, Kang Ryoung

2018-02-26

Although face recognition systems have wide application, they are vulnerable to presentation attack samples (fake samples). Therefore, a presentation attack detection (PAD) method is required to enhance the security level of face recognition systems. Most of the previously proposed PAD methods for face recognition systems have focused on using handcrafted image features, which are designed by expert knowledge of designers, such as Gabor filter, local binary pattern (LBP), local ternary pattern (LTP), and histogram of oriented gradients (HOG). As a result, the extracted features reflect limited aspects of the problem, yielding a detection accuracy that is low and varies with the characteristics of presentation attack face images. The deep learning method has been developed in the computer vision research community, which is proven to be suitable for automatically training a feature extractor that can be used to enhance the ability of handcrafted features. To overcome the limitations of previously proposed PAD methods, we propose a new PAD method that uses a combination of deep and handcrafted features extracted from the images by visible-light camera sensor. Our proposed method uses the convolutional neural network (CNN) method to extract deep image features and the multi-level local binary pattern (MLBP) method to extract skin detail features from face images to discriminate the real and presentation attack face images. By combining the two types of image features, we form a new type of image features, called hybrid features, which has stronger discrimination ability than single image features. Finally, we use the support vector machine (SVM) method to classify the image features into real or presentation attack class. Our experimental results indicate that our proposed method outperforms previous PAD methods by yielding the smallest error rates on the same image databases.

Neighbourhood-consensus message passing and its potentials in image processing applications

NASA Astrophysics Data System (ADS)

Ružic, Tijana; Pižurica, Aleksandra; Philips, Wilfried

2011-03-01

In this paper, a novel algorithm for inference in Markov Random Fields (MRFs) is presented. Its goal is to find approximate maximum a posteriori estimates in a simple manner by combining neighbourhood influence of iterated conditional modes (ICM) and message passing of loopy belief propagation (LBP). We call the proposed method neighbourhood-consensus message passing because a single joint message is sent from the specified neighbourhood to the central node. The message, as a function of beliefs, represents the agreement of all nodes within the neighbourhood regarding the labels of the central node. This way we are able to overcome the disadvantages of reference algorithms, ICM and LBP. On one hand, more information is propagated in comparison with ICM, while on the other hand, the huge amount of pairwise interactions is avoided in comparison with LBP by working with neighbourhoods. The idea is related to the previously developed iterated conditional expectations algorithm. Here we revisit it and redefine it in a message passing framework in a more general form. The results on three different benchmarks demonstrate that the proposed technique can perform well both for binary and multi-label MRFs without any limitations on the model definition. Furthermore, it manifests improved performance over related techniques either in terms of quality and/or speed.

Structural and Functional Features of a Developmentally Regulated Lipopolysaccharide-Binding Protein

PubMed Central

Krasity, Benjamin C.; Troll, Joshua V.; Lehnert, Erik M.; Hackett, Kathleen T.; Dillard, Joseph P.; Apicella, Michael A.; Goldman, William E.

2015-01-01

ABSTRACT Mammalian lipopolysaccharide (LPS) binding proteins (LBPs) occur mainly in extracellular fluids and promote LPS delivery to specific host cell receptors. The function of LBPs has been studied principally in the context of host defense; the possible role of LBPs in nonpathogenic host-microbe interactions has not been well characterized. Using the Euprymna scolopes-Vibrio fischeri model, we analyzed the structure and function of an LBP family protein, E. scolopes LBP1 (EsLBP1), and provide evidence for its role in triggering a symbiont-induced host developmental program. Previous studies showed that, during initial host colonization, the LPS of V. fischeri synergizes with peptidoglycan (PGN) monomer to induce morphogenesis of epithelial tissues of the host animal. Computationally modeled EsLBP1 shares some but not all structural features of mammalian LBPs that are thought important for LPS binding. Similar to human LBP, recombinant EsLBP1 expressed in insect cells bound V. fischeri LPS and Neisseria meningitidis lipooligosaccharide (LOS) with nanomolar or greater affinity but bound Francisella tularensis LPS only weakly and did not bind PGN monomer. Unlike human LBP, EsLBP1 did not bind N. meningitidis LOS:CD14 complexes. The eslbp1 transcript was upregulated ~22-fold by V. fischeri at 24 h postinoculation. Surprisingly, this upregulation was not induced by exposure to LPS but, rather, to the PGN monomer alone. Hybridization chain reaction-fluorescent in situ hybridization (HCR-FISH) and immunocytochemistry (ICC) localized eslbp1 transcript and protein in crypt epithelia, where V. fischeri induces morphogenesis. The data presented here provide a window into the evolution of LBPs and the scope of their roles in animal symbioses. PMID:26463160

Low back pain in healthy postmenopausal women and the effect of physical activity: A secondary analysis in a randomized trial

PubMed Central

Marini, Mirca; Bendinelli, Benedetta; Assedi, Melania; Occhini, Daniela; Castaldo, Maria; Fabiano, Jacopo; Petranelli, Marco; Migliolo, Mario; Monaci, Marco; Masala, Giovanna

2017-01-01

Epidemiological studies on the prevalence of musculoskeletal pain have consistently shown that this is a relevant health problem, with non-specific low back pain (LBP) being the most commonly reported in adult females. Conflicting data on the association between LBP symptoms and physical activity (PA) have been reported. Here, we investigated the prevalence of LBP and the effect of a 24-month non-specific PA intervention on changes in LBP prevalence in a series of Italian healthy postmenopausal women. We performed a secondary analysis in the frame of the DAMA trial, a factorial randomized intervention trial aimed to evaluate the ability of a 24-month intervention, based on moderate-intensity PA, and/or dietary modification, in reducing mammographic breast density in healthy postmenopausal women. The PA intervention included at least 1 hour/day of moderate PA and a more strenuous weekly activity, collective walks and theoretical group sessions. A self-administered pain questionnaire was administered at baseline and at the end of the intervention. The questionnaire was specifically structured to investigate the occurrence of musculoskeletal pain, the body localization, intensity and duration of the pain. Two hundred and ten women (102 randomized to PA intervention, 108 not receiving the PA intervention) filled out the questionnaires. At baseline LBP was present in 32.9% of the participants. Among women randomized to the PA intervention, LBP prevalence at follow up (21.6%) was lower than at baseline (33.3%) (p = 0.02), while in women who did not receive the PA intervention the LBP prevalence at baseline and follow up were 32.4% and 25.9%, respectively (p = 0.30). Overall, there was no significant between-group effect of PA intervention on LBP. Further studies are needed to understand the role of non-specific PA intervention, aimed to improve overall fitness, on LBP prevalence. PMID:28489877

Low back pain and disability in individuals with plantar heel pain.

PubMed

McClinton, Shane; Weber, Carolyn F; Heiderscheit, Bryan

2018-03-01

Lack of response to plantar heel pain (PHP) treatment may be related to unmanaged low back pain (LBP) and low back dysfunction, but a relationship between LBP and PHP has not been established. The purpose of this investigation was to compare the prevalence of LBP among individuals with and without PHP and to assess the association between low back disability and foot/ankle function. A cross-sectional study compared the prevalence and likelihood of LBP in individuals with (n=27) and without (n=27) PHP matched to age, sex, BMI, foot posture, and foot mobility. In individuals with PHP, correlations were examined between foot/ankle function using the foot and ankle ability measure (FAAM), low back disability using the Oswestry low back disability questionnaire (OSW), duration of PHP symptoms, body mass index (BMI), and age. A greater percentage of individuals with PHP had LBP (74% versus 37% of controls, odds ratio=5.2, P=0.009) and higher levels of low back disability (17% higher OSW score than controls, P<0.001). In individuals with PHP, FAAM scores were correlated with OSW scores (ρ=-0.463, P=0.015), but not with duration of PHP symptoms, BMI, or age (P>0.150). Individuals with PHP had a greater prevalence of LBP and higher low back disability that was correlated to reduced foot and ankle function. Treatment to address both local and proximal impairments, including impairments related to LBP, may be warranted to improve the management of PHP. Copyright © 2017 Elsevier Ltd. All rights reserved.

Subchondral bone histology and grading in osteoarthritis

PubMed Central

Aho, Olli-Matti; Finnilä, Mikko; Thevenot, Jerome; Saarakkala, Simo; Lehenkari, Petri

2017-01-01

Objective Osteoarthritis (OA) has often regarded as a disease of articular cartilage only. New evidence has shifted the paradigm towards a system biology approach, where also the surrounding tissue, especially bone is studied more vigorously. However, the histological features of subchondral bone are only poorly characterized in current histological grading scales of OA. The aim of this study is to specifically characterize histological changes occurring in subchondral bone at different stages of OA and propose a simple grading system for them. Design 20 patients undergoing total knee replacement surgery were randomly selected for the study and series of osteochondral samples were harvested from the tibial plateaus for histological analysis. Cartilage degeneration was assessed using the standardized OARSI grading system, while a novel four-stage grading system was developed to illustrate the changes in subchondral bone. Subchondral bone histology was further quantitatively analyzed by measuring the thickness of uncalcified and calcified cartilage as well as subchondral bone plate. Furthermore, internal structure of calcified cartilage-bone interface was characterized utilizing local binary patterns (LBP) based method. Results The histological appearance of subchondral bone changed drastically in correlation with the OARSI grading of cartilage degeneration. As the cartilage layer thickness decreases the subchondral plate thickness and disorientation, as measured with LBP, increases. Calcified cartilage thickness was highest in samples with moderate OA. Conclusion The proposed grading system for subchondral bone has significant relationship with the corresponding OARSI grading for cartilage. Our results suggest that subchondral bone remodeling is a fundamental factor already in early stages of cartilage degeneration. PMID:28319157

Autonomous celestial navigation based on Earth ultraviolet radiance and fast gradient statistic feature extraction

NASA Astrophysics Data System (ADS)

Lu, Shan; Zhang, Hanmo

2016-01-01

To meet the requirement of autonomous orbit determination, this paper proposes a fast curve fitting method based on earth ultraviolet features to obtain accurate earth vector direction, in order to achieve the high precision autonomous navigation. Firstly, combining the stable characters of earth ultraviolet radiance and the use of transmission model software of atmospheric radiation, the paper simulates earth ultraviolet radiation model on different time and chooses the proper observation band. Then the fast improved edge extracting method combined Sobel operator and local binary pattern (LBP) is utilized, which can both eliminate noises efficiently and extract earth ultraviolet limb features accurately. And earth's centroid locations on simulated images are estimated via the least square fitting method using part of the limb edges. Taken advantage of the estimated earth vector direction and earth distance, Extended Kalman Filter (EKF) is applied to realize the autonomous navigation finally. Experiment results indicate the proposed method can achieve a sub-pixel earth centroid location estimation and extremely enhance autonomous celestial navigation precision.

Embedded Palmprint Recognition System Using OMAP 3530

PubMed Central

Shen, Linlin; Wu, Shipei; Zheng, Songhao; Ji, Zhen

2012-01-01

We have proposed in this paper an embedded palmprint recognition system using the dual-core OMAP 3530 platform. An improved algorithm based on palm code was proposed first. In this method, a Gabor wavelet is first convolved with the palmprint image to produce a response image, where local binary patterns are then applied to code the relation among the magnitude of wavelet response at the ccentral pixel with that of its neighbors. The method is fully tested using the public PolyU palmprint database. While palm code achieves only about 89% accuracy, over 96% accuracy is achieved by the proposed G-LBP approach. The proposed algorithm was then deployed to the DSP processor of OMAP 3530 and work together with the ARM processor for feature extraction. When complicated algorithms run on the DSP processor, the ARM processor can focus on image capture, user interface and peripheral control. Integrated with an image sensing module and central processing board, the designed device can achieve accurate and real time performance. PMID:22438721

Embedded palmprint recognition system using OMAP 3530.

PubMed

Shen, Linlin; Wu, Shipei; Zheng, Songhao; Ji, Zhen

2012-01-01

We have proposed in this paper an embedded palmprint recognition system using the dual-core OMAP 3530 platform. An improved algorithm based on palm code was proposed first. In this method, a Gabor wavelet is first convolved with the palmprint image to produce a response image, where local binary patterns are then applied to code the relation among the magnitude of wavelet response at the central pixel with that of its neighbors. The method is fully tested using the public PolyU palmprint database. While palm code achieves only about 89% accuracy, over 96% accuracy is achieved by the proposed G-LBP approach. The proposed algorithm was then deployed to the DSP processor of OMAP 3530 and work together with the ARM processor for feature extraction. When complicated algorithms run on the DSP processor, the ARM processor can focus on image capture, user interface and peripheral control. Integrated with an image sensing module and central processing board, the designed device can achieve accurate and real time performance.

Implementation of age and gender recognition system for intelligent digital signage

NASA Astrophysics Data System (ADS)

Lee, Sang-Heon; Sohn, Myoung-Kyu; Kim, Hyunduk

2015-12-01

Intelligent digital signage systems transmit customized advertising and information by analyzing users and customers, unlike existing system that presented advertising in the form of broadcast without regard to type of customers. Currently, development of intelligent digital signage system has been pushed forward vigorously. In this study, we designed a system capable of analyzing gender and age of customers based on image obtained from camera, although there are many different methods for analyzing customers. We conducted age and gender recognition experiments using public database. The age/gender recognition experiments were performed through histogram matching method by extracting Local binary patterns (LBP) features after facial area on input image was normalized. The results of experiment showed that gender recognition rate was as high as approximately 97% on average. Age recognition was conducted based on categorization into 5 age classes. Age recognition rates for women and men were about 67% and 68%, respectively when that conducted separately for different gender.

A Major Binding Protein for Leukemia Inhibitory Factor in Normal Mouse Serum: Identification as a Soluble Form of the Cellular Receptor

NASA Astrophysics Data System (ADS)

Layton, Meredith J.; Cross, Bronwyn A.; Metcalf, Donald; Ward, Larry D.; Simpson, Richard J.; Nicola, Nicos A.

1992-09-01

A protein that specifically binds leukemia inhibitory factor (LIF) has been isolated from normal mouse serum by using four successive fractionation steps: chromatography on a LIF affinity matrix, anion-exchange chromatography, size-exclusion chromatography, and preparative native gel electrophoresis. The purified LIF-binding protein (LBP) is a glycoprotein with an apparent molecular mass of 90 kDa that specifically binds 125I-labeled murine LIF with an affinity comparable to that of the low-affinity cellular LIF receptor (K_d = 600 pM). N-terminal sequencing has identified this protein as a soluble truncated form of the α chain of the cellular LIF receptor. LBP is present in normal mouse serum at high levels (1 μg/ml) and these levels are elevated in pregnant mice and reduced in neonatal mice. Since normal serum concentrations of LBP can block the biological actions of LIF in culture, LBP may serve as an inhibitor of the systemic effects of locally produced LIF.

Analysis of lower back pain disorder using deep learning

NASA Astrophysics Data System (ADS)

Ritwik Kulkarni, K.; Gaonkar, Abhijitsingh; Vijayarajan, V.; Manikandan, K.

2017-11-01

Lower back pain (LBP) is caused because of assorted reasons involving body parts such as the interconnected network of spinal cord, nerves, bones, discs or tendons in the lumbar spine. LBP is pain, muscle pressure, or stiffness localized underneath the costal edge or more the substandard gluteal folds, with or without leg torment for the most part sciatica, and is characterized as endless when it holds on for 12 weeks or more then again, non-particular LBP is torment not credited to an unmistakable pathology such as infection, tumour, osteoporosis, rheumatoid arthritis, fracture, or inflammation. Over 70% of people usually suffer from such backpain disorder at some time. But recovery is not always favorable, 82% of non-recent-onset patients still experience pain 1 year later. Even though not having any history of lower back pain, many patients suffering from this disorder spend months or years healing from it. Hence aiming to look for preventive measure rather than curative, this study suggests a classification methodology for Chronic LBP disorder using Deep Learning techniques.

Automated retinal nerve fiber layer defect detection using fundus imaging in glaucoma.

PubMed

Panda, Rashmi; Puhan, N B; Rao, Aparna; Padhy, Debananda; Panda, Ganapati

2018-06-01

Retinal nerve fiber layer defect (RNFLD) provides an early objective evidence of structural changes in glaucoma. RNFLD detection is currently carried out using imaging modalities like OCT and GDx which are expensive for routine practice. In this regard, we propose a novel automatic method for RNFLD detection and angular width quantification using cost effective redfree fundus images to be practically useful for computer-assisted glaucoma risk assessment. After blood vessel inpainting and CLAHE based contrast enhancement, the initial boundary pixels are identified by local minima analysis of the 1-D intensity profiles on concentric circles. The true boundary pixels are classified using random forest trained by newly proposed cumulative zero count local binary pattern (CZC-LBP) and directional differential energy (DDE) along with Shannon, Tsallis entropy and intensity features. Finally, the RNFLD angular width is obtained by random sample consensus (RANSAC) line fitting on the detected set of boundary pixels. The proposed method is found to achieve high RNFLD detection performance on a newly created dataset with sensitivity (SN) of 0.7821 at 0.2727 false positives per image (FPI) and the area under curve (AUC) value is obtained as 0.8733. Copyright © 2018 Elsevier Ltd. All rights reserved.

Information needs of people with low back pain for an online resource: a qualitative study of consumer views.

PubMed

Nielsen, Mandy; Jull, Gwendolen; Hodges, Paul W

2014-01-01

To identify the information needs of people with low back pain (LBP) in Australia, and the preferred methods to present this information online, as a basis for development of a patient-centred website. Available online LBP resources are limited in quality and content and it is not clear if they are meeting the needs of sufferers. Focus groups and semi-structured telephone interviews, involving 28 people with LBP. Seven categories of information were identified: reasons for LBP, treatment and management options, self-help information, psychological and social dimensions, lay stories, quality assurance of information and roles of different healthcare professionals and locally available services. Identified preferences for online presentation included: multimodality, emphasis on visual media, readability and interactivity. Participants had been unable to obtain desired LBP information using existing resources. This study provides important guidance for development of a patient-centred website grounded in the expressed needs and preferences of people with LBP. Understanding the breadth of patients' questions and concerns is essential for provision of patient-centred information and interventions. Incorporating these with the current evidence base would provide an accessible and relevant LBP patient education referral point, which is currently lacking. Implications for Rehabilitation Use of the internet to obtain health information is increasing, although there is little evidence that existing low back pain websites are meeting the expressed needs of health consumers. Our research suggests that people with low back pain have difficulty finding relevant and trustworthy information about the condition on the internet. Taking patient information needs and presentation preferences into account when designing online information material will provide people with low back pain an accessible and relevant educational resource that is currently lacking.

CT-Guided Transfacet Pedicle Screw Fixation in Facet Joint Syndrome: A Novel Approach

PubMed Central

Manfré, Luigi

2014-01-01

Summary Axial microinstability secondary to disc degeneration and consequent chronic facet joint syndrome (CFJS) is a well-known pathological entity, usually responsible for low back pain (LBP). Although posterior lumbar fixation (PIF) has been widely used for lumbar spine instability and LBP, complications related to wrong screw introduction, perineural scars and extensive muscle dissection leading to muscle dysfunction have been described. Radiofrequency ablation (RFA) of facet joints zygapophyseal nerves conventionally used for pain treatment fails in approximately 21% of patients. We investigated a “covert-surgery” minimal invasive technique to treat local spinal instability and LBP, using a novel fully CT-guided approach in patients with axial instability complicated by CFJS resistant to radioablation, by introducing direct fully or partially threaded transfacet screws (transfacet fixation - TFF), to acquire solid arthrodesis, reducing instability and LBP. The CT-guided procedure was well tolerated by all patients in simple analogue sedation, and mean operative time was approximately 45 minutes. All eight patients treated underwent clinical and CT study follow-up at two months, revealing LBP disappearance in six patients, and a significant reduction of lumbar pain in two. In conclusion, CT-guided TFF is a fast and safe technique when facet posterior fixation is needed. PMID:25363265

Structural and functional features of a developmentally regulated lipopolysaccharide-binding protein.

PubMed

Krasity, Benjamin C; Troll, Joshua V; Lehnert, Erik M; Hackett, Kathleen T; Dillard, Joseph P; Apicella, Michael A; Goldman, William E; Weiss, Jerrold P; McFall-Ngai, Margaret J

2015-10-13

Mammalian lipopolysaccharide (LPS) binding proteins (LBPs) occur mainly in extracellular fluids and promote LPS delivery to specific host cell receptors. The function of LBPs has been studied principally in the context of host defense; the possible role of LBPs in nonpathogenic host-microbe interactions has not been well characterized. Using the Euprymna scolopes-Vibrio fischeri model, we analyzed the structure and function of an LBP family protein, E. scolopes LBP1 (EsLBP1), and provide evidence for its role in triggering a symbiont-induced host developmental program. Previous studies showed that, during initial host colonization, the LPS of V. fischeri synergizes with peptidoglycan (PGN) monomer to induce morphogenesis of epithelial tissues of the host animal. Computationally modeled EsLBP1 shares some but not all structural features of mammalian LBPs that are thought important for LPS binding. Similar to human LBP, recombinant EsLBP1 expressed in insect cells bound V. fischeri LPS and Neisseria meningitidis lipooligosaccharide (LOS) with nanomolar or greater affinity but bound Francisella tularensis LPS only weakly and did not bind PGN monomer. Unlike human LBP, EsLBP1 did not bind N. meningitidis LOS:CD14 complexes. The eslbp1 transcript was upregulated ~22-fold by V. fischeri at 24 h postinoculation. Surprisingly, this upregulation was not induced by exposure to LPS but, rather, to the PGN monomer alone. Hybridization chain reaction-fluorescent in situ hybridization (HCR-FISH) and immunocytochemistry (ICC) localized eslbp1 transcript and protein in crypt epithelia, where V. fischeri induces morphogenesis. The data presented here provide a window into the evolution of LBPs and the scope of their roles in animal symbioses. Mammalian lipopolysaccharide (LPS)-binding protein (LBP) is implicated in conveying LPS to host cells and potentiating its signaling activity. In certain disease states, such as obesity, the overproduction of this protein has been a reliable biomarker of chronic inflammation. Here, we describe a symbiosis-induced invertebrate LBP whose tertiary structure and LPS-binding characteristics are similar to those of mammalian LBPs; however, the primary structure of this distantly related squid protein (EsLBP1) differs in key residues previously believed to be essential for LPS binding, suggesting that an alternative strategy exists. Surprisingly, symbiotic expression of eslbp1 is induced by peptidoglycan derivatives, not LPS, a pattern converse to that of RegIIIγ, an important mammalian immunity protein that binds peptidoglycan but whose gene expression is induced by LPS. Finally, EsLBP1 occurs along the apical surfaces of all the host's epithelia, suggesting that it was recruited from a general defensive role to one that mediates specific interactions with its symbiont. Copyright © 2015 Krasity et al.

Evaluation of the impact of the revised National Institute for Occupational Safety and Health Lifting Equation

PubMed Central

Lu, Ming-Lun; Putz-Anderson, Vern; Garg, Arun; Davis, Kermit

2016-01-01

Objective To evaluate the impact of the revised National Institute for Occupational Safety and Health lifting equation (RNLE). Background The RNLE has been used extensively as a risk assessment method for prevention of low back pain (LBP). However, the impact of the RNLE has not been documented. Methods A systematic review of the literature on the RNLE was conducted. The review consisted of three parts: characterization of the RNLE publications; assessment of the impact of the RNLE; and evaluation of the influences of the RNLE on ergonomic standards. The literature for assessing the impact was categorized into four research areas: methodology, laboratory, field and risk assessment studies using the Lifting Index (LI) or Composite LI (CLI), both of which are the products of the RNLE. Results The impact of the RNLE has been both widespread and influential. We found 24 studies that examined the criteria used to define lifting capacity used by the RNLE, 28 studies that compared risk assessment methods for identifying LBP, 23 studies that found the RNLE useful in identifying the risk of LBP with different work populations, and 13 studies on the relationship between LI/CLI and LBP outcomes. We also found evidence on the adoption of the RNLE as an ergonomic standard for use by various local, state, and international entities. Conclusion The review found 13 studies that link LI/CLI to adverse LBP outcomes. These studies showed a positive relationship between LI/CLI metrics and the severity of LBP outcomes. PMID:26822795

Machine learning techniques for diabetic macular edema (DME) classification on SD-OCT images.

PubMed

Alsaih, Khaled; Lemaitre, Guillaume; Rastgoo, Mojdeh; Massich, Joan; Sidibé, Désiré; Meriaudeau, Fabrice

2017-06-07

Spectral domain optical coherence tomography (OCT) (SD-OCT) is most widely imaging equipment used in ophthalmology to detect diabetic macular edema (DME). Indeed, it offers an accurate visualization of the morphology of the retina as well as the retina layers. The dataset used in this study has been acquired by the Singapore Eye Research Institute (SERI), using CIRRUS TM (Carl Zeiss Meditec, Inc., Dublin, CA, USA) SD-OCT device. The dataset consists of 32 OCT volumes (16 DME and 16 normal cases). Each volume contains 128 B-scans with resolution of 1024 px × 512 px, resulting in more than 3800 images being processed. All SD-OCT volumes are read and assessed by trained graders and identified as normal or DME cases based on evaluation of retinal thickening, hard exudates, intraretinal cystoid space formation, and subretinal fluid. Within the DME sub-set, a large number of lesions has been selected to create a rather complete and diverse DME dataset. This paper presents an automatic classification framework for SD-OCT volumes in order to identify DME versus normal volumes. In this regard, a generic pipeline including pre-processing, feature detection, feature representation, and classification was investigated. More precisely, extraction of histogram of oriented gradients and local binary pattern (LBP) features within a multiresolution approach is used as well as principal component analysis (PCA) and bag of words (BoW) representations. Besides comparing individual and combined features, different representation approaches and different classifiers are evaluated. The best results are obtained for LBP[Formula: see text] vectors while represented and classified using PCA and a linear-support vector machine (SVM), leading to a sensitivity(SE) and specificity (SP) of 87.5 and 87.5%, respectively.

Vision-Based Detection and Distance Estimation of Micro Unmanned Aerial Vehicles

PubMed Central

Gökçe, Fatih; Üçoluk, Göktürk; Şahin, Erol; Kalkan, Sinan

2015-01-01

Detection and distance estimation of micro unmanned aerial vehicles (mUAVs) is crucial for (i) the detection of intruder mUAVs in protected environments; (ii) sense and avoid purposes on mUAVs or on other aerial vehicles and (iii) multi-mUAV control scenarios, such as environmental monitoring, surveillance and exploration. In this article, we evaluate vision algorithms as alternatives for detection and distance estimation of mUAVs, since other sensing modalities entail certain limitations on the environment or on the distance. For this purpose, we test Haar-like features, histogram of gradients (HOG) and local binary patterns (LBP) using cascades of boosted classifiers. Cascaded boosted classifiers allow fast processing by performing detection tests at multiple stages, where only candidates passing earlier simple stages are processed at the preceding more complex stages. We also integrate a distance estimation method with our system utilizing geometric cues with support vector regressors. We evaluated each method on indoor and outdoor videos that are collected in a systematic way and also on videos having motion blur. Our experiments show that, using boosted cascaded classifiers with LBP, near real-time detection and distance estimation of mUAVs are possible in about 60 ms indoors (1032×778 resolution) and 150 ms outdoors (1280×720 resolution) per frame, with a detection rate of 0.96 F-score. However, the cascaded classifiers using Haar-like features lead to better distance estimation since they can position the bounding boxes on mUAVs more accurately. On the other hand, our time analysis yields that the cascaded classifiers using HOG train and run faster than the other algorithms. PMID:26393599

An automated technique for potential differentiation of ovarian mature teratomas from other benign tumours using neural networks classification of 2D ultrasound static images: a pilot study

NASA Astrophysics Data System (ADS)

Al-karawi, Dhurgham; Sayasneh, A.; Al-Assam, Hisham; Jassim, Sabah; Page, N.; Timmerman, D.; Bourne, T.; Du, Hongbo

2017-05-01

Ovarian cysts are a common pathology in women of all age groups. It is estimated that 5-10% of women have a surgical intervention to remove an ovarian cyst in their lifetime. Given this frequency rate, characterization of ovarian masses is essential for optimal management of patients. Patients with benign ovarian masses can be managed conservatively if they are asymptomatic. Mature teratomas are common benign ovarian cysts that occur, in most cases, in premenopausal women. These ovarian cysts can contain different types of human tissue including bone, cartilage, fat, hair, or other tissue. If they are causing no symptoms, they can be harmless and may not require surgery. Subjective assessment by ultrasound examiners has a high diagnostic accuracy when characterising mature teratomas from other types of tumours. The aim of this study is to develop a computerised technique with the potential to characterise mature teratomas and distinguish them from other types of benign ovarian tumours. Local Binary Pattern (LBP) was applied to extract texture features that are specific in distinguishing teratomas. Neural Networks (NN) was then used as a classifier for recognising mature teratomas. A pilot sample set of 130 B-mode static ovarian ultrasound images (41 mature teratomas tumours and 89 other types of benign tumours) was used to test the effectiveness of the proposed technique. Test results show an average accuracy rate of 99.4% with a sensitivity of 100%, specificity of 98.8% and positive predictive value of 98.9%. This study demonstrates that the NN and LBP techniques can accurately classify static 2D B-mode ultrasound images of benign ovarian masses into mature teratomas and other types of benign tumours.

Multi-layer sparse representation for weighted LBP-patches based facial expression recognition.

PubMed

Jia, Qi; Gao, Xinkai; Guo, He; Luo, Zhongxuan; Wang, Yi

2015-03-19

In this paper, a novel facial expression recognition method based on sparse representation is proposed. Most contemporary facial expression recognition systems suffer from limited ability to handle image nuisances such as low resolution and noise. Especially for low intensity expression, most of the existing training methods have quite low recognition rates. Motivated by sparse representation, the problem can be solved by finding sparse coefficients of the test image by the whole training set. Deriving an effective facial representation from original face images is a vital step for successful facial expression recognition. We evaluate facial representation based on weighted local binary patterns, and Fisher separation criterion is used to calculate the weighs of patches. A multi-layer sparse representation framework is proposed for multi-intensity facial expression recognition, especially for low-intensity expressions and noisy expressions in reality, which is a critical problem but seldom addressed in the existing works. To this end, several experiments based on low-resolution and multi-intensity expressions are carried out. Promising results on publicly available databases demonstrate the potential of the proposed approach.

Evaluation of Efficacy of Bone Scan With SPECT/CT in the Management of Low Back Pain: A Study Supported by Differential Diagnostic Local Anesthetic Blocks.

PubMed

Jain, Anuj; Jain, Suruchi; Agarwal, Anil; Gambhir, Sanjay; Shamshery, Chetna; Agarwal, Amita

2015-12-01

Conventional radiologic modalities provide details only about the anatomic aspect of the various structures of the spine. Frequently the structures that show abnormal morphology may not be the cause of low back pain (LBP). Functional imaging in the form of bone scan along with single photon emission computerized tomography (SPECT/CT) may be helpful in identifying structures causing pain, whether morphologically normal or not. The objective of this study is to evaluate the role of bone scan with SPECT/CT in management of patients with LBP. This is randomized double-blinded controlled study performed on 80 patients with LBP aged 20 to 80 years, ASA physical status I to III. Patients were randomized into bone scan and control groups consisting of 40 patients each. On the basis of the clinical features and radiologic findings a clinical diagnosis was made. After making a clinical diagnosis, the patients in bone scan group were subjected to bone scan with SPECT/CT. On the basis of the finding of the bone scan and SPECT/CT, a new working diagnosis was made and intervention was performed according to the new working diagnosis. Diagnostic blocks in the control group were given based on clinical diagnosis. Controlled comparative diagnostic blocks were performed with local anesthetic. The pain score just after the diagnostic block and at the time of discharge (approximately 4 h later) was recorded; the pain relief was recorded in percentage. In both the groups, sacroilitis was the most common diagnosis followed by facet joint arthropathy. The number of patients obtaining pain relief of >50% was significantly higher in the bone scan-positive group as compared with the control group. Three new clinical conditions were identified in the bone scan group. These conditions were multiple myeloma, avascular necrosis of the femoral head, and ankylosing spondylitis. Bone scan with SPECT/CT was found to complement the clinical workup of patients with LBP. Inclusion of bone scan with SPECT/CT in LBP management protocol can help in making a correct diagnosis. At times it might bring out some new information that may be vital for further management of the patients with LBP.

Diastasis of rectus abdominis muscles in low back pain patients.

PubMed

Doubkova, Lucie; Andel, Ross; Palascakova-Springrova, Ingrid; Kolar, Pavel; Kriz, Jiri; Kobesova, Alena

2018-02-06

Abdominal muscles are important spinal stabilizers and its poor coordination, as seen in diastasis of rectus abdominis (DRA), may contribute to chronic low back pain (LBP). However, this has not yet been studied directly. To conduct a pilot study to examine the association between DRA and LBP. Using a digital caliper, standard clinical DRA measurement was performed in 55 participants with and 54 without chronic LBP. Participants were on average 55 years old, 69 (63%) were women. Among the 16 participants with DRA, 11 (69%) had chronic LBP; among the 93 participants without DRA, 44 (47%) had LBP. Among men, 7 of 9 (77%) with DRA had LBP and 14 of 31 (45%) without DRA had LBP. Among women, 4 of 7 (57%) with DRA had LBP and 30 of 62 (48%) without DRA had LBP. BMI was the strongest correlate of DRA and may explain the relation between DRA and chronic LBP. DRA and LBP may be interrelated, especially among men. This may be a function of greater BMI in individuals with chronic LBP. Understanding the association between DRA, LBP, and BMI may have important implications for treatment of LBP and for intervention.

The prevalence and characteristics of low back pain among sitting workers in a Japanese manufacturing company.

PubMed

Inoue, Gen; Miyagi, Masayuki; Uchida, Kentaro; Ishikawa, Tetsuhiro; Kamoda, Hiroto; Eguchi, Yawara; Orita, Sumihisa; Yamauchi, Kazuyo; Takaso, Masashi; Tsuchiya, Kei-Ichi; Takahashi, Kazuhisa; Ohtori, Seiji

2015-01-01

Low back pain (LBP) is a major public health problem and the most common cause of workers' disability, resulting in substantial economic burden in terms of workers' compensation and medical costs. Sitting is a recognized potential risk factor for developing LBP. Therefore, eliminating risk factors associated with working conditions and individual work capacity may be beneficial in preventing LBP in sitting workers. The purpose of this prospective cross-sectional study is to investigate the prevalence of LBP and examine risk factors that contribute to the development of LBP in sitting workers at an electronics manufacturing company. A cross-sectional survey was administered to all subjects to assess the prevalence of LBP persisting for at least 48 h during the recent week. Data on demographic characteristics and potential risk factors for LBP were collected at routine annual check-ups. Patients with LBP completed the Roland-Morris Disability Questionnaire (RDQ), which provided information on the attributes of LBP. Univariate and multivariate regression analyses examined the association between LBP and potential risk factors. Of the 1,329 sitting workers, 201 (15.1 %) acknowledged experiencing LBP during the recent week. In female workers, weight and body mass index were significantly correlated with the RDQ score. Univariate analyses identified male sex, prior history of LBP, height ≥170 cm, and weight ≥70 kg as significant risk factors of LBP. Multivariate logistic regression analyses identified prior history of LBP and past history of lumbar spine surgery as significant risk factors of LBP. This study characterized the prevalence and attributes of LBP in Japanese sitting workers and provided information about potential risk factors contributing to occurrence of LBP in the workplace.

Low back pain during military service predicts low back pain later in life.

PubMed

Mattila, Ville M; Kyröläinen, Heikki; Santtila, Matti; Pihlajamäki, Harri

2017-01-01

The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life.

Low back pain during military service predicts low back pain later in life

PubMed Central

Mattila, Ville M.; Kyröläinen, Heikki; Santtila, Matti; Pihlajamäki, Harri

2017-01-01

The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life. PMID:28282419

Learning Rotation-Invariant Local Binary Descriptor.

PubMed

Duan, Yueqi; Lu, Jiwen; Feng, Jianjiang; Zhou, Jie

2017-08-01

In this paper, we propose a rotation-invariant local binary descriptor (RI-LBD) learning method for visual recognition. Compared with hand-crafted local binary descriptors, such as local binary pattern and its variants, which require strong prior knowledge, local binary feature learning methods are more efficient and data-adaptive. Unlike existing learning-based local binary descriptors, such as compact binary face descriptor and simultaneous local binary feature learning and encoding, which are susceptible to rotations, our RI-LBD first categorizes each local patch into a rotational binary pattern (RBP), and then jointly learns the orientation for each pattern and the projection matrix to obtain RI-LBDs. As all the rotation variants of a patch belong to the same RBP, they are rotated into the same orientation and projected into the same binary descriptor. Then, we construct a codebook by a clustering method on the learned binary codes, and obtain a histogram feature for each image as the final representation. In order to exploit higher order statistical information, we extend our RI-LBD to the triple rotation-invariant co-occurrence local binary descriptor (TRICo-LBD) learning method, which learns a triple co-occurrence binary code for each local patch. Extensive experimental results on four different visual recognition tasks, including image patch matching, texture classification, face recognition, and scene classification, show that our RI-LBD and TRICo-LBD outperform most existing local descriptors.

Increased prevalence of low back pain among physiotherapy students compared to medical students.

PubMed

Falavigna, Asdrubal; Teles, Alisson Roberto; Mazzocchin, Thaís; de Braga, Gustavo Lisbôa; Kleber, Fabrício Diniz; Barreto, Felipe; Santin, Juliana Tosetto; Barazzetti, Daniel; Lazzaretti, Lucas; Steiner, Bruna; Beckenkamp, Natália Laste

2011-03-01

Some studies have demonstrated that physiotherapists have a high prevalence of low back pain (LBP). The association between physiotherapy students, who are potentially exposed to the same LBP occupational risks as graduates, and LBP has never been demonstrated. The objective of the study is to evaluate the association between undergraduate physiotherapy study and LBP. The study design includes a cross-sectional study. A questionnaire-based study was carried out with physiotherapy and medical students. LBP was measured as lifetime, 1-year and point prevalence. Bivariate and multivariate analyses were performed to find the factors associated with LBP. Bivariate analyses were also performed to assess differences between LBP characteristics in the two courses. 77.9% of the students had LBP at some point in their lives, 66.8% in the last year and 14.4% of them reported they were suffering from LBP at the moment of answering the questionnaire. Physiotherapy students reported a higher prevalence of LBP when compared with the medical students in all measures. In the logistic regression model, physiotherapy students (A-OR 2.51; 95% CI 1.35-4.67; p = 0.003), and being exposed to the undergraduate study for more than four semesters (A-OR 2.55; 95% CI 1.43-4.55; p = 0.001) were independently associated with LBP. There were no differences between the courses concerning pain intensity and disability. As it was a cross-sectional study, we were not able to observe accurately if there is an increasing incidence of LBP during the course. Also, we did not intend to identify which activities in the course were associated with the development of LBP. This study clearly demonstrated an association between undergraduate physiotherapy study and LBP. The length of course exposure is also associated with LBP.

Risk factors for low back pain and sciatica in elderly men-the MrOS Sweden study.

PubMed

Kherad, Mehrsa; Rosengren, Björn E; Hasserius, Ralph; Nilsson, Jan-Åke; Redlund-Johnell, Inga; Ohlsson, Claes; Mellström, Dan; Lorentzon, Mattiaz; Ljunggren, Östen; Karlsson, Magnus K

2017-01-08

The aim of this study was to identify whether factors beyond anatomical abnormalities are associated with low back pain (LBP) and LBP with sciatica (SCI) in older men. Mister Osteoporosis Sweden includes 3,014 men aged 69–81 years. They answered questionnaires on lifestyle and whether they had experienced LBP and SCI during the preceding 12 months. About 3,007 men answered the back pain (BP) questions, 258 reported BP without specified region. We identified 1,388 with no BP, 1,361 with any LBP (regardless of SCI), 1,074 of those with LBP also indicated if they had experienced LBP (n = 615), LBP+SCI (n = 459). About 49% of those with LBP and 54% of those with LBP+SCI rated their health as poor/very poor (P < 0.001). Men with any LBP to a greater extent than those without BP had poor self-estimated health, depressive symptoms, dizziness, fall tendency, serious comorbidity (diabetes, stroke, coronary heart disease, pulmonary disease and/or cancer) (all P < 0.001), foreign background, were smokers (all P < 0.01), had low physical activity and used walking aids (all P < 0.05). Men with LBP+SCI to a greater extent than those with LBP had lower education, lower self-estimated health, comorbidity, dizziness and used walking aids (all P < 0.001). In older men with LBP and SCI, anatomical abnormalities such as vertebral fractures, metastases, central or lateral spinal stenosis or degenerative conditions may only in part explain prevalent symptoms and disability. Social and lifestyle factors must also be evaluated since they are associated not only with unspecific LBP but also with LBP with SCI.

Adaptive detection of missed text areas in OCR outputs: application to the automatic assessment of OCR quality in mass digitization projects

NASA Astrophysics Data System (ADS)

Ben Salah, Ahmed; Ragot, Nicolas; Paquet, Thierry

2013-01-01

The French National Library (BnF*) has launched many mass digitization projects in order to give access to its collection. The indexation of digital documents on Gallica (digital library of the BnF) is done through their textual content obtained thanks to service providers that use Optical Character Recognition softwares (OCR). OCR softwares have become increasingly complex systems composed of several subsystems dedicated to the analysis and the recognition of the elements in a page. However, the reliability of these systems is always an issue at stake. Indeed, in some cases, we can find errors in OCR outputs that occur because of an accumulation of several errors at different levels in the OCR process. One of the frequent errors in OCR outputs is the missed text components. The presence of such errors may lead to severe defects in digital libraries. In this paper, we investigate the detection of missed text components to control the OCR results from the collections of the French National Library. Our verification approach uses local information inside the pages based on Radon transform descriptors and Local Binary Patterns descriptors (LBP) coupled with OCR results to control their consistency. The experimental results show that our method detects 84.15% of the missed textual components, by comparing the OCR ALTO files outputs (produced by the service providers) to the images of the document.

Hip Rotation Range of Motion in People With and Without Low Back Pain Who Participate in Rotation-Related Sports

PubMed Central

Van Dillen, Linda R.; Bloom, Nancy J.; Gombatto, Sara P.; Susco, Thomas M.

2008-01-01

Objective To examine whether passive hip rotation motion was different between people with and without low back pain (LBP) who regularly participate in sports that require repeated rotation of the trunk and hips. We hypothesized that people with LBP would have less total hip rotation motion and more asymmetry of motion between sides than people without LBP. Design Two group, case-control. Setting University-based musculoskeletal analysis laboratory. Participants Forty-eight subjects (35 males, 13 females; mean age: 26.56±7.44 years) who reported regular participation in a rotation-related sport participated. Two groups were compared; people with LBP (N=24) and people without LBP (N=24; NoLBP). Main outcome measures Data were collected on participant-related, LBP-related, sport-related and activity-related variables. Measures of passive hip rotation range of motion were obtained. The differences between the LBP and NoLBP groups were examined. Results People with and without a history of LBP were the same with regard to all participant-related, sport-related and activity-related variables. The LBP group had significantly less total rotation (P=.035) and more asymmetry of total rotation, right hip versus left hip, (P=.022) than the NoLBP group. Left total hip rotation was more limited than right total hip rotation in the LBP group (P=.004). There were no significant differences in left and right total hip rotation for the NoLBP group (P=.323). Conclusions Among people who participate in rotation-related sports, those with LBP had less overall passive hip rotation motion and more asymmetry of rotation between sides than people without LBP. These findings suggest that the specific directional demands imposed on the hip and trunk during regularly performed activities may be an important consideration in deciding which impairments may be most relevant to test and to consider in prevention and intervention strategies. PMID:19081817

Antimicrobial activity of peptides derived from olive flounder lipopolysaccharide binding protein/bactericidal permeability-increasing protein (LBP/BPI).

PubMed

Nam, Bo-Hye; Moon, Ji-Young; Park, Eun-Hee; Kim, Young-Ok; Kim, Dong-Gyun; Kong, Hee Jeong; Kim, Woo-Jin; Jee, Young Ju; An, Cheul Min; Park, Nam Gyu; Seo, Jung-Kil

2014-10-17

We describe the antimicrobial function of peptides derived from the C-terminus of the olive flounder LBP BPI precursor protein. The investigated peptides, namely, ofLBP1N, ofLBP2A, ofLBP4N, ofLBP5A, and ofLBP6A, formed α-helical structures, showing significant antimicrobial activity against several Gram-negative bacteria, Gram-positive bacteria, and the yeast Candida albicans, but very limited hemolytic activities. The biological activities of these five analogs were evaluated against biomembranes or artificial membranes for the development of candidate therapeutic agents. Gel retardation studies revealed that peptides bound to DNA and inhibited migration on an agarose gel. In addition, we demonstrated that ofLBP6A inhibited polymerase chain reaction. These results suggested that the ofLBP-derived peptide bactericidal mechanism may be related to the interaction with intracellular components such as DNA or polymerase.

Nationwide firefighter survey: the prevalence of lower back pain and its related psychological factors among Korean firefighters.

PubMed

Kim, Min Gi; Seo, Ju-Il; Kim, KyooSang; Ahn, Yeon-Soon

2017-12-01

The main objective of this study was to assess the prevalence of lower back pain (LBP) and clarify the effect of work-related psychological factors on LBP. Nationwide survey data collected from male Korean firefighters (FIFS) were used. To identify the risk factors (work-related psychological factors such as job stress and depression) affecting LBP, the χ 2 test and multivariate logistic regression analyses were conducted. The prevalence of LBP was 19.3% and was highest in the emergency medical service (31.8%) part of FF job types. Within job stress, an uncomfortable physical environment, high mental job demand and organizational injustice were associated with LBP. However, inadequate social support inversely associated with LBP. Depression and high-risk alcohol drinking were related to LBP. LBP was closely related to job stress, depression and alcohol intake. Proper interventions of psychological factors should therefore be addressed to control LBP in FIFS.

Independent effect of physical workload and childhood socioeconomic status on low back pain among health care workers in Denmark.

PubMed

Jørgensen, Marie Birk; Nabe-Nielsen, Kirsten; Clausen, Thomas; Holtermann, Andreas

2013-03-15

Prospective cohort study. To investigate the independent effect of physical workload and childhood socioeconomic status (CSES) on low back pain (LBP) and LBP-related sickness absence among female health care workers. The role of physical workload on LBP independently from CSES is still subject to controversy. We used questionnaire data from 1661 female social and health care workers responding to a questionnaire in 2004, 2005, and 2006. We collected information on CSES (parental occupation), physical workload, and LBP-prevalence (no LBP, subchronic LBP, and frequent LBP), and LBP-related sickness absence. The participants were categorized into 5 groups according to CSES (I = highest, V = lowest). Data were analyzed using logistic regression analysis. Irrespective of CSES, high physical workload increased the odds ratio (OR) of future subchronic LBP (OR = 2.03; 95% confidence interval [CI], 1.61-2.57) and frequent LBP (OR = 2.20; 95% CI, 1.65-3.00), but not LBP-related sickness absence. The odds of subchronic LBP were lower in CSES groups II (OR = 0.62; 95% CI, 0.42-0.93) and III (OR = 0.58; 95% CI, 0.39-0.86) referencing CSES group I, irrespective of physical workload. The odds of short-term LBP-related sickness absence were higher in CSES groups III (OR = 2.78; 95% CI, 1.41-5.47) and IV (OR = 2.18; 95% CI, 1.11-4.27) referencing CSES group I, irrespective of physical workload. We found no interaction between physical workload and CSES. Physical workload and CSES are independently associated with future LBP within a group with similar occupational status. N/A.

Lipopolysaccharide stimulates HepG2 human hepatoma cells in the presence of lipopolysaccharide-binding protein via CD14.

PubMed

Nanbo, A; Nishimura, H; Muta, T; Nagasawa, S

1999-02-01

Lipopolysaccharide (LPS)-binding protein (LBP), an opsonin for activation of macrophages by bacterial LPS, is synthesized in hepatocytes and is known to be an acute phase protein. Recently, cytokine-induced production of LBP was reported to increase 10-fold in hepatocytes isolated from LPS-treated rats, compared with those from normal rats. However, the mechanism by which the LPS treatment enhances the effect of cytokines remains to be clarified. In the present study, we examined whether LPS alone or an LPS/LBP complex directly stimulates the hepatocytes, leading to acceleration of the cytokine-induced LBP production. HepG2 cells (a human hepatoma cell line) were shown to express CD14, a glycosylphosphatidylinositol-anchored LPS receptor, by both RT/PCR and flow cytometric analyses. An LPS/LBP complex was an effective stimulator for LBP and CD14 production in HepG2 cells, but stimulation of the cells with either LPS or LBP alone did not significantly accelerate the production of these proteins. The findings were confirmed by semiquantitative RT/PCR analysis of mRNA levels of LBP and CD14 in HepG2 cells after stimulation with LPS alone and an LPS/LBP complex. In addition, two monoclonal antibodies (mAbs) to CD14 (3C10 and MEM-18) inhibited LPS/LBP-induced cellular responses of HepG2 cells. Furthermore, prestimulation of HepG2 cells with LPS/LBP augmented cytokine-induced production and gene expression of LBP and CD14. All these findings suggest that an LPS/LBP complex, but not free LPS, stimulates HepG2 cells via CD14 leading to increased basal and cytokine-induced LBP and CD14 production.

Risk factors associated with chronic low back pain in Syria.

PubMed

Alhalabi, Mohammad Salem; Alhaleeb, Hassan; Madani, Sarah

2015-01-01

We aimed to identify risk factors associated with chronic low back pain (C-LBP) in Syria. We conducted the study in a busy outpatient neurology clinic in Damascus city from October 2011 to August 2012. We enrolled all eligible adults presenting with C-LBP along with those who denied any back pain as a controls. We considered C-LBP any LBP lasting over 3 months. We developed our own questionnaire. A clinical nurse interviewed each person and filled in the results. We had a total of 911 subjects; 513 patients and 398 controls. We found that C-LBP increased with age. Having a sibling with C-LBP was a strong predictor of C-LBP. In women obesity, but not overweight, was a risk factor. Number of children was a risk factor for mothers. Higher level of education decreased the chance of C-LBP in women. Sedentary job increased the risk of C-LBP. This study sheds some light on risk factors for C-LBP in our population and might help find possible preventive measures.

Computerized lung cancer malignancy level analysis using 3D texture features

NASA Astrophysics Data System (ADS)

Sun, Wenqing; Huang, Xia; Tseng, Tzu-Liang; Zhang, Jianying; Qian, Wei

2016-03-01

Based on the likelihood of malignancy, the nodules are classified into five different levels in Lung Image Database Consortium (LIDC) database. In this study, we tested the possibility of using threedimensional (3D) texture features to identify the malignancy level of each nodule. Five groups of features were implemented and tested on 172 nodules with confident malignancy levels from four radiologists. These five feature groups are: grey level co-occurrence matrix (GLCM) features, local binary pattern (LBP) features, scale-invariant feature transform (SIFT) features, steerable features, and wavelet features. Because of the high dimensionality of our proposed features, multidimensional scaling (MDS) was used for dimension reduction. RUSBoost was applied for our extracted features for classification, due to its advantages in handling imbalanced dataset. Each group of features and the final combined features were used to classify nodules highly suspicious for cancer (level 5) and moderately suspicious (level 4). The results showed that the area under the curve (AUC) and accuracy are 0.7659 and 0.8365 when using the finalized features. These features were also tested on differentiating benign and malignant cases, and the reported AUC and accuracy were 0.8901 and 0.9353.

Accelerating image recognition on mobile devices using GPGPU

NASA Astrophysics Data System (ADS)

Bordallo López, Miguel; Nykänen, Henri; Hannuksela, Jari; Silvén, Olli; Vehviläinen, Markku

2011-01-01

The future multi-modal user interfaces of battery-powered mobile devices are expected to require computationally costly image analysis techniques. The use of Graphic Processing Units for computing is very well suited for parallel processing and the addition of programmable stages and high precision arithmetic provide for opportunities to implement energy-efficient complete algorithms. At the moment the first mobile graphics accelerators with programmable pipelines are available, enabling the GPGPU implementation of several image processing algorithms. In this context, we consider a face tracking approach that uses efficient gray-scale invariant texture features and boosting. The solution is based on the Local Binary Pattern (LBP) features and makes use of the GPU on the pre-processing and feature extraction phase. We have implemented a series of image processing techniques in the shader language of OpenGL ES 2.0, compiled them for a mobile graphics processing unit and performed tests on a mobile application processor platform (OMAP3530). In our contribution, we describe the challenges of designing on a mobile platform, present the performance achieved and provide measurement results for the actual power consumption in comparison to using the CPU (ARM) on the same platform.

New generation of human machine interfaces for controlling UAV through depth-based gesture recognition

NASA Astrophysics Data System (ADS)

Mantecón, Tomás.; del Blanco, Carlos Roberto; Jaureguizar, Fernando; García, Narciso

2014-06-01

New forms of natural interactions between human operators and UAVs (Unmanned Aerial Vehicle) are demanded by the military industry to achieve a better balance of the UAV control and the burden of the human operator. In this work, a human machine interface (HMI) based on a novel gesture recognition system using depth imagery is proposed for the control of UAVs. Hand gesture recognition based on depth imagery is a promising approach for HMIs because it is more intuitive, natural, and non-intrusive than other alternatives using complex controllers. The proposed system is based on a Support Vector Machine (SVM) classifier that uses spatio-temporal depth descriptors as input features. The designed descriptor is based on a variation of the Local Binary Pattern (LBP) technique to efficiently work with depth video sequences. Other major consideration is the especial hand sign language used for the UAV control. A tradeoff between the use of natural hand signs and the minimization of the inter-sign interference has been established. Promising results have been achieved in a depth based database of hand gestures especially developed for the validation of the proposed system.

A comparative study of auroral morphology distribution between the Northern and Southern Hemisphere based on automatic classification

NASA Astrophysics Data System (ADS)

Yang, Qiuju; Hu, Ze-Jun

2018-03-01

Aurora is a very important geophysical phenomenon in the high latitudes of Arctic and Antarctic regions, and it is important to make a comparative study of the auroral morphology between the two hemispheres. Based on the morphological characteristics of the four labeled dayside discrete auroral types (auroral arc, drapery corona, radial corona and hot-spot aurora) on the 8001 dayside auroral images at the Chinese Arctic Yellow River Station in 2003, and by extracting the local binary pattern (LBP) features and using a k-nearest classifier, this paper performs an automatic classification of the 65 361 auroral images of the Chinese Arctic Yellow River Station during 2004-2009 and the 39 335 auroral images of the South Pole Station between 2003 and 2005. Finally, it obtains the occurrence distribution of the dayside auroral morphology in the Northern and Southern Hemisphere. The statistical results indicate that the four dayside discrete auroral types present a similar occurrence distribution between the two stations. To the best of our knowledge, we are the first to report statistical comparative results of dayside auroral morphology distribution between the Northern and Southern Hemisphere.

The Negatively Charged Regions of Lactoferrin Binding Protein B, an Adaptation against Anti-Microbial Peptides

PubMed Central

Morgenthau, Ari; Beddek, Amanda; Schryvers, Anthony B.

2014-01-01

Lactoferrin binding protein B (LbpB) is a bi-lobed membrane bound lipoprotein that is part of the lactoferrin receptor complex in a variety of Gram-negative pathogens. Despite high sequence diversity among LbpBs from various strains and species, a cluster of negatively charged amino acids is invariably present in the protein’s C-terminal lobe in all species except Moraxella bovis. The function of LbpB in iron acquisition has yet to be experimentally demonstrated, whereas in vitro studies have shown that LbpB confers protection against lactoferricin, a short cationic antimicrobial peptide released from the N- terminus of lactoferrin. In this study we demonstrate that the negatively charged regions can be removed from the Neisseria meningitidis LbpB without compromising stability, and this results in the inability of LbpB to protect against the bactericidal effects of lactoferricin. The release of LbpB from the cell surface by the autotransporter NalP reduces the protection against lactoferricin in the in vitro killing assay, attributed to removal of LbpB during washing steps, but is unlikely to have a similar impact in vivo. The protective effect of the negatively charged polysaccharide capsule in the killing assay was less than the protection conferred by LbpB, suggesting that LbpB plays a major role in protection against cationic antimicrobial peptides in vivo. The selective release of LbpB by NalP has been proposed to be a mechanism for evading the adaptive immune response, by reducing the antibody binding to the cell surface, but may also provide insights into the primary function of LbpB in vivo. Although TbpB and LbpB have been shown to be major targets of the human immune response, the selective release of LbpB suggests that unlike TbpB, LbpB may not be essential for iron acquisition, but important for protection against cationic antimicrobial peptides. PMID:24465982

Addressing Disparities in Low Back Pain Care by Developing Culturally Appropriate Information for Aboriginal Australians: "My Back on Track, My Future".

PubMed

Lin, Ivan B; Ryder, Kim; Coffin, Juli; Green, Charmaine; Dalgety, Eric; Scott, Brian; Straker, Leon M; Smith, Anne J; O'Sullivan, Peter B

2017-11-01

Addressing disparities in low back pain care (LBP) is an important yet largely unaddressed issue. One avenue to addressing disparities, recommended by clinical guidelines, is to ensure that LBP information is culturally appropriate. Our objectives were, first, to develop LBP information that was culturally appropriate for Aboriginal Australians living in a rural area and, second, to compare this to traditional information. The overall information development process was guided by a "cultural security" framework and included partnerships between Aboriginal/non-Aboriginal investigators, a synthesis of research evidence, and participation of a project steering group consisting of local Aboriginal people. LBP information (entitled My Back on Track, My Future [MBOT]) was developed as five short audio-visual scenarios, filmed using Aboriginal community actors. A qualitative randomized crossover design compared MBOT with an evidence-based standard (the Back Book [BB]). Twenty Aboriginal adults participated. Qualitatively we ascertained which information participants' preferred and why, perceptions about each resource, and LBP management. Thirteen participants preferred MBOT, four the BB, two both, and one neither. Participants valued seeing "Aboriginal faces," language that was understandable, the visual format, and seeing Aboriginal people undertaking positive changes in MBOT. In contrast, many participants found the language and format of the BB a barrier. Participants who preferred the BB were more comfortable with written information and appreciated the detailed content. The MBOT information was more preferred and addressed important barriers to care, providing support for use in practice. Similar processes are needed to develop pain information for other cultural groups, particularly those underserved by existing approaches to care. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Does educational attainment increase the risk of low back pain when genetics are considered? A population-based study of Spanish twins.

PubMed

Zadro, Joshua R; Shirley, Debra; Pinheiro, Marina B; Sánchez-Romera, Juan F; Pérez-Riquelme, Francisco; Ordoñana, Juan R; Ferreira, Paulo H

2017-04-01

There is limited research investigating educational attainment as a risk factor for low back pain (LBP), with the influence of gender commonly being neglected. Furthermore, genetics and early shared environment explain a substantial proportion of LBP cases and need to be controlled for when investigating risk factors for LBP. To investigate whether educational attainment affects the prevalence and risk of LBP differently in men and women while controlling for the influence of genetics and early shared environment. This is a cross-sectional and prospective twin case-control study. Adult monozygotic (MZ) and dizygotic (DZ) twins from the Murcia Twin Registry, with available data on educational attainment, formed the base sample for this study. The prevalence analysis considered twins with available data on LBP in 2013 (n=1,580). The longitudinal analysis considered twins free of LBP at baseline (2009-2011), with available data on LBP at follow-up (2013) (n=1,077). Data on the lifetime prevalence of activity limiting LBP (outcome) and educational attainment (risk factor) were self-reported. The prevalence analysis investigated the cross-sectional association between educational attainment and LBP, whereas the longitudinal analysis investigated whether educational attainment increased the risk of developing LBP. Both analyses were performed in the following sequence. First, a total sample analysis was performed on all twins (considering them as individuals), adjusting for confounding variables selected by the data. Second, to control for the influence of genetics and early shared environment, a within-pair case-control analysis (stratified by zygosity) was performed on complete twin pairs discordant for LBP (ie, one twin had LBP, whereas the co-twin did not). All analyses were stratified for gender where possible, with an interaction term determining whether gender was a significant moderator of the association between educational attainment and LBP. Women with either general secondary or university education were less likely to experience (prevalence analysis) or to develop LBP (longitudinal analysis). Educational attainment did not affect the risk of LBP in men. When controlling for the effects of genetics and early shared environment, the relationship between educational status and LBP in women was no longer statistically significant. Educational attainment affects LBP differently in men and women, with higher levels of education only decreasing the risk of developing LBP in women. After adjusting for genetics and early shared environment, the relationship between educational attainment and LBP in women disappears. This suggests that genetics and early shared environment are confounding the relationship between educational attainment and LBP in women. Copyright © 2016 Elsevier Inc. All rights reserved.

Physical therapists’ treatment choices for non-specific low back pain in Florida: an electronic survey

PubMed Central

Ladeira, Carlos E; Samuel Cheng, M; Hill, Cheryl J

2015-01-01

Objectives: No study has described low back pain (LBP) treatment choices among physical therapists (PTs) in the United States (US) in the new millennium. Intervention for LBP in the new millennium is largely based on evidence-based practice (EBP) recommendations. The purpose of this study was twofold: (a) to describe PTs' preferences for treating acute and subacute non-specific LBP in Florida and to compare these preferences to EBP guideline recommendations and (b) to compare outpatient musculoskeletal therapist (MSPT) choices for management of acute and subacute LBP to non-outpatient musculoskeletal therapist (NMSPT) choices. Methods: The data were collected with an electronic survey. Study participants selected treatment choices for acute and subacute LBP clinical vignettes. Results: A total of 327 PTs participated in the study, of which 128 worked in outpatient musculoskeletal settings. The most common treatment choices for acute and subacute LBP were home exercise program, exercise in the clinic, back care education, joint mobilization, ice/heat, and interferential current. The EBP adherence rate for acute LBP was 30% for MSPTs and 15% for NMSPTs. Thirty-seven percent (37%) of MSPTs and 30% of NMSPTs adhered to EBP guidelines for subacute LBP. Discussion: The EBP adherence rate for management of acute and subacute LBP was low. Spinal manipulation was underutilized for management of acute LBP, and passive therapeutic procedures were overutilized for subacute LBP. Physical Therapy schools and professional associations should reemphasize the benefits of spinal manipulation to manage non-specific acute LBP and active interventional procedures to manage subacute LBP. PMID:26109832

Accumulation of psychosocial and lifestyle factors and risk of low back pain in adolescence: a cohort study.

PubMed

Mikkonen, Paula; Heikkala, Eveliina; Paananen, Markus; Remes, Jouko; Taimela, Simo; Auvinen, Juha; Karppinen, Jaro

2016-02-01

Low back pain (LBP) is common already in adolescence, and many risk indicators including both psychosocial and lifestyle factors have been recognized. Our purpose was to assess whether the co-occurrence of psychosocial (externalizing and internalizing) problems and lifestyle factors (leisure time physical activity, sedentary behaviour, sleep, smoking, and overweight/obesity) associate with LBP at 16 years cross-sectionally or with new LBP at 18-year follow-up. The study population, drawn from the Northern Finland Birth Cohort 1986, consisted of 1625 participants (712 boys and 913 girls) who completed a questionnaire on potential explanatory factors at 16 years and on LBP at 16 and 18 years. The outcome measure was 'reporting LBP' or 'consultation for LBP' during the past 6 months. Latent Class Analysis (LCA) was utilized to study the co-occurrence of the explanatory factors. Among both genders, four clusters were found. Externalizing behaviour problems were associated with 'reporting LBP' (RR 1.5, boys 1.4, girls) and 'consultation for LBP' (RR 1.6 for both genders) at baseline among both genders. In addition, the cluster of multiple risk behaviours was associated with both 'reporting LBP' (RR 1.3) and 'consultation for LBP' (RR 2.5) and the obese cluster with 'consultation for LBP' (RR 1.7) among girls. Externalizing behaviour problems at 16 years predicted 'consultation for LBP' at 18 years among girls (RR 3.6). Our results stress the role of psychosocial factors in reporting and seeking care for adolescent LBP.

Narcotic Drug Use Among Patients with Lower Back Pain in Employer Health Plans: A Retrospective Analysis of Risk Factors and Health Care Services

PubMed Central

Rhee, YongJoo; Taitel, Michael S.; Walker, David R.; Lau, Denys T.

2009-01-01

Objective: This study examines the risk factors of narcotic drug use, medical and pharmacy claim costs, and health services use among lower back pain (LBP) patients who use narcotic medications. Methods: This retrospective study used administrative claims data between September 2002 and March 2004 from 3 employer health plans that collectively contained records of 165,569 employees 18 to 64 years of age. Multivariate regression analyses were performed to examine risk factors and health care services use consequences of narcotic drug use in patients with LBR Results: The study sample included 13,760 patients with LBP due to mechanical causes. Nearly 60% were female and the average age was 47 years. Almost half of the patients with LBP (45%) used narcotic drugs. Narcotic-using patients with LBP had significantly higher rates of comorbid conditions than patients with LBP not using narcotic drugs; hypertension (23% vs 13%), arthritis (14% vs 4%), depression (10% vs 5%), anxiety (6% vs 3%), and cancer (2% vs 1%) (P < 0.001). Patients with LBP with 2 identified psychological comorbid conditions, depression and anxiety, on average used more narcotic medications. Patients with LBP who had surgery were significantly more likely to use narcotic drugs within 1 week of procedure than those patients without surgery (P < 0.001). In contrast, patients with LBP who had chiropractic services for LBP were less likely to take narcotic drugs within 7 days after services compared to those without chiropractic services (P < 0.001). Furthermore, controlling for health conditions, patients with LBP who took narcotic medications were significantly more likely than patients not taking narcotics to have an emergency room visit within 30 days after the initial narcotic drug prescription dates (P < 0.001). Narcotic-using patients with LBP accounted for 62% of health care costs among all patients with LBP. The average monthly health care cost for a narcotic-using LBP patient was $1222, compared to $430 for a LBP patient not using narcotic drugs (P < 0.001). Conclusions: The subjects with LBP who used narcotic medications were more likely to have additional coexisting health conditions and used more health care services than nonusing patients with LBP (P < 0.001). Unadjusted health care services costs, including pharmacy claims costs, were significantly higher in patients with LBP using narcotic drugs than in nonusing patients with LBP (P < 0.001). PMID:18164925

Low back pain among office workers in three Spanish speaking-countries: findings from the CUPID study

PubMed Central

Campos-Fumero, Adriana; Delclos, George L.; Douphrate, David I.; Felknor, Sarah A.; Vargas-Prada, Sergio; Serra, Consol; Coggon, David; Gimeno Ruiz de Porras, David

2017-01-01

Objectives To assess differences in the prevalence and incidence of low back pain (LBP) and associated disability among office workers in Costa Rica, Nicaragua and Spain. Methods Data were collected at baseline (n=947, 93% response) in November 2007 and at follow-up after 12 months (n=853, 90% response). Six outcome measures were examined: baseline prevalence of (1) LBP in past 12 months, (2) LBP in past month, and (3) disabling LBP in past month; and at follow-up: (4) incidence of new LBP in the past month, (5) new disabling LBP, and (6) persistent LBP. Differences in prevalence by country were characterized by odd ratios (ORs) with 95% confidence intervals (95%CIs), before and after adjustment for covariates. Results Prevalence of LBP in the past month among office employees in Costa Rica (46.0%) and Nicaragua (44.2%) was higher than in Spain (33.6%). Incidence of new LBP was 37.0% in Nicaragua (OR=2.49; 95% CI: 1.57-3.95), 14.9% in Costa Rica (OR=0.74; 95% CI: 0.41-1.34), and 19.0% in Spain (reference). Incidence of new disabling LBP was higher in Nicaragua, 17.2% (OR=2.49; 95% CI: 1.43-4.34) and Costa Rica, 13.6% (OR=1.89; 95% CI: 1.03-3.48) than Spain (7.7%), while persistence of LBP was higher only in Nicaragua. Conclusions Prevalence of LBP and disabling LBP was higher in Costa Rican and Nicaraguan office workers than in Spain, but incidence was higher mainly in Nicaragua. Measured sociodemographic, job-related and health-related variables only partly explained the differences between countries, and further research is needed to explore reasons for the remaining differences. PMID:27585564

Association between sitting and occupational LBP

PubMed Central

Black, Katia M.; Korn, Hayley; Nordin, Margareta

2006-01-01

Low back pain (LBP) has been identified as one of the most costly disorders among the worldwide working population. Sitting has been associated with risk of developing LBP. The purpose of this literature review is to assemble and describe evidence of research on the association between sitting and the presence of LBP. The systematic literature review was restricted to those occupations that require sitting for more than half of working time and where workers have physical co-exposure factors such as whole body vibration (WBV) and/or awkward postures. Twenty-five studies were carefully selected and critically reviewed, and a model was developed to describe the relationships between these factors. Sitting alone was not associated with the risk of developing LBP. However, when the co-exposure factors of WBV and awkward postures were added to the analysis, the risk of LBP increased fourfold. The occupational group that showed the strongest association with LBP was Helicopter Pilots (OR=9.0, 90% CI 4.9–16.4). For all studied occupations, the odds ratio (OR) increased when WBV and/or awkward postures were analyzed as co-exposure factors. WBV while sitting was also independently associated with non-specific LBP and sciatica. Vibration dose, as well as vibration magnitude and duration of exposure, were associated with LBP in all occupations. Exposure duration was associated with LBP to a greater extent than vibration magnitude. However, for the presence of sciatica, this difference was not found. Awkward posture was also independently associated with the presence of LBP and/or sciatica. The risk effect of prolonged sitting increased significantly when the factors of WBV and awkward postures were combined. Sitting by itself does not increase the risk of LBP. However, sitting for more than half a workday, in combination with WBV and/or awkward postures, does increase the likelihood of having LBP and/or sciatica, and it is the combination of those risk factors, which leads to the greatest increase in LBP. PMID:16736200

Association between sitting and occupational LBP.

PubMed

Lis, Angela Maria; Black, Katia M; Korn, Hayley; Nordin, Margareta

2007-02-01

Low back pain (LBP) has been identified as one of the most costly disorders among the worldwide working population. Sitting has been associated with risk of developing LBP. The purpose of this literature review is to assemble and describe evidence of research on the association between sitting and the presence of LBP. The systematic literature review was restricted to those occupations that require sitting for more than half of working time and where workers have physical co-exposure factors such as whole body vibration (WBV) and/or awkward postures. Twenty-five studies were carefully selected and critically reviewed, and a model was developed to describe the relationships between these factors. Sitting alone was not associated with the risk of developing LBP. However, when the co-exposure factors of WBV and awkward postures were added to the analysis, the risk of LBP increased fourfold. The occupational group that showed the strongest association with LBP was Helicopter Pilots (OR=9.0, 90% CI 4.9-16.4). For all studied occupations, the odds ratio (OR) increased when WBV and/or awkward postures were analyzed as co-exposure factors. WBV while sitting was also independently associated with non-specific LBP and sciatica. Vibration dose, as well as vibration magnitude and duration of exposure, were associated with LBP in all occupations. Exposure duration was associated with LBP to a greater extent than vibration magnitude. However, for the presence of sciatica, this difference was not found. Awkward posture was also independently associated with the presence of LBP and/or sciatica. The risk effect of prolonged sitting increased significantly when the factors of WBV and awkward postures were combined. Sitting by itself does not increase the risk of LBP. However, sitting for more than half a workday, in combination with WBV and/or awkward postures, does increase the likelihood of having LBP and/or sciatica, and it is the combination of those risk factors, which leads to the greatest increase in LBP.

Lipopolysaccharide binding protein enhances the responsiveness of alveolar macrophages to bacterial lipopolysaccharide. Implications for cytokine production in normal and injured lungs.

PubMed Central

Martin, T R; Mathison, J C; Tobias, P S; Letúrcq, D J; Moriarty, A M; Maunder, R J; Ulevitch, R J

1992-01-01

A plasma lipopolysaccharide (LPS)-binding protein (LBP) has been shown to regulate the response of rabbit peritoneal macrophages and human blood monocytes to endotoxin (LPS). We investigated whether LBP is present in lung fluids and the effects of LBP on the response of lung macrophages to LPS. Immunoreactive LBP was detectable in the lavage fluids of patients with the adult respiratory distress syndrome by immunoprecipitation followed by Western blotting, and also by specific immunoassay. In rabbits, the LBP appeared to originate outside of the lungs, inasmuch as mRNA transcripts for LBP were identified in total cellular RNA from liver, but not from lung homogenates or alveolar macrophages. Purified LBP enhanced the response of human and rabbit alveolar macrophages to both smooth form LPS (Escherichia coli O111B:4) and rough form LPS (Salmonella minnesota Re595). In the presence of LBP and LPS, the onset of tumor necrosis factor-alpha (TNF alpha) production occurred earlier and at an LPS threshold dose that was as much as 1,000-fold lower for both types of LPS. In rabbit alveolar macrophages treated with LBP and LPS, TNF alpha mRNA appeared earlier, reached higher levels, and had a prolonged half-life as compared with LPS treatment alone. Neither LPS nor LPS and LBP affected pHi or [Cai++] in alveolar macrophages. Specific monoclonal antibodies to CD14, a receptor that binds LPS/LBP complexes, inhibited TNF alpha production by human alveolar macrophages stimulated with LPS alone or with LPS/LBP complexes, indicating the importance of CD14 in mediating the effects of LPS on alveolar macrophages. Thus, immunoreactive LBP accumulates in lung lavage fluids in patients with lung injury and enhances LPS-stimulated TNF alpha gene expression in alveolar macrophages by a pathway that depends on the CD14 receptor. LBP may play an important role in augmenting TNF alpha expression by alveolar macrophages within the lungs. Images PMID:1281827

Factors affecting low back pain in adolescents.

PubMed

Korovessis, Panagiotis; Repantis, Thomas; Baikousis, Andreas

2010-12-01

Prospective multifactorial study on low back pain (LBP) in adolescents. Most studies on LBP have focused on adults although many investigations have shown that the roots of LBP lie in adolescence. Several mechanical, physical, and behavioral factors have been associated with nonspecific LBP in adolescents. To investigate the effect of all previously reported parameters together with psychological and psychosocial factors using advanced statistics, on LBP in adolescents aged 15 to 19 years. Six hundred and eighty-eight students aged 16±1 years from 5 randomly selected high schools participated in this study and completed a questionnaire containing questions on daily activity, backpack carrying, psychological and psychosocial behavior. Anthropometric data as well as biplane spinal curvatures together with questionnaire results were included in the analysis using advanced statistics. LBP reported 41% of the participants. Generally, statistically significant correlations were found between LBP (0.002), physical activity (P<0.001), physician consultation (P=0.024), and depression (P<0.001). Sex-related differences were shown regarding LBP intensity (P=0.005) and frequency (P=0.013), stress (P<0.03), depression (P=0.005), and nervous mood (P=0.036) in favor of male students. Male adolescents had continuous energy (P=0.0258) and were calm (P=0.029) in contrast with female counterparts. LBP was sex-related and was less common in adolescents with frequent activity. Adolescent girls with stress, depressive mood, and low energy have more LBP than boys, which makes physician consultation for LBP more common in female adolescents. Systematic physical activity and control of psychological profile should decrease LBP frequency and intensity.

Low back pain prevalence in healthcare professionals and identification of factors affecting low back pain.

PubMed

Çınar-Medeni, Özge; Elbasan, Bulent; Duzgun, Irem

2017-01-01

Work-related musculoskeletal system diseases are commonly observed among nurses, physiotherapists, dentists, and dieticians. To assess working postures of nurses, physiotherapists, dentists and dieticians, to identify whether low back pain (LBP) is present, and to put forth the correlation between LBP, working posture, and other factors. Twenty seven physiotherapists, 34 nurses, 30 dentists, and 16 dieticians were included. Impairment ratings of cases with LBP were analysed with Quebec Back Pain Disability Scale (Quebec). Working postures were analysed with Owako Working Posture Analysis System. LBP was observed in 70.09% of healthcare professionals. Of the individuals suffering from LBP, 57.2% were working with a risky posture. 40.63% of individuals without LBP were using risky working postures. Trunk and head posture distribution of individuals with and without LBP was found as different from each other (p < 0.05). LBP prevalence of dentists and nurses were higher compared to other groups (p < 0.05). Quebec scores of professionals with LBP were not different among occupations (p > 0.05). Quebec scores were observed as correlated with various factors in various occupation groups. Considering that head-neck and trunk postures are changeable factors that are among the factors affecting LBP, correcting the working posture gains importance.

Relationship between mechanical factors and incidence of low back pain.

PubMed

Nourbakhsh, Mohammad Reza; Arab, Amir Massoud

2002-09-01

A multifactorial cross-sectional nonexperimental design. To collectively investigate the association among 17 mechanical factors and occurrence of low back pain (LBP). Several physical characteristics, based on assumptions, clinical findings, and scientific experiments, have been associated with the development of LBP Controversy exists regarding the degree of association between some of these physical characteristics and LBP. Information regarding the degree of association of each factor to LBP is needed for effective prevention and appropriate treatment strategies. A total of 600 subjects participated in this study. Subjects were categorized into 4 groups: asymptomatic men (n = 150, age [mean +/- SD] = 43 +/- 15 years), asymptomatic women (n = 150, age [mean +/- SD] = 43 +/- 13 years), men with LBP (n = 150, age [mean +/- SD] = 43 +/- 14 years), and women with LBP (n = 150, age [mean +/- SD] = 43 +/- 13 years). Seventeen physical characteristics were measured in each group and the relative association of each characteristic with LBP was assessed. Among all the factors tested, endurance of the back extensor muscles had the highest association with LBP Other factors such as the length of the back extensor muscles, and the strength of the hip flexor, hip adductor, and abdominal muscles also had a significant association with LBP. It appears that muscle endurance and weakness are associated with LBP and that structural factors such as the size of the lumbar lordosis, pelvic tilt, leg length discrepancy, and the length of abdominal, hamstring, and iliopsoas muscles are not associated with the occurrence of LBP.

Risk of Recurrence of Low Back Pain: A Systematic Review.

PubMed

da Silva, Tatiane; Mills, Kathryn; Brown, Benjamin T; Herbert, Robert D; Maher, Christopher G; Hancock, Mark J

2017-05-01

Study Design Systematic review. Background While most people with acute low back pain (LBP) recover quickly, recurrences are believed to be common. To our knowledge, no published high-quality systematic review has assessed the risk of recurrent LBP or the factors that would predict LBP recurrence. Objectives The aim of this study was to investigate the risk of, and prognostic factors for, a recurrence of LBP in patients who have recovered from a previous episode of LBP within the last year. Methods Systematic searches were conducted in the MEDLINE, Embase, and CINAHL databases. We included longitudinal studies of adults who had recovered from a previous episode of LBP within 12 months. The primary outcome was a new episode of LBP. Secondary outcomes were other types of recurrence (eg, episodes causing care seeking). Results Eight studies were included in the review: 7 observational studies and 1 randomized trial (2 publications). Six studies reported recurrence proportions for the primary outcome of an episode of LBP. Meta-analysis was not conducted due to the low quality and heterogeneity of studies. Only 1 study was considered an inception cohort study; it reported a 1-year recurrence proportion of 33%. A history of previous episodes of LBP prior to the most recent episode was the only factor that consistently predicted recurrence of LBP. Conclusion The available research does not provide robust estimates of the risk of LBP recurrence and provides little information about factors that predict recurrence in people recently recovered from an episode of LBP. Level of Evidence Prognosis, 1a-. Prospectively registered in PROSPERO on February 9, 2016 (CRD42016030220). J Orthop Sports Phys Ther 2017;47(5):305-313. Epub 29 Mar 2017. doi:10.2519/jospt.2017.7415.

Risk of falls in Brazilian elders with and without low back pain assessed using the Physiological Profile Assessment: BACE study

PubMed Central

Rosa, Nayza M. B.; Queiroz, Bárbara Z.; Lopes, Renata A.; Sampaio, Natalia R.; Pereira, Daniele S.; Pereira, Leani S. M.

2016-01-01

ABSTRACT Background Low back pain (LBP) is a common musculoskeletal condition among elders and is associated with falls. However, the underlying biological risk factors for falling among elders with LBP has been poorly investigated. The Physiological Profile Assessment (PPA) is a validated fall-risk assessment tool that involves the direct assessment of sensorimotor abilities and may contribute to the understanding of risk factors for falls among elders with LBP. Objective To assess fall risk using the PPA in elders with and without LBP. Method This is an observational, comparative, cross-sectional study with elders aged ≥65 years. The present study was conducted with a subsample of participants from the Back Complaints in the Elders (BACE) - Brazil study. Fall risk was assessed using the PPA, which contains five tests: visual contrast sensitivity, hand reaction time, quadriceps strength, lower limb proprioception, and postural sway. Results Study participants included 104 individuals with average age of 72.3 (SD=4.0) years, divided into two groups: GI) 52 participants with LBP; GII) 52 participants without LBP. The participants with LBP had a significantly higher fall risk (1.10 95% CI 0.72 to 1.48), greater postural sway (49.78 95% CI 13.54 to 86.01), longer reaction time (58.95 95% CI 33.24 to 84.65), and lower quadriceps strength (–4.42 95% CI –8.24 to –0.59) compared to asymptomatic participants. There was no significant difference for vision and proprioception tests between LBP and non-LBP participants. Conclusion Elders with LBP have greater risk for falls than those without LBP. Our results suggest fall-risk screening may be sensible in elders with LBP. PMID:27683833

Association between rotation-related impairments and activity type in people with and without low back pain

PubMed Central

Weyrauch, Stephanie A.; Bohall, Sara C.; Sorensen, Christopher J.; Van Dillen, Linda R.

2015-01-01

Objective To determine if people with low back pain (LBP) who regularly participated in a rotation-related activity displayed more rotation-related impairments than people without LBP who did and did not participate in the activity. Design Secondary analysis of data from a case-control study. Setting Musculoskeletal analysis laboratory at an academic medical center. Participants A convenience sample of 55 participants with LBP who participated in a rotation-related sport, 26 back healthy controls who participated in a rotation-related sport (BHC+RRS) and 42 back healthy controls who did not participate in a rotation-related sport (BHC-RRS). Participants were matched based on age, gender, and activity level. Interventions Not applicable. Main Outcome Measures The total number of rotation-related impairments and asymmetric rotation-related impairments identified during a standardized clinical examination. Results Compared to the BHC-RRS group, both the LBP and BHC+RRS groups displayed significantly more (1) rotation-related impairments (LBP: p<.001; BHC+RRS: p=.015) (2) asymmetric rotation-related impairments (LBP: p=.006; BHC+RRS: p=.020) and (3) rotation-related impairments with trunk movement tests (LBP: p=.002; BHC+RRS: p<.001). The LBP group had significantly more rotation-related impairments with extremity movement tests than both of the back healthy groups (BHC+RRS: p=.011; BHC-RRS: p<.001). Conclusions LBP and BHC+RRS groups demonstrated a similar number of total rotation-related impairments and asymmetric rotation-related impairments, and these numbers were greater than those of the BHC-RRS group. Compared to people without LBP, people with LBP displayed more rotation-related impairments when moving an extremity. These findings suggest that impairments associated with extremity movements may be associated with having a LBP condition. PMID:25933914

Size and symmetry of trunk muscles in ballet dancers with and without low back pain.

PubMed

Gildea, Jan E; Hides, Julie A; Hodges, Paul W

2013-08-01

Cross-sectional, observational study. To investigate the cross-sectional area (CSA) of trunk muscles in professional ballet dancers with and without low back pain (LBP). LBP is the most prevalent chronic injury in classical ballet dancers. Research on nondancers has found changes in trunk muscle size and symmetry to be associated with LBP. There are no studies that examine these changes in ballet dancers. Magnetic resonance imaging was performed in 14 male and 17 female dancers. The CSAs of 4 muscles (multifidus, lumbar erector spinae, psoas, and quadratus lumborum) were measured and compared among 3 groups of dancers: those without LBP or hip pain (n = 8), those with LBP only (n = 13), and those with both hip-region pain and LBP (n = 10). Dancers with no pain had larger multifidus muscles compared to those with LBP at L3-5 (P<.024) and those with both hip-region pain and LBP at L3 and L4 on the right side (P<.027). Multifidus CSA was larger on the left side at L4 and L5 in dancers with hip-region pain and LBP compared to those with LBP only (P<.033). Changes in CSA were not related to the side of pain (all, P>.05). The CSAs of the other muscles did not differ between groups. The psoas (P<.0001) and quadratus lumborum (P<.01) muscles were larger in male dancers compared to female dancers. There was a positive correlation between the size of the psoas muscles and the number of years of professional dancing (P = .03). In classical ballet dancers, LBP and hip-region pain and LBP are associated with a smaller CSA of the multifidus but not the erector spinae, psoas, or quadratus lumborum muscles.

From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing—an exploratory study

PubMed Central

Marcuzzi, Anna; Wrigley, Paul J.; Dean, Catherine M.; Graham, Petra L.; Hush, Julia M.

2018-01-01

Abstract Introduction: Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published. Objectives: This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset. Methods: Twenty-five people with acute LBP (<3 weeks' duration) and 48 pain-free controls were prospectively assessed at baseline using quantitative sensory testing with the assessor blinded to group allocation, and again at 2 and 4 months. Psychological variables were concurrently assessed. People with acute LBP were classified based on their average pain severity over the previous week at 4 months as recovered (≤1/10 numeric rating scale) or persistent (≥2/10 numeric rating scale) LBP. Results: In the persistent LBP group, (1) there was a significant decrease in pressure pain threshold between 2 and 4 months (P < 0.013), and at 4 months, pressure pain threshold was significantly different from the recovered LBP group (P < 0.001); (2) a trend towards increased temporal summation was found at 2 months and 4 months, at which point it exceeded 2 SDs beyond the pain-free control reference value. Pain-related psychological variables were significantly higher in those with persistent LBP compared with the recovered LBP group at all time points (P < 0.05). Conclusion: Changes in mechanical pain sensitivity occurring in the subacute stage warrant further longitudinal evaluation to better understand the role of somatosensory changes in the development of persistent LBP. Pain-related cognitions at baseline distinguished persistent from the recovered LBP groups, emphasizing the importance of concurrent evaluation of psychological contributors in acute LBP. PMID:29756087

Standardized measurement of recovery from nonspecific back pain.

PubMed

Hush, Julia M; Kamper, Steven J; Stanton, Tasha R; Ostelo, Raymond; Refshauge, Kathryn M

2012-05-01

To propose standardized, patient-centered measures of recovery from nonspecific low back pain (LBP) in research, underpinned by an empirically derived concept of recovery and informed by expert opinion. Synthesis of literature reviews and expert panel opinion. Primary care centers for the management of nonspecific LBP. Persons with nonspecific LBP. Conservative treatments for nonspecific LBP. Three phases of research were conducted. First, qualitative research that explored patients' perspectives of recovery from nonspecific LBP was reviewed. Second, measures of recovery used in LBP clinical trials during the past decade were investigated in a systematic review. Third, opinion was sought from an expert panel of clinicians and researchers about how to measure recovery from nonspecific LBP, in a workshop at the 10th International Forum for Primary Care Research in Low Back Pain. An empirically derived and patient-centered concept of recovery from nonspecific LBP was developed from the qualitative research phase. The systematic review conducted in the second study phase revealed that researchers have used vastly heterogeneous measures of LBP recovery in clinical trials during the past decade. Finally, the key conclusions of the LBP Forum workshop were (1) that appropriate patient-centered instruments to measure recovery include global measures and patient-specific measures; and (2) that the benefits of implementing the same recovery measures for acute and chronic LBP outweigh the disadvantages of using different measures. The results were synthesized to inform our recommendation that researchers consider adopting 2 instruments as standardized measures of recovery from nonspecific LBP, as an adjunct to the existing core set of LBP outcome measures. These instruments are an 11-point Global Back Recovery Scale, for a simple measure of global recovery, and the Patient-Generated Index of Quality of Life-Back Pain, to evaluate specific relevant dimensions of recovery. This recommendation has majority endorsement by members of the Australian National Health and Medical Research Council Acute Low Back Pain Review Group. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing-an exploratory study.

PubMed

Marcuzzi, Anna; Wrigley, Paul J; Dean, Catherine M; Graham, Petra L; Hush, Julia M

2018-03-01

Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published. This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset. Twenty-five people with acute LBP (<3 weeks' duration) and 48 pain-free controls were prospectively assessed at baseline using quantitative sensory testing with the assessor blinded to group allocation, and again at 2 and 4 months. Psychological variables were concurrently assessed. People with acute LBP were classified based on their average pain severity over the previous week at 4 months as recovered (≤1/10 numeric rating scale) or persistent (≥2/10 numeric rating scale) LBP. In the persistent LBP group, (1) there was a significant decrease in pressure pain threshold between 2 and 4 months ( P < 0.013), and at 4 months, pressure pain threshold was significantly different from the recovered LBP group ( P < 0.001); (2) a trend towards increased temporal summation was found at 2 months and 4 months, at which point it exceeded 2 SDs beyond the pain-free control reference value. Pain-related psychological variables were significantly higher in those with persistent LBP compared with the recovered LBP group at all time points ( P < 0.05). Changes in mechanical pain sensitivity occurring in the subacute stage warrant further longitudinal evaluation to better understand the role of somatosensory changes in the development of persistent LBP. Pain-related cognitions at baseline distinguished persistent from the recovered LBP groups, emphasizing the importance of concurrent evaluation of psychological contributors in acute LBP.

An Exploratory Examination of the Association Between Altered Lumbar Motor Control, Joint Mobility and Low Back Pain in Athletes

PubMed Central

Corkery, Marie B.; O’Rourke, Brittany; Viola, Samantha; Yen, Sheng-Che; Rigby, Joseph; Singer, Kevin; Thomas, Adam

2014-01-01

Background: Low back pain (LBP) is a common cause of lost playing time and can be a challenging clinical condition in competitive athletes. LBP in athletes may be associated with joint and ligamentous hypermobility and impairments in activation and coordination of the trunk musculature, however there is limited research in this area. Objectives: To determine if there is an association between altered lumbar motor control, joint mobility and low back pain (LBP) in a sample of athletes. Materials and Methods: Fifteen athletes with LBP were matched by age, gender and body mass index (BMI) with controls without LBP. Athletes completed a questionnaire with questions pertaining to demographics, activity level, medical history, need to self-manipulate their spine, pain intensity and location. Flexibility and lumbar motor control were assessed using: active and passive straight leg raise, lumbar range of motion (ROM), hip internal rotation ROM (HIR), Beighton ligamentous laxity scale, prone instability test (PIT), observation of lumbar aberrant movements, double leg lowering and Trendelenburg tests. Descriptive statistics were compiled and the chi square test was used to analyze results. Results: Descriptive statistics showed that 40% of athletes with LBP exhibited aberrant movements (AM), compared to 6% without LBP. 66% of athletes with LBP reported frequently self-manipulating their spine compared to 40% without LBP. No significant differences in motor control tests were found between groups. Athletes with LBP tended to have less lumbar flexion (63 ± 11°) compared to those without LBP (66 ± 13°). Chi-Square tests revealed that the AM were more likely to be present in athletes with LBP than those without (X2 = 4.66, P = 0.03). Conclusions: The presence of aberrant movement patterns is a significant clinical finding and associated with LBP in athletes. PMID:25741418

A Comparison of Anthropometric Measures for Assessing the Association between Body Size and Risk of Chronic Low Back Pain: The HUNT Study.

PubMed

Heuch, Ingrid; Heuch, Ivar; Hagen, Knut; Zwart, John-Anker

2015-01-01

Previous work indicates that overweight and obese individuals carry an increased risk of experiencing chronic low back pain (LBP). It is not known, however, how the association with body size depends on the choice of anthropometric measure used. This work compares relationships with LBP for several measures of body size. Different results may indicate underlying mechanisms for the association between body size and risk of LBP. In a cohort study, baseline information was collected in the community-based HUNT2 (1995-1997) and HUNT3 (2006-2008) surveys in Norway. Participants were 10,059 women and 8725 men aged 30-69 years without LBP, and 3883 women and 2662 men with LBP at baseline. Associations with LBP at end of follow-up were assessed by generalized linear modeling, with adjustment for potential confounders. Relationships between waist-hip-ratio and occurrence of LBP at end of follow-up were weak and non-significant after adjustment for age, education, work status, physical activity, smoking, lipid levels and blood pressure. Positive associations with LBP at end of follow-up were all significant for body weight, BMI, waist circumference and hip circumference after similar adjustment, both in women without and with LBP at baseline, and in men without LBP at baseline. After additional mutual adjustment for anthropometric measures, the magnitude of the association with body weight increased in women without LBP at baseline (RR: 1.130 per standard deviation, 95% CI: 0.995-1.284) and in men (RR: 1.124, 95% CI 0.976-1.294), with other measures showing weak associations only. Central adiposity is unlikely to play a major role in the etiology of LBP. Total fat mass may be one common factor underlying the associations observed. The association with body weight remaining after mutual adjustment may reflect mechanical or structural components behind the relationship between overweight or obesity and LBP.

Cocontraction of Ankle Dorsiflexors and Transversus Abdominis Function in Patients With Low Back Pain

PubMed Central

Chon, Seung-Chul; You, Joshua H.; Saliba, Susan A.

2012-01-01

Context The abdominal draw-in maneuver (ADIM) with cocontraction has been shown to be a more effective method of activating the transversus abdominis (TrA) in healthy adults than the ADIM alone. Whether such an augmented core stabilization exercise is effective in managing low back pain (LBP) remains uncertain. Objective To determine the effect of 2 weeks of ADIM and cocontraction training on abdominal muscle thickness and activation timing and to monitor pain and function in patients with LBP. Design Case-control study. Setting Local orthopaedic clinic and research laboratory. Patients or Other Participants Twenty patients with mechanical LBP (age = 27.20 ± 6.46 years, height = 166.25 ± 8.70 cm, mass = 58.10 ± 11.81 kg) and 20 healthy, age-matched people (age = 24.25 ± 1.59 years, height = 168.00 ± 8.89 cm, mass = 60.65 ± 11.99 kg) volunteered for the study. Intervention(s) Both the LBP and control groups received ten 30-minute sessions of ADIM and cocontraction training of the tibialis anterior (TA) and rectus femoris (RF) muscles over a 2-week period. Main Outcome Measure(s) A separate, mixed-model analysis of variance was computed for the thicknesses of the TrA, internal oblique (IO), and external oblique muscles. The differences in mean and peak electromyographic (EMG) amplitudes, onset time, and latency were compared between the groups. The visual analog pain scale, Pain Disability Index, and LBP rating scale were used to assess pain in the LBP group before and after the intervention. Results We found an interaction between the LBP and control groups and a main effect from pretest to posttest for only TrA muscle thickness change (F1,38 = 6.57, P = .01). Reductions in all pain measures were observed after training (P < .05). Group differences in peak and mean EMG amplitudes and onset time values for TrA/IO and TA were achieved (P < .05). The RF peak (t38 = −3.12, P = .003) and mean (t38 = −4.12, P = .001) EMG amplitudes were different, but no group difference was observed in RF onset time (t38 = 1.63, P = .11) or the cocontracted TrA/IO peak (t38 = −1.90, P = .07) and mean (t38 = −1.81, P = .08). The test-retest reliability for the muscle thickness measure revealed excellent correlations (intraclass correlation coefficient range, 0.95–0.99). Conclusions We are the first to demonstrate that a cocontraction of the ankle dorsiflexors with ADIM training might result in a thickness change in the TrA muscle and associated pain management in patients with chronic LBP. PMID:22889653

Relationship between the hip and low back pain in athletes who participate in rotation-related sports.

PubMed

Harris-Hayes, Marcie; Sahrmann, Shirley A; Van Dillen, Linda R

2009-02-01

Hip function has been proposed to be related to low back pain (LBP) because of the anatomical proximity of the hip and lumbopelvic region. To date, findings have been inconclusive, possibly because the samples studied were heterogeneous. Sub-grouping samples based on characteristics such as activity demand, LBP classification, and sex might clarify research findings. To describe and summarize studies that examine 3 factors proposed to be important to the study of the hip-LBP relationship. Review of cross-sectional studies. Academic health-care center and research laboratory. 3 groups: athletes with a history of LBP who regularly participate in rotation-related sports, athletes without a history of LBP who are active but do not regularly participate in rotation-related sports, and athletes without a history of LBP who participate in rotation-related sports. Hip range of motion and hip-lumbopelvic region coordination. Hip range of motion was measured with an inclinometer. Coordination was examined based on kinematics obtained with a 3-dimensional motion-capture system. Differences among groups were found based on activity demand, LBP classification, and sex. When assessing athletes with and without LBP, characteristics such as activity demand, LBP classification, and sex should be considered.

Low back pain among school teachers in Botswana, prevalence and risk factors.

PubMed

Erick, Patience N; Smith, Derek R

2014-10-30

Although low back pain (LBP) represents a common occupational problem, few epidemiological studies have investigated the prevalence and risk factors for LBP among school teachers, particularly in Africa. School teachers are known to represent an occupational group among which there appears to be a high prevalence of LBP. The objective of this study was, therefore, to conduct one of the first epidemiological investigations of LBP among teachers in Botswana. A cross-sectional study was conducted among teachers in Botswana using self-administered questionnaires which were distributed to 3100 randomly selected school teachers and collected over a five-month period between July and November 2012. The questionnaire included low back pain information, demographic data, lifestyle, work-related characteristics and psychosocial factors. Data were analysed using Chi-squared and logistic regression models. The 12 month prevalence and LBP disability and associated risk factors were also analysed. A total of 1747 teachers returned completed questionnaires, yielding a response rate of 56.3%. The 12-month prevalence of LBP was 55.7%, with 67.1% of them reporting minimal disability. The results of logistic regression analysis revealed that female gender [OR: 1.51, 95% CI: 1.14-2.00] and previous back injury [OR: 9.67, 95% CI: 4.94-18.93] were positively correlated to LBP. Awkward arm position [OR: 1.81, 95% CI: 1.24-2.62] and high psychological job demands [OR: 1.40, 95% CI: 1.02-1.93] were also significantly associated with LBP. Regular physical exercise was negatively associated with LBP [OR: 0.63, 95% CI: 0.43-0.93]. Female gender [OR: 2.67, 95% CI: 1.52-3.99] and previous back injury [OR: 3.01, 95% CI: 1.92-4.74] were also positively associated with LBP disability. The prevalence of LBP appears to be high among school teachers in Botswana. A wide variety of LBP risk factors were identified in this study. Female gender and previous injury were both associated with LBP presence and disability. The complex nature of LBP risk factors found in this study suggests than no single specific preventative or intervention strategy will help in reducing these conditions. As such, to help reduce the prevalence, progression and burden of LBP among Botswana teachers, a greater emphasis should now be placed on ergonomics education, regular physical exercise and occupational stress.

Lipopolysaccharide-binding protein is a negative regulator of adipose tissue browning in mice and humans.

PubMed

Gavaldà-Navarro, Aleix; Moreno-Navarrete, José M; Quesada-López, Tania; Cairó, Montserrat; Giralt, Marta; Fernández-Real, José M; Villarroya, Francesc

2016-10-01

Adipocyte lipopolysaccharide-binding protein (LBP) biosynthesis is associated with obesity-induced adipose tissue dysfunction. Our purpose was to study the role of LBP in regulating the browning of adipose tissue. Adult mice were maintained at 4°C for 3 weeks or treated with the β3-adrenergic agonist, CL316,243, for 1 week to induce the browning of white fat. Precursor cells from brown and white adipose tissues were cultured under differentiation-inducing conditions to yield brown and beige/brite adipocytes, respectively. In vitro, Lbp was knocked down in 3T3-L1 adipocytes, and cells were treated with recombinant LBP or co-cultured in transwells with control 3T3-L1 adipocytes. Wild-type and Lbp-null mice, fed a standard or high fat diet (HFD) for 15 weeks, were also used in investigations. In humans, subcutaneous and visceral adipose tissue samples were obtained from a cohort of morbidly obese participants. The induction of white fat browning by exposure of mice to cold or CL316,243 treatment was strongly associated with decreased Lbp mRNA expression in white adipose tissue. The acquisition of the beige/brite phenotype in cultured cells was associated with downregulation of Lbp. Moreover, silencing of Lbp induced the expression of brown fat-related genes in adipocytes, whereas LBP treatment reversed this effect. Lbp-null mice exhibited the spontaneous induction of subcutaneous adipose tissue browning, as evidenced by a remarkable increase in Ucp1 and Dio2 gene expression and the appearance of multivacuolar adipocyte clusters. The amount of brown adipose tissue, and brown adipose tissue activity were also increased in Lbp-null mice. These changes were associated with decreased weight gain in Lbp-null mice and protection against HFD-induced inflammatory responses, as shown by reduced IL-6 levels. However, rather than improving glucose homeostasis, these effects led to glucose intolerance and insulin resistance. LBP is identified as a negative regulator of the browning process, which is likely to contribute to the obesity-promoting action of LBP. The deleterious metabolic effects of LBP deletion are compatible with the concept that the appropriate regulation of inflammatory pathways is necessary for a healthy systemic metabolic profile, regardless of body weight regulation.

Challenges and solutions in the evaluation of a low back pain disease management program.

PubMed

Kotsos, Thomas; Muldowney, Kevin; Chapa, Griselda; Martin, J Eric; Linares, Antonio

2009-02-01

This paper examines a novel approach to evaluating a nurse-run telephonic low back pain (LBP) disease management (DM) program offered by a fully-insured commercial health plan population with approximately 150,000 members located in the northeastern United States. Members with at least 6 member months of eligibility were identified to have LBP using administrative claims and eligibility data. The LBP program relies on telephonic nurse management augmented by printed materials, adapting and advocating HEDIS imaging guidelines, and drug utilization review. Outcomes of this LBP DM program were assessed using a pre-post population-based approach as recommended in the DMAA Outcomes Guidelines Report. Baseline year and program year populations were segmented into 5 LBP clinical categories and each was weight adjusted using population size. LBP-related medical service utilization and pharmacy utilization also were evaluated. Individuals under active LBP management exhibited a decrease in LBP-related imaging and surgeries. Overall analgesic use also decreased. These data suggest the LBP DM program is associated with a decrease in imaging, surgeries, and analgesic use. The magnitude of the clinically segmented weight-adjusted return on investment (ROI) was lower than the unadjusted ROI, but was directionally positive indicating program impact. This adjustment is necessary in order to gain insight into and consistency of the results of a comprehensive LBP DM program evaluation.

Incidence and trends of low back pain hospitalisation during military service--an analysis of 387,070 Finnish young males.

PubMed

Mattila, Ville M; Sillanpää, Petri; Visuri, Tuomo; Pihlajamäki, Harri

2009-01-19

There is evidence that low back pain (LBP) during young adulthood and military service predicts LBP later in life. The purpose of this study was to investigate the incidence and trends of LBP hospitalisation among Finnish military conscripts. All male conscripts performing their compulsory military service during 1990-2002 were included in the study population. Altogether 387,070 military conscripts were followed throughout their six-to-twelve-month service period. Data on LBP hospitalisations were obtained from the National Hospital Discharge Register. Altogether 7,240 LBP hospitalisations were identified among 5,061 (1.3%) male conscripts during the study period. The event-based incidence of LBP hospitalisation was 27.0 (95% confidence interval (CI): 25.7-28.2). In most cases, the diagnosis was unspecified LBP (n = 5,141, 71%) followed by lumbar disc disorders (n = 2,069, 29%). Hospitalisation incidence due to unspecified LBP was 19.1 per 1,000 person-years (95% CI: 18.3 to 20.4), and 7.8 per 1,000 person-years (95% CI: 6.7 to 8.3) due to lumbar disc disorders. The incidence of unspecified LBP remained unaltered, while hospitalisation due to lumbar disc disorders declined from 1993 onwards. Although conscripts accepted into military training pass physician-performed examinations as healthy, young adults, LBP hospitalisation causes significant morbidity during military service.

Backache and its prevention.

PubMed

Dwyer, A P

1987-09-01

Low back pain (LBP) is a symptom produced by disorders of the lumbar spine. It may be impossible to prevent all LBP, and while most episodes of acute LBP are self-limiting, the disorders producing recurrent and chronic LBP are usually incurable. The difficulties in diagnosing the disorders complicate effective management and prevention; however, prevention of spinal trauma reduces the incidence and prevalence of LBP. Effective preventive measures include the reduction of road trauma and smoking, improved vehicle seating, the control of vehicle vibrations, careful worker selection, job redesign, improved physical fitness, and the proper use of the spine in the home, at school, at work, and in sports. Frymoyer includes these and other measures in his tips to prevent LBP. Medical and paramedical professionals must be sure their investigations and treatments do not contribute to making the disorder chronic and more complex. The inappropriate use and interpretation of spinal investigations and the overzealous use of surgical procedures certainly add to the problem. An agreement on an acceptable "glossary" of lumbar terms and clinical syndromes is needed together with a new research emphasis on prevention and a continuation of research efforts in epidemiology, etiology, and management of LBP. Effective public education is vital, so that everyone is aware of the causes and methods of prevention of LBP. Discussion on the "20th-century epidemic of LBP" may be concluded on an optimistic note by citing White, who considers most LBP to be preventable and controllable with simple measures, reinforcable through public education, which can do for LBP what has been done in the field of dental hygiene.

Psychological detachment as moderator between psychosocial work conditions and low back pain development.

PubMed

Mierswa, Tobias; Kellmann, Michael

2017-03-30

Recovery processes in leisure time influence the effect of psychosocial work factors on health issues. However, this function of recovery has been neglected in research regarding the influence of work-related risk factors on low back pain (LBP) development. The aim of this prospective study was to examine the function of psychological detachment - a relevant recovery experience - concerning the influence of psychosocial work factors on LBP development. A moderating function of detachment for the interplay of work factors and LBP was assumed. Sixty pain-free administrative employees of German universities completed an online survey 3 times during a 6-month period. Generalized estimating equations were used to estimate risk-factors of LBP. Analyses revealed an increased chance of LBP development for smokers and a decreasing chance when work resources were high. Detachment had no direct influence on LBP development, although it moderated the influence of work stressors and work resources on LBP. On the one hand, high detachment values seem to protect against an increased chance of LBP development when employees were confronted with high work stressors, while on the other hand high detachment values enhance the protective effect of high work resources. The results indicated a moderating role of detachment concerning the influence of psychosocial work factors on LBP development. Therefore, it is necessary to include recovery processes in future research regarding LBP development and consequently in LBP prevention concepts. Int J Occup Med Environ Health 2017;30(2):313-327. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

The lived experience of low back pain among Irish farmers: case studies.

PubMed

Osborne, Aoife; Blake, Catherine; Meredith, David; McNamara, John; Phelan, Jim; Cunningham, Caitriona

2014-01-01

Low back pain (LBP) is the most commonly reported musculoskeletal disorder (MSD) among farmers. There is limited researching regarding the lived experience of LBP among farmers. Video interviews were conducted with three dairy farmers who reported having a significant episode of LBP. The interview data were transcribed and analyzed, and results were presented in relation to the constructs explored. The farmers experienced their first significant episode of LBP in their late 20s or early 30s and all attributed their LBP to farm work or a farm-related incident. Hours worked per day ranged from 9 to 13 hours. Tasks identified by farmers that they were unable to do due to LBP included physical work, working with sheep, building work, and "certain jobs." Work changes made due to LBP included getting help, slowing down, avoiding strenuous work, carrying smaller loads, mechanizing the farm, using the tractor more, and wearing a back belt for certain jobs. Each farmer had his own way of preventing or managing his LBP, including a mix of active self-management and passive coping strategies such as swimming, using ice, spinal manipulation, and taking medication. The farmers were unable to quantify how much their LBP had cost them directly or indirectly. The case studies illustrate farmers engaging in ongoing work despite significant pain. All of the farmers have adapted at work and engaged in self-management strategies to reduce the occurrence of LBP. Given the rich data produced by these case studies, future case studies are recommended to gain greater insights into farmers' experiences concerning LBP.

Role of local sequence in the folding of cellular retinoic abinding protein I: structural propensities of reverse turns.

PubMed

Rotondi, Kenneth S; Gierasch, Lila M

2003-07-08

The experiments described here explore the role of local sequence in the folding of cellular retinoic acid binding protein I (CRABP I). This is a 136-residue, 10-stranded, antiparallel beta-barrel protein with seven beta-hairpins and is a member of the intracellular lipid binding protein (iLBP) family. The relative roles of local and global sequence information in governing the folding of this class of proteins are not well-understood. In question is whether the beta-turns are locally defined by short-range interactions within their sequences, and are thus able to play an active role in reducing the conformational space available to the folding chain, or whether the turns are passive, relying upon global forces to form. Short (six- and seven-residue) peptides corresponding to the seven CRABP I turns were analyzed by circular dichroism and NMR for their tendencies to take up the conformations they adopt in the context of the native protein. The results indicate that two of the peptides, encompassing turns III and IV in CRABP I, have a strong intrinsic bias to form native turns. Intriguingly, these turns are on linked hairpins in CRABP I and represent the best-conserved turns in the iLBP family. These results suggest that local sequence may play an important role in narrowing the conformational ensemble of CRABP I during folding.

Hamstring muscle length and pelvic tilt range among individuals with and without low back pain.

PubMed

Fasuyi, Francis Oluwafunsho; Fabunmi, Ayodele A; Adegoke, Babatunde O A

2017-04-01

Hamstring tightness has been documented not to be related to the pelvic tilt position during static standing posture, but there is limited data on the relationship between hamstring muscle length (HML) and pelvic tilt range (PTR) during the dynamic movement of forward bending. This ex-post facto study was designed to compare each of HML and PTR in individuals with low back pain (LBP) and counterparts without LBP, and the relationship between HML and PTR in individuals with and without LBP. The study involved 30 purposively recruited individuals with LBP and 30 height and weight-matched individuals without LBP. Participants' PTR and HML were assessed using digital inclinometer and active knee extension test respectively. Data were analyzed using t-test and Pearson Correlation (r) at α = 0.05. Participants without LBP had significantly longer (p = 0.01) HML than those with LBP but the PTR of both groups were not significantly different. HML and PTR had indirect but not significant correlations in participants with and without LBP. Hamstring muscle length is significantly reduced in individuals with LBP but it has no significant correlation with pelvic tilt range. Pelvic tilt range reduces as hamstring muscle length increases. Copyright © 2016 Elsevier Ltd. All rights reserved.

An evaluation of low back pain among female brick field workers of West Bengal, India.

PubMed

Das, Banibrata

2015-09-01

The purpose of the study was to determine the prevalence of low back pain (LBP) among brick field workers and to explore attributed causes of LBP, investigate the relationship between LBP and psychophysical and psychosocial factors and measure the impact of LBP. A modified Nordic Musculoskeletal Disorder Questionnaire along with Body Part Discomfort scale were administered to brick field workers (N = 148). Working posture of the participants was assessed using Rapid Entire Body Assessment (REBA) method. The study showed that 70 % of the female workers reported LBP due to awkward working posture for prolonged period of time. This was mainly reported by brick moulders. 45 % reported LBP due to manual material handling (MMH) and 40 % due to awkward lifting of heavy objects (brick). The study shows that the LBP is more prevalent (OR 1.59 and 95 % CI 0.411-6.207). 78 % of the female workers want the job rotation to relieve from their job monotony. LBP occurred among female workers due to awkward posture, repetitive work and MMH. This study also stated that psychosocial cause of LBP is inadequacy income, monotony work, job dissatisfaction. Working posture analysis REBA suggests that all the working postures are high-risk level.

Low back pain and associated presenteeism among hospital nursing staff.

PubMed

d'Errico, Angelo; Viotti, Sara; Baratti, Alberto; Mottura, Bianca; Barocelli, Anna Pia; Tagna, Marina; Sgambelluri, Barbara; Battaglino, Paolo; Converso, Daniela

2013-01-01

In spite of the high prevalence of low back pain (LBP) and presenteeism previously observed among nurses, no study has assessed the risk of presenteeism specifically due to LBP in nursing staff. Therefore, aim of the present study was to assess prevalence and risk factors of presenteeism due to LBP among hospital nursing personnel. 174 female nurses underwent a clinical interview and filled in a questionnaire on sociodemographics, LBP symptoms and associated sickness absence, mental symptoms, burnout and on exposure to workplace organizational, psychosocial and ergonomic factors; 111 subjects affected by LBP were included in the analysis. The effect of sociodemographic and workplace characteristics on presenteeism was examined through multivariate Poisson robust regression models. Prevalence of presenteeism due to LBP was 58%, with wide differences between registered nurses and nursing aides (p=0.001). Only a few workplace factors were significantly associated with presenteeism, including frequent stooping, which decreased the risk of presenteeism, and good working climate and procedural justice, which increased it. Presenteeism due to LBP was very high among registered nurses and was influenced only by workplace, but not by sociodemographic characteristics. Presenteeism due to LBP among registered nurses should be closely monitored, and effort should be made to reduce it to prevent future work disability associated with LBP.

Risk Factors Linked to Psychological Distress, Productivity Losses, and Sick Leave in Low-Back-Pain Employees: A Three-Year Longitudinal Cohort Study

PubMed Central

Marchettini, Paolo; Zarbo, Cristina

2016-01-01

Background. Low back pain (LBP) is one of the most common health problems worldwide. Purpose. To investigate the link between baseline demographic and occupational, medical, and lifestyle data with following psychological and occupational outcomes in a large sample of employees with LBP over a 3-year period. Study Design. Three-year prospective cohort study. Methods. Italian-speaking employees (N = 4492) with a diagnosis of LBP were included. Screening at Time 1 was done in order to collect information about severity and classification of LBP, demographic, lifestyle, and occupational status data. Psychological distress (PGWBI) and occupational burden were assessed after 3 years. Results. After 3 years, employees with LBP not due to organic causes had an increased risk of psychological distress. Gender appears to be an important variable for following occupational burden. Indeed, being a white-collar man with a LBP without organic causes seems to be a protective factor for following work outcomes, while being a white-collar woman with a LBP not due to organic causes appears to be a risk factor for subsequent sick leave. Moreover, LBP severity affects psychological and occupational outcomes. Conclusion. Our findings have several implications that could be considered in preventive and supportive programs for LBP employees. PMID:27635259

Long-term effects of exercise programs among helicopter pilots with flying related LBP

PubMed Central

Andersen, Knut; Baardsen, Roald; Dalen, Ingvild; Larsen, Jan Petter

2017-01-01

BACKGROUND: Flying related transient Low Back Pain (LBP) among helicopter pilots is considered an occupational distress. OBJECTIVE: To examine if exercise programs can alleviate transient LBP. METHODS: Sixty-five helicopter pilots (92% males), all reporting flying related LBP, responded to an epidemiological survey and a long-term follow-up, 44.8 months later, comprising questions regarding transient LBP and number of sick leaves. Data from 37 pilots participating in two exercise programs, A; general for LBP, B; focused for lumbar trunk (LT), included information from clinical examinations and muscular endurance tests of the LT before and after intervention. Twenty-eight pilots did not participate in any intervention. RESULTS: At long-term follow-up 42% of the pilots still reported flying related transient LBP. Among participants in program B 26% had persistent pain, 70% in program A and 46% among pilots without intervention. Sick-leave reduction was only observed among participants in program B (30% to 4%). Upon re-occurrence of LBP symptoms, half of the pilots in program B again performed exercises to improve their pain. CONCLUSION: This study indicates that exercise programs focused towards lumbar trunk muscular endurance reduces flying related transient LBP and sick-leave among helicopter pilots. These findings may have implications for the pilots’ working conditions. PMID:29278872

Does self-assessed physical capacity predict development of low back pain among health care workers? A 2-year follow-up study.

PubMed

Rasmussen, Charlotte D N; Jørgensen, Marie B; Clausen, Thomas; Andersen, Lars L; Strøyer, Jesper; Holtermann, Andreas

2013-02-01

Prospective cohort study. To determine the prognostic value of self-assessed physical capacity for the development of low back pain (LBP) among female health care workers without LBP. High physical capacities in terms of strength, endurance, flexibility, and balance are assumed to prevent LBP among persons with high physical work demands. However, the few existing studies investigating this relationship show contrasting findings. Female health care workers answered a questionnaire about physical capacity in 2004, and days with LBP in 2005 and 2006. The odds ratios (ORs) for developing nonchronic (1-30 d of the past 12 mo) and persistent (>30 d of the past 12 mo) LBP in 2006 from self-assessed physical capacity were investigated with multiadjusted logistic regressions among female health care workers without LBP in 2005 (n = 1612). Health care workers with low and medium physical capacity had increased risk of developing nonchronic LBP (OR = 1.52 [CI = 1.05-2.20] and OR = 1.37 [CI = 1.01-1.84], respectively), and health care workers with low physical capacity had an increased risk of developing persistent LBP (OR = 2.13 [CI = 1.15-3.96]), referencing those with high physical capacity. Self-assessed low physical capacity is a strong predictor for developing nonchronic and persistent LBP among pain-free female health care workers. Future intervention studies should investigate whether increased physical capacity, for example, through exercise training prevents development of LBP among female health care workers.

Low back pain in female elite football and handball players compared with an active control group.

PubMed

Tunås, Paula; Nilstad, Agnethe; Myklebust, Grethe

2015-09-01

The purpose of this cross-sectional study was to compare the prevalence of low back pain (LBP) among female elite football and handball players to a matched non-professional active control group. The participants were requested to answer a questionnaire based on standardized Nordic questionnaires for musculoskeletal symptoms to assess the prevalence of LBP. Included participants were elite female football (n = 277) and handball players (n = 190), and a randomly selected control group from the Norwegian population (n = 167). Fifty-seven percentage of the football players, 59 % of the handball players and 60 % of the control group had experienced LBP the previous year. There were no significant group differences in the prevalence of LBP ever (p = 0.62), the previous year (p = 0.85) or the previous 7 days (p = 0.63). For both sports, there was a significant increase in prevalence of LBP from the resting period to the competitive periods of the season (p ≤ 0.001). Seventy percent of the goalkeepers in both football and handball had experienced LBP the previous year. There were no difference in LBP among female elite football and handball players compared with the control group. However, female elite athletes in football and handball reported a high prevalence of LBP compared to previous studies. The variations in LBP and playing positions indicate that specific field positions, in football and handball, is a risk factor for developing LBP.

General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome.

PubMed

Sieben, Judith M; Vlaeyen, Johan W S; Portegijs, Piet J M; Warmenhoven, Franca C; Sint, Ageeth G; Dautzenberg, Nadine; Romeijnders, Arnold; Arntz, Arnoud; Knottnerus, J André

2009-04-01

In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients' LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers' ideas about LBP are also important predictors of treatment behaviour and outcome. In the present study we examined whether (1) differences in General Practitioners' (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients. Two hundred twenty two patients consulting their GP with a new episode of LBP were recruited and completed questionnaires on (among others) LBP outcome (graded chronic pain scale) at baseline, during 12 months of follow-up and at the end of the study. Data on treatment were collected from the GPs. The GPs also completed a set of questionnaires on LBP treatment orientation. Associations between measures of treatment orientation, treatment recommendations, treatment behaviour and LBP outcome were analysed. A biomedical treatment orientation was found to be associated with more concern about tissue damage and the effect of physical activity on pain and recovery in vignettes. No associations were found between treatment orientation measures, actual treatment behaviour and LBP outcome. Associations were not found as expected. Still these findings are relevant and may feed a clinically important debate on widely accepted assumptions about the role and influence of health care providers in changing patients' pain behaviours.

Incidence and trends of low back pain hospitalisation during military service – An analysis of 387,070 Finnish young males

PubMed Central

Mattila, Ville M; Sillanpää, Petri; Visuri, Tuomo; Pihlajamäki, Harri

2009-01-01

Background There is evidence that low back pain (LBP) during young adulthood and military service predicts LBP later in life. The purpose of this study was to investigate the incidence and trends of LBP hospitalisation among Finnish military conscripts. Methods All male conscripts performing their compulsory military service during 1990–2002 were included in the study population. Altogether 387,070 military conscripts were followed throughout their six-to-twelve-month service period. Data on LBP hospitalisations were obtained from the National Hospital Discharge Register. Results Altogether 7,240 LBP hospitalisations were identified among 5,061 (1.3%) male conscripts during the study period. The event-based incidence of LBP hospitalisation was 27.0 (95% confidence interval (CI): 25.7–28.2). In most cases, the diagnosis was unspecified LBP (n = 5,141, 71%) followed by lumbar disc disorders (n = 2,069, 29%). Hospitalisation incidence due to unspecified LBP was 19.1 per 1,000 person-years (95% CI: 18.3 to 20.4), and 7.8 per 1,000 person-years (95% CI: 6.7 to 8.3) due to lumbar disc disorders. The incidence of unspecified LBP remained unaltered, while hospitalisation due to lumbar disc disorders declined from 1993 onwards. Conclusion Although conscripts accepted into military training pass physician-performed examinations as healthy, young adults, LBP hospitalisation causes significant morbidity during military service. PMID:19152697

Heritability and lifestyle factors in chronic low back pain: results of the Australian twin low back pain study (The AUTBACK study).

PubMed

Junqueira, D R G; Ferreira, M L; Refshauge, K; Maher, C G; Hopper, J L; Hancock, M; Carvalho, M G; Ferreira, P H

2014-11-01

Heritability and population-specific lifestyle factors are considered to significantly contribute to chronic low back pain (LBP), but traditional population studies fail to (1) adjust for genetics; and (2) use standard and validated definitions for LBP and for lifestyle factors. Using a classical and a co-twin control study design and validated definitions for chronic LBP and lifestyle variables, we explored the relative contribution of genetics and environment on the prevalence of chronic LBP in a sample of adult Australian twins. Data from 105 twin pairs showed that the prevalence of chronic LBP is significantly determined by genetic factors (heritability = 32%). Additionally, monozygotic twins were five times more likely to have chronic LBP than dizygotic twins when one of the siblings of the pair was affected. In a case-control analysis (n = 38 twin pairs), an exploratory analysis showed higher prevalence of chronic LBP associated with light walking exercises and vigorous gardening or heavy work around the house. Daily time spent in sitting was also positively associated with chronic LBP, but not moderate physical activities such as jogging, cycling and gentle swimming. In the final multivariate model, only time spent in vigorous gardening or heavy work around the house remained associated with chronic LBP (odds ratio 6.5; 95% confidence interval 1.47-28.8). The type, frequency and duration of physical activity may be important to understand risk factors for chronic LBP. The causation path between chronic LBP and people's engagement in activities involving frequent bending and twisting such as gardening and housework should be further investigated. © 2014 European Pain Federation - EFIC®

Activity characteristics and movement patterns in people with and people without low back pain who participate in rotation-related sports

PubMed Central

Chimenti, Ruth L.; Scholtes, Sara A.

2013-01-01

Many risk factors have been identified as contributing to the development or persistence of low back pain (LBP). However, the juxtaposition of both high and low levels of physical activity being associated with LBP reflects the complexity of the relationship between a risk factor and LBP. Moreover, not everyone with an identified risk factor, such as a movement pattern of increased lumbopelvic rotation, has LBP. Objective The purpose of this study was to examine differences in activity level and movement patterns between people with and people without chronic or recurrent LBP who participate in rotation-related sports. Design Case Case-control study. Setting University laboratory environment. Participants 52 people with chronic or recurrent LBP and 25 people without LBP who all play a rotation-related sport. Main Outcome Measures Participants completed self-report measures including the Baecke Habitual Activity Questionnaire and a questionnaire on rotation-related sports. A 3-dimensional motion-capture system was used to collect movement-pattern variables during 2 lower-limb-movement tests. Results Compared with people without LBP, people with LBP reported a greater difference between the sport subscore and an average work and leisure composite subscore on the Baecke Habitual Activity Questionnaire (F = 6.55, P = .01). There were no differences between groups in either rotation-related-sport participation or movement-pattern variables demonstrated during 2 lower-limb movement tests (P > .05 for all comparisons). Conclusions People with and people without LBP who regularly play a rotation-related sport differed in the amount and nature of activity participation but not in movement pattern variables. An imbalance between level of activity during sport and daily functions may contribute to the development or persistence of LBP in people who play a rotation-related sport. PMID:23295458

Chronic low back pain: a mini-review on pharmacological management and pathophysiological insights from clinical and pre-clinical data.

PubMed

Park, Thomas S W; Kuo, Andy; Smith, Maree T

2018-05-12

Globally, low back pain (LBP) is one of the most common health problems affecting humans. The lifetime prevalence of non-specific LBP is approximately 84%, with the chronic prevalence at about 23%. Chronic LBP in humans is defined as LBP that persists for more than 12 weeks without a significant pain improvement. Although there are numerous evidence-based guidelines on the management of acute LBP, this is not the case for chronic LBP, which is regarded as particularly difficult to treat. Research aimed at discovering new drug treatments for alleviation of chronic mechanical LBP is lacking due to the paucity of knowledge on the pathobiology of this condition, despite its high morbidity in the affected adult population. For a debilitating condition such as chronic LBP, it is necessary to assess the sustained effects of pharmacotherapy of various agents spanning months to years. Although many rodent models of mechanical LBP have been developed to mimic the human condition, some of the major shortcomings of many of these models are (1) the presence of a concurrent neuropathic component that develops secondary to posterior intervertebral disc puncture, (2) severe model phenotype, and/or (3) use of behavioural endpoints that have yet to be validated for pain. Hence, there is a great, unmet need for research aimed at discovering new biological targets in rodent models of chronic mechanical LBP for use in drug discovery programs as a means to potentially produce new highly effective and well-tolerated analgesic agents to improve relief of chronic LBP. On a cautionary note, it must be borne in mind that because humans and rats display orthograde and pronograde postures, respectively, the different mechanical forces on their spines add to the difficulty in translation of promising rodent data to humans.

Risk Factors for Low Back Pain and Spine Surgery: A Retrospective Cohort Study in Soldiers.

PubMed

Kardouni, Joseph R; Shing, Tracie L; Rhon, Daniel I

2016-11-01

Musculoskeletal low back pain (LBP) is commonly treated symptomatically, with practice guidelines advocating reserving surgery for cases that fail conservative care. This study examined medical comorbidities and demographic variables as risk factors for chronic/recurrent LBP, spinal surgery, and time to surgery. A 2015 retrospective cohort study was conducted in U.S. Army soldiers (N=1,092,420) from 2002 to 2011. Soldiers with medical encounters for LBP were identified using ICD-9 codes. Surgical treatment for LBP was identified according to Current Procedural Terminology codes. Comorbid medical conditions (psychological disorders, sleep disorders, tobacco use, alcohol use, obesity) and demographic variables were examined as risk factors for chronic/recurrent LBP within 1 year of the incident encounter, surgery for LBP, and time to surgery. Of 383,586 patients with incident LBP, 104,169 (27%) were treated for chronic/recurrent LBP and 7,446 (1.9%) had surgery. Comorbid variables showed increased risk of chronic/recurrent LBP ranging from 26% to 52%. Tobacco use increased risk for surgery by 33% (risk ratio, 1.33; 95% CI=1.24, 1.44). Comorbid variables showed 10%-42% shorter time to surgery (psychological disorders, time ratio [TR]=0.90, 95% CI=0.83, 0.98; sleep disorders, TR=0.68, 95% CI=0.60, 0.78; obesity, TR=0.88, 95% CI=0.79, 0.98; tobacco use, TR=0.58, 95% CI=0.54, 0.63; alcohol use, TR=0.85, 95% CI=0.70, 1.05). Women showed 20% increased risk of chronic/recurrent LBP than men but 42% less risk of surgery. In the presence of comorbidities associated with mental health, sleep, obesity, tobacco use, and alcohol use, LBP shows increased risk of becoming chronic/recurrent and faster time to surgery. Published by Elsevier Inc.

Trunk Dynamics Are Impaired in Ballet Dancers with Back Pain but Improve with Imagery.

PubMed

Gildea, Jan E; VAN DEN Hoorn, Wolbert; Hides, Julie A; Hodges, Paul W

2015-08-01

Trunk control is essential in ballet and may be compromised in dancers with a history of low back pain (LBP) by associated changes in motor control. This study aimed to compare trunk mechanical properties between professional ballet dancers with and without a history of LBP. As a secondary aim, we assessed whether asking dancers to use motor imagery to respond in a "fluid" manner could change the mechanical properties of the trunk and whether this was possible for both groups. Trunk mechanical properties of stiffness and damping were estimated with a linear second-order system, from trunk movement in response to perturbations, in professional ballet dancers with (n = 22) and without (n = 8) a history of LBP. The second-order model adequately described trunk movement in response to the perturbations. Trials were performed with and without motor imagery to respond in a fluid manner to the perturbation. Dancers with a history of LBP had lower damping than dancers without LBP during the standard condition (P = 0.002) but had greater damping during the "fluid" condition (P < 0.001), with values similar to dancers without LBP (P = 0.226). Damping in the dancers without LBP was similar between the conditions (P > 0.99). Stiffness was not different between the dancers with and those without a history of LBP (P = 0.252) but was less during the fluid condition than the standard condition (P < 0.001). Although dancers with a history of LBP have less trunk damping than those without LBP, they have the capacity to modulate the trunk's mechanical properties to match that of pain-free dancers by increasing damping with motor imagery. These observations have potential relevance for LBP recurrence and rehabilitation.

A magnetic resonance imaging investigation of the transversus abdominis muscle during drawing-in of the abdominal wall in elite Australian Football League players with and without low back pain.

PubMed

Hides, Julie A; Boughen, Carly L; Stanton, Warren R; Strudwick, Mark W; Wilson, Stephen J

2010-01-01

Single-blinded quasi-experimental study. To investigate the ability of elite football players with and without low back pain (LBP) to voluntarily draw-in the abdominal wall. While there has been considerable debate regarding the contribution of the transversus abdominis (TrA) muscle to control the lumbar spine and pelvis, there is evidence that retraining motor control of the deep trunk muscles is commensurate with decreases in LBP. Magnetic resonance imaging (MRI) has been used to assess the TrA muscle during the draw-in maneuver, with the contraction of the TrA muscle reducing the circumference of the trunk. Impairments in performance of the draw-in maneuver have been shown in people with LBP. Forty-three elite players from a team in the Australian Football League were allocated to 3 groups: those with "no LBP," "a history of LBP but no current LBP," or "current LBP." MRI was used to image the cross-sectional area (CSA) of the trunk at the level of the L3-4 disc at the start and end of the draw-in maneuver. There was a significant decrease in the CSA of the trunk with the performance of the draw-in maneuver (P<.001). Subjects in the "no LBP" group were better able to "draw-in" the abdominal wall than subjects with current LBP (P = .015). This study provides evidence of an altered ability to draw-in the abdominal wall in footballers with current LBP. Retraining contraction of the TrA muscle may constitute one part of an exercise-therapy approach for athletes with current LBP.

Serum LBP Is Associated with Insulin Resistance in Women with PCOS.

PubMed

Zhu, Qibo; Zhou, Huang; Zhang, Aipin; Gao, Rufei; Yang, Shumin; Zhao, Changhong; Wang, Yue; Hu, Jinbo; Goswami, Richa; Gong, Lilin; Li, Qifu

2016-01-01

Lipopolysaccharide-binding protein (LBP) is closely associated with many metabolic disorders. However, no study has been done to explore the relationship between LBP and polycystic ovary syndrome (PCOS). The objective of this study was to investigate whether the serum LBP level is elevated and associated with insulin resistance (IR) in PCOS. In this cross-sectional study, 117 PCOS patients and 121 age-matched controls were recruited. Hyperinsulinemic-euglycemic clamp was performed with an expression of M value for insulin sensitivity. Fasting serum samples were collected to detect LBP, lipids, insulin, sex hormones and high sensitive C reactive protein (hs-CRP). Pearson's correlation and multiple linear regression was used to analyze the associations between M value and LBP level. The study was performed in a clinical research center. Compared with controls, PCOS subjects had a significantly higher LBP concentration (33.03±14.59 vs. 24.35±10.31 μg/ml, p<0.001), and lower M value (8.21±3.06 vs. 12.31±1.72 mg/min/kg, p<0.001). Both in lean and overweight/obese individuals, serum LBP level was higher in PCOS subjects than that in controls. M value was negatively correlated with body mass index (BMI), fasting serum insulin, triglycerides, low-density lipoprotein cholesterol (LDL-c), free testosterone, high sensitive C reactive protein (hs-CRP) and LBP, whereas positively correlated with high-density lipoprotein cholesterol (HDL-c) and sex hormone binding globulin (SHBG). Serum LBP level was associated with M value after adjusting for BMI, fasting serum insulin, SHBG, as well as hs-CRP. Serum LBP level significantly is elevated in PCOS, and is independently associated with IR in PCOS.

Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific).

PubMed

Krismer, M; van Tulder, M

2007-02-01

Low back pain (LBP) is defined as pain localised between the 12th rib and the inferior gluteal folds, with or without leg pain. Most cases are non-specific, but in about 10% of cases a specific cause is identified. Red flags are typical signs or symptoms that are frequently associated with specific LBP. Yellow flags are prognostic factors associated with a more unfavourable and often chronic disabling course of the disease. LBP has a lifetime prevalence of 60-85%. At any one time, about 15% of adults have LBP. LBP poses an economic burden to society, mainly in terms of the large number of work days lost (indirect costs) and less so by direct treatment costs. A substantial proportion of individuals with chronic LBP has been found to have chronic widespread pain. LBP is often associated with other pain manifestations such as headache, abdominal pain and pain in different locations of the extremities. Widespread pain is associated with a worse prognosis compared to localised LBP. Treatment targets are reduction of pain and better activity/participation, including prevention of disability as well as maintainance of work capacity. The evidence from selected and appraised guidelines, systematic reviews and major clinical studies was classified into four levels, level Ia being the best level with evidence from meta-analysis of randomised controlled trials. Key recommendations (level Ia): fitness programmes and advice to stay active can reduce pain, improve function and can prevent LBP becoming chronic. Simple analgesics, NSAIDs and muscle relaxants can reduce pain and can improve and maintain function. Maintaining physical activity, avoiding rest and manual therapy can reduce pain and maintain and restore function in acute LBP. Behavioural treatment can prevent LBP becoming chronic. Aerobic fitness and endurance training, behavioural treatment and multi-disciplinary treatment programmes can reduce pain and can improve/maintain function in chronic LBP.

Low back pain and limitations of daily living in Asia: longitudinal findings in the Thai cohort study.

PubMed

Yiengprugsawan, Vasoontara; Hoy, Damian; Buchbinder, Rachelle; Bain, Chris; Seubsman, Sam-Ang; Sleigh, Adrian C

2017-01-19

Low back pain (LBP) is a major cause of disability throughout the world. However, longitudinal evidence to relate low back pain and functional limitations is mostly confined to Western countries. In this study, we investigate the associations between low back pain and functional limitations in a prospective cohort of Thai adults. We analysed information from the Thai Cohort Study of adult Open University adults which included 42,785 participants in both 2009 and 2013, with the majority aged 30 to 65 years and residing nationwide. We used multivariate logistic regression to explore the longitudinal associations between LBP in 2009 and 2013 ('never': no LBP in 2009 or 2013; 'reverting': LBP in 2009 but not in 2013; 'incident': no LBP in 2009 but LBP in 2013; and 'chronic': reporting LBP at both time points) and the outcome of functional limitations relating to Activities of Daily Living (ADL) in 2013. Low back pain was common with 30% of cohort members reporting low back pain in both 2009 and 2013 ('chronic LBP'). The 'chronic LBP' group was more likely than the 'never' back pain group to report functional limitations in 2013: adjusted odds ratios 1.60 [95% Confidence Interval: 1.38-1.85] for difficulties getting dressed; 1.98 [1.71-2.30] for walking; 2.02 [1.71-2.39] for climbing stairs; and 3.80 [3.38-4.27] for bending/kneeling. Those with 'incident LBP' or 'reverting LBP' both had increased odds of functional limitations in 2013 but the odds were not generally as high. Our nationwide data from Thailand suggests that LBP is a frequent public health problem among economically productive age groups with adverse effects on the activities of daily living. This study adds to the limited longitudinal evidence on the substantial impact of low back pain in Southeast Asia.

Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis

PubMed Central

2014-01-01

Background Clinicians commonly examine posture and movement in people with the belief that correcting dysfunctional movement may reduce pain. If dysfunctional movement is to be accurately identified, clinicians should know what constitutes normal movement and how this differs in people with low back pain (LBP). This systematic review examined studies that compared biomechanical aspects of lumbo-pelvic movement in people with and without LBP. Methods MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2014 for relevant studies. Studies had to compare adults with and without LBP using skin surface measurement techniques to measure lumbo-pelvic posture or movement. Two reviewers independently applied inclusion and exclusion criteria, and identified and extracted data. Standardised mean differences and 95% confidence intervals were estimated for group differences between people with and without LBP, and where possible, meta-analyses were performed. Within-group variability in all measurements was also compared. Results The search identified 43 eligible studies. Compared to people without LBP, on average, people with LBP display: (i) no difference in lordosis angle (8 studies), (ii) reduced lumbar ROM (19 studies), (iii) no difference in lumbar relative to hip contribution to end-range flexion (4 studies), (iv) no difference in standing pelvic tilt angle (3 studies), (v) slower movement (8 studies), and (vi) reduced proprioception (17 studies). Movement variability appeared greater for people with LBP for flexion, lateral flexion and rotation ROM, and movement speed, but not for other movement characteristics. Considerable heterogeneity exists between studies, including a lack of detail or standardization between studies on the criteria used to define participants as people with LBP (cases) or without LBP (controls). Conclusions On average, people with LBP have reduced lumbar ROM and proprioception, and move more slowly compared to people without LBP. Whether these deficits exist prior to LBP onset is unknown. PMID:25012528

Risk factors for nonspecific low-back pain in Chinese adolescents: a case-control study.

PubMed

Yao, WeiGuang; Luo, ChenLing; Ai, FuZhi; Chen, Qing

2012-05-01

The objective of this study was to gain a basic understanding of the influential factors for nonspecific low-back pain (LBP) among adolescents of southern China. The study was designed as a school-based case control study. Nonspecific LBP is a common health problem in adolescence. Although some behaviors and socio-demographic factors are believed to contribute to the disorder, influential factors of LBP remain undefined. Moreover, until now there is no available information of influential factors for LBP in Chinese adolescents. A total of 1,214 adolescents were involved in the study, including 607 cases with nonspecific LBP and 607 controls without history of nonspecific LBP. A self-administered questionnaire was designed for epidemiological survey to investigate the risk factors for nonspecific LBP. All cases and controls were investigated for their family histories of nonspecific LBP, physical activities, sedentary activities, schoolbag weights, school performances, living conditions, and etc. A 1:1 matched case-control study was conducted on 1,214 adolescents from an elementary school and a secondary school in Guangzhou City, southern China. Family history (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.85-3.58), long duration of carrying schoolbag (OR 1.38, 95% CI 1.11-1.72) and rest position between classes (OR 1.18, 95% CI 1.01-1.39) were positively correlated with self-reported nonspecific LBP. Students regularly playing basketball (OR 1.58, 95% CI 1.09-2.30) was found to be significantly more likely to have LBP. Also, students who feel schoolbag uncomfortable (OR 1.38, 95% CI 1.11-1.72) was found to experience more LBP. Family history, feeling schoolbag uncomfortable, duration of schoolbag carrying, basketball playing and rest position between classes are the major risk factors for nonspecific LBP in adolescents. Wiley Periodicals, Inc.

Competing effects of pain and fear of pain on postural control in low back pain?

PubMed

Mazaheri, Masood; Heidari, Elham; Mostamand, Javid; Negahban, Hossein; van Dieen, Jaap H

2014-12-01

A cross-sectional, observational study. To determine whether pain and fear of pain have competing effects on postural sway in patients with low back pain (LBP). Competing effects of pain and pain-related fear on postural control can be proposed as the likely explanation for inconsistent results regarding postural sway in the LBP literature. We hypothesized that although pain might increase postural sway, fear of pain might reduce sway through an increased cognitive effort or increased cocontraction to restrict body movement. The cognitive strategy would be less effective under dual-task conditions and the cocontraction strategy was expected to be less effective when standing on a narrow base of support surface. Postural sway was measured in combined conditions of base of support (full and narrow) and cognitive loading (single and dual tasks) in 3 experimental groups with current LBP, recent LBP, and no LBP. Sway amplitude, path length, mean power frequency, and sample entropy were extracted from center-of-pressure data. The current-LBP group and recent-LBP group reported significantly different levels of pain, but similar levels of pain catastrophizing and kinesiophobia. The current-LBP group tended to display larger sway amplitudes in the anteroposterior direction compared with the other 2 groups. Mean power frequency values in mediolateral direction were lower in patients with the current LBP compared with recent LBP. Smaller sample entropy was found in the current-LBP group than the other groups in most experimental conditions, particularly when standing on a narrow base of support. Alterations of postural sway are mostly mediated by pain but not pain-related fear. LBP tends to increase sway amplitude, which seems to be counteracted by increased effort invested in postural control leading to decreased frequency and increased regularity of sway particularly under increased task demands. Cross-sectional study.

Failure to define low back pain as a disease or an episode renders research on causality unsuitable: results of a systematic review.

PubMed

Ardakani, Emad M; Leboeuf-Yde, Charlotte; Walker, Bruce F

2018-01-01

Causative factors may be different for the very first onset of symptoms of the 'disease' of low back pain (LBP) than for ensuing episodes that occur after a pain-free period. This differentiation hinges on a life-time absence of low back pain at first onset and short-term absence for further episodes. In this systematic review, we explored whether researchers make these distinctions when investigating the causality of LBP. A literature search of PUBMED, CINAHL, and SCOPUS databases was performed from January 2010 until September 2016 using the search terms 'low back pain' or 'back pain' and 'risk factor' or 'caus*' or 'predict*' or 'onset' or 'first-time' or 'inception' or 'incidence'. Two reviewers extracted information on study design, types of episodes of back pain to distinguish the disease of LBP and recurring episodes, and also to determine the definitions of disease- or pain-free periods. Thirty-three articles purporting to study causes of LBP were included. Upon scrutiny, 31 of the 33 articles were unclear as to what type of causality they were studying, that of the 'disease' or the episode, or a mere association with LBP. Only 9 studies used a prospective study design. Five studies appeared to investigate the onset of the disease of LBP, however, only one study truly captured the first incidence of LBP, which was the result of sports injury. Six appeared to study episodes but only one clearly related to the concept of episodes. Therefore, among those 11 studies, nine included both first-time LBP and episodes of LBP. Consequently, 22 studies related to the prevalence of LBP, as they probably included a mixture of first-time, recurring and ongoing episodes without distinction. Recent literature concerning the causality of LBP does not differentiate between the 'disease' of LBP and its recurring episodes mainly due to a lack of a clear definition of absence of LBP at baseline. Therefore, current research is not capable of providing a valid answer on this topic.

Symptomatology of recurrent low back pain in nursing and administrative professions

PubMed Central

Läubli, Thomas; Hodler, Juerg; Klipstein, Andreas

2007-01-01

The aim of the present study was to explore if (a) recurrent low back pain (LBP) has different symptomatologies in cases from occupations with predominantly sitting postures compared to cases from occupations involving dynamic postures and frequent lifting and (b) if in the two occupational groups, different factors were associated with the presence of recurrent LBP. Hundred and eleven female subjects aged between 45 and 62 years with a long-standing occupation either in administrative or nursing professions, with and without recurrent LBP were examined. An extensive evaluation of six areas of interest (pain and disability, clinical examination, functional tests, MR examination, physical and psychosocial workplace factors) was performed. The variables from the six areas of interest were analyzed for their potential to discriminate between the four groups of subjects (administrative worker and nurses with and without recurrent LBP) by canonical discriminant analysis. As expected, the self-evaluation of physical and psychosocial workplace factors showed significant differences between the two occupational groups, which holds true for cases as well as for controls (P < 0.01). The functional tests revealed a tendency for rather good capacity in nurses with LBP and a decreased capacity in administrative personnel with LBP (P = 0.049). Neither self completed pain and disability questionnaires nor clinical examination or MR imaging revealed any significant difference between LBP cases from sedentary and non-sedentary occupations. When comparing LBP cases and controls within the two occupational groups, the functional tests revealed significant differences (P = 0.0001) yet only in administrative personnel. The clinical examination on the other hand only discriminated between LBP cases and controls in the nurses group (P < 0.0001). Neither MRI imaging nor self reported physical and psychosocial workplace factors discriminated between LBP cases and controls from both occupational groups. Although we used a battery of tests that have broad application in clinical and epidemiological studies of LBP, a clear difference in the pattern of symptoms between LBP cases from nursing and hospital administration personnel could not be ascertained. We conclude that there is no evidence for different mechanisms leading to non-specific, recurrent LBP in the two occupations, and thus no generalizable recommendations for the prevention and therapy of non-specific LBP in the two professions can be given. PMID:17611784

Evidence-based classification of low back pain in the general population: one-year data collected with SMS Track.

PubMed

Leboeuf-Yde, Charlotte; Lemeunier, Nadège; Wedderkopp, Niels; Kjaer, Per

2013-01-01

It was previously assumed that low back pain (LBP) is a disorder that can be classified as acute, subacute and chronic. Lately, the opinion seems to have veered towards a concept of it being a more recurrent or cyclic condition. Interestingly, a recent review of the literature indicated that LBP in the general population is a rather stable condition, characterized as either being present or absent. However, only one of the reviewed studies had used frequent data collection, which would be necessary when studying detailed course patterns over time. It was the purpose of this study to see, if it was possible to identify whether LBP, when present, is rather episodic or chronic/persistent. Further, we wanted to see if it was possible to describe any specific course profiles of LBP in the general population. In all, 293 49/50-yr old Danes, who previously participated in a population-based study on LBP were invited to respond to 26 fortnightly text-messages over one year, each time asking them the number of days they had been bothered by LBP in the past two weeks. The course patterns for these individuals were identified through manual analysis, by observing the interplay between non-episodes and episodes of LBP. A non-episode of LBP was defined as a period of at least one month without LBP as proposed by de Vet et al. A fortnight with at least one day of pain was defined as a pain fortnight (FN). At least one pain FN surrounded by a non-episode on each side was defined as an episode of LBP. After some preliminary observations of the spread of data, episodes were further classified as brief (consisting of only one pain FN) or longer (if there were at least 2 pain FNs in a row). An episode of at least 6 pain FNs in a row (i.e. 3 months) was defined as a long-lasting episode. In all, 261 study subjects were included in the analyses, for which 7 distinct LBP subsets could be identified. These could be grouped into three major clusters; those mainly without LBP (35%), those with episodic LBP (30%) and those with persistent LBP (35%). There was a positive association between number of episodes and their duration. In this study population, consisting of 50-yr old persons from the general population, LBP, when present, could be classified as either 'episodic' or 'mainly persistent'. About one third was mainly LBP-free throughout the year of study. More information is needed in relation to their relative proportions in various populations and the clinical relevance of these subgroups.

The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis.

PubMed

Chun, Se-Woong; Lim, Chai-Young; Kim, Keewon; Hwang, Jinseub; Chung, Sun G

2017-08-01

Clinicians regard lumbar lordotic curvature (LLC) with respect to low back pain (LBP) in a contradictory fashion. The time-honored point of view is that LLC itself, or its increment, causes LBP. On the other hand, recently, the biomechanical role of LLC has been emphasized, and loss of lordosis is considered a possible cause of LBP. The relationship between LLC and LBP has immense clinical significance, because it serves as the basis of therapeutic exercises for treating and preventing LBP. This study aimed to (1) determine the difference in LLC in those with and without LBP and (2) investigate confounding factors that might affect the association between LLC and LBP. Systematic review and meta-analysis. The inclusion criteria consisted of observational studies that included information on lumbar lordotic angle (LLA) assessed by radiological image, in both patients with LBP and healthy controls. Studies solely involving pediatric populations, or addressing spinal conditions of nondegenerative causes, were excluded. A systematic electronic search of Medline, Embase, Cochrane Library, CINAHL, Scopus, PEDro, and Web of Science using terms related to lumbar alignment and Boolean logic was performed: (lumbar lordo*) or (lumbar alignment) or (sagittal alignment) or (sagittal balance). Standardized mean differences (SMD) and 95% confidence intervals (CI) were estimated, and chi-square and I 2 statistics were used to assess within-group heterogeneity by random effects model. Additionally, the age and gender of participants, spinal disease entity, and the severity and duration of LBP were evaluated as possible confounding factors. A total of 13 studies consisting of 796 patients with LBP and 927 healthy controls were identified. Overall, patients with LBP tended to have smaller LLA than healthy controls. However, the studies were heterogeneous. In the meta-regression analysis, the factors of age, severity of LBP, and spinal disease entity were revealed to contribute significantly to variance between studies. In the subgroup analysis of the five studies that compared patients with disc herniation or degeneration with healthy controls, patients with LBP had smaller LLA (SMD: -0.94, 95% CI: -1.19 to -0.69), with sufficient homogeneity based on significance level of .1 (I 2 =45.7%, p=.118). In the six age-matched studies, patients with LBP had smaller LLA than healthy controls (SMD: -0.33, 95% CI: -0.46 to -0.21), without statistical heterogeneity (I 2 =0%, p=.916). This meta-analysis demonstrates a strong relationship between LBP and decreased LLC, especially when compared with age-matched healthy controls. Among specific diseases, LBP by disc herniation or degeneration was shown to be substantially associated with the loss of LLC. Copyright © 2017 Elsevier Inc. All rights reserved.

Classification of SD-OCT volumes for DME detection: an anomaly detection approach

NASA Astrophysics Data System (ADS)

Sankar, S.; Sidibé, D.; Cheung, Y.; Wong, T. Y.; Lamoureux, E.; Milea, D.; Meriaudeau, F.

2016-03-01

Diabetic Macular Edema (DME) is the leading cause of blindness amongst diabetic patients worldwide. It is characterized by accumulation of water molecules in the macula leading to swelling. Early detection of the disease helps prevent further loss of vision. Naturally, automated detection of DME from Optical Coherence Tomography (OCT) volumes plays a key role. To this end, a pipeline for detecting DME diseases in OCT volumes is proposed in this paper. The method is based on anomaly detection using Gaussian Mixture Model (GMM). It starts with pre-processing the B-scans by resizing, flattening, filtering and extracting features from them. Both intensity and Local Binary Pattern (LBP) features are considered. The dimensionality of the extracted features is reduced using PCA. As the last stage, a GMM is fitted with features from normal volumes. During testing, features extracted from the test volume are evaluated with the fitted model for anomaly and classification is made based on the number of B-scans detected as outliers. The proposed method is tested on two OCT datasets achieving a sensitivity and a specificity of 80% and 93% on the first dataset, and 100% and 80% on the second one. Moreover, experiments show that the proposed method achieves better classification performances than other recently published works.

Application of texture analysis method for mammogram density classification

NASA Astrophysics Data System (ADS)

Nithya, R.; Santhi, B.

2017-07-01

Mammographic density is considered a major risk factor for developing breast cancer. This paper proposes an automated approach to classify breast tissue types in digital mammogram. The main objective of the proposed Computer-Aided Diagnosis (CAD) system is to investigate various feature extraction methods and classifiers to improve the diagnostic accuracy in mammogram density classification. Texture analysis methods are used to extract the features from the mammogram. Texture features are extracted by using histogram, Gray Level Co-Occurrence Matrix (GLCM), Gray Level Run Length Matrix (GLRLM), Gray Level Difference Matrix (GLDM), Local Binary Pattern (LBP), Entropy, Discrete Wavelet Transform (DWT), Wavelet Packet Transform (WPT), Gabor transform and trace transform. These extracted features are selected using Analysis of Variance (ANOVA). The features selected by ANOVA are fed into the classifiers to characterize the mammogram into two-class (fatty/dense) and three-class (fatty/glandular/dense) breast density classification. This work has been carried out by using the mini-Mammographic Image Analysis Society (MIAS) database. Five classifiers are employed namely, Artificial Neural Network (ANN), Linear Discriminant Analysis (LDA), Naive Bayes (NB), K-Nearest Neighbor (KNN), and Support Vector Machine (SVM). Experimental results show that ANN provides better performance than LDA, NB, KNN and SVM classifiers. The proposed methodology has achieved 97.5% accuracy for three-class and 99.37% for two-class density classification.

An effective method for cirrhosis recognition based on multi-feature fusion

NASA Astrophysics Data System (ADS)

Chen, Yameng; Sun, Gengxin; Lei, Yiming; Zhang, Jinpeng

2018-04-01

Liver disease is one of the main causes of human healthy problem. Cirrhosis, of course, is the critical phase during the development of liver lesion, especially the hepatoma. Many clinical cases are still influenced by the subjectivity of physicians in some degree, and some objective factors such as illumination, scale, edge blurring will affect the judgment of clinicians. Then the subjectivity will affect the accuracy of diagnosis and the treatment of patients. In order to solve the difficulty above and improve the recognition rate of liver cirrhosis, we propose a method of multi-feature fusion to obtain more robust representations of texture in ultrasound liver images, the texture features we extract include local binary pattern(LBP), gray level co-occurrence matrix(GLCM) and histogram of oriented gradient(HOG). In this paper, we firstly make a fusion of multi-feature to recognize cirrhosis and normal liver based on parallel combination concept, and the experimental results shows that the classifier is effective for cirrhosis recognition which is evaluated by the satisfying classification rate, sensitivity and specificity of receiver operating characteristic(ROC), and cost time. Through the method we proposed, it will be helpful to improve the accuracy of diagnosis of cirrhosis and prevent the development of liver lesion towards hepatoma.

Music-Elicited Emotion Identification Using Optical Flow Analysis of Human Face

NASA Astrophysics Data System (ADS)

Kniaz, V. V.; Smirnova, Z. N.

2015-05-01

Human emotion identification from image sequences is highly demanded nowadays. The range of possible applications can vary from an automatic smile shutter function of consumer grade digital cameras to Biofied Building technologies, which enables communication between building space and residents. The highly perceptual nature of human emotions leads to the complexity of their classification and identification. The main question arises from the subjective quality of emotional classification of events that elicit human emotions. A variety of methods for formal classification of emotions were developed in musical psychology. This work is focused on identification of human emotions evoked by musical pieces using human face tracking and optical flow analysis. Facial feature tracking algorithm used for facial feature speed and position estimation is presented. Facial features were extracted from each image sequence using human face tracking with local binary patterns (LBP) features. Accurate relative speeds of facial features were estimated using optical flow analysis. Obtained relative positions and speeds were used as the output facial emotion vector. The algorithm was tested using original software and recorded image sequences. The proposed technique proves to give a robust identification of human emotions elicited by musical pieces. The estimated models could be used for human emotion identification from image sequences in such fields as emotion based musical background or mood dependent radio.

Automatic detection of Martian dark slope streaks by machine learning using HiRISE images

NASA Astrophysics Data System (ADS)

Wang, Yexin; Di, Kaichang; Xin, Xin; Wan, Wenhui

2017-07-01

Dark slope streaks (DSSs) on the Martian surface are one of the active geologic features that can be observed on Mars nowadays. The detection of DSS is a prerequisite for studying its appearance, morphology, and distribution to reveal its underlying geological mechanisms. In addition, increasingly massive amounts of Mars high resolution data are now available. Hence, an automatic detection method for locating DSSs is highly desirable. In this research, we present an automatic DSS detection method by combining interest region extraction and machine learning techniques. The interest region extraction combines gradient and regional grayscale information. Moreover, a novel recognition strategy is proposed that takes the normalized minimum bounding rectangles (MBRs) of the extracted regions to calculate the Local Binary Pattern (LBP) feature and train a DSS classifier using the Adaboost machine learning algorithm. Comparative experiments using five different feature descriptors and three different machine learning algorithms show the superiority of the proposed method. Experimental results utilizing 888 extracted region samples from 28 HiRISE images show that the overall detection accuracy of our proposed method is 92.4%, with a true positive rate of 79.1% and false positive rate of 3.7%, which in particular indicates great performance of the method at eliminating non-DSS regions.

Comparison of Lateral Abdominal Muscle Thickness and Cross Sectional Area of Multifidus in Adolescent Soccer Players with and without Low Back Pain: A Case Control Study.

PubMed

Noormohammadpour, Pardis; Hosseini Khezri, Alireza; Linek, Paweł; Mansournia, Mohammad Ali; Hassannejad, Alireza; Younesian, Ali; Farahbakhsh, Farzin; Kordi, Ramin

2016-12-01

Low back pain (LBP) is a common complaint amongst adolescent athletes. While different studies have shown association between LBP and trunk muscle thickness in the general population, few articles have studied it in adolescent athletes. The aim of this study is to compare lateral abdominal muscle thickness and function, and cross sectional area (CSA) of lumbar multifidus (LM) in adolescent soccer players with and without LBP. In total, 28 adolescent soccer players with and without LBP, from the premier league participated in this study. The thickness of external oblique, internal oblique and transversus abdominis and the CSA of the LM muscles at L4 level on both sides were measured at rest and contraction via ultrasound imaging (USI). In addition, leg length discrepancy, hamstring flexibility, active lumbar forward flexion, and isometric muscle endurance of trunk extensors were measured in both groups. (study design/setting: case control study). The mean (SD) age in LBP group and non-LBP group were 14.0 (1.1) and 14.1 (0.9) years, respectively. There was no significant difference in baseline characteristics of participants between groups. Findings showed no significant difference between LBP and non-LBP groups comparing all measured variables. The data obtained support that there is not a correlation between abdominal muscle thickness and CSA of the lumbar multifidi and LBP in adolescent soccer players. These findings suggest that other factors rather than the thickness of deep trunk muscles may play a more significant role in the etiology of LBP in adolescent soccer players.

Study protocol title: a prospective cohort study of low back pain

PubMed Central

2013-01-01

Background Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date. PMID:23497211

Prevalence and Pharmacologic Treatment of Patients with Low Back Pain Treated at Kosovo Energetic Corporation

PubMed Central

Ibraimi, Zana; Murtezani, Ardiana; Haxhiu, Bekim; Mustafa, Aziz; Martinaj, Merita

2013-01-01

ABSTRACT Introduction: Low back pain (LBP) is a common complaint among the general population with a subgroup developing chronic and disabling symptoms generating large societal costs. Recurrences and functional limitations can be minimized with appropriate conservative management, including medications, physical therapy modalities, exercise and patient education. Objectives: The purpose of this study was to determine the prevalence of low back complaints in industrial workers, to investigate whether individual risk factors involved in the occurrence of LBP, and to determine the most frequent used drug in LBP treatment. Materials and Methods: Data for this study were provided from Kosovo Energetic Corporation. A cross-sectional study design was utilized. Self-administered questionnaires were distributed among 228 industrial workers. Patient with LBP underwent a comprehensive clinical, radiological and biochemical evaluation. Results: showed that LBP occurred in 63.5% of workers. Individual factors did not show significant associations with LBP. Age (OR=0.99/95% Cl 0.95-1.03), weight (OR=1.13/95% Cl 0.99-1.06), height (OR=0.97/95% Cl 0.91-1.02), and work experience (OR=1.01/95% Cl 0.97-1.05) increase odds for LBP but not significantly. The most frequently used drugs in patients included in this study are NSAIDs. In 33 (55.0%) patients for the treatment of LBP two types of drugs are administered. Conclusion: Increased physical activity, health promotion and reduced body weight can prevent morbidity from LBP. A continuous consultation with the Clinical Pharmacist demonstrates effective way of dosage and drug re-evaluation for the patients with LBP. PMID:25568510

Study protocol title: a prospective cohort study of low back pain.

PubMed

Garg, Arun; Hegmann, Kurt T; Moore, J Steven; Kapellusch, Jay; Thiese, Matthew S; Boda, Sruthi; Bhoyr, Parag; Bloswick, Donald; Merryweather, Andrew; Sesek, Richard; Deckow-Schaefer, Gwen; Foster, James; Wood, Eric; Sheng, Xiaoming; Holubkov, Richard

2013-03-07

Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors. A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers' jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date.

Functional test measures as risk indicators for low back pain among fixed-wing military pilots.

PubMed

Honkanen, Tuomas; Kyröläinen, H; Avela, J; Mäntysaari, M

2017-02-01

The purpose of this study was to find out the risk value of functional fitness test (FFT) results for low back pain (LBP) among fixed-wing military pilots. A total of 104 male military pilots were recruited for this study. The study was conducted with a self-administered questionnaire and FFT. The functional tests were performed in the beginning of study (baseline). The questionnaire was carried out at the baseline and 5 years later. The isometric low back endurance test result was associated with physical activity-related LBP experienced 5 years later. Demographic information was not associated with LBP. The prevalence of overall LBP was 71% and the flight-related LBP prevalence was 31% at the baseline. Our findings show that LBP among military pilots is a common problem but it is also associated with tasks other than flying. The functional test results were not associated with flight-related LBP but adequate isometric back endurance may have protective role in LBP caused in physical activities. When trying to find the pilots with increased risk of flight-related LBP, a more sensitive set of tests should be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Occupational correlates of low back pain among U.S. Marines following combat deployment.

PubMed

MacGregor, Andrew J; Dougherty, Amber L; Mayo, Jonathan A; Rauh, Mitchell J; Galarneau, Michael R

2012-07-01

Many U.S. Marines have experienced routine combat deployments during Operation Iraqi Freedom, which present numerous occupational hazards that may result in low back pain (LBP). The objective of this retrospective cohort study was to identify new-onset LBP among Marines following initial deployment to Operation Iraqi Freedom. Active duty Marines deployed to Iraq or Kuwait between 2005 and 2008 were identified from deployment records and linked to medical databases (n = 36,680). The outcome of interest was an International Classification of Diseases, 9th Revision, Clinical Modification code indicating LBP (724.2) within 1 year postdeployment. Multivariate logistic regression examined the effect of occupation on LBP. Overall, 4.1% (n = 1,517) of Marines were diagnosed with LBP. After adjusting for covariates, the service/supply (odds ratio 1.33, 95% confidence interval, 1.12-1.59) and electrical/mechanical/craftsworker occupations (odds ratio 1.31, 95% confidence interval, 1.12-1.53) had higher odds of LBP when compared to the administrative/other referent group. Within these groups, the highest LBP prevalence was in the construction (8.6%) and law enforcement (6.2%) subgroups. Although infantry occupations purposefully engage the enemy and often face sustained physical rigors of combat, LBP was most prevalent in noninfantry occupations. Future studies should include detailed exposure histories to elucidate occupation-specific etiologies of LBP in order to guide prevention efforts.

Lycium barbarum polysaccharide protects against oxygen glucose deprivation/reoxygenation-induced apoptosis and autophagic cell death via the PI3K/Akt/mTOR signaling pathway in primary cultured hippocampal neurons.

PubMed

Yu, Yang; Wu, Xiuquan; Pu, Jingnan; Luo, Peng; Ma, Wenke; Wang, Jiu; Wei, Jialiang; Wang, Yuanxin; Fei, Zhou

2018-01-01

Lycium barbarum polysaccharide (LBP) is the main active ingredient of Lycium barbarum, which exhibits several beneficial effects, including neuroprotection, anti-aging and anti-oxidation. However, the mechanism by which LBP protects against cerebral ischemia/reperfusion-induced injury remains obscure. In this study, we found that LBP pretreatment greatly attenuated oxygen glucose deprivation/reperfusion (OGD/R) injury in primary cultured hippocampal neurons. LBP also suppressed OGD/R-induced lactate dehydrogenase (LDH) leakage, and ameliorated oxidative stress. In addition, LBP significantly reduced OGD/R-induced apoptosis and autophagic cell death. LBP caused the down-regulation of cleaved Caspase-3/Caspase-3, LC3II/LC3I and Beclin 1, as well as up-regulation of Bcl-2/Bax and p62. Furthermore, mechanistic studies indicated that LBP pretreatment increased p-Akt and p-mTOR levels after OGD/R. In summary, our results indicated that LBP protects against OGD/R-induced neuronal injury in primary hippocampal neurons by activating the PI3K/Akt/mTOR signaling pathway. Copyright © 2017 Elsevier Inc. All rights reserved.

Polysaccharides from Wolfberry Prevents Corticosterone-Induced Inhibition of Sexual Behavior and Increases Neurogenesis

PubMed Central

Lau, Benson Wui-Man; Lee, Jada Chia-Di; Li, Yue; Fung, Sophia Man-Yuk; Sang, Yan-Hua; Shen, Jiangang; Chang, Raymond Chuen-Chung; So, Kwok-Fai

2012-01-01

Lycium barbarum, commonly known as wolfberry, has been used as a traditional Chinese medicine for the treatment of infertility and sexual dysfunction. However, there is still a scarcity of experimental evidence to support the pro-sexual effect of wolfberry. The aim of this study is to determine the effect of Lycium barbarum polysaccharides (LBP) on male sexual behavior of rats. Here we report that oral feeding of LBP for 21 days significantly improved the male copulatory performance including increase of copulatory efficiency, increase of ejaculation frequency and shortening of ejaculation latency. Furthermore, sexual inhibition caused by chronic corticosterone was prevented by LBP. Simultaneously, corticosterone suppressed neurogenesis in subventricular zone and hippocampus in adult rats, which could be reversed by LBP. The neurogenic effect of LBP was also shown in vitro. Significant correlation was found between neurogenesis and sexual performance, suggesting that the newborn neurons are associated with reproductive successfulness. Blocking neurogenesis in male rats abolished the pro-sexual effect of LBP. Taken together, these results demonstrate the pro-sexual effect of LBP on normal and sexually-inhibited rats, and LBP may modulate sexual behavior by regulating neurogenesis. PMID:22523540

Lycium barbarum polysaccharide protects human keratinocytes against UVB-induced photo-damage.

PubMed

Li, Huaping; Li, Zhenjie; Peng, Liqian; Jiang, Na; Liu, Qing; Zhang, Erting; Liang, Bihua; Li, Runxiang; Zhu, Huilan

2017-02-01

Ultraviolet B (UVB) irradiation plays a key role in skin damage, which induces oxidative and inflammatory damages, thereby causing photoaging or photocarcinogenesis. Lycium barbarum polysaccharide (LBP), the most biologically active fraction of wolfberry, possesses significant antioxidative and anti-inflammatory effects on multiple tissues. In the present study, the photoprotective effects and potential underlying molecular mechanisms of LBP against UVB-induced photo-damage were investigated in immortalized human keratinocytes (HaCaT cells). The data indicated that pretreatment with LBP significantly attenuated UVB-induced decrease in cell viability, increase in ROS production and DNA damage. LBP also significantly suppressed UVB-induced p38 MAPK activation, and subsequently reversed caspase-3 activation and MMP-9 expression. Notably, LBP was found to induce Nrf2 nuclear translocation and increase the expression of Nrf2-dependent ARE target genes. Furthermore, the protective effects of LBP were abolished by siRNA-mediated Nrf2 silencing. These results showed that the antioxidant LBP could partially protect against UVB irradiation-induced photo-damage through activation of Nrf2/ARE pathway, thereby scavenging ROS and reducing DNA damage, and subsequently suppressing UVB-induced p38 MAP pathway. Thus, LBP can be potentially used for skincare against oxidative damage from environmental insults.

Low back pain in childhood and adolescence: a cross-sectional study in Niigata City

PubMed Central

Ito, Takui; Hirano, Toru; Morita, Osamu; Kikuchi, Ren; Endo, Naoto; Tanabe, Naohito

2008-01-01

A cross-sectional study targeted a total of 43,630 pupils in Niigata City, Japan was performed. The objective was to clarify the present incidence of low back pain (LBP) in childhood and adolescence in Japan. It has recently been recognized that LBP in childhood and adolescence is also as common a problem as that for adults and most of these studies have been conducted in Europe, however, none have so far been made in Japan. A questionnaire survey was conducted using 43,630 pupils, including all elementary school students from the fourth to sixth grade (21,893 pupils) and all junior high students from the first to third year (21,737 pupils) in Niigata City (population of 785,067) to examine the point prevalence of LBP, the lifetime prevalence, the gender differences, the age of first onset of LBP in third year of junior high school students, the duration, the presence of recurrent LBP or not, the trigger of LBP, and the influences of sports and physical activities. In addition, the severity of LBP was divided into three levels (level 1: no limitation in any activity; level 2: necessary to refrain from participating in sports and physical activities, and level 3: necessary to be absent from school) in order to examine the factors that contribute to severe LBP. The validity rate was 79.8% and the valid response rate was 98.8%. The point prevalence was 10.2% (52.3% male and 47.7% female) and the lifetime prevalence was 28.8% (48.5% male and 51.5% female). Both increased as the grade level increased and in third year of junior high school students, a point prevalence was seen in 15.2% while a lifetime prevalence was observed in 42.5%. About 90% of these students experienced first-time LBP during the first and third year of junior high school. Regarding the duration of LBP, 66.7% experienced it for less than 1 week, while 86.1% suffered from it for less than 1 month. The recurrence rate was 60.5%. Regarding the triggers of LBP, 23.7% of them reported the influence of sports and exercise such as club activities and physical education, 13.5% reported trauma, while 55.6% reported no specific triggers associated with their LBP. The severity of LBP included 81.9% at level 1, 13.9% at level 2 and 4.2% at level 3. It was revealed that LBP in childhood and adolescence is also a common complaint in Japan, and these findings are similar to previous studies conducted in Europe. LBP increased as the grade level increased and it appeared that the point and lifetime prevalence in adolescence are close to the same levels as those seen in the adulthood and there was a tendency to have more severe LBP in both cases who experienced pain for more than 1 month and those with recurrent LBP. PMID:18830637

Are people with chronic low back pain meeting the physical activity guidelines? A co-twin control study.

PubMed

Zadro, Joshua Robert; Shirley, Debra; Amorim, Anita; Pérez-Riquelme, Francisco; Ordoñana, Juan R; Ferreira, Paulo H

2017-06-01

Despite a large amount of research investigating physical activity (PA) levels in people with chronic low back pain (LBP), no study has investigated whether people with chronic LBP are meeting the World Health Organization (WHO) PA guidelines. Furthermore, with genetics and the early shared environment substantially influencing the presence of LBP and PA engagement, these factors could confound the association between LBP and PA and need to be controlled for. This study aimed to investigate the association between chronic LBP and meeting the PA guidelines, while controlling for the effects of genetics and early shared environment. This is a cross-sectional co-twin control study. A cross-sectional analysis was performed on 1,588 twins from the Murcia Twin Registry in Spain with available data on LBP and PA from the 2013 data collection wave. The exposure and outcome variables in our study were self-reported. Twins reporting a history of chronic LBP were asked follow-up questions to inform on the presence of recent LBP (within the past 4 weeks), previous LBP (no pain within the past 4 weeks), and persistent LBP (no pain-free month in the last 6 months). These were our exposure variables. Our outcome variable was meeting the WHO PA guidelines, which involved at least 75 minutes of vigorous-intensity PA, or at least 150 minutes of moderate-intensity PA per week. To investigate the association between chronic LBP and meeting the PA guidelines, we first performed a multivariate logistic regression on the total sample of twins. Co-variables entered the model if the univariate association between the co-variable, and both the exposure and the outcome reached a significance of p<.2. Second, to adjust for the influence of genetics and early shared environment, we performed a conditional multivariate logistic regression on complete twin pairs discordant for LBP. The Murcia Twin Registry is supported by Fundación Séneca, Regional Agency for Science and Technology, Murcia, Spain (08633/PHCS/08 and 15302/PHCS/10) and the Ministry of Science and Innovation, Spain (PSI11560-2009). Funding for this project has also been received from Fundación MAPFRE (2012). The authors declare that there are no conflicts of interest. There was a significant inverse association between recent LBP and meeting the PA guidelines (odds ratio [OR]=0.71, p=.034). When controlling for genetics and early shared environment, this association disappeared. There was no association between previous (OR=0.95, p=.779) or persistent LBP (OR=0.78, p=.192) and meeting the PA guidelines. Twins with recent LBP are less likely to meet the PA guidelines than those with no history of chronic LBP, highlighting the importance of incorporating PA promotion in the treatment of these individuals. Genetics and early shared environment appear to be confounding the association between LBP and PA, although this needs to be further tested in larger twin samples. Copyright © 2017 Elsevier Inc. All rights reserved.

[The actual condition of musculoskeletal disorders of workers working at new special nursing homes for the aged in Osaka Prefecture--comparison of musculoskeletal disorder between manager's awareness and care workers' complaints by questionnaire survey].

PubMed

Tomioka, Kimiko; Matsunaga, Ichiro

2007-09-01

In order to examine the actual condition of health problems of workers working at new special nursing homes for the aged, we conducted an interview survey with the managers and a questionnaire survey among the workers. Subjects of the interview survey were managers at the 7 nursing homes. Subjects of the questionnaire survey were 362 workers employed at the 7 nursing homes, 214 care workers (CWs) and 104 workers other than care workers (non-CWs); 299 questionnaires were returned. The response rate was 82.6%. We asked the managers "How many CWs are complaining of low back pain (LBP) and upper extremity pain at your nursing home?" One manager answered that 80% of CWs were complaining of LBP, but other managers answered that a few but no more than 5 CWs were complaining of LBP. On the other hand, the prevalence of LBP among CWs by the questionnaire survey was high. The point prevalence of LBP was 70.0%, the one month prevalence of LBP was 81.6%, and the period prevalence of LBP in present job was 88.6%. The managers had less interest in upper extremity pain than in LBP. But more than 60% of CWs had complained of upper extremity pain in the previous 1 month. Seventy-three percent of CWs had not received any education about work-related musculoskeletal disorders although about half of them had got some education or training to minimize the risk of injury in training school. Regarding female workers (77% of all CWs, 73% of all non-CWs), the percentages of current smokers and night shift workers were higher in CWs than in non-CWs with statistically significant differences. The percentages of workers working without work breaks and working overtime were higher in non-CWs than in CWs with statistically significant differences. For prevalence of LBP among female CWs and female non-CWs, the workers having LBP now, having had LBP in present job, and having first experienced LBP in present job were higher in CWs than in non-CWs with statistically significant differences. All nursing homes surveyed had provided no special health examination for LBP. For managers to grasp the actual condition of musculoskeletal disorders of workers working at the nursing homes for the aged, we recommend that care workers should have a special health examination for LBP.

Low back pain beliefs are associated to age, location of work, education and pain-related disability in Chinese healthcare professionals working in China: a cross sectional survey.

PubMed

Tan, B-K; Smith, Anne J; O'Sullivan, Peter B; Chen, Gang; Burnett, Angus F; Briggs, Andrew M

2014-07-28

Low back pain (LBP) is the leading cause of disability worldwide. Evidence pointing towards a more efficacious model of care using a biopsychosocial approach for LBP management highlights the need to understand the pain-related beliefs of patients and those who treat them. The beliefs held by healthcare professionals (HCPs) are known to influence the treatment advice given to patients and consequently management outcomes. Back pain beliefs are known to be influenced by factors such as culture, education, health literacy, place of work, personal experience of LBP and the sequelae of LBP such as disability. There is currently a knowledge gap among these relationships in non-western countries. The aim of this study was to examine the associations between LBP-related beliefs among Chinese HCPs and characteristics of these HCPs. A convenience sample of 432 HCPs working in various health settings in Shanghai, China, completed a series of questionnaires assessing their demographic characteristics, LBP status, pain-related disability and their beliefs about their own LBP experience, using the Back beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ). Younger Chinese HCPs (20-29 years) held more negative beliefs and attitudes related to LBP compared to older HCPs (>40years; BBQ mean difference [95% CI]: 2.4 [0.9 - 3.9], p = 0.001). HCPs working outside tertiary hospitals had poorer beliefs concerning the inevitable consequences of LBP (BBQ mean difference [95% CI]: -2.4 [-3.8 - -1.0], p = 0.001). HCPs who experienced LBP had higher level of fear avoidance beliefs when experiencing high LBP-related disability (FABQ-physical mean difference [95% CI]: 2.8 [1.5 - 4.1], p < 0.001; FABQ-work mean difference [95% CI]: 6.2 [4.0 - 8.4], p < 0.001)) and had lower level of fear avoidance beliefs if they had completed postgraduate study (FABQ-physical mean difference [95% CI]: 2.9 [-5.8 - 0.0], p = 0.049). This study suggests that LBP-related beliefs and attitudes among Chinese HCPs are influenced by age, location of work, level of LBP-related disability and education level. Understanding back pain beliefs of Chinese HCPs forms an important foundation for future studies into the condition and its management in China.

Regulatory and policy issues for reuse and remanufacture of wood materials coated with lead-based paint

Treesearch

Thomas R. Napier; Robert H. Falk; George B. Guy; Susan Drodz

2005-01-01

At present, there is no regulatory or policy guidance at the Federal level that permits, prohibits, or qualifies practice for salvaging and reusing building materials coated with lead-based paint (LBP). This paper describes the current regulations and standards relative to LBP in buildings (in particular LBP on lumber and timber products), LBP mitigation, and disposal...

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

PubMed Central

Karppinen, Jaro; Sorensen, Joan S.; Niinimäki, Jaakko; Leboeuf-Yde, Charlotte

2008-01-01

The prevalence of “vertebral endplate signal changes” (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 × 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP. PMID:18787845

Changes in Cytokines, Sensory Tests, and Self-reported Pain Levels After Manual Treatment of Low Back Pain.

PubMed

Degenhardt, Brian F; Johnson, Jane C; Fossum, Christian; Andicochea, Chad T; Stuart, Melissa K

2017-07-01

Unbalanced 3-factor design with repeated measures on 1 factor. To determine the effect of manual treatment (MT) on cytokine and pain sensations in those with and without low back pain (LBP). Evidence suggests that MT reduces LBP but by unknown mechanisms. Certain cytokines have been elevated in patients with LBP and may be affected by MT. Participants aged 20-60 years with chronic LBP or without LBP were recruited and randomly assigned to MT, sham ultrasound treatment, or no treatment groups. Venous blood samples were collected and pain levels assessed at baseline, 1 hour later, and 24 hours later. Blood was analyzed for interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and C-reactive protein. Pain levels were measured by pressure pain threshold (PPT), mechanical detection threshold (MDT), dynamic mechanical allodynia, and self-report. Forty (30 women, age 36±11 y) participants completed the study, 33 with LBP (13 MT, 13 sham ultrasound treatment, and 7 no treatment) and 7 without LBP. Participants with or without LBP could not be differentiated on the basis of serum cytokine levels, PPT, or MDT (P≥0.08). There were no significant differences between the groups at 1 hour or 24 hours on serum cytokines, PPT, or MDT (P≥0.07). There was a significant decrease from baseline in IL-6 for the no treatment (LBP) group (P=0.04), in C-reactive protein for the sham ultrasound treatment group (P=0.03), in MDT for all 3 LBP groups (P≤0.02), and in self-reported pain for the MT and sham ultrasound treatment groups (P=0.03 and 0.01). Self-reported pain was reduced with MT and sham ultrasound treatment 24 hours after treatment, but inflammatory markers within venous circulation and quantitative sensory tests were unable to differentiate between study groups. Therefore, we were unable to characterize mechanisms underlying chronic LBP.

The effect of physical and psychosocial occupational factors on the chronicity of low back pain in the workers of Iranian metal industry: a cohort study.

PubMed

Aghilinejad, Mashallah; Tavakolifard, Negah; Mortazavi, Sayed Aliakbar; Kabir Mokamelkhah, Elahe; Sotudehmanesh, Akbar; Mortazavi, Seyed Alireza

2015-01-01

Low back pain (LBP) is one of the most common problems among the workers of different industries. The role of occupational factors in causing the LBP has been indicated previously. LBP has great socio-economic costs and most of its costs are related to the chronic LBP. The aim of this study was to identify the occupational risk factors that are related to the progression of the LBP from acute to chronic phase. This cohort study has been conducted on 185 workers with acute LBP. Information related to their occupational exposure at baseline has been measured with a valid questionnaire using the self-report approach. Patients follow up was done monthly for three months after the start of the pain. Those workers whose occupational exposure had not changed during the follow up were divided into two groups of chronic LBP (n = 49) and cured (n = 136) according to the duration of the pain period (more or less than 3 months), and their job exposures were compared. Among the physical and psychosocial risk factors, social support (OR= 0.466, CI= 0.231- 0.940) and job satisfaction (OR= 0.455, CI= 0.232-0.891), and lifting weights more than 15kg (OR=2.482, CI= 1.274-4.834) indicated a significant relationship with the chronicity of the LBP. After putting the variables into the regression model, only lifting>15kg remained statistically significant. According to the observed relationship between these occupational risk factors (social support, job satisfaction, lifting>15kg) and the chronicity of the LBP, there is hope that eliminating these factors in the workers with acute LBP will prevent its progression to the chronic phase.

Putting Physical Activity While Experiencing Low Back Pain in Context: Balancing the Risks and Benefits.

PubMed

Darlow, Ben; Perry, Meredith; Dean, Sarah; Mathieson, Fiona; Baxter, G David; Dowell, Anthony

2016-02-01

To analyze attitudes and beliefs about movement and physical activity in people with low back pain (LBP) and compare these beliefs between people with acute and chronic LBP. Qualitative inductive analysis of data collected via face-to-face semistructured interviews. Interviews were audio-recorded and transcribed verbatim. Participants were purposively recruited from 1 region of New Zealand. Persons with LBP (N=23), consisting of individuals with acute LBP (<6wk; n=12) and chronic LBP (>3mo; n=11). Not applicable. Themes that emerged from participant interview transcripts using analysis based on Interpretative Description. Participants with acute and chronic LBP made judgments about physical activity and rest using the same conceptual model. Concerns about creating more pain, tissue damage, or impairment influenced the physical activity judgments of most participants with acute and chronic LBP. These perceived risks were balanced against the perceived benefits, the most important of which were psychological or social rather than physical. Judgments made by those with acute and chronic LBP were context dependent and influenced by the nature and duration of pain, the type of physical activity, the importance of the activity, and the participant's previous experience. Participants with acute pain who had not experienced back pain previously often expressed more uncertainty, whereas those with chronic LBP appeared to have developed cognitive rules that determined physical activity decisions. Exploring the perceived risks, benefits, and contextual factors that influence decisions about physical activity and rest may help clinicians to understand the behavior of patients with acute and chronic LBP. Clinicians may best support their patients to engage in physical activity by providing an informed assessment of risks and an explanation about the range of potential benefits. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of experimentally induced low back pain on the sit-to-stand movement and electroencephalographic contingent negative variation

PubMed Central

Jacobs, Jesse V.; Yaguchi, Chie; Kaida, Chizuru; Irei, Mariko; Naka, Masami; Henry, Sharon M.; Fujiwara, Katsuo

2011-01-01

It is becoming increasingly evident that people with chronic, recurrent low back pain (LBP) exhibit changes in cerebrocortical activity that associate with altered postural coordination, suggesting a need for a better understanding of how the experience of LBP alters postural coordination and cerebrocortical activity. To characterize changes in postural coordination and pre-movement cerebrocortical activity related to the experience of acutely induced LBP, 14 healthy participants with no history of LBP performed sit-to-stand movements in 3 sequential conditions: (1) without experimentally induced LBP; NoPain1, (2) with movement-associated LBP induced by electrocutaneous stimulation; Pain, and (3) again without induced LBP; NoPain2. The Pain condition elicited altered muscle activation and redistributed forces under the seat and feet prior to movement, decreased peak vertical force exerted under the feet during weight transfer, longer movement times, as well as decreased and earlier peak hip extension. Stepwise regression models demonstrated that electroencephalographic amplitudes of contingent negative variation during the Pain condition significantly correlated with the participants’ change in sit-to-stand measures between the NoPain1 and Pain conditions, as well as with the subsequent difference in sit-to-stand measures between the NoPain1 and NoPain2 conditions. The results, therefore, identify the contingent negative variation as a correlate for the extent of an individual’s LBP-related movement modifications and to the subsequent change in movement patterns from before to after the experience of acutely induced LBP, thereby providing a direction for future studies aimed to understand the neural mechanisms underlying the development of altered movement patterns with LBP. PMID:21952791

Working with low back pain: problem-solving orientation and function.

PubMed

Shaw, W S; Feuerstein, M; Haufler, A J; Berkowitz, S M; Lopez, M S

2001-08-01

A number of ergonomic, workplace and individual psychosocial factors and health behaviors have been associated with the onset, exacerbation and/or maintenance of low back pain (LBP). The functional impact of these factors may be influenced by how a worker approaches problems in general. The present study was conducted to determine whether problem-solving orientation was associated with physical and mental health outcomes in fully employed workers (soldiers) reporting a history of LBP in the past year. The sample consisted of 475 soldiers (446 male, 29 female; mean age 24.5 years) who worked in jobs identified as high risk for LBP-related disability and reported LBP symptoms in the past 12 months. The Social Problem-Solving Inventory and the Standard Form-12 (SF-12) were completed by all subjects. Hierarchical multiple regression analyses were used to predict the SF-12 physical health summary scale from interactions of LBP symptoms with each of five problem-solving subscales. Low scores on positive problem-solving orientation (F(1,457)=4.49), and high scores on impulsivity/carelessness (F(1,457)=9.11) were associated with a steeper gradient in functional loss related to LBP. Among those with a longer history of low-grade LBP, an avoidant approach to problem-solving was also associated with a steeper gradient of functional loss (three-way interaction; F(1,458)=4.58). These results suggest that the prolonged impact of LBP on daily function may be reduced by assisting affected workers to conceptualize LBP as a problem that can be overcome and using strategies that promote taking an active role in reducing risks for LBP. Secondary prevention efforts may be improved by addressing these factors.

Antioxidant effects of Lycium barbarum polysaccharides on photoreceptor degeneration in the light-exposed mouse retina.

PubMed

Tang, Liujiu; Bao, Shuyin; Du, Yu; Jiang, Zengyan; Wuliji, A O; Ren, Xiang; Zhang, Chenghong; Chu, Haiying; Kong, Li; Ma, Haiying

2018-04-20

We assessed the neuroprotective effects of Lycium barbarum Polysaccharides (LBP) on photoreceptor degeneration and the mechanisms involved in oxidative stress in light-exposed mouse retinas. Mice were given a gavage of LBP (150 mg/kg or 300 mg/kg) or phosphate buffered saline (PBS) for 7 days before exposure to light (5000 lx for 24 h). We found that LBP significantly improved the electroretinography (ERG) amplitudes of the a- and b-waves that had been attenuated by light exposure. In addition, changes caused by light exposure including photoreceptor cell loss, nuclear condensation, an increased number of mitochondria vacuoles, outer membrane disc swelling and cristae fractures were distinctly ameliorated by LBP. LBP treatment also significantly prevented the generation of reactive oxygen species (ROS) compared with PBS treatment. The levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and thioredoxin reductase (TrxR1) mRNA were decreased in PBS-treated mice compared with controls but increased remarkably in LBP-treated mice. The mRNA levels of the DNA repair gene Poly (ADP-ribose) polymerase (PARP14) was increased in PBS-treated mice but decreased significantly in the LBP-treated mice. Our findings indicate that pretreatment with LBP effectively protected photoreceptor cells against light-induced retinal damage probably through the up-regulation of the antioxidative genes Nrf2 and TrxR1, the elimination of oxygen free radicals, and the subsequent reduction in the mitochondrial reaction to oxidative stress and enhancement in antioxidant capacity. In addition, the decreased level of PARP14 mRNA in LBP-treated mice also indicated a protective effect of LBP on delaying photoreceptor in the light-damaged retina. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management.

PubMed

O'Sullivan, Peter; Smith, Anne; Beales, Darren; Straker, Leon

2017-10-01

Synopsis Low back pain (LBP) is the leading cause of disability worldwide. It often begins in adolescence, setting a course for later in life. We have tracked the course of LBP in the Raine Study cohort from the age of 14 years into early adulthood. Our work has found that LBP is already prevalent in individuals at 14 years of age and increases throughout adolescence and into early adulthood. It is often comorbid with other musculoskeletal pain. For some adolescents, LBP has little impact; for others, its impact includes care seeking, taking medication, taking time off from school and work, as well as modifying physical and functional activity. Of concern is the increasing prevalence of LBP with impact across adolescence, reaching adult rates by 22 years of age. The predictors of disabling LBP in adolescence are multidimensional. They include female sex, negative back pain beliefs, poor mental health status, somatic complaints, involvement in sports, and altered stress responses. Genetics also plays a role. Ironically, the factors that we have historically thought to be important predictors of LBP, such as "poor" spinal posture, scoliosis, carrying school bags, joint hypermobility, and poor back muscle endurance, are not strong predictors. This challenges our clinical beliefs and highlights that adolescent LBP needs a flexible and targeted multidimensional approach to assessment and management. In most cases, we recommend a cognitive functional approach that challenges negative LBP beliefs, educates adolescents regarding factors associated with their LBP, restores functional capacity where it is impaired, and encourages healthy lifestyle habits. J Orthop Sports Phys Ther 2017;47(10):741-751. Epub 12 Sep 2017. doi:10.2519/jospt.2017.7376.

Predictors of low back pain in physically active conscripts with special emphasis on muscular fitness.

PubMed

Taanila, Henri P; Suni, Jaana H; Pihlajamäki, Harri K; Mattila, Ville M; Ohrankämmen, Olli; Vuorinen, Petteri; Parkkari, Jari P

2012-09-01

Association between low physical fitness and low back pain (LBP) is contradictory in previous studies. The objective of the present prospective cohort study was to investigate the predictive associations of various intrinsic risk factors in young conscripts for LBP, with special attention to physical fitness. A prospective cohort study. A representative sample of Finnish male conscripts. In Finland, military service is compulsory for male citizens and 90% of young men enter into the service. Incidence of LBP and recurrent LBP prompting a visit at the garrison health clinic during 6-month military training. Four successive cohorts of 18- to 28-year-old male conscripts (N=982) were followed for 6 months. Conscripts with incidence of LBP were identified and treated at the garrison clinic. Predictive associations between intrinsic risk factors and LBP were examined using multivariate Cox proportional hazard models. The cumulative incidence of LBP was 16%, the incidence rate being 1.2 (95% confidence interval [CI], 1.0-1.4) per 1,000 person-days. Conscripts with low educational level had increased risk for incidence of LBP (hazard ratio [HR], 1.6; 95% CI, 1.1-2.3). Conscripts with low dynamic trunk muscle endurance and low aerobic endurance simultaneously (ie, having coimpairment) at baseline also had an increased risk for incidence of LBP. The strongest risk factor was coimpairment of trunk muscular endurance in tests of back lift and push-up (HR, 2.8; 95% CI, 1.4-5.9). The increased risk for LBP was observed among young men who had a low educational level and poor fitness level in both muscular and aerobic performance. Copyright © 2012 Elsevier Inc. All rights reserved.

The NIOSH lifting equation and low-back pain, Part 1: Association with low-back pain in the backworks prospective cohort study.

PubMed

Garg, Arun; Boda, Sruthi; Hegmann, Kurt T; Moore, J Steven; Kapellusch, Jay M; Bhoyar, Parag; Thiese, Matthew S; Merryweather, Andrew; Deckow-Schaefer, Gwen; Bloswick, Donald; Malloy, Elizabeth J

2014-02-01

The aim of this study was to evaluate relationships between the revised NIOSH lifting equation (RNLE) and risk of low-back pain (LBP). The RNLE is commonly used to quantify job physical stressors to the low back from lifting and/or lowering of loads. There is no prospective study on the relationship between RNLE and LBP that includes accounting for relevant covariates. A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, hobbies, and current LBP were obtained at baseline. The cohort was followed monthly to ascertain development of LBP and quarterly to determine changes in job physical exposure. The relationship between LBP and peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression. Point and lifetime prevalences of LBP at baseline were 7.1% and 75.1%, respectively. During follow-up, there were 123 incident LBP cases. Factors predicting development of LBP included job physical exposure (PLI and PCLI), history of LBP, psychosocial factors, and housework. In adjusted models, risk (hazard ratio [HR]) increased per-unit increase in PLI and PCLI (p = .05 and .02; maximum HR = 4.3 and 4.2, respectively). PLI suggested a continuous increase in risk with an increase in PLI, whereas the PCLI showed elevated, but somewhat reduced, risk at higher exposures. Job physical stressors are associated with increased risk of LBP. Data suggest that the PLI and PCLI are useful metrics for estimating exposure to job physical stressors.

Low back pain in school-age children: risk factors, clinical features and diagnostic managment.

PubMed

Boćkowski, L; Sobaniec, W; Kułak, W; Smigielska-Kuzia, J; Sendrowski, K; Roszkowska, M

2007-01-01

Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. On surveys, about every fifth child in the school-age reports LBP. The study objective was to analysis the natural history, risk factors, clinical symptoms, causes and diagnostic management in school-age children hospitalized with LBP. The study group consisted of 36 patients at the age between 10 and 18 years, 22 girls and 14 boys suffering from LBP hospitalized in our Department of Pediatric Neurology and Rehabilitation in years 2000-2004. The mean age of clinical onset of LBP in our group was 14.7 years, earlier in girls, later in boys. We find the family history of LBP in 50% children. Most frequent factors associated with LBP were: spina bifida (16.7%) and incorrect posture (13.9%). Half of patients pointed the factor initialising LBP: rapid, incoordinated move (39%) or heavy load rise (11%). 58% of patients present the symptoms of ischialgia. Diagnostic imaging showed disc protrusion in 11 children (31%) 6 in computed tomography, 4 in magnetic resonance imaging and 1 in X-Ray examination only. Other causes of LBP included: spondylolysis in 2 patients, Scheuermann disease in one case and juvenile reumatoid arthritis in one case. Some school-age children suffering on low back pain, particulary with sciatic neuralgia symptoms seek medical care in hospital. Althought the main causes are mechanical, associated with lack of physical activity or strenous exercise, serious diagnostic managment is strongly recommended.

Physical activity and low-back pain in schoolchildren.

PubMed

Skoffer, Birgit; Foldspang, Anders

2008-03-01

Design of the experiment is to study the cross-sectional sample with retrospective information. The objective is to identify the types of physical activity associated with the decreased occurrence of low-back pain (LBP) in schoolchildren. Physical activity may be hypothesized to possess a potential for LBP prevention. The possible connection between LBP and specific sports activities is however sparsely documented. A total of 546, 15- to 16-year-old schoolchildren filled a questionnaire on current physical activities and LBP occurrence and severity. In multiple logistic regressions, the association of LBP with exposure variables was corrected for body height and weight (data from school health service files) and for anthropometric and school furniture parameters. More than half of the children reported pain or discomfort in the low-back region during the preceding 3 months, and 1/4 experienced a decreased functioning or need of care because of LBP. LBP correlated with physical inactivity, e.g. time spent on homework and hours watching TV or video, and with a series of sports activities, e.g. jogging, handball playing and gymnastics. Among sports activities, only swimming and the number of hours per week participating in soccer were associated with a decreased LBP prevalence. With the exception of swimming and soccer, the types of sport reported by this schoolchild population do not offer themselves for consideration as tools for LBP prevention. Based on the associations found with indicators of physical inactivity, attempts to motivate the children to increase their general physical activity level should be considered for trial.

Difference in kick motion of adolescent soccer players in presence and absence of low back pain.

PubMed

Tojima, Michio; Torii, Suguru

2018-01-01

Many adolescent soccer players experience low back pain (LBP). However, there are no reports studying the kick motion of adolescent soccer players experiencing LBP. This study aimed to clarify the kick motion of adolescent soccer players in the presence and absence of LBP. We recruited 42 adolescent soccer players and divided them into two groups according to the presence of LBP (LBP group, n=22) and absence of LBP (NBP group, n=20). We measured real-time kick motion using a three-dimensional motion analysis system. We placed 65 spherical markers on each anatomical landmark and calculated the angle of the lumbar spine, center of mass (COM) of the whole body, and displacement of the support foot. We used an unpaired t-test to compare the data between the groups. Compared with the NBP group, the LBP group showed a lateral shift in COM, which increased the duration of kick motion. The presence of LBP affected the posterior positioning of the support foot and restricted the player's lumbar spine from bending laterally. A lateral shift in COM and larger rotation of the lumbar spine could stress the lumbar spine during kick motion. Therefore, coaches and athletic trainers should pay attention to soccer players' lumbar spine rotation and the COM shift during kick motion. This would be important for preventing LBP in adolescent soccer players. Copyright © 2017 Elsevier B.V. All rights reserved.

Altered trunk muscle recruitment patterns during lifting in individuals in remission from recurrent low back pain.

PubMed

Suehiro, Tadanobu; Ishida, Hiroshi; Kobara, Kenichi; Osaka, Hiroshi; Watanabe, Susumu

2018-04-01

Changes in the recruitment pattern of trunk muscles may contribute to the development of recurrent or chronic symptoms in people with low back pain (LBP). However, the recruitment pattern of trunk muscles during lifting tasks associated with a high risk of LBP has not been clearly determined in recurrent LBP. The present study aimed to investigate potential differences in trunk muscles recruitment patterns between individuals with recurrent LBP and asymptomatic individuals during lifting. The subjects were 25 individuals with recurrent LBP and 20 asymptomatic individuals. Electromyography (EMG) was used to measure onset time, EMG amplitude, overall activity of abdominal muscles, and overall activity of back muscles during a lifting task. The onsets of the transversus abdominis/internal abdominal oblique and multifidus were delayed in the recurrent LBP group despite remission from symptoms. Additionally, the EMG amplitudes of the erector spinae, as well as the overall activity of abdominal muscles or back muscles, were greater in the recurrent LBP group. No differences in EMG amplitude of the external oblique, transversus abdominis/internal abdominal oblique, and multifidus were found between the groups. Our findings indicate the presence of an altered trunk muscle recruitment pattern in individuals with recurrent LBP during lifting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Low back pain among mineworkers in relation to driving, cold environment and ergonomics.

PubMed

Skandfer, Morten; Talykova, Ljudmila; Brenn, Tormod; Nilsson, Tohr; Vaktskjold, Arild

2014-01-01

We aimed to study the association between low back pain (LBP) and exposure to low temperature, wet clothes, heavy lifting and jobs that involve whole body vibration (WBV) in a population of miners. Health and personal data were collected in a population study by a questionnaire. A total of 3530 workers from four mines participated in the study. 51% of the workers reported LBP within the last 12 months. The adjusted odds ratio for LBP was above unity for working with wet clothes (1.82), working in cold conditions (1.52), lifting heavy (1.54), having worked as a driver previously (1.79) and driving Toro400 (2.61) or train (1.69). Wet clothing, cold working conditions, heavy lifting, previous work as a driver and driving certain vehicles were associated with LBP, but vehicles with WBV levels above action value were not. For better prevention of LBP, improved cabin conditions and clothing should be emphasised. To address risk factors for low back pain (LBP) in miners, a population study measured exposures and LBP. Cold work conditions, wet clothes and awkward postures appeared to be more strongly associated with LBP than exposure to whole body vibration from driving heavy vehicles. Prevention strategies must focus more on clothing and ergonomics.

The effect of low back pain on trunk muscle size/function and hip strength in elite football (soccer) players.

PubMed

Hides, Julie A; Oostenbroek, Tim; Franettovich Smith, Melinda M; Mendis, M Dilani

2016-12-01

Low back pain (LBP) is a common problem in football (soccer) players. The effect of LBP on the trunk and hip muscles in this group is unknown. The relationship between LBP and trunk muscle size and function in football players across the preseason was examined. A secondary aim was to assess hip muscle strength. Twenty-five elite soccer players participated in the study, with assessments conducted on 23 players at both the start and end of the preseason. LBP was assessed with questionnaires and ultrasound imaging was used to assess size and function of trunk muscles at the start and end of preseason. Dynamometry was used to assess hip muscle strength at the start of the preseason. At the start of the preseason, 28% of players reported the presence of LBP and this was associated with reduced size of the multifidus, increased contraction of the transversus abdominis and multifidus muscles. LBP decreased across the preseason, and size of the multifidus muscle improved over the preseason. Ability to contract the abdominal and multifidus muscles did not alter across the preseason. Asymmetry in hip adductor and abductor muscle strength was found between players with and without LBP. Identifying modifiable factors in players with LBP may allow development of more targeted preseason rehabilitation programmes.

The Protective Effects of Lycium Barbarum Polysaccharides on Transient Retinal Ischemia

PubMed Central

Yang, Di; Li, Suk-Yee; Yeung, Chung-Man; Yu, Wing-Yan; Chang, Raymond Chuen-Chung; So, Kwok-Fai; Wong, David; Lo, Amy C. Y.

2011-01-01

Retinal ischemia/reperfusion (I/R) injury leads to irreversible neuronal death, glial activation, retinal swelling and oxidative stress. It is a common feature in various ocular diseases, such as glaucoma, diabetic retinopathy and amaurosis fugax. In the present study, we aimed to evaluate the effects of Lycium Barbarum Polysaccharides (LBP) in a murine retinal I/R model. Mice were orally treated with either vehicle (PBS) or LBP (1mg/kg) daily for 1 week before induction of retinal ischemia. Retinae were collected after 2 hours ischemia and 22 hours reperfusion. Paraffin-embedded sections were prepared for immunohistochemical analyses. Significantly fewer viable cells were found in vehicle-treated retinae comparing to LBP group. This finding was further confirmed by TUNEL assay where significantly fewer apoptotic cells were identified in LBP-treated retinae. Additionally, retinal swelling induced by retinal I/R injury in the vehicle-treated group was not observed in LBP-treated group. Moreover, intense GFAP immunoreactivity and IgG extravasation were observed in vehicle-treated group but not in LBP treated group. The results showed that pre-treatment with LBP was protective in retinal I/R injury via reducing neuronal death, apoptosis, retinal swelling, GFAP activation and blood vessel leakage. LBP may be used as a preventive agent for retinal ischemia diseases.

Spine Conditions: Mechanical and Inflammatory Low Back Pain.

PubMed

Ledford, Christopher

2017-10-01

Mechanical low back pain (LBP) is an injury or derangement of an anatomic structure in the low back. When evaluating patients with LBP, clinicians should maintain clinical suspicion for vertebral fracture, cancer, and cauda equina syndrome. Management includes patient education focused on exercise, massage, and behavioral approaches such as cognitive behavioral therapy. Acupuncture can be an effective alternative and specific herbal supplements may provide short-term pain relief. The prognosis for patients with mechanical LBP is good. Inflammatory LBP is pain resulting from a systemic inflammatory condition, often referred to as axial spondyloarthritis. Ankylosing spondylitis is chronic inflammatory LBP characterized by early onset (mean age 24 years), with a higher prevalence in men. Five clinical parameters can help identify inflammatory LBP: improvement with exercise, pain at night, insidious onset, onset at younger than 40 years, and no improvement with rest. Management of inflammatory LBP typically includes nonsteroidal anti-inflammatory drugs and structured exercise programs, with emphasis on the involvement of a rheumatology subspecialist. Spondyloarthritis is associated with other rheumatic or autoimmune conditions, including rheumatoid arthritis, inflammatory bowel disease, and psoriasis. These should be considered when evaluating patients with inflammatory LBP. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Lycium barbarum polysaccharide protects against LPS-induced ARDS by inhibiting apoptosis, oxidative stress, and inflammation in pulmonary endothelial cells.

PubMed

Chen, Lan; Li, Wen; Qi, Di; Wang, Daoxin

2018-04-01

Acute respiratory distress syndrome (ARDS) is a heterogenous syndrome characterised by diffuse alveolar damage, with an increase in lung endothelial and epithelial permeability. Lycium barbarum polysaccharide (LBP), the most biologically active fraction of wolfberry, possesses antiapoptotic and antioxidative effects in distinct situations. In the present study, the protective effects and potential molecular mechanisms of LBP against lipopolysaccharide (LPS)-induced ARDS were investigated in the mice and in the human pulmonary microvascular endothelial cells (HPMECs). The data indicated that pretreatment with LBP significantly attenuated LPS-induced lung inflammation and pulmonary oedema in vivo. LBP significantly reversed LPS-induced decrease in cell viability, increase in apoptosis and oxidative stress via inhibiting caspase-3 activation and intracellular reactive oxygen species (ROS) production in vitro. Moreover, the scratch assay verified that LBP restored the dysfunction of endothelial cells (ECs) migration induced by LPS stimulation. Furthermore, LBP also significantly suppressed LPS-induced NF-κB activation, and subsequently reversed the release of cytochrome c. These results showed the antiapoptosis and antioxidant LBP could partially protect against LPS-induced ARDS through promoting the ECs survival and scavenging ROS via inhibition of NF-κB signalling pathway. Thus, LBP could be potentially used for ARDS against pulmonary inflammation and pulmonary oedema.

Life history and point prevalence of low back pain in pre-professional and professional dancers.

PubMed

Swain, Christopher T V; Bradshaw, Elizabeth J; Whyte, Douglas G; Ekegren, Christina L

2017-05-01

To investigate lifetime history and point prevalence of low back pain (LBP) in pre-professional and professional dancers and to identify any demographic or physical factors associated with LBP in dancers. Cross-sectional study. One pre-professional ballet school, two pre-professional university dance programs, and a professional nationally touring ballet company. Male and female classical ballet and contemporary dancers aged 12 years old and above. Lifetime history and point prevalence of LBP. A total of 110 (n = 19 male) dancers (mean (SD) 17.8 (2.9) years old) participated in the study, which represented 50% of the population invited to participate. A 74% lifetime prevalence of LBP was reported by dancers. Point and 12 month prevalence were 24 and 64%, respectively. No significant association was observed between LBP and any demographic or physical variables. Pre-professional and professional dancers have an increased vulnerability to LBP. The development of LBP within this population is complex and may not be associated with individual factors measured in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Automated oral cancer identification using histopathological images: a hybrid feature extraction paradigm.

PubMed

Krishnan, M Muthu Rama; Venkatraghavan, Vikram; Acharya, U Rajendra; Pal, Mousumi; Paul, Ranjan Rashmi; Min, Lim Choo; Ray, Ajoy Kumar; Chatterjee, Jyotirmoy; Chakraborty, Chandan

2012-02-01

Oral cancer (OC) is the sixth most common cancer in the world. In India it is the most common malignant neoplasm. Histopathological images have widely been used in the differential diagnosis of normal, oral precancerous (oral sub-mucous fibrosis (OSF)) and cancer lesions. However, this technique is limited by subjective interpretations and less accurate diagnosis. The objective of this work is to improve the classification accuracy based on textural features in the development of a computer assisted screening of OSF. The approach introduced here is to grade the histopathological tissue sections into normal, OSF without Dysplasia (OSFWD) and OSF with Dysplasia (OSFD), which would help the oral onco-pathologists to screen the subjects rapidly. The biopsy sections are stained with H&E. The optical density of the pixels in the light microscopic images is recorded and represented as matrix quantized as integers from 0 to 255 for each fundamental color (Red, Green, Blue), resulting in a M×N×3 matrix of integers. Depending on either normal or OSF condition, the image has various granular structures which are self similar patterns at different scales termed "texture". We have extracted these textural changes using Higher Order Spectra (HOS), Local Binary Pattern (LBP), and Laws Texture Energy (LTE) from the histopathological images (normal, OSFWD and OSFD). These feature vectors were fed to five different classifiers: Decision Tree (DT), Sugeno Fuzzy, Gaussian Mixture Model (GMM), K-Nearest Neighbor (K-NN), Radial Basis Probabilistic Neural Network (RBPNN) to select the best classifier. Our results show that combination of texture and HOS features coupled with Fuzzy classifier resulted in 95.7% accuracy, sensitivity and specificity of 94.5% and 98.8% respectively. Finally, we have proposed a novel integrated index called Oral Malignancy Index (OMI) using the HOS, LBP, LTE features, to diagnose benign or malignant tissues using just one number. We hope that this OMI can help the clinicians in making a faster and more objective detection of benign/malignant oral lesions. Copyright © 2011 Elsevier Ltd. All rights reserved.

MO-DE-207A-09: Low-Dose CT Image Reconstruction Via Learning From Different Patient Normal-Dose Images

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

Han, H; Xing, L; Liang, Z

Purpose: To investigate a novel low-dose CT (LdCT) image reconstruction strategy for lung CT imaging in radiation therapy. Methods: The proposed approach consists of four steps: (1) use the traditional filtered back-projection (FBP) method to reconstruct the LdCT image; (2) calculate structure similarity (SSIM) index between the FBP-reconstructed LdCT image and a set of normal-dose CT (NdCT) images, and select the NdCT image with the highest SSIM as the learning source; (3) segment the NdCT source image into lung and outside tissue regions via simple thresholding, and adopt multiple linear regression to learn high-order Markov random field (MRF) pattern formore » each tissue region in the NdCT source image; (4) segment the FBP-reconstructed LdCT image into lung and outside regions as well, and apply the learnt MRF prior in each tissue region for statistical iterative reconstruction of the LdCT image following the penalized weighted least squares (PWLS) framework. Quantitative evaluation of the reconstructed images was based on the signal-to-noise ratio (SNR), local binary pattern (LBP) and histogram of oriented gradients (HOG) metrics. Results: It was observed that lung and outside tissue regions have different MRF patterns predicted from the NdCT. Visual inspection showed that our method obviously outperformed the traditional FBP method. Comparing with the region-smoothing PWLS method, our method has, in average, 13% increase in SNR, 15% decrease in LBP difference, and 12% decrease in HOG difference from reference standard for all regions of interest, which indicated the superior performance of the proposed method in terms of image resolution and texture preservation. Conclusion: We proposed a novel LdCT image reconstruction method by learning similar image characteristics from a set of NdCT images, and the to-be-learnt NdCT image does not need to be scans from the same subject. This approach is particularly important for enhancing image quality in radiation therapy.« less

A signature dissimilarity measure for trabecular bone texture in knee radiographs

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

Woloszynski, T.; Podsiadlo, P.; Stachowiak, G. W.

Purpose: The purpose of this study is to develop a dissimilarity measure for the classification of trabecular bone (TB) texture in knee radiographs. Problems associated with the traditional extraction and selection of texture features and with the invariance to imaging conditions such as image size, anisotropy, noise, blur, exposure, magnification, and projection angle were addressed. Methods: In the method developed, called a signature dissimilarity measure (SDM), a sum of earth mover's distances calculated for roughness and orientation signatures is used to quantify dissimilarities between textures. Scale-space theory was used to ensure scale and rotation invariance. The effects of image size,more » anisotropy, noise, and blur on the SDM developed were studied using computer generated fractal texture images. The invariance of the measure to image exposure, magnification, and projection angle was studied using x-ray images of human tibia head. For the studies, Mann-Whitney tests with significance level of 0.01 were used. A comparison study between the performances of a SDM based classification system and other two systems in the classification of Brodatz textures and the detection of knee osteoarthritis (OA) were conducted. The other systems are based on weighted neighbor distance using compound hierarchy of algorithms representing morphology (WND-CHARM) and local binary patterns (LBP). Results: Results obtained indicate that the SDM developed is invariant to image exposure (2.5-30 mA s), magnification (x1.00-x1.35), noise associated with film graininess and quantum mottle (<25%), blur generated by a sharp film screen, and image size (>64x64 pixels). However, the measure is sensitive to changes in projection angle (>5 deg.), image anisotropy (>30 deg.), and blur generated by a regular film screen. For the classification of Brodatz textures, the SDM based system produced comparable results to the LBP system. For the detection of knee OA, the SDM based system achieved 78.8% classification accuracy and outperformed the WND-CHARM system (64.2%). Conclusions: The SDM is well suited for the classification of TB texture images in knee OA detection and may be useful for the texture classification of medical images in general.« less

Many local pattern texture features: which is better for image-based multilabel human protein subcellular localization classification?

PubMed

Yang, Fan; Xu, Ying-Ying; Shen, Hong-Bin

2014-01-01

Human protein subcellular location prediction can provide critical knowledge for understanding a protein's function. Since significant progress has been made on digital microscopy, automated image-based protein subcellular location classification is urgently needed. In this paper, we aim to investigate more representative image features that can be effectively used for dealing with the multilabel subcellular image samples. We prepared a large multilabel immunohistochemistry (IHC) image benchmark from the Human Protein Atlas database and tested the performance of different local texture features, including completed local binary pattern, local tetra pattern, and the standard local binary pattern feature. According to our experimental results from binary relevance multilabel machine learning models, the completed local binary pattern, and local tetra pattern are more discriminative for describing IHC images when compared to the traditional local binary pattern descriptor. The combination of these two novel local pattern features and the conventional global texture features is also studied. The enhanced performance of final binary relevance classification model trained on the combined feature space demonstrates that different features are complementary to each other and thus capable of improving the accuracy of classification.

Purification, crystallization and preliminary crystallographic analysis of Streptococcus pyogenes laminin-binding protein Lbp

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

Linke, Christian, E-mail: clin180@ec.auckland.ac.nz; Caradoc-Davies, Tom T.; Australian Synchrotron, Clayton, Victoria 3168

2008-02-01

The S. pyogenes laminin-binding protein Lbp, which is essential for adhesion to human laminin, has been expressed, purified and crystallized. The laminin-binding protein Lbp (Spy2007) from Streptococcus pyogenes (a group A streptococcus) mediates adhesion to the human basal lamina glycoprotein laminin. Accordingly, Lbp is essential in in vitro models of cell adhesion and invasion. However, the molecular and structural basis of laminin binding by bacteria remains unknown. Therefore, the lbp gene has been cloned for recombinant expression in Escherichia coli. Lbp has been purified and crystallized from 30%(w/v) PEG 1500 by the sitting-drop vapour-diffusion method. The crystals belonged to themore » monoclinic space group P2{sub 1}, with unit-cell parameters a = 42.62, b = 92.16, c = 70.61 Å, β = 106.27°, and diffracted to 2.5 Å resolution.« less

Low back pain beliefs are associated to age, location of work, education and pain-related disability in Chinese healthcare professionals working in China: a cross sectional survey

PubMed Central

2014-01-01

Background Low back pain (LBP) is the leading cause of disability worldwide. Evidence pointing towards a more efficacious model of care using a biopsychosocial approach for LBP management highlights the need to understand the pain-related beliefs of patients and those who treat them. The beliefs held by healthcare professionals (HCPs) are known to influence the treatment advice given to patients and consequently management outcomes. Back pain beliefs are known to be influenced by factors such as culture, education, health literacy, place of work, personal experience of LBP and the sequelae of LBP such as disability. There is currently a knowledge gap among these relationships in non-western countries. The aim of this study was to examine the associations between LBP-related beliefs among Chinese HCPs and characteristics of these HCPs. Methods A convenience sample of 432 HCPs working in various health settings in Shanghai, China, completed a series of questionnaires assessing their demographic characteristics, LBP status, pain-related disability and their beliefs about their own LBP experience, using the Back beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ). Results Younger Chinese HCPs (20–29 years) held more negative beliefs and attitudes related to LBP compared to older HCPs (>40years; BBQ mean difference [95% CI]: 2.4 [0.9 - 3.9], p = 0.001). HCPs working outside tertiary hospitals had poorer beliefs concerning the inevitable consequences of LBP (BBQ mean difference [95% CI]: −2.4 [−3.8 - −1.0], p = 0.001). HCPs who experienced LBP had higher level of fear avoidance beliefs when experiencing high LBP-related disability (FABQ-physical mean difference [95% CI]: 2.8 [1.5 - 4.1], p < 0.001; FABQ-work mean difference [95% CI]: 6.2 [4.0 - 8.4], p < 0.001)) and had lower level of fear avoidance beliefs if they had completed postgraduate study (FABQ-physical mean difference [95% CI]: 2.9 [−5.8 - 0.0], p = 0.049). Conclusion This study suggests that LBP-related beliefs and attitudes among Chinese HCPs are influenced by age, location of work, level of LBP-related disability and education level. Understanding back pain beliefs of Chinese HCPs forms an important foundation for future studies into the condition and its management in China. PMID:25065641

The relative importance of whole body vibration and occupational lifting as risk factors for low-back pain

PubMed Central

Palmer, K; Griffin, M; Syddall, H; Pannett, B; Cooper, C; Coggon, D

2003-01-01

Aims: To explore the impact of occupational exposure to whole body vibration (WBV) on low back pain (LBP) in the general population and to estimate the burden of LBP attributable to occupational WBV in comparison with that due to occupational lifting. Methods: A questionnaire including sections on WBV at work, LBP, and potential risk factors was mailed to a community sample of 22 194 men and women of working age. Sources and durations of exposure to occupational WBV were ascertained for the past week and personal vibration doses (eVDV) were estimated. Analysis was confined to subjects reporting exposures in the past week as typical of their work. Associations of LBP with eVDV, driving industrial vehicles, and occupational lifting were explored by logistic regression and attributable numbers were calculated. Results: Significant associations were found between daily lifting of weights greater than 10 kg at work and LBP, troublesome LBP (which made it difficult to put on hosiery), and sciatica (prevalence ratios 1.3 to 1.7); but the risk of these outcomes in both sexes varied little by eVDV and only weak associations were found with riding on industrial vehicles. Assuming causal associations, the numbers of cases of LBP in Britain attributable to occupational WBV were estimated to be 444 000 in men and 95 000 in women. This compared with an estimated 940 000 male cases and 370 000 female cases of LBP from occupational lifting. Conclusions: The burden of LBP in Britain from occupational exposure to WBV is smaller than that attributable to lifting at work. PMID:14504358

Low back pain predict sickness absence among power plant workers

PubMed Central

Murtezani, Ardiana; Hundozi, Hajrije; Orovcanec, Nikola; Berisha, Merita; Meka, Vjollca

2010-01-01

Background: Low back pain (LBP) remains the predominant occupational health problem in most industrialized countries and low-income countries. Both work characteristics and individual factors have been identified as risk factors. More knowledge about the predictors of sickness absence from LBP in the industry will be valuable in determining strategies for prevention. Objectives: The aim of this longitudinal study was to investigate whether individual, work-related physical risk factors were involved in the occurrence of LBP sickness absence. Methods: A follow-up study was conducted among 489 workers, aged 18–65 years, at Kosovo Energetic Corporation in Kosovo. This cross-sectional study used a self-administered questionnaire to collect data on individual and work-related risk factors and the occurrence of LBP sickness absence. Logistic regression models were used to determine associations between risk factors and the occurrence of sickness absence due to LBP. Results: Individual factors did not influence sickness absence, whereas work-related physical factors showed strong associations with sickness absence. The main risk factors for sickness absence due to LBP among production workers were extreme trunk flexion (OR = 1.71, 95% CI = 1.05–2.78) as well as very extreme trunk flexion (OR = 6.04, 95% CI = 1.12–32.49) and exposure to whole-body vibration (OR = 1.75, 95% CI = 1.04–2.95). Conclusion: Reducing sickness absence from LBP among power plant workers requires focusing on the working conditions of blue-collar workers and risk factors for LBP. Increasing social support in the work environment may have effects in reducing sickness absence from LBP. PMID:21120081

Assessment of potential risk factors for new onset disabling low back pain in Japanese workers: findings from the CUPID (cultural and psychosocial influences on disability) study.

PubMed

Kawaguchi, Mika; Matsudaira, Ko; Sawada, Takayuki; Koga, Tadashi; Ishizuka, Akiko; Isomura, Tatsuya; Coggon, David

2017-08-02

Most studies of risk factors for new low back pain (LBP) have been conducted in Western populations, but because of cultural and environmental differences, the impact of causal factors may not be the same in other countries. We used longitudinal data from the Cultural and Psychosocial Influences on Disability (CUPID) study to assess risk factors for new onset of disabling LBP among Japanese workers. Data came from a 1-year prospective follow-up of nurses, office workers, sales/marketing personnel, and transportation workers, initially aged 20-59 years, who were employed in or near Tokyo. A baseline questionnaire included items on past history of LBP, personal characteristics, ergonomic work demands, and work-related psychosocial factors. Further information about LBP was collected at follow-up. Analysis was restricted to participants who had been free from LBP during the 12 months before baseline. Logistic regression was used to assess baseline risk factors for new onset of disabling LBP (i.e. LBP that had interfered with work) during the 12 months of follow-up. Among 955 participants free from LBP during the 12 months before baseline, 58 (6.1%) reported a new episode of disabling LBP during the 12-month follow-up period. After mutual adjustment in a multivariate logistic regression analysis, which included the four factors that showed associations individually (p < 0.1) in analyses adjusted only for gender and age, the highest odds ratio (OR) was for past history of LBP (2.8, 95% [confidence interval {CI}]: 1.6-4.9), followed by working ≥60 h per week (1.8, 95% CI: 1.0-3.5) and lifting weights ≥25 kg by hand (1.6, 95% CI: 0.9-3.0). When past history of LBP was excluded from the model, ORs for the remaining risk factors were virtually unchanged. Our findings suggest that among Japanese workers, as elsewhere, past history of LBP is a major risk factor for the development of new episodes of disabling back pain. They give limited support to the association with occupational lifting that has been observed in earlier research, both in Japan and in Western countries. In addition, they suggest a possible role of long working hours, which merits further investigation.

Disrupted functional connectivity of the periaqueductal gray in chronic low back pain

PubMed Central

Yu, Rongjun; Gollub, Randy L.; Spaeth, Rosa; Napadow, Vitaly; Wasan, Ajay; Kong, Jian

2014-01-01

Chronic low back pain is a common neurological disorder. The periaqueductal gray (PAG) plays a key role in the descending modulation of pain. In this study, we investigated brain resting state PAG functional connectivity (FC) differences between patients with chronic low back pain (cLBP) in low pain or high pain condition and matched healthy controls (HCs). PAG seed based functional connectivity (FC) analysis of the functional MR imaging data was performed to investigate the difference among the connectivity maps in the cLBP in the low or high pain condition and HC groups as well as within the cLBP at differing endogenous back pain intensities. Results showed that FC between the PAG and the ventral medial prefrontal cortex (vmPFC)/rostral anterior cingulate cortex (rACC) increased in cLBP patients compared to matched controls. In addition, we also found significant negative correlations between pain ratings and PAG–vmPFC/rACC FC in cLBP patients after pain-inducing maneuver. The duration of cLBP was negatively correlated with PAG–insula and PAG–amygdala FC before pain-inducing maneuver in the patient group. These findings are in line with the impairments of the descending pain modulation reported in patients with cLBP. Our results provide evidence showing that cLBP patients have abnormal FC in PAG centered pain modulation network during rest. PMID:25379421

Multifidus Muscle Size and Symmetry in Ballroom Dancers with and without Low Back Pain.

PubMed

Smyers Evanson, Alyssa; Myrer, Joseph William; Eggett, Dennis L; Mitchell, Ulrike H; Johnson, A Wayne

2018-06-08

The incidence of low back pain (LBP) among elite ballroom dancers is high and understanding associations between muscle morphology and pain may provide insight into treatment or training options. Research has linked multifidus muscle atrophy to LBP in the general and some athletic populations; however, this has not been examined in ballroom dancers. We compared the lumbar multifidus cross-sectional area (CSA) at rest in 57 elite level ballroom dancers (age 23±2.4 years; height, 174±11 cm; mass, 64±10 kg) divided into one of three pain groups, according to their self-reported symptoms, 1) LBP group (n=19), 2) minimal LBP (n=17), and 3) no LBP (n=21). There were no significant difference in demographics between the groups (P>0.05). The LBP group demonstrated significant differences in reported pain and Oswestry Disability Index scores compared to the other two groups. There was no significant difference between groups in multifidus cross-sectional area (P=0.49). Asymmetry was found in all groups with the overall left side being significantly larger than the right (P<0.002). Pain associated with segmental decrease in multifidus CSA was not observed in ballroom dancers with LBP, suggesting other reasons for persistent LBP in ballroom dancers. © Georg Thieme Verlag KG Stuttgart · New York.

Differences in end-range lumbar flexion during slumped sitting and forward bending between low back pain subgroups and genders

PubMed Central

Hoffman, Shannon L.; Johnson, Molly B.; Zou, Dequan; Van Dillen, Linda R.

2012-01-01

Patterns of lumbar posture and motion are associated with low back pain (LBP). Research suggests LBP subgroups demonstrate different patterns during common tasks. This study assessed differences in end-range lumbar flexion during two tasks between two LBP subgroups classified according to the Movement System Impairment model. Additionally, the impact of gender differences on subgroup differences was assessed. Kinematic data were collected. Subjects in the Rotation (Rot) and Rotation with Extension (RotExt) LBP subgroups were asked to sit slumped and bend forward from standing. Lumbar end-range flexion was calculated. Subjects reported symptom behavior during each test. Compared to the RotExt subgroup, the Rot subgroup demonstrated greater end-range lumbar flexion during slumped sitting and a trend towards greater end-range lumbar flexion with forward bending. Compared to females, males demonstrated greater end-range lumbar flexion during slumped sitting and forward bending. A greater proportion of people in the Rot subgroup reported symptoms with each test compared to the RotExt subgroup. Males and females were equally likely to report symptoms with each test. Gender differences were not responsible for LBP subgroup differences. Subgrouping people with LBP provides insight into differences in lumbar motion within the LBP population. Results suggesting potential consistent differences across flexion-related tasks support the presence of stereotypical movement patterns that are related to LBP. PMID:22261650

The role of trunk muscles in sitting balance control in people with low back pain.

PubMed

Freddolini, Marco; Strike, Siobhan; Lee, Raymond Y W

2014-12-01

The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p>0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p<0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p<0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neuromuscular response amplitude to mechanical stimulation using large-array surface electromyography in participants with and without chronic low back pain.

PubMed

Pagé, Isabelle; Nougarou, François; Descarreaux, Martin

2016-04-01

The present study aimed to compare the neuromuscular response under various mechanical stimulations of the lumbar spine in participants with and without chronic low back pain (cLBP). Four mechanical stimulations, characterized by forces ranging from 75 to 225N, were delivered using a servo-controlled linear actuator motor to the L3 spinous process of 25 healthy participants and 26 participants with cLBP. Lumbar neuromuscular responses were recorded using 64-electrodes large surface electromyography arrays. Between-group differences in the dose-response relationship (neuromuscular response amplitude according to each force level) were assessed using mixed model ANOVAs. No differences between groups were shown (all p values>.05). A significant linear relationship was observed between forces and neuromuscular response amplitudes (p<.001) indicating an increase in response amplitudes with increasing stimulation force. Responses were observed throughout the lumbar region with highest response amplitudes in the vicinity of the contacted vertebra. The neuromuscular response amplitude triggered by localized lumbar mechanical stimulations does not differ between participants with and without cLBP. Moreover, even though stimulations were delivered at specific spinal segment, a neuromuscular response, although rapidly decreasing, was observed in areas distant from the contact site. Copyright © 2016 Elsevier Ltd. All rights reserved.

Automatic discrimination of color retinal images using the bag of words approach

NASA Astrophysics Data System (ADS)

Sadek, I.; Sidibé, D.; Meriaudeau, F.

2015-03-01

Diabetic retinopathy (DR) and age related macular degeneration (ARMD) are among the major causes of visual impairment all over the world. DR is mainly characterized by small red spots, namely microaneurysms and bright lesions, specifically exudates. However, ARMD is mainly identified by tiny yellow or white deposits called drusen. Since exudates might be the only visible signs of the early diabetic retinopathy, there is an increase demand for automatic diagnosis of retinopathy. Exudates and drusen may share similar appearances; as a result discriminating between them plays a key role in improving screening performance. In this research, we investigative the role of bag of words approach in the automatic diagnosis of retinopathy diabetes. Initially, the color retinal images are preprocessed in order to reduce the intra and inter patient variability. Subsequently, SURF (Speeded up Robust Features), HOG (Histogram of Oriented Gradients), and LBP (Local Binary Patterns) descriptors are extracted. We proposed to use single-based and multiple-based methods to construct the visual dictionary by combining the histogram of word occurrences from each dictionary and building a single histogram. Finally, this histogram representation is fed into a support vector machine with linear kernel for classification. The introduced approach is evaluated for automatic diagnosis of normal and abnormal color retinal images with bright lesions such as drusen and exudates. This approach has been implemented on 430 color retinal images, including six publicly available datasets, in addition to one local dataset. The mean accuracies achieved are 97.2% and 99.77% for single-based and multiple-based dictionaries respectively.

Mechanical factors and vitamin D deficiency in schoolchildren with low back pain: biochemical and cross-sectional survey analysis

PubMed Central

Alghadir, Ahmad H; Gabr, Sami A; Al-Eisa, Einas S

2017-01-01

Objective This study was designed to evaluate the role of vitamin D, muscle fatigue biomarkers, and mechanical factors in the progression of low back pain (LBP) in schoolchildren. Background Children and adolescents frequently suffer from LBP with no clear clinical causes, and >71% of schoolchildren aged 12–17 years will show at least one episode of LBP. Materials and methods A total of 250 schoolchildren aged 12–16 years were randomly enrolled in this study. For all schoolchildren height, weight, percentage of daily sun exposure and and areas of skin exposed to sun, method of carrying the bag, and bag weight and type were recorded over a typical school week. Pain scores, physical activity (PA), LBP, serum vitamin 25(OH)D level, serum bone-specific alkaline phosphatase, creatine kinase (CK), and lactate dehydrogenase (LDH) activities and calcium (Ca) concentrations were estimated using prevalidated Pain Rating Scale, modified Oswestry Low Back Pain Disability Questionnaire, short-form PA questionnaire, and colorimetric and immunoassay techniques. Results During the period of October 2013–May 2014, LBP was estimated in 52.2% of the schoolchildren. It was classified into moderate (34%) and severe (18%). Girls showed a higher LBP (36%) compared with boys (24%). In schoolchildren with moderate and severe LBP significantly higher (P=0.01) body mass index, waist, hip, and waist-to-hip ratio measurements were observed compared with normal schoolchildren. LBP significantly correlated with less sun exposure, lower PA, sedentary activity (TV/computer use), and overloaded school bags. In addition, schoolchildren with severe LBP showed lower levels of vitamin 25(OH)D and Ca and higher levels of CK, LDH, and serum bone-specific alkaline phosphatase compared with moderate and healthy schoolchildren. Stepwise regression analysis revealed that age, gender, demographic parameters, PA, vitamin D levels, Ca, CK, and LDH associated with ~56.8%–86.7% of the incidence of LBP among schoolchildren. Conclusion In children and adolescents, LBP was shown to be linked with limited sun exposure, inadequate vitamin D diets, adiposity, lower PA, sedentary lifestyles, vitamin 25 (OH) D deficiency, and lower levels of Ca, CK, and LDH. PMID:28442927

Mechanical factors and vitamin D deficiency in schoolchildren with low back pain: biochemical and cross-sectional survey analysis.

PubMed

Alghadir, Ahmad H; Gabr, Sami A; Al-Eisa, Einas S

2017-01-01

This study was designed to evaluate the role of vitamin D, muscle fatigue biomarkers, and mechanical factors in the progression of low back pain (LBP) in schoolchildren. Children and adolescents frequently suffer from LBP with no clear clinical causes, and >71% of schoolchildren aged 12-17 years will show at least one episode of LBP. A total of 250 schoolchildren aged 12-16 years were randomly enrolled in this study. For all schoolchildren height, weight, percentage of daily sun exposure and and areas of skin exposed to sun, method of carrying the bag, and bag weight and type were recorded over a typical school week. Pain scores, physical activity (PA), LBP, serum vitamin 25(OH)D level, serum bone-specific alkaline phosphatase, creatine kinase (CK), and lactate dehydrogenase (LDH) activities and calcium (Ca) concentrations were estimated using prevalidated Pain Rating Scale, modified Oswestry Low Back Pain Disability Questionnaire, short-form PA questionnaire, and colorimetric and immunoassay techniques. During the period of October 2013-May 2014, LBP was estimated in 52.2% of the schoolchildren. It was classified into moderate (34%) and severe (18%). Girls showed a higher LBP (36%) compared with boys (24%). In schoolchildren with moderate and severe LBP significantly higher ( P =0.01) body mass index, waist, hip, and waist-to-hip ratio measurements were observed compared with normal schoolchildren. LBP significantly correlated with less sun exposure, lower PA, sedentary activity (TV/computer use), and overloaded school bags. In addition, schoolchildren with severe LBP showed lower levels of vitamin 25(OH)D and Ca and higher levels of CK, LDH, and serum bone-specific alkaline phosphatase compared with moderate and healthy schoolchildren. Stepwise regression analysis revealed that age, gender, demographic parameters, PA, vitamin D levels, Ca, CK, and LDH associated with ~56.8%-86.7% of the incidence of LBP among schoolchildren. In children and adolescents, LBP was shown to be linked with limited sun exposure, inadequate vitamin D diets, adiposity, lower PA, sedentary lifestyles, vitamin 25 (OH) D deficiency, and lower levels of Ca, CK, and LDH.

The development of the Dutch version of the Fremantle Back Awareness Questionnaire.

PubMed

Janssens, Lotte; Goossens, Nina; Wand, Benedict M; Pijnenburg, Madelon; Thys, Tinne; Brumagne, Simon

2017-12-01

Disturbed body perception may play a role in the aetiology of chronic low back pain (LBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is currently the only self-report questionnaire to assess back-specific body perception in individuals with LBP. To perform a cross-cultural adaptation of the FreBAQ into Dutch. Psychometric study. A Dutch version of the FreBAQ was generated through forward-backward translation, and was completed by 73 patients with LBP and 73 controls to assess discriminant validity. Structural validity was assessed by principal component analysis. Internal consistency was assessed by the Cronbach's alpha coefficient. Construct validity was assessed by examining the relationship with clinical measures (Numerical Rating Scale pain, Oswestry Disability Index (ODI), Tampa Scale for Kinesiophobia). Test-retest reliability was assessed in a subgroup (n = 48 with LBP and 48 controls) using intraclass correlation coefficients (ICC), standard error of measurement (SEM) and minimal detectable change (MDC 95%) RESULTS: The Dutch FreBAQ showed one component with eigenvalue >2. Cronbach's alpha values were respectively 0.82 and 0.73 for the LBP and control group. ICC values were respectively 0.69 and 0.70 for the LBP and control group. In the LBP group, the SEM was 3.9 and the MDC (95%) was 10.8. The LBP group (ODI 22 ± 21%) scored significantly higher on the Dutch FreBAQ than the control group (ODI 0%) (11 ± 7 vs. 3 ± 9, p < 0.001). Within the LBP group, higher Dutch FreBAQ scores correlated significantly with higher ODI scores (rho = 0.30, p = 0.010), although not with pain (rho = 0.10, p = 0.419) or kinesiophobia (r = 0.14, p = 0.226). The Dutch version of the FreBAQ can be considered as unidimensional and showed adequate internal consistency, sufficient test-retest reliability and adequate discriminant and construct validity in individuals with and without LBP. It can improve our understanding on back-specific perception in the Dutch-speaking population with LBP. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain.

PubMed

Hides, Julie A; Stanton, Warren R; McMahon, Shaun; Sims, Kevin; Richardson, Carolyn A

2008-03-01

A single-blinded, pretreatment-posttreatment assessment. To investigate, using ultrasound imaging, the cross-sectional area (CSA) of the lumbar multifidus muscle at 4 vertebral levels (L2, L3, L4, L5) in elite cricketers with and without low back pain (LBP) and (2) to document the effect of a staged stabilization training program on multifidus muscle CSA. Despite high fitness levels and often intensive strength training programs, athletes still suffer LBP. The incidence of LBP among Australian cricketers is 8% and as high as 14% among fast bowlers. Previous researchers have found that the multifidus muscle contributes to segmental stability of the lumbopelvic region; however, the CSA of this muscle has not been previously assessed in elite cricketers. CSAs of the multifidus muscles were assessed at rest on the left and right sides for 4 vertebral levels at the start and completion of a 13-week cricket training camp. Participants who reported current or previous LBP were placed in a rehabilitation group. The stabilization program involved voluntary contraction of the multifidus, transversus abdominis, and pelvic floor muscles, with real-time feedback from rehabilitative ultrasound imaging (RUSI), progressed from non-weight-bearing to weight-bearing positions and movement training. Pain scores (using a visual analogue scale) were also collected from those with LBP. The CSAs of the multifidus muscles at the L5 vertebral level increased for the 7 cricketers with LBP who received the stabilization training, compared with the 14 cricketers without LBP who did not receive rehabilitation (P = .004). In addition, the amount of muscle asymmetry among those with LBP significantly decreased (P = .029) and became comparable to cricketers without LBP. These effects were not evident for the L2, L3, and L4 vertebral levels. There was also a 50% decrease in the mean reported pain level among the cricketers with LBP. Multifidus muscle atrophy can exist in highly active, elite athletes with LBP. Specific retraining resulted in an improvement in multifidus muscle CSA and this was concomitant with a decrease in pain. Therapy, level 2b.

An epidemiological study of low back pain in professional drivers

NASA Astrophysics Data System (ADS)

Bovenzi, Massimo; Rui, Francesca; Negro, Corrado; D'Agostin, Flavia; Angotzi, Giuliano; Bianchi, Sandra; Bramanti, Lucia; Festa, GianLuca; Gatti, Silvana; Pinto, Iole; Rondina, Livia; Stacchini, Nicola

2006-12-01

The prevalence of low back pain (LBP) was investigated in 598 Italian professional drivers exposed to whole-body vibration (WBV) and ergonomic risk factors (drivers of earth moving machines, fork-lift truck drivers, truck drivers, bus drivers). The control group consisted of a small sample of 30 fire inspectors not exposed to WBV. Personal, occupational and health histories were collected by means of a structured questionnaire. Vibration measurements were performed on representative samples of the machines and vehicles used by the driver groups. From the vibration magnitudes and exposure durations, alternative measures of vibration dose were estimated for each subject. Daily vibration exposure, expressed in terms of 8-h energy-equivalent frequency-weighted acceleration, A(8), averaged 0.28-0.61 (range 0.10-1.18) m s -2 rms in the driver groups. Duration of exposure to WBV ranged between 1 and 41 years. The 7-day and 12-month prevalence of LBP was greater in the driver groups than in the controls. In the professional drivers, the occurrence of 12-month LBP, high intensity of LBP (Von Korff pain scale score ⩾5), and LBP disability (Roland & Morris disability scale score ⩾12) significantly increased with increasing cumulative vibration exposure. Even though several alternative measures of vibration exposure were associated with LBP outcomes, nevertheless a more regular trend of association with LBP was found for vibration dose expressed as ∑ a vit i (m s -2 h), in which the frequency-weighted acceleration, a v, and lifetime exposure duration, t, were given equal weight. In multivariate data analysis, individual characteristics (e.g. age, body mass index) and a physical load index (derived from combining manual materials handling and awkward postures) were significantly associated with LBP outcomes, while psychosocial work factors (e.g. job decision, job support) showed a marginal relation to LBP. This study tends to confirm that professional driving in industry is associated with an increased risk of work-related LBP. Exposure to WBV and physical loading factors at work are important components of the multifactorial origin of LBP in professional drivers.

Back pain beliefs are related to the impact of low back pain in baby boomers in the Busselton Healthy Aging Study.

PubMed

Beales, Darren; Smith, Anne; O'Sullivan, Peter; Hunter, Michael; Straker, Leon

2015-02-01

Back pain beliefs (BPBs) are an important modifiable factor related to disability associated with low back pain (LBP). Back pain beliefs have not been characterized in baby boomers, a group at risk for decreased activity levels and reduced productivity. The aims of this study were: (1) to identify factors related to BPBs and (2) to evaluate the association between LBP disability and beliefs. A cross-sectional survey of community-dwelling baby boomers (born 1946-1964) was conducted. Nine hundred fifty-eight baby boomers (mean age=56.2 years) participating in the Busselton Healthy Aging Study provided their history of LBP, BPBs, LBP behaviors related to care seeking (taking medication, seeking professional help) and activity modification (missing work, interference with normal activities, interference with recreational activities), LBP-related disability, and additional covariates with known associations with BPBs. Regression analyses were used to: (1) identify factors associated with more positive beliefs and (2) test the association between more positive BPBs and lower LBP disability, independent of other correlates of BPBs. More positive BPBs were associated with younger age, better mental well-being, and higher income, whereas more negative BPBs were associated with receiving sickness or disability benefits and the experience of LBP in the previous month. In participants who reported experiencing LBP within the previous month, more positive BPBs were associated with lower disability scale scores and a decreased probability of interference with usual activities, independent of pain intensity, age, mental well-being, income, and employment status. Cross-sectional analysis limits assessment of causality. Poorer BPBs were associated with greater disability. Characterization of the relationships between BPBs and LBP-associated behaviors and disability in baby boomers can assist in developing interventions to improve activity participation and productivity, potentially reducing the burden of LBP in this age group. © 2015 American Physical Therapy Association.

Causal assessment of occupational pushing or pulling and low back pain: results of a systematic review.

PubMed

Roffey, Darren M; Wai, Eugene K; Bishop, Paul; Kwon, Brian K; Dagenais, Simon

2010-06-01

Low back pain (LBP) is a prevalent and expensive musculoskeletal condition that predominantly occurs in working-age individuals of industrialized nations. Although numerous occupational physical activities have been implicated in its etiology, determining the causation of occupational LBP still remains a challenge. To conduct a systematic review evaluating the causal relationship between occupational pushing or pulling and LBP. Systematic review of the literature. Studies reporting an association between occupational pushing or pulling and LBP. Numerical association between exposure to pushing or pulling and the presence of LBP. A systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford-Hill criteria for causation for occupational pushing or pulling and LBP. A search was conducted using Medline, EMBASE, CINAHL, Cochrane Library, and OSH-ROM, gray literature, hand-searching occupational health journals, reference lists of included studies, and expert knowledge. Methodological quality was assessed using a modified Newcastle-Ottawa Scale. This search yielded 2,766 citations. Thirteen studies met the inclusion criteria. Eight were high-quality studies and five were low-quality studies. There was conflicting evidence with one high-quality study demonstrating a positive association between occupational pushing or pulling and LBP and five studies showing no relationship. One study reported a nonstatistically significant dose-response trend, four studies discussed temporality of which one indicated a positive finding, two studies discussed the biological plausibility of a causal link between occupational pushing or pulling and LBP, and no evidence was uncovered to assess the experiment criterion. A qualitative summary of existing studies was not able to find any high-quality studies that fully satisfied any of the Bradford-Hill causation criteria for occupational pushing or pulling and LBP. Based on the evidence reviewed, it is unlikely that occupational pushing or pulling is independently causative of LBP in the populations of workers studied. Copyright 2010 Elsevier Inc. All rights reserved.

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.

Gender differences in asymmetrical limb support patterns between subjects with and without recurrent low back pain.

PubMed

Sung, Paul S; Zipple, J Tim; Danial, Pamela

2017-04-01

New insight regarding limb-dominance effects on temporal-spatial gait parameters is needed to further investigate subjects with recurrent low back pain (LBP). Although an asymmetrical gait pattern was found to reflect natural functional differences, there is a lack of information regarding gender differences on dominant limb support patterns in subjects with LBP. The purpose of this study was to investigate temporal-spatial gait parameters based on limb dominance and gender between subjects with and without LBP. One hundred and ten right limb dominant older adults (51 subjects with LBP and 59 control subjects) participated in the study. A three-dimensional motion capture system was utilized to measure temporal-spatial gait parameters, including initial double, single, and terminal double limb support times and walking speed. The gender differences between subjects with and without LBP were analyzed based on dominance for those parameters. Overall, limb dominance demonstrated significant differences on single and terminal double limb support times as well as walking speed. Limb dominance also demonstrated interactions on group x gender for single limb support time and walking speed. The male subjects with LBP demonstrated significantly increased single limb support times on the non-dominant limb. The significant gender and group interactions based on limb dominance account for a possible pain avoidance, asymmetrical limb support pattern. The causal pathway in dominance dependency gait by unweighted ambulation might be considered as an intervention for correcting these gait deviations in subjects with LBP. The specific modification recovery profiles of the subjects with LBP could shed light on variability of current LBP experiences of the subjects and reasons for gait deviations. Clinicians need to consider the mechanism of dominant limb dependency, which requires postural control strategies in male subjects with recurrent LBP. Copyright © 2017 Elsevier B.V. All rights reserved.

Identification and characterisation of the BPI/LBP/PLUNC-like gene repertoire in chickens reveals the absence of a LBP gene☆

PubMed Central

Chiang, Shih-Chieh; Veldhuizen, Edwin J.A.; Barnes, Frances A.; Craven, C. Jeremy; Haagsman, Henk P.; Bingle, Colin D.

2011-01-01

Palate, lung and nasal epithelial clone (PLUNC) proteins are structural homologues to the innate defence molecules LPS-binding protein (LBP) and bactericidal/permeability-increasing protein (BPI). PLUNCs make up the largest portion of the wider BPI/LBP/PLUNC-like protein family and are amongst the most rapidly evolving mammalian genes. In this study we systematically identified and characterised BPI/LBP/PLUNC-like protein-encoding genes in the chicken genome. We identified eleven complete genes (and a pseudogene). Five of them are clustered on a >50 kb locus on chromosome 20, immediately adjacent to BPI. In addition to BPI, we have identified presumptive orthologues LPLUNCs 2, 3, 4 and 6, and BPIL-2. We find no evidence for the existence of single domain containing proteins in birds. Strikingly our analysis also suggests that there is no LBP orthologue in chicken. This observation may in part account for the relative resistance to LPS toxicity observed in birds. Our results indicate significant differences between the avian and mammalian repertoires of BPI/LBP/PLUNC-like genes at the genomic and transcriptional levels and provide a framework for further functional analyses of this gene family in chickens. PMID:20959152

Low back pain functional disability in athletes; conceptualization and initial development of a questionnaire.

PubMed

Zamani, Elham; Kordi, Ramin; Nourian, Ruhollah; Noorian, Negin; Memari, Amir Hossein; Shariati, Mohammad

2014-12-01

Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. The findings of this study suggest that apart from non-sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes.

Low Back Pain Functional Disability in Athletes; Conceptualization and Initial Development of a Questionnaire

PubMed Central

Zamani, Elham; Kordi, Ramin; Nourian, Ruhollah; Noorian, Negin; Memari, Amir Hossein; Shariati, Mohammad

2014-01-01

Background: Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. Objectives: This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. Patients and Methods: We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. Results: The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. Conclusions: The findings of this study suggest that apart from non-sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes. PMID:25741417

DNA sensing by a Eu-binding peptide containing a proflavine unit.

PubMed

Ancel, Laetitia; Gateau, Christelle; Lebrun, Colette; Delangle, Pascale

2013-01-18

Synthesis of a lanthanide-binding peptide (LBP) for the detection of double-stranded DNA is presented. A proflavine moiety was introduced into a high affinity LBP involving two unnatural chelating amino acids in the Ln ion coordination. The Eu(3+)-LBP complex is demonstrated to bind to ct-DNA and to sensitize Eu luminescence. The DNA binding process is effectively detected via the Eu-centered luminescence thanks to the intimate coupling between the LBP scaffold and DNA intercalating unit.

Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI.

PubMed

D'hooge, Roseline; Cagnie, Barbara; Crombez, Geert; Vanderstraeten, Guy; Achten, Eric; Danneels, Lieven

2013-03-01

After cessation of a low-back pain (LBP) episode, alterations in trunk muscle behavior, despite recovery from pain, have been hypothesized to play a pathogenic role in the recurrence of LBP. This study aimed to identify the presence of lumbar muscle dysfunction during the remission of recurrent LBP, while performing a low-load trunk-extension movement. Thirteen participants with unilateral recurrent LBP were tested at least 1 month after cessation of the previous LBP episode and were compared with a healthy control group without any history of LBP (n=13). Also, differences between previously painful and nonpainful sides were examined. Muscle functional magnetic resonance imaging, based on quantitative T2-imaging, was used to examine muscle tissue characteristics (T2 rest) and muscle recruitment (T2 shift) during prone trunk extension. The lumbar multifidus, erector spinae, quadratus lumborum, and psoas were bilaterally visualized on 2 lumbar levels using a T2-weighted (spin-echo multicontrast) magnetic resonance imaging sequence. Linear mixed model analysis revealed a significantly lower T2 rest (P=0.044) and a significantly higher T2 shift (P=0.034) solely for the multifidus in the LBP group compared with the control group. No significant differences between pain sides were found. Lower T2-rest values have been suggested to correlate with a conversion of the multifidus' fiber typing toward the glycolytic muscle spectrum. Elevated T2 shifts correspond with increased levels of metabolic activity in the multifidus in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide evidence of concurrent alterations in the multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain free and functionally recovered.

The effects of educational interventions on pharmacists' knowledge, attitudes and beliefs towards low back pain.

PubMed

Abdel Shaheed, Christina; Maher, Christopher G; Mak, Wendy; Williams, Kylie A; McLachlan, Andrew J

2015-08-01

Practitioner beliefs and attitudes towards low back pain (LBP) influence treatment decisions. Little is known about pharmacists' knowledge, attitudes and beliefs towards LBP. To investigate the effect of educational interventions on pharmacists' knowledge, attitudes and beliefs towards LBP. Setting Sydney Metropolitan Area. Knowledge, attitudes and beliefs was measured using the "Pharmacists' Back Beliefs Questionnaire", with items from two previously reported questionnaires on back beliefs. Responses from pharmacists attending a 2-h educational workshop on LBP (n = 204) and pharmacists recruiting participants for a LBP clinical trial (n = 66) were compared to responses from a control group of pharmacists (n = 65) to allow an evaluation of the two interventions. Responses from workshop participants were also evaluated before and after the session. Participants indicated their agreement with statements about LBP on a 5-point Likert scale. Preferred responses were based on guidelines for the evidence-based management of LBP. The primary analysis evaluated total score on the nine-inevitability items of the Back Beliefs Questionnaire ("inevitability score"). Inevitability score. There was no significant difference in inevitability score between LBP clinical trial pharmacists and the control group [mean difference (MD) 0.47 (95 % CI -1.35 to 2.29; p = 0.61)]. The educational workshop led to a significant and favourable change in inevitability score (MD 7.23 p < 0.001) and notable changes in responses to misconceptions regarding bed rest and the need for imaging (p < 0.001) among participating pharmacists. Pharmacists attending the educational workshop provided the most compelling evidence that education specifically aimed at delivering evidence-based information can be successful in changing practitioner knowledge, beliefs and attitudes towards LBP.

Relationship between the type and amount of physical activity and low back pain in Koreans aged 50 years and older.

PubMed

Kim, Won; Jin, Young Soo; Lee, Choon Sung; Hwang, Chang Ju; Lee, Sang Yoon; Chung, Sun G; Choi, Kyoung Hyo

2014-10-01

To examine the association between the type and amount of physical activity (PA) and low back pain (LBP) in people aged ≥50 years. Cross-sectional study. A nationwide survey. Data were obtained from the Fifth Korea National Health and Nutrition Examination Survey, which was conducted in 2010 and 2011. Overall, 1796 men and 2198 women aged ≥50 years were included. PA was categorized as vigorous, moderate, walking, strength exercises, or flexibility exercises. The total amount of PA was presented as quartiles of the total metabolic equivalent (MET)-minutes/week based on the PA questionnaire. Multivariate logistic regression analysis was performed to examine associations between LBP and the type and amount of PA. Odds ratio for LBP according to the type of PA and the quartiles of the total MET-minutes/week. After adjusting for age and body mass index, vigorous and moderate PA were associated with an increased risk of LBP in both men and women, whereas strength exercises were associated with a reduced risk of LBP. These associations were maintained after adjusting for all potential confounders. Subgroup analysis according to age revealed that these trends were most significantly demonstrated in women aged ≥65 years. The PA quartiles for total MET-minutes/week for men showed a U-shaped association with LBP, whereas only the fourth PA quartile for women showed an increased risk of LBP compared with the second quartile. These results suggest that both the type and amount of PA affect the development of LBP in people aged ≥50 years and thus activity modification might be helpful for prevention and management of LBP. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Physical and psychosocial ergonomic risk factors for low back pain in automobile manufacturing workers.

PubMed

Vandergrift, Jonathan L; Gold, Judith E; Hanlon, Alexandra; Punnett, Laura

2012-01-01

To examine the association between ergonomic physical and psychosocial exposures and the risk of prevalent and incident low back pain (LBP) in a longitudinal cohort of automobile manufacturing workers. Ergonomic exposure intensity and LBP presence were determined through questionnaires at baseline (n=1181) and to workers in the same job 1 year later (n=505). Models were constructed using log-binomial regression with special attention to interactions between ergonomic exposures. Awkward back posture (prevalence ratio (PR) 1.12, 95% CI 1.07 to 1.17), hand force (PR 1.06, 95% CI 1.02 to 1.10), physical effort (PR 1.10, 95% CI 1.04 to 1.16) and whole body vibration (PR 1.04, 95% CI 1.01 to 1.08) were each associated cross-sectionally with LBP. Awkward back posture (RR 1.13, 95% CI 0.98 to 1.31) and hand force (RR 1.07, 95% CI 0.93 to 1.22) also predicted incident LBP, although estimates were statistically less precise. Neither job control, psychological demands, nor job strain was independently related to risk of incident LBP. Among participants reporting high physical ergonomic exposures and moderate to high job control, increasing job demands was associated with a reduced LBP risk (RR 0.72, 95% CI 0.52 to 1.00). Among participants reporting high physical exposures and low job control, psychological demands was associated with an increased LBP risk (RR 1.30, 95% CI 1.02 to 1.66). Psychosocial workplace interventions for LBP should prioritise jobs in which there are high physical ergonomic exposures. Future studies of LBP should examine the interactions between physical ergonomic risk factors.

Physiotherapy for low back pain: differences between public and private healthcare sectors in Ireland--a retrospective survey.

PubMed

Casserley-Feeney, Sarah N; Bury, Gerard; Daly, Leslie; Hurley, Deirdre A

2008-10-01

European clinical guidelines for low back pain (LBP) recommend early referral of appropriate patients to health services such as physiotherapy. The current study aimed to investigate any differences between the physiotherapy management of LBP, and the physiotherapist and patient profiles in public and private health settings in Ireland. A retrospective chart survey of all LBP patients referred for physiotherapy to one Dublin City hospital and three neighbouring private practices in 2003 was conducted. In total, 249 physiotherapy charts (hospital [H] n=93; private practice [Pr] n=156) were identified and demographic, LBP, and management details analysed. Only charts containing full LBP duration and physiotherapy treatment data were included in the analysis of these parameters (LBP duration: H=84, Pr=130; physiotherapy treatment: H=79, Pr=155). There were significantly higher percentages of female (H=66%; Pr=50%: p=0.017), older (H=46 years; Pr=36 years: p<0.001), and chronic LBP patients (>12 weeks; H=50%; Pr=2%: p<0.001) in the public setting. Public patients had significantly longer waiting times for physiotherapy (median H=10 weeks; Pr=0; p<0.001), and more treatment (H=5.1; Pr=2.5: p0.001) than private patients. While treatment approaches were similar for both settings, there was a significantly higher use of advice and spinal stabilisation exercises in the public setting. However, there was minimal difference in the management of acute or chronic LBP in both setting suggesting poor adherence to European guidelines. Findings showed longer waiting times, and a higher number and duration of physiotherapy treatments for acute and chronic LBP in the public setting suggesting the need to develop publicly funded primary healthcare in Ireland.

Reduced health resource use after acupuncture for low-back pain.

PubMed

Moritz, Sabine; Liu, Ming F; Rickhi, Badri; Xu, Tracy J; Paccagnan, Patricia; Quan, Hude

2011-11-01

Acupuncture is commonly used to treat low-back pain (LBP) and clinical trials have demonstrated its efficacy. However, less is known about how the utilization of acupuncture impacts public health service utilization in the real world. This study investigates the association between acupuncture utilization for LBP and health care utilization by assessing whether patients who undergo acupuncture subsequently use fewer health care resources and whether those patients differ in their health care use from the general population with LBP. This study employed the design of a two-group pre/post secondary data analysis. There were two study populations. To identify patients who received acupuncture for LBP in 2000, patient charts at Alberta registered acupuncture clinics were reviewed. The comparison group was identified from the Alberta physician claims administrative database. Acupuncture group cases were matched with four comparison cases from the general population with LBP based on gender and age. Number of physician visits and physician service cost for LBP-related services for 1 year pre- and postacupuncture treatment period were calculated from the physician claims data for both study groups. For the 201 cases and 804 controls, the mean age was 48 years and 54% were female. The number of physician visits for the 1-year period postacupuncture decreased 49% for the acupuncture group (p<0.01) compared to the 1-year period preacupuncture. For the comparison there was a decrease of 2% in physician visits (p=0.59) for the same time periods. Corresponding to the decrease, physician services cost declined 37% for the case group (p=0.01) and 1% for the comparison (p=0.86). Results suggest that patients with LBP were less likely to visit physicians for LBP after acupuncture treatment. This led to reduced health services spending on LBP. © Mary Ann Liebert, Inc.

Neighborhood walkability moderates the association between low back pain and physical activity: A co-twin control study.

PubMed

Zadro, J R; Shirley, D; Pinheiro, M B; Bauman, A; Duncan, G E; Ferreira, P H

2017-06-01

The aim of this study was to investigate whether neighborhood walkability moderates the association between low back pain (LBP) and physical activity (PA), using a co-twin design to control for genetics and shared environmental factors. A cross-sectional analysis was performed on 10,228 twins from the Washington State Twin Registry with available data on LBP from recruitment surveys between 2009 and 2013. LBP within the past 3months was our exposure variable. Our outcome variables were sufficient moderate or vigorous-intensity PA (MVPA, defined as at least 75min of vigorous-intensity PA, or 150min of moderate-intensity PA per week), and walking (≥150min per week). Neighborhood walkability, estimated using the commercially available Walk Score®, was our moderator variable. After controlling for the influence of genetics and shared environment, individuals reporting LBP were significantly less likely to engage in sufficient MVPA if they lived in a neighborhood with high walkability (OR=0.59, 95%CI: 0.36-0.96). There was no association between LBP and sufficient MVPA for individuals living in a neighborhood with low walkability (OR=1.27, 95%CI: 0.93-1.72), demonstrating that walkability is a significant moderator of the association between LBP and PA (interaction p=0.013). These findings were similar for the association between LBP and walking (high walkability OR=0.42, 95%CI: 0.22-0.78; low walkability OR=0.71, 95%CI: 0.46-1.12), although the interaction was not significant (p=0.700). Neighborhood walkability moderates the association between LBP and PA. Our results highlight the importance of targeting interventions promoting PA towards individuals with LBP living in a neighborhood with good walkable access to amenities. Copyright © 2017 Elsevier Inc. All rights reserved.

Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.

PubMed

Kim, Si-hyun; Kwon, Oh-yun; Yi, Chung-hwi; Cynn, Heon-seock; Ha, Sung-min; Park, Kyue-nam

2014-01-01

Limited hip flexion may lead to a poor lumbopelvic motion during seated active hip flexion in people with low-back pain (LBP). The purpose of this study was to compare lumbopelvic motion during seated hip flexion between subjects with and without LBP accompanying limited hip flexion. Fifteen patients with LBP accompanying limited hip flexion and 16 healthy subjects were recruited. The subjects performed seated hip flexion with the dominant leg three times. A three-dimensional motion-analysis system was used to measure lumbopelvic motion during seated hip flexion. During seated active hip flexion, the angle of hip flexion was significantly lower in patients with LBP accompanying limited hip flexion (17.4 ± 4.4 in the LBP group, 20.8 ± 2.6 in the healthy group; t = 2.63, p = 0.014). The angle of the lumbar flexion (4.8 ± 2.2 in the LBP group, 2.6 ± 2.0 in the healthy group; t = -2.96, p = 0.006) and posterior pelvic tilting (5.0 ± 2.6 in the LBP group, 2.9 ± 2.0 in the healthy group; t = 2.48 p = 0.019), however, were significantly greater in patients with this condition. The results of this study suggest that limited hip flexion in LBP can contribute to excessive lumbar flexion and posterior pelvic tilting during hip flexion in the sitting position. Further studies are required to confirm whether improving the hip flexion range of motion can reduce excessive lumbar flexion in patients with LBP accompanying limited hip flexion.

Frequent computer-related activities increase the risk of neck-shoulder and low back pain in adolescents.

PubMed

Hakala, Paula T; Rimpelä, Arja H; Saarni, Lea A; Salminen, Jouko J

2006-10-01

Neck-shoulder pain (NSP) and low back pain (LBP) increased among adolescents in the 1990s and the beginning of 2000. A potential risk factor for this increase is the use of information and communication technology. We studied how the use of computers, the Internet, and mobile phones, playing digital games and viewing television are related to NSP and LBP in adolescents. Mailed survey with nationally representative samples of 14-, 16-, and 18-year-old Finns in 2003 (n = 6003, response rate 68%). The outcome variables were weekly NSP and LBP. NSP was perceived by 26% and LBP by 12%. When compared with non-users, the risk of NSP was 1.3 (adjusted odds ratios) when using computers > 2-3 h/day, and 1.8 when using 4-5 h/day; 2.5 when using computers > or = 42 h/week, and 1.7 when using the Internet > or = 42 h/week. Compared with non-users, the risk of LBP was 2.0 when using computers > 5 h/day, 1.7 when using > or = 42 h/week, 1.8 when using the Internet > or = 42 h/week, and 2.0 when playing digital games > 5 h/day. Times spent on digital gaming, viewing television, and using mobile phones were not associated with NSP, nor were use of mobile phones and viewing television with LBP after adjusting for confounding factors. Frequent computer-related activities are an independent risk factor for NSP and LBP. Daily use of computers exceeding 2-3 h seems to be a threshold for NSP and exceeding 5 h for LBP. Computer-related activities may explain the increase of NSP and LBP in the 1990s and the beginning of 2000.

Prevalence and risk factors of low back pain among undergraduate students of a sports and physical education institute in Tunisia

PubMed Central

Triki, Moez; Koubaa, Abdessalem; Masmoudi, Liwa; Fellmann, Nicole; Tabka, Zouhair

2015-01-01

Introduction For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5–24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP. PMID:25758252

Lycium barbarum Extracts Protect the Brain from Blood-Brain Barrier Disruption and Cerebral Edema in Experimental Stroke

PubMed Central

Yang, Di; Li, Suk-Yee; Yeung, Chung-Man; Chang, Raymond Chuen-Chung; So, Kwok-Fai; Wong, David; Lo, Amy C. Y.

2012-01-01

Background and Purpose Ischemic stroke is a destructive cerebrovascular disease and a leading cause of death. Yet, no ideal neuroprotective agents are available, leaving prevention an attractive alternative. The extracts from the fruits of Lycium barbarum (LBP), a Chinese anti-aging medicine and food supplement, showed neuroprotective function in the retina when given prophylactically. We aim to evaluate the protective effects of LBP pre-treatment in an experimental stroke model. Methods C57BL/6N male mice were first fed with either vehicle (PBS) or LBP (1 or 10 mg/kg) daily for 7 days. Mice were then subjected to 2-hour transient middle cerebral artery occlusion (MCAO) by the intraluminal method followed by 22-hour reperfusion upon filament removal. Mice were evaluated for neurological deficits just before sacrifice. Brains were harvested for infarct size estimation, water content measurement, immunohistochemical analysis, and Western blot experiments. Evans blue (EB) extravasation was determined to assess blood-brain barrier (BBB) disruption after MCAO. Results LBP pre-treatment significantly improved neurological deficits as well as decreased infarct size, hemispheric swelling, and water content. Fewer apoptotic cells were identified in LBP-treated brains by TUNEL assay. Reduced EB extravasation, fewer IgG-leaky vessels, and up-regulation of occludin expression were also observed in LBP-treated brains. Moreover, immunoreactivity for aquaporin-4 and glial fibrillary acidic protein were significantly decreased in LBP-treated brains. Conclusions Seven-day oral LBP pre-treatment effectively improved neurological deficits, decreased infarct size and cerebral edema as well as protected the brain from BBB disruption, aquaporin-4 up-regulation, and glial activation. The present study suggests that LBP may be used as a prophylactic neuroprotectant in patients at high risk for ischemic stroke. PMID:22438957

Prevalence and risk factors of low back pain among undergraduate students of a sports and physical education institute in Tunisia.

PubMed

Triki, Moez; Koubaa, Abdessalem; Masmoudi, Liwa; Fellmann, Nicole; Tabka, Zouhair

2015-01-01

Introduction : For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim : To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods : A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5-24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results : LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion : LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP.

The association between sleep quality, low back pain and disability: A prospective study in routine practice.

PubMed

Kovacs, F M; Seco, J; Royuela, A; Betegon, J N; Sánchez-Herráez, S; Meli, M; Martínez Rodríguez, M E; Núñez, M; Álvarez-Galovich, L; Moyá, J; Sánchez, C; Luna, S; Borrego, P; Moix, J; Rodríguez-Pérez, V; Torres-Unda, J; Burgos-Alonso, N; Gago-Fernández, I; González-Rubio, Y; Abraira, V

2018-01-01

The objective of this study was to estimate the association between sleep quality (SQ) and improvements in low back pain (LBP) and disability, among patients treated for LBP in routine practice. This prospective cohort study included 461 subacute and chronic LBP patients treated in 11 specialized centres, 14 primary care centres and eight physical therapy practices across 12 Spanish regions. LBP, leg pain, disability, catastrophizing, depression and SQ were assessed through validated questionnaires upon recruitment and 3 months later. Logistic regression models were developed to assess: (1) the association between the baseline score for SQ and improvements in LBP and disability at 3 months, and (2) the association between improvement in SQ and improvements in LBP and disability during the follow-up period. Seventy-three per cent of patients were subacute. Median scores at baseline were four points for both pain and disability, as assessed with a visual analog scale and the Roland-Morris Questionnaire, respectively. Regression models showed (OR [95% CI]) that baseline SQ was not associated with improvements in LBP (0.99 [0.94; 1.06]) or in disability (0.99 [0.93; 1.05]), although associations existed between 'improvement in SQ' and 'improvement in LBP' (4.34 [2.21; 8.51]), and 'improvement in SQ' and 'improvement in disability' (4.60 [2.29; 9.27]). Improvement in SQ is associated with improvements in LBP and in disability at 3-month follow-up, suggesting that they may reflect or be influenced by common factors. However, baseline SQ does not predict improvements in pain or disability. In clinical practice, sleep quality, low back pain and disability are associated. However, sleep quality at baseline does not predict improvement in pain and disability. © 2017 European Pain Federation - EFIC®.

Prevalence and risk factors of low back pain among undergraduate students of a sports and physical education institute in Tunisia.

PubMed

Triki, Moez; Koubaa, Abdessalem; Masmoudi, Liwa; Fellmann, Nicole; Tabka, Zouhair

2015-01-01

Introduction For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5-24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP.

Hamstring muscle length and lumbar lordosis in subjects with different lifestyle and work setting: comparison between individuals with and without chronic low back pain.

PubMed

Arab, Amir Massoud; Nourbakhsh, Mohammad Reza

2014-01-01

Shortened hamstring muscle length has been noted in persons with low back pain (LBP). Prolonged sitting postures, such as those adopted during different work settings and sedentary lifestyle has been associated with hamstring shortness and LBP. The purpose of this study was to investigate the effect of lifestyle and work setting on hamstring length and lumbar lordosis in subjects with and without LBP and to identify the relationship between hamstring muscles length and lumbar lordosis in individuals with different lifestyle and work setting. A total of 508 subjects between the ages of 20 and 65 were selected. Subjects were categorized into two groups of individuals with and without LBP. A questionnaire was used to obtain information about the subjects' lifestyle and work setting. Hamstring muscle length and lumbar lordosis were measured in all subjects. The results showed no significant difference in the number of subjects with different work setting or lifestyle in individuals with and without LBP. Hamstring muscle length or lumbar lordosis was not affected by type of work setting and lifestyle. Our data showed significant difference in hamstring length and no significant difference in lumbar lordosis between subjects with and without LBP in all categories. Lumbar lordosis was not different between individuals with and without hamstring tightness in normal and LBP subjects with different work setting and lifestyle. The findings of this study did not support the assumption that work setting and sedentary lifestyle would lead to hamstring tightness in subjects with LBP. It seems that work setting and lifestyle was not a contributing factor for hamstring tightness in subjects with LBP.

The structure of lactoferrin-binding protein B from Neisseria meningitidis suggests roles in iron acquisition and neutralization of host defences

PubMed Central

Brooks, Cory L.; Arutyunova, Elena; Lemieux, M. Joanne

2014-01-01

Pathogens have evolved a range of mechanisms to acquire iron from the host during infection. Several Gram-negative pathogens including members of the genera Neisseria and Moraxella have evolved two-component systems that can extract iron from the host glycoproteins lactoferrin and transferrin. The homologous iron-transport systems consist of a membrane-bound transporter and an accessory lipoprotein. While the mechanism behind iron acquisition from transferrin is well understood, relatively little is known regarding how iron is extracted from lactoferrin. Here, the crystal structure of the N-terminal domain (N-lobe) of the accessory lipoprotein lactoferrin-binding protein B (LbpB) from the pathogen Neisseria meningitidis is reported. The structure is highly homologous to the previously determined structures of the accessory lipoprotein transferrin-binding protein B (TbpB) and LbpB from the bovine pathogen Moraxella bovis. Docking the LbpB structure with lactoferrin reveals extensive binding interactions with the N1 subdomain of lactoferrin. The nature of the interaction precludes apolactoferrin from binding LbpB, ensuring the specificity of iron-loaded lactoferrin. The specificity of LbpB safeguards proper delivery of iron-bound lactoferrin to the transporter lactoferrin-binding protein A (LbpA). The structure also reveals a possible secondary role for LbpB in protecting the bacteria from host defences. Following proteolytic digestion of lactoferrin, a cationic peptide derived from the N-terminus is released. This peptide, called lactoferricin, exhibits potent antimicrobial effects. The docked model of LbpB with lactoferrin reveals that LbpB interacts extensively with the N-terminal lactoferricin region. This may provide a venue for preventing the production of the peptide by proteolysis, or directly sequestering the peptide, protecting the bacteria from the toxic effects of lactoferricin. PMID:25286931

Cost-Sensitive Local Binary Feature Learning for Facial Age Estimation.

PubMed

Lu, Jiwen; Liong, Venice Erin; Zhou, Jie

2015-12-01

In this paper, we propose a cost-sensitive local binary feature learning (CS-LBFL) method for facial age estimation. Unlike the conventional facial age estimation methods that employ hand-crafted descriptors or holistically learned descriptors for feature representation, our CS-LBFL method learns discriminative local features directly from raw pixels for face representation. Motivated by the fact that facial age estimation is a cost-sensitive computer vision problem and local binary features are more robust to illumination and expression variations than holistic features, we learn a series of hashing functions to project raw pixel values extracted from face patches into low-dimensional binary codes, where binary codes with similar chronological ages are projected as close as possible, and those with dissimilar chronological ages are projected as far as possible. Then, we pool and encode these local binary codes within each face image as a real-valued histogram feature for face representation. Moreover, we propose a cost-sensitive local binary multi-feature learning method to jointly learn multiple sets of hashing functions using face patches extracted from different scales to exploit complementary information. Our methods achieve competitive performance on four widely used face aging data sets.

The effect of a backrest and seatpan inclination on sitting discomfort and trunk muscle activation in subjects with extension-related low back pain.

PubMed

Curran, Máire; Dankaerts, Wim; O'Sullivan, Peter; O'Sullivan, Leonard; O'Sullivan, Kieran

2014-01-01

Few studies have demonstrated that seating modifications reduce low back pain (LBP). One recent study found that a forward-inclined seatpan reduced low back discomfort (LBD), however this was only examined in people with flexion-related LBP. No study has yet investigated its effectiveness among people with extension-related LBP. This crossover study examined 12 subjects with extension-related LBP. Sitting discomfort and surface electromyography of three trunk muscles were recorded during a 10-minute typing task while sitting with two different seatpan inclinations, both with and without a backrest. LBD (p < 0.001) and overall body discomfort (OBD) (p = 0.016) were significantly greater on the forward-inclined seatpan. The backrest did not alter trunk muscle activation or sitting discomfort. The results demonstrate that in a specific subgroup of people with extension-related LBP, increasing forward seatpan inclination significantly increased LBD and OBD. Future research should consider matching ergonomics prescriptions according to the individual presentation of people with LBP.

Lower back pain in nurses working in home care: linked to work-family conflict, emotional dissonance, and appreciation?

PubMed

Elfering, Achim; Häfliger, Evelyne; Celik, Zehra; Grebner, Simone

2018-07-01

In industrial countries home care services for elderly people living in the community are growing rapidly. Home care nursing is intensive and the nurses often suffer from musculoskeletal pain. Time pressure and job control are job-related factors linked to the risk of experiencing lower back pain (LBP) and LBP-related work impairment. This survey investigated whether work-family conflict (WFC), emotional dissonance and being appreciated at work have incremental predictive value. Responses were obtained from 125 home care nurses (63% response rate). Multiple linear regression showed that emotional dissonance and being appreciated at work predicted LBP intensity and LBP-related disability independently of time pressure and job control. WFC was not a predictor of LBP-related disability in multiple regression analyses despite a zero-order correlation with it. Redesigning the working pattern of home care nurses to reduce the emotional demands and improve appreciation of their work might reduce the incidence of LBP in this group.

Occupational low back pain in primary and high school teachers: prevalence and associated factors.

PubMed

Mohseni Bandpei, Mohammad A; Ehsani, Fatemeh; Behtash, Hamid; Ghanipour, Marziyeh

2014-01-01

The purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP. In this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires. Point, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P < .05 in all instances). Prolonged sitting and standing, working hours with computer, and correcting examination papers were the most aggravating factors, respectively. Rest and participation in physical activity were found to be the most relieving factors. The prevalence of LBP in teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Low back pain status of female university students in relation to different sport activities.

PubMed

Noormohammadpour, Pardis; Rostami, Mohsen; Mansournia, Mohammad Ali; Farahbakhsh, Farzin; Pourgharib Shahi, Mohammad Hosein; Kordi, Ramin

2016-04-01

To investigate the prevalence of low back pain (LBP) and its absence rate among female university student athletes in different types of sports. A cross-sectional study based on a standard self-reporting questionnaire was performed among 1335 athletes. Participants were female athletes who attended the National Sports Olympiad of Female University Students in basketball, volleyball, futsal, tennis, badminton, swimming, track and field, shooting, and karate. One thousand and fifty-nine athletes with the mean (SD) age of 23.1 (3.8) years responded to the questionnaire (response rate 79%). The 12-month prevalence of LBP was 39.0%; in addition, lifetime and point prevalence of LBP were 59.7 and 17.8%, respectively. Basketball (47.9 %) and karate (44.0 %) players had reported the highest 12-month prevalence of LBP. Also, LBP prevalences in shooting (29.7 %) and badminton (42.4 %) players were not negligible. Results show that, LBP led to relatively high absence rate from training sessions (27.9%) and matches (13.0%). While most of the existing literatures regarding female athletes' LBP have focused on particular sports with specific low back demands (such as skiing and rowing), many other sports have not been studied very well in this regard. Investigating LBP prevalence and related factors in other types of sports, such as combat sports, badminton and shooting, can help us better understand the prevalence of low back pain and provide us with necessary insight to take effective steps towards its prevention in athletes.

The impact of chronic low back pain is partly related to loss of social role: A qualitative study.

PubMed

Bailly, Florian; Foltz, Violaine; Rozenberg, Sylvie; Fautrel, Bruno; Gossec, Laure

2015-12-01

Chronic low back pain (LBP) has an important impact on quality of life, through pain and functional incapacity, but also psychosocial distress. The social participation consequences of LBP have been less explored. The objective was to better understand experiences of patients living with chronic LBP, with a focus on impact on relationships with family, friends and work colleagues. Monocentric qualitative study in a tertiary-referral centre in Paris, France. Participants had chronic mechanical LBP. Semi-structured interviews were conducted during 4 focus groups discussions focusing on living with LBP. Verbatim was categorized and coded using thematic content analysis. Twenty-five persons (11 men, 14 women) participated; ages ranged 25-81 years. Participants often reported a negative self-perception in social interactions, with shame and frustration regarding their difficulties to perform activities of daily living. They often felt misunderstood and unsupported, partly due to the absence of visible signs of the condition. Participants suffered from the negative collective image attached to LBP ("benign/psychological disease"). LBP resulted in some patients in a significant loss of social identity with perceived impossibility to perform one's social role at home and at work. In contrast, family and friends were sometimes a support and helped in pain management. A systematic assessment of social role is needed in LBP care. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

De-educate to re-educate: aging and low back pain.

PubMed

Louw, Adriaan; Zimney, Kory; Johnson, Eldon A; Kraemer, Chris; Fesler, Justin; Burcham, Tyler

2017-12-01

Patients' beliefs about their condition have been shown to play a significant role in their pain experience and response to treatment, especially when a patient sees their tissue health as vulnerable or aged. Educational can alter these beliefs. Prior to new information, patients often have to be de-educated regarding common misbeliefs to undergo re-education. To determine if a brief de-education session regarding aging and low back pain (LBP) can shift pain ratings, fear-avoidance beliefs, beliefs regarding aging and LBP, and limited active trunk flexion. Fifty adults ranging from 50 to 93 years of age (SD = 10.73) with a 15.1 years of LBP were education on the poor correlation between aging and LBP. Prior to and immediately after the education pain ratings for LBP and leg pain (numeric pain rating scale-NPRS), fear-avoidance (fear avoidance beliefs questionnaire-FABQ), beliefs regarding aging and LBP (Likert scale) and active trunk flexion were measured. Significant changes were found in positive shifts with LBP (p = 0.002), leg pain (p = 0.042), FABQ-physical activity subscale (p = 0.004) and active trunk forward flexion (p < 0.001). The results show that education aimed at altering beliefs regarding LBP and aging result in a positive shift in pain, fear avoidance related to physical activity and active trunk flexion. Prior to providing patients with new healthcare information, de-educating them regarding poor beliefs may be helpful in shifting them towards new, healthier paradigms associated with their condition.

Are Irish therapists at heightened risk for low back pain?

PubMed Central

Hogan, D. A. M.; O’Sullivan, L. W.; Nolan, S.

2016-01-01

Background Within the international literature, no studies have been identified that compare prevalence rates of low back pain (LBP) in chartered physiotherapists, physical and athletic therapists and those in the national working population, making it unclear whether such therapists are an occupational group at high risk of developing LBP. Aims To establish the prevalence of LBP among therapists (both employed and self-employed) in Ireland, to compare the employment status-, gender- and age-specific LBP prevalence rates between therapists and the national working population and to estimate the adjusted odds of developing LBP among therapists relative to the national working population. Methods An analysis of data from the Health In Hand Intensive Tasks and Safety (HITS) study and the third national Survey on Lifestyle, Attitudes and Nutrition (SLÁN). The HITS study was a cross-sectional study investigating work-related musculoskeletal disorders in practising therapists. The SLÁN 2007 was a face-to-face interview study of adults. Results LBP prevalence in therapists was 49% with no significant difference by employment status. Therapists had a much higher prevalence compared with the national working population across all demographic strata, with therapists nearly five times more likely to suffer from LBP than the national working population after careful adjustment for differences in sociodemographic factors. Conclusions Therapists in Ireland are an occupational group at high risk of developing LBP, warranting further research into their physical and psychosocial work-related risk factors. PMID:26968686

Inflammatory Mediators and Pain in the First Year After Acute Episode of Low-Back Pain in Elderly Women: Longitudinal Data from Back Complaints in the Elders-Brazil.

PubMed

Queiroz, Bárbara Zille; Pereira, Daniele Sirineu; Rosa, Nayza Maciel de Britto; Lopes, Renata Antunes; Andrade, André Gustavo Pereira; Felício, Diogo Carvalho; Jardim, Renata Muniz Freire Vinhal Siqueira; Leopoldino, Amanda Aparecida Oliveira; Silva, Juscélio Pereira; Pereira, Leani Souza Máximo

2017-08-01

The aims of this study were to determine the course of plasma levels of inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor α [TNF-α], soluble TNF receptor 1 [sTNF-R1]) and the severity of low-back pain (LBP) over 6 to 12 months after an acute episode of LBP in elderly women and to establish an association between inflammatory mediators and LBP recovery. This was a longitudinal study of a subsample (155 elderly women with acute LBP, aged ≥65 years) of the international Back Complaints in the Elders cohort study. Plasma levels of IL-6, TNF-α, and sTNF-R1 were measured using enzyme-linked immunosorbent assays and pain severity using the numerical pain scale. There was a decrease in the severity of LBP (P = 0.033) and in the levels of IL-6 and TNF-α (P < 0.001) and an increase in sTNF-R1 (P < 0.001) in the first year after an acute episode of LBP. The probability of occurrence of pain relief at the 12-month follow-up was 2.22 times higher in elderly women who had low levels of IL-6 (<1.58 pg/mL) at baseline. Our findings showed a relationship between inflammation and LBP by establishing that low IL-6 plasma levels preceded outcome (LBP recovery), supporting the concept that proinflammatory cytokines promote pain.

75 FR 880 - Sunshine Act; Notice of Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-06

... County Nuclear Power Plant, Units 1 and 2), LBP-09-10 (Tentative) e. Detroit Edison Co. (Fermi Power Plant Independent Spent Fuel Storage Installation), LBP-09-20 (Aug. 21, 2009), Docket No. 72-72-EA..., Petition for Review of LBP-09-7 (Tentative) g. Tennessee Valley Authority (Bellefonte Nuclear Power Plant...

Altered muscular activation during prone hip extension in women with and without low back pain.

PubMed

Arab, Amir M; Ghamkhar, Leila; Emami, Mahnaz; Nourbakhsh, Mohammad R

2011-08-14

Altered movement pattern has been associated with the development of low back pain (LBP). The purpose of this study was to investigate the activity pattern of the ipsilateral erector spinae (IES) and contralateral erectorspinae (CES), gluteus maximus (GM) and hamstring (HAM) muscles during prone hip extension (PHE) test in women with and without LBP. A cross-sectional non-experimental design was used. Convenience sample of 20 female participated in the study. Subjects were categorized into two groups: with LBP (n = 10) and without LBP (n = 10). The electromyography (EMG) signal amplitude of the tested muscles during PHE (normalized to maximum voluntary electrical activity (MVE)) was measured in the dominant lower extremity in all subjects. Statistical analysis revealed greater normalized EMG signal amplitude in women with LBP compared to non-LBP women. There was significant difference in EMG activity of the IES (P = 0.03) and CES (P = 0.03) between two groups. However, no significant difference was found in EMG signals of the GM (P = 0.11) and HAM (P = 0.14) among two groups. The findings of this study demonstrated altered activation pattern of the lumbo-pelvic muscles during PHE in the women with chronic LBP. This information is important for investigators using PHE as either an evaluation tool or a rehabilitation exercise.

The safety and feasibility of probiotics in children and adolescents undergoing hematopoietic cell transplantation.

PubMed

Ladas, E J; Bhatia, M; Chen, L; Sandler, E; Petrovic, A; Berman, D M; Hamblin, F; Gates, M; Hawks, R; Sung, L; Nieder, M

2016-02-01

Hematopoietic cell transplantation (HCT) has become a standard treatment for many adult and pediatric conditions. Emerging evidence suggests that perturbations in the microbiota diversity increase recipients' susceptibilities to gut-mediated conditions such as diarrhea, infection and acute GvHD. Probiotics preserve the microbiota and may minimize the risk of developing a gut-mediated condition; however, their safety has not been evaluated in the setting of HCT. We evaluated the safety and feasibility of the probiotic, Lactobacillus plantarum (LBP), in children and adolescents undergoing allogeneic HCT. Participants received once-daily supplementation with LBP beginning on day -8 or -7 and continued until day +14. Outcomes were compliance with daily administration and incidence of LBP bacteremia. Administration of LBP was feasible with 97% (30/31, 95% confidence interval (CI) 83-100%) of children receiving at least 50% of the probiotic dose (median 97%; range 50-100%). We did not observe any case of LBP bacteremia (0% (0/30) with 95% CI 0-12%). There were not any unexpected adverse events related to LBP. Our study provides preliminary evidence that administration of LBP is safe and feasible in children and adolescents undergoing HCT. Future steps include the conduct of an approved randomized, controlled trial through Children's Oncology Group.

Lower back pain in physically demanding college academic programs: a questionnaire based study

PubMed Central

Brennan, Graham; Shafat, Amir; Donncha, Ciarán Mac; Vekins, Carmel

2007-01-01

Background Lower back pain (LBP) is ranked first as a cause of disability and inability to work, and is expected to affect up to 90% of the worlds population at some point in their lifetime. The annual first time incidence of LBP is 5%, and the annual prevalence (i.e. those suffering at time of questioning) is between 15 and 63%. Prospective studies demonstrate that low back problems do not display a six-week spontaneous recovery pattern, as was once believed. The condition is regularly seen to worsen over time, becoming a chronic disorder, influenced by both physical and psychosocial factors. Methods The current study assessed the level of LBP amongst students engaged in educational programs that were physically demanding, and its influence on lower back problems. A 1-year retrospective questionnaire consisting of 37 closed, open and multi-choice questions was designed to ascertain self-reported information on the occurrence, cause and type of LBP. Treatment, care seeking and general knowledge regarding LBP were also recorded. Students were enrolled in BSc Equine Science, BSc Physical Education and BSc Sports & Exercise Science degree programs and a total number of 188 valid questionnaires were collected. Results The self reported, anthropometrical data for participants in this study are: age 20.9 ± 2.7 yrs; height 171.8 ± 9.3 cm; weight 66.7 ± 10.4 kg; female 64% (n = 120), male 36% (n = 68). The overall self reported prevalence of LBP was 32% (n = 61). Within the LBP population, 77% reported their problem as recurring. Two factors showed significance as having an influence on LBP. They were age (21.6 ± 3.5 yrs, p = 0.005) and hours of personal training physical activity (14.0 ± 8.2 hrs per week, p = 0.02). LBP sufferers also displayed poor management of their condition and an interest in education and treatment of their problem. Conclusion The current study revealed high prevalence of LBP consistent with that of the literature, and unveiled a recurrence rate and behavioral habits of sufferers, which are warning signs of a more chronic state to come. Novel data presented here offers strong support for the need for prospective injury tracking, plus educational intervention and treatment aimed at prevention of LBP. PMID:17631036

Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: a cross-sectional study using the sixth korea national health and nutrition examination survey.

PubMed

Park, Sang-Min; Kim, Ho-Joong; Jeong, Hyunseok; Kim, Hyoungmin; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

2018-04-17

There is increasing evidence supporting an association between sitting time and low back pain (LBP). However, the degree of the association between the total daily sitting time and LBP in the general population is poorly understood. (1) To analyze the association between the duration of sitting time and LBP, and (2) to examine this association according to the degree of physical activity in population over 50 years of age with a nationally representative sample of Korean adults. A cross-sectional study PATIENT SAMPLE: Data from version VI-2, 3 of the Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 and 2015. Multiple logistic regression was performed to find the rates of association between chronic LBP, level of sitting time, and physical activity. Nationwide Health surveys and examinations were conducted in general Korean representative populations (n = 7,550 in 2014, n = 7,380 in 2015). Chronic LBP was defined as self-reported LBP lasting for more than 30 days during the past 3 months in a health survey. Sitting time and daily physical activity were evaluated using the long version of the international physical activity questionnaires (IPAQ). The duration of sitting time was divided into 2 categories according to the median value (7 hours), and further divided into 4 categories using quartiles. Physical activity was also divided into low and high physical activity according to duration of mid- to high-intensity activities. There were no sources of funding and no conflicts of interest associated with this study. On multiple logistic regression analysis, sitting time more than 7 hours/day was significantly associated with LBP (adjusted odds ratio, aOR: 1.33, p<.001). The risk of LBP increased with increasing duration of sitting time. In participants with low levels of physical activity, the duration of sitting time showed more positive association with LBP than that in all the participants and participants with high levels of physical activity. Longer duration of sitting time is a risk factor for LBP. Furthermore, long duration of sitting time with low physical activity further increases the risk of LBP. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparative effectiveness of exercise, acupuncture, and spinal manipulation for low back pain.

PubMed

Standaert, Christopher J; Friedly, Janna; Erwin, Mark W; Lee, Michael J; Rechtine, Glenn; Henrikson, Nora B; Norvell, Daniel C

2011-10-01

Systematic review. We sought to answer the following clinical questions: (1) Is structured exercise more effective in the treatment of chronic low back pain (LBP) than spinal manipulative therapy (SMT)? (2) Is structured exercise more effective in the treatment of chronic LBP than acupuncture? (3) Is SMT more effective in the treatment of chronic LBP than acupuncture? (4) Do certain subgroups respond more favorably to specific treatments? (5) Are any of these treatments more cost-effective than the others? Exercise, SMT, and acupuncture are widely used interventions in the treatment of chronic LBP. There is evidence that all of these approaches may offer some benefit for patients with chronic LBP when compared with usual care or no treatment. The relative benefits or cost-effectiveness of any one of these treatments when compared with the others are less well-defined, and it is difficult to identify specific subgroups of those with chronic LBP who may preferentially respond to a particular treatment modality. A systematic review of the literature was performed to identify randomized controlled trials comparing a structured exercise program, SMT, or acupuncture with one another in patients with chronic LBP. Two studies were identified comparing the use of structured exercise with SMT that met our inclusion criteria. Although these studies utilized different approaches for the exercise and SMT treatment groups, patients in both groups improved in terms of pain and function in both studies. Using random-effects modeling, there was no difference between the exercise and SMT groups when the data from these studies were pooled. We identified no studies meeting our inclusion criteria that compared acupuncture with either structured exercise or SMT or that addressed the relative cost-effectiveness of these approaches in the treatment of patients with chronic LBP. The studies identified indicate that structured exercise and SMT appear to offer equivalent benefits in terms of pain and functional improvement for those with chronic LBP with clinical benefits evident within 8 weeks of care. However, the level of evidence is low. There is insufficient evidence to comment on the relative benefit of acupuncture compared with either structured exercise or SMT or to address the differential effects of structured exercise, SMT, or acupuncture for specific subgroups of individuals with chronic LBP. There is also insufficient evidence regarding the relative cost-effectiveness of structured exercise, SMT, or acupuncture in the treatment of chronic LBP. Structured exercise and SMT appear to offer equivalent benefits in the management of pain and function for patients with nonspecific chronic LBP. If no clinical benefit is appreciated after using one of these approaches for 8 weeks, then the treatment plan should be reevaluated and consideration should be given to modifying the treatment approach or using alternate forms of care. Strength of recommendation: Weak.There is insufficient evidence regarding the relative benefits of the acupuncture compared with either structured exercise or SMT in the treatment of chronic LBP.There is insufficient evidence to address differential effects of structured exercise, SMT, or acupuncture for specific subgroups of individuals with chronic LBP. There is insufficient evidence regarding the relative cost-effectiveness of structured exercise, SMT, or acupuncture in the treatment of chronic LBP.

Low back pain in childhood and adolescence: assessment of sports activities.

PubMed

Sato, Tsuyoshi; Ito, Takui; Hirano, Toru; Morita, Osamu; Kikuchi, Ren; Endo, Naoto; Tanabe, Naohito

2011-01-01

A cross-sectional study that targeted a total of 43,630 pupils in Niigata City, Japan was performed. The objective of the study was to evaluate the association between sports activities and low back pain (LBP) in childhood and adolescence in Japan. Regarding risk factors of LBP, a large number of studies have been conducted that have examined gender differences, height and weight, body mass index, sports time, differences in lifestyle, family history, and mental factors; however, no definitive conclusion has yet been made. A questionnaire survey was conducted using 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of 785,067). 26,766 pupils who were determined to have valid responses (valid response rate 61.3%) were analyzed. Among the 26,766 pupils with valid responses, 2,591 (9.7%) had LBP at the time of the survey, and 8,588 (32.1%) had a history of LBP. The pupils were divided between those who did not participate in sports activities except the physical education in school (No sports group: 5,486, 20.5%) and those who participated in sports activities (Sports group: 21,280, 79.5%), and the difference in lifetime prevalence between No sports group and Sports group was examined. The odds ratio for LBP according to sports activity was calculated by multiple logistic regression analysis adjusted for gender, age, and body mass index. In addition, the severity of LBP was divided into three levels (Level 1: no limitation in any activity, Level 2: necessary to refrain from participating in sports and physical activities, and Level 3: necessary to be absent from school), and Levels 2 and 3 were defined as severe LBP; the severity was compared between No sports group and Sports group and in each sport's items. Moreover, in Sports group, the amount of time spent participating in sports activities were divided into three groups (Group 1: less than 6 h per week, Group 2: 6-12 h per week, and Group 3: 12.1 h per week or more), and the dose-response between the amount of time spent participating in sports activities and the occurrence of LBP were compared. In No sports group, 21.3% experienced a history of LBP; in Sports group, 34.9% experienced LBP (P < 0.001). In comparison to No sports group, the odds ratio was significantly higher for Sports group (1.57), and also significantly higher for most of the sports items. The severity of LBP was significantly higher in Sports group (20.1 vs. 3.2%, P < 0.001). The amount of time spent participating in sports activities averaged 9.8 h per week, and a history of LBP significantly increased in the group which spent a longer time participating in sports activities (odds ratio 1.43 in Group 3). These findings suggest that sports activity is possible risk factors for the occurrence of LBP, and it might increase the risk for LBP in childhood and adolescence.

Image-based Analysis of Emotional Facial Expressions in Full Face Transplants.

PubMed

Bedeloglu, Merve; Topcu, Çagdas; Akgul, Arzu; Döger, Ela Naz; Sever, Refik; Ozkan, Ozlenen; Ozkan, Omer; Uysal, Hilmi; Polat, Ovunc; Çolak, Omer Halil

2018-01-20

In this study, it is aimed to determine the degree of the development in emotional expression of full face transplant patients from photographs. Hence, a rehabilitation process can be planned according to the determination of degrees as a later work. As envisaged, in full face transplant cases, the determination of expressions can be confused or cannot be achieved as the healthy control group. In order to perform image-based analysis, a control group consist of 9 healthy males and 2 full-face transplant patients participated in the study. Appearance-based Gabor Wavelet Transform (GWT) and Local Binary Pattern (LBP) methods are adopted for recognizing neutral and 6 emotional expressions which consist of angry, scared, happy, hate, confused and sad. Feature extraction was carried out by using both methods and combination of these methods serially. In the performed expressions, the extracted features of the most distinct zones in the facial area where the eye and mouth region, have been used to classify the emotions. Also, the combination of these region features has been used to improve classifier performance. Control subjects and transplant patients' ability to perform emotional expressions have been determined with K-nearest neighbor (KNN) classifier with region-specific and method-specific decision stages. The results have been compared with healthy group. It has been observed that transplant patients don't reflect some emotional expressions. Also, there were confusions among expressions.

EEG artifact elimination by extraction of ICA-component features using image processing algorithms.

PubMed

Radüntz, T; Scouten, J; Hochmuth, O; Meffert, B

2015-03-30

Artifact rejection is a central issue when dealing with electroencephalogram recordings. Although independent component analysis (ICA) separates data in linearly independent components (IC), the classification of these components as artifact or EEG signal still requires visual inspection by experts. In this paper, we achieve automated artifact elimination using linear discriminant analysis (LDA) for classification of feature vectors extracted from ICA components via image processing algorithms. We compare the performance of this automated classifier to visual classification by experts and identify range filtering as a feature extraction method with great potential for automated IC artifact recognition (accuracy rate 88%). We obtain almost the same level of recognition performance for geometric features and local binary pattern (LBP) features. Compared to the existing automated solutions the proposed method has two main advantages: First, it does not depend on direct recording of artifact signals, which then, e.g. have to be subtracted from the contaminated EEG. Second, it is not limited to a specific number or type of artifact. In summary, the present method is an automatic, reliable, real-time capable and practical tool that reduces the time intensive manual selection of ICs for artifact removal. The results are very promising despite the relatively small channel resolution of 25 electrodes. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Identifying subgroups of patients using latent class analysis: should we use a single-stage or a two-stage approach? A methodological study using a cohort of patients with low back pain.

PubMed

Nielsen, Anne Molgaard; Kent, Peter; Hestbaek, Lise; Vach, Werner; Kongsted, Alice

2017-02-01

Heterogeneity in patients with low back pain (LBP) is well recognised and different approaches to subgrouping have been proposed. Latent Class Analysis (LCA) is a statistical technique that is increasingly being used to identify subgroups based on patient characteristics. However, as LBP is a complex multi-domain condition, the optimal approach when using LCA is unknown. Therefore, this paper describes the exploration of two approaches to LCA that may help improve the identification of clinically relevant and interpretable LBP subgroups. From 928 LBP patients consulting a chiropractor, baseline data were used as input to the statistical subgrouping. In a single-stage LCA, all variables were modelled simultaneously to identify patient subgroups. In a two-stage LCA, we used the latent class membership from our previously published LCA within each of six domains of health (activity, contextual factors, pain, participation, physical impairment and psychology) (first stage) as the variables entered into the second stage of the two-stage LCA to identify patient subgroups. The description of the results of the single-stage and two-stage LCA was based on a combination of statistical performance measures, qualitative evaluation of clinical interpretability (face validity) and a subgroup membership comparison. For the single-stage LCA, a model solution with seven patient subgroups was preferred, and for the two-stage LCA, a nine patient subgroup model. Both approaches identified similar, but not identical, patient subgroups characterised by (i) mild intermittent LBP, (ii) recent severe LBP and activity limitations, (iii) very recent severe LBP with both activity and participation limitations, (iv) work-related LBP, (v) LBP and several negative consequences and (vi) LBP with nerve root involvement. Both approaches identified clinically interpretable patient subgroups. The potential importance of these subgroups needs to be investigated by exploring whether they can be identified in other cohorts and by examining their possible association with patient outcomes. This may inform the selection of a preferred LCA approach.

Kinematics of Shooting in High School and Collegiate Lacrosse Players With and Without Low Back Pain.

PubMed

Wasser, Joseph G; Chen, Cong; Vincent, Heather K

2016-07-01

Low back pain (LBP) and motion alterations can occur in athletes who engage in high-speed throwing motions. The relationship between LBP and shooting motion in lacrosse players is not yet known. To quantify the effects of LBP on key kinematic parameters of the lacrosse shot and determine the contribution of the severity of LBP on specific kinematic parameters of the shooting motion. Controlled laboratory study. High school and collegiate players (N = 24) were stratified into 2 groups based on back pain symptoms (LBP or no pain). Three-dimensional motion capture of overhead throws was used to collect data on knee, pelvis, trunk, and shoulder kinematics as well as crosse stick (the stick capped with a strung net) and ball speed. Mean low back numeric pain rating scale (NRSpain) score was 2.9. Knee flexion at ball release was greater in the LBP than no pain group, indicating a more bent knee (P = .04). The LBP group demonstrated less angular velocity transfer from pelvis to trunk than the no pain group (P = .05). Total range of motion of the pelvis and shoulders during the shot and follow-through were less in the LBP group than the no pain group (83.6° ± 24.5° vs 75.9° ± 24.5°, P = .05). Age- and sex-adjusted regression analyses revealed that the low back NRSpain rating contributed 6.3% to 25.0% of the variance to the models of shoulder transverse rotation range of motion, trunk and shoulder rotation angular velocities, and knee flexion angle (P < .05). LBP severity significantly contributes to trunk and shoulder motion restriction during lacrosse shooting. Inclusion of lumbopelvic and core training and prehabilitation programs for high school and collegiate players may reduce pain in affected players as well as help them to attain appropriate motion parameters and avoid secondary musculoskeletal injuries. This research identified a prehabilitation need in the understudied lacrosse population. Therapeutic strategies can be developed to strengthen the throwing motion, which could control mechanical loading patterns on the low back and minimize pain symptoms in players with chronic LBP.

[Effects of physical factors on neck or shoulder pain and low back pain of adolescents].

PubMed

Deng, Guoying; Zhang, Yongxing; Cai, Haifeng; Gu, Wentao; Cai, Yun; Xie, Lei; Liu, Bo; Li, Jipeng; Li, Siyu; Cheng, Dantong; Zhao, Qinghua

2014-11-25

To explore the incidence of self-reported neck or shoulder pain (NSP) and lower back pain (LBP) among Chinese adolescents in Shanghai and identify the influencing factors for the incidences of NSP and LBP. A total of 3 600 students were selected from 30 high schools randomly chosen from 237 regular full-time high schools registered in Shanghai. From each school, 40 students were selected from each of the tenth, eleventh and twelfth grades for a total of 120 students per school. The questionnaire involved questions pertaining to demographic profiles, learning environment and exercise habits of each student. And it also contained questions regarding the amount of weight carried by each student while commuting to and from school, and it was also used to collect specific information related to the occurrence of NSP and LBP. Logistic regression was performed to analyze the potential risk factors for NSP and LBP. Among 3 600 questionnaires, a total of 2 842 valid ones were returned. The results revealed that the incidence of NSP and LBP in the Chinese adolescent population was 41.1% and 32.8% respectively. Both NSP and LBP were more common in girls than in boys, and 6.3% students reported at least one NSP- or LBP-induced absence from school. A relatively large portion of Chinese adolescents reported experiencing problems such as sedentary behavior (26.7% of the students continued to sit for more than 3 hours after school), a lack of exercise (29.3% exercised less than once each week and 38.2% of students reported that their exercise duration was less than half an hour each time) and overweight backpacks (53.0% complained that their backpack was too heavy). Multivariate logistic regression analysis revealed that gender, grade, physical activity and learning environment were all significantly correlated with the occurrences of NSP and LBP. The incidences of NSP and LBP are relatively high among adolescents in Shanghai. And several factors, including sedentary behavior, personal exercise habits and backpack weight, influence the occurrences of NSP and LBP in adolesents.

Associations of objectively measured sitting and standing with low-back pain intensity: a 6-month follow-up of construction and healthcare workers.

PubMed

Lunde, Lars-Kristian; Koch, Markus; Knardahl, Stein; Veiersted, Kaj Bo

2017-05-01

Objectives This study aimed to determine the associations between objectively measured sitting and standing duration and intensity of low-back pain (LBP) among Norwegian construction and healthcare workers. Methods One-hundred and twenty-four workers wore two accelerometers for 3-4 consecutive days, during work and leisure. Minutes of sitting and standing was calculated from accelerometer data. We obtained self-reported LBP intensity (0-3) at the time of objective measurement and after six months. We examined associations with linear mixed models and presented results per 100 minutes. Results For healthcare workers, the duration of sitting during work [β= -0.33, 95% confidence interval (95% CI) -0.55- -0.10] and during full-day (work + leisure) (β= -0.21, 95% CI -0.38- -0.04) was associated with baseline LBP intensity. Furthermore, minutes of sitting at work (β=-0.35, 95% CI -0.57- -0.13) and during the full day (β=-0.20, 95% CI -0.37- -0.04) were significantly associated with LBP intensity at six months. Associations were attenuated when adjusting for work-related mechanical and psychosocial covariates and objectively measured exposure during leisure time. No significant associations between sitting and LBP intensity were found for construction workers. Standing at work was not consistently associated with LBP intensity at baseline or after six months for any work sector. Conclusions This study suggests that a long duration of sitting at work is associated with lower levels of LBP intensity among healthcare workers. Standing duration had no consistent associations with LBP intensity.

Protective effect of Lycium Barbarum polysaccharides on dextromethorphan-induced mood impairment and neurogenesis suppression.

PubMed

Po, Kevin Kai-Ting; Leung, Joseph Wai-Hin; Chan, Jackie Ngai-Man; Fung, Timothy Kai-Hang; Sánchez-Vidaña, Dalinda Isabel; Sin, Emily Lok-Lam; So, Kwok-Fai; Lau, Benson Wui-Man; Siu, Andrew Man-Hong

2017-09-01

Dextromethorphan (DXM) is one of the common drugs abused by adolescents. It is the active ingredient found in cough medicine which is used for suppressing cough. High dosage of DXM can induce euphoria, dissociative effects and even hallucinations. Chronic use of DXM may also lead to depressive-related symptoms. Lycium barbarum, commonly known as wolfberry, has been used as a traditional Chinese medicine for the treatment of ageing-related neurodegenerative diseases. A recent study has shown the potential beneficial effect of Lycium barbarum to reduce depression-like behavior. In the present study, we investigated the role of Lycium barbarum polysaccharide (LBP) to alleviate DXM-induced emotional distress. Sprague Dawley rats were divided into 4 groups (n=6 per group), including the normal control (vehicles only), DXM-treated group (40 mg/kg DXM), LBP-treated group (1 mg/kg LBP) and DXM+ LBP-treated group (40 mg/kg DXM and 1 mg/kg LBP). After two-week treatment, the DXM-treated group showed increased depression-like and social anxiety-like behaviors in the forced swim test and social interaction test respectively. On the other hand, the adverse behavioral effects induced by DXM were reduced by LBP treatment. Histological results showed that LBP treatment alone did not promote hippocampal neurogenesis when compared to the normal control, but LBP could lessen the suppression of hippocampal neurogenesis induced by DXM. The findings provide insights for the potential use of wolfberry as an adjunct treatment option for alleviating mood disturbances during rehabilitation of cough syrup abusers. Copyright © 2017 Elsevier Inc. All rights reserved.

Treatment of d-galactose induced mouse aging with Lycium barbarum polysaccharides and its mechanism study.

PubMed

Tang, Tao; He, Bixiu

2013-01-01

We evaluated the effects of Lycium barbarum polysaccharides LBP) on D-galactose aging model mouse, and explored its possible mechanism. Kunming mice were randomly divided into the control group, the model group, the high-dose LBP group, and the low-dose LBP group. Except the control group, D-galactose was used for modelling. The drug was administrated when modelling. Mouse behavioural, learning and memory changes were observed, and the contents of lipid peroxidation (LPO), lipofuscin (LF) and monoamine oxidase B (MAO-B) in mouse brain tissue and the weight of immune organs were measured after 6 weeks. Compared with the control group, mouse weight gain in the model group reduced significantly. Compared with model group, after mice drank LBP, the times of electric shock was less than aging mice (in which, the high-dose LBP group, P<0.05), and electric shock incubation period was longer (P<0.01). On Day 45 after modelling and drug administration, the contents of LPO, LF and MAO-B in mouse brain tissue in the model group increased significantly, while those in the drug administration groups decreased significantly. The thymus index in the aging model group decreased significantly; the thymus index and the spleen index in the high-dose LBP group and the low-dose LBP group rebounded significantly (P<0.01). We concluded that LBP has an anti-aging effect on D-galactose induced aging model mouse, and its mechanism may be related with the alleviation of glucose metabolism disorder and the resistance of the generation of lipid peroxide and other substances, which damage cell membrane lipid.

Differences between two subgroups of low back pain patients in lumbopelvic rotation and symmetry in the erector spinae and hamstring muscles during trunk flexion when standing.

PubMed

Kim, Min-hee; Yoo, Won-gyu; Choi, Bo-ram

2013-04-01

The present study was performed to examine lumbopelvic rotation and to identify asymmetry of the erector spinae and hamstring muscles in people with and without low back pain (LBP). The control group included 16 healthy subjects, the lumbar-flexion-rotation syndrome LBP group included 17 subjects, and the lumbar-extension-rotation syndrome LBP group included 14 subjects. Kinematic parameters were recorded using a 3D motion-capture system, and electromyography parameters were measured using a Noraxon TeleMyo 2400T. The two LBP subgroups showed significantly more lumbopelvic rotation during trunk flexion in standing than did the control group. The muscle activity and flexion-relaxation ratio asymmetries of the erector spinae muscles in the lumbar-flexion-rotation syndrome LBP group were significantly greater than those in the control group, and the muscle activity and flexion-relaxation ratio asymmetry of the hamstring muscles in the lumbar-extension-rotation syndrome LBP group were significantly greater than those in the control group. Imbalance or asymmetry of passive tissue could lead to asymmetry of muscular activation. Muscle imbalance can cause asymmetrical alignment or movements such as unexpected rotation. The results showed a greater increase in lumbopelvic rotation during trunk flexion in standing among the lumbar-flexion-rotation syndrome and lumbar-extension-rotation syndrome LBP groups compared with the control group. The differences between the two LBP subgroups may be a result of imbalance and asymmetry in erector spinae and hamstring muscle properties. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

Is objectively measured sitting at work associated with low-back pain? A cross sectional study in the DPhacto cohort.

PubMed

Korshøj, Mette; Hallman, David M; Mathiassen, Svend Erik; Aadahl, Mette; Holtermann, Andreas; Jørgensen, Marie Birk

2018-01-01

Objectives Low-back pain (LBP) is a substantial health challenge due to the risk for long-term sickness absence and early retirement. Several biomechanical exposures at work, including sitting, have been suggested to increase the risk for LBP. The objectives of this study were to determine (i) the extent to which temporal patterns and total amount of objectively measured sitting is associated with LBP intensity and (ii) whether selected modifiers influence these associations. Methods This cross sectional study uses baseline data from the Danish PHysical ACTivity cohort with Objective measurements (DPhacto) of physical activities in the cleaning, transport and manufacturing sectors. Peak intensity of LBP was collected by questionnaire on a 0-10 scale and sitting was expressed in terms of total duration and temporal pattern, ie, time spent in brief bursts (≤5 minutes), moderate periods (>5-≤20 minutes), and prolonged periods of sitting (>20 minutes); both during work and whole day (waking hours only). Associations were determined using linear regression in models accounting for moderation and confounding. Factors evaluated as moderators or confounders were assessed by questionnaire. Results The population consisted of 704 participants. No significant associations were found between total duration or temporal patterns of sitting and LBP intensity, neither during work nor for the whole day. Body mass index (BMI) significantly moderated the association between sitting and LBP; participants with a high and low BMI showing a negative and positive association, respectively. Conclusion Sitting was not independently associated with peak LBP intensity, suggesting other exposures are more powerful risk factors for LBP.

Adding localization information in a fingerprint binary feature vector representation

NASA Astrophysics Data System (ADS)

Bringer, Julien; Despiegel, Vincent; Favre, Mélanie

2011-06-01

At BTAS'10, a new framework to transform a fingerprint minutiae template into a binary feature vector of fixed length is described. A fingerprint is characterized by its similarity with a fixed number set of representative local minutiae vicinities. This approach by representative leads to a fixed length binary representation, and, as the approach is local, it enables to deal with local distortions that may occur between two acquisitions. We extend this construction to incorporate additional information in the binary vector, in particular on localization of the vicinities. We explore the use of position and orientation information. The performance improvement is promising for utilization into fast identification algorithms or into privacy protection algorithms.

Low back pain, radiculopathy, and bilateral proximal hamstring ruptures: a case report.

PubMed

Deren, Matthew E; DeFroda, Steven F; Mukand, Nita H; Mukand, Jon A

2015-12-01

Low back pain (LBP) is a common complaint in the United States, with an incidence of 6.3%-15.4% and yearly recurrence in 54%-90% of patients.1 Trends show more frequent diagnostic testing, opioid use, and surgical intervention as the incidence of LBP increases.2 LBP is defined as pain at and near the lumbosacral region that can vary with physical activity and time. LBP is usually related to pathology of muscles, ligaments, spinal column joints, nerve roots, and the spinal cord. During the assessment of LBP, practitioners must also consider less common causes of pain in that region. For instance, patients with indolent or nighttime pain may have infectious or malignant processes. Referred pain from injuries to pelvic musculature or abdominal contents should be considered, especially following a traumatic event. One of these injuries, which can present as acute low back pain, is rupture of the proximal hamstring tendon. On rare occasion, concomitant LBP, radiculopathy, and hamstring injuries can occur;. This diagnostic challenge is described in the following case.

Integrated method of thermosensitive triblock copolymer-salt aqueous two phase extraction and dialysis membrane separation for purification of lycium barbarum polysaccharide.

PubMed

Wang, Yun; Hu, Xiaowei; Han, Juan; Ni, Liang; Tang, Xu; Hu, Yutao; Chen, Tong

2016-03-01

A polymer-salt aqueous two-phase system (ATPS) consisting of thermosensitive copolymer ethylene-oxide-b-propylene-oxide-b-ethylene-oxide (EOPOEO) and NaH2PO4 was employed in deproteinization for lycium barbarum polysaccharide (LBP). The effects of salt type and concentration, EOPOEO concentration, amount of crude LBP solution and temperature were studied. In the primary extraction process, LBP was preferentially partitioned to the bottom (salt-rich) phase with high recovery ratio of 96.3%, while 94.4% of impurity protein was removed to the top (EOPOEO-rich) phase. Moreover, the majority of pigments could be discarded to top phase. After phase-separation, the LBP in the bottom phase was further purified by dialysis membrane to remove salt and other small molecular impurities. The purity of LBP was enhanced to 64%. Additionally, the FT-IR spectrum was used to identify LBP. EOPOEO was recovered by a temperature-induced separation, and reused in a new ATPS. An ideal extraction and recycle result were achieved. Copyright © 2015 Elsevier Ltd. All rights reserved.

The influence of a seated break on prolonged standing induced low back pain development.

PubMed

Gallagher, Kaitlin M; Campbell, Troy; Callaghan, Jack P

2014-01-01

With the recent attention to 'sitting disease', health practitioners and scientists are promoting standing in the workplace to decrease sedentary time, despite a high prevalence of low back pain (LBP) development during prolonged standing. The purpose of this study was to assess how a seated break inserted between bouts of prolonged standing would influence LBP development, posture and movement. A total of 20 participants stood for 45 minutes, sat for 15 minutes and repeated this sequence while lumbar and thoracic angles were measured, and LBP visual analogue scale reports were taken. Of the sample, 55% participants reported LBP in standing. A stand to sit ratio of 3:1 did not provide lasting recovery of LBP from standing and pain developers utilised a limited range of their lumbar spine angle and increased thoracic extension, resulting in static postures that caused tissue aggravation that was not resolved after 15 minutes of sitting. Prolonged standing in the workplace has the potential to result in LBP for some workers and alternate ways to reduce sedentary time should be investigated.

A Cochrane review of combined chiropractic interventions for low-back pain.

PubMed

Walker, Bruce F; French, Simon D; Grant, William; Green, Sally

2011-02-01

Cochrane systematic review of randomized controlled trials. To determine the effects of combined chiropractic interventions on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with low-back pain (LBP). Chiropractors commonly use a combination of interventions to treat people with LBP, but little is known about the effects of this care. We used a comprehensive search strategy. All randomized trials comparing combined chiropractic interventions (rather than spinal manipulation alone) with no treatment or other therapies were included. At least two authors selected studies, assessed bias risk, and extracted data. Descriptive synthesis and meta-analyses were performed. We included 12 studies involving 2887 LBP participants. Three studies had low risk of bias. Included studies evaluated a range of chiropractic procedures in a variety of subpopulations with LBP. For acute and subacute LBP, chiropractic interventions improved short- and medium-term pain (standardized mean difference [SMD] -0.25 [95% CI: -0.46 to -0.04] and MD -0.89 [95%CI: -1.60 to -0.18]) compared with other treatments, but there was no significant difference in long-term pain (MD -0.46 [95% CI -1.18 to 0.26]). Short-term improvement in disability was greater in the chiropractic group compared to other therapies (SMD -0.36 [95% CI: -0.70 to -0.02]). However, the effect was small and studies contributing to these results had high risk of bias. There was no difference in medium- and long-term disability. No difference was demonstrated for combined chiropractic interventions for chronic LBP and studies that had a mixed population of LBP. Combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute/subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.

Catastrophizing, state anxiety, anger, and depressive symptoms do not correlate with disability when variations of trait anxiety are taken into account. a study of chronic low back pain patients treated in Spanish pain units [NCT00360802].

PubMed

Moix, Jenny; Kovacs, Francisco M; Martín, Andrés; Plana, María N; Royuela, Ana

2011-07-01

To assess the influence of pain severity, catastrophizing, anger, anxiety, and depression on nonspecific low back pain (LBP)-related disability in Spanish patients with chronic LBP. Study Design.  Cross-sectional correlation between psychological variables and disability. Methods.  One hundred twenty-three patients treated for chronic LBP in pain units within nine Spanish National Health Service Hospitals, in eight cities, were included in this study. Intensity of LBP and pain referred to the leg, disability, catastrophizing, anger, state anxiety, trait anxiety, and depression were assessed through previously validated questionnaires. The association of disability with these variables, as well as gender, age, academic level, work status, and use of antidepressants, was analyzed through linear regression models. Correlations between LBP, referred pain, disability, catastrophizing, anger, state anxiety, trait anxiety, and depression were significant, except for the ones between anger and LBP and between anger and referred pain. The multivariate regression model showed that when variations of trait anxiety were taken into account, the association of the other psychological variables with disability was no longer significant. The final model explained 49% of the variability of disability. Standardized coefficients were 0.452 for trait anxiety, 0.362 for intensity of LBP, 0.253 for failed back surgery, and -0.140 for higher academic level. Among Spanish chronic LBP patients treated at pain units, the correlation of catastrophizing, state anxiety, anger, and depression with disability ceases to be significant when variations of trait anxiety are taken into account. Further studies with LBP patients should determine whether anxiety trait mediates the effects of the other variables, explore its prognostic value, and assess the therapeutic effect of reducing it. Wiley Periodicals, Inc.

Lipopolysaccharide (LPS)-binding protein stimulates CD14-dependent Toll-like receptor 4 internalization and LPS-induced TBK1-IKKϵ-IRF3 axis activation.

PubMed

Tsukamoto, Hiroki; Takeuchi, Shino; Kubota, Kanae; Kobayashi, Yohei; Kozakai, Sao; Ukai, Ippo; Shichiku, Ayumi; Okubo, Misaki; Numasaki, Muneo; Kanemitsu, Yoshitomi; Matsumoto, Yotaro; Nochi, Tomonori; Watanabe, Kouichi; Aso, Hisashi; Tomioka, Yoshihisa

2018-05-14

Toll-like receptor 4 (TLR4) is an indispensable immune receptor for lipopolysaccharide (LPS), a major component of the Gram-negative bacterial cell wall. Following LPS stimulation, TLR4 transmits the signal from the cell surface and becomes internalized in an endosome. However, the spatial regulation of TLR4 signaling is not fully understood. Here, we investigated the mechanisms of LPS-induced TLR4 internalization and clarified the roles of the extracellular LPS-binding molecules, LPS-binding protein (LBP), and glycerophosphatidylinositol-anchored protein (CD14). LPS stimulation of CD14-expressing cells induced TLR4 internalization in the presence of serum, and an inhibitory anti-LBP mAb blocked its internalization. Addition of LBP to serum-free cultures restored LPS-induced TLR4 internalization to comparable levels of serum. The secretory form of the CD14 (sCD14) induced internalization but required a much higher concentration than LBP. An inhibitory anti-sCD14 mAb was ineffective for serum-mediated internalization. LBP lacking the domain for LPS transfer to CD14 and a CD14 mutant with reduced LPS binding both attenuated TLR4 internalization. Accordingly, LBP is an essential serum molecule for TLR4 internalization, and its LPS transfer to membrane-anchored CD14 (mCD14) is a prerequisite. LBP induced the LPS-stimulated phosphorylation of TBK1, IKKϵ, and IRF3, leading to IFN-β expression. However, LPS-stimulated late activation of NFκB or necroptosis were not affected. Collectively, our results indicate that LBP controls LPS-induced TLR4 internalization, which induces TLR adaptor molecule 1 (TRIF)-dependent activation of the TBK1-IKKϵ-IRF3-IFN-β pathway. In summary, we showed that LBP-mediated LPS transfer to mCD14 is required for serum-dependent TLR4 internalization and activation of the TRIF pathway. Copyright © 2018, The American Society for Biochemistry and Molecular Biology.

The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males.

PubMed

Savage, R A; Whitehouse, G H; Roberts, N

1997-01-01

The purpose of this study was to undertake a critical review of the potential role of magnetic resonance imaging (MRI) in the evaluation of low back pain (LBP) and to determine if there were differences in the MRI appearances between various occupational groups. The study group, 149 working men (78 aged 20-30 years and 71 aged 31-58 years) from five different occupations (car production workers, ambulance men, office staff, hospital porters and brewery draymen), underwent MRI of the lumbar spine. Thirty-four percent of the subjects had never experienced LBP. Twelve months later, the examination was repeated on 89 men. Age-related differences were seen in the MRI appearances of the lumbar spine. Disc degeneration was most common at L5/S1 and was significantly more prevalent (P < 0.01) in the older age group (52%) than in the younger age group (27%). Although LBP was more prevalent in the older subjects there was no relationship between LBP and disc degeneration. No differences in the MRI appearance of the lumbar spine were observed between the five occupational groups. Overall, 45% had 'abnormal' lumbar spines (evidence of disc degeneration, disc bulging or protrusion, facet hypertrophy, or nerve root compression). There was not a clear relationship between the MRI appearance of the lumbar spine and LBP. Thirty-two percent of asymptomatic subjects had 'abnormal' lumbar spines and 47% of all the subjects who had experienced LBP had 'normal' lumbar spines. During the 12-month follow-up period, 13 subjects experienced LBP for the first time. However, there was no change in the MRI appearances of their lumbar spines that could account for the onset of LBP. Although MRI is an excellent technique for evaluating the lumbar spine, this study shows that it does not provide a suitable pre-employment screening technique capable of identifying those at risk of LBP.

Effect of Zoledronic Acid and Denosumab in Patients With Low Back Pain and Modic Change: A Proof-of-Principle Trial.

PubMed

Cai, Guoqi; Laslett, Laura L; Aitken, Dawn; Halliday, Andrew; Pan, Feng; Otahal, Petr; Speden, Deborah; Winzenberg, Tania M; Jones, Graeme

2018-05-01

The aim of this study was to evaluate the effect of zoledronic acid (ZA) and denosumab on low back pain (LBP) and Modic change (MC) over 6 months. Adults aged ≥40 years with significant LBP for at least 6 months duration and MC (type 1, 2, or mixed) were randomized to receive ZA (5 mg/100 mL), denosumab (60 mg), or placebo. LBP was measured monthly by visual analogue scale (VAS) and the LBP Rating Scale (RS). MC was measured from MRIs of T 12 -S 1 vertebrae at screening and 6 months. A total of 103 participants with moderate/severe LBP (mean VAS = 57 mm; mean RS = 18) and median total MC area 538 mm 2 were enrolled. Compared to placebo, LBP reduced significantly at 6 months in the ZA group for RS (-3.3; 95% CI, -5.9 to -0.7) but not VAS (-8.2; 95% CI, -18.8 to +2.4) with similar findings for denosumab (RS, -3.0; 95% CI, -5.7 to -0.3; VAS, -10.7; 95% CI, -21.7 to +0.2). There was little change in areal MC size overall and no difference between groups with the exception of denosumab in those with type 1 Modic change (-22.1 mm 2 ; 95% CI, -41.5 to -2.7). In post hoc analyses, both medications significantly reduced VAS LBP in participants with milder disc degeneration and non-neuropathic pain, and denosumab reduced VAS LBP in those with type 1 MC over 6 months, compared to placebo. Adverse events were more frequent in the ZA group. These results suggests a potential therapeutic role for ZA and denosumab in MC-associated LBP. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.

[Effects of non-physical factors on neck and shoulder pain and low back pain of adolescents].

PubMed

Zhang, Yongxing; Deng, Guoying; Zhao, Sheng; Zhou, Qian; Gao, Xiang; Wang, Hang; Zhang, Zhiqing; Ju, Yaping; Wang, Roujia; Wang, Yuyuan; Zhao, Qinghua

2014-10-14

To explore the incidence of self-reported neck/shoulder pain (NSP) and lower back pain (LBP) among Chinese adolescents in Shanghai and identify the influencing factors for the incidences of these musculoskeletal disorders. A total of 3 600 students were selected from 30 high schools randomly chosen from 237 regular full-time high schools registered in Shanghai. From each school, 40 students were selected from each of the tenth, eleventh and twelfth grades for a total of 120 students per school. The questionnaire involved questions pertaining to demographic information, learning environment and exercise habits of each student. The questionnaire also contained questions regarding the amount of weight carried by each student while commuting to and from school. And it was also used to collect specific information related with the occurrence of NSP and LBP. Logistic regression was performed to analyze the potential risk factors for NSP and LBP. Among 3 600 distributed questionnaires, a total of 2 842 valid questionnaires were returned. The results revealed that the incidences of NSP and LBP in the Chinese adolescent population were 41.1% and 32.8%, respectively. Both NSP and LBP were more common in girls than in boys. And 6.3% students reported at least one NSP- or LBP-induced absence from school. Chinese adolescents generally experienced a heavy academic burden (32.7% failing to achieve daily academic goals) and mental stress (16.3% suffering from insomnia); the problem of insufficient sleep was even more pronounced (52.0% falling asleep after midnight and 64.3% suffering insufficient sleep while only 31.9% feeling physically relaxed after awaking). The multivariate Logistic regression analysis suggested that gender, grade, academic burden, stress and sleep situation had a significant correlation with NSP and LBP in adolescents. The incidences of NSP and LBP are relatively high among adolescents in Shanghai. And several factors, including sedentary behaviors, personal exercise habits and backpack weight, influences the occurrences of NSP and LBP in youth.

Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

PubMed

Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

2016-03-01

Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Pain intensity and abdominal muscle activation during walking in patients with low back pain: The STROBE study.

PubMed

Kim, Si-Hyun; Park, Kyue-Nam; Kwon, Oh-Yun

2017-10-01

Nonspecific low back pain (LBP) is a common musculoskeletal problem that is intensified during physical activity. Patients with LBP have been reported to change their abdominal muscle activity during walking; however, the effects of pain intensity, disability level, and fear-avoidance belief on this relationship have not been evaluated. Thus, we compared abdominal muscle activity in patients with LBP and asymptomatic controls, and assessed the impact of pain intensity, disability level, and fear-avoidance belief.Thirty patients with LBP divided into groups reporting low (LLBP) and high-pain intensity low back pain (HLBP), and 15 participants without LBP were recruited. LBP patients' self-reported pain intensity, disability, and fear-avoidance belief were recorded. To examine abdominal muscle activity (rectus abdominis [RA], internal [IO], and external oblique [EO] muscles) during walking, all subjects walked at a self-selected speed. Abdominal muscle activity (RA, IO, and EO) was compared among groups (LLBP, HLBP, and controls) in different phases of walking (double support vs swing). Relationships between abdominal muscle activity and clinical measures (pain intensity, disability, fear-avoidance belief) were analyzed using partial correlation analysis.Right IO muscle activity during walking was significantly decreased in LLBP and HLBP compared with controls in certain walking phase. Partial correlation coefficients showed significant correlations between fear-avoidance belief and right EO activity (r = .377, P < .05) and between disability index and left IO activity (r = .377, P < .05) in patients with LBP. No significant difference was found in abdominal muscle activity in walking between patients with LLBP and HLBP (P > .05).This study demonstrated decreased IO muscle activity during certain walking phases in LLBP and HLBP compared with asymptomatic participants. Although altered IO muscle activity during walking was observed in patients with LBP, no changes were found with other abdominal muscles (EO, RA). Thus, these results provide useful information about abdominal muscle activity during walking in patients with LBP.

The serial message-passing schedule for LDPC decoding algorithms

NASA Astrophysics Data System (ADS)

Liu, Mingshan; Liu, Shanshan; Zhou, Yuan; Jiang, Xue

2015-12-01

The conventional message-passing schedule for LDPC decoding algorithms is the so-called flooding schedule. It has the disadvantage that the updated messages cannot be used until next iteration, thus reducing the convergence speed . In this case, the Layered Decoding algorithm (LBP) based on serial message-passing schedule is proposed. In this paper the decoding principle of LBP algorithm is briefly introduced, and then proposed its two improved algorithms, the grouped serial decoding algorithm (Grouped LBP) and the semi-serial decoding algorithm .They can improve LBP algorithm's decoding speed while maintaining a good decoding performance.

Time-varying surface electromyography topography as a prognostic tool for chronic low back pain rehabilitation.

PubMed

Hu, Yong; Kwok, Jerry Weilun; Tse, Jessica Yuk-Hang; Luk, Keith Dip-Kei

2014-06-01

Nonsurgical rehabilitation therapy is a commonly used strategy to treat chronic low back pain (LBP). The selection of the most appropriate therapeutic options is still a big challenge in clinical practices. Surface electromyography (sEMG) topography has been proposed to be an objective assessment of LBP rehabilitation. The quantitative analysis of dynamic sEMG would provide an objective tool of prognosis for LBP rehabilitation. To evaluate the prognostic value of quantitative sEMG topographic analysis and to verify the accuracy of the performance of proposed time-varying topographic parameters for identifying the patients who have better response toward the rehabilitation program. A retrospective study of consecutive patients. Thirty-eight patients with chronic nonspecific LBP and 43 healthy subjects. The accuracy of the time-varying quantitative sEMG topographic analysis for monitoring LBP rehabilitation progress was determined by calculating the corresponding receiver-operating characteristic (ROC) curves. Physiologic measure was the sEMG during lumbar flexion and extension. Patients who suffered from chronic nonspecific LBP without the history of back surgery and any medical conditions causing acute exacerbation of LBP during the clinical test were enlisted to perform the clinical test during the 12-week physiotherapy (PT) treatment. Low back pain patients were classified into two groups: "responding" and "nonresponding" based on the clinical assessment. The responding group referred to the LBP patients who began to recover after the PT treatment, whereas the nonresponding group referred to some LBP patients who did not recover or got worse after the treatment. The results of the time-varying analysis in the responding group were compared with those in the nonresponding group. In addition, the accuracy of the analysis was analyzed through ROC curves. The time-varying analysis showed discrepancies in the root-mean-square difference (RMSD) parameters between the responding and nonresponding groups. The relative area (RA) and relative width (RW) of RMSD at flexion and extension in the responding group were significantly lower than those in the nonresponding group (p<.05). The areas under the ROC curve of RA and RW of RMSD at flexion and extension were greater than 0.7 and were statistically significant. The quantitative time-varying analysis of sEMG topography showed significant difference between the healthy and LBP groups. The discrepancies in quantitative dynamic sEMG topography of LBP group from normal group, in terms of RA and RW of RMSD at flexion and extension, were able to identify those LBP subjects who would respond to a conservative rehabilitation program focused on functional restoration of lumbar muscle. Copyright © 2014 Elsevier Inc. All rights reserved.

Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009)

PubMed Central

George, Steven Z; Childs, John D; Teyhen, Deydre S; Wu, Samuel S; Wright, Alison C; Dugan, Jessica L; Robinson, Michael E

2007-01-01

Background There are few effective strategies reported for the primary prevention of low back pain (LBP). Core stabilization exercises targeting the deep abdominal and trunk musculature and psychosocial education programs addressing patient beliefs and coping styles represent the current best evidence for secondary prevention of low back pain. However, these programs have not been widely tested to determine if they are effective at preventing the primary onset and/or severity of LBP. The purpose of this cluster randomized clinical trial is to determine if a combined core stabilization exercise and education program is effective in preventing the onset and/or severity of LBP. The effect of the combined program will be compared to three other standard programs. Methods/Design Consecutive Soldiers participating in advanced individual training (AIT) will be screened for eligibility requirements and consented to study participation, as appropriate. Companies of Soldiers will be randomly assigned to receive the following standard prevention programs; a core stabilization exercise program (CSEP) alone, a CSEP with a psychosocial education (PSEP), a traditional exercise (TEP), or a TEP with a PSEP. Proximal outcome measures will be assessed at the conclusion of AIT (a 12 week training period) and include imaging of deep lumbar musculature using real-time ultrasound imaging and beliefs about LBP by self-report questionnaire. We are hypothesizing that Soldiers receiving the CSEP will have improved thickness of selected deep lumbar musculature (transversus abdominus, multifidi, and erector spinae muscles). We are also hypothesizing that Soldiers receiving the PSEP will have improved beliefs about the management of LBP. After AIT, Soldiers will be followed monthly to measure the distal outcomes of LBP occurrence and severity. This information will be collected during the subsequent 2 years following completion of AIT using a web-based data entry system. Soldiers will receive a monthly email that queries whether any LBP was experienced in the previous calendar month. Soldiers reporting LBP will enter episode-specific data related to pain intensity, pain-related disability, fear-avoidance beliefs, and pain catastrophizing. We are hypothesizing that Soldiers receiving the CSEP and PSEP will report the longest duration to first episode of LBP, the lowest frequency of LBP, and the lowest severity of LBP episodes. Statistical comparisons will be made between each of the randomly assigned prevention programs to test our hypotheses related to determining which of the 4 programs is most effective. Discussion We have presented the design and protocol for the POLM trial. Completion of this trial will provide important information on how to effectively train Soldiers for the prevention of LBP. Trial registration NCT00373009 PMID:17868436

Neuromuscular ultrasound imaging in low back pain patients with radiculopathy.

PubMed

Frost, Lydia R; Brown, Stephen H M

2016-02-01

Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. To expand neuromuscular research of LBP-R patients into the lower limb, using ultrasound imaging. Case control study comparing LBP-R patients to matched healthy controls. LBP-R patients with disc bulge or herniation (L3/L4 to L5/S1) resulting in unilateral radiculopathy (n = 17) and healthy matched controls (n = 17) were recruited. High-resolution ultrasound imaging was used to investigate sciatic nerve structure, as well as the quality (relative magnitude of fat/fibrosis infiltration) and contraction (muscle thickening) of associated musculature in the lower back (paraspinals) and lower limb (biceps femoris, gastrocnemius, soleus). LBP-R patients had swollen sciatic nerves (increased cross sectional area), but this was not associated with evidence of reduced lower limb muscle quality. As compared to controls, LBP-R patients demonstrated less soleus muscle thickening during submaximal contraction; however, there were no impairments in the hamstring or lower back musculature. Ultrasound imaging was an effective method to detect sciatic nerve swelling in mild to moderately affected LBP-R patients. Nerve swelling was not associated with poorer muscle quality, nor consistently impaired muscle contraction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reliability of plasma lipopolysaccharide-binding protein (LBP) from repeated measures in healthy adults.

PubMed

Citronberg, Jessica S; Wilkens, Lynne R; Lim, Unhee; Hullar, Meredith A J; White, Emily; Newcomb, Polly A; Le Marchand, Loïc; Lampe, Johanna W

2016-09-01

Plasma lipopolysaccharide-binding protein (LBP), a measure of internal exposure to bacterial lipopolysaccharide, has been associated with several chronic conditions and may be a marker of chronic inflammation; however, no studies have examined the reliability of this biomarker in a healthy population. We examined the temporal reliability of LBP measured in archived samples from participants in two studies. In Study one, 60 healthy participants had blood drawn at two time points: baseline and follow-up (either three, six, or nine months). In Study two, 24 individuals had blood drawn three to four times over a seven-month period. We measured LBP in archived plasma by ELISA. Test-retest reliability was estimated by calculating the intraclass correlation coefficient (ICC). Plasma LBP concentrations showed moderate reliability in Study one (ICC 0.60, 95 % CI 0.43-0.75) and Study two (ICC 0.46, 95 % CI 0.26-0.69). Restricting the follow-up period improved reliability. In Study one, the reliability of LBP over a three-month period was 0.68 (95 % CI: 0.41-0.87). In Study two, the ICC of samples taken ≤seven days apart was 0.61 (95 % CI 0.29-0.86). Plasma LBP concentrations demonstrated moderate test-retest reliability in healthy individuals with reliability improving over a shorter follow-up period.

Effective physical treatment for chronic low back pain.

PubMed

Maher, C G

2004-01-01

It is now feasible to adopt an evidence-based approach when providing physical treatment for patients with chronic LBP. A summary of the efficacy of a range of physical treatments is provided in Table 1. The evidence-based primary care options are exercise, laser, massage, and spinal manipulation; however, the latter three have small or transient effects that limit their value as therapies for chronic LBP. In contrast, exercise produces large reductions in pain and disability, a feature that suggests that exercise should play a major role in the management of chronic LBP. Physical treatments, such as acupuncture, backschool, hydrotherapy, lumbar supports, magnets, TENS, traction, ultrasound, Pilates therapy, Feldenkrais therapy, Alexander technique, and craniosacral therapy are either of unknown value or ineffective and so should not be considered. Outside of primary care, multidisciplinary treatment or functional restoration is effective; however, the high cost probably means that these programs should be reserved for patients who do not respond to cheaper treatment options for chronic LBP. Although there are now effective treatment options for chronic LBP, it needs to be acknowledged that the problem of chronic LBP is far from solved. Though treatments can provide marked improvements in the patient's condition, the available evidence suggests that the typical chronic LBP patient is left with some residual pain and disability. Developing new, more powerful treatments and refining the current group of known effective treatments is the challenge for the future.

Changes in muscle activation patterns and subjective low back pain ratings during prolonged standing in response to an exercise intervention.

PubMed

Nelson-Wong, Erika; Callaghan, Jack P

2010-12-01

Low back pain (LBP) development has been associated with occupational standing. Increased hip and trunk muscle co-activation is considered to be predisposing for LBP development during standing in previously asymptomatic individuals. The purpose of this work was to investigate muscle activation and LBP responses to a prescribed exercise program. Pain-developing (PD) individuals were expected to have decreased LBP and muscle co-activation following exercise intervention. Electromyography (EMG) data were recorded from trunk and hip muscle groups during 2-h of standing. An increase of >10mm on visual analog scale (VAS) during standing was threshold for PD categorization. Participants were assigned to progressive exercise program with weekly supervision or control (usual activity) for 4 weeks then re-tested. Forty percent were categorized as PD on day 1, VAS=24.2 (±4.0)mm. PD exercisers (PDEX) had lower VAS scores (8.93±3.66 mm) than PD control (PDCON) (16.5±6.3 mm) on day 2 (p=0.007). Male PDEX had decreased gluteus medius co-activation levels (p<0.05) on day 2. The exercise program proved beneficial in reducing LBP during standing. There were changes in muscle activation patterns previously associated with LBP. Predisposing factors for LBP during standing were shown to change positively with appropriate exercise intervention. Copyright © 2010 Elsevier Ltd. All rights reserved.

Factors influencing physiotherapists' attitudes and beliefs toward chronic low back pain: Impact of a care network belonging.

PubMed

Petit, Audrey; Begue, Cyril; Richard, Isabelle; Roquelaure, Yves

2018-03-09

To assess the attitudes and beliefs of physiotherapists (PTs) regarding the management of chronic LBP and to investigate the factors which influence them. A cross-sectional study conducted in the French Loire Valley region by a questionnaire sent to the private PTs between June and September 2014. Demographic data and modalities of practices were collected in association with the Pain Attitudes and Beliefs Scale (PABS) which is a specific self-administered questionnaire designed to assess the "biomedical" or "behavioral" (i.e., biopsychosocial) management orientation of PTs toward chronic LBP. One hundred and sixty-eight of the 704 PTs entirely completed the questionnaire (63% of men, 58% >40 years of age) of whom 15 were involved in a LBP care network. A higher biomechanical score was observed with a higher age and lower with full-time employment, less than 20 years of length of practice and a recent LBP-specific training (p < 0.005). Belonging to a LBP care network was associated with a lower biomedical score (p < 0.01) and a higher biopsychosocial score (p < 0.005). Belonging to a LBP care network, which implies closer collaboration with multidisciplinary rehabilitation teams, was the most significant factor associated with higher biopsychosocial beliefs in PTs toward chronic LBP management.

Managing Low-Back Pain: Steps To Optimize Function and Hasten Return to Activity.

ERIC Educational Resources Information Center

Drezner, Jonathan A.; Herring, Stanley A.

2001-01-01

Low-back pain (LBP) in active people is common and recurrent. This paper describes: the natural history and clinical course of LBP; anatomy and biomechanics of LBP; what causes pain; diagnosis; initial treatment (e.g., pain and inflammation control, bed rest, and exercises); rehabilitation (e.g., lumbar stabilization exercises, conditioning, and…

Lipopolysaccharide Binding Protein Enables Intestinal Epithelial Restitution Despite Lipopolysaccharide Exposure

PubMed Central

Richter, Juli M.; Schanbacher, Brandon L.; Huang, Hong; Xue, Jianjing; Bauer, John A.; Giannone, Peter J.

2011-01-01

Intestinal epithelial restitution is the first part in the process of mucosal repair after injury in the intestine. Integrity of the intestinal mucosal barrier is important as a first line of defense against bacteria and endotoxin. Necrotizing enterocolitis (NEC) is a major cause of morbidity and mortality in extremely low birth weight infants, but its mechanisms are not well defined. Abnormal bacterial colonization, immature barrier function, innate immunity activation and inflammation likely play a role. Lipopolysaccharide (LPS) binding protein (LBP) is secreted by enterocytes in response to inflammatory stimuli and has concentration-dependent effects. At basal concentrations, LBP stimulates the inflammatory response by presenting LPS to its receptor. However, at high concentrations, LBP is able to neutralize LPS and prevent an exaggerated inflammatory response. We sought to determine how LBP would affect wound healing in an in vitro model of intestinal cell restitution and protect against intestinal injury in a rodent model of NEC. Immature intestinal epithelial cells (IEC-6) were seeded in poly-l-lysine coated 8 chamber slides and grown to confluence. A 500μm wound was created using a cell scraper mounted on the microscope to achieve uniform wounding. Media was replaced with media containing LPS +/− LBP. Slide wells were imaged after 0, 8, and 24 hours and then fixed. Cellular restitution was evaluated via digital images captured on an inverted microscope and wound closure was determined by automated analysis. TLR4 was determined by rtPCR after RNA isolation from wounded cells 24 hours after treatment. LPS alone attenuated wound healing in immature intestinal epithelium. This attenuation is reversed by 24 hours with increasing concentrations of LBP so that wound healing is equivalent to control (p< 0.001). TLR4 was increased with LPS alone but levels returned to that of control after addition of LBP in the higher concentrations. LBP had no effect on the development of intestinal injury when given during our rodent model of NEC. Abnormal bacterial colonization and activation of innate immunity by LPS are likely involved in the pathogenesis of NEC. The attentuation of wound healing was reversed when LBP was added to LPS but only in the higher concentrations. At these same concentrations of LBP, TLR4 was decreased to that of control. These results indicate that LBP may be a novel therapeutic strategy to facilitate wound healing after the acute phase of NEC and other forms of intestinal injury. PMID:22002480

Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers.

PubMed

Masaki, Mitsuhiro; Aoyama, Tomoki; Murakami, Takashi; Yanase, Ko; Ji, Xiang; Tateuchi, Hiroshige; Ichihashi, Noriaki

2017-11-01

Muscle stiffness of the lumbar back muscles in low back pain (LBP) patients has not been clearly elucidated because quantitative assessment of the stiffness of individual muscles was conventionally difficult. This study aimed to examine the association of LBP with muscle stiffness assessed using ultrasonic shear wave elastography (SWE) and muscle mass of the lumbar back muscle, and spinal alignment in young and middle-aged medical workers. The study comprised 23 asymptomatic medical workers [control (CTR) group] and 9 medical workers with LBP (LBP group). Muscle stiffness and mass of the lumbar back muscles (lumbar erector spinae, multifidus, and quadratus lumborum) in the prone position were measured using ultrasonic SWE. Sagittal spinal alignment in the standing and prone positions was measured using a Spinal Mouse. The association with LBP was investigated by multiple logistic regression analysis with a forward selection method. The analysis was conducted using the shear elastic modulus and muscle thickness of the lumbar back muscles, and spinal alignment, age, body height, body weight, and sex as independent variables. Multiple logistic regression analysis showed that muscle stiffness of the lumbar multifidus muscle and body height were significant and independent determinants of LBP, but that muscle mass and spinal alignment were not. Muscle stiffness of the lumbar multifidus muscle in the LBP group was significantly higher than that in the CTR group. The results of this study suggest that LBP is associated with muscle stiffness of the lumbar multifidus muscle in young and middle-aged medical workers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Correlates of a Recent History of Disabling Low Back Pain in Community-dwelling Older Persons: The Pain in the Elderly (PAINEL) Study.

PubMed

Machado, Luciana A C; Viana, Joana U; da Silva, Sílvia L A; Couto, Flávia G P; Mendes, Liliane P; Ferreira, Paulo H; Ferreira, Manuela L; Dias, João M D; Dias, Rosângela C

2018-06-01

To investigate the correlates of a recent history of disabling low back pain (LBP) in older persons. The Pain in the Elderly (PAINEL) Study was derived from the Frailty among Brazilian Older Adults (FIBRA) Network Study. Data were collected through face-to-face/telephone interviews and clinical examination. A series of logistic regressions assessed associations between a recent history of disabling LBP and sociodemographic, physical/lifestyle, and psychological factors. Of the 378 community-dwelling elders included in the study (age±SD, 75.5±6.1), 9.3% experienced LBP that was bad enough to limit or change their daily activities during the past year. Those reporting a recent history of disabling LBP were more likely to be women and under financial strain, to present poor self-rated health, overweight, multimorbidity, low physical activity level, fatigue, depressive symptomatology/diagnosis and fear beliefs, and to report decreased sleep time, prolonged sitting time, chronic pain (in location other than lower back), and frequently recurring LBP. The multivariate logistic regression analysis indicated that overweight (odds ratio [OR], 29.6; 95% confidence interval [CI], 2.3-391.0), low physical activity level (OR, 4.4; 95% CI, 1.3-15.4), fatigue (OR, 10.3; 95% CI, 2.4-43.4), depression diagnosis (OR, 4.9; 95% CI, 1.3-18.4), and frequently recurring LBP (OR, 4.6; 95% CI, 1.0-20.1) were independently associated with a recent history of disabling LBP. Our study supports the link between disabling LBP and other age-related chronic conditions in a middle-income country with a rapidly aging population.

Discrete geometric analysis of message passing algorithm on graphs

NASA Astrophysics Data System (ADS)

Watanabe, Yusuke

2010-04-01

We often encounter probability distributions given as unnormalized products of non-negative functions. The factorization structures are represented by hypergraphs called factor graphs. Such distributions appear in various fields, including statistics, artificial intelligence, statistical physics, error correcting codes, etc. Given such a distribution, computations of marginal distributions and the normalization constant are often required. However, they are computationally intractable because of their computational costs. One successful approximation method is Loopy Belief Propagation (LBP) algorithm. The focus of this thesis is an analysis of the LBP algorithm. If the factor graph is a tree, i.e. having no cycle, the algorithm gives the exact quantities. If the factor graph has cycles, however, the LBP algorithm does not give exact results and possibly exhibits oscillatory and non-convergent behaviors. The thematic question of this thesis is "How the behaviors of the LBP algorithm are affected by the discrete geometry of the factor graph?" The primary contribution of this thesis is the discovery of a formula that establishes the relation between the LBP, the Bethe free energy and the graph zeta function. This formula provides new techniques for analysis of the LBP algorithm, connecting properties of the graph and of the LBP and the Bethe free energy. We demonstrate applications of the techniques to several problems including (non) convexity of the Bethe free energy, the uniqueness and stability of the LBP fixed point. We also discuss the loop series initiated by Chertkov and Chernyak. The loop series is a subgraph expansion of the normalization constant, or partition function, and reflects the graph geometry. We investigate theoretical natures of the series. Moreover, we show a partial connection between the loop series and the graph zeta function.

Identification of two p23 co-chaperone isoforms in Leishmania braziliensis exhibiting similar structures and Hsp90 interaction properties despite divergent stabilities.

PubMed

Batista, Fernanda A H; Almeida, Glessler S; Seraphim, Thiago V; Silva, Kelly P; Murta, Silvane M F; Barbosa, Leandro R S; Borges, Júlio C

2015-01-01

The small acidic protein called p23 acts as a co-chaperone for heat-shock protein of 90 kDa (Hsp90) during its ATPase cycle. p23 proteins inhibit Hsp90 ATPase activity and show intrinsic chaperone activity. A search for p23 in protozoa, especially trypanosomatids, led us to identify two putative proteins in the Leishmania braziliensis genome that share approximately 30% identity with each other and with the human p23. To understand the presence of two p23 isoforms in trypanosomatids, we obtained the recombinant p23 proteins of L. braziliensis (named Lbp23A and Lbp23B) and performed structural and functional studies. The recombinant proteins share similar solution structures; however, temperature- and chemical-induced unfolding experiments showed that Lbp23A is more stable than Lbp23B, suggesting that they may have different functions. Lbp23B prevented the temperature-induced aggregation of malic dehydrogenase more efficiently than did Lbp23A, whereas the two proteins had equivalent efficiencies with respect to preventing the temperature-induced aggregation of luciferase. Both proteins interacted with L. braziliensis Hsp90 (LbHsp90) and inhibited its ATPase activity, although their efficiencies differed. In vivo identification studies suggested that both proteins are present in L. braziliensis cells grown under different conditions, although Lbp23B may undergo post-translation modifications. Interaction studies indicated that both Lbp23 proteins interact with LbHsp90. Taken together, our data suggest that the two protozoa p23 isoforms act similarly when regulating Hsp90 function. However, they also have some differences, indicating that the L. braziliensis Hsp90 machine has features providing an opportunity for novel forms of selective inhibition of protozoan Hsp90. © 2014 FEBS.

Epidemiological Differences Between Localised and Non-Localised Low Back Pain

PubMed Central

Coggon, David; Ntani, Georgia; Walker-Bone, Karen; Palmer, Keith T; Felli, Vanda E; Harari, Raul; Barrero, Lope H; Felknor, Sarah A.; Gimeno, David; Cattrell, Anna; Vargas-Prada, Sergio; Bonzini, Matteo; Solidaki, Eleni; Merisalu, Eda; Habib, Rima R.; Sadeghian, Farideh; Kadir, M Masood; Warnakulasuriya, Sudath SP; Matsudaira, Ko; Nyantumbu, Busisiwe; Sim, Malcolm R; Harcombe, Helen; Cox, Ken; Sarquis, Leila M M; Marziale, Maria H; Harari, Florencia; Freire, Rocio; Harari, Natalia; Monroy, Magda V; Quintana, Leonardo A; Rojas, Marianela; Harris, E Clare; Serra, Consol; Martinez, J Miguel; Delclos, George; Benavides, Fernando G; Carugno, Michele; Ferrario, Marco M; Pesatori, Angela C; Chatzi, Leda; Bitsios, Panos; Kogevinas, Manolis; Oha, Kristel; Freimann, Tiina; Sadeghian, Ali; Peiris-John, Roshini J; Sathiakumar, Nalini; Wickremasinghe, A Rajitha; Yoshimura, Noriko; Kelsall, Helen L; Hoe, Victor C W; Urquhart, Donna M; Derrett, Sarah; McBride, David; Herbison, Peter; Gray, Andrew; Salazar Vega, Eduardo J.

2017-01-01

Study design Cross-sectional survey with longitudinal follow-up Objectives To test the hypothesis that pain which is localised to the low back differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites Summary of background data Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain. Methods We analysed data from a cohort study of musculoskeletal pain and associated disability in 47 occupational groups from 18 countries. Results Among 12,197 subjects at baseline, 609 (4.9%) reported localised LBP in the past month, and 3,820 (31.3%) non-localised LBP. Non-localised LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, non-localised LBP was differentially associated with female sex, older age, somatising tendency, poor mental health and report of time pressure at work,. There were also marked differences in the relative prevalence of localised and non-localised LBP by occupational group. Conclusions Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP which occurs in association with pain at other anatomical locations. PMID:27820794

Low back pain in a natural disaster.

PubMed

Angeletti, Chiara; Guetti, Cristiana; Ursini, Maria L; Taylor, Robert; Papola, Roberta; Petrucci, Emiliano; Ciccozzi, Alessandra; Paladini, Antonella; Marinangeli, Franco; Pergolizzi, Joseph; Varrassi, Giustino

2014-02-01

Low back pain is usually self-limited. The transition from acute to chronic LBP is influenced by physical and psychological factors. Identification of all contributing factors, in a mass emergency setting, differentiating primary and secondary life-threatening forms of LBP, is the best approach for success. Aims of the present report were to estimate the prevalence of LBP in population afferent to four advanced medical presidiums (AMPs) during postseismic emergency period and to evaluate frequency of use, types of pain killers administered to patients and short-term efficacy of them. Study was carried out in four AMPs during the first 5 weeks after the earthquake. Site, type of eventual trauma, pain intensity during LBP episode by Verbal Numerical Rating Scale (vNRS) were registered. Diagnosis of primary or secondary LBP was made on the basis of clinical features and therapeutic treatment was also analyzed. The prevalence of acute LBP was 4.9% (95%, IC 3.7 to 6.4), among 958 first accesses to AMP, representing 14.1% (95%, IC 10.8 to 18.3) of cases on the total of 322 patients treated for all pain conditions. Episodes of relapsed LBP in chronic pre-existing LBP represented the 40% (n = 19) of cases, while the first episode was present in 60% of patients (n = 28). Pain treatment was effective with a significant reduction in vNRS in short term evaluation. The emotional stress induced by natural disaster tends to heighten norepinephrine and sympathetic nervous system activity, which may further amplify nociception through peripheral or central mechanisms that result in consistent prevalence of primary NSLBP and become potential risk factor for pain chronicization. © 2013 World Institute of Pain.

The relation of social support and depression in patients with chronic low back pain.

PubMed

McKillop, Ashley B; Carroll, Linda J; Jones, C Allyson; Battié, Michele C

2017-07-01

Depression is a common condition in adults with low back pain (LBP), and is associated with poorer patient outcomes. Social support is a modifiable factor that may influence depressive symptoms in people with LBP and, if so, could be a consideration in LBP management when depression is an issue. The aim of this study was to examine social support as a prognostic factor for depressive symptoms and recovery from depression in patients with LBP. Patients with LBP (n = 483), recruited from four imaging centers in Canada, completed an initial survey following imaging and a follow-up survey one year later, including the Medical Outcomes Study (MOS) Social Support Survey and the Center for Epidemiologic Studies Depression Scale. Multivariable regression analyses were used to examine the relationship between social support and depression. More social support (overall functional social support) at baseline was associated with recovery from depression (OR = 0.24; 95% CI 0.10, 0.55) and less depressive symptoms (β = 1.68; 95% CI = 0.36, 3.00) at one-year follow-up. In addition, associations were found between specific aspects (subscales) of social support and the two depression outcomes. Functional social support as a prognostic factor for depression and possible target of LBP management warrants further investigation. Implications for Rehabilitation Depression is a common condition in adults with low back pain (LBP), and is associated with poorer patient outcomes. This study provides evidence for social support as a prognostic factor for depressive symptoms and recovery from depression in patients with LBP problems. Management of pain conditions may be enhanced by a better understanding of modifiable risk factors for depression, such as social support.

Postural strategy and trunk muscle activation during prolonged standing in chronic low back pain patients.

PubMed

Ringheim, Inge; Austein, Helene; Indahl, Aage; Roeleveld, Karin

2015-10-01

Prolonged standing has been associated with development and aggravation of low back pain (LBP). However, the underlying mechanisms are not well known. The aim of the present study was to investigate postural control and muscle activation during and as a result of prolonged standing in chronic LBP (cLBP) patients compared to healthy controls (HCs). Body weight shifts and trunk and hip muscle activity was measured during 15 min standing. Prior and after the standing trial, strength, postural sway, reposition error (RE), flexion relaxation ratio (FRR), and pain were assessed and after the prolonged standing, ratings of perceived exertion. During prolonged standing, the cLBP patients performed significantly more body weight shifts (p<.01) with more activated back and abdominal muscles (p=.01) and similar temporal variability in muscle activation compared to HCs, while the cLBP patients reported more pain and perceived exertion at the end of prolonged standing. Moreover, both groups had a similar change in strength, postural sway, RE and FRR from before to after prolonged standing, where changes in HC were towards pre-standing values of cLBP patients. Thus, despite a more variable postural strategy, the cLBP patients did not have higher muscle activation variability, but a general increased muscle activation level. This may indicate a reduced ability to individually deactivate trunk muscles. Plausibly, due to the increased variable postural strategy, the cLBP patients could compensate for the relatively high muscle activation level, resulting in normal variation in muscle activation and normal reduction in strength, RE and FRR after prolonged standing. Copyright © 2015 Elsevier B.V. All rights reserved.

Dynamic stability of the trunk during unstable sitting in people with low back pain.

PubMed

Freddolini, Marco; Strike, Siobhan; Lee, Raymond

2014-05-01

Cross-sectional study. To evaluate the dynamic stability and kinematics of the trunk during unstable sitting, and to determine the differences in these biomechanical parameters between healthy participants and participants with low back pain (LBP). Patients with LBP exhibited alterations in trunk kinematics while performing different dynamic tasks and in static posture as a result of pain. It is not clear if changing in trunk motion may reduce postural control and the ability to perform a balancing task. Twenty-three participants with LBP and 31 healthy participants were requested to sit on a custom-made swinging chair and to regain the balance after tilting the chair backward for 10° and 20°. Lumbar spine, pelvis, and chair motions were recorded using FASTRAK sensors. The thoracolumbar curvature of all participants was also evaluated in the standing position. The angular displacement of the chair was fitted in an equation describing the underdamped second-order response to a step input. Kinematic analysis showed that the hip range of motion increased whereas spine range of motion angle decreased in participants with LBP for both tilt angles (P < 0.05). There were no significant differences between the 2 subject groups in the time required to regain balance, and the natural frequency and damping ratio of the kinematic equation. Lumbar lordosis significantly decreased in LBP group. Participants with LBP showed trunk postural and movement adaptations that seems to be compensatory strategies to decrease the risk of further injuries and aggravation of the symptoms, but their ability to regain the balance was not affected by LBP. Clinicians should encourage patients with LBP to remain active while they are experiencing pain.

Prevalence and Risk Factors for Lumbar Spondylosis and Its Association with Low Back Pain among Rural Korean Residents.

PubMed

Lee, Sung Yeon; Cho, Nam H; Jung, Young Ok; Seo, Young Il; Kim, Hyun Ah

2017-01-01

The purpose of this study was to investigate the prevalence of and the relevant risk factors for lumbar spondylosis (LS) among middle-aged and elderly rural Korean residents and to explore the association between radiographic LS and lower back pain (LBP) in relation to age and gender. This community-based, cross-sectional study evaluated 1512 subjects with available radiograph. The prevalence of LBP was obtained using a questionnaire and disability resulting from LBP was measured using a validated Korean version of the Oswestry disability index (ODI). In lumbar spine radiographs, vertebral levels from L1/2 to L4/5 were evaluated for the presence of osteophytes and joint-space narrowing (JSN), and Kellgren-Lawrence (KL) grading was applied. Of 4261 subjects aged 40-79 years, data from 1512 subjects were included. The prevalence of radiographic LS indicated by grade ≥2 osteophytes and JSN were 53.9 and 15.8%, respectively. Seventy-three percent of subjects had KL grade ≥2 spondylosis and LBP was present in 36.5% of subjects. Although LS was more common among males, the prevalence of LBP was higher among females. Age, male gender and history of hand or knee arthritis were risk factors for LS. LS was significantly associated with LBP mostly among females over 60 years old and correlated with the ODI after adjusting for age and gender. Our study among rural Korean residents revealed a high prevalence of LS and LBP. The association between LS and LBP was observed mostly among females and LS was significantly correlated with the severity of back pain.

Association between Hypertension and the Prevalence of Low Back Pain and Osteoarthritis in Koreans: A Cross-Sectional Study

PubMed Central

Bae, Young-Hyeon; Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Park, Ki Byung; Cho, Jae-Heung; Ha, In-Hyuk

2015-01-01

Background Hypertension and musculoskeletal disorders are highly prevalent in adult populations. The objective of this study was to investigate the association between hypertension and prevalence of low back pain (LBP) and osteoarthritis in Koreans. Methods A total 17,128 participants (age ≥20 years) who answered low back pain and osteoarthritis items in the 4th Korean National Health and Nutrition Examination Survey (2007–2009) were analyzed. Odds ratios were calculated using logistic regression and were adjusted for age, sex, income level, education, occupation, BMI, smoking status, alcohol consumption, and physical activity. Results Lifetime prevalence of LBP in hypertensive subjects was 34.4%, and that of osteoarthritis 26.2%. LBP prevalence was significantly lower in hypertensives (fully adjusted OR 0.79; 95% CI 0.70–0.90), and both LBP and osteoarthritis prevalence was significantly lower in participants with systolic blood pressure ≥140mmHg than those with <120mmHg (fully adjusted OR 0.81; 95% CI 0.70–0.94, and 0.81; 95% CI 0.68–0.96, respectively). Prevalence of LBP in subjects with diastolic blood pressure ≥90mmHg was also significantly lower than those with <80mmHg (fully adjusted OR 0.73; 95% CI 0.63–0.85). LBP and osteoarthritis prevalence did not differ by systolic or diastolic blood pressure interval in respondents taking antihypertensive medication. LBP and osteoarthritis prevalence increased with longer hypertension duration (fully adjusted p for trend 0.028, and 0.0008, respectively). Conclusions Hypertension showed an inverse relationship with LBP and osteoarthritis prevalence, which may be ascribed to hypertension-associated hypalgesia, and antihypertensive medication intake and longer hypertension duration attenuated this association. PMID:26393797

The level of depression in lower back pain patient at outpatient of neurology Haji Adam Malik hospital Medan (RS HAM

NASA Astrophysics Data System (ADS)

Pardosi, M. C.; Loebis’, B.; Husada, M. S.

2018-03-01

The incidence of Lower Back Pain (LBP) in Indonesia is unclear. Various data in some developing countries stated that the LBP incidence is approximately 15% - 20% of the population. Because there is the unclear incidence of psychological symptoms such as depression on LBP, the researchers were interested in doing this research. A descriptive study was conducted to know the level of depression of patients with LBP in outpatient of neurology RS HAM Medan. Patients with LBP (n=78) in outpatient were examined BDI-II. The minimum depression was 47.44% (n=37), mild depression was 21.79% (n=17), moderate depression was 21.79% (n=17), severe depression was 8.98% (n=7). In conclusion, the level of depression in lower back pain patient at outpatient of neurology Haji Adam Malik Hospital Medan is higher at minimum depression.

Structural equation modelling of lower back pain due to whole-body vibration exposure in the construction industry.

PubMed

Vitharana, Vitharanage Hashini Paramitha; Chinda, Thanwadee

2017-09-21

Whole-body vibration (WBV) exposure is a health hazard among workers, causing lower back pain (LBP) in the construction industry. This study examines key factors affecting LBP due to WBV exposure using exploratory factor analysis and structural equation modelling. The results confirm five key factors (equipment, job related, organizational, personal, social context) with their 17 associated items. The organizational factor is found the most important, as it influences the other four factors. The results also show that appropriate seat type, specific training programme, job rotation, workers' satisfaction and workers' physical condition are crucial in reducing LBP due to WBV exposure. Moreover, provision of new machines without proper training and good working condition might not help reduce LBP due to WBV exposure. The results help the construction companies to better understand key factors affecting LBP due to WBV exposure, and to plan for a better health improvement programme.

Context-Aware Local Binary Feature Learning for Face Recognition.

PubMed

Duan, Yueqi; Lu, Jiwen; Feng, Jianjiang; Zhou, Jie

2018-05-01

In this paper, we propose a context-aware local binary feature learning (CA-LBFL) method for face recognition. Unlike existing learning-based local face descriptors such as discriminant face descriptor (DFD) and compact binary face descriptor (CBFD) which learn each feature code individually, our CA-LBFL exploits the contextual information of adjacent bits by constraining the number of shifts from different binary bits, so that more robust information can be exploited for face representation. Given a face image, we first extract pixel difference vectors (PDV) in local patches, and learn a discriminative mapping in an unsupervised manner to project each pixel difference vector into a context-aware binary vector. Then, we perform clustering on the learned binary codes to construct a codebook, and extract a histogram feature for each face image with the learned codebook as the final representation. In order to exploit local information from different scales, we propose a context-aware local binary multi-scale feature learning (CA-LBMFL) method to jointly learn multiple projection matrices for face representation. To make the proposed methods applicable for heterogeneous face recognition, we present a coupled CA-LBFL (C-CA-LBFL) method and a coupled CA-LBMFL (C-CA-LBMFL) method to reduce the modality gap of corresponding heterogeneous faces in the feature level, respectively. Extensive experimental results on four widely used face datasets clearly show that our methods outperform most state-of-the-art face descriptors.

Factors influencing loblolly pine stand health in Fort Benning, Georgia, USA

Treesearch

Soung Ryoul Ryu; G. Geoff Wang; Joan L. Walker

2013-01-01

Loblolly pine (LBP; Pinus taeda L.) stands provide two-thirds of the existing federally protected red-cockaded woodpecker (RCW; Picoides borealis) habitat in Fort Benning, Georgia, USA. However, LBP in this area is suspected to face a forest decline issue, which may risk the sustainability of the RCW population. Land managers are attempting to convert LBP stands to...

Policy analysis of the budget used in training program for reducing lower back pain among heavy equipment operators in the construction industry: System dynamics approach

NASA Astrophysics Data System (ADS)

Vitharana, V. H. P.; Chinda, T.

2018-04-01

Lower back pain (LBP), prevalence is high among the heavy equipment operators leading to high compensation cost in the construction industry. It is found that proper training program assists in reducing chances of having LBP. This study, therefore aims to examine different safety related budget available to support LBP related training program for different age group workers, utilizing system dynamics modeling approach. The simulation results show that at least 2.5% of the total budget must be allocated in the safety and health budget to reduce the chances of having LBP cases.

Lycium barbarum Polysaccharide Promotes Nigrostriatal Dopamine Function by Modulating PTEN/AKT/mTOR Pathway in a Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) Murine Model of Parkinson's Disease.

PubMed

Wang, Xiaohong; Pang, Lei; Zhang, Yanqing; Xu, Jiang; Ding, Dongyi; Yang, Tianli; Zhao, Qian; Wu, Fan; Li, Fei; Meng, Haiwei; Yu, Duonan

2018-04-01

To investigate the effects of Lycium barbarum polysaccharide (LBP) on pathological symptoms and behavioral deficits in a Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease (PD) mouse model. The therapeutic effects of LBP were monitored with an Open field test, a Rotarod test and a Morris water maze test. We also investigated the mechanisms with qRT-PCR and Western blotting analyses. After a relatively short-term LBP treatment, the total distance and walking time of PD mice significantly increased. The staying duration on the rod of PD mice increased in the Rotarod test. LBP can up-regulate levels of SOD2, CAT and GPX1 and inhibit the abnormal aggregation of α-synuclein induced by MPTP. LBP treatment can also up-regulate the phosphorylation of AKT and mTOR, and may play its protective role by activating the PTEN/AKT/mTOR signaling axis. These results suggest that LBP can effectively alleviate the degeneration in the nigrostriatal system induced by MPTP treatment. It may be a potential candidate for the treatment of Parkinson's disease.

High-mobility group box-1 protein, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in children with community acquired infections and bacteraemia: a prospective study.

PubMed

Pavare, Jana; Grope, Ilze; Kalnins, Imants; Gardovska, Dace

2010-02-16

Even though sepsis is one of the common causes of children morbidity and mortality, specific inflammatory markers for identifying sepsis are less studied in children. The main aim of this study was to compare the levels of high-mobility group box-1 protein (HMGB1), Lipopolysaccharide-binding protein (LBP), Interleukin-6 (IL-6) and C-reactive protein (CRP) between infected children without systemic inflammatory response syndrome (SIRS) and children with severe and less severe sepsis. The second aim was to examine HMGB1, LBP, IL6 and CRP as markers for of bacteraemia. Totally, 140 children with suspected or proven infections admitted to the Children's Clinical University Hospital of Latvia during 2008 and 2009 were included. Clinical and demographical information as well as infection focus were assessed in all patients. HMGB1, LBP, IL-6 and CRP blood samples were determined. Children with suspected or diagnosed infections were categorized into three groups of severity of infection: (i) infected without SIRS (n = 36), (ii) sepsis (n = 91) and, (iii) severe sepsis (n = 13). They were furthermore classified according bacteraemia into (i) bacteremia (n = 30) and (ii) no bacteraemia (n = 74). There was no statistically significant difference in HMGB1 levels between children with different levels of sepsis or with and without bacteraemia. The levels of LBP, IL-6 and CRP were statistically significantly higher among patients with sepsis compared to those infected but without SIRS (p < 0.001). Furthermore, LBP, IL-6 and CRP were significantly higher in children with severe sepsis compared to those ones with less severe sepsis (p < 0.001). Median values of LBP, IL6 and CRP were significantly higher in children with bacteraemia compared to those without bacteraemia. The area under the receiver operating curve (ROC) for detecting bacteraemia was 0.87 for both IL6 and CRP and 0.82 for LBP, respectively. Elevated levels of LBP, IL-6 and CRP were associated with a more severe level of infection in children. Whereas LBP, IL-6 and CRP seem to be good markers to detect patients with bacteraemia, HMGB1 seem to be of minor importance. LBP, IL-6 and CRP levels may serve as good biomarkers for identifying children with severe sepsis and bacteraemia and, thus, may be routinely used in clinical practice.

Psychosocial Risk Factors, Interventions, and Comorbidity in Patients with Non-Specific Low Back Pain in Primary Care: Need for Comprehensive and Patient-Centered Care

PubMed Central

Ramond-Roquin, Aline; Bouton, Céline; Bègue, Cyril; Petit, Audrey; Roquelaure, Yves; Huez, Jean-François

2015-01-01

Non-specific low back pain (LBP) affects many people and has major socio-economic consequences. Traditional therapeutic strategies, mainly focused on biomechanical factors, have had moderate and short-term impact. Certain psychosocial factors have been linked to poor prognosis of LBP and they are increasingly considered as promising targets for management of LBP. Primary health care providers (HCPs) are involved in most of the management of people with LBP and they are skilled in providing comprehensive care, including consideration of psychosocial dimensions. This review aims to discuss three pieces of recent research focusing on psychosocial issues in LBP patients in primary care. In the first systematic review, the patients’ or HCPs’ overall judgment about the likely evolution of LBP was the factor most strongly linked to poor outcome, with predictive validity similar to that of multidimensional scales. This result may be explained by the implicit aggregation of many prognostic factors underlying this judgment and suggests the relevance of considering the patients from biopsychosocial and longitudinal points of view. The second review showed that most of the interventions targeting psychosocial factors in LBP in primary care have to date focused on the cognitive-behavioral factors, resulting in little impact. It is unlikely that any intervention focusing on a single factor would ever fit the needs of most patients; interventions targeting determinants from several fields (mainly psychosocial, biomechanical, and occupational) may be more relevant. Should multiple stakeholders be involved in such interventions, enhanced interprofessional collaboration would be critical to ensure the delivery of coordinated care. Finally, in the third study, the prevalence of psychosocial comorbidity in chronic LBP patients was not found to be significantly higher than in other patients consulting in primary care. Rather than specifically screening for psychosocial conditions, this suggests taking into account any potential comorbidity in patients with chronic LBP, as in other patients. All these results support the adoption of a more comprehensive and patient-centered approach when dealing with patients with LBP in primary care. As this condition is illustrative of many situations encountered in primary care, the strategies proposed here may benefit most patients consulting in this setting. PMID:26501062

Pain intensity attenuates movement control of the lumbar spine in low back pain.

PubMed

Bauer, C M; Rast, F M; Ernst, M J; Oetiker, S; Meichtry, A; Kool, J; Rissanen, S M; Suni, J H; Kankaanpää, M

2015-12-01

Pain intensity attenuates muscular activity, proprioception, and tactile acuity, with consequent changes of joint kinematics. People suffering from low back pain (LBP) frequently show movement control impairments of the lumbar spine in sagittal plane. This cross-sectional, observational study investigated if the intensity of LBP attenuates lumbar movement control. The hypothesis was that lumbar movement control becomes more limited with increased pain intensity. The effect of LBP intensity, measured with a numeric rating scale (NRS), on lumbar movement control was tested using three movement control tests. The lumbar range of motion (ROM), the ratio of lumbar and hip ROM as indicators of direction specific movement control, and the recurrence and determinism of repetitive lumbar movement patterns were assessed in ninety-four persons suffering from LBP of different intensity and measured with an inertial measurement unit system. Generalized linear models were fitted for each outcome. Lumbar ROM (+ 0.03°, p = 0.24) and ratio of lumbar and hip ROM (0.01, p = 0.84) were unaffected by LBP intensity. Each one point increase on the NRS resulted in a decrease of recurrence and determinism of lumbar movement patterns (-3.11 to -0.06, p ⩽ 0.05). Our results indicate changes in movement control in people suffering from LBP. Whether decreased recurrence and determinism of lumbar movement patterns are intensifiers of LBP intensity or a consequence thereof should be addressed in a future prospective study. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lactoferrin binding protein B – a bi-functional bacterial receptor protein

PubMed Central

Ostan, Nicholas K. H.; Yu, Rong-Hua; Ng, Dixon; Lai, Christine Chieh-Lin; Sarpe, Vladimir; Schriemer, David C.

2017-01-01

Lactoferrin binding protein B (LbpB) is a bi-lobed outer membrane-bound lipoprotein that comprises part of the lactoferrin (Lf) receptor complex in Neisseria meningitidis and other Gram-negative pathogens. Recent studies have demonstrated that LbpB plays a role in protecting the bacteria from cationic antimicrobial peptides due to large regions rich in anionic residues in the C-terminal lobe. Relative to its homolog, transferrin-binding protein B (TbpB), there currently is little evidence for its role in iron acquisition and relatively little structural and biophysical information on its interaction with Lf. In this study, a combination of crosslinking and deuterium exchange coupled to mass spectrometry, information-driven computational docking, bio-layer interferometry, and site-directed mutagenesis was used to probe LbpB:hLf complexes. The formation of a 1:1 complex of iron-loaded Lf and LbpB involves an interaction between the Lf C-lobe and LbpB N-lobe, comparable to TbpB, consistent with a potential role in iron acquisition. The Lf N-lobe is also capable of binding to negatively charged regions of the LbpB C-lobe and possibly other sites such that a variety of higher order complexes are formed. Our results are consistent with LbpB serving dual roles focused primarily on iron acquisition when exposed to limited levels of iron-loaded Lf on the mucosal surface and effectively binding apo Lf when exposed to high levels at sites of inflammation. PMID:28257520

A longitudinal study of low back pain and daily vibration exposure in professional drivers.

PubMed

Bovenzi, Massimo

2010-01-01

The aim of this study was to investigate the relation between low back pain (LBP) outcomes and measures of daily exposure to whole-body vibration (WBV) in professional drivers. In a study population of 202 male drivers, who were not affected with LBP at the initial survey, LBP in terms of duration, intensity, and disability was investigated over a two-year follow-up period. Vibration measurements were made on representative samples of machines and vehicles. The following measures of daily WBV exposure were obtained: (i) 8-h energy-equivalent frequency-weighted acceleration (highest axis), A(8)(max) in ms(-2) r.m.s.; (ii) A(8)(sum) (root-sum-of-squares) in ms(-2) r.m.s.; (iii) Vibration Dose Value (highest axis), VDV(max) in ms(-1.75); (iv) VDV(sum) (root-sum-of-quads) in ms(-1.75). The cumulative incidence of LBP over the follow-up period was 38.6%. The incidence of high pain intensity and severe disability was 16.8 and 14.4%, respectively. After adjustment for several confounders, VDV(max) or VDV(sum) gave better predictions of LBP outcomes over time than A(8)(max) or A(8)(sum), respectively. Poor predictions were obtained with A(8)(max), which is the currently preferred measure of daily WBV exposure in European countries. In multivariate data analysis, physical work load was a significant predictor of LBP outcomes over the follow-up period. Perceived psychosocial work environment was not associated with LBP.

Reliability and Validity of Athletes Disability Index Questionnaire.

PubMed

Noormohammadpour, Pardis; Hosseini Khezri, Alireza; Farahbakhsh, Farzin; Mansournia, Mohammad Ali; Smuck, Matthew; Kordi, Ramin

2018-03-01

The purpose of this study was to evaluate validity and reliability of a new proposed questionnaire for assessment of functional disability in athletes with low back pain (LBP). Validity and reliability study. Elite athletes participating in different fields of sports. Participants were 165 male and female athletes (between 12 and 50 years old) with LBP. Athlete Disability Index (ADI) Questionnaire which is developed by the authors for assessing LBP-related disability in athletes, Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ). Self-reported responses were collected regarding LBP-related disability through ADI, ODI, and RDQ. The test-retest reliability was strong, and intraclass correlation value ranged between 0.74 and 0.94. The Cronbach alpha coefficient value of 0.91 (P < 0.001) demonstrated excellent internal consistency of the questionnaire. The correlation coefficient between ADI and ODI was r = 0.918 (P < 0.0001), between ADI and RDQ was r = 0.669 (P < 0.0001), and between ADI and visual analog scale was r = 0.626 (P < 0.001). According to ODI and RDQ, disability levels were mild in the large majority of subjects (91.5% and 86.0%, respectively). Alternatively, disability assessments by the ADI did not cluster at the mild level and ranged more broadly from mild to very high. The ADI is a reliable and valid instrument for assessing disability in athletes with LBP. Compared with the available LBP disability questionnaires used in the general population, ADI can more precisely stratify the disability levels of athletes due to LBP.

Does anterior trunk pain predict a different course of recovery in chronic low back pain?

PubMed

Panagopoulos, John; Hancock, Mark J; Kongsted, Alice; Hush, Julia; Kent, Peter

2014-05-01

Patient characteristics associated with the course and severity of low back pain (LBP) and disability have been the focus of extensive research, however, known characteristics do not explain much of the variance in outcomes. The relationship between anterior trunk pain (ATP) and LBP has not been explored, though mechanisms for visceral referred pain have been described. Study objectives were: (1) determine prevalence of ATP in chronic LBP patients, (2) determine whether ATP is associated with increased pain and disability in these patients, and (3) evaluate whether ATP predicts the course of pain and disability in these patients. In this study, spinal outpatient department patients mapped the distribution of their pain and patients describing pain in their chest, abdomen or groin were classified with ATP. Generalized estimating equations were performed to investigate the relationship between ATP and LBP outcomes. A total of 2974 patients were included and 19.6% of patients reported ATP. At all time points, there were significant differences in absolute pain intensity and disability in those with ATP compared with those without. The presence of ATP did not affect the clinical course of LBP outcomes. The results of this study suggest that patients who present with LBP and ATP have higher pain and disability levels than patients with localised LBP. Visceral referred pain mechanisms may help to explain some of this difference. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

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

PubMed

Yip, Y B; Ho, S C; Chan, S G

2001-11-01

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

A Feasibility Study to Assess Vibration and Sound from Zygapophyseal Joints During Motion Before and After Spinal Manipulation

PubMed Central

Cramer, Gregory D.; Budavich, Matthew; Bora, Preetam; Ross, Kim

2017-01-01

Objective This feasibility study used novel accelerometry (vibration) and microphone (sound) methods to assess crepitus originating from the lumbar spine before and after side-posture spinal manipulation (SMT). Methods This study included 5 healthy and 5 low back pain (LBP) subjects. Nine accelerometers and 1 specialized directional microphone were applied to the lumbar region, allowing assessment of crepitus. Each subject underwent full lumbar ranges of motion (ROM), bilateral lumbar SMT, and repeated full ROM. Following full ROMs the subjects received side-posture lumbar SMT on both sides by a licensed doctor of chiropractic. Accelerometer and microphone recordings were made during all pre- and post-SMT ROMs. Primary outcome was a descriptive report of crepitus prevalence (average number of crepitus events/subject). Subjects were also divided into 3 age groups for comparisons (18–25, 26–45, and 46–65 years). Results Overall, crepitus prevalence decreased pre-post SMT (average pre= 1.4 crepitus/subject vs. post= 0.9). Prevalence progressively increased from the youngest to oldest age groups (pre-SMT= 0.0, 1.67, and 2.0, respectively; and post-SMT= 0.5, 0.83, and 1.5). Prevalence was higher in LBP subjects compared to healthy (pre-SMT-LBP= 2.0, vs. pre-SMT-healthy= 0.8; post-SMT-LBP= 1.0 vs. post-SMT-healthy= 0.8), even though healthy subjects were older than LBP subjects (40.8 years vs. 27.8 years); accounting for age: pre-SMT-LBP= 2.0 vs. pre-SMT-healthy= 0.0; post-SMT-LBP= 1.0 vs. post-SMT-healthy= 0.3. Conclusions Our findings showed that a larger study is feasible. Other findings included that crepitus prevalence increased with age, was higher in LBP than healthy subjects, and overall decreased following SMT. This study showed that crepitus assessment using accelerometers has the potential of being an outcome measure/biomarker for assessing spinal joint (facet/Z joint) function during movement and the effects of LBP treatments (eg, SMT) on Z joint function. PMID:28268027

Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility.

PubMed

Tozzi, P; Bongiorno, D; Vitturini, C

2012-07-01

a) To calculate and compare a Kidney Mobility Score (KMS) in asymptomatic and Low Back Pain (LBP) individuals through real-time Ultrasound (US) investigation. b) To assess the effect of Osteopathic Fascial Manipulation (OFM), consisting of Still Technique (ST) and Fascial Unwinding (FU), on renal mobility in people with non-specific LBP. c) To evaluate 'if' and 'to what degree' pain perception may vary in patients with LBP, after OFM is applied. 101 asymptomatic people (F 30; M 71; mean age 38.9 ± 8) were evaluated by abdominal US screening. The distance between the superior renal pole of the right kidney and the ipsilateral diaphragmatic pillar was calculated in both maximal expiration (RdE) and maximal inspiration (RdI). The mean of the RdE-RdI ratios provided a Kidney Mobility Score (KMS) in the cohort of asymptomatic people. The same procedure was applied to 140 participants (F 66; M 74; mean age 39.3 ± 8) complaining of non-specific LBP: 109 of whom were randomly assigned to the Experimental group and 31 to the Control group. For both groups, a difference of RdE and RdI values was calculated (RD = RdE-RdI), before (RD-T0) and after (RD-T1) treatment was delivered, to assess the effective range of right kidney mobility. A blind assessment of each patient was carried using US screening. Both groups completed a Short-Form McGill Pain Assessment Questionnaire (SF-MPQ) on the day of recruitment (SF-MPQ T0) as well as on the third day following treatment (SF-MPQ T1). An Osteopathic assessment of the thoraco-lumbo-pelvic region to all the Experimental participants was performed, in order to identify specific areas of major myofascial tension. Each individual of the Experimental group received OFM by the same Osteopath who had previously assessed them. A sham-treatment was applied to the Control group for the equivalent amount of time. a) The factorial ANOVA test showed a significant difference (p-value < 0.05) between KMS in asymptomatic individuals (1.92 mm, Std. Dev. 1.14) compared with the findings in patients with LBP (1.52 mm, Std. Dev. 0.79). b) The ANOVA test at repeated measures showed a significant difference (p-value < 0.0001) between pre- to post-RD values of the Experimental group compared with those found in the Control. c) A significant difference (p-value < 0.0001) between pre- to post-SF-MPQ results was found in the Experimental cohort compared with those obtained in the Control. People with non-specific LBP present with a reduced range of kidney mobility compared to the findings in asymptomatic individuals. Osteopathic manipulation is shown to be an effective manual approach towards improvement of kidney mobility and reduction of pain perception over the short-term, in individuals with non-specific LBP. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effect of unilateral exercises on low back pain in an urban driver

PubMed Central

Yoo, Won-gyu

2016-01-01

[Purpose] This study aimed to develop unilateral exercises for urban drivers and investigate the effect of these exercises on low back pain (LBP). [Subject and Methods] A 40-year-old male driver, who complained of LBP on the left side at L3–5 levels, participated in this study. A two-session program was conducted, and LBP, pelvic tilt angle, and trunk range of motion were measured after each session. [Results] After the unilateral exercises, the anterior pelvic tilt angle was improved and the visual analog scale score of back pain decreased. [Conclusion] Analyzing car features and performing individual approaches are necessary in providing treatment for urban drivers with LBP. PMID:27942161

USING THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT AND REGIONAL INTERDEPENDENCE THEORY TO GUIDE TREATMENT OF AN ATHLETE WITH BACK PAIN: A CASE REPORT.

PubMed

Goshtigian, Gabriella R; Swanson, Brian T

2016-08-01

Despite the multidirectional quality of human movement, common measurement procedures used in physical therapy examination are often uni-planar and lack the ability to assess functional complexities involved in daily activities. Currently, there is no widely accepted, validated standard to assess movement quality. The Selective Functional Movement Assessment (SFMA) is one possible system to objectively assess complex functional movements. The purpose of this case report is to illustrate the application of the SFMA as a guide to the examination, evaluation, and management of a patient with non-specific low back pain (LBP). An adolescent male athlete with LBP was evaluated using the SFMA. It was determined that the patient had mobility limitations remote to the site of pain (thoracic spine and hips) which therapists hypothesized were leading to compensatory hypermobility at the lumbar spine. Guided by the SFMA, initial interventions focused on local (lumbar) symptom management, progressing to remote mobility deficits, and then addressing the local stability deficit. All movement patterns became functional/non-painful except the right upper extremity medial rotation-extension pattern. At discharge, the patient demonstrated increased soft tissue extensibility of hip musculature and joint mobility of the thoracic spine along with normalization of lumbopelvic motor control. Improvements in pain exceeded minimal clinically important differences, from 2-7/10 on a verbal analog scale at initial exam to 0-2/10 at discharge. Developing and progressing a plan of care for an otherwise healthy and active adolescent with non-specific LBP can be challenging. Human movement is a collaborative effort of muscle groups that are interdependent; the use of a movement-based assessment model can help identify weak links affecting overall function. The SFMA helped guide therapists to dysfunctional movements not seen with more conventional examination procedures. Level 4.

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.

Effects of workplace, family and cultural influences on low back pain: what opportunities exist to address social factors in general consultations?

PubMed

Shaw, William S; Campbell, Paul; Nelson, Candace C; Main, Chris J; Linton, Steven J

2013-10-01

Social factors are widely acknowledged in behavioural models of pain and pain management, but incorporating these factors into general medical consultations for low back pain (LBP) can be challenging. While there is no compelling evidence that social factors contribute to LBP onset, these factors have been shown to influence functional limitation and disability, especially the effects of organisational support in the workplace, spousal support, family conflict and social disadvantage. A number of barriers exist to address such social factors in routine medical encounters for LBP, but there is emerging evidence that improving social and organisational support may be an effective strategy to reduce the negative lifestyle consequences of LBP. For clinicians to address these factors in LBP treatment requires a clearer psychosocial framework in assessment and screening, more individualised problem-solving efforts, more patient-centred interventions involving family, peers and workplace supports and a less biomechanical and diagnostic approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

Smartphone apps for the self-management of low back pain: A systematic review.

PubMed

Machado, Gustavo C; Pinheiro, Marina B; Lee, Hopin; Ahmed, Osman H; Hendrick, Paul; Williams, Chris; Kamper, Steven J

2016-12-01

Guidelines for low back pain (LBP) often recommend the use of self-management such as unsupervised exercise, booklets, and online education. Another potentially useful way for patients to self-manage LBP is by using smartphone applications (apps). However, to date, there has been no rigorous evaluation of LBP apps and no guidance for consumers on how to select high-quality, evidence-based apps. This chapter reviews smartphone apps for the self-management of LBP and evaluates their content quality and whether they recommend evidence-based interventions. This chapter shows that generally app developers are selecting interventions that are endorsed by guidelines, although their quality is low. There are many apps available for the self-management of LBP, but their effectiveness in improving patient outcomes has not been rigorously assessed. App developers need to work closely with healthcare professionals, researchers, and patients to ensure app content is accurate, evidence based, and engaging. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment and rehabilitation of chronic low back pain in baseball: part II

PubMed Central

Wasser, Joseph G.; Zaremski, Jason L.; Herman, Daniel C.; Vincent, Heather K.

2017-01-01

Repetitive throwing and hitting motions in baseball place mechanical stresses to the lumbar spine which may cause low back pain (LBP). Pain may be due to vertebral stress reactions or insufficiency fractures, intervertebral disc degeneration or intervertebral disc herniation. Untreated chronic conditions have high potential to lead to a more significant injury such as spondylolysis. Chronic LBP increases the risk for missed playing time, early career termination and lower quality of life after retirement. Proper clinical assessment and prevention/rehabilitation of LBP in this population is thus important for performance, play time and overall long-term quality of life. This narrative review synopsizes the available evidence for assessment and rehabilitation of baseball players with LBP, including the structured rehabilitative techniques and programmes which should be administered to affected players. The state of the evidence suggests that there are deficits in identifying the optimal prevention and rehabilitation prescription components for the variety of LBP-inducing injuries in this athletic population. PMID:28128000

Assessment and rehabilitation of chronic low back pain in baseball: part II.

PubMed

Wasser, Joseph G; Zaremski, Jason L; Herman, Daniel C; Vincent, Heather K

2017-01-01

Repetitive throwing and hitting motions in baseball place mechanical stresses to the lumbar spine which may cause low back pain (LBP). Pain may be due to vertebral stress reactions or insufficiency fractures, intervertebral disc degeneration or intervertebral disc herniation. Untreated chronic conditions have high potential to lead to a more significant injury such as spondylolysis. Chronic LBP increases the risk for missed playing time, early career termination and lower quality of life after retirement. Proper clinical assessment and prevention/rehabilitation of LBP in this population is thus important for performance, play time and overall long-term quality of life. This narrative review synopsizes the available evidence for assessment and rehabilitation of baseball players with LBP, including the structured rehabilitative techniques and programmes which should be administered to affected players. The state of the evidence suggests that there are deficits in identifying the optimal prevention and rehabilitation prescription components for the variety of LBP-inducing injuries in this athletic population.

Exercise reduces C-reactive protein and improves physical function in automotive workers with low back pain.

PubMed

Kim, Sang Kook; Jung, Ilho; Kim, Jae Hee

2008-06-01

Little is known about the effect of exercise on C-reactive protein (CRP) in patients with low back pain (LBP). The aim of the study was to investigate the effects of 8-week exercise intervention on CRP and physical function in automotive workers with LBP. Thirteen male workers (40 +/- 6 years) with LBP completed an 8-week multicomponent exercise intervention program which consisted of resistance training, swimming, stretching and hiking. Serum CRP concentration and physical functions were measured at baseline and after 8-week exercise intervention. Compared to baseline, CRP levels decreased by 38% (P = 0.005), back flexibility improved, isokinetic leg strengths increased (all P < 0.05), and back strength tended to increase. The results of the present study show that CRP levels decrease with exercise in subjects with LBP and physical function improves. This suggests that exercise-related decreases in inflammation in persons with LBP are associated with improvements in physical function.

Specific flexion-related low back pain and sitting: comparison of seated discomfort on two different chairs.

PubMed

O'Keeffe, Mary; Dankaerts, Wim; O'Sullivan, Peter; O'Sullivan, Leonard; O'Sullivan, Kieran

2013-01-01

No study has examined the effectiveness of prescribing seating modifications according to the individual clinical presentation of people with low back pain (LBP). A dynamic, forward-inclined chair ('Back App') can reduce seated paraspinal muscle activation among pain-free participants. This study examined 21 participants whose LBP was specifically aggravated by prolonged sitting and was eased by standing. Low back discomfort (LBD) and overall body discomfort (OBD) were assessed every 15 min while participants sat for 1 h on both the dynamic, forward-inclined chair and a standard office chair. LBD increased significantly more (p = 0.005) on the standard office chair, with no significant difference (p = 0.178) in OBD between the chairs. The results demonstrate that, in a specific flexion-related subgroup of people with LBP, increased LBD during sitting can be minimised through modifying chair design. Mechanisms that minimise seated discomfort may be of relevance in LBP management, as part of a biopsychosocial management plan. This study examined low back discomfort (LBD) during a typing task among people with low back pain (LBP). Sitting on a dynamic, forward-inclined chair resulted in less seated LBD than sitting on a standard office chair. Further research is required to examine the long-term effectiveness of ergonomics interventions in LBP.

Low back pain media campaign: no effect on sickness behaviour.

PubMed

Werner, Erik L; Ihlebaek, Camilla; Laerum, Even; Wormgoor, Marjon E A; Indahl, Aage

2008-05-01

To evaluate the effect of a media campaign on popular beliefs about LBP, and eventual changes in sick leave, imaging examinations, and surgery. Quasi-experimental telephone survey of 1500 randomly chosen people before, during, and after a media campaign in two Norwegian counties, with residents of an adjacent county as the control group. Data on sickness absence, surgery rates for disc herniation and imaging examinations on LBP in the area were collected at the same intervals. The campaign led to a small but statistically significant shift in beliefs about LBP in the general public. In particular, beliefs about the use of X-rays, and the importance of remaining active and at work, seemed to have changed in response to the campaign messages. However, this change in attitude and understanding of the condition did not lead to any corresponding change in sickness behaviour. Although the media campaign seemed to somewhat improve beliefs about LBP in the general public, the magnitude of this was too small to produce any significant change in behaviour. A media campaign on LBP should not be limited to small areas and low-budget. A much larger investment is needed for a media campaign to have sufficient impact on public's beliefs on LBP to lead to altered sickness behaviour.

Perspectives on prevention, assessment, and rehabilitation of low back pain in WORK.

PubMed

Ravenek, Michael J; Bryson-Campbell, Mikelle M; Shaw, Lynn; Hughes, Ian D

2010-01-01

The aim of this review was to describe the low back pain (LBP) knowledge base developed in WORK and to discuss its relevance to current perspectives in the broader literature on LBP and employment. A scoping review of the literature in WORK on LBP and employment was conducted using published articles from 1990-2009. Articles were organized into geographical regions and summarized for contributions to the domains of WORK: prevention, assessment, and rehabilitation. Methodological accordance of the articles was also assessed. Fifty articles were extracted and organized into contributions from authors within North America (n=34) and outside North America (n=16). In total there were 26 prevention, 7 assessment, and 12 rehabilitation articles in this review. Five articles were also classified as 'understanding' articles. More than half of the articles retrieved employed quantitative methodology. WORK has contributed a broad realm of publications to the knowledge base on LBP and employment. Two thirds of the articles were contributed from authors within North America, with a greater emphasis on prevention. This article highlights the similarities and differences in the international knowledge base in the management of LBP in WORK. Future directions for research are elaborated drawing on current perspectives of two experts on the management of LBP.

Noninvasive optical diagnosis of low back pain with the aid of Chinese cupping procedure

NASA Astrophysics Data System (ADS)

Li, Nanxi; Li, Ting

2018-02-01

Low back pain (LBP) is a complex disease that can be cause by a variety of reasons. Now LBP has become a very common and severe disease among kinds of occupational groups with showing a younger trend. The traditional diagnosis relies on complicated imaging modalities and other dangerous and invasive methods. Noninvasive near-infrared spectroscopy (NIRS) is noninvasive and convenient, and has been successful used in point-of-care diagnosis. Here, we attempt to explore NIRS's application in in low back pain diagnosis and the effect of aid-use of Chinese cupping procedure. 13 LBP patients and 13 healthy subjects participated in NIRS measurements of concentrations of oxy- and deoxy-hemoglobins (Δ[HbO2] and Δ[Hb]) at the middle of the lumbar spine. It was showed that there was significant differences (p < 0.001) between healthy subjects and LBP patients after cupping procedure, while insignificant before cupping. Moreover, it was found that healthy subjects showed stronger responses to cupping procedure than LBP patients, with prominently higher concentration of Δ[HbO2] and Δ[Hb]. It indicates the potential of NIRS in noninvasive, measurable and straightforward monitoring/therapeutic effect evaluation of LBP with bedside and point-of-care monitoring capability.

Multivariate Classification of Structural MRI Data Detects Chronic Low Back Pain

PubMed Central

Ung, Hoameng; Brown, Justin E.; Johnson, Kevin A.; Younger, Jarred; Hush, Julia; Mackey, Sean

2014-01-01

Chronic low back pain (cLBP) has a tremendous personal and socioeconomic impact, yet the underlying pathology remains a mystery in the majority of cases. An objective measure of this condition, that augments self-report of pain, could have profound implications for diagnostic characterization and therapeutic development. Contemporary research indicates that cLBP is associated with abnormal brain structure and function. Multivariate analyses have shown potential to detect a number of neurological diseases based on structural neuroimaging. Therefore, we aimed to empirically evaluate such an approach in the detection of cLBP, with a goal to also explore the relevant neuroanatomy. We extracted brain gray matter (GM) density from magnetic resonance imaging scans of 47 patients with cLBP and 47 healthy controls. cLBP was classified with an accuracy of 76% by support vector machine analysis. Primary drivers of the classification included areas of the somatosensory, motor, and prefrontal cortices—all areas implicated in the pain experience. Differences in areas of the temporal lobe, including bordering the amygdala, medial orbital gyrus, cerebellum, and visual cortex, were also useful for the classification. Our findings suggest that cLBP is characterized by a pattern of GM changes that can have discriminative power and reflect relevant pathological brain morphology. PMID:23246778

Prognostic value of quantitative sensory testing in low back pain: a systematic review of the literature

PubMed Central

Marcuzzi, Anna; Dean, Catherine M; Wrigley, Paul J; Chakiath, Rosemary J; Hush, Julia M

2016-01-01

Quantitative sensory testing (QST) measures have recently been shown to predict outcomes in various musculoskeletal and pain conditions. The aim of this systematic review was to summarize the emerging body of evidence investigating the prognostic value of QST measures in people with low back pain (LBP). The protocol for this review was prospectively registered on the International Prospective Register of Systematic Reviews. An electronic search of six databases was conducted from inception to October 2015. Experts in the field were contacted to retrieve additional unpublished data. Studies were included if they were prospective longitudinal in design, assessed at least one QST measure in people with LBP, assessed LBP status at follow-up, and reported the association of QST data with LBP status at follow-up. Statistical pooling of results was not possible due to heterogeneity between studies. Of 6,408 references screened after duplicates removed, three studies were finally included. None of them reported a significant association between the QST measures assessed and the LBP outcome. Three areas at high risk of bias were identified which potentially compromise the validity of these results. Due to the paucity of available studies and the methodological shortcomings identified, it remains unknown whether QST measures are predictive of outcome in LBP. PMID:27660486

Prognostic value of quantitative sensory testing in low back pain: a systematic review of the literature.

PubMed

Marcuzzi, Anna; Dean, Catherine M; Wrigley, Paul J; Chakiath, Rosemary J; Hush, Julia M

2016-01-01

Quantitative sensory testing (QST) measures have recently been shown to predict outcomes in various musculoskeletal and pain conditions. The aim of this systematic review was to summarize the emerging body of evidence investigating the prognostic value of QST measures in people with low back pain (LBP). The protocol for this review was prospectively registered on the International Prospective Register of Systematic Reviews. An electronic search of six databases was conducted from inception to October 2015. Experts in the field were contacted to retrieve additional unpublished data. Studies were included if they were prospective longitudinal in design, assessed at least one QST measure in people with LBP, assessed LBP status at follow-up, and reported the association of QST data with LBP status at follow-up. Statistical pooling of results was not possible due to heterogeneity between studies. Of 6,408 references screened after duplicates removed, three studies were finally included. None of them reported a significant association between the QST measures assessed and the LBP outcome. Three areas at high risk of bias were identified which potentially compromise the validity of these results. Due to the paucity of available studies and the methodological shortcomings identified, it remains unknown whether QST measures are predictive of outcome in LBP.

Role of environmental factors and history of low back pain in sciatica symptoms among Finnish adolescents.

PubMed

Karjalainen, Ulla; Paananen, Markus; Okuloff, Annaleena; Taimela, Simo; Auvinen, Juha; Männikkö, Minna; Karppinen, Jaro

2013-06-01

Cross-sectional study in a subcohort of the 1986 Northern Finland Birth Cohort (n = 1987). To investigate the role of environmental factors and LBP history in sciatica symptoms among Finnish young adults. History of low back pain (LBP), smoking, and male sex are associated with sciatica in adult populations. The role of the environmental determinants of sciatica has not been evaluated in populations consisting of only adolescents. Sciatic symptoms and environmental exposures were elicited by a mailed questionnaire and the associations were analyzed using multinomial logistic regression. Female sex was associated with severe sciatica at 18 years (OR, 3.9; 95% confidence interval (CI), 1.6-9.3). Both reported LBP at 16 years and LBP requiring consultation of a health care professional were associated with mild sciatica at 18 years (OR, 2.5; 95% CI, 1.3-4.9; and OR, 3.8; 95% CI, 1.2-11.9). In addition, LBP at 16 years requiring consultation of a health care professional was associated with severe sciatica at 18 years (OR, 5.0; 95% CI, 1.7-15.3). Smoking, obesity, physical workload, and level of physical activity were not associated with sciatica. Females reported sciatic pain more often than males. LBP at 16 years predicted sciatica at 18 years. 2.

Are flexibility and muscle-strengthening activities associated with a higher risk of developing low back pain?

PubMed Central

Sandler, Robert D.; Sui, Xuemei; Church, Timothy S.; Fritz, Stacy L.; Beattie, Paul F.; Blair, Steven N.

2013-01-01

Objective To examine the association between participation in flexibility or muscle-strengthening activities with the development of low back pain (LBP). Design Observational cohort study. Methods The cohort included 4,610 adults, 17% female, between 20 and 81 years of age (mean 46.6, s.d. 4.96). The cohort was followed for a mean of 4.9 years for self-reported LBP. All participants reported at baseline whether they performed flexibility or muscle-strengthening activities, including specific sub-types. Results Neither general performance of flexibility or muscle-strengthening activities were associated with a higher incidence of LBP compared to those who did not perform these activities. Those who reported stretching, as a specific flexibility activity were at a higher risk of developing LBP compared with those who performed no flexibility exercises, reported calisthenic flexibility activities, or attended exercise classes. Those who reported using weight training machines, as part of muscle-strengthening activities, had a higher risk of reporting LBP, compared with those who did not perform muscle-strengthening activities or performed calisthenic or free weight activities. Conclusion In this sample, stretching or use of weight training machines is associated with increased risk of developing LBP compared to use of free weights, calisthenics or flexibility classes. PMID:23988784

Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

PubMed Central

Kazdal, Hizir; Batcik, Osman Ersagun; Ozdemir, Bulent; Senturk, Senol; Yildirim, Murat; Kazancioglu, Leyla; Sen, Ahmet; Batcik, Sule; Balik, Mehmet Sabri

2017-01-01

Study Design Retrospective. Purpose This study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia. Overview of Literature Many women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia. Methods We examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS). Results Fifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months. Conclusions Age, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results. PMID:29093782

Morphology Development During Deposition in OPV Low Band Gap Polymer:Bis-Fullerene Heterojunctions: Effect of a Second Solvent

NASA Astrophysics Data System (ADS)

Chen, Huipeng; Hsiao, Yu-Che; Hu, Bin; Dadmun, Mark

2014-03-01

Polymer based bulk-heterojunction solar cells, based on blends of conjugated polymers and fullerenes are one potential option for low cost renewable power generation. One way to improve power conversion efficiency (PCE) of this cell is to increase the open-circuit voltage (Voc) . It has been reported that replacing PCBM with bis-adduct fullerenes (i.e. ICBA) significantly improves Voc and PCE in P3HT device. However, for the most promising low band-gap polymer (LBP) system, replacing PCBM with ICBA gives very poor short-circuit current (Jsc) and PCE although Voc is significantly improved. As Jsc and PCE strongly depend on the morphology, we therefore tried to optimize the morphology of as-cast LBP/ICBA mixture by adding a second solvent with varying solubility to LBP and ICBA to the deposition solution. The results show that there is no change of LBP ordering by adding the second solvent regardless of its solubility. The morphology of all the as-cast samples is then determined by neutron scattering. A homogenous dispersion of ICBA in LBP is found in the sample where the second solvent is selective to LBP, giving poor PCE. Aggregates of ICBA are formed in those samples where the second solvent is selective to ICBA. The resultant morphology improves PCE by up to 246%. A quantitative analysis of neutron data shows that the interfacial area between ICBA aggregates and LBP/ICBA mixed phase is improved in these samples, which appears to facilitate charge transport and reduce the recombination of free charge carriers.

Neck/shoulder pain and low back pain among school teachers in China, prevalence and risk factors

PubMed Central

2012-01-01

Background School teachers represent an occupational group among which there appears to be a high prevalence of neck and/or shoulder pain (NSP) and low back pain (LBP). Epidemiological data on NSP and LBP in Chinese teachers are limited. The aim of this study was to investigate the prevalence of and risk factors for NSP and LBP among primary, secondary and high school teachers. Methods In a cross-sectional study of teachers from 7 schools, information on participant demographics, work characteristics, occupational factors and musculoskeletal symptoms and pain were collected. Results Among 893 teachers, the prevalence of NSP and LBP was 48.7% and 45.6% respectively. There was significant association between the level and prevalence of NSP and LBP among teachers in different schools. The prevalence of NSP among female teachers was much higher than that for males. Self-reported NSP was associated with physical exercise (OR 0.55, 95% CI 0.35 to 0.86), prolonged standing (1.74, 1.03 to 2.95), sitting (1.76, 1.23 to 2.52) and static posture (2.25, 1.56 to 3.24), and uncomfortable back support (1.77, 1.23 to 2.55). LBP was more consistently associated with twisting posture (1.93, 1.30 to 2.87), uncomfortable back support (1.62, 1.13 to 2.32) and prolonged sitting (1.42, 1.00 to 2.02) and static posture (1.60, 1.11 to 2.31). Conclusions NSP and LBP are common among teachers. There were strong associations with different individual, ergonomic, and occupational factors. PMID:22978655

Assessment of psychosocial risk factors for the development of non-specific chronic disabling low back pain in Japanese workers-findings from the Japan Epidemiological Research of Occupation-related Back Pain (JOB) study.

PubMed

Matsudaira, Ko; Kawaguchi, Mika; Isomura, Tatsuya; Inuzuka, Kyoko; Koga, Tadashi; Miyoshi, Kota; Konishi, Hiroaki

2015-01-01

To investigate the associations between psychosocial factors and the development of chronic disabling low back pain (LBP) in Japanese workers. A 1 yr prospective cohort of the Japan Epidemiological Research of Occupation-related Back Pain (JOB) study was used. The participants were office workers, nurses, sales/marketing personnel, and manufacturing engineers. Self-administered questionnaires were distributed twice: at baseline and 1 yr after baseline. The outcome of interest was the development of chronic disabling LBP during the 1 yr follow-up period. Incidence was calculated for the participants who experienced disabling LBP during the month prior to baseline. Logistic regression was used to assess risk factors for chronic disabling LBP. Of 5,310 participants responding at baseline (response rate: 86.5%), 3,811 completed the questionnaire at follow-up. Among 171 eligible participants who experienced disabling back pain during the month prior to baseline, 29 (17.0%) developed chronic disabling LBP during the follow-up period. Multivariate logistic regression analysis implied reward to work (not feeling rewarded, OR: 3.62, 95%CI: 1.17-11.19), anxiety (anxious, OR: 2.89, 95%CI: 0.97-8.57), and daily-life satisfaction (not satisfied, ORs: 4.14, 95%CI: 1.18-14.58) were significant. Psychosocial factors are key to the development of chronic disabling LBP in Japanese workers. Psychosocial interventions may reduce the impact of LBP in the workplace.

Efficacy of a Sleep Quality Intervention in People With Low Back Pain: Protocol for a Feasibility Randomized Co-Twin Controlled Trial.

PubMed

Pinheiro, Marina B; Ho, Kevin K; Ferreira, Manuela L; Refshauge, Kathryn M; Grunstein, Ron; Hopper, John L; Maher, Christopher G; Koes, Bart W; Ordoñana, Juan R; Ferreira, Paulo H

2016-10-01

Poor sleep quality is highly prevalent in patients with low back pain (LBP) and is associated with high levels of pain, psychological distress, and physical disability. Studies have reported a bidirectional relationship between sleep problems and intensity of LBP. Accordingly, effective management of LBP should address sleep quality. In addition, genetics has been found to significantly affect the prevalence of both LBP and insomnia. Our study aims to establish the feasibility of a trial exploring the efficacy of a web-based sleep quality intervention in people with LBP, with the genetic influences being controlled for. 30 twins (15 complete pairs) with subacute or chronic LBP (>6 weeks) will be recruited from the Australian Twin Registry. Participants will be randomly assigned to one of the two groups with each twin within a pair receiving either an interactive web-based sleep intervention based on cognitive behavioral therapy principles (intervention) or a web-based education program (control) for 6 weeks. The feasibility of the trial will be investigated with regard to recruitment rate, feasibility of data collection and outcome measure completion, contamination of intervention, acceptability and experience of intervention, and sample size requirement for the full trial. Patient outcomes will be collected electronically at baseline, immediately post-treatment, and at 3-months' follow-up post-randomization. This trial employs a robust design that will effectively control for the influence of genetics on treatment effect. Additionally, this study addresses sleep quality, a significant but under-explored issue in LBP. Results will inform the design and implementation of the definitive trial.

Low back and lower-limb muscle performance in male and female recreational runners with chronic low back pain.

PubMed

Cai, Congcong; Kong, Pui W

2015-06-01

Controlled laboratory study, cross-sectional. To compare lumbar extensor muscle fatigability, lumbar stabilizing muscle activation, and lower-limb strength between male and female runners with chronic low back pain (LBP) and healthy runners. Little is known about muscle performance in runners with chronic LBP. Eighteen recreational runners with chronic LBP (9 men, 9 women; mean age, 27.8 years) and 18 healthy recreational runners (9 men, 9 women; mean age, 24.6 years) were recruited. The median frequency slopes for bilateral iliocostalis and longissimus were calculated from electromyographic signals captured during a 2-minute Sorensen test. The thickness changes of the transversus abdominis and lumbar multifidus between resting and contraction were measured using an ultrasound scanner. Peak concentric torques of the bilateral hip extensors, hip abductors, and knee extensors were measured using an isokinetic dynamometer at 60°/s. The average values for both sides were used for statistical analysis. When averaged across sexes, peak knee extensor torque was 12.2% lower in the LBP group compared to the healthy group (mean difference, 0.29 Nm/kg; 95% confidence interval: 0.06, 0.53; P = .016). Male runners with chronic LBP exhibited smaller lumbar multifidus thickness changes compared to healthy male runners (mean difference, 0.13 cm; 95% confidence interval: 0.01, 0.25; P = .033). No other group differences were observed. Runners with chronic LBP exhibited diminished knee extensor strength compared to healthy runners. Male runners with chronic LBP demonstrated additional deficits in lumbar multifidus activation.

Practice patterns when treating patients with low back pain: a survey of physical therapists.

PubMed

Davies, Claire; Nitz, Arthur J; Mattacola, Carl G; Kitzman, Patrick; Howell, Dana; Viele, Kert; Baxter, David; Brockopp, Dorothy

2014-08-01

Low back pain (LBP), is a common musculoskeletal problem, affecting 75-85% of adults in their lifetime. Direct costs of LBP in the USA were estimated over 85 billion dollars in 2005 resulting in a significant economic burden for the healthcare system. LBP classification systems and outcome measures are available to guide physical therapy assessments and intervention. However, little is known about which, if any, physical therapists use in clinical practice. The purpose of this study was to identify the use of and barriers to LBP classification systems and outcome measures among physical therapists in one state. A mixed methods study using a cross-sectional cohort design with descriptive qualitative methods was performed. A survey collected both quantitative and qualitative data relevant to classification systems and outcome measures used by physical therapists working with patients with LBP. Physical therapists responded using classification systems designed to direct treatment predominantly. The McKenzie method was the most frequent approach to classify LBP. Barriers to use of classification systems and outcome measures were lack of knowledge, too limiting and time. Classification systems are being used for decision-making in physical therapy practice for patients with LBP. Lack of knowledge and training seems to be the main barrier to the use of classification systems in practice. The Oswestry Disability Index and Numerical Pain Scale were the most commonly used outcome measures. The main barrier to their use was lack of time. Continuing education and reading the literature were identified as important tools to teach evidence-based practice to physical therapists in practice.

Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study.

PubMed

Harreby, M; Nygaard, B; Jessen, T; Larsen, E; Storr-Paulsen, A; Lindahl, A; Fisker, I; Laegaard, E

1999-01-01

This study was designed as a cross-sectional questionnaire-based survey of low back pain (LBP) in 13- to 16-year-old Danish school children. The cohort consisted of 671 boys and 718 girls in eighth and ninth grade in 46 municipal schools in three counties of Sealand. All the pupils filled in a questionnaire with LBP as the main topic and were at the same time examined by the school doctors. The first part of the questionnaire contained questions about leisure time sports activity, TV watching, PC use, job in leisure time and smoking. The second part dealt with LBP in relation to frequency and severity, influence on daily living and use of the health system. The school doctor measured body height and weight, (BMI), degree of hypermobility and the tightness of the hamstring muscles. The results showed a cumulative life-time prevalence of LBP of 58.9%, a 1-year prevalence of 50.8% and an increase in LBP prevalence of 6.4% from 14 to 15 years of age, independent of gender. Fourteen percent (141 F, 54 M) fulfilled the criteria for general hypermobility and 12.2% (45 F, 124 M) had tightness of hamstring muscles of more than 40 degrees. Recurrent/continuous LBP in a moderate to severe degree was recorded in 19.4% of children (182 F, 88 M). This was positively correlated to female gender, BMI more than 25 kg/m(2), competitive sport for boys, poor physical fitness, daily smoking, heavy jobs in leisure time, increased use of the health system and reduced life quality. Stepwise logistic regression analysis indicates that female gender, daily smoking and heavy jobs are important associated factors for severe LBP in adolescents, with an observed probability of 46% if all factors are present. We don't know yet whether these factors are of any causal importance in the development of severe LBP.

A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong.

PubMed

Yip, Y

2001-12-01

Low back pain (LBP) remains a common and costly problem among the nursing profession. Several studies have indicated that LBP is attributed to mentally straining or demanding work, fatigue or exhaustion or general work satisfaction. This study aims to measure the magnitude of LBP among Hong Kong nurses and its association with the work-related psychological strain and patients handling activities. RESEARCH METHODS AND MEASURES: A cross-sectional study of Hong Kong hospital nurses was conducted. Three hundred and seventy-seven nurses were recruited from six district hospitals. They were registered nurses or enrolled nurses working full-time for at least 1 month in the current ward. One hundred and seventy-eight (47.2%) study subjects were randomly selected from two district hospitals and 199 (52.8%) study nurses made up the convenience sample. Possible bias from psychological distress, socio-demographics and lifestyle factors was controlled for. Data were collected by face-to-face interviews. The data included work factors (both psychological stress and patient handling activities related to work), demographics, psychological distress and lifestyle factors and the occurrence of LBP. Of the 377 nurses interviewed, 153 (40.6%) reported having LBP within the last 12 months. With symptoms of LBP as the outcome, risks were increased where nurses self-reported that they only occasionally or never enjoyed their work [adjusted odds ratio (OR) 2.07], where frequent manual repositioning of patients on the bed was required (adjusted OR 1.84) and where they were required to assist patients while walking (adjusted OR 2.11) after adjustment for other potential confounders. The results indicate that an association exists between work stress, manual lifting and LBP prevalence. The main route to prevention of LBP among nurses is likely to lie in improved ergonomics and psychological health in their work place. Good posture and correct transferring techniques in ward situations should be reinforced with hands-on practice performed on nurses' common types of clients.

Predicting the evolution of low back pain patients in routine clinical practice: results from a registry within the Spanish National Health Service.

PubMed

Kovacs, Francisco M; Seco, Jesús; Royuela, Ana; Corcoll Reixach, Josep; Abraira, Víctor

2012-11-01

The Spanish National Health Service (SNHS) is a tax-funded public organization that provides free health care to every resident in Spain. To develop models for predicting the evolution of low back pain (LBP) in routine clinical practice within SNHS. Analysis of a prospective registry in routine clinical practice, in 17 centers across SNHS. Patient sample includes 4,477 acute and chronic LBP patients treated in primary and hospital care. Pain and disability, measured through validated instruments. Patients treated for LBP were assessed at baseline and 3 months later. Data gathered were the following: sex, age, employment status, duration of pain, severity of LBP, pain down to the leg (LP) and disability, history of lumbar surgery, diagnostic procedures undertaken, imaging findings, and treatments used throughout the study period. Three separate multivariate logistic regression models were developed for predicting a clinically relevant improvement in LBP, LP, and disability at 3 months. In total, 4,261 patients (95.2%) attended follow-up. For all the models, calibration was reasonable and the area under the receiver operating characteristic curve was ≥0.640. For LBP, LP, and disability, factors associated with a higher probability of improvement at 3 months were the following: not having undergone lumbar surgery, higher baseline scores for the corresponding variable, lower ones for the rest, and being treated with neuroreflexotherapy. Additional factors were the following: for LBP, shorter pain duration; for LP, not undergoing electromyography; and for disability, shorter pain duration, not being diagnosed with disc degeneration, and being treated with muscle relaxants and not opioids. A prospective registry can be used for developing predictive models to quantify the odds that a given LBP patient will experience a clinically relevant improvement. This may empower patients for an informed shared decision making. Copyright © 2012 Elsevier Inc. All rights reserved.

A novel diagnostic method (spectral computed tomography of sacroiliac joints) for axial spondyloarthritis.

PubMed

Zhang, Ping; Yu, Kai Hu; Guo, Rui Min; Ran, Jun; Liu, Yao; Morelli, John; Runge, Val M; Li, Xiao Ming

2016-08-01

To evaluate the diagnostic value of spectral computed tomography (CT) of sacroiliac joints for axial spondyloarthritis (SpA). We retrospectively analyzed the records of 125 patients with low back pain (LBP) suspected of having SpA. Each patient underwent sacroiliac joint spectral CT examination. Water- and calcium-based material decomposition images were reconstructed. After 3-6 months of follow-up, 76 were diagnosed with SpA, and the remaining 49 patients were diagnosed with nonspecific LBP (nLBP). The slope of sacroiliac bone marrow HU (Hounsfield unit) curve (λHU), CT value, and bone marrow to normal muscle ratios of water and calcium concentrations in the ilium and sacrum were calculated and compared between nLBP and SpA patients. The iliac λHU was 8.26 ± 3.91 for nLBP and 9.81 ± 4.92 for SpA. The mean iliac ratios of water and calcium concentrations were 1.04 ± 0.03 and 21.67 ± 4.40, respectively, for nLBP, and 1.07 ± 0.04 and 111.5 ± 358.98, respectively, for SpA. The mean iliac CT values were 311.12 ± 86.52 HU for nLBP and 423.97 ± 127.51 HU for SpA. There were statistically significant differences in iliac ratios of water and calcium concentrations, CT value, and λHU between nLBP and SpA patients (p < 0.05). The sensitivity of iliac λHU was the highest. The diagnostic odds ratio of ratio of iliac calcium concentration was the highest, and its negative likelihood ratio was the lowest. Spectral CT not only shows bone erosion and sclerosis, but also shows and quantitatively measures bone marrow edema in the sacroiliac joints of SpA patients. Copyright © 2015. Published by Elsevier B.V.

Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme.

PubMed

Gold, Judith E; Punnett, Laura; Gore, Rebecca J

2017-06-01

Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors. Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5-6 years (F5) post-SRHP implementation among workers also in at least one prior survey. LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and 'intense' aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work-family imbalance (RR=1.82 (1.12 to 2.98)). In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Neuropathic low back pain in clinical practice.

PubMed

Baron, R; Binder, A; Attal, N; Casale, R; Dickenson, A H; Treede, R-D

2016-07-01

Low back pain (LBP) is one of the most common chronic pain conditions. This paper reviews the available literature on the role of neuropathic mechanisms in chronic LBP and discusses implications for its clinical management, with a particular focus on pharmacological treatments. Literature searches were performed in PubMed, key pain congresses and ProQuest Dialog to identify published evidence on neuropathic back pain and its management. All titles were assessed for relevant literature. Chronic LBP comprises both nociceptive and neuropathic components, however, the neuropathic component appears under-recognized and undertreated. Neuropathic pain (NP) is challenging to manage. Many patients with chronic LBP have pain that is refractory to existing treatments. Typically, less than half of patients experience clinically meaningful analgesia with oral pharmacotherapies; these are also associated with risks of adverse effects. Paracetamol and NSAIDs, although widely used for LBP, are unlikely to ameliorate the neuropathic component and data on the use of NP medications such as antidepressants and gabapentin/pregabalin are limited. While there is an unmet need for improved treatment options, recent data have shown tapentadol to have efficacy in the neuropathic component of LBP, and studies suggest that the capsaicin 8% patch and lidocaine 5% medicated plaster, topical analgesics available for the treatment of peripheral NP, may be a valuable additional approach for the management of neuropathic LBP. Chronic LBP often has an under-recognized neuropathic component, which can be challenging to manage, and requires improved understanding and better diagnosis and treatment. WHAT DOES THIS REVIEW ADD?: Increased recognition and improved understanding of the neuropathic component of low back pain raises the potential for the development of mechanism-based therapies. Open and retrospective studies suggest that agents like tapentadol and topical analgesics - such as the capsaicin 8% patch and the lidocaine 5% medicated plaster - may be effective options for the treatment of neuropathic low back pain in defined patient groups. © 2016 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.

PubMed

Al-Eisa, Einas; Egan, David; Deluzio, Kevin; Wassersug, Richard

2006-02-01

Comparative analysis and correlational research design were used to investigate the association between anthropometry and biomechanical performance among asymptomatic subjects and patients with low back pain (LBP). To examine the association between pelvic asymmetry and patterns of trunk motion in asymptomatic and LBP subjects. Secondary objective was to investigate the association between restricted trunk motion, laterality of referred pain, and pelvic asymmetry. Subtle pelvic asymmetry (exhibited as either lateral pelvic tilt or iliac rotational asymmetry), which is common among normal individuals, has not been convincingly linked to abnormalities in back movements. Given the difficulty in diagnosing most LBP, a classification using pelvic asymmetry and patterns of movement could be helpful in establishing a rational treatment plan. Fifty-nine subjects with no history of LBP and 54 patients with mechanical unilateral LBP were tested. An anthropometric frame was used to measure pelvic asymmetry in standing. Dynamic motion data, comprised of the principal and coupled movements, were collected using the Qualysis Motion Capture System. While the groups did not differ in the total range of lumbar movement, the LBP group exhibited significantly higher asymmetry in the principal motion. The groups differed significantly in the pattern of coupled rotation during lateral flexion. Asymmetry in lumbar lateral flexion was highly related to two types of pelvic asymmetry: lateral pelvic tilt (LPT) and iliac rotation asymmetry (IRA). Asymmetry in lumbar axial rotation was highly related to IRA but weakly related to LPT. This study demonstrates objective differences in patterns of lumbar movement between asymptomatic subjects and patients with LBP. The study also demonstrates that subtle anatomic abnormality in the pelvis is associated with altered mechanics in the lumbar spine. We suggest that asymmetry of lumbar movement may be a better indicator of functional deficit than the absolute range of movement in LBP.

Effect on healthcare utilization and costs of spinal manual therapy for acute low back pain in routine care: A propensity score matched cohort study.

PubMed

Walker, Jochen; Mertens, Ulf Kai; Schmidt, Carsten Oliver; Chenot, Jean-François

2017-01-01

Spinal manual therapy (SMT) is a popular treatment option for low back pain (LBP). The aim of our analysis was to evaluate the effects of manual therapy delivered by general practitioners and ambulatory orthopedic surgeons in routine care on follow up consultations, sick leave, health service utilization and costs for acute LBP compared to matched patients not receiving manual therapy. This is a propensity score matched cohort study based on health claims data. We identified a total of 113.652 adult patients with acute LBP and no coded red flags of whom 21.021 (18%) received SMT by physicians. In the final analysis 17.965 patients in each group could be matched. Balance on patients' coded characteristics, comorbidity and prior health service utilization was achieved. The provision of SMT for acute LBP had no relevant impact on follow up visits and days of sick leave for LBP in the index billing period and the following year. SMT was associated with a higher proportion of imaging studies for LBP (30.6% vs. 23%, SMD: 0.164 [95% CI 0.143-0.185]). SMT did not lead to meaningful savings by replacing other health services for LBP. SMT for acute non-specific LBP in routine care was not clinically meaningful effective to reduce sick leave and reconsultation rates compared to no SMT and did not lead to meaningful savings by replacing other health services from the perspective of health insurance. This does not imply that SMT is ineffective but might reflect a problem with selection of suitable patients and the quality and quantity of SMT in routine care. National Manual Medicine societies should state clearly that imaging is not routinely needed prior to SMT in patients with low suspicion of presence of red flags and monitor the quality of provided services.

Predominant Leg Pain Is Associated With Better Surgical Outcomes in Degenerative Spondylolisthesis and Spinal Stenosis: Results from the Spine Patient Outcomes Research Trial (SPORT)

PubMed Central

Pearson, Adam; Blood, Emily; Lurie, Jon; Abdu, William; Sengupta, Dilip; Frymoyer, John W.; Weinstein, James

2010-01-01

Study Design As-treated analysis of the Spine Patient Outcomes Research Trial (SPORT). Objective To compare baseline characteristics and surgical and nonoperative outcomes in degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients stratified by predominant pain location (i.e. leg vs. back). Summary of Background Data Evidence suggests that degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients with predominant leg pain may have better surgical outcomes than patients with predominant low back pain (LBP). Methods The DS cohort included 591 patients (62% underwent surgery), and the SpS cohort included 615 patients (62% underwent surgery). Patients were classified as leg pain predominant, LBP predominant or having equal pain according to baseline pain scores. Baseline characteristics were compared between the three predominant pain location groups within each diagnostic category, and changes in surgical and nonoperative outcome scores were compared through two years. Longitudinal regression models including baseline covariates were used to control for confounders. Results Among DS patients at baseline, 34% had predominant leg pain, 26% had predominant LBP, and 40% had equal pain. Similarly, 32% of SpS patients had predominant leg pain, 26% had predominant LBP, and 42% had equal pain. DS and SpS patients with predominant leg pain had baseline scores indicative of less severe symptoms. Leg pain predominant DS and SpS patients treated surgically improved significantly more than LBP predominant patients on all primary outcome measures at one and two years. Surgical outcomes for the equal pain groups were intermediate to those of the predominant leg pain and LBP groups. The differences in nonoperative outcomes were less consistent. Conclusions Predominant leg pain patients improved significantly more with surgery than predominant LBP patients. However, predominant LBP patients still improved significantly more with surgery than with nonoperative treatment. PMID:21124260

Hip-abduction torque and muscle activation in people with low back pain.

PubMed

Sutherlin, Mark A; Hart, Joseph M

2015-02-01

Individuals with a history of low back pain (LBP) may present with decreased hip-abduction strength and increased trunk or gluteus maximus (GMax) fatigability. However, the effect of hip-abduction exercise on hip-muscle function has not been previously reported. To compare hip-abduction torque and muscle activation of the hip, thigh, and trunk between individuals with and without a history of LBP during repeated bouts of side-lying hip-abduction exercise. Repeated measures. Clinical laboratory. 12 individuals with a history of LBP and 12 controls. Repeated 30-s hip-abduction contractions. Hip-abduction torque, normalized root-mean-squared (RMS) muscle activation, percent RMS muscle activation, and forward general linear regression. Hip-abduction torque reduced in all participants as a result of exercise (1.57 ± 0.36 Nm/kg, 1.12 ± 0.36 Nm/kg; P < .001), but there were no group differences (F = 0.129, P = .723) or group-by-time interactions (F = 1.098, P = .358). All participants had increased GMax activation during the first bout of exercise (0.96 ± 1.00, 1.18 ± 1.03; P = .038). Individuals with a history of LBP had significantly greater GMax activation at multiple points during repeated exercise (P < .05) and a significantly lower percent of muscle activation for the GMax (P = .050) at the start of the third bout of exercise and for the biceps femoris (P = .039) at the end of exercise. The gluteal muscles best predicted hip-abduction torque in controls, while no consistent muscles were identified for individuals with a history of LBP. Hip-abduction torque decreased in all individuals after hip-abduction exercise, although individuals with a history of LBP had increased GMax activation during exercise. Gluteal muscle activity explained hip-abduction torque in healthy individuals but not in those with a history of LBP. Alterations in hip-muscle function may exist in individuals with a history of LBP.

A biopsychosocial understanding of lower back pain: Content analysis of online information.

PubMed

Black, N M; Sullivan, S J; Mani, R

2018-04-01

(1) To develop a checklist to assess the representation of biopsychosocial lower back pain (LBP) online information; (2) to analyse publicly accessed online LBP information from a Google search for the degree that psychosocial contributors are described alongside the traditional biomedical approach to explaining LBP; (3) whether websites use information on pain biology to educate on LBP; (4) any inaccurate or false information regarding the mechanisms of LBP and; (5) the amount of websites certified by established benchmarks for quality health information. An online search was conducted using the Google search engines of six major English-speaking countries. Website content was analysed using three checklists developed for the purpose of this study - Biopsychosocial information categorisation checklist and scoring criteria; pain biology information checklist; and the inaccurate information checklist. Website quality was identified by the presence of an Health on the Net certification (HONcode). Of the fifteen websites analysed, the content of 26.7% of websites was classified as 'biomedical', 60% 'limited psychosocial' and 13.3% 'reasonable psychosocial'; 20% included information on pain biology; 46.7% inaccurately implied pain to be equal to tissue damage and 46.7% implied pathways specific to pain transmission; 40% were HONcode certified. Online LBP information retrieved through a Google search has limited to no integration of psychosocial or pain biology information. The focus on tissue pathology is further supported by the inaccurate descriptions of pain as equal to tissue damage and as an input to the central nervous system (CNS). Online LBP information needs to be guided by criteria more sensitive to the psychosocial contributors to pain. The online LBP information retrieved from a Google search needs to be guided by information more sensitive to the psychosocial contributors to pain and disability. This study also highlights the presence of inaccurate information that implied pain as a measure of tissue damage or as an input to the nervous system. © 2017 European Pain Federation - EFIC®.

Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial

PubMed Central

Traeger, Adrian C; Moseley, G Lorimer; Hübscher, Markus; Lee, Hopin; Skinner, Ian W; Nicholas, Michael K; Henschke, Nicholas; Refshauge, Kathryn M; Blyth, Fiona M; Main, Chris J; Hush, Julia M; Pearce, Garry; McAuley, James H

2014-01-01

Introduction Low back pain (LBP) is the leading cause of disability worldwide. Of those patients who present to primary care with acute LBP, 40% continue to report symptoms 3 months later and develop chronic LBP. Although it is possible to identify these patients early, effective interventions to improve their outcomes are not available. This double-blind (participant/outcome assessor) randomised controlled trial will investigate the efficacy of a brief educational approach to prevent chronic LBP in ‘at-risk’ individuals. Methods/analysis Participants will be recruited from primary care practices in the Sydney metropolitan area. To be eligible for inclusion participants will be aged 18–75 years, with acute LBP (<4 weeks’ duration) preceded by at least a 1 month pain-free period and at-risk of developing chronic LBP. Potential participants with chronic spinal pain and those with suspected serious spinal pathology will be excluded. Eligible participants who agree to take part will be randomly allocated to receive 2×1 h sessions of pain biology education or 2×1 h sessions of sham education from a specially trained study physiotherapist. The study requires 101 participants per group to detect a 1-point difference in pain intensity 3 months after pain onset. Secondary outcomes include the incidence of chronic LBP, disability, pain intensity, depression, healthcare utilisation, pain attitudes and beliefs, global recovery and recurrence and are measured at 1 week post-intervention, and at 3, 6 and 12 months post LBP onset. Ethics/dissemination Ethical approval was obtained from the University of New South Wales Human Ethics Committee in June 2013 (ref number HC12664). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings. Trial registration number https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612001180808 PMID:24889854

Steadiness of Spinal Regions during Single-Leg Standing in Older Adults with and without Chronic Low Back Pain

PubMed Central

Kuo, Yi-Liang; Huang, Kuo-Yuan; Chiang, Pei-Tzu; Lee, Pei-Yun; Tsai, Yi-Ju

2015-01-01

The aims of this study were to compare the steadiness index of spinal regions during single-leg standing in older adults with and without chronic low back pain (LBP) and to correlate measurements of steadiness index with the performance of clinical balance tests. Thirteen community-dwelling older adults (aged 55 years or above) with chronic LBP and 13 age- and gender-matched asymptomatic volunteers participated in this study. Data collection was conducted in a university research laboratory. Measurements were steadiness index of spinal regions (trunk, thoracic spine, lumbar spine, and pelvis) during single-leg standing including relative holding time (RHT) and relative standstill time (RST), and clinical balance tests (timed up and go test and 5-repetition sit to stand test). The LBP group had a statistically significantly smaller RHT than the control group, regardless of one leg stance on the painful or non-painful sides. The RSTs on the painful side leg in the LBP group were not statistically significantly different from the average RSTs of both legs in the control group; however, the RSTs on the non-painful side leg in the LBP group were statistically significantly smaller than those in the control group for the trunk, thoracic spine, and lumbar spine. No statistically significant intra-group differences were found in the RHTs and RSTs between the painful and non-painful side legs in the LBP group. Measurements of clinical balance tests also showed insignificant weak to moderate correlations with steadiness index. In conclusion, older adults with chronic LBP demonstrated decreased spinal steadiness not only in the symptomatic lumbar spine but also in the other spinal regions within the kinetic chain of the spine. When treating older adults with chronic LBP, clinicians may also need to examine their balance performance and spinal steadiness during balance challenging tests. PMID:26024534

Do Work-Related Mechanical and Psychosocial Factors Contribute to the Social Gradient in Low Back Pain?: A 3-Year Follow-Up Study of the General Working Population in Norway.

PubMed

Sterud, Tom; Johannessen, Håkon A; Tynes, Tore

2016-07-01

A prospective cohort study. The aim of the study was to investigate the extent to which work-related factors contribute to the social gradient in low back pain (LBP). A social gradient in LBP is well established, but only a few studies have examined the extent to which exposure to mechanical and psychosocial work environment factors is a pathway for this gradient. A randomly drawn cohort from the general population in Norway aged 18 to 66 years was followed up for 3 years (n = 12,550, response rate at baseline = 67%). Eligible respondents were in paid work during 2006 and 2009 (n = 6819). Based on administrative register data respondents were coded into five educational levels (university/college ≥4 years was set as the reference group). Outcome of interest was self-reported moderate or severe LBP at follow-up adjusted for baseline LBP. In total, 11.2% (397 individuals) men and 14.5% (461 individual) women reported LBP at follow-up. There was a strong social gradient ranging from 16.4% (elementary) to 6.4% (university/college ≥4 years). The corresponding figures among women were 22.4% and 7.5%. Corrected for age, LBP at baseline and working hours, educational level was a significant predictor of LBP at follow-up (odds ratios 1.8-2.3 in men and 1.7-3.1 in women). Adjusting for mechanical factors reduced the gradient by 39% to 43% in men and 28% to 34% in women. Adjusting for psychosocial factors reduced the gradient by 5% to 12% in men and increased the gradient by 7% to 11% in women. Work-related mechanical factors contributed substantially to the social gradient in LBP among both men and women. The impact of psychosocial factors was modest among men and contributed to an increased gradient among women. 3.

Infrared target recognition based on improved joint local ternary pattern

NASA Astrophysics Data System (ADS)

Sun, Junding; Wu, Xiaosheng

2016-05-01

This paper presents a simple, efficient, yet robust approach, named joint orthogonal combination of local ternary pattern, for automatic forward-looking infrared target recognition. It gives more advantages to describe the macroscopic textures and microscopic textures by fusing variety of scales than the traditional LBP-based methods. In addition, it can effectively reduce the feature dimensionality. Further, the rotation invariant and uniform scheme, the robust LTP, and soft concave-convex partition are introduced to enhance its discriminative power. Experimental results demonstrate that the proposed method can achieve competitive results compared with the state-of-the-art methods.

Immediate Effects of a Single Session of Motor Skill Training on the Lumbar Movement Pattern During a Functional Activity in People With Low Back Pain: A Repeated-Measures Study.

PubMed

Marich, Andrej V; Lanier, Vanessa M; Salsich, Gretchen B; Lang, Catherine E; Van Dillen, Linda R

2018-04-06

People with low back pain (LBP) may display an altered lumbar movement pattern of early lumbar motion compared to people with healthy backs. Modifying this movement pattern during a clinical test decreases pain. It is unknown whether similar effects would be seen during a functional activity. The objective of this study is was to examine the lumbar movement patterns before and after motor skill training, effects on pain, and characteristics that influenced the ability to modify movement patterns. The design consisted of a repeated-measures study examining early-phase lumbar excursion in people with LBP during a functional activity test. Twenty-six people with chronic LBP received motor skill training, and 16 people with healthy backs were recruited as a reference standard. Twenty minutes of motor skill training to decrease early-phase lumbar excursion during the performance of a functional activity were used as a treatment intervention. Early-phase lumbar excursion was measured before and after training. Participants verbally reported increased pain, decreased pain, or no change in pain during performance of the functional activity test movement in relation to their baseline pain. The characteristics of people with LBP that influenced the ability to decrease early-phase lumbar excursion were examined. People with LBP displayed greater early-phase lumbar excursion before training than people with healthy backs (LBP: mean = 11.2°, 95% CI = 9.3°-13.1°; healthy backs: mean = 7.1°, 95% CI = 5.8°-8.4°). Following training, the LBP group showed a decrease in the amount of early-phase lumbar excursion (mean change = 4.1°, 95% CI = 2.4°-5.8°); 91% of people with LBP reported that their pain decreased from baseline following training. The longer the duration of LBP (β = - 0.22) and the more early-phase lumbar excursion before training (β = - 0.82), the greater the change in early-phase lumbar excursion following training. The long-term implications of modifying the movement pattern and whether the decrease in pain attained was clinically significant are unknown. People with LBP were able to modify their lumbar movement pattern and decrease their pain with the movement pattern within a single session of motor skill training.

High-mobility group box-1 protein, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in children with community acquired infections and bacteraemia: a prospective study

PubMed Central

2010-01-01

Introduction Even though sepsis is one of the common causes of children morbidity and mortality, specific inflammatory markers for identifying sepsis are less studied in children. The main aim of this study was to compare the levels of high-mobility group box-1 protein (HMGB1), Lipopolysaccharide-binding protein (LBP), Interleukin-6 (IL-6) and C-reactive protein (CRP) between infected children without systemic inflammatory response syndrome (SIRS) and children with severe and less severe sepsis. The second aim was to examine HMGB1, LBP, IL6 and CRP as markers for of bacteraemia. Methods Totally, 140 children with suspected or proven infections admitted to the Children's Clinical University Hospital of Latvia during 2008 and 2009 were included. Clinical and demographical information as well as infection focus were assessed in all patients. HMGB1, LBP, IL-6 and CRP blood samples were determined. Children with suspected or diagnosed infections were categorized into three groups of severity of infection: (i) infected without SIRS (n = 36), (ii) sepsis (n = 91) and, (iii) severe sepsis (n = 13). They were furthermore classified according bacteraemia into (i) bacteremia (n = 30) and (ii) no bacteraemia (n = 74). Results There was no statistically significant difference in HMGB1 levels between children with different levels of sepsis or with and without bacteraemia. The levels of LBP, IL-6 and CRP were statistically significantly higher among patients with sepsis compared to those infected but without SIRS (p < 0.001). Furthermore, LBP, IL-6 and CRP were significantly higher in children with severe sepsis compared to those ones with less severe sepsis (p < 0.001). Median values of LBP, IL6 and CRP were significantly higher in children with bacteraemia compared to those without bacteraemia. The area under the receiver operating curve (ROC) for detecting bacteraemia was 0.87 for both IL6 and CRP and 0.82 for LBP, respectively. Conclusion Elevated levels of LBP, IL-6 and CRP were associated with a more severe level of infection in children. Whereas LBP, IL-6 and CRP seem to be good markers to detect patients with bacteraemia, HMGB1 seem to be of minor importance. LBP, IL-6 and CRP levels may serve as good biomarkers for identifying children with severe sepsis and bacteraemia and, thus, may be routinely used in clinical practice. PMID:20158885

Sequence analysis to assess labour market participation following vocational rehabilitation: an observational study among patients sick-listed with low back pain from a randomised clinical trial in Denmark

PubMed Central

Lindholdt, Louise; Labriola, Merete; Nielsen, Claus Vinther; Horsbøl, Trine Allerslev; Lund, Thomas

2017-01-01

Introduction The return-to-work (RTW) process after long-term sickness absence is often complex and long and implies multiple shifts between different labour market states for the absentee. Standard methods for examining RTW research typically rely on the analysis of one outcome measure at a time, which will not capture the many possible states and transitions the absentee can go through. The purpose of this study was to explore the potential added value of sequence analysis in supplement to standard regression analysis of a multidisciplinary RTW intervention among patients with low back pain (LBP). Methods The study population consisted of 160 patients randomly allocated to either a hospital-based brief or a multidisciplinary intervention. Data on labour market participation following intervention were obtained from a national register and analysed in two ways: as a binary outcome expressed as active or passive relief at a 1-year follow-up and as four different categories for labour market participation. Logistic regression and sequence analysis were performed. Results The logistic regression analysis showed no difference in labour market participation for patients in the two groups after 1 year. Applying sequence analysis showed differences in subsequent labour market participation after 2 years after baseline in favour of the brief intervention group versus the multidisciplinary intervention group. Conclusion The study indicated that sequence analysis could provide added analytical value as a supplement to traditional regression analysis in prospective studies of RTW among patients with LBP. PMID:28729315

Aggregation-Induced Emission Luminogen-Based Direct Visualization of Concentration Gradient Inside an Evaporating Binary Sessile Droplet.

PubMed

Cai, Xin; Xie, Ni; Qiu, Zijie; Yang, Junxian; He, Minghao; Wong, Kam Sing; Tang, Ben Zhong; Qiu, Huihe

2017-08-30

In this study, the concentration gradient inside evaporating binary sessile droplets of 30, 50, and 60 vol % tetrahydrofuran (THF)/water mixtures was investigated. The 5 μL THF/water droplets were evaporated on a transparent hydrophobic substrate. This is the first demonstration of local concentration mapping within an evaporating binary droplet utilizing the aggregation-induced emission material. During the first two evaporation stages of the binary droplet, the local concentration can be directly visualized by the change of fluorescence emission intensity. Time-resolved average and local concentrations can be estimated by using the pre-established function of fluorescence intensity versus water volume fraction.

Fast Localization in Large-Scale Environments Using Supervised Indexing of Binary Features.

PubMed

Youji Feng; Lixin Fan; Yihong Wu

2016-01-01

The essence of image-based localization lies in matching 2D key points in the query image and 3D points in the database. State-of-the-art methods mostly employ sophisticated key point detectors and feature descriptors, e.g., Difference of Gaussian (DoG) and Scale Invariant Feature Transform (SIFT), to ensure robust matching. While a high registration rate is attained, the registration speed is impeded by the expensive key point detection and the descriptor extraction. In this paper, we propose to use efficient key point detectors along with binary feature descriptors, since the extraction of such binary features is extremely fast. The naive usage of binary features, however, does not lend itself to significant speedup of localization, since existing indexing approaches, such as hierarchical clustering trees and locality sensitive hashing, are not efficient enough in indexing binary features and matching binary features turns out to be much slower than matching SIFT features. To overcome this, we propose a much more efficient indexing approach for approximate nearest neighbor search of binary features. This approach resorts to randomized trees that are constructed in a supervised training process by exploiting the label information derived from that multiple features correspond to a common 3D point. In the tree construction process, node tests are selected in a way such that trees have uniform leaf sizes and low error rates, which are two desired properties for efficient approximate nearest neighbor search. To further improve the search efficiency, a probabilistic priority search strategy is adopted. Apart from the label information, this strategy also uses non-binary pixel intensity differences available in descriptor extraction. By using the proposed indexing approach, matching binary features is no longer much slower but slightly faster than matching SIFT features. Consequently, the overall localization speed is significantly improved due to the much faster key point detection and descriptor extraction. It is empirically demonstrated that the localization speed is improved by an order of magnitude as compared with state-of-the-art methods, while comparable registration rate and localization accuracy are still maintained.

Learning moment-based fast local binary descriptor

NASA Astrophysics Data System (ADS)

Bellarbi, Abdelkader; Zenati, Nadia; Otmane, Samir; Belghit, Hayet

2017-03-01

Recently, binary descriptors have attracted significant attention due to their speed and low memory consumption; however, using intensity differences to calculate the binary descriptive vector is not efficient enough. We propose an approach to binary description called POLAR_MOBIL, in which we perform binary tests between geometrical and statistical information using moments in the patch instead of the classical intensity binary test. In addition, we introduce a learning technique used to select an optimized set of binary tests with low correlation and high variance. This approach offers high distinctiveness against affine transformations and appearance changes. An extensive evaluation on well-known benchmark datasets reveals the robustness and the effectiveness of the proposed descriptor, as well as its good performance in terms of low computation complexity when compared with state-of-the-art real-time local descriptors.

Pain One Week After an Emergency Department Visit for Acute Low Back Pain Is Associated With Poor Three-month Outcomes.

PubMed

Friedman, Benjamin W; Conway, John; Campbell, Caron; Bijur, Polly E; John Gallagher, E

2018-05-16

Low back pain (LBP) is responsible for more than 2.5 million visits to U.S. emergency departments (EDs) annually. Nearly 30% of patients who present to an ED with acute LBP report functional impairment or pain 3 months later. These patients are at risk of chronic LBP, a highly debilitating condition. In this study, we assessed whether three variables assessable shortly after symptom onset could independently predict poor 3-month outcomes among LBP patients who present to an ED. This was a planned analysis of data from two randomized comparative effectiveness studies of patients with acute, nontraumatic, nonradicular LBP. Patients were enrolled during an ED visit, contacted by telephone 1 week after the ED visit, and then followed up by telephone 3 months later. The coprimary 3-month outcomes were LBP-related functional impairment and persistent moderate or severe LBP. Two of the three hypothesized predictor variables were assessed during the index visit: 1) the STarT Back Screening Tool score, a nine-item, multidimensional tool validated and widely used in the outpatient setting, and 2) the patient's own anticipated duration of LBP. The third hypothesized predictor was presence of pain assessed by phone 1 week after the ED visit. We then determined whether these three predictor variables were independently associated with poor outcomes at 3 months, after controlling for medication received, age, and sex. A total of 354 patients were enrolled. Of these, 309 (87%) provided 3-month impairment data and 311 (88%) provided 3-month pain data. At 3 months, 122 of 309 (39%) patients reported functional impairment and 51 of 311(16%) patients reported moderate or severe LBP. Among the three hypothesized predictor variables, 58 of 352 (16%) patients with available data reported a moderate or high STarT Back Screening Tool score, 35 of 321 (11%) patients with available data reported anticipated duration of LBP > 1 week, and 235 of 346 (68%) patients reported pain at 1-week telephone follow-up. After age, sex, and medication received were controlled for in a multivariable logistic regression model, only pain at 1 week was independently associated with 3-month impairment (odds ratio [OR] = 2.42, 95% CI = 1.39-4.22) and 3-month moderate or severe pain (OR = 3.83, 95% CI = 1.53-9.58). More than one-third of patients reported functional impairment 3 months after an ED visit for acute, nontraumatic, nonradicular LBP. Moderate or severe LBP was less common, reported in about half as many patients (16%). Of the three hypothesized predictor variables, only persistent pain at 1 week was independently associated with poor outcomes at 3 months. Despite its important role in the outpatient setting, the STarT Back Tool was not associated with poor outcomes in this ED cohort. © 2018 by the Society for Academic Emergency Medicine.

Elevated Production of Nociceptive CC Chemokines and sE-Selectin in Patients With Low Back Pain and the Effects of Spinal Manipulation: A Nonrandomized Clinical Trial.

PubMed

Teodorczyk-Injeyan, Julita A; McGregor, Marion; Triano, John J; Injeyan, Stephen H

2018-01-01

The involvement of inflammatory components in the pathophysiology of low back pain (LBP) is poorly understood. It has been suggested that spinal manipulative therapy (SMT) may exert anti-inflammatory effects. The purpose of this study was to determine the involvement of inflammation-associated chemokines (CC series) in the pathogenesis of nonspecific LBP and to evaluate the effect of SMT on that process. Patients presenting with nonradicular, nonspecific LBP (minimum pain score 3 on 10-point visual analog scale) were recruited according to stringent inclusion criteria. They were evaluated for appropriateness to treat using a high velocity low amplitude manipulative thrust in the lumbar-lumbosacral region. Blood samples were obtained at baseline and following the administration of a series of 6 high velocity low amplitude manipulative thrusts on alternate days over the period of 2 weeks. The in vitro levels of CC chemokine ligands (CCL2, CCL3, and CCL4) production and plasma levels of an inflammatory biomarker, soluble E-selectin (sE-selectin), were determined at baseline and at the termination of treatments 2 weeks later. Compared with asymptomatic controls baseline production of all chemokines was significantly elevated in acute (P=0.004 to <0.0001), and that of CCL2 and CCL4 in chronic LBP patients (P<0.0001). Furthermore, CCL4 production was significantly higher (P<0.0001) in the acute versus chronic LBP group. sE-selectin levels were significantly higher (P=0.003) in chronic but not in acute LBP patients. Following SMT, patient-reported outcomes showed significant (P<0.0001) improvements in visual analog scale and Oswestry Disability Index scores. This was accompanied by a significant decline in CCL3 production (P<0.0001) in both groups of patients. Change scores for CCL4 production differed significantly (P<0.0001) only for the acute LBP cohort, and no effect on the production of CCL2 or plasma sE-selectin levels was noted in either group. The production of chemotactic cytokines is significantly and protractedly elevated in LBP patients. Changes in chemokine production levels, which might be related to SMT, differ in the acute and chronic LBP patient cohorts.

A systematic review of diagnostic imaging use for low back pain in the United States.

PubMed

Dagenais, Simon; Galloway, Erin K; Roffey, Darren M

2014-06-01

Various studies have reported on the increasing use and costs of diagnostic imaging for low back pain (LBP) in the United States. However, it is unclear whether the methods used in these studies allowed for meaningful comparisons or whether the reported use data can be used to develop evidence-based use benchmarks. The primary purpose of this study was to review previous estimates of the use of diagnostic imaging for LBP in the United States. The study design is a systematic review of published literature. A search through May 2012 was conducted using keywords and free text terms related to health services and LBP in Medline and Health Policy Reference; results were screened for relevance independently, and full-text studies were assessed for eligibility. Only studies published in English since the year 2000 reporting on use of diagnostic imaging for LBP using claims data from the United States were included. Reporting quality was assessed using a modified Downs and Black tool for observational studies. The search strategy yielded 1,102 citations, seven of which met the criteria for eligibility. Studies reported use from commercial health plans (N=4) and Medicare (N=3), with sample sizes ranging from 13,760 to 740,467 members with LBP from specific states or across the United States. The number of diagnostic codes used to identify nonspecific LBP ranged from 2 to 66; other heterogeneity was noted in the methods used across these studies. In commercial health plans, use of radiography occurred in 12.0% to 32.2% of patients with LBP, magnetic resonance imaging (MRI) was used in 16.0% to 21.0%, computed tomography (CT) was used in 1.4% to 3.0%, and MRI and/or CT was used in 10.9% to 16.1%. Findings in Medicare populations were 22.9% to 48.2% for radiography, 11.6% for MRI, and 10.4% to 16.3% for MRI and/or CT. The reported use of diagnostic imaging for LBP varied across the studies reviewed; differences in methodology made meaningful comparisons difficult. Standardizing methods for performing and reporting analyses of claims data related to use could facilitate efforts by third-party payers, health care providers, and researchers to identify and address the perceived overuse of diagnostic imaging for LBP. Copyright © 2014 Elsevier Inc. All rights reserved.

Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting.

PubMed

George, Steven Z; Teyhen, Deydre S; Wu, Samuel S; Wright, Alison C; Dugan, Jessica L; Yang, Guijun; Robinson, Michael E; Childs, John D

2009-07-01

The general population has a pessimistic view of low back pain (LBP), and evidence-based information has been used to positively influence LBP beliefs in previously reported mass media studies. However, there is a lack of randomized trials investigating whether LBP beliefs can be modified in primary prevention settings. This cluster randomized clinical trial investigated the effect of an evidence-based psychosocial educational program (PSEP) on LBP beliefs for soldiers completing military training. A military setting was selected for this clinical trial, because LBP is a common cause of soldier disability. Companies of soldiers (n = 3,792) were recruited, and cluster randomized to receive a PSEP or no education (control group, CG). The PSEP consisted of an interactive seminar, and soldiers were issued the Back Book for reference material. The primary outcome measure was the back beliefs questionnaire (BBQ), which assesses inevitable consequences of and ability to cope with LBP. The BBQ was administered before randomization and 12 weeks later. A linear mixed model was fitted for the BBQ at the 12-week follow-up, and a generalized linear mixed model was fitted for the dichotomous outcomes on BBQ change of greater than two points. Sensitivity analyses were performed to account for drop out. BBQ scores (potential range: 9-45) improved significantly from baseline of 25.6 +/- 5.7 (mean +/- SD) to 26.9 +/- 6.2 for those receiving the PSEP, while there was a significant decline from 26.1 +/- 5.7 to 25.6 +/- 6.0 for those in the CG. The adjusted mean BBQ score at follow-up for those receiving the PSEP was 1.49 points higher than those in the CG (P < 0.0001). The adjusted odds ratio of BBQ improvement of greater than two points for those receiving the PSEP was 1.51 (95% CI = 1.22-1.86) times that of those in the CG. BBQ improvement was also mildly associated with race and college education. Sensitivity analyses suggested minimal influence of drop out. In conclusion, soldiers that received the PSEP had an improvement in their beliefs related to the inevitable consequences of and ability to cope with LBP. This is the first randomized trial to show positive influence on LBP beliefs in a primary prevention setting, and these findings have potentially important public health implications for prevention of LBP.

The local nanohertz gravitational-wave landscape from supermassive black hole binaries

NASA Astrophysics Data System (ADS)

Mingarelli, Chiara M. F.; Lazio, T. Joseph W.; Sesana, Alberto; Greene, Jenny E.; Ellis, Justin A.; Ma, Chung-Pei; Croft, Steve; Burke-Spolaor, Sarah; Taylor, Stephen R.

2017-12-01

Supermassive black hole binary systems form in galaxy mergers and reside in galactic nuclei with large and poorly constrained concentrations of gas and stars. These systems emit nanohertz gravitational waves that will be detectable by pulsar timing arrays. Here we estimate the properties of the local nanohertz gravitational-wave landscape that includes individual supermassive black hole binaries emitting continuous gravitational waves and the gravitational-wave background that they generate. Using the 2 Micron All-Sky Survey, together with galaxy merger rates from the Illustris simulation project, we find that there are on average 91 ± 7 continuous nanohertz gravitational-wave sources, and 7 ± 2 binaries that will never merge, within 225 Mpc. These local unresolved gravitational-wave sources can generate a departure from an isotropic gravitational-wave background at a level of about 20 per cent, and if the cosmic gravitational-wave background can be successfully isolated, gravitational waves from at least one local supermassive black hole binary could be detected in 10 years with pulsar timing arrays.

Effect of hamstring flexibility on hip and lumbar spine joint excursions during forward-reaching tasks in participants with and without low back pain.

PubMed

Johnson, Erica N; Thomas, James S

2010-07-01

To examine the correlation between hamstring flexibility and hip and lumbar spine joint excursions during standardized reaching and forward-bending tasks. Retrospective analysis of data obtained during 2 previous prospective studies that examined kinematics and kinetics during forward-reaching tasks in participants with and without low back pain (LBP). The 2 previous studies were conducted in the Motor Control Lab at Ohio University and the Orthopaedic Ergonomics Laboratory at The Ohio State University. Data from a total of 122 subjects from 2 previous studies: study 1: 86 subjects recovered from an episode of acute LBP (recovered) and study 2 (A.I. McCallum, unpublished data): 18 chronic LBP subjects and 18 healthy-matched controls (healthy). Not applicable. Correlation values between hamstring flexibility as measured by straight leg raise (SLR) and amount of hip and lumbar spine joint excursions used during standardized reaching and forward-bending tasks. No significant correlation was found between hamstring flexibility and hip and lumbar joint excursions during forward-bending tasks in the LBP or recovered groups. The SLR had a significant negative correlation with lumbar spine excursions during reaching tasks to a low target in the healthy group (right SLR: P=.011, left SLR: P=.004). Hamstring flexibility is not strongly related to the amount of lumbar flexion used to perform forward-reaching tasks in participants who have chronic LBP or who have recovered from LBP. More research needs to be conducted to examine the influence of hamstring flexibility on observed movement patterns to further evaluate the efficacy of flexibility training in the rehabilitation of patients with LBP. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Tactile allodynia in patients with lumbar radicular pain (sciatica).

PubMed

Defrin, Ruth; Devor, Marshall; Brill, Silviu

2014-12-01

We report a novel symptom in many patients with low back pain (LBP) that sheds new light on the underlying pain mechanism. By means of quantitative sensory testing, we compared patients with radicular LBP (sciatica), axial LBP (LBP without radiation into the leg), and healthy controls, searching for cutaneous allodynia in response to weak tactile and cooling stimuli on the leg and low back. Most patients with radicular pain (~60%) reported static and dynamic tactile allodynia, as well as cooling allodynia, on the leg, often extending into the foot. Some also reported allodynia on the low back. In axial LBP, allodynia was almost exclusively on the back. The degree of dynamic tactile allodynia correlated with the degree of background pain. The presence of allodynia suggests that the peripheral nerve generators of background leg and back pain have also induced central sensitization. The distal (foot) location of the allodynia in patients who have it indicates that the nociceptive drive that maintains the central sensitization arises paraspinally (ectopically) in injured ventral ramus afferents; this is not an instance of somatic referred pain. The presence of central sensitization also provides the first cogent account of shooting pain in sciatica as a wave of activity sweeping vectorially across the width of the sensitized dorsal horn. Finally, the results endorse leg allodynia as a pain biomarker in animal research on LBP, which is commonly used but has not been previously validated. In addition to informing the underlying mechanism of LBP, bedside mapping of allodynia might have practical implications for prognosis and treatment. How can you tell whether pain radiating into the leg in a patient with sciatica is neuropathic, ie, due to nerve injury? Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain.

PubMed

Hides, Julie A; Belavý, Daniel L; Cassar, Lana; Williams, Michelle; Wilson, Stephen J; Richardson, Carolyn A

2009-03-01

An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement ("slide") of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP.

A Marker of Endotoxemia Is Associated With Obesity and Related Metabolic Disorders in Apparently Healthy Chinese

PubMed Central

Sun, Liang; Yu, Zhijie; Ye, Xingwang; Zou, Shurong; Li, Huaixing; Yu, Danxia; Wu, Hongyu; Chen, Yan; Dore, Joel; Clément, Karine; Hu, Frank B.; Lin, Xu

2010-01-01

OBJECTIVE Elevated lipopolysaccharide-binding protein (LBP), a marker of subclinical endotoxemia, may be involved in the pathogenesis of obesity and metabolic risk. We aimed to investigate the association between plasma LBP and metabolic disorders in apparently healthy Chinese. RESEARCH DESIGN AND METHODS A population-based study including 559 overweight/obese (BMI ≥24.0 kg/m2) and 500 normal-weight (18.0 ≤ BMI <24.0 kg/m2) subjects aged 35–54 years was conducted in Shanghai, China. Fasting plasma glucose, lipid profile, LBP, high-sensitivity C-reactive protein, interleukin-6, high-molecular-weight (HMW) adiponectin, leptin, hepatic enzymes, and body composition were measured. Metabolic syndrome was defined by the updated National Cholesterol Education Program Adult Treatment Panel III criterion for Asian Americans. RESULTS LBP levels were significantly higher in overweight/obese individuals than in normal-weight individuals (geometric mean 27.6 [95% CI 25.2–30.3] vs. 10.0 [9.1–11.1] μg/ml; P < 0.001). After multiple adjustments including BMI, the odds ratios were 3.54 (95% CI 2.05–6.09) and 5.53 (95% CI 2.64–11.59) for metabolic syndrome and type 2 diabetes, respectively, comparing the highest with the lowest LBP quartile. Further adjustments for inflammatory markers almost abolished the significant association of LBP with metabolic syndrome but not that with type 2 diabetes, and controlling for adipokines and hepatic enzymes did not substantially alter the results. CONCLUSIONS Elevated circulating LBP was associated with obesity, metabolic syndrome, and type 2 diabetes in apparently healthy Chinese. These findings suggested a role of lipopolysaccharide via initiation of innate immune mechanism(s) in metabolic disorders. Prospective studies are needed to confirm these results. PMID:20530747

A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.

PubMed

Sung, Paul S

2013-06-01

Low back pain (LBP) is one of the most common symptoms reported in adults. However, the contribution of postural control on the lumbar spine and hips during squatting has not been carefully investigated in individuals with LBP. The aim of this study was to compare three-dimensional kinematic changes of the lumbar spine and hips between subjects with and without idiopathic chronic LBP during squatting activities. In total, 30 subjects enrolled in the study (15 control subjects and 15 subjects with idiopathic chronic LBP). All participants were asked to perform squatting activities five times repeatedly while holding a load of 2kg in a basket. The outcome measures included the Oswestry Disability Index (ODI) and kinematic angular displacement for the hips and lumbar spine. The LBP group demonstrated increased range of motion (ROM) in flexion of the dominant (T=-2.14, p=0.03) and non-dominant (T=-2.11, p=0.03) hips during squatting. The lumbar spine flexion ROM significantly decreased (T=2.20, p=0.03). The kinematic changes demonstrated interactions with region×group (F=5.56, p=0.02), plane×group (F=4.36, p=0.04), and region×plane (F=2292.47, p=0.001). The ODI level demonstrated significant interaction on combined effects of body region and plane (F=4.91, p=0.03). Therefore, the LBP group utilized a compensation strategy to increase hip flexion with a stiffened lumbar spine in the sagittal plane during squatting. This compensatory kinematic strategy could apply to clinical management used to enhance lumbar spine flexibility in subjects with idiopathic chronic LBP. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain.

PubMed

Haddas, Ram; Sawyer, Steven F; Sizer, Phillip S; Brooks, Toby; Chyu, Ming-Chien; James, C Roger

2017-09-01

Recurrent lower back pain (rLBP) and neuromuscular fatigue are independently thought to increase the risk of lower extremity (LE) injury. Volitional preemptive abdominal contraction (VPAC) is thought to improve lumbar spine and pelvis control in individuals with rLBP. The effects of VPAC on fatigued landing performance in individuals with rLBP are unknown. To determine the effects of VPAC and LE fatigue on landing performance in a rLBP population. Cross-sectional pretest-posttest cohort control design. A clinical biomechanics laboratory. 32 rLBP (age 21.2 ± 2.7 y) but without current symptoms and 33 healthy (age 20.9 ± 2.3 y) subjects. (i) Volitional preemptive abdominal contraction using abdominal bracing and (ii) fatigue using submaximal free-weight squat protocol with 15% body weight until task failure was achieved. Knee and ankle angles, moments, electromyographic measurements from semitendinosus and vastus medialis muscles, and ground reaction force (GRF) were collected during 0.30 m drop-jump landings. The VPAC resulted in significantly earlier muscle onsets across all muscles with and without fatigue in both groups (mean ± SD, 0.063 ± 0.016 s earlier; P ≤ .001). Fatigue significantly delayed semitendinosus muscle onsets (0.033 ± 0.024 s later; P ≤ .001), decreased GRF (P ≤ .001), and altered landing kinematics in a variety of ways. The rLBP group exhibited delayed semitendinosus and vastus medialis muscle onsets (0.031 ± 0.028 s later; P ≤ .001) and 1.8° less knee flexion at initial contact (P ≤ .008). The VPAC decreases some of the detrimental effects of fatigue on landing biomechanics and thus may reduce LE injury risk in a rLBP population.

Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai.

PubMed

Shan, Zhi; Deng, Guoying; Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

2013-01-01

This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student's grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP.

Neural mechanisms and functional correlates of altered postural responses to perturbed standing balance with chronic low back pain

PubMed Central

Jacobs, Jesse V.; Roy, Carrie L.; Hitt, Juvena R.; Popov, Roman E.; Henry, Sharon M.

2016-01-01

This study sought to determine the effects of chronic low back pain (LBP) on the cortical evoked potentials, muscle activation, and kinematics of postural responses to perturbations of standing balance. Thirteen subjects with chronic, recurrent, non-specific LBP and 13 subjects without LBP participated. The subjects responded to unpredictably timed postural perturbations while standing on a platform that randomly rotated either “toes up” or “toes down”. Electroencephalography (EEG) was used to calculate the negative peak (N1) and subsequent positive peak (P2) amplitudes of the perturbation evoked cortical potentials. Passive-marker motion capture was used to calculate joint and center-of-mass (CoM) displacements. Surface electromyography was used to record muscle onset latencies. Questionnaires assessed pain, interference with activity, fear of activity, and pain catastrophizing. Results demonstrated that subjects with LBP exhibited significantly larger P2 potentials, delayed erector spinae, rectus abdominae, and external oblique onset latencies, as well as smaller trunk extension yet larger trunk flexion, knee flexion, and ankle dorsiflexion displacements compared to subjects without LBP. For the subjects with LBP, CoM displacements significantly and positively correlated with knee displacements as well as activity interference and fear scores. The P2 potentials significantly and negatively correlated with CoM displacements as well as activity interference, catastrophizing, and fear scores. These results demonstrate that people with LBP exhibit altered late-phase cortical processing of postural perturbations concomitant with altered kinematic and muscle responses, and these cortical and postural response characteristics correlate with each other as well as with clinical reports of pain-related fears and activity interference. PMID:27771534

Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis.

PubMed

Lin, Chung-Wei Christine; McAuley, James H; Macedo, Luciana; Barnett, Dominique C; Smeets, Rob J; Verbunt, Jeanine A

2011-03-01

It is often assumed that patients with pain-related disability due to low back pain (LBP) will have reduced physical activity levels, but recent studies have provided results that challenge this assumption. The aim of our systematic review was to examine the relationship between physical activity and disability in LBP. The literature search included 6 electronic databases and the reference list of relevant systematic reviews and studies to May 2010. To be included, studies had to measure both disability (eg, with the Roland Morris Disability Questionnaire) and physical activity (eg, by accelerometry) in patients with non-specific LBP. Two independent reviewers screened search results and extracted data, and authors were contacted for additional data. Correlation coefficients were pooled using the random-effects model. The search identified 3213 records and 18 studies were eligible for inclusion. The pooled results showed a weak relationship between physical activity and disability in acute or subacute (<3months) LBP (r=-0.08, 95% confidence interval=-0.17 to 0.002), and a moderate and negative relationship in chronic (>3months) LBP (r=-0.33, 95% confidence interval=-0.51 to -0.15). That is, persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability. Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity. Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability. Persons with chronic back pain with high levels of disability will likely have low levels of physical activity. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Prevalence and Risk Factors for Low Back Pain in 1,355 Young Adults: A Cross-Sectional Study

PubMed Central

Acharya, Anita Shankar; Chauhan, Ravi; Acharya, Shankar

2017-01-01

Study Design Cross-sectional study. Purpose To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India. Overview of Literature LBP is an emerging problem in adolescents, with an incidence that is the highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature. Methods A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18–35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated. Results Most subjects (90.6%) were aged 20–29 years (mean, 24.49; range, 18–35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems (p<0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP. Conclusions The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual's quality of life and increasing productivity. PMID:28874980

Human Lipopolysaccharide-binding Protein (LBP) and CD14 Independently Deliver Triacylated Lipoproteins to Toll-like Receptor 1 (TLR1) and TLR2 and Enhance Formation of the Ternary Signaling Complex*

PubMed Central

Ranoa, Diana Rose E.; Kelley, Stacy L.; Tapping, Richard I.

2013-01-01

Bacterial lipoproteins are the most potent microbial agonists for the Toll-like receptor 2 (TLR2) subfamily, and this pattern recognition event induces cellular activation, leading to host immune responses. Triacylated bacterial lipoproteins coordinately bind TLR1 and TLR2, resulting in a stable ternary complex that drives intracellular signaling. The sensitivity of TLR-expressing cells to lipoproteins is greatly enhanced by two lipid-binding serum proteins known as lipopolysaccharide-binding protein (LBP) and soluble CD14 (sCD14); however, the physical mechanism that underlies this increased sensitivity is not known. To address this, we measured the ability of LBP and sCD14 to drive ternary complex formation between soluble extracellular domains of TLR1 and TLR2 and a synthetic triacylated lipopeptide agonist. Importantly, addition of substoichiometric amounts of either LBP or sCD14 significantly enhanced formation of a TLR1·TLR2 lipopeptide ternary complex as measured by size exclusion chromatography. However, neither LBP nor sCD14 was physically associated with the final ternary complex. Similar results were obtained using outer surface protein A (OspA), a naturally occurring triacylated lipoprotein agonist from Borrelia burgdorferi. Activation studies revealed that either LBP or sCD14 sensitized TLR-expressing cells to nanogram levels of either the synthetic lipopeptide or OspA lipoprotein agonist. Together, our results show that either LBP or sCD14 can drive ternary complex formation and TLR activation by acting as mobile carriers of triacylated lipopeptides or lipoproteins. PMID:23430250

Multiplanar lumbopelvic control in patients with low back pain: is multiplanar assessment better than single plane assessment in discriminating between patients and healthy controls?

PubMed

Nelson-Wong, E; Gallant, P; Alexander, S; Dehmer, K; Ingvalson, S; McClenahan, B; Piatte, A; Poupore, K; Davis, A M

2016-02-01

Patients with low back pain (LBP) commonly have lumbopelvic control deficits. Lumbopelvic assessment during sagittal motion is incorporated into commonly used clinical examination algorithms for Treatment Based Classification. The purpose of this study was to investigate whether combined assessment of lumbopelvic control during sagittal and frontal plane motion discriminates between people with and without LBP better than single plane assessment alone. Nineteen patients with LBP and 18 healthy control participants volunteered for this study. The active straight leg raise (ASLR) and active hip abduction (AHAbd) tests were used to assess lumbopelvic control during sagittal and frontal plane motion, respectively. The tests were scored as positive or negative using published scoring criteria. Contingency tables were created for each test alone and for the combined tests (both positive/both negative) with presence/absence of LBP as the reference standard to calculate accuracy statistics of sensitivity (sn), specificity (sp), likelihood (+LR and -LR), and diagnostic odds ratios (OR). Active straight leg raise and AHAbd tests alone had sn of 0·63, 0·74, respectively, sp of 0·61, 0·50, respectively, and OR of 2·7, 2·8, respectively. The combined tests had sn = 0·89, sp = 0·60, and OR = 12·0. Forty percent of patients with LBP had control deficits in both planes of motion. The AHAbd and ALSR tests appear to have greater diagnostic discrimination when used in combination than when used independently. A percentage of patients with LBP had control deficits in both planes, while others demonstrated uniplanar deficits only. These findings highlight the importance of multiplanar assessment in patients with LBP.

Low back pain status in elite and semi-elite Australian football codes: a cross-sectional survey of football (soccer), Australian rules, rugby league, rugby union and non-athletic controls.

PubMed

Hoskins, Wayne; Pollard, Henry; Daff, Chris; Odell, Andrew; Garbutt, Peter; McHardy, Andrew; Hardy, Kate; Dragasevic, George

2009-04-17

Our understanding of the effects of football code participation on low back pain (LBP) is limited. It is unclear whether LBP is more prevalent in athletic populations or differs between levels of competition. Thus it was the aim of this study to document and compare the prevalence, intensity, quality and frequency of LBP between elite and semi-elite male Australian football code participants and a non-athletic group. A cross-sectional survey of elite and semi-elite male Australian football code participants and a non-athletic group was performed. Participants completed a self-reported questionnaire incorporating the Quadruple Visual Analogue Scale (QVAS) and McGill Pain Questionnaire (short form) (MPQ-SF), along with additional questions adapted from an Australian epidemiological study. Respondents were 271 elite players (mean age 23.3, range 17-39), 360 semi-elite players (mean age 23.8, range 16-46) and 148 non-athletic controls (mean age 23.9, range 18-39). Groups were matched for age (p = 0.42) and experienced the same age of first onset LBP (p = 0.40). A significant linear increase in LBP from the non-athletic group, to the semi-elite and elite groups for the QVAS and the MPQ-SF was evident (p < 0.001). Elite subjects were more likely to experience more frequent (daily or weekly OR 1.77, 95% CI 1.29-2.42) and severe LBP (discomforting and greater OR 1.75, 95% CI 1.29-2.38). Foolers in Australia have significantly more severe and frequent LBP than a non-athletic group and this escalates with level of competition.

Prevalence and Risk Factors for Low Back Pain in 1,355 Young Adults: A Cross-Sectional Study.

PubMed

Ganesan, Sudhir; Acharya, Anita Shankar; Chauhan, Ravi; Acharya, Shankar

2017-08-01

Cross-sectional study. To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India. LBP is an emerging problem in adolescents, with an incidence that is the highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature. A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18-35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated. Most subjects (90.6%) were aged 20-29 years (mean, 24.49; range, 18-35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems ( p <0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP. The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual's quality of life and increasing productivity.

Does physical activity moderate the relationship between depression symptomatology and low back pain? Cohort and co-twin control analyses nested in the longitudinal study of aging Danish twins (LSADT).

PubMed

Hübscher, Markus; Hartvigsen, Jan; Fernandez, Matthew; Christensen, Kaare; Ferreira, Paulo

2016-04-01

To investigate whether depression symptomatology is associated with low back pain (LBP) in twins aged 70+ and whether this effect depends on a person's physical activity (PA) status. This prospective cohort and nested case-control study used a nationally representative sample of twins. Data on depression symptomatology (modified Cambridge Mental Disorders Examination) and self-reported PA were obtained from the Longitudinal Study of Aging Danish Twins using twins without LBP at baseline. Associations between depression symptomatology (highest quartile) at baseline and LBP two years later were investigated using logistic regression analyses adjusted for sex. To examine the moderating effect of PA, we tested its interaction with depression. Associations were analysed using the complete sample of 2446 twins and a matched case-control analysis of 97 twin pairs discordant for LBP at follow-up. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Using the whole sample, high depression scores were associated with an increased probability of LBP (OR 1.56, 95% CI 1.22-1.99, P ≤ 0.01). There was no statistically significant interaction of light PA and depression symptomatology (OR 0.78, 95% CI 0.46-1.35, P = 0.39) and strenuous PA and depression symptomatology (0.84, 95% CI 0.50-1.41, P = 0.51). The case-control analysis showed similar ORs, although statistically insignificant. High depression symptomatology predicted incident LBP. This effect is supposedly not attributable to genetic or shared environmental factors. Physical activity did not moderate the effect of depression symptomatology on LBP.

Protective effects of Lycium barbarum polysaccharide on male sexual dysfunction and fertility impairments by activating hypothalamic pituitary gonadal axis in streptozotocin-induced type-1 diabetic male mice.

PubMed

Shi, Guang-Jiang; Zheng, Jie; Wu, Jing; Qiao, Hai-Qi; Chang, Qing; Niu, Yang; Sun, Tao; Li, Yu-Xiang; Yu, Jian-Qiang

2017-09-30

Diabetes-associated male sexual dysfunction and fertility impairments are both common clinical complications with limited therapeutic options; hence it seriously affects the quality of life of the patients, in particular, the patients of reproductive age. Lycium barbarum polysaccharide (LBP) has long being believed to maintain and to promote reproductive functions in the traditional medical practice in China. The current study was to investigate if LBP may contribute to recovery of male sexual dysfunction and fertility impairments in diabetic individuals. The effects of LBP on sexual behaviors and histological changes of testis were studied in the type-1 diabetes male mice induced by intra-peritoneal (i.p.) injection of streptozotocin (STZ). After oral administration of LBP (10, 20 or 40 mg/kg), sildenafil citrate (SC, 5 mg/kg) or saline for 62 consecutive days, the typical abnormal changes in the sperm parameters, in relative weight of reproductive organs and in morphology of testis were observed in diabetic mice. LBP treatment of the diabetic mice considerably reversed those changes and Johnsen's testicular score, serum testosterone (T), follicular stimulating hormone (FSH) and luteinizing hormone (LH) level were also increased to different degrees. Moreover, our data have also shown that a marked improvement in sexual behavior and fertility level after administration of LBP (40 mg/kg) compared to the diabetic group. These results suggested that LBP can exert functional recovery of male sexual dysfunction and fertility damages induced by diabetes in male mice, which is likely to be mediated through regulating the hypothalamus- pituitary-gonadal axis endocrine activity.

Diagnosis and Characters of Non-Specific Low Back Pain in Japan: The Yamaguchi Low Back Pain Study

PubMed Central

Suzuki, Hidenori; Kanchiku, Tsukasa; Imajo, Yasuaki; Yoshida, Yuichiro; Nishida, Norihiro; Taguchi, Toshihiko

2016-01-01

Study Design Cross sectional data from the Yamaguchi low back pain study conducted in Yamaguchi prefecture, Japan, was used for this analysis. Methods A total of 320 patients were recruited from walk-in orthopedic clinics in Yamaguchi Prefecture, Japan. Patients visited the clinics primarily for low back pain (LBP) and sought treatment between April and May 2015. A self-questionnaire was completed by patients, while radiographic testing and neurological and physical examination was performed by the orthopedist in each hospital. The cause and characters of LBP was determined following examination of the data, regional anesthesia and block injection. Results ‘Specific LBP’ was diagnosed in 250 (78%) patients and non-diagnosable, ‘non-specific LBP’ in 70 (22%) patients. The VAS scores of patients were: LBP, 5.8±0.18; leg pain, 2.9±0.18 and the intensity of leg numbness was 1.9±0.16. Item scores for SF-8 were: general health, 46.6±0.40; physical function, 43.5±0.51; physical limitations, 42.8±0.53; body pain, 42.1±0.52; vitality, 48.4±0.37; social function, 46.9±0.53; emotional problems, 48.9±0.43; mental health, 46.9±0.43. Conclusions The incidence of non-specific LBP in Japan was lower than previous reports from western countries, presumably because of variation in the diagnosis of LBP between different health care systems. In Japan, 78% of cases were classified as ‘specific LBP’ by orthopedists. Identification of the definitive cause of LBP should help to improve the quality of LBP treatment. PMID:27548658

The effect of motor control training on abdominal muscle contraction during simulated weight bearing in elite cricketers.

PubMed

Hides, Julie A; Endicott, Timothy; Mendis, M Dilani; Stanton, Warren R

2016-07-01

To investigate whether motor control training alters automatic contraction of abdominal muscles in elite cricketers with low back pain (LBP) during performance of a simulated unilateral weight-bearing task. Clinical trial. 26 male elite-cricketers attended a 13-week cricket training camp. Prior to the camp, participants were allocated to a LBP or asymptomatic group. Real-time ultrasound imaging was used to assess automatic abdominal muscle response to axial loading. During the camp, the LBP group performed a staged motor control training program. Following the camp, the automatic response of the abdominal muscles was re-assessed. At pre-camp assessment, when participants were axially loaded with 25% of their own bodyweight, the LBP group showed a 15.5% thicker internal oblique (IO) muscle compared to the asymptomatic group (p = 0.009). The post-camp assessment showed that participants in the LBP group demonstrated less contraction of the IO muscle in response to axial loading compared with the asymptomatic group. A trend was found in the automatic recruitment pattern of the transversus abdominis (p = 0.08). Motor control training normalized excessive contraction of abdominal muscles in response to a low load task. This may be a useful strategy for rehabilitation of cricketers with LBP. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical Effects of Laser Acupuncture plus Chinese Cupping on the Pain and Plasma Cortisol Levels in Patients with Chronic Nonspecific Lower Back Pain: A Randomized Controlled Trial

PubMed Central

Lin, Mu-Lien; Wu, Hung-Chien; Shih, Yong-Sheng; Chiu, I-Ting; Chen, Chao-Yi

2017-01-01

Objectives Chronic nonspecific lower back pain (LBP) is a common disease. Insufficient data is currently available to conclusively confirm the analgesic effects of laser acupuncture on LBP. This study evaluated the effectiveness of laser acupuncture plus Chinese cupping in LBP treatment. Methods Patients with chronic nonspecific LBP were enrolled for a randomized controlled trial and assigned to the laser acupuncture group (laser acupuncture plus Chinese cupping) and control group (sham laser plus Chinese cupping). Laser acupuncture (808 nm; 40 mW; 20 Hz; 15 J/cm2) and Chinese cupping were applied on the Weizhong (BL40) and Ashi acupoints for 5 consecutive days. Plasma cortisol levels were assessed before and after the 5-day treatment session. The visual analog scale (VAS) scores were recorded at baseline and throughout the 5-day treatment session. Results After the treatment session, the plasma cortisol levels and VAS scores decreased significantly in both groups. In the laser acupuncture group, the VAS scores decreased significantly on days 4 and 5, and an enhanced reduction in VAS scores was observed. Conclusion Laser acupuncture plus Chinese cupping at the Weizhong (BL40) and Ashi acupoints effectively reduced pain and inflammation in chronic nonspecific LBP. This therapy could be a suitable option for LBP treatment in clinical settings. PMID:28848615

Clinical Effects of Laser Acupuncture plus Chinese Cupping on the Pain and Plasma Cortisol Levels in Patients with Chronic Nonspecific Lower Back Pain: A Randomized Controlled Trial.

PubMed

Lin, Mu-Lien; Wu, Jih-Huah; Lin, Chi-Wan; Su, Chuan-Tsung; Wu, Hung-Chien; Shih, Yong-Sheng; Chiu, I-Ting; Chen, Chao-Yi; Chang, Wen-Dien

2017-01-01

Chronic nonspecific lower back pain (LBP) is a common disease. Insufficient data is currently available to conclusively confirm the analgesic effects of laser acupuncture on LBP. This study evaluated the effectiveness of laser acupuncture plus Chinese cupping in LBP treatment. Patients with chronic nonspecific LBP were enrolled for a randomized controlled trial and assigned to the laser acupuncture group (laser acupuncture plus Chinese cupping) and control group (sham laser plus Chinese cupping). Laser acupuncture (808 nm; 40 mW; 20 Hz; 15 J/cm 2 ) and Chinese cupping were applied on the Weizhong (BL40) and Ashi acupoints for 5 consecutive days. Plasma cortisol levels were assessed before and after the 5-day treatment session. The visual analog scale (VAS) scores were recorded at baseline and throughout the 5-day treatment session. After the treatment session, the plasma cortisol levels and VAS scores decreased significantly in both groups. In the laser acupuncture group, the VAS scores decreased significantly on days 4 and 5, and an enhanced reduction in VAS scores was observed. Laser acupuncture plus Chinese cupping at the Weizhong (BL40) and Ashi acupoints effectively reduced pain and inflammation in chronic nonspecific LBP. This therapy could be a suitable option for LBP treatment in clinical settings.

The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes.

PubMed

Nadler, S F; Malanga, G A; DePrince, M; Stitik, T P; Feinberg, J H

2000-04-01

To determine the relationship of previous lower extremity (LE) injury and/or low back pain (LBP) on hip abduction and extension strength. Cohort study of college athletes at time of preparticipation screening physical. An NCAA Division I college. Two hundred ten college athletes (140 males and 70 females) from an NCAA Division I school. Mean and maximal hip abduction and extension strengths were recorded using a specially designed dynamometer anchoring station. Previous injury to the LE or LBP in the past year was recorded via personal interview at the time of screening and verified by review of previous injury records. A significant difference in side-to-side symmetry of maximum hip extension strength was observed in female subjects who reported LE injury or LBP as compared to those who did not. Side-to-side difference in hip strength, however, did not differ between male athletes, regardless of reported LE injury or LBP status. Female athletes appear to have a differing response of the proximal hip musculature to LE injury or LBP, as compared with their male counterparts. Research is under way to further validate these findings. This study provides some reasoning to support the screening of hip strength during the preparticipation physical, as it may be important in the prevention of LE injury and LBP in collegiate athletes.

Physical therapist vs. family practitioner knowledge of simple low back pain management in the U.S. Air Force.

PubMed

Ross, Michael D; Childs, John D; Middel, Cory; Kujawa, Julie; Brown, Daniel; Corrigan, Molly; Parsons, Nate

2014-02-01

The purpose of this study was to compare knowledge in managing low back pain (LBP) between physical therapists and family practice physicians. Fifty-four physical therapists and 130 family practice physicians currently serving in the U.S. Air Force completed standardized examinations assessing knowledge, attitudes, the usefulness of clinical practice guidelines, and management strategies for patients with LBP. Beliefs of physical therapists and family practice physicians about LBP were compared using relative risks and independent t tests. Scores related to knowledge, attitudes, and the usefulness of clinical practice guidelines were generally similar between the groups. However, physical therapists were more likely to recommend the correct drug treatments for patients with acute LBP compared to family practice physicians (85.2% vs. 68.5%; relative risk: 1.24 [95% confidence interval: 1.06-1.46]) and believe that patient encouragement and explanation is important (75.9% vs. 56.2%; relative risk: 1.35 [95% confidence interval: 1.09-1.67]). In addition, physical therapists showed significantly greater knowledge regarding optimal management strategies for patients with LBP compared to family practice physicians. The results of this study may have implications for health policy decisions regarding the utilization of physical therapists to provide care for patients with LBP without a referral. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Integrative Therapies for Low Back Pain That Include Complementary and Alternative Medicine Care: A Systematic Review

PubMed Central

Rose, Kevin; Kadar, Gena E.

2014-01-01

Study Design: Systematic review of the literature. Objective: To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. Summary of Background Data: LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. Methods: The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Results: Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. Conclusions: There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians. PMID:25568825

The effect of within-session instruction on lumbopelvic motion during a lower limb movement in people with and people without low back pain

PubMed Central

Scholtes, Sara A.; Norton, Barbara J.; Lang, Catherine E.; Van Dillen, Linda R.

2010-01-01

The purpose of the current study was to examine how effectively people with and people without low back pain (LBP) modify lumbopelvic motion during a limb movement test. Nineteen subjects with LBP and 20 subjects without LBP participated. Kinematic data were collected while subjects performed active hip lateral rotation (HLR) in prone. Subjects completed trials (1) using their natural method (Natural condition) of performing HLR, and (2) following standardized instructions to modify lumbopelvic motion while performing HLR (Modified condition). Variables of interest included (1) the amount of HLR completed prior to the start of lumbopelvic motion, and (2) the maximum amount of lumbopelvic motion demonstrated during HLR. Compared to the Natural Condition, all subjects improved their performance during the Modified condition by (1) completing a greater amount of HLR prior to the start of lumbopelvic motion, and (2) demonstrating less lumbopelvic motion (P<0.01 for all comparisons). There was a tendency for people without LBP to demonstrate a greater difference in maximal lumbopelvic rotation between the Natural and Modified conditions (P=0.07). In conclusion, people are able to modify lumbopelvic motion following instruction. Further study is needed to determine if people without LBP improve lumbopelvic motion following instruction to a greater extent than people with LBP. PMID:20627798

Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.

PubMed

Crosbie, Jack; de Faria Negrão Filho, Ruben; Nascimento, Dafne Port; Ferreira, Paulo

2013-03-01

Observational cohort study. To investigate spinal coordination during preferred and fast speed walking in pain-free subjects with and without a history of recurrent low back pain (LBP). Dynamic motion of the spine during walking is compromised in the presence of back pain (LBP), but its analysis often presents some challenges. The coexistence of significant symptoms may change gait because of pain or adaptation of the musculoskeletal structures or both. A history of LBP without the overlay of a current symptomatic episode allows a better model in which to explore the impact on spinal coordination during walking. Spinal and lower limb segmental motions were tracked using electromagnetic sensors. Analyses were conducted to explore the synchrony and spatial coordination of the segments and to compare the control and subjects with LBP. We found no apparent differences between the groups for either overall amplitude of motion or most indicators of coordination in the lumbar region; however, there were significant postural differences in the mid-stance phase and other indicators of less phase locking in controls compared with subjects with LBP. The lower thoracic spinal segment was more affected by the history of back pain than the lumbar segment. Although small, there were indicators that alterations in spinal movement and coordination in subjects with recurrent LBP were due to adaptive changes rather than the presence of pain.

Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain.

PubMed

O'Sullivan, Peter B; Caneiro, J P; O'Keeffe, Mary; Smith, Anne; Dankaerts, Wim; Fersum, Kjartan; O'Sullivan, Kieran

2018-05-01

Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes. Cognitive functional therapy was developed as a flexible integrated behavioral approach for individualizing the management of disabling LBP. This approach has evolved from an integration of foundational behavioral psychology and neuroscience within physical therapist practice. It is underpinned by a multidimensional clinical reasoning framework in order to identify the modifiable and nonmodifiable factors associated with an individual's disabling LBP. This article illustrates the application of cognitive functional therapy to provide care that can be adapted to an individual with disabling LBP.

Electromyographic evaluation of abdominal-muscle function with and without concomitant pelvic-floor-muscle contraction.

PubMed

Tahan, Nahid; Arab, Amir Massoud; Vaseghi, Bita; Khademi, Khosro

2013-05-01

Coactivation of abdominal and pelvic-floor muscles (PFM) is an issue considered by researchers recently. Electromyography (EMG) studies have shown that the abdominal-muscle activity is a normal response to PFM activity, and increase in EMG activity of the PFM concomitant with abdominal-muscle contraction was also reported. The purpose of this study was to compare the changes in EMG activity of the deep abdominal muscles during abdominal-muscle contraction (abdominal hollowing and bracing) with and without concomitant PFM contraction in healthy and low-back-pain (LBP) subjects. A 2 × 2 repeated-measures design. Laboratory. 30 subjects (15 with LBP, 15 without LBP). Peak rectified EMG of abdominal muscles. No difference in EMG of abdominal muscles with and without concomitant PFM contraction in abdominal hollowing (P = .84) and abdominal bracing (P = .53). No difference in EMG signal of abdominal muscles with and without PFM contraction between LBP and healthy subjects in both abdominal hollowing (P = .88) and abdominal bracing (P = .98) maneuvers. Adding PFM contraction had no significant effect on abdominal-muscle contraction in subjects with and without LBP.

Low back pain in Norwegian helicopter aircrew.

PubMed

Hansen, O B; Wagstaff, A S

2001-03-01

The size and consequences of low back pain (LBP) in Norwegian helicopter aircrew has been investigated in a retrospective and prospective survey. With 50.5% reporting such pain in a 2-yr period, and Sea King aircrew reporting LBP on on almost half (49.3%) of the missions flown, the magnitude of the problem equals that reported from other air forces. Pilots reported LBP six times more often than other crewmembers and almost half (48.6%) felt the pain influenced the quality of work. This could have flight safety implications. Crewmembers with total flying time over 2,000 h have a significantly higher incidence of sick leave than those with less than 2,000 h. Only 1 pilot out of 10 with total flying time under 500 h had had flight-related LBP.

Hip and Lumbar Spine Physical Examination Findings in People Presenting With Low Back Pain, With or Without Lower Extremity Pain.

PubMed

Prather, Heidi; Cheng, Abby; Steger-May, Karen; Maheshwari, Vaibhav; Van Dillen, Linda

2017-03-01

Study Design Prospective cohort study, cross-sectional design. Background The hip-spine syndrome is described in patients with known arthritis of the hip. This study describes the hip examination findings of people presenting with low back pain (LBP). Objectives To (1) report examination findings of the hip in patients with LBP and (2) compare pain and function in patients with positive hip examination findings to those in patients without positive hip examination findings. Methods An examination and validated questionnaires of spine and hip pain and function were completed. Pain and function scores were compared between patients with and without positive hip findings. Results Consecutive patients (68 women, 33 men) with a mean age of 47.6 years (range, 18.4-79.8 years) participated. On physical examination, 81 (80%) had reduced hip flexion; 76 (75%) had reduced hip internal rotation; and 25 (25%) had 1, 32 (32%) had 2, and 23 (23%) had 3 positive provocative hip tests. Patients with reduced hip flexion had worse LBP-related (mean modified Oswestry Disability Index, 35.3 versus 25.6; P = .04) and hip-related function (mean modified Harris Hip Score, 66.0 versus 82.0; P = .03). Patients with reduced hip internal rotation had worse LBP-related function (mean Roland-Morris questionnaire, 12.4 versus 8.2; P = .003). A positive provocative hip test was coupled with more intense pain (median, 9 versus 7; P = .05) and worse LBP-related (mean Roland-Morris questionnaire, 12.1 versus 8.5; P = .02) and hip-related function (mean modified Harris Hip Score, 65.8 versus 89.7; P = .005). Conclusion Physical examination findings indicating hip dysfunction are common in patients presenting with LBP. Patients with LBP and positive hip examination findings have more pain and worse function compared to patients with LBP but without positive hip examination findings. Level of Evidence Symptom prevalence, level 1b. J Orthop Sports Phys Ther 2017;47(3):163-172. Epub 3 Feb 2017. doi:10.2519/jospt.2017.6567.

Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial.

PubMed

Traeger, Adrian C; Moseley, G Lorimer; Hübscher, Markus; Lee, Hopin; Skinner, Ian W; Nicholas, Michael K; Henschke, Nicholas; Refshauge, Kathryn M; Blyth, Fiona M; Main, Chris J; Hush, Julia M; Pearce, Garry; McAuley, James H

2014-06-02

Low back pain (LBP) is the leading cause of disability worldwide. Of those patients who present to primary care with acute LBP, 40% continue to report symptoms 3 months later and develop chronic LBP. Although it is possible to identify these patients early, effective interventions to improve their outcomes are not available. This double-blind (participant/outcome assessor) randomised controlled trial will investigate the efficacy of a brief educational approach to prevent chronic LBP in 'at-risk' individuals. Participants will be recruited from primary care practices in the Sydney metropolitan area. To be eligible for inclusion participants will be aged 18-75 years, with acute LBP (<4 weeks' duration) preceded by at least a 1 month pain-free period and at-risk of developing chronic LBP. Potential participants with chronic spinal pain and those with suspected serious spinal pathology will be excluded. Eligible participants who agree to take part will be randomly allocated to receive 2×1 h sessions of pain biology education or 2×1 h sessions of sham education from a specially trained study physiotherapist. The study requires 101 participants per group to detect a 1-point difference in pain intensity 3 months after pain onset. Secondary outcomes include the incidence of chronic LBP, disability, pain intensity, depression, healthcare utilisation, pain attitudes and beliefs, global recovery and recurrence and are measured at 1 week post-intervention, and at 3, 6 and 12 months post LBP onset. Ethical approval was obtained from the University of New South Wales Human Ethics Committee in June 2013 (ref number HC12664). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612001180808. 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.

Association of low back pain on physical, sociodemographic and lifestyle factors across a general population sample within Greece.

PubMed

Billis, E; Koutsojannis, C; Matzaroglou, C; Gliatis, J; Fousekis, K; Gioftsos, G; Papandreou, M; McCarthy, C; Oldham, J A; Tsepis, E

2017-01-01

Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors. A sample of 3125 people of the Greek adult population was randomly selected by stratified sampling encompassing rural and urban representation within the Greek mainland. An extended survey form was developed entailing three sections; personal (sociodemographic) information, questions on symptomatology and physical factors (i.e. pain characteristics, recurrence, physical disability etc.) and 3 self-administered questionnaires (including mostly lifestyle factors); Hospital Anxiety and Depression (HAD) scale for anxiety and depression, SF-12 for quality of life (QoL) and Roland-Morris for disability. A total of 471 (15%) people reported LBP (210 males, mean age: 47.04 ± 15.03). Amongst them 60% reported sciatica, 76% suffered recurrent LBP and 70% received specialist care. Low disability levels, moderate to high pain intensity, gender differences and good self-reported QoL and psychosocial status were reported. Sociodemographic characteristics (income, smoking, marital status etc.) were not associated with LBP physical factors, apart from age which correlated with physical disability and wellness (r being 0.446 and 0.405, respectively, p< 0.001). Physical factors (particularly pain intensity and location) correlated with lifestyle factors (QoL) and disability (r ranging between 0.396 and 0.543, p< 0.001). Mental wellness, anxiety and depression (as lifestyle factors) were not associated with sociodemographic or physical factors. Physical parameters were amongst the most prevalent characteristics of the Greek sample, thus offering a direction towards a more targeted treatment and rehabilitation planning. Unlike previous literature, most sociodemographic characteristics were not correlated with any LBP physical or lifestyle factors, thus possibly indicating a different socioeconomic background and aetiology domain to that of the usual non-specific LBP spectrum.

Activation of the Nrf2/HO-1 Antioxidant Pathway Contributes to the Protective Effects of Lycium Barbarum Polysaccharides in the Rodent Retina after Ischemia-Reperfusion-Induced Damage

PubMed Central

Chang, Raymond Chuen-Chung; So, Kwok-Fai; Brecha, Nicholas C.; Pu, Mingliang

2014-01-01

Lycium barbarum polysaccharides (LBP), extracts from the wolfberries, are protective to retina after ischemia-reperfusion (I/R). The antioxidant response element (ARE)–mediated antioxidant pathway plays an important role in maintaining the redox status of the retina. Heme oxygenase-1 (HO-1), combined with potent AREs in its promoter, is a highly effective therapeutic target for the protection against neurodegenerative diseases, including I/R-induced retinal damage. The aim of our present study was to investigate whether the protective effect of LBP after I/R damage was mediated via activation of the Nrf2/HO-1-antioxidant pathway in the retina. Retinal I/R was induced by an increase in intraocular pressure to 130 mm Hg for 60 minutes. Prior to the induction of ischemia, rats were orally treated with either vehicle (PBS) or LBP (1 mg/kg) once a day for 1 week. For specific experiments, zinc protoporphyrin (ZnPP, 20 mg/kg), an HO-1 inhibitor, was intraperitoneally administered at 24 h prior to ischemia. The protective effects of LBP were evaluated by quantifying ganglion cell and amacrine cell survival, and by measuring cell apoptosis in the retinal layers. In addition, HO-1 expression was examined using Western blotting and immunofluorescence analyses. Cytosolic and nuclear Nrf2 was measured using immunofluorescent staining. LBP treatment significantly increased Nrf2 nuclear accumulation and HO-1 expression in the retina after I/R injury. Increased apoptosis and a decrease in the number of viable cells were observed in the ganglion cell layer (GCL) and inner nuclear layer (INL) in the I/R retina, which were reversed by LBP treatment. The HO-1 inhibitor, ZnPP, diminished the LBP treatment-induced protective effects in the retina after I/R. Taken together, these results suggested that LBP partially exerted its beneficial neuroprotective effects via the activation of Nrf2 and an increase in HO-1 protein expression. PMID:24400114

ISSLS PRIZE IN CLINICAL SCIENCE 2018: longitudinal analysis of inflammatory, psychological, and sleep-related factors following an acute low back pain episode-the good, the bad, and the ugly.

PubMed

Klyne, David M; Barbe, Mary F; van den Hoorn, Wolbert; Hodges, Paul W

2018-04-01

Prospective longitudinal study. To determine whether systemic cytokines and C-reactive protein (CRP) during an acute episode of low back pain (LBP) differ between individuals who did and did not recover by 6 months and to identify sub-groups based on patterns of inflammatory, psychological, and sleep features associated with recovery/non-recovery. Systemic inflammation is observed in chronic LBP and may contribute to the transition from acute to persistent LBP. Longitudinal studies are required to determine whether changes present early or develop over time. Psychological and/or sleep-related factors may be related. Individuals within 2 weeks of onset of acute LBP (N = 109) and pain-free controls (N = 55) provided blood for assessment of CRP, tumor necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-1β, and completed questionnaires related to pain, disability, sleep, and psychological status. LBP participants repeated measurements at 6 months. Biomarkers were compared between LBP and control participants at baseline, and in longitudinal (baseline/6 months) analysis, between unrecovered (≥pain and disability), partially recovered (reduced pain and/or disability) and recovered (no pain and disability) participants at 6 months. We assessed baseline patterns of inflammatory, psychological, sleep, and pain data using hierarchical clustering and related the clusters to recovery (% change in pain) at 6 months. CRP was higher in acute LBP than controls at baseline. In LBP, baseline CRP was higher in the recovered than non-recovered groups. Conversely, TNF was higher at both time-points in the non-recovered than recovered groups. Two sub-groups were identified that associated with more ("inflammatory/poor sleep") or less ("high TNF/depression") recovery. This is the first evidence of a relationship between an "acute-phase" systemic inflammatory response and recovery at 6 months. High inflammation (CRP/IL-6) was associated with good recovery, but specific elevation of TNF, along with depressive symptoms, was associated with bad recovery. Depression and TNF may have a two-way relationship. These slides can be retrieved under Electronic Supplementary Material.

Older adult's experience of chronic low back pain and its implications on their daily life: Study protocol of a systematic review of qualitative research.

PubMed

Wong, Arnold Y L; Forss, Katarina Sjögren; Jakobsson, Jenny; Schoeb, Veronika; Kumlien, Christine; Borglin, Gunilla

2018-05-24

Of various chronic diseases, low back pain (LBP) is the most common and debilitating musculoskeletal condition among older adults aged 65 years or older. While more than 17 million older adults in the USA suffer from at least one episode of LBP annually, approximately six million of them experience chronic LBP that significantly affects their quality of life and physical function. Since many older adults with chronic LBP may also have comorbidities and are more sensitive to pain than younger counterparts, these older individuals may face unique age-related physical and psychosocial problems. While some qualitative research studies have investigated the life experiences of older adults with chronic LBP, no systematic review has integrated and synthesized the scientific knowledge regarding the influence of chronic LBP on the physical, psychological, and social aspects of lives in older adults. Without such information, it may result in unmet care needs and ineffective interventions for this vulnerable group. Therefore, the objective of this systematic review is to synthesize knowledge regarding older adults' experiences of living with chronic LBP and the implications on their daily lives. Candidate publications will be sought from databases: PubMed, CINAHL, and PsycINFO. Qualitative research studies will be included if they are related to the experiences of older adults with chronic LBP. Two independent reviewers will screen the titles, abstracts, and full-text articles for eligibility. The reference lists of the included studies will be checked for additional relevant studies. Forward citation tracking will be conducted. Meta-ethnography will be chosen to synthesize the data from the included studies. Specifically, the second-order concepts that are deemed to be translatable by two independent reviewers will be included and synthesized to capture the core of the idiomatic translations (i.e., a translation focusing on salient categories of meaning rather than the literal translation of words or phrases). This systematic review of qualitative evidence will enable researchers to identify potential unmet care needs, as well as to facilitate the development of effective, appropriate, person-centered health care interventions targeting this group of individuals. PROSPERO 2018: CRD42018091292.

The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review.

PubMed

Wertli, Maria M; Rasmussen-Barr, Eva; Weiser, Sherri; Bachmann, Lucas M; Brunner, Florian

2014-05-01

Psychological factors including fear avoidance beliefs are believed to influence the development of chronic low back pain (LBP). The purpose of this study was to determine the prognostic importance of fear avoidance beliefs as assessed by the Fear Avoidance Beliefs Questionnaire (FABQ) and the Tampa Scale of Kinesiophobia for clinically relevant outcomes in patients with nonspecific LBP. The design of this study was a systematic review. In October 2011, the following databases were searched: BIOSIS, CINAHL, Cochrane Library, Embase, OTSeeker, PeDRO, PsycInfo, PubMed/Medline, Scopus, and Web of Science. To ensure the completeness of the search, a hand search and a search of bibliographies was conducted and all relevant references included. A total of 2,031 references were retrieved, leaving 566 references after the removal of duplicates. For 53 references, the full-text was assessed and, finally, 21 studies were included in the analysis. The most convincing evidence was found supporting fear avoidance beliefs to be a prognostic factor for work-related outcomes in patients with subacute LBP (ie, 4 weeks-3 months of LBP). Four cohort studies, conducted by disability insurance companies in the United States, Canada, and Belgium, included 258 to 1,068 patients mostly with nonspecific LBP. These researchers found an increased risk for work-related outcomes (not returning to work, sick days) with elevated FABQ scores. The odds ratio (OR) ranged from 1.05 (95% confidence interval [CI] 1.02-1.09) to 4.64 (95% CI, 1.57-13.71). The highest OR was found when applying a high cutoff for FABQ Work subscale scores. This may indicate that the use of cutoff values increases the likelihood of positive findings. This issue requires further study. Fear avoidance beliefs in very acute LBP (<2 weeks) and chronic LBP (>3 months) was mostly not predictive. Evidence suggests that fear avoidance beliefs are prognostic for poor outcome in subacute LBP, and thus early treatment, including interventions to reduce fear avoidance beliefs, may avoid delayed recovery and chronicity. Copyright © 2014 Elsevier Inc. All rights reserved.

The effect of the presence and characteristics of an outlying group on exposure-outcome associations.

PubMed

Coenen, Pieter; Mathiassen, Svend Erik; Kingma, Idsart; Boot, Cécile R L; Bongers, Paulien M; van Dieën, Jaap H

2015-01-01

Physical exposures (eg, lifting or bending) are believed to be risk factors for low-back pain (LBP), but the literature is inconsistent. Exposure and LBP prevalence differ considerably between occupations, and exposure-outcome associations could be severely modified by the presence of particular occupational groups. We aimed to investigate the influence of such outlying groups on the properties of associations between exposure and LBP. Lifting and trunk flexion were observed for 371 of 1131 workers within 19 groups. LBP was obtained from all workers during three follow-up years. Both exposure variables were associated with LBP (P<0.01) in this parent dataset. By removing the 19 groups one-by-one and performing logistic regressions analysis on the 18 remaining groups, we demonstrated that one group, mainly road workers, with outlying exposures and LBP prevalence substantially affected the exposure-outcome association in the total population. In order to further examine this phenomenon, we assessed, by simulation, the influence of realistic sizes (n=4, 8, 16, 32, 64, 128), mean exposures (e=2000, 3000, 4000 lifts and e=30, 40, 50% trunk flexion time) and LBP prevalences (p=70, 80, 90, 100%) of the outlying group on the strength and certainty of the eventual relationship between exposure and LBP. For each combination of n, e and p, 3000 virtual studies were constructed, including the simulated group together with the other 18 original groups from the parent data-set. Average odds ratios (OR), 95% confidence limits, and power (P<0.05) were calculated across these 3000 studies as measures of the properties of each virtual study design. OR were attenuated more towards 1 and power decreased with smaller values of n, e, and p in the outlying group. Changes in group size and prevalence had a larger influence on OR and power than changes in mean exposure. The size and characteristics of a single group with high exposure and outcome prevalence can strongly influence both the OR point estimate and the likelihood of obtaining significant exposure-outcome associations in studies of large populations. These findings can guide interpretations of prior epidemiological studies and support informed design of future studies.

Face Alignment via Regressing Local Binary Features.

PubMed

Ren, Shaoqing; Cao, Xudong; Wei, Yichen; Sun, Jian

2016-03-01

This paper presents a highly efficient and accurate regression approach for face alignment. Our approach has two novel components: 1) a set of local binary features and 2) a locality principle for learning those features. The locality principle guides us to learn a set of highly discriminative local binary features for each facial landmark independently. The obtained local binary features are used to jointly learn a linear regression for the final output. This approach achieves the state-of-the-art results when tested on the most challenging benchmarks to date. Furthermore, because extracting and regressing local binary features are computationally very cheap, our system is much faster than previous methods. It achieves over 3000 frames per second (FPS) on a desktop or 300 FPS on a mobile phone for locating a few dozens of landmarks. We also study a key issue that is important but has received little attention in the previous research, which is the face detector used to initialize alignment. We investigate several face detectors and perform quantitative evaluation on how they affect alignment accuracy. We find that an alignment friendly detector can further greatly boost the accuracy of our alignment method, reducing the error up to 16% relatively. To facilitate practical usage of face detection/alignment methods, we also propose a convenient metric to measure how good a detector is for alignment initialization.

Aging and low back pain among exercise participants: a follow-up study with psychological adaptation factors.

PubMed

Wilks, Scott E; Kadivar, Zahra; Guillory, Stephen A; Isaza, Jorge

2009-01-01

This study is a follow-up to a study previously published in this journal that reported the moderating function of exercise exertion amid the relationship between age and low back pain (LBP) among consistent exercise participants. The current study analyzed factors of psychological adaptation as potential mediators within the age--LBP relationship. Measures of psychological adaptation included psychological vulnerability, avoidant coping, resilient coping, and perceived resilience. The sample reported slightly moderate psychological vulnerability; a moderate extent of avoidant coping and resilient coping; and high resilience. Age inversely correlated with psychological vulnerability and avoidance coping. LBP correlated inversely with avoidant coping. Avoidant coping positively mediated (enhanced) age's effect on LBP. Results from this follow-up analysis highlight the importance of understanding and testing psychological factors in models with age and a physical health outcome.

Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial.

PubMed

Karimi, Noureddin; Akbarov, Parvin; Rahnama, Leila

2017-01-01

Low Back Pain (LBP) is considered as one of the most frequent disorders, which about 80% of adults experience in their lives. Lumbar disc herniation (LDH) is a cause for acute LBP. Among conservative treatments, traction is frequently used by clinicians to manage LBP resulting from LDH. However, there is still a lack of consensus about its efficacy. The purpose of this study was to evaluate the effects of segmental traction therapy on lumbar discs herniation, pain, lumbar range of motion (ROM), and back extensor muscles endurance in patients with acute LBP induced by LDH. Fifteen patients with acute LBP diagnosed by LDH participated in the present study. Participants undertook 15 sessions of segmental traction therapy along with conventional physiotherapy, 5 times a week for 3 weeks. Lumbar herniated mass size was measured before and after the treatment protocol using magnetic resonance imaging. Furthermore, pain, lumbar ROM and back muscle endurance were evaluated before and after the procedure using clinical outcome measures. Following the treatment protocol, herniated mass size and patients' pain were reduced significantly. In addition, lumbar flexion ROM showed a significant improvement. However, no significant change was observed for back extensor muscle endurance after the treatment procedure. The result of the present study showed segmental traction therapy might play an important role in the treatment of acute LBP stimulated by LDH.

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.

Liquid Based Preparation (LBP) cytology versus Conventional Cytology (CS) in FNA samples from breast, thyroid, salivary glands and soft tissues. Our experience in Crete (Greece).

PubMed

Mygdakos, N; Nikolaidou, Sylvia; Tzilivaki, Anna; Tamiolakis, D

2009-01-01

The improvement in quality of cytological preparations with the use of LBP methodology has been well-documented, but the cytological artifacts resulting from this technique have not been adequately described. This study describes and illustrates the cytological artifacts introduced by LBP technique when used on fine-needle aspirates (FNAs), and evaluates these artifacts as potential diagnostic pitfalls. We reviewed a total of 96 FNAs simultaneously processed by both conventional smears and LBP. FNAs were obtained from the following sites: lymph node (38), breast (28), soft-tissue sites (nine), salivary glands (six), and thyroid gland (15). The LBP smears were consistently devoid of obscuring elements, and the cells were adequately preserved and evenly dispersed. However, we noted some cytomorphological alterations that should be recognized to avoid erroneous diagnoses. The size of cell clusters was decreased, large branching sheets were fragmented, and there were more single cells, resulting in apparent discohesion. Small cells such as lymphocytes tended to aggregate. All cells were generally smaller and occasionally spindled, the chromatin detail was attenuated, and nucleoli were more prominent. Intranuclear inclusions were difficult to visualize. Background matrix was often altered in both quantity and quality. Extracellular particles, small mononuclear cells, red blood cells, and myoepithelial cells were markedly decreased in number. Cytopathologists should be careful in interpreting FNAs prepared using LBP technique if that is the only methodology employed. Familiarity with artifacts is essential to avoid misdiagnoses.

Evolution of the duplicated intracellular lipid-binding protein genes of teleost fishes.

PubMed

Venkatachalam, Ananda B; Parmar, Manoj B; Wright, Jonathan M

2017-08-01

Increasing organismal complexity during the evolution of life has been attributed to the duplication of genes and entire genomes. More recently, theoretical models have been proposed that postulate the fate of duplicated genes, among them the duplication-degeneration-complementation (DDC) model. In the DDC model, the common fate of a duplicated gene is lost from the genome owing to nonfunctionalization. Duplicated genes are retained in the genome either by subfunctionalization, where the functions of the ancestral gene are sub-divided between the sister duplicate genes, or by neofunctionalization, where one of the duplicate genes acquires a new function. Both processes occur either by loss or gain of regulatory elements in the promoters of duplicated genes. Here, we review the genomic organization, evolution, and transcriptional regulation of the multigene family of intracellular lipid-binding protein (iLBP) genes from teleost fishes. Teleost fishes possess many copies of iLBP genes owing to a whole genome duplication (WGD) early in the teleost fish radiation. Moreover, the retention of duplicated iLBP genes is substantially higher than the retention of all other genes duplicated in the teleost genome. The fatty acid-binding protein genes, a subfamily of the iLBP multigene family in zebrafish, are differentially regulated by peroxisome proliferator-activated receptor (PPAR) isoforms, which may account for the retention of iLBP genes in the zebrafish genome by the process of subfunctionalization of cis-acting regulatory elements in iLBP gene promoters.

Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein.

PubMed

Pavcnik-Arnol, Maja; Hojker, Sergej; Derganc, Metka

2004-07-01

To evaluate markers of infection in critically ill neonates and children, comparing lipopolysaccharide-binding protein (LBP) with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP). Prospective, observational study in the level III multidisciplinary neonatal and pediatric intensive care unit. Sixty patients with systemic inflammatory response syndrome (SIRS) and suspected infection classified into two groups: SIRS/sepsis ( n=33) and SIRS/no sepsis ( n=27). We included 29 neonates aged less than 48 h (neonates <48 h), 12 neonates older than 48 h (neonates >48 h), and 19 children. Median disease severity was high in neonates aged under 48 h and moderate in neonates aged over 48 h and children. Serum LBP, PCT, IL-6, and CRP were measured on two consecutive days. Area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and predictive values were evaluated. Serum LBP was higher in patients with SIRS/sepsis than in patients with SIRS/no sepsis. AUC for LBP on the first day of suspected infection was 0.89 in the younger neonates, 0.93 in the older neonates, and 0.91 in children. In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.

Relative abdominal adiposity is associated with chronic low back pain: a preliminary explorative study.

PubMed

Brooks, Cristy; Siegler, Jason C; Marshall, Paul W M

2016-08-02

Although previous research suggests a relationship between chronic low back pain (cLBP) and adiposity, this relationship is poorly understood. No research has explored the relationship between abdominal-specific subcutaneous and visceral adiposity with pain and disability in cLBP individuals. The aim of this study therefore was to examine the relationship of regional and total body adiposity to pain and disability in cLBP individuals. A preliminary explorative study design of seventy (n = 70) adult men and women with cLBP was employed. Anthropometric and adiposity measures were collected, including body mass index, waist-to-hip ratio, total body adiposity and specific ultrasound-based abdominal adiposity measurements. Self-reported pain and disability were measured using a Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) questionnaires respectively. Relationships between anthropometric and adiposity measures with pain and disability were assessed using correlation and regression analyses. Significant correlations between abdominal to lumbar adiposity ratio (A-L) variables and the waist-to-hip ratio with self-reported pain were observed. A-L variables were found to predict pain, with 9.1-30.5 % of the variance in pain across the three analysis models explained by these variables. No relationships between anthropometric or adiposity variables to self-reported disability were identified. The findings of this study indicated that regional distribution of adiposity via the A-L is associated with cLBP, providing a rationale for future research on adiposity and cLBP.

Texture Classification by Texton: Statistical versus Binary

PubMed Central

Guo, Zhenhua; Zhang, Zhongcheng; Li, Xiu; Li, Qin; You, Jane

2014-01-01

Using statistical textons for texture classification has shown great success recently. The maximal response 8 (Statistical_MR8), image patch (Statistical_Joint) and locally invariant fractal (Statistical_Fractal) are typical statistical texton algorithms and state-of-the-art texture classification methods. However, there are two limitations when using these methods. First, it needs a training stage to build a texton library, thus the recognition accuracy will be highly depended on the training samples; second, during feature extraction, local feature is assigned to a texton by searching for the nearest texton in the whole library, which is time consuming when the library size is big and the dimension of feature is high. To address the above two issues, in this paper, three binary texton counterpart methods were proposed, Binary_MR8, Binary_Joint, and Binary_Fractal. These methods do not require any training step but encode local feature into binary representation directly. The experimental results on the CUReT, UIUC and KTH-TIPS databases show that binary texton could get sound results with fast feature extraction, especially when the image size is not big and the quality of image is not poor. PMID:24520346

Localization of binary neutron star mergers with second and third generation gravitational-wave detectors

NASA Astrophysics Data System (ADS)

Mills, Cameron; Tiwari, Vaibhav; Fairhurst, Stephen

2018-05-01

The observation of gravitational wave signals from binary black hole and binary neutron star mergers has established the field of gravitational wave astronomy. It is expected that future networks of gravitational wave detectors will possess great potential in probing various aspects of astronomy. An important consideration for successive improvement of current detectors or establishment on new sites is knowledge of the minimum number of detectors required to perform precision astronomy. We attempt to answer this question by assessing the ability of future detector networks to detect and localize binary neutron stars mergers on the sky. Good localization ability is crucial for many of the scientific goals of gravitational wave astronomy, such as electromagnetic follow-up, measuring the properties of compact binaries throughout cosmic history, and cosmology. We find that although two detectors at improved sensitivity are sufficient to get a substantial increase in the number of observed signals, at least three detectors of comparable sensitivity are required to localize majority of the signals, typically to within around 10 deg2 —adequate for follow-up with most wide field of view optical telescopes.

Combined chiropractic interventions for low-back pain.

PubMed

Walker, Bruce F; French, Simon D; Grant, William; Green, Sally

2010-04-14

Chiropractors commonly use a combination of interventions to treat people with low-back pain (LBP). To determine the effects of combined chiropractic interventions (that is, a combination of therapies, other than spinal manipulation alone) on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with LBP, aged 18 and older. We searched: The Cochrane Back Review Group Trials Register (May 2009), CENTRAL (The Cochrane Library 2009, Issue 2), and MEDLINE (from January 1966), EMBASE (from January 1980), CINAHL (from January 1982), MANTIS (from Inception) and the Index to Chiropractic Literature (from Inception) to May 2009. We also screened references of identified articles and contacted chiropractic researchers. All randomised trials comparing the use of combined chiropractic interventions (rather than spinal manipulation alone) with no treatment or other therapies. At least two review authors selected studies, assessed the risk of bias, and extracted the data using standardised forms. Both descriptive synthesis and meta-analyses were performed. We included 12 studies involving 2887 participants with LBP. Three studies had low risk of bias. Included studies evaluated a range of chiropractic procedures in a variety of sub-populations of people with LBP.No trials were located of combined chiropractic interventions compared to no treatment. For acute and subacute LBP, chiropractic interventions improved short- and medium-term pain (SMD -0.25 (95% CI -0.46 to -0.04) and MD -0.89 (95%CI -1.60 to -0.18)) compared to other treatments, but there was no significant difference in long-term pain (MD -0.46 (95% CI -1.18 to 0.26)). Short-term improvement in disability was greater in the chiropractic group compared to other therapies (SMD -0.36 (95% CI -0.70 to -0.02)). However, the effect was small and all studies contributing to these results had high risk of bias. There was no difference in medium- and long-term disability. No difference was demonstrated for combined chiropractic interventions for chronic LBP and for studies that had a mixed population of LBP. Combined chiropractic interventions slightly improved pain and disability in the short-term and pain in the medium-term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions. Future research is very likely to change the estimate of effect and our confidence in the results.

The Fear Reduction Exercised Early (FREE) approach to low back pain: study protocol for a randomised controlled trial.

PubMed

Darlow, Ben; Stanley, James; Dean, Sarah; Abbott, J Haxby; Garrett, Sue; Mathieson, Fiona; Dowell, Anthony

2017-10-17

Low back pain (LBP) is a major health issue associated with considerable health loss and societal costs. General practitioners (GPs) play an important role in the management of LBP; however, GP care has not been shown to be the most cost-effective approach unless exercise and behavioural counselling are added to usual care. The Fear Reduction Exercised Early (FREE) approach to LBP has been developed to assist GPs to manage LBP by empowering exploration and management of psychosocial barriers to recovery and provision of evidence-based care and information. The aim of the Low Back Pain in General Practice (LBPinGP) trial is to explore whether patients with LBP who receive care from GPs trained in the FREE approach have better outcomes than those who receive usual care. This is a cluster randomised controlled superiority trial comparing the FREE approach with usual care for LBP management with investigator-blinded assessment of outcomes. GPs will be recruited and then cluster randomised (in practice groups) to the intervention or control arm. Intervention arm GPs will receive training in the FREE approach, and control arm GPs will continue to practice as usual. Patients presenting to their GP with a primary complaint of LBP will be allocated on the basis of allocation of the GP they consult. We aim to recruit 60 GPs and 275 patients (assuming patients are recruited from 75% of GPs and an average of 5 patients per GP complete the study, accounting for 20% patient participant dropout). Patient participants and the trial statistician will be blind to group allocation throughout the study. Analyses will be undertaken on an intention-to-treat basis. The primary outcome will be back-related functional impairment 6 months post-initial LBP consultation (interim data at 2 weeks, 6 weeks and 3 months), measured with the Roland-Morris Disability Questionnaire. Secondary patient outcomes include pain, satisfaction, quality of life, days off from work and costs of care. Secondary GP outcomes include beliefs about pain and impairment, GP confidence, and actual and reported clinical behaviour. Health economic and process evaluations will be conducted. In the LBPinGP trial, we will investigate providing an intervention during the first interaction a person with back pain has with their GP. Because the FREE approach is used within a normal GP consultation, if effective, it may be a cost-effective means of improving LBP care. Australian New Zealand Clinical Trials Registry, ACTRN12616000888460 . Registered on 6 July 2016.

Prevalence of low back pain in Iranian nurses: a systematic review and meta-analysis.

PubMed

Azizpour, Yosra; Delpisheh, Ali; Montazeri, Zahra; Sayehmiri, Kourosh

2017-01-01

Low back pain (LBP) as a musculoskeletal disorder is one of the most common occupational injuries in nurses but there isn't any valid measure of the prevalence of LBP in Iranian nursing. In order to increase the power and improve the estimates of the prevalence of LBP in Iranian nurses, a comprehensive meta-analysis was carried out. A summary measure of all studies conducted in this field was found and distributions of LBP were evaluated based on different variables. Inclusion criteria included articles with prevalence of LBP in Iranian nurses, who had at least six months of work experience without any trauma, injuries to spine, or any underlying disease. The keywords"prevalence, low back pain, nurses", and "Iran" were used as part of this search. Databases such as Pubmed, Web of Science, Science direct, Scopus, IranMedex, Irandoc, Magiran, SID, CIVILICA, IMEMR and Google scholar were searched up to and including 15 June 2016. For data extraction a form was designed that included the following variables: Author names, province, sample size, age, gender, marital status, work experience, body mass index, job type, smoking status, work schedule, year of publication, type of standard questionnaire, prevalence of LBP, studies' quality score and climate classifications. Data analysis was carried out using fixed and random effects model. Heterogeneity between studies was assessed by using the I 2 and Q tests. In all 1250 articles were identified and 22 articles with 9347 participants met the inclusion criteria for meta-analyses after filtering. The prevalence of low back pain during their working life and during the last year, was estimated at 63% (95% Confidence Interval (CI): 57.4-68.5) and 61.2% (95% CI: 55.7-66.7) respectively. The prevalence rate of this disorder was 58.7% (95% CI: 35.8-81.7) and 60.4% (95% CI: 52.2-68.6) among men and women respectively. Furthermore, prevalence's of LBP were 59.5% in wards nurses, 50.3% in operating room technicians, and 39.4% in aid nurses. The results showed the high prevalence of LBP injury in nurses, especially female nurses. The effect of musculoskeletal disorders such as LBP may be reduced by considering proper observation of the principles of ergonomics in the workplace, performing physical examinations on a regular basis, identifying risk factors in the advancement of musculoskeletal disorders and then trying to fix them.

Non-gynecologic cytology on liquid-based preparations: A morphologic review of facts and artifacts.

PubMed

Hoda, Rana S

2007-10-01

Liquid-based preparations (LBP) are increasingly being used both for gynecologic (gyn) and non-gynecologic (non-gyn) cytology including fine needle aspirations (FNA). The two FDA-approved LBP currently in use include ThinPrep (TP), (Cytyc Corp, Marlborough, MA) and SurePath (SP), (TriPath Imaging Inc., Burlington, NC). TP was approved for cervico-vaginal (Pap test) cytology in 1996 and SP in 1999 and both have since also been used for non-gyn cytology. In the LBP, instead of being smeared, cells are rinsed into a liquid preservative collection medium and processed on automated devices. Even after a decade of use, the morphological interpretation of LBP remains a diagnostic challenge because of somewhat altered morphology and artifacts or facts resulting from the fixation and processing techniques. These changes include cleaner background with altered or reduced background and extracellular elements; architectural changes such as smaller cell clusters and sheets, breakage of papillae; altered cell distribution with more dyscohesion and changes in cellular morphology with enhanced nuclear features, smaller cell size and slightly more three-dimensional (3-D) clusters. Herein, we review the published literature on morphological aspects of LBP for non-gyn cytology. (c) 2007 Wiley-Liss, Inc.

Content validity and test-retest reliability of a low back pain questionnaire in Zimbabwean adolescents.

PubMed

Chiwaridzo, Matthew; Chikasha, Tafadzwa Nicole; Naidoo, Nirmala; Dambi, Jermaine Matewu; Tadyanemhandu, Cathrine; Munambah, Nyaradzai; Chizanga, Precious Trish

2017-01-01

In Zimbabwe, a recent increase in the volume of research on recurrent non-specific low back pain (NSLBP) has revealed that adolescents are commonly affected. This is alarming to health professionals and parents and calls for serious primary preventative strategies to be developed and implemented forthwith. Early identification initiatives should be prioritised in order to curtail the condition and its progression. In an attempt to be proactive in minimising the prevalence of recurrent NSLBP, this study was conducted to evaluate the content validity and test-retest reliability of a survey questionnaire with the aim of proffering a valid and reliable questionnaire which can be used in non-clinical settings to identify adolescents with recurrent NSLBP in Harare, Zimbabwe and determine the possible factors associated with the condition. The study was conducted in two parts. The first part assessed content validity of the questionnaire using four experts derived from academia and clinical practice. The second part evaluated the reliability of the questionnaire among 125 high school-children aged between 13 and 19 years in a test-retest study. Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. Overall, the Scale Content Validity Index for the questionnaire was 0.97. Item completion for the reliability study was satisfactory. The questionnaire items had kappa values ranging from 0.17 (slight agreement) to 1 (perfect agreement). High levels of reliability were found for the questions on school bag use ( k =0.94), sports participation ( k =0.97), and lifetime prevalence ( k =0.89). Excellent content validity and slight to perfect test-retest reliability was found for the Low Back Pain (LBP) questionnaire. These results are comparable to findings of other studies evaluating the psychometric properties of LBP questionnaires. Cognisant of the limitations of the study, the results of this study suggest that the LBP questionnaire could be used in local studies investigating LBP among adolescents although questions enquiring on functional limitations and sciatica may need further consideration.

Sequence analysis to assess labour market participation following vocational rehabilitation: an observational study among patients sick-listed with low back pain from a randomised clinical trial in Denmark.

PubMed

Lindholdt, Louise; Labriola, Merete; Nielsen, Claus Vinther; Horsbøl, Trine Allerslev; Lund, Thomas

2017-07-20

The return-to-work (RTW) process after long-term sickness absence is often complex and long and implies multiple shifts between different labour market states for the absentee. Standard methods for examining RTW research typically rely on the analysis of one outcome measure at a time, which will not capture the many possible states and transitions the absentee can go through. The purpose of this study was to explore the potential added value of sequence analysis in supplement to standard regression analysis of a multidisciplinary RTW intervention among patients with low back pain (LBP). The study population consisted of 160 patients randomly allocated to either a hospital-based brief or a multidisciplinary intervention. Data on labour market participation following intervention were obtained from a national register and analysed in two ways: as a binary outcome expressed as active or passive relief at a 1-year follow-up and as four different categories for labour market participation. Logistic regression and sequence analysis were performed. The logistic regression analysis showed no difference in labour market participation for patients in the two groups after 1 year. Applying sequence analysis showed differences in subsequent labour market participation after 2 years after baseline in favour of the brief intervention group versus the multidisciplinary intervention group. The study indicated that sequence analysis could provide added analytical value as a supplement to traditional regression analysis in prospective studies of RTW among patients with LBP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevention of low back pain in the military cluster randomized trial: effects of brief psychosocial education on total and low back pain-related health care costs.

PubMed

Childs, John D; Wu, Samuel S; Teyhen, Deydre S; Robinson, Michael E; George, Steven Z

2014-04-01

Effective strategies for preventing low back pain (LBP) have remained elusive, despite annual direct health care costs exceeding $85 billion dollars annually. In our recently completed Prevention of Low Back Pain in the Military (POLM) trial, a brief psychosocial education program (PSEP) that reduced fear and threat of LBP reduced the incidence of health care-seeking for LBP. The purpose of this cost analysis was to determine if soldiers who received psychosocial education experienced lower health care costs compared with soldiers who did not receive psychosocial education. The POLM trial was a cluster randomized trial with four intervention arms and a 2-year follow-up. Consecutive subjects (n=4,295) entering a 16-week training program at Fort Sam Houston, TX, to become a combat medic in the U.S. Army were considered for participation. In addition to an assigned exercise program, soldiers were cluster randomized to receive or not receive a brief psychosocial education program delivered in a group setting. The Military Health System Management Analysis and Reporting Tool was used to extract total and LBP-related health care costs associated with LBP incidence over a 2-year follow-up period. After adjusting for postrandomization differences between the groups, the median total LBP-related health care costs for soldiers who received PSEP and incurred LBP-related costs during the 2-year follow-up period were $26 per soldier lower than for those who did not receive PSEP ($60 vs. $86, respectively, p=.034). The adjusted median total health care costs for soldiers who received PSEP and incurred at least some health care costs during the 2-year follow-up period were estimated at $2 per soldier lower than for those who did not receive PSEP ($2,439 vs. $2,441, respectively, p=.242). The results from this analysis demonstrate that a brief psychosocial education program was only marginally effective in reducing LBP-related health care costs and was not effective in reducing total health care costs. Had the 1,995 soldiers in the PSEP group not received PSEP, we would estimate that 16.7% of them would incur an adjusted median LBP-related health care cost of $517 compared with the current 15.0% soldiers incurring an adjusted median cost of $399, which translates into an actual LBP-related health care cost savings of $52,846 during the POLM trial. However, it is likely that the unaccounted for direct and indirect costs might erase even these small cost savings. The results of this study will help to inform policy- and decision-making regarding the feasibility of implementing psychosocial education in military training environments across the services. It would be interesting to explore in future research whether cost savings from psychosocial education could be enhanced given a more individualized delivery method tailored to an individual's specific psychosocial risk factors. Published by Elsevier Inc.

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.

Survey of inspection and palpation rates among spine providers: evaluation of physician performance of the physical examination for patients with low back pain.

PubMed

Press, Joel; Liem, Brian; Walega, David; Garfin, Steven

2013-09-15

Survey from July 2011 to April 2012 of adult patients with primary complaint of low back pain (LBP). To determine the frequency of physical examination being performed by various providers, as measured by frequency of inspection and palpation, of patients with LBP and to describe patient ratings of these examinations. The physical examination is a cornerstone of any evaluation of patients with LBP. With increasing reliance on diagnostic imaging, there is concern that patients are not being examined comprehensively, but to our knowledge, no studies have ever investigated how often the physical examination is performed in patients with LBP. Survey participants were asked to list the types of physicians that they had seen for LBP within the past 1 year and for each physician encounter to answer 2 "yes/no" questions: (1) whether they had removed their clothes or put on a gown or shorts during the examination (our proxy for inspection) and (2) whether the provider had placed his or her hands on the patient (our proxy for palpation). Subjects also provided quality ratings for each provider's physical examination. Main outcome measures included frequency of inspection and palpation and subjects' ratings of each physical examination. A total of 295 surveys were collected reflecting 696 prior physician encounters. Inspection was done in 57% of physician encounters. Across specialties, orthopedic surgeons had the highest reported rate of inspection at 72%. The worst was among chiropractors at 40%. Palpation occurred in 80% of physician encounters. Chiropractors had the highest rate of palpation at 94%. The lowest rate was among neurosurgeons at 58%. Our data suggest that approximately 43% of patient visits for LBP involved no inspection and nearly 20% without palpation. These numbers reflect a need for improvement among providers who treat patients with LBP. N/A.

Key characteristics of low back pain and disability in college-aged adults: a pilot study.

PubMed

Handrakis, John P; Friel, Karen; Hoeffner, Frank; Akinkunle, Ola; Genova, Vito; Isakov, Edward; Mathew, Jerrill; Vitulli, Frank

2012-07-01

To identify which factors commonly associated with low back pain (LBP) and disability differ between college-aged persons with LBP and with no or minimal LBP. Clinical measurement, observational study. Subjects were assessed for LBP with the visual analog scale (VAS) and for disability from LBP using the Oswestry Disability Index (ODI). Subjects were measured for variables commonly associated with LBP and were grouped by both VAS (minimum [min]/no pain, pain) and ODI (no disability, disability) scores. College campus at a university. A convenience sample (N=84) of English-speaking students (34 men, 50 women) between 18 and 30 years of age. Not applicable. Sports activity (sports activity score of the Baecke Physical Activity Questionnaire), depression, hamstring and hip flexor range of motion, low back extensor endurance, abdominal strength and endurance. A significant main effect of group was found for both pain (P=.019) and disability groups (P=.006). The min/no pain and pain groups differed in back endurance (114.2±38.8s vs 94.5±44.5s, respectively; P=.04). The no disability and disability groups differed in back endurance (116.3±35.9s vs 97.1±45.7s, respectively; P=.03) and the sports activity score of the Baecke Physical Activity Questionnaire (2.98±.95 vs 2.48±.85, respectively; P=.01). Subjects with hyperkyphotic postures compared with the normative thoracic group had higher depression scores (49 vs 38.5, respectively; P=.03) and less hamstring flexibility (30.5 vs 49.9, respectively; P<.001). Back extensor endurance was consistently different between both the pain and disability groups. Addressing limited low back extensor endurance and low levels of physical activity in young adults may have clinical relevance for the prevention and treatment of LBP and disability. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

An evidence map of yoga for low back pain.

PubMed

Goode, Adam P; Coeytaux, Remy R; McDuffie, Jennifer; Duan-Porter, Wei; Sharma, Poonam; Mennella, Hillary; Nagi, Avishek; Williams, John W

2016-04-01

Yoga is being increasingly studied as a treatment strategy for a variety of different clinical conditions, including low back pain (LBP). We set out to conduct an evidence map of yoga for the treatment, prevention and recurrence of acute or chronic low back pain (cLBP). We searched Medline, Cochrane Database of Systematic Reviews, EMBASE, Allied and Complementary Medicine Database and ClinicalTrials.gov for randomized controlled trials (RCT), systematic reviews or planned studies on the treatment or prevention of acute back pain or cLBP. Two independent reviewers screened papers for inclusion, extracted data and assessed the quality of included studies. Three eligible systematic reviews were identified that included 10 RCTs (n=956) that evaluated yoga for non-specific cLBP. We did not identify additional RCTs beyond those included in the systematic reviews. Our search of ClinicalTrials.gov identified one small (n=10) unpublished trial and one large (n=320) planned clinical trial. The most recent good quality systematic review indicated significant effects for short- and long-term pain reduction (n=6 trials; standardized mean difference [SMD] -0.48; 95% CI, -0.65 to -0.31; I(2)=0% and n=5; SMD -0.33; 95% CI, -0.59 to -0.07; I(2)=48%, respectively). Long-term effects for back specific disability were also identified (n=5; SMD -0.35; 95% CI, -0.55 to -0.15; I(2)=20%). No studies were identified evaluating yoga for prevention or treatment of acute LBP. Evidence suggests benefit of yoga in midlife adults with non-specific cLBP for short- and long-term pain and back-specific disability, but the effects of yoga for health-related quality of life, well- being and acute LBP are uncertain. Without additional studies, further systematic reviews are unlikely to be informative. Copyright © 2016 Elsevier Ltd. All rights reserved.

Phenotype Matters: The Absence of a Positive Association between Cortical Thinning and Chronic Low Back Pain when Controlling for Salient Clinical Variables

PubMed Central

Dolman, Andrew J; Loggia, Marco L.; Edwards, Robert R.; Gollub, Randy L.; Jian, Jian Kong; Vitaly, Napadow; Wasan, Ajay D.

2014-01-01

Studies have associated chronic low back pain (cLBP) with grey matter thinning. But these studies have not controlled for important clinical variables (such as a comorbid affective disorder, pain medication, age, or pain phenotype), which may reduce or eliminate these associations. We conducted cortical thickness and voxel-based morphometry (VBM) analyses in 14 cLBP patients with a discogenic component to their pain, not taking opioids or benzodiazepines, and not depressed or anxious. They were age and gender matched to 14 healthy controls (HCs). An ROI-driven analysis (regions of interest) was conducted, using 18 clusters from a previous arterial spin labeling study demonstrating greater regional cerebral blood flow (rCBF) in these cLBP subjects than the HCs. Cortical thickness and VBM-based gray matter volume measurements were obtained from a structural MRI scan and group contrasts were calculated. MANOVA showed a trend toward cortical thickening in the right paracentral lobule in cLBP subjects (F(1,17)=3.667, p<0.067), and significant thickening in the right rostral middle frontal gyrus (F(1,17)=6.880, p<0.014). These clusters were non-significant after including age as a covariate (p<0.891; p<0.279). A whole-brain cortical thickness and VBM analysis also did not identify significant clusters of thinning or thickening. Exploratory analyses identified group differences for correlations between age and cortical thickness of the right rostral middle frontal gyrus (cLBP: R=-0.03, p=0.9; HCs: R=-0.81, p<0.001), i.e., HCs demonstrated age-related thinning while cLBP patients did not. Our pilot results suggest that controlling for affect, age, and concurrent medications may reduce or eliminate some of the previously reported structural brain alterations in cLBP. PMID:24135900

Recruitment of discrete regions of the psoas major and quadratus lumborum muscles is changed in specific sitting postures in individuals with recurrent low back pain.

PubMed

Park, Rachel J; Tsao, Henry; Claus, Andrew; Cresswell, Andrew G; Hodges, Paul W

2013-11-01

Cross-sectional controlled laboratory study. To investigate potential changes in the function of discrete regions of the psoas major (PM) and quadratus lumborum (QL) with changes in spinal curvatures and hip positions in sitting, in people with recurrent low back pain (LBP). Although the PM and QL contribute to control of spinal curvature in sitting, whether activity of these muscles is changed in individuals with LBP is unknown. Ten volunteers with recurrent LBP (pain free at the time of testing) and 9 pain-free individuals in a comparison group participated. Participants with LBP were grouped into those with high and low erector spinae (ES) electromyographic (EMG) signal amplitude, recorded when sitting with a lumbar lordosis. Data were recorded as participants assumed 3 sitting postures. Fine-wire electrodes were inserted with ultrasound guidance into fascicles of the PM arising from the transverse process and vertebral body, and the anterior and posterior layers of the QL. When data from those with recurrent LBP were analyzed as 1 group, PM and QL EMG signal amplitudes did not differ between groups in any of the sitting postures. However, when subgrouped, those with low ES EMG had greater EMG signal amplitude of the PM vertebral body and QL posterior layer in flat posture and greater EMG signal amplitude of the QL posterior layer in short lordotic posture, compared to those in the pain-free group. For the group with high ES EMG, the PM transverse process and PM vertebral body EMG was less than that of the other LBP group in short lordotic posture. The findings suggest a redistribution of activity between muscles that have a potential extensor moment in individuals with LBP. The modification of EMG of discrete fascicles of the PM and QL was related to changes in ES EMG signal amplitude recorded in sitting.

The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review.

PubMed

Seco, Jesús; Kovacs, Francisco M; Urrutia, Gerard

2011-10-01

Shock wave and especially ultrasound are commonly used to treat low back pain (LBP) in routine practice. To assess the evidence on the efficacy, effectiveness, cost-effectiveness, and safety of ultrasound and shock wave to treat LBP. Systematic review. An electronic search was performed in MEDLINE, EMBASE, and the Cochrane Library databases up to July 2009 to identify randomized controlled trials (RCTs) comparing vibrotherapy with placebo or with other treatments for LBP. No language restrictions were applied. Additional data were requested from the authors of the original studies. The risk of bias of each study was assessed following the criteria recommended by the Cochrane Back Review Group. Thirteen studies were identified. The four RCTs complying with the inclusion criteria included 252 patients. Two of the three RCTs on ultrasound had a high risk of bias. For acute patients with LBP and leg pain attributed to disc herniation, ultrasound, traction, and low-power laser obtained similar results. For chronic LBP patients without leg pain, ultrasound was less effective than spinal manipulation, whereas a shock wave device and transcutaneous electrical nerve stimulation led to similar results. Results from the only study comparing ultrasound versus a sham procedure are unreliable because of the inappropriateness of the sham procedure, low sample size, and lack of adjustment for potential confounders. No study assessed cost-effectiveness. No adverse events were reported. The available evidence does not support the effectiveness of ultrasound or shock wave for treating LBP. High-quality RCTs are needed to assess their efficacy versus appropriate sham procedures, and their effectiveness and cost-effectiveness versus other procedures shown to be effective for LBP. In the absence of such evidence, the clinical use of these forms of treatment is not justified and should be discouraged. Copyright © 2011 Elsevier Inc. All rights reserved.

The lumbar spine and low back pain in golf: a literature review of swing biomechanics and injury prevention.

PubMed

Gluck, George S; Bendo, John A; Spivak, Jeffrey M

2008-01-01

The golf swing imparts significant stress on the lumbar spine. Not surprisingly, low back pain (LBP) is one of the most common musculoskeletal complaints among golfers. This article provides a review of lumbar spine forces during the golf swing and other research available on swing biomechanics and muscle activity during trunk rotation. The role of "modern" and "classic" swing styles in golf-associated LBP, as well as LBP causation theories, treatment, and prevention strategies, are reviewed. A PubMed literature search was performed using various permutations of the following keywords: lumbar, spine, low, back, therapy, pain, prevention, injuries, golf, swing, trunk, rotation, and biomechanics. Articles were screened and selected for relevance to injuries in golf, swing mechanics, and biomechanics of the trunk and lumbar spine. Articles addressing treatment of LBP with discussions on trunk rotation or golf were also selected. Primary references were included from the initial selection of articles where appropriate. General web searches were performed to identify articles for background information on the sport of golf and postsurgical return to play. Prospective, randomized studies have shown that focus on the transversus abdominus (TA) and multifidi (MF) muscles is a necessary part of physical therapy for LBP. Some studies also suggest that the coaching of a "classic" golf swing and increasing trunk flexibility may provide additional benefit. There is a notable lack of studies separating the effects of swing modification from physical rehabilitation, and controlled trials are necessary to identify the true effectiveness of specific swing modifications for reducing LBP in golf. Although the establishment of a commonly used regimen to address all golf-associated LBP would be ideal, it may be more practical to apply basic principles mentioned in this article to the tailoring of a unique regimen for the patient. Guidelines for returning to golf after spine surgery are also discussed.

Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai

PubMed Central

Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

2013-01-01

Purpose This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. Methods An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Results Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student’s grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. Conclusions High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP. PMID:24147114

Hip bone marrow edema presenting as low back pain: a case report.

PubMed

Mourad, Firas; Maselli, Filippo; Cataldi, Fabio; Pennella, Denis; Fernández-De-Las-Peñas, César; Dunning, James

2018-06-01

Nonspecific low back pain (LBP) is frequently managed by physiotherapists. However, physiotherapists in a direct access setting may encounter patients with serious medical conditions, such as Bone Marrow Edema Syndrome (BMES) of the hip with symptoms mimicking LBP. To our knowledge, this is the first case to describe hip BMES presenting as LBP. Diagnosis was based on the patient's symptoms in conjunction with magnetic resonance imaging (MRI). In order to avoid misdiagnosing the patient, primary care clinicians should be aware that BMES can mimic nonspecific LBP. To present a rare clinical presentation of BMES of the hip mimicking nonspecific LBP. To the best of the author's knowledge, this is the first case to describe hip BMES presenting as mechanical nonspecific LBP. This case report describes the history, examination findings, and clinical reasoning used for a patient with LBP as a chief complaint. Furthermore, the clinical presentation (i.e. pain location and its changes related to load) and the symptoms behavior (i.e. immediate symptoms decrease after few hip treatment sessions and quick worsening of the hip pain related to loading activities) after two treatment sessions increased the suspicion of an underlying medical condition of the hip joint and lead to the decision for additional evaluation. A MRI showed a serious hip BMES. This case report highlights the importance of including a comprehensive and continuous differential diagnostic process throughout the treatment period, looking for those risk factors (i.e. red flags) that warrant further investigation and referral to the appropriate physician. Physiotherapy diagnosis should include clinical reasoning, clinical presentation, and symptom behavior in addition to appropriate referral for medical assessment and diagnostic imaging when appropriate. Physiotherapists working within a direct access environment have the competence and responsibility to participate with other health professionals in the differential diagnose process especially for patients presenting with serious pathology mimicking musculoskeletal disorders.

Effect of the Individual Strengthening Exercises for Posterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROM of a LBP Patient with Excessive Lordosis: A Case Study.

PubMed

Yoo, Won-Gyu

2014-02-01

[Purpose] The purpose of this study was to document the effect of individual strengthening exercises for posterior pelvic tilt muscles on back pain, pelvic tilt angle, and lumbar ROM of a low back pain (LBP) patient with excessive lordosis. [Subjects] The subject was a 28 year-old male with excessive lordosis who complained of severe LBP at the L3 level. [Methods] He performed individual strengthening exercises for the posterior pelvic tilt muscles (rectus abdominis, gluteus maximus, hamstring). [Results] Pelvic tilt angles on the right and left sides recovered to his normal ranges. Limited lumbar ROM increased, and low back pain decreased. [Conclusion] We suggest that an approach of individual resistance exercises is necessary for the effective and fast strengthening of the pelvic posterior tilt muscles in case of LBP with excessive lordosis.

Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial.

PubMed

Ognibene, Grant T; Torres, Wilson; von Eyben, Rie; Horst, Kathleen C

2016-03-01

The aim of the study was to determine whether chronic low back pain (LBP) might be attenuated through the introduction of a sit-stand workstation (SSW) in office employees. Participants were randomized to receive a SSW at the beginning or at the end of a 3-month study period. Participants responded to a short survey at the end of each workday and a comprehensive survey at weeks 1, 6, and 12. Surveys consisted of a modified brief pain inventory and the Roland Morris Disability Questionnaire. Forty-six university employees with self-reported chronic LBP were enrolled. Participants who were given access to a SSW reported a significant reduction in current (P = 0.02) and worst (P = 0.04) LBP over time. Our findings support the hypothesis that chronic LBP might be improved by the introduction of a SSW in an office environment.

Long-term evaluation of a Canadian back pain mass media campaign.

PubMed

Suman, Arnela; Bostick, Geoffrey P; Schopflocher, Donald; Russell, Anthony S; Ferrari, Robert; Battié, Michele C; Hu, Richard; Buchbinder, Rachelle; Gross, Douglas P

2017-09-01

This paper evaluates the long-term impact of a Canadian mass media campaign on general public beliefs about staying active when experiencing low back pain (LBP). Changes in beliefs about staying active during an episode of LBP were studied using telephone and web-based surveys. Logistic regression analysis was used to investigate changes in beliefs over time and the effect of exposure to campaign messaging. The percentage of survey respondents agreeing that they should stay active through LBP increased annually from 58.9 to ~72.0%. Respondents reporting exposure to campaign messaging were statistically significantly more likely to agree with staying active than respondents who did not report exposure to campaign messaging (adjusted OR, 95% CI = 1.96, 1.73-2.21). The mass media campaign had continued impact on public LBP beliefs over the course of 7 years. Improvements over time were associated with exposure to campaign messaging.

Prevalence of occupation-related pain among baristas and an examination of low back and shoulder demand during the preparation of espresso-based beverages.

PubMed

Dainty, R Scott; Alcorn, Eric; Ferguson, Chantelle A; Gregory, Diane E

2014-01-01

Many baristas complain of low back pain (LBP) and upper extremity discomfort while at work. This study documented the prevalence of LBP and shoulder pain, via questionnaire, among a population of baristas to determine whether cumulative low back loads and shoulder moments are associated with pain reporting. Fifty-nine baristas completed the questionnaire; ten were also video-recorded for biomechanical analysis while making espresso beverages and cumulative and peak low back loads and shoulder moments were calculated. Seventy-three percent of those who completed the questionnaire reported having experienced LBP, and half attributed this pain to their job as a barista. Furthermore, 68% reported having experienced shoulder pain and half also attributed this pain to their job. Those who suffered from LBP had higher peak low back compression and those with shoulder pain had, in general, higher moments about their dominant shoulder.

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.

The Effects of the Nintendo Wii Exercise Program on Chronic Work-related Low Back Pain in Industrial Workers.

PubMed

Park, Ji-Hyuk; Lee, Sang-Heon; Ko, Dae-Sik

2013-08-01

[Purpose] The purpose of this study was to investigate the effects of a Nintendo Wii exercise program on chronic work-related LBP compared with stability exercise. [Methods] Twenty-four workers participated in this study. All of the participants were diagnosed with chronic LBP by a physician. Participants were randomly assigned to three groups: a control group (CG), lumbar stabilization exercise group (LSE), and Nintendo Wii exercise group (NWE). Participants were treated 3 times a week for 8 weeks. Each session lasted 30 minutes. [Results] The results demonstrated that exercise programs improved significantly physical functions related to LBP. In health-related QOL, the Nintendo Wii exercise program significantly improved both the mental and physical health composites, but other groups had significant improvement only in the physical health composite. [Conclusion] The Nintendo Wii exercise program could be a biopsychosocial intervention for work-related LBP in factory workers.

The Effects of the Nintendo Wii Exercise Program on Chronic Work-related Low Back Pain in Industrial Workers

PubMed Central

Park, Ji-Hyuk; Lee, Sang-Heon; Ko, Dae-Sik

2013-01-01

[Purpose] The purpose of this study was to investigate the effects of a Nintendo Wii exercise program on chronic work-related LBP compared with stability exercise. [Methods] Twenty-four workers participated in this study. All of the participants were diagnosed with chronic LBP by a physician. Participants were randomly assigned to three groups: a control group (CG), lumbar stabilization exercise group (LSE), and Nintendo Wii exercise group (NWE). Participants were treated 3 times a week for 8 weeks. Each session lasted 30 minutes. [Results] The results demonstrated that exercise programs improved significantly physical functions related to LBP. In health-related QOL, the Nintendo Wii exercise program significantly improved both the mental and physical health composites, but other groups had significant improvement only in the physical health composite. [Conclusion] The Nintendo Wii exercise program could be a biopsychosocial intervention for work-related LBP in factory workers. PMID:24259899

Robust image region descriptor using local derivative ordinal binary pattern

NASA Astrophysics Data System (ADS)

Shang, Jun; Chen, Chuanbo; Pei, Xiaobing; Liang, Hu; Tang, He; Sarem, Mudar

2015-05-01

Binary image descriptors have received a lot of attention in recent years, since they provide numerous advantages, such as low memory footprint and efficient matching strategy. However, they utilize intermediate representations and are generally less discriminative than floating-point descriptors. We propose an image region descriptor, namely local derivative ordinal binary pattern, for object recognition and image categorization. In order to preserve more local contrast and edge information, we quantize the intensity differences between the central pixels and their neighbors of the detected local affine covariant regions in an adaptive way. These differences are then sorted and mapped into binary codes and histogrammed with a weight of the sum of the absolute value of the differences. Furthermore, the gray level of the central pixel is quantized to further improve the discriminative ability. Finally, we combine them to form a joint histogram to represent the features of the image. We observe that our descriptor preserves more local brightness and edge information than traditional binary descriptors. Also, our descriptor is robust to rotation, illumination variations, and other geometric transformations. We conduct extensive experiments on the standard ETHZ and Kentucky datasets for object recognition and PASCAL for image classification. The experimental results show that our descriptor outperforms existing state-of-the-art methods.

REPORT OF THE NIH TASK FORCE ON RESEARCH STANDARDS FOR CHRONIC LOW BACK PAIN

PubMed Central

Deyo, Richard A.; Dworkin, Samuel F.; Amtmann, Dagmar; Andersson, Gunnar; Borenstein, David; Carragee, Eugene; Carrino, John; Chou, Roger; Cook, Karon; DeLitto, Anthony; Goertz, Christine; Khalsa, Partap; Loeser, John; Mackey, Sean; Panagis, James; Rainville, James; Tosteson, Tor; Turk, Dennis; Von Korff, Michael; Weiner, Debra K.

2014-01-01

Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients’ lives. Such cLBP is often termed non-specific, and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The NIH Pain Consortium therefore charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research participants (drawing heavily on the PROMIS methodology); reporting “responder analyses” in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recommendations, which investigators should incorporate into NIH grant proposals. The RTF believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. We expect the RTF recommendations will become a dynamic document, and undergo continual improvement. Perspective A Task Force was convened by the NIH Pain Consortium, with the goal of developing research standards for chronic low back pain. The results included recommendations for definitions, a minimal dataset, reporting outcomes, and future research. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. PMID:24787228

Variable Lifting Index for Manual-Lifting Risk Assessment: A Preliminary Validation Study.

PubMed

Battevi, Natale; Pandolfi, Monica; Cortinovis, Ivan

2016-08-01

The aim of this study was to evaluate the efficacy of the new Variable Lifting Index (VLI) method, theoretically based on the Revised National Institute for Occupational Safety and Health [NIOSH] Lifting Equation (RNLE), in predicting the risk of acute low-back pain (LBP) in the past 12 months. A new risk variable termed the VLI for assessing variable manual lifting has been developed, but there has been no epidemiological study that evaluates the relationship between the VLI and LBP. A sample of 3,402 study participants from 16 companies in different industrial sectors was analyzed. Of the participants, 2,374 were in the risk exposure group involving manual materials handling (MMH), and 1,028 were in the control group without MMH. The VLI was calculated for each participant in the exposure group using a systematic approach. LBP information was collected by occupational physicians at the study sites. The risk of acute LBP was estimated by calculating the odds ratio (OR) between levels of the risk exposure and the control group using a logistic regression analysis. Both crude and adjusted ORs for body mass index, gender, and age were analyzed. Both crude and adjusted ORs showed a dose-response relationship. As the levels of VLI increased, the risk of LBP increased. This risk relationship existed when VLI was greater than 1. The VLI method can be used to assess the risk of acute LBP, although further studies are needed to confirm the outcome and to define better VLI categories. © 2016, Human Factors and Ergonomics Society.

Prevalence, perception and correlates of low back pain among healthcare workers in tertiary health institutions in Sokoto, Nigeria.

PubMed

Awosan, Kehinde J; Yikawe, Semen S; Oche, Oche M; Oboirien, Muhammad

2017-12-01

Low back pain (LBP) is a common cause of disability worldwide. Healthcare workers are particularly prone to it because of the physical and emotional factors associated with their profession. To determine the prevalence, perception and correlates of LBP among healthcare workers in tertiary health institutions in Sokoto, Nigeria. A cross-sectional study was conducted among 320 healthcare workers selected by multistage sampling technique from July to September 2016. Anthropometry was done for the participants in addition to questionnaire administration. The mean age of the study participants was 36.99 ± 8.23 years. The lifetime, annual, and point prevalence of LBP among the participants were 56.2%, 39.1% and 17.2% respectively. Most, 151 (83.9%) of the 180 participants that have ever experienced LBP reported that it commenced after starting work, and they perceived it to be due to standing for long hours (57.2%), awkward postures (22.2%) and carrying heavy objects/patients at work (20.6%). Older age, female sex, longer duration of practice, overweight/obesity, and lifting heavy objects/patients at work were significantly associated with LBP among the participants. The prevalence of LBP is high among healthcare workers in Sokoto, Nigeria; although it was also associated with older age and female sex, being in practice for 10 years and above, overweight/obesity, and lifting heavy objects/patients at work were the predictors identified. Management of the respective hospitals should prevent workplace exposures to heavy weight/objects by establishing "lift teams" as a temporary measure, and also implement "zero lift programs" in their facilities. Nil.

The Role of Anger in Psychosocial Subgrouping for Patients with Low Back Pain

PubMed Central

Nisenzon, Anne N.; George, Steven Z.; Beneciuk, Jason M.; Wandner, Laura D.; Torres, Calia; Robinson, Michael E.

2014-01-01

Low back pain (LBP) is a common and costly condition that often becomes chronic if not properly addressed. Recent research has shown that psychosocial symptoms can complicate LBP, necessitating more comprehensive screening measures. The present study investigated the role of psychosocial factors, including anger regulation, in pain and disability using a screening measure designed for LBP treated with physical therapy. One-hundred and three LBP patients initiating physical therapy completed an established screening measure to assess risk for developing chronic pain, as well as psychosocial measures assessing anger, depression, anxiety, fear-avoidance, and pain-catastrophizing before and after four weeks of treatment. Dependent variables were pain intensity, physical impairment, and patient-reported disability. Risk subgrouping based on anger and other psychosocial measures was examined using established screening methods and through employing an empirical statistical approach. Analyses revealed that risk subgroups differed according to corresponding levels of negative affect, as opposed to anger alone. General psychosocial distress also predicted disability post-treatment, but, interestingly, did not have a strong relationship to pain. Subsequent hierarchical agglomerative clustering procedures divided patients into overall High and Low Distress groups, with follow-up analyses revealing that the High Distress group had higher baseline measures of pain, disability, and impairment. Findings suggest that anger may be part of generalized negative affect rather than a unique predictor when assessing risk for pain and disability in LBP treatment. Continued research in the area of screening for psychosocial prognostic indicators in LBP may ultimately guide treatment protocols in physical therapy for more comprehensive patient care. PMID:24281272

TOPS: Trial Of Prevention Strategies for low back pain in patients recently recovered from low back pain—study rationale and protocol

PubMed Central

Lin, Chung-Wei C; Hancock, Mark J; Latimer, Jane; Buchbinder, Rachelle; Grotle, Margreth; van Tulder, Maurits; New, Charles H; Wisby-Roth, Trish; Maher, Chris G

2016-01-01

Introduction Low back pain (LBP) is the health condition that carries the greatest disability burden worldwide; however, there is only modest support for interventions to prevent LBP. The aim of this trial is to establish the effectiveness and cost-effectiveness of group-based exercise and educational classes compared with a minimal intervention control in preventing recurrence of LBP in people who have recently recovered from an episode of LBP. Methods and analysis TOPS will be a pragmatic comparative effectiveness randomised clinical trial with a parallel economic evaluation combining three separate cohorts (TOPS Workers, TOPS Primary Care, TOPS Defence) with the same methodology. 1482 participants who have recently recovered from LBP will be randomised to either a comprehensive exercise and education programme or a minimal intervention control. Participants will be followed up for a minimum of 1 year. The primary outcome will be days till recurrence of LBP. Effectiveness will be assessed using survival analysis. Cost-effectiveness will be assessed from the societal perspective. Ethics and dissemination This trial has been approved by the University of Sydney Human Research Ethics Committee (HREC) (ref: 2015/728) and prospectively registered with the Australian and New Zealand Clinical Trials Registry (ref: 12615000939594). We will also obtain ethics approval from the Australian Defence Force HREC. The results of this study will be submitted for publication in a prominent journal and widely publicised in the general media. Trial registration number Australian and New Zealand Clinical Trial Registry (ANZCTR) 12615000939594. PMID:27217287

Cross-Cultural Adaptation of the Micheli Functional Scale to Persian Language for Evaluation of Low Back Pain in the Young Athletes.

PubMed

Naghdi, Soofia; Nakhostin Ansari, Noureddin; Ashrafi, Hanieh; Entezary, Ebrahim; Nakhostin Ansari, Amin; Olyaei, Gholamreza

2015-12-01

A clinical outcome tool is needed for the assessment of young athletes with low back pain. To translate and culturally adapt the Micheli functional scale (MFS), a self-report questionnaire developed to evaluate young athletes with low back pain (LBP) into Persian language and examine the reliability and validity of the Persian MFS (PMFS). A cross-sectional study was conducted to assess the psychometric properties of the PMFS. The PMFS was cross-culturally adapted into Persian language adopting forward/backward translation, expert panel review, and pre-testing. The PMFS was administered to young athletes with and without LBP. Main outcome measures were Persian MFS, Persian functional rating Index (PFRI), and visual analogue scale (VAS). A sample of 100 young athletes with LBP with a mean age of 16.5 ± 2.5 years participated. Fifty young athletes without LBP completed the PMFS. There was no missing responses and floor or ceiling effects. There was a significant difference for the total PMFS scores between young athletes with and without LBP. A significant correlation was found between the total PMFS score and the VAS (r = 0.92) or the PFRI (r = 0.82; P < 0.001). A high internal consistency reliability (Cronbach α = 0.73), and excellent test-retest reliability (ICCagreement = 0.99, P < 0.001) were demonstrated for the PMFS. Factor analysis indicated a single-factor model for PMFS scores. The Persian MFS is valid and reliable for use in Persian-speaking young athletes with LBP.

The effect of muscle fatigue and low back pain on lumbar movement variability and complexity.

PubMed

Bauer, C M; Rast, F M; Ernst, M J; Meichtry, A; Kool, J; Rissanen, S M; Suni, J H; Kankaanpää, M

2017-04-01

Changes in movement variability and complexity may reflect an adaptation strategy to fatigue. One unresolved question is whether this adaptation is hampered by the presence of low back pain (LBP). This study investigated if changes in movement variability and complexity after fatigue are influenced by the presence of LBP. It is hypothesised that pain free people and people suffering from LBP differ in their response to fatigue. The effect of an isometric endurance test on lumbar movement was tested in 27 pain free participants and 59 participants suffering from LBP. Movement variability and complexity were quantified with %determinism and sample entropy of lumbar angular displacement and velocity. Generalized linear models were fitted for each outcome. Bayesian estimation of the group-fatigue effect with 95% highest posterior density intervals (95%HPDI) was performed. After fatiguing %determinism decreased and sample entropy increased in the pain free group, compared to the LBP group. The corresponding group-fatigue effects were 3.7 (95%HPDI: 2.3-7.1) and -1.4 (95%HPDI: -2.7 to -0.1). These effects manifested in angular velocity, but not in angular displacement. The effects indicate that pain free participants showed more complex and less predictable lumbar movement with a lower degree of structure in its variability following fatigue while participants suffering from LBP did not. This may be physiological responses to avoid overload of fatigued tissue, increase endurance, or a consequence of reduced movement control caused by fatigue. Copyright © 2017 Elsevier Ltd. All rights reserved.

Laterality judgments in people with low back pain--A cross-sectional observational and test-retest reliability study.

PubMed

Linder, Martin; Michaelson, Peter; Röijezon, Ulrik

2016-02-01

Disruption of cortical representation, or body schema, has been indicated as a factor in the persistence and recurrence of low back pain (LBP). This has been observed through impaired laterality judgment ability and it has been suggested that this ability is affected in a spatial rather than anatomical manner. We compared laterality judgment performance of foot and trunk movements between people with LBP with or without leg pain and healthy controls, and investigated associations between test performance and pain. We also assessed the test-retest reliability of the Recognise Online™ software when used in a clinical and a home setting. Cross-sectional observational and test-retest study. Thirty individuals with LBP and 30 healthy controls performed judgment tests of foot and trunk laterality once supervised in a clinic and twice at home. No statistically significant group differences were found. LBP intensity was negatively related to trunk laterality accuracy (p = 0.019). Intraclass correlation values ranged from 0.51 to 0.91. Reaction time improved significantly between test occasions while accuracy did not. Laterality judgments were not impaired in subjects with LBP compared to controls. Further research may clarify the relationship between pain mechanisms in LBP and laterality judgment ability. Reliability values were mostly acceptable, with wide and low confidence intervals, suggesting test-retest reliability for Recognise Online™ could be questioned in this trial. A significant learning effect was observed which should be considered in clinical and research application of the test. Copyright © 2015 Elsevier Ltd. All rights reserved.

Does Using a Chair Backrest or Reducing Seated Hip Flexion Influence Trunk Muscle Activity and Discomfort? A Systematic Review.

PubMed

Curran, Máire; O'Sullivan, Leonard; O'Sullivan, Peter; Dankaerts, Wim; O'Sullivan, Kieran

2015-11-01

This paper systematically reviews the effect of chair backrests and reducing seated hip flexion on low back discomfort (LBD) and trunk muscle activation. Prolonged sitting commonly exacerbates low back pain (LBP). Several modifications to seated posture and chair design have been recommended, including using chairs with backrests and chairs that reduce hip flexion. Electronic databases were searched by two independent assessors. Part 1 of this review includes 26 studies comparing the effect of sitting with at least two different hip angles. In Part 2, seven studies that compared the effect of sitting with and without a backrest were eligible. Study quality was assessed using the PEDro scale. Significant confounding variables and a relatively small number of randomized controlled trials (RCTs) involving people with LBP complicates analysis of the results. There was moderate evidence that chair backrests reduce paraspinal muscle activation, and limited evidence that chair backrests reduce LBD. There was no evidence that chairs involving less hip flexion reduce LBP or LBD, or consistently alter trunk muscle activation. However, participants in several studies subjectively preferred the modified chairs involving less hip flexion. The limited evidence to support the use of chairs involving less seated hip flexion, or the effect of a backrest, is consistent with the limited evidence that other isolated chair design features can reduce LBP. LBP management is likely to require consideration of several factors in addition to sitting position. Larger RCTs involving people with LBP are required. © 2015, Human Factors and Ergonomics Society.

Phagocytosis of gram-negative bacteria by a unique CD14-dependent mechanism.

PubMed

Schiff, D E; Kline, L; Soldau, K; Lee, J D; Pugin, J; Tobias, P S; Ulevitch, R J

1997-12-01

THP-1-derived cell lines were stably transfected with constructs encoding glycophosphatidylinositol (GPI)-anchored or transmembrane forms of human CD14. CD14 expression was associated with enhanced phagocytosis of serum (heat-inactivated)-opsonized Escherichia coli (opEc). Both the GPI-anchored and transmembrane forms of CD14 supported phagocytosis of opEc equally well. Lipopolysaccharide-binding protein (LBP) played a role in CD14-dependent phagocytosis as evidenced by inhibition of CD14-dependent phagocytosis of opEc with anti-LBP monoclonal antibody (mAb) and by enhanced phagocytosis of E. coli opsonized with purified LBP. CD14-dependent phagocytosis was inhibited by a phosphatidylinositol (PI) 3-kinase inhibitor (wortmannin) and a protein tyrosine kinase inhibitor (tyrphostin 23) but not a protein kinase C inhibitor (bisindolyl-maleimide) or a divalent cation chelator (ethylenediaminetetraacetate). Anti-LBP mAb 18G4 and anti-CD14 mAb 18E12 were used to differentiate between the pathways involved in CD14-dependent phagocytosis and CD14-dependent cell activation. F(ab')2 fragments of 18G4, a mAb to LBP that does not block cell activation, inhibited ingestion of opEc by THP1-wtCD14 cells. 18E12 (an anti-CD14 mAb that does not block LPS binding to CD14 but does inhibit CD14-dependent cell activation) did not inhibit phagocytosis of LBP-opEc by THP1-wtCD14 cells. Furthermore, CD14-dependent phagocytosis was not inhibited by anti-CD18 (CR3 and CR4 beta-chain) or anti-Fcgamma receptor mAb.

Are religious beliefs and practices of Buddhism associated with disability and salivary cortisol in office workers with chronic low back pain?

PubMed

Sooksawat, Annop; Janwantanakul, Prawit; Tencomnao, Tewin; Pensri, Praneet

2013-01-17

Low back pain (LBP) is common among office workers. A number of studies have established a relationship between Christianity and physical and mental health outcomes among chronic pain patients. The purpose of this study was to examine the relationship between the religious beliefs and practices of Buddhism and disability and psychological stress in office workers with chronic LBP. A cross-sectional survey was conducted with a self-administered questionnaire delivered by hand to 463 office workers with chronic LBP. Saliva samples were collected from a randomly selected sub-sample of respondents (n=96). Disability due to LBP was assessed using the Roland-Morris Disability Questionnaire and psychological stress was assessed based on salivary cortisol. Two hierarchical regression models were built to determine how much variance in disability and psychological stress could be explained by religious beliefs and practices of Buddhism variables after controlling for potential confounder variables. Only 6% of variance in psychological stress was accounted for by the religious beliefs and practices of Buddhism. Those with high religiousness experienced lower psychological stress. No association between the religious beliefs and practices of Buddhism and disability level was found. Depressive symptoms were attributed to both psychological stress and disability status in our study population. The findings suggest that, although being religious may improve the psychological condition in workers with chronic LBP, its effect is insufficient to reduce disability due to illness. Further research should examine the role of depression as a mediator of the effect of psychological stress on disability in patients with chronic LBP.

The efficacy of a HUBER exercise system mediated sensorimotor training protocol on proprioceptive system, lumbar movement control and quality of life in patients with chronic non-specific low back pain.

PubMed

Letafatkar, Amir; Nazarzadeh, Maryam; Hadadnezhad, Malihe; Farivar, Niloufar

2017-08-03

There is a relation between deficits of the proprioceptive system and movement control dysfunction in patients with chronic low back pain (LBP) but, the exact mechanism of this relation is unknown. Exercise therapy has been recognized as an effective method for low back pain treatment. In spite of this, it is not clear which of the various exercise therapy programs lead to better results. Therefore, the present analyze the efficacy of a HUBER study aims to exercise system mediated sensorimotor training protocol on proprioceptive system, lumbar movement control (LMC) and quality of life (QOL) in patients with chronic non-specific LBP. Quasi-experimental study. 53 patients with chronic non-specific LBP (mean age 37.55 ± 6.67 years,and Body Mass Index (BMI) 22.4 ± 3.33) were selected by using Roland-Morris Disability Questionnaire (RMQ) and were assigned into two experimental (N= 27) and control groups (N= 26) The experimental group underwent a five-week (10 sessions) Sensorimotor training by using the Human Body Equalizer (HUBER) spine force under the supervision of an investigator. The movement control battery tests, the HUBER machine testing option, goniometer and visual analogue scale used for movement control, neuromuscular coordination, proprioception and LBP assessment respectively. The assessments were completed in pre-test and after five weeks. The paired and sample T tests were used for data analysis in SPSS program version 18 (Significance level were set at a P value < 0.05). The HUBER system mediated sensorimotor training demonstrated significant improvement in the proprioceptive system, LMC and QOL (P= 0.001). Also There was a significant reduction in the pain scores of subjects with chronic non-specific LBP in the sensorimotor group (P= 0.001). In this study, only the short term effects of the sensorimotor training were examined. The results suggest that a sensorimotor training program causes significant improvement in patients with chronic non-specific LBP. Future research should be carried out with a larger sample size to examine the long term effects of the sensorimotor training program on treatment of patients with chronic non-specific LBP. Considering the efficacy of the sensorimotor training, it is recommended that this intervention should be applied to treatment of patients with chronic non-specific LBP in the future.

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.

HKF-R 10 - screening for predicting chronicity in acute low back pain (LBP): a prospective clinical trial.

PubMed

Neubauer, Eva; Junge, Astrid; Pirron, Peter; Seemann, Hanne; Schiltenwolf, Marcus

2006-08-01

Prospective cohort study. To develop a short instrument to reliably predict chronicity in low back pain (LBP). Health care expenditures on the treatment of low back pain continue to increase. It is therefore important to prevent the development of chronicity. In Germany, there is at present no early risk assessment tool to predict the risk of developing chronic LBP for patients presenting with acute LBP. Undertaken in an orthopedic practice setting, this study examined known risk factors for chronicity. It resulted in the development of a short questionnaire that successfully predicted the course of chronicity with an accuracy of 78%. A cohort of 192 orthopaedic outpatients was assessed for clinical, behavioral, emotional, and cognitive parameters bsed on a self-report test battery of 167 established items predictive for chronicity in LBP. Chronicity was defined as back pain persisting for longer than six months. Logistic regression analysis was performed to evaluate the predictive value of all items significantly associated with the dependent variable. The study found the following items to have the strongest predictive value in the development of chronicity: "How strong was your back pain during the last week when it was most tolerable?" and the question "How much residual pain would you be willing to tolerate while still considering the therapy successful?" These were followed by the variables for "Duration of existing LBP" (more than eight days), the patient's educational level (low levels are related to higher risks of chronicity) and pain being experienced elsewhere in the body. Other significant factors were five items assessing depression (Zung) and the palliative effect of therapeutic massage (where a positive correlation was found). Female patients have a higher risk for chronicity, as do patients with a high total score on the scales assessing "catastrophizing thoughts" and thoughts of "helplessness". Using the items listed above, the study was able to predict a patient's risk of developing chronic LBP with a probability of 78%. These items were assembled in a brief questionnaire and were paired with a corresponding evaluative tool. This enables practitioners to assess an individual patient's risk for chronicity by means of a simple calculator in just a few minutes. A validation study for the questionnaire is currently being prepared. MINI ABSTRACT: The objective of this study was the development of a brief questionnaire to assess the risk for chronicity for LBP.

Evidence base and future research directions in the management of low back pain.

PubMed

Abbott, Allan

2016-03-18

Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.

[Risk factors for low back pain among 1.389 pupils in the 8th and 9th grade. An epidemiologic study].

PubMed

Harreby, M S; Nygaard, B; Jessen, T T; Larsen, E; Storr-Paulsen, A; Lindahl, A; Fisker, I; Laegaard, E

2001-01-15

The aim of this study was to investigate the frequency and severity of low back pain (LBP) in 13-16-year-old pupils in relation to selected factors, such as anthropometry, physical activity, smoking, hypermobility, and tightness of hamstring muscles. The study was designed as a cross-sectional questionnaire-based survey and all the pupils were examined by the school doctor for height, weight, mobility of joints, and general health status. The lifetime prevalence of non-specific LBP was 58.9% and the one-year prevalence was 50.8% with no differences between the sexes. Recurrent/continuous LBP in a moderate to severe degree was recorded in 19.4% of the school children (182 F, 88 M). This was positively correlated to a female gender, a BMI of more than 25 kg/square meter, competitive sports for boys, poor physical fitness, daily smoking, heavy jobs in leisure time, increased use of the health system, and reduced life quality. Stepwise logistic regression analysis indicates that a female gender, daily smoking, and heavy jobs are important associated factors for severe LBP in adolescents, with an observed probability of 46% if all factors are present. We do not know yet whether these factors have any causal importance for the development of severe LBP.

Factors contributing to work related low back pain among personal care workers in old age.

PubMed

Yeung, Simon S

2012-01-01

This study aims to preliminary explore the work related and individual factors that contributed to the occurrence of low back pain (LBP) that affected work activities of Personal Care Workers (PCWs). A cross-sectional study was conducted to 36 PCWs in an old age home of Hong Kong. The study is divided into three parts: 1) a questionnaire to document the workload exposure factors and the musculoskeletal symptoms survey of the PCWs, 2) work posture evaluation; and 3) an evaluation of the physical fitness and lifting capacity of the PCWs. Univariate analyses were used to explore the risk factors associated with LBP that affected work activities. The results indicated that individual physical profile and lifting capacities did not contribute to occurrence of low back pain at work. For the work demand factors, the perceived physical demands in lifting and lowering heavy objects, awkward sustain neck and back postures, loading on the back, and perceived effort of cleaning task contributed to the occurrence of LBP. For the physical environment factors, thermal stress and improper ventilation were associated with the occurrence of LBP cases. For the individual factor, LBP cases were associated with workers' self perceived muscular effort, and perceived risk of mental illness in response to work requirements.

Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain.

PubMed

Tetsunaga, Tomoko; Tetsunaga, Tomonori; Tanaka, Masato; Nishida, Keiichiro; Takei, Yoshitaka; Ozaki, Toshifumi

2016-01-01

Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.

Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain

PubMed Central

Tetsunaga, Tomoko; Tetsunaga, Tomonori; Tanaka, Masato; Nishida, Keiichiro; Takei, Yoshitaka; Ozaki, Toshifumi

2016-01-01

Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP. PMID:27445626

The effect of cupping therapy for low back pain: A meta-analysis based on existing randomized controlled trials.

PubMed

Wang, Yun-Ting; Qi, Yong; Tang, Fu-Yong; Li, Fei-Meng; Li, Qi-Huo; Xu, Chang-Peng; Xie, Guo-Ping; Sun, Hong-Tao

2017-11-06

LBP is one of the most common symptoms with high prevalence throughout the world. Conflicting conclusions exist in RCTs on cupping for LBP. To assess the effects and safety of cupping for the patients with LBP. Pubmed, Cochrane Library databases, and Embase database were electronically researched. RCTs reporting the cupping for the patients with LBP were included. The meta-analysis was conducted using Review Manager software (version 5.3, Nordic Cochrane Centre). The primary outcome was VAS scores. The secondary outcomes included ODI scores, MPPI scores and complications. Six RCTs were included in this synthesized analysis. The results showed that cupping therapy was superior to the control management with respect to VAS scores (SMD: -0.73, [95% CI: -1.42 to -0.04]; P= 0.04), and ODI scores (SMD: -3.64, [95% CI: -5.85 to -1.42]; P= 0.001). There was no statistical significant difference as regard to MPPI scores. No serious adverse event was reported in the included studies. Cupping therapy can significantly decrease the VAS scores and ODI scores for patients with LBP compared to the control management. High heterogeneity and risk of bias existing in studies limit the authenticity of the findings.

Lycium barbarum polysaccharide encapsulated Poly lactic-co-glycolic acid Nanofibers: cost effective herbal medicine for potential application in peripheral nerve tissue engineering.

PubMed

Wang, Jing; Tian, Lingling; He, Liumin; Chen, Nuan; Ramakrishna, Seeram; So, Kwok-Fai; Mo, Xiumei

2018-06-06

Nerve regeneration is a serious clinical challenge following peripheral nerve injury. Lycium barbarum polysaccharide (LBP) is the major component of wolfberry extract, which has been shown to be neuroprotective and promising in nerve recovery in many studies. Electrospun nanofibers, especially core-shell structured nanofibers being capable of serving as both drug delivery system and tissue engineering scaffolds, are well known to be suitable scaffolds for regeneration of peripheral nerve applications. In this study, LBP was incorporated into core-shell structured nanofibrous scaffolds via coaxial electrospinning. Alamar blue assays were performed to investigate the proliferation of both PC12 and Schwann cells cultured on the scaffolds. The neuronal differentiation of PC12 cells was evaluated by NF200 expression with immunostaining and morphology changes observed by SEM. The results indicated that the released LBP dramatically enhanced both proliferation and neuronal differentiation of PC12 cells induced by NGF. Additionally, the promotion of Schwann cells myelination and neurite outgrowth of DRG neurons were also observed on LBP loaded scaffolds by LSCM with immunostaining. In summary, LBP, as a drug with neuroprotection, encapsulated into electrospun nanofibers could be a potential candidate as tissue engineered scaffold for peripheral nerve regeneration.

Does weather affect daily pain intensity levels in patients with acute low back pain? A prospective cohort study.

PubMed

Duong, Vicky; Maher, Chris G; Steffens, Daniel; Li, Qiang; Hancock, Mark J

2016-05-01

The aim of this study was to investigate the influence of various weather parameters on pain intensity levels in patients with acute low back pain (LBP). We performed a secondary analysis using data from the PACE trial that evaluated paracetamol (acetaminophen) in the treatment of acute LBP. Data on 1604 patients with LBP were included in the analysis. Weather parameters (precipitation, temperature, relative humidity, and air pressure) were obtained from the Australian Bureau of Meteorology. Pain intensity was assessed daily on a 0-10 numerical pain rating scale over a 2-week period. A generalised estimating equation analysis was used to examine the relationship between daily pain intensity levels and weather in three different time epochs (current day, previous day, and change between previous and current days). A second model was adjusted for important back pain prognostic factors. The analysis did not show any association between weather and pain intensity levels in patients with acute LBP in each of the time epochs. There was no change in strength of association after the model was adjusted for prognostic factors. Contrary to common belief, the results demonstrated that the weather parameters of precipitation, temperature, relative humidity, and air pressure did not influence the intensity of pain reported by patients during an episode of acute LBP.