On magnetohydrodynamic thermal instabilities in magnetic flux tubes. [in plane parallel stellar atmosphere in LTE and hydrostatic equilibrium

NASA Technical Reports Server (NTRS)

Massaglia, S.; Ferrari, A.; Bodo, G.; Kalkofen, W.; Rosner, R.

1985-01-01

The stability of current-driven filamentary modes in magnetic flux tubes embedded in a plane-parallel atmosphere in LTE and in hydrostatic equilibrium is discussed. Within the tube, energy transport by radiation only is considered. The dominant contribution to the opacity is due to H- ions and H atoms (in the Paschen continuum). A region in the parameter space of the equilibrium configuration in which the instability is effective is delimited, and the relevance of this process for the formation of structured coronae in late-type stars and accretion disks is discussed.

Planetary geology, stellar evolution and galactic cosmology

NASA Technical Reports Server (NTRS)

1972-01-01

Field studies of selected basalt flows in the Snake River Plain, Idaho, were made for comparative lunar and Mars geological investigations. Studies of basalt lava tubes were also initiated in Washington, Oregon, Hawaii, and northern California. The main effort in the stellar evolution research is toward the development of a computer code to calculate hydrodynamic flow coupled with radiative energy transport. Estimates of the rotation effects on a collapsing cloud indicate that the total angular momentum is the critical parameter. The study of Paschen and Balmer alpha lines of positronium atoms in the center of a galaxy is mentioned.

Selective Reflection of Potassium Vapor Nanolayers in a Magnetic Field

NASA Astrophysics Data System (ADS)

Sargsyan, A.; Tonoyan, A.; Keaveney, J.; Hughes, I. G.; Adams, C. S.; Sarkisyan, D.

2018-03-01

The selective reflection of laser radiation from the interface between a dielectric window and the atomic vapors confined in a nanocell of thickness L ≈ 350 nm is used to develop effective Doppler-broadening- free spectroscopy of potassium atoms. A small atomic line width and a relation between the signal intensity and the transition probability allowed us to resolve four lines of atomic transitions responsible for the D1 lines of the 39K and 41K isotopes. Two groups containing four atomic transitions form in an applied magnetic field upon pumping by radiation with circular polarization σ+ or σ-. Different intensities (probabilities) of transitions for the σ+ and σ- excitations are detected in magnetic field B 0 ≈ A hfs /μB ≈ 165 G ( A hfs is the magnetic dipole constant for the ground state and μB is the Bohr magneton). A substantially different situation is observed at B ≫ B 0, since high symmetry appears for the two groups formed by radiation with circular polarization σ+ or σ-. Each group is the mirror image of the other group with respect to the frequency of the 42 S 1/2-42 P 1/2 transition, which additionally proves the occurrence of the complete Paschen-Back regime of the hyperfine structure at B ≈ 2.5 kG. A developed theoretical model well reproduces the experimental results. Possible practical applications are described. The results obtained can also be applied to the D 1 lines of 87Rb and 23Na.

The highly obscured nucleus of 3C 219

NASA Technical Reports Server (NTRS)

Fabbiano, G.; Willner, S. P.; Carleton, N. P; Elvis, M.

1986-01-01

The detection of a strong, and possibly broad, Paschen-alpha line from the narrow-line radio galaxy 3C 219 is reported. The detected flux is larger than predicted from the H-alpha line and the case B recombination. This implies the presence of a highly reddened line-emitting region in the nucleus.

Photospheric and chromospheric activity on EY Dra

NASA Astrophysics Data System (ADS)

Korhonen, H.; Brogaard, K.; Holhjem, K.; Ramstedt, S.; Rantala, J.; Thöne, C. C.; Vida, K.

2007-11-01

Magnetic activity in the photosphere and chromosphere of the M dwarf EY Dra is studied and possible correlations between the two are investigated using photometric observations in the V and R bands and optical and near infrared spectroscopy. The longitudinal spot configuration in the photosphere is obtained from the V band photometry, and the chromospheric structures are investigated using variations in the Hα line profile and observations of the Paschen β line. The shape of the V band light-curve indicates two active regions on the stellar surface, about 0.4 in phase apart. The spectroscopic observations show enhanced Hα emission observed close to the phases of the photometrically detected starspots. This could indicate chromospheric plages associated with the photospheric starspots. Some indications of prominence structures are also seen. The chromospheric pressure is limited to log {m}_TR < -4 based on the non-detection of emission in the Paschen β wavelength region. Based on observations made with the Nordic Optical Telescope, operated on the island of La Palma jointly by Denmark, Finland, Iceland, Norway, and Sweden, in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofisica de Canarias.

On the difference between breakdown and quench voltages of argon plasma and its relation to 4p–4s atomic state transitions

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

Forati, Ebrahim, E-mail: forati@ieee.org; Piltan, Shiva; Sievenpiper, Dan, E-mail: dsievenpiper@ucsd.edu

Using a relaxation oscillator circuit, breakdown (V{sub BD}) and quench (V{sub Q}) voltages of a DC discharge microplasma between two needle probes are measured. High resolution modified Paschen curves are obtained for argon microplasmas including a quench voltage curve representing the voltage at which the plasma turns off. It is shown that for a point to point microgap (e.g., the microgap between two needle probes) which describes many realistic microdevices, neither Paschen's law applies nor field emission is noticeable. Although normally V{sub BD} > V{sub Q,} it is observed that depending on environmental parameters of argon, such as pressure and the drivingmore » circuitry, plasma can exist in a different state with equal V{sub BD} and V{sub Q.} Using emission line spectroscopy, it is shown that V{sub BD} and V{sub Q} are equal if the atomic excitation by the electric field dipole moment dominantly leads to one of the argon's metastable states (4P{sub 5} in our study)« less

A universal theory for gas breakdown from microscale to the classical Paschen law

NASA Astrophysics Data System (ADS)

Loveless, Amanda M.; Garner, Allen L.

2017-11-01

While well established for larger gaps, Paschen's law (PL) fails to accurately predict breakdown for microscale gaps, where field emission becomes important. This deviation from PL is characterized by the absence of a minimum breakdown voltage as a function of the product of pressure and gap distance, which has been demonstrated analytically for microscale and smaller gaps with no secondary emission at atmospheric pressure [A. M. Loveless and A. L. Garner, IEEE Trans. Plasma Sci. 45, 574-583 (2017)]. We extend these previous results by deriving analytic expressions that incorporate the nonzero secondary emission coefficient, γS E, that are valid for gap distances larger than those at which quantum effects become important (˜100 nm) while remaining below those at which streamers arise. We demonstrate the validity of this model by benchmarking to particle-in-cell simulations with γSE = 0 and comparing numerical results to an experiment with argon, while additionally predicting a minimum voltage that was masked by fixing the gap pressure in previous analyses. Incorporating γSE demonstrates the smooth transition from field emission dominated breakdown to the classical PL once the combination of electric field, pressure, and gap distance satisfies the conventional criterion for the Townsend avalanche; however, such a condition generally requires supra-atmospheric pressures for breakdown at the microscale. Therefore, this study provides a single universal breakdown theory for any gas at any pressure dominated by field emission or Townsend avalanche to guide engineers in avoiding breakdown when designing microscale and larger devices, or inducing breakdown for generating microplasmas.

Anomalous accretion activity and the spotted nature of the DQ Tau binary system

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

Bary, Jeffrey S.; Petersen, Michael S.

2014-09-01

We report the detection of an anomalous accretion flare in the tight eccentric pre-main-sequence binary system DQ Tau. In a multi-epoch survey consisting of randomly acquired low- to moderate-resolution near-infrared spectra obtained over a period of almost 10 yr, we detect a significant and simultaneous brightening of four standard accretion indicators (Ca II infrared triplet, the Paschen and Brackett series H I lines, and He I 1.083 μm), on back-to-back nights (φ = 0.372 and 0.433) with the flare increasing in strength as the system approached apastron (φ = 0.5). The mass accretion rate measured for the anomalous flare ismore » nearly an order of magnitude stronger than the average quiescent rate. While previous observations established that frequent, periodic accretion flares phased with periastron passages occur in this system, these data provide evidence that orbitally modulated accretion flares occur near apastron, when the stars make their closest approach to the circumbinary disk. The timing of the flare suggests that this outburst is due to interactions of the stellar cores (or the highly truncated circumstellar disks) with material in non-axisymmetric structures located at the inner edge of the circumbinary disk. We also explore the optical/infrared spectral type mismatch previously observed for T Tauri stars (TTSs) and successfully model the shape of the spectra from 0.8 to 1.0 μm and the strengths of the TiO and FeH bands as manifestations of large cool spots on the surfaces of the stellar companions in DQ Tau. These findings illustrate that a complete model of near-infrared spectra of many TTSs must include parameters for spot filling factors and temperatures.« less

A near-infrared relationship for estimating black hole masses in active galactic nuclei

NASA Astrophysics Data System (ADS)

Landt, Hermine; Ward, Martin J.; Peterson, Bradley M.; Bentz, Misty C.; Elvis, Martin; Korista, Kirk T.; Karovska, Margarita

2013-06-01

Black hole masses for samples of active galactic nuclei (AGN) are currently estimated from single-epoch optical spectra using scaling relations anchored in reverberation mapping results. In particular, the two quantities needed for calculating black hole masses, namely the velocity and the radial distance of the orbiting gas are derived from the widths of the Balmer hydrogen broad emission lines and the optical continuum luminosity, respectively. We have recently presented a near-infrared (near-IR) relationship for estimating AGN black hole masses based on the widths of the Paschen hydrogen broad emission lines and the total 1 μm continuum luminosity. The near-IR offers several advantages over the optical: it suffers less from dust extinction, the AGN continuum is observed only weakly contaminated by the host galaxy and the strongest Paschen broad emission lines Paα and Paβ are unblended. Here, we improve the calibration of the near-IR black hole mass relationship by increasing the sample from 14 to 23 reverberation-mapped AGN using additional spectroscopy obtained with the Gemini Near-Infrared Spectrograph. The additional sample improves the number statistics in particular at the high-luminosity end.

ISOLATED WOLF-RAYET STARS AND O SUPERGIANTS IN THE GALACTIC CENTER REGION IDENTIFIED VIA PASCHEN-{alpha} EXCESS

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

Mauerhan, J. C.; Stolovy, S. R.; Cotera, A.

We report the discovery of 19 hot, evolved, massive stars near the Galactic center region (GCR). These objects were selected for spectroscopy owing to their detection as strong sources of Paschen-{alpha} (P{alpha}) emission-line excess, following a narrowband imaging survey of the central 0.{sup 0}65 x 0.{sup 0}25 (l, b) around Sgr A* with the Hubble Space Telescope. Discoveries include six carbon-type (WC) and five nitrogen-type (WN) Wolf-Rayet stars, six O supergiants, and two B supergiants. Two of the O supergiants have X-ray counterparts having properties consistent with solitary O stars and colliding-wind binaries. The infrared photometry of 17 stars ismore » consistent with the Galactic center distance, but 2 of them are located in the foreground. Several WC stars exhibit a relatively large infrared excess, which is possibly thermal emission from hot dust. Most of the stars appear scattered throughout the GCR, with no relation to the three known massive young clusters; several others lie near the Arches and Quintuplet clusters and may have originated within one of these systems. The results of this work bring the total sample of Wolf-Rayet (WR) stars in the GCR to 88. All sources of strong P{alpha} excess have been identified in the area surveyed with HST, which implies that the sample of WN stars in this region is near completion, and is dominated by late (WNL) types. The current WC sample, although probably not complete, is almost exclusively dominated by late (WCL) types. The observed WR subtype distribution in the GCR is a reflection of the intrinsic rarity of early subtypes (WNE and WCE) in the inner Galaxy, an effect that is driven by metallicity.« less

Constraints on the outer radius of the broad emission line region of active galactic nuclei

NASA Astrophysics Data System (ADS)

Landt, Hermine; Ward, Martin J.; Elvis, Martin; Karovska, Margarita

2014-03-01

Here we present observational evidence that the broad emission line region (BELR) of active galactic nuclei (AGN) generally has an outer boundary. This was already clear for sources with an obvious transition between the broad and narrow components of their emission lines. We show that the narrow component of the higher-order Paschen lines is absent in all sources, revealing a broad emission line profile with a broad, flat top. This indicates that the BELR is kinematically separate from the narrow emission line region. We use the virial theorem to estimate the BELR outer radius from the flat top width of the unblended profiles of the strongest Paschen lines, Paα and Paβ, and find that it scales with the ionizing continuum luminosity roughly as expected from photoionization theory. The value of the incident continuum photon flux resulting from this relationship corresponds to that required for dust sublimation. A flat-topped broad emission line profile is produced by both a spherical gas distribution in orbital motion and an accretion disc wind if the ratio between the BELR outer and inner radius is assumed to be less than ˜100-200. On the other hand, a pure Keplerian disc can be largely excluded, since for most orientations and radial extents of the disc the emission line profile is double-horned.

Effect of lost charged particles on the breakdown characteristics of the gaseous electrical discharge in non-uniform axial electric field

NASA Astrophysics Data System (ADS)

Noori, H.; Ranjbar, A. H.

2017-10-01

The secondary emission coefficient is a valuable parameter for numerical modeling of the discharge process in gaseous insulation. A theoretical model has been developed to consider the effects of the radial electric field, non-uniformity of the axial electric field, and radial diffusion of charged particles on the secondary emission coefficient. In the model, a modified breakdown criterion is employed to determine the effective secondary electron emission, γeff. Using the geometry factor gi which is introduced based on the effect of radial diffusion of charged particles on the fraction of ions which arrive at the cathode, the geometry-independent term of γeff (Δi) was obtained as a function of the energy of the incident ions on the cathode. The results show that Δi is approximately a unique function of the ion energy for the ratios of d/R = 39, 50, 77, 115, and 200. It means that the considered mechanisms in the model are responsible for the deviation from Paschen's law.

Line-blanketed model stellar atmospheres applied to Sirius. Ph.D. Thesis - Maryland Univ.

NASA Technical Reports Server (NTRS)

Fowler, J. W.

1972-01-01

The primary goal of this analysis is to determine whether the effects of atomic bound-bound transitions on stellar atmospheric structure can be represented well in models. The investigation is based on an approach which is called the method of artificial absorption edges. The method is described, developed, tested, and applied to the problem of fitting a model stellar atmosphere to Sirius. It is shown that the main features of the entire observed spectrum of Sirius can be reproduced to within the observational uncertainty by a blanketed flux-constant model with T sub eff = 9700 K and Log g = 4.26. The profile of H sub gamma is reproduced completely within the standard deviations of the measurements except near line center, where non-LTE effects are expected to be significant. The equivalent width of H sub gamma, the Paschen slope, the Balmer jump, and the absolute flux at 5550 A all agree with the observed values.

The Effect of Reaction Control System Thruster Plume Impingement on Orion Service Module Solar Array Power Production

NASA Technical Reports Server (NTRS)

Bury, Kristen M.; Kerslake, Thomas W.

2008-01-01

NASA's new Orion Crew Exploration Vehicle has geometry that orients the reaction control system (RCS) thrusters such that they can impinge upon the surface of Orion's solar array wings (SAW). Plume impingement can cause Paschen discharge, chemical contamination, thermal loading, erosion, and force loading on the SAW surface, especially when the SAWs are in a worst-case orientation (pointed 45 towards the aft end of the vehicle). Preliminary plume impingement assessment methods were needed to determine whether in-depth, timeconsuming calculations were required to assess power loss. Simple methods for assessing power loss as a result of these anomalies were developed to determine whether plume impingement induced power losses were below the assumed contamination loss budget of 2 percent. This paper details the methods that were developed and applies them to Orion's worst-case orientation.

Principle of radial transport in low temperature annular plasmas

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

Zhang, Yunchao, E-mail: yunchao.zhang@anu.edu.au; Charles, Christine; Boswell, Rod

2015-07-15

Radial transport in low temperature annular plasmas is investigated theoretically in this paper. The electrons are assumed to be in quasi-equilibrium due to their high temperature and light inertial mass. The ions are not in equilibrium and their transport is analyzed in three different situations: a low electric field (LEF) model, an intermediate electric field (IEF) model, and a high electric field (HEF) model. The universal IEF model smoothly connects the LEF and HEF models at their respective electric field strength limits and gives more accurate results of the ion mobility coefficient and effective ion temperature over the entire electricmore » field strength range. Annular modelling is applied to an argon plasma and numerical results of the density peak position, the annular boundary loss coefficient and the electron temperature are given as functions of the annular geometry ratio and Paschen number.« less

The Effect of Reaction Control System Thruster Plume Impingement on Orion Service Module Solar Array Power Production

NASA Astrophysics Data System (ADS)

Bury, Kristen M.; Kerslake, Thomas W.

2008-06-01

NASA's new Orion Crew Exploration Vehicle has geometry that orients the reaction control system (RCS) thrusters such that they can impinge upon the surface of Orion's solar array wings (SAW). Plume impingement can cause Paschen discharge, chemical contamination, thermal loading, erosion, and force loading on the SAW surface, especially when the SAWs are in a worst-case orientation (pointed 45 towards the aft end of the vehicle). Preliminary plume impingement assessment methods were needed to determine whether in-depth, timeconsuming calculations were required to assess power loss. Simple methods for assessing power loss as a result of these anomalies were developed to determine whether plume impingement induced power losses were below the assumed contamination loss budget of 2 percent. This paper details the methods that were developed and applies them to Orion's worst-case orientation.

Nuclear Rings in the IR: Hidden Super Star Clusters

NASA Astrophysics Data System (ADS)

Maoz, Dan

1997-07-01

We propose NICMOS broad-band {F160W, F187W} and Paschen Alpha {F187N} imaging of nuclear starburst rings in two nearby galaxies. We already have UV {F220W} FOC data, and are scheduled to obtain WFPC2 images in U, V, I, and Halpha+[NII] of these rings. The rings contain large populations of super star clusters similar to those recently discovered in other types of starburst systems. Nuclear rings contain large numbers of these clusters in relatively unobscured starburst environments. Measurement of the age, size, and stellar contents of the clusters can test the hypothesis that super star clusters are young globular clusters. Together with our UV and optical data, NICMOS images will provide the SED of numerous super star clusters over a decade in wavelength. Our already-approved observations will allow us to estimate, by comparison with evolutionary synthesis models, the masses and ages of the clusters. The proposed IR data will be sensitive to the number of supergiants {1.6 micron} and O-stars {Paschen Alpha} in each of the clusters. The observations will provide an independent determination of the reddening, mass, and age of each cluster. We expect to see in the IR numerous clusters that are obscured in the UV and optical. These clusters may be the younger ones, which are still embedded in their molecular clouds. By measuring the mass, age, and size of a large number of clusters, we can actually obtain an evolutionary picture of these objects at different stages in their lives.

Reliability of large superconducting magnets through design

NASA Astrophysics Data System (ADS)

Henning, C. D.

1981-01-01

Design and quality control of large superconducting magnets for reliability comparable to pressure vessels are discussed. The failure modes are analyzed including thermoelectric instabilities, electrical shorts, cryogenic/vacuum defects, and mechanical malfunctions. Design must take into consideration conductor stability, insulation based on the Paschen curves, and the possible burnout of cryogenic transition leads if the He flow is interrupted. The final stage of the metal drawing process should stress the superconductor material to a stress value higher than the magnet design stress, cabled conductors should be used to achieve mechanical redundancy, and ground-plane insulation must be multilayered for arc prevention.

VizieR Online Data Catalog: GJ 1214b optical and near-IR transit phot. (Angerhausen+, 2017)

NASA Astrophysics Data System (ADS)

Angerhausen, D.; Dreyer, C.; Placek, B.; Csizmadia, Sz.; Eigmueller, P.; Godolt, M.; Kitzmann, D.; Mallonn, M.; Becklin, E.; Collins, P.; Dunham, E. W.; Grenfell, J. L.; Hamilton, R. T.; Kabath, P.; Logsdon, S. E.; Mandell, A.; Mandushev, G.; McElwain, M.; McLean, I. S.; Pfueller, E.; Rauer, H.; Savage, M.; Shenoy, S.; Vacca, W. D.; van Cleve, J. E.; Wiedemann, M.; Wolf, J.

2017-11-01

The joint US-German Cycle 2 Guest Investigator (GI) programme - US-proposal: Angerhausen (2013); Germanproposal: Dreyer (2013) - was performed on SOFIAs flight number 149 on UT February 27, 2014. Observations were simultaneously conducted in two optical HIPO channels: open blue at 0.3-0.6um and Sloan z' at 0.9-m; and one infrared FLITECAM fiter: Paschen-α cont. at 1.9um. Complementary data were also obtained with the optical focal plane guiding camera FPI+ in the Sloan i' band (0.8um). (5 data files).

An Optical and Infrared Time-domain Study of the Supergiant Fast X-Ray Transient Candidate IC 10 X-2

NASA Astrophysics Data System (ADS)

Kwan, Stephanie; Lau, Ryan M.; Jencson, Jacob; Kasliwal, Mansi M.; Boyer, Martha L.; Ofek, Eran; Masci, Frank; Laher, Russ

2018-03-01

We present an optical and infrared (IR) study of IC 10 X-2, a high-mass X-ray binary in the galaxy IC 10. Previous optical and X-ray studies suggest that X-2 is a Supergiant Fast X-ray Transient: a large-amplitude (factor of ∼100), short-duration (hours to weeks) X-ray outburst on 2010 May 21. We analyze R- and g-band light curves of X-2 from the intermediate Palomar Transient Factory taken between 2013 July 15 and 2017 February 14 that show high-amplitude (≳1 mag), short-duration (≲8 days) flares and dips (≳0.5 mag). Near-IR spectroscopy of X-2 from Palomar/TripleSpec show He I, Paschen-γ, and Paschen-β emission lines with similar shapes and amplitudes as those of luminous blue variables (LBVs) and LBV candidates (LBVc). Mid-IR colors and magnitudes from Spitzer/Infrared Array Camera photometry of X-2 resemble those of known LBV/LBVcs. We suggest that the stellar companion in X-2 is an LBV/LBVc and discuss possible origins of the optical flares. Dips in the optical light curve are indicative of eclipses from optically thick clumps formed in the winds of the stellar counterpart. Given the constraints on the flare duration (0.02–0.8 days) and the time between flares (15.1 ± 7.8 days), we estimate the clump volume filling factor in the stellar winds, f V , to be 0.01< {f}V< 0.71, which overlaps with values measured from massive star winds. In X-2, we interpret the origin of the optical flares as the accretion of clumps formed in the winds of an LBV/LBVc onto the compact object.

On the Nature of Off-limb Flare Continuum Sources Detected by SDO /HMI

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

Heinzel, P.; Kašparová, J.; Kleint, L.

The Helioseismic and Magnetic Imager on board the Solar Dynamics Observatory has provided unique observations of off-limb flare emission. White-light continuum enhancements were detected in the “continuum” channel of the Fe 6173 Å line during the impulsive phase of the observed flares. In this paper we aim to determine which radiation mechanism is responsible for such enhancement being seen above the limb, at chromospheric heights around or below 1000 km. Using a simple analytical approach, we compare two candidate mechanisms, the hydrogen recombination continuum (Paschen) and the Thomson continuum due to scattering of disk radiation on flare electrons. Both mechanismsmore » depend on the electron density, which is typically enhanced during the impulsive phase of a flare as the result of collisional ionization (both thermal and also non-thermal due to electron beams). We conclude that for electron densities higher than 10{sup 12} cm{sup −3}, the Paschen recombination continuum significantly dominates the Thomson scattering continuum and there is some contribution from the hydrogen free–free emission. This is further supported by detailed radiation-hydrodynamical (RHD) simulations of the flare chromosphere heated by the electron beams. We use the RHD code FLARIX to compute the temporal evolution of the flare-heating in a semi-circular loop. The synthesized continuum structure above the limb resembles the off-limb flare structures detected by HMI, namely their height above the limb, as well as the radiation intensity. These results are consistent with recent findings related to hydrogen Balmer continuum enhancements, which were clearly detected in disk flares by the IRIS near-ultraviolet spectrometer.« less

Enhanced visible and near-infrared capabilities of the JET mirror-linked divertor spectroscopy system

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

Lomanowski, B. A., E-mail: b.a.lomanowski@durham.ac.uk; Sharples, R. M.; Meigs, A. G.

2014-11-15

The mirror-linked divertor spectroscopy diagnostic on JET has been upgraded with a new visible and near-infrared grating and filtered spectroscopy system. New capabilities include extended near-infrared coverage up to 1875 nm, capturing the hydrogen Paschen series, as well as a 2 kHz frame rate filtered imaging camera system for fast measurements of impurity (Be II) and deuterium Dα, Dβ, Dγ line emission in the outer divertor. The expanded system provides unique capabilities for studying spatially resolved divertor plasma dynamics at near-ELM resolved timescales as well as a test bed for feasibility assessment of near-infrared spectroscopy.

Polarized radiation diagnostics of stellar magnetic fields

NASA Astrophysics Data System (ADS)

Mathys, Gautier

The main techniques used to diagnose magnetic fields in stars from polarimetric observations are presented. First, a summary of the physics of spectral line formation in the presence of a magnetic field is given. Departures from the simple case of linear Zeeman effect are briefly considered: partial Paschen-Back effect, contribution of hyperfine structure, and combined Stark and Zeeman effects. Important approximate solutions of the equation of transfer of polarized light in spectral lines are introduced. The procedure for disk-integration of emergent Stokes profiles, which is central to stellar magnetic field studies, is described, with special attention to the treatment of stellar rotation. This formalism is used to discuss the determination of the mean longitudinal magnetic field (through the photographic technique and through Balmer line photopolarimetry). This is done within the specific framework of Ap stars, which, with their unique large-scale organized magnetic fields, are an ideal laboratory for studies of stellar magnetism. Special attention is paid to those Ap stars whose magnetically split line components are resolved in high-dispersion Stokes I spectra, and to the determination of their mean magnetic field modulus. Various techniques of exploitation of the information contained in polarized spectral line profiles are reviewed: the moment technique (in particular, the determination of the crossover and of the mean quadratic field), Zeeman-Doppler imaging, and least-squares deconvolution. The prospects that these methods open for linear polarization studies are sketched. The way in which linear polarization diagnostics complement their Stokes I and V counterparts is emphasized by consideration of the results of broad band linear polarization measurements. Illustrations of the use of various diagnostics to derive properties of the magnetic fields of Ap stars are given. This is used to show the interest of deriving more physically realistic models of the geometric structure of these fields. How this can possibly be achieved is briefly discussed. An overview of the current status of polarimetric studies of magnetic fields in non-degenerate stars of other types is presented. The final section is devoted to magnetic fields of white dwarfs. Current knowledge of magnetic fields of isolated white dwarfs is briefly reviewed. Diagnostic techniques are discussed, with particular emphasis on the variety of physical processes to be considered for understanding of spectral line formation over the broad range of magnetic field strengths encountered in these stars.

The OmegaWhite Survey for short-period variable stars - IV. Discovery of the warm DQ white dwarf OW J175358.85-310728.9

NASA Astrophysics Data System (ADS)

Macfarlane, S. A.; Woudt, P. A.; Dufour, P.; Ramsay, G.; Groot, P. J.; Toma, R.; Warner, B.; Paterson, K.; Kupfer, T.; van Roestel, J.; Berdnikov, L.; Dagne, T.; Hardy, F.

2017-09-01

We present the discovery and follow-up observations of the second known variable warm DQ white dwarf OW J175358.85-310728.9 (OW J1753-3107). OW J1753-3107 is the brightest of any of the currently known warm or hot DQ and was discovered in the OmegaWhite Survey as exhibiting optical variations on a period of 35.5452 (2) min, with no evidence for other periods in its light curves. This period has remained constant over the last 2 yr and a single-period sinusoidal model provides a good fit for all follow-up light curves. The spectrum consists of a very blue continuum with strong absorption lines of neutral and ionized carbon, a broad He I λ4471 line and possibly weaker hydrogen lines. The C I lines are Zeeman split, and indicate the presence of a strong magnetic field. Using spectral Paschen-Back model descriptions, we determine that OW J1753-3107 exhibits the following physical parameters: Teff = 15 430 K, log (g) = 9.0, log (N(C)/N(He)) = -1.2 and the mean magnetic field strength is Bz =2.1 MG. This relatively low temperature and carbon abundance (compared to the expected properties of hot DQs) is similar to that seen in the other warm DQ SDSS J1036+6522. Although OW J1753-3107 appears to be a twin of SDSS J1036+6522, it exhibits a modulation on a period slightly longer than the dominant period in SDSS J1036+6522 and has a higher carbon abundance. The source of variations is uncertain, but they are believed to originate from the rotation of the magnetic white dwarf.

Effects of discharge parameters on deposition rate of hydrogenated amorphous silicon for solar cells from pure SiH/sub 4/ plasma

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

Ishihara, S.; Kitagawa, M.; Hirao, T.

1987-07-15

A systematic deposition of hydrogenated amorphous silicon films from pureSiH/sub 4/ plasma was made in a capacitively coupled RF glow-discharge system by changing anode--cathode spacing d and chamber pressure p simultaneously. The data of the deposition rate in the p-vs-d space had two boundaries. One was pd = const. The other seems to be pd/sup 2/ = const. The RF plasma can stably sustain between the boundaries. The boundaries are discussed with RF power per SiH/sub 4/ molecule and with overlapping Paschen's lines of various fragments, especially H/sub 2/ due to the SiH/sub 4/ dissociation. We found the optimum conditionsmore » in which the deposition rate was more than 10 A/s without large photo-induced degradation. 10% efficient p-i-n solar cells were achieved with the intrinsic layer deposition rate of 3.9 A/s and more than 6% efficiency with 10 A/s.« less

VLT/X-shooter observations of the low-metallicity blue compact dwarf galaxy PHL 293B including a luminous blue variable star

NASA Astrophysics Data System (ADS)

Izotov, Y. I.; Guseva, N. G.; Fricke, K. J.; Henkel, C.

2011-09-01

Context. We present VLT/X-shooter spectroscopic observations in the wavelength range λλ3000-23 000 Å of the extremely metal-deficient blue compact dwarf (BCD) galaxy PHL 293B containing a luminous blue variable (LBV) star and compare them with previous data. Aims: This BCD is one of the two lowest-metallicity galaxies where LBV stars were detected, allowing us to study the LBV phenomenon in the extremely low metallicity regime. Methods: We determine abundances of nitrogen, oxygen, neon, sulfur, argon, and iron by analyzing the fluxes of narrow components of the emission lines using empirical methods and study the properties of the LBV from the fluxes and widths of broad emission lines. Results: We derive an interstellar oxygen abundance of 12+log O/H = 7.71 ± 0.02, which is in agreement with previous determinations. The observed fluxes of narrow Balmer, Paschen and Brackett hydrogen lines correspond to the theoretical recombination values after correction for extinction with a single value C(Hβ) = 0.225. This implies that the star-forming region observed in the optical range is the only source of ionisation and there is no additional source of ionisation that is seen in the NIR range but is hidden in the optical range. We detect three v = 1-0 vibrational lines of molecular hydrogen. Their flux ratios and non-detection of v = 2-1 and 3-1 emission lines suggest that collisional excitation is the main source producing H2 lines. For the LBV star in PHL 293B we find broad emission with P Cygni profiles in several Balmer hydrogen emission lines and for the first time in several Paschen hydrogen lines and in several He i emission lines, implying temporal evolution of the LBV on a time scale of 8 years. The Hα luminosity of the LBV star is by one order of magnitude higher than the one obtained for the LBV star in NGC 2363 ≡ Mrk 71 which has a slightly higher metallicity 12+logO/H = 7.87. The terminal velocity of the stellar wind in the low-metallicity LBV of PHL293B is high, ~800 km s-1, and is comparable to that seen in spectra of some extragalactic LBVs during outbursts. We find that the averaged terminal velocities derived from the Paschen and He i emission lines are by some ~40-60 km s-1 lower than those derived from the Balmer emission lines. This probably indicates the presence of the wind accelerating outward. Based on observations collected at the European Southern Observatory, Chile, ESO program 60.A-9442(A).The reduced data in Figures 1 and 2 are available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/533/A25

Role of photoacoustics in optogalvanics

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

Kumar, D.; McGlynn, S.P.

1990-09-15

Time-resolved laser optogalvanic (LOG) signals have been induced by pulsed laser excitation (l{ital s}{sub {ital j}}{r arrow}2{ital p}{sub {ital k}}, Paschen notation) of a {approximately}30 MHz radio-frequency (rf) discharge in neon at {approximately}5 torr. Dramatic changes of the shape/polarity of certain parts of the LOG signals occur when the rf excitation frequency is scanned over the electrical resonance peak of the plasma and the associated driving/detecting circuits. These effects are attributed to ionization rate changes (i.e., laser-induced alterations of the plasma conductivity), with concomitant variations in the plasma resonance characteristics. In addition to ionization rate changes, it is shown thatmore » photoacoustic (PA) effects also play a significant role in the generation of the LOG signal. Those parts of the LOG signal that are invariant with respect to the rf frequency are attributed to a PA effect. The similarity of LOG signal shapes from both rf and dc discharges suggests that photoacoustics play a similar role in the LOG effect in dc discharges. Contrary to common belief, most reported LOG signal profiles, ones produced by excitation to levels that do not lie close to the ionization threshold, appear to be totally mediated by the PA effect.« less

Using Models for How Energetic Electrons Heat the Atmosphere During Flares

NASA Technical Reports Server (NTRS)

Allred, Joel

2011-01-01

Using models for how energetic electrons heat the atmosphere during flares, we simulate the radiative-hydrodynamic response of the lower solar atmosphere to flare heating. The simulations account for much of the non-LTE, optically thick radiative transfer that occurs in the chromosphere. Our models predict an increase in white light continuum during the flare on the order of 20%, but this is highly sensitive to the electron beam flux used in the simulation. We find that a majority of the white light continuum originates in the chromosphere as a result of Balmer and Paschen recombinations, but a significant portion also forms in the photosphere which has been heated by radiative backwarming.

Observations of emission in bright, low redshift quasars

NASA Technical Reports Server (NTRS)

1983-01-01

Ultraviolet, infrared, and optical spectra were combined to obtain a data set sample as broad as possible in the range of hydrogen lines in individual quasars. From the measured Lyman fluxes, coupled with Balmer and Paschen line fluxes measured in these same objects, an effort was made to establish observational constraints that would guide models of the broad emission line regions of quasars. It was found that IUE spectra were generally of sufficiently high quality to derive line profiles of the ultraviolet lines Lyman alpha and CIV 1550 A, which were compared to the Balmer line profiles. The objects observed and the line fluxes are tabulated. Plots of line profiles are included.

NASA GRC and MSFC Space-Plasma Arc Testing Procedures

NASA Technical Reports Server (NTRS)

Ferguson, Dale C.; Vayner, Boris V.; Galofaro, Joel T,; Hillard, G. Barry; Vaughn, Jason; Schneider, Todd

2005-01-01

Tests of arcing and current collection in simulated space plasma conditions have been performed at the NASA Glenn Research Center (GRC) in Cleveland, Ohio, for over 30 years and at the Marshall Space Flight Center (MSFC) in Huntsville, Alabama, for almost as long. During this period, proper test conditions for accurate and meaningful space simulation have been worked out, comparisons with actual space performance in spaceflight tests and with real operational satellites have been made, and NASA has achieved our own internal standards for test protocols. It is the purpose of this paper to communicate the test conditions, test procedures, and types of analysis used at NASA GRC and MSFC to the space environmental testing community at large, to help with international space-plasma arcing-testing standardization. To be discussed are: 1.Neutral pressures, neutral gases, and vacuum chamber sizes. 2. Electron and ion densities, plasma uniformity, sample sizes, and Debuy lengths. 3. Biasing samples versus self-generated voltages. Floating samples versus grounded. 4. Power supplies and current limits. Isolation of samples from power supplies during arcs. 5. Arc circuits. Capacitance during biased arc-threshold tests. Capacitance during sustained arcing and damage tests. Arc detection. Prevention sustained discharges during testing. 6. Real array or structure samples versus idealized samples. 7. Validity of LEO tests for GEO samples. 8. Extracting arc threshold information from arc rate versus voltage tests. 9. Snapover and current collection at positive sample bias. Glows at positive bias. Kapon (R) pyrolisis. 10. Trigger arc thresholds. Sustained arc thresholds. Paschen discharge during sustained arcing. 11. Testing for Paschen discharge threshold. Testing for dielectric breakdown thresholds. Testing for tether arcing. 12. Testing in very dense plasmas (ie thruster plumes). 13. Arc mitigation strategies. Charging mitigation strategies. Models. 14. Analysis of test results. Finally, the necessity of testing will be emphasized, not to the exclusion of modeling, but as part of a complete strategy for determining when and if arcs will occur, and preventing them from occurring in space.

NASA GRC and MSFC Space-Plasma Arc Testing Procedures

NASA Technical Reports Server (NTRS)

Ferguson, Dale C.a; Vayner, Boris V.; Galofaro, Joel T.; Hillard, G. Barry; Vaughn, Jason; Schneider, Todd

2005-01-01

Tests of arcing and current collection in simulated space plasma conditions have been performed at the NASA Glenn Research Center (GRC) in Cleveland, Ohio, for over 30 years and at the Marshall Space flight Center (MSFC) for almost as long. During this period, proper test conditions for accurate and meaningful space simulation have been worked out, comparisons with actual space performance in spaceflight tests and with real operational satellites have been made, and NASA has achieved our own internal standards for test protocols. It is the purpose of this paper to communicate the test conditions, test procedures, and types of analysis used at NASA GRC and MSFC to the space environmental testing community at large, to help with international space-plasma arcing testing standardization. To be discussed are: 1. Neutral pressures, neutral gases, and vacuum chamber sizes. 2. Electron and ion densities, plasma uniformity, sample sizes, and Debye lengths. 3. Biasing samples versus self-generated voltages. Floating samples versus grounded. 4. Power supplies and current limits. Isolation of samples from power supplies during arcs. Arc circuits. Capacitance during biased arc-threshold tests. Capacitance during sustained arcing and damage tests. Arc detection. Preventing sustained discharges during testing. 5. Real array or structure samples versus idealized samples. 6. Validity of LEO tests for GEO samples. 7. Extracting arc threshold information from arc rate versus voltage tests. 8 . Snapover and current collection at positive sample bias. Glows at positive bias. Kapton pyrolization. 9. Trigger arc thresholds. Sustained arc thresholds. Paschen discharge during sustained arcing. 10. Testing for Paschen discharge thresholds. Testing for dielectric breakdown thresholds. Testing for tether arcing. 11. Testing in very dense plasmas (ie thruster plumes). 12. Arc mitigation strategies. Charging mitigation strategies. Models. 13. Analysis of test results. Finally, the necessity of testing will be emphasized, not to the exclusion of modeling, but as part of a complete strategy for determining when and if arcs will occur, and preventing them from occurring in space.

Discharge characteristics of a needle-to-plate electrode at a micro-scale gap

NASA Astrophysics Data System (ADS)

Ronggang, WANG; Qizheng, JI; Tongkai, ZHANG; Qing, XIA; Yu, ZHANG; Jiting, OUYANG

2018-05-01

To understand the discharge characteristics under a gap of micrometers, the breakdown voltage and current–voltage curve are measured experimentally in a needle-to-plate electrode at a micro-scale gap of 3–50 μm in air. The effect of the needle radius and the gas pressure on the discharge characteristics are tested. The results show that when the gap is larger than 10 μm, the relation between the breakdown voltage and the gap looks like the Paschen curve; while below 10 μm, the breakdown voltage is nearly constant in the range of the tested gap. However, at the same gap distance, the breakdown voltage is still affected by the pressure and shows a trend similar to Paschen’s law. The current–voltage characteristic in all the gaps is similar and follows the trend of a typical Townsend-to-glow discharge. A simple model is used to explain the non-normality of breakdown in the micro-gaps. The Townsend mechanism is suggested to control the breakdown process in this configuration before the gap reduces much smaller in air.

SOFIA/FORCAST Observations of the Arched Filamentary Region in the Galactic Center

NASA Astrophysics Data System (ADS)

Hankins, Matthew; Lau, Ryan M.; Morris, Mark; Herter, Terry L.

2016-06-01

Abstract: We present 19.7, 25.2, 31.5, and 37.1 μm maps of the Thermal Arched Filament region in the Galactic Center taken with the Faint Object Infrared Camera for the SOFIA Telescope (FORCAST) with an angular resolution of 3.2-3.8". We calculate the integrated infrared luminosity of the Arched Filaments and show that they are consistent with being heated by the nearby Arches cluster. Additionally, using our observations, we infer dust temperatures (75 - 90 K) across the Arched Filaments which are remarkably consistent over large spatial scales (˜ 25 pc). We discuss the possible geometric effects needed to recreate this temperature structure. Additionally, we compare the observed morphology of the Arches in the FORCAST maps with the Paschen-α emission in the region to study what fraction of the infrared emission may be coming from dust in the HII region versus the PDR beneath it. Finally, we use Spitzer/IRAC 8 μm data to look for spatial variations in PAH abundance in the rich UV environment of the young (~2-4 Myr) and massive Arches cluster.

Insulator Surface Charge as a Function of Pressure: Theory and Simulation

NASA Technical Reports Server (NTRS)

Hogue, Michael D.; Calle, Carlos I.; Mucciolo, Eduardo; Hintze, Paul

2005-01-01

A two-phase equilibrium model was developed to explain the discontinuous surface charge decay versus atmospheric pressure of insulators that had been charged triboelectrically. The two-phase model is an electrostatic form of the Langmuir Isotherm for ions adsorbed on a surface in equilibrium with ions in the gas phase. In this paper, the model was extended to account for vibrational states of the adsorbed surface ions via the vibrational partition function. An analysis is performed that rules out Paschen discharge as the cause of the discharge observed. Also, a numerical simulation is performed using NWChem to calculate the adsorption energies of ions on insulator surfaces for comparison to curve fit adsorption energies developed from the model and experimental data.

Lessons learned from the manufacture of the W7-X planar coils

NASA Astrophysics Data System (ADS)

Viebke, H.; Gustke, D.; Rummel, T.; Sborchia, C.; Schroeder, R.; Williams, D.; Bates, S.; Leigh, B.; Winter, R.

2006-06-01

WENDELSTEIN 7-X (W7-X) is a superconducting stellarator. The planar coils are in charge to modify the magnetic filed configuration of the W7-X. The major challenges during manufacturing were the fabrication of the cable-in-conduit conductor, the accuracy of the coil cases after welding and machining and the development of electrical joints with a resistance below 1 nΩ. Leaks were detected during repetitive in the case cooling system, which were caused by stress corrosion cracking. High voltage tests in a reduced vacuum environment (Paschen conditions) revealed that the insulation had to be reinforced and the quench detection wires had to be exchanged. This paper gives an overview about the main technical challenges of the planar coils and the lessons learned during production.

Model predictions for atmospheric air breakdown by radio-frequency excitation in large gaps

NASA Astrophysics Data System (ADS)

Nguyen, H. K.; Mankowski, J.; Dickens, J. C.; Neuber, A. A.; Joshi, R. P.

2017-07-01

The behavior of the breakdown electric field versus frequency (DC to 100 MHz) for different gap lengths has been studied numerically at atmospheric pressure. Unlike previous reports, the focus here is on much larger gap lengths in the 1-5 cm range. A numerical analysis, with transport coefficients obtained from Monte Carlo calculations, is used to ascertain the electric field thresholds at which the growth and extinction of the electron population over time are balanced. Our analysis is indicative of a U-shaped frequency dependence, lower breakdown fields with increasing gap lengths, and trends qualitatively similar to the frequency-dependent field behavior for microgaps. The low frequency value of ˜34 kV/cm for a 1 cm gap approaches the reported DC Paschen limit.

Scaling laws for gas breakdown for nanoscale to microscale gaps at atmospheric pressure

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

Loveless, Amanda M.; Garner, Allen L., E-mail: algarner@purdue.edu

2016-06-06

Electronics miniaturization motivates gas breakdown predictions for microscale and smaller gaps, since traditional breakdown theory fails when gap size, d, is smaller than ∼15 μm at atmospheric pressure, p{sub atm}. We perform a matched asymptotic analysis to derive analytic expressions for breakdown voltage, V{sub b}, at p{sub atm} for 1 nm ≤ d ≤ 35 μm. We obtain excellent agreement between numerical, analytic, and particle-in-cell simulations for argon, and show V{sub b} decreasing as d → 0, instead of increasing as predicted by Paschen's law. This work provides an analytic framework for determining V{sub b} at atmospheric pressure for various gap distances that may be extended tomore » other gases.« less

Experimental visualization of the cathode layer in AC surface dielectric barrier discharge

NASA Astrophysics Data System (ADS)

Kim, Sang-You; Lho, Taihyeop; Chung, Kyu-Sun

2018-06-01

A narrow etched polyimide line at the bottom edge of a biased electrode (BE) and a non-etched dielectric surface near the biased electrode were observed in an atmospheric AC flexible surface dielectric barrier discharge of polyimide dielectric. These findings are attributed to the bombardment of positive oxygen ions on the bottom edge of the BE and the electron breakdown trajectory not contacting the polyimide surface following the electric field lines formed between the BE edge and the surface charge layer on the dielectric. The length of the non-etched dielectric surface during the first micro-discharge was observed as 22 μm. This occurred, regardless of three different operating durations, which is in good agreement with the length of the cathode layer according to Paschen's law.

Dynamics of Quiet Solar Chromosphere at the Limb

NASA Astrophysics Data System (ADS)

Choudhary, D.; Tejomoortula, U.; Penn, M. J.

2008-12-01

We have observed the solar limb using 1024 × 1024 InSb Near Infrared Camera and Spectroheliograph at McMath-Pierce telescope during the solar minimum period of April 29 to May 1, 2008. A 120 micron slit, corresponding to 0.3 arc second was aligned perpendicular to the solar limb for the observations. The slit spectrum with a resolution of 0.036 Å corresponding to about 05 to 1.0 km/s were obtained in the wavelength regions of HeI 10830 Å, Hydogen Paschen α 12818 Å and Hydrogen Brackett γ 21661 Å. Excellent seeing conditions and the use of adaptive optics produced stable observing conditions during most of the observations. We present the results of line width variation as a function of chromospheric height around the solar limb.

What makes red quasars red?. Observational evidence for dust extinction from line ratio analysis

NASA Astrophysics Data System (ADS)

Kim, Dohyeong; Im, Myungshin

2018-02-01

Red quasars are very red in the optical through near-infrared (NIR) wavelengths, which is possibly due to dust extinction in their host galaxies as expected in a scenario in which red quasars are an intermediate population between merger-driven star-forming galaxies and unobscured type 1 quasars. However, alternative mechanisms also exist to explain their red colors: (i) an intrinsically red continuum; (ii) an unusual high covering factor of the hot dust component, that is, CFHD = LHD/Lbol, where the LHD is the luminosity from the hot dust component and the Lbol is the bolometric luminosity; and (iii) a moderate viewing angle. In order to investigate why red quasars are red, we studied optical and NIR spectra of 20 red quasars at z 0.3 and 0.7, where the usage of the NIR spectra allowed us to look into red quasar properties in ways that are little affected by dust extinction. The Paschen to Balmer line ratios were derived for 13 red quasars and the values were found to be 10 times higher than unobscured type 1 quasars, suggesting a heavy dust extinction with AV > 2.5 mag. Furthermore, the Paschen to Balmer line ratios of red quasars are difficult to explain with plausible physical conditions without adopting the concept of the dust extinction. The CFHD of red quasars are similar to, or marginally higher than, those of unobscured type 1 quasars. The Eddington ratios, computed for 19 out of 20 red quasars, are higher than those of unobscured type 1 quasars (by factors of 3-5), and hence the moderate viewing angle scenario is disfavored. Consequently, these results strongly suggest the dust extinction that is connected to an enhanced nuclear activity as the origin of the red color of red quasars, which is consistent with the merger-driven quasar evolution scenario. Full Table A.1 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/610/A31

High resolution spectroscopy over 8500-8750 Å for GAIA <= 7500 K. II. A library of synthetic spectra for T_eff <= 7500 K

NASA Astrophysics Data System (ADS)

Munari, U.; Castelli, F.

2000-01-01

We present a library of synthetic spectra characterized by -2.5 <= [Z/Z_sun] <= +0.5, 4.5 <= log g<= 1.0, and Teff <= 7500 K computed at the same lambda /bigtriangleup lambda = 20000 resolving power of the observed spectra given in Paper I for 131 standard stars mapping the MKK spectral classification system. This range of parameters includes the majority of the galactic stars expected to dominate the GAIA target population, i.e. F-G-K-M type stars with metallicity ranging from that of the galactic globular clusters to Population I objects. Extension to Teff > 7500 K will be given later on in this series. The 254 synthetic spectra presented here are based on Kurucz's codes and line data and have been computed over a more extended wavelength interval (7650-8750 Ä) than that currently baselined for implementation on GAIA, i.e. the 8500-8750 Ä. This last range is dominated by the near-IR Ca II triplet and the head of the Paschen series. The more extended wavelength range allows us to investigate the behaviour of other strong near-IR spectral features (severely contaminated by telluric absorptions in ground-based observed spectra) as the K I doublet (7664, 7699 Ä), the Na I doublet (8183, 8194 Ä) and the lines of Fe I multiplet N.60 at 8327 and 8388 Ä. The synthetic spectra support our previous conclusions about the superior performance of the Paschen/Ca II 8500-8750 Ä region in meeting the GAIA requirements when compared to other near-IR intervals of similar bigtriangleup lambda = 250 Ä. Table 2 are only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/Abstract.html Figures 5-93 are only available in electronic form at the http://www.edpsciences.org The spectra are also available in electronic form at the CDS or via the personal HomePage http://ulisse.pd.astro.it/Astro/Atlases/

Breakdown voltage determination of gaseous and near cryogenic fluids with application to rocket engine ignition

NASA Astrophysics Data System (ADS)

Nugent, Nicholas Jeremy

Liquid rocket engines extensively use spark-initiated torch igniters for ignition. As the focus shifts to longer missions that require multiple starts of the main engines, there exists a need to solve the significant problems associated with using spark-initiated devices. Improving the fundamental understanding of predicting the required breakdown voltage in rocket environments along with reducing electrical noise is necessary to ensure that missions can be completed successfully. To better understand spark ignition systems and add to the fundamental research on spark development in rocket applications, several parameter categories of interest were hypothesized to affect breakdown voltage: (i) fluid, (ii) electrode, and (iii) electrical. The fluid properties varied were pressure, temperature, density and mass flow rate. Electrode materials, insert electrode angle and spark gap distance were the electrode properties varied. Polarity was the electrical property investigated. Testing how breakdown voltage is affected by each parameter was conducted using three different isolated insert electrodes fabricated from copper and nickel. A spark plug commonly used in torch igniters was the other electrode. A continuous output power source connected to a large impedance source and capacitance provided the pulsing potential. Temperature, pressure and high voltage measurements were recorded for the 418 tests that were successfully completed. Nitrogen, being inert and similar to oxygen, a propellant widely used in torch igniters, was used as the fluid for the majority of testing. There were 68 tests completed with oxygen and 45 with helium. A regression of the nitrogen data produced a correction coefficient to Paschen's Law that predicts the breakdown voltage to within 3000 volts, better than 20%, compared to an over prediction on the order of 100,000 volts using Paschen's Law. The correction coefficient is based on the parameters most influencing breakdown voltage: fluid density, spark gap distance, electrode angles, electrode materials and polarity. The research added to the fundamental knowledge of spark development in rocket ignition applications by determining the parameters that most influence breakdown voltage. Some improvements to the research should include better temperature measurements near the spark gap, additional testing with oxygen and testing with fuels of interest such as hydrogen and methane.

NIR and MM observations of the globulettes in the Rosette Nebula

NASA Astrophysics Data System (ADS)

Mäkelä, Minja; Haikala, Lauri; Gahm, Gösta; Persson, Carina

2013-07-01

Globulettes are tiny, optically dark molecular clouds, most likely detached from eroding elephant trunks. They form a class of objects whose shape resembles that of starless globules but their size is considerably smaller with masses ranging from 1 to about 500M_Jup. We have observed the globulette and shell system in the northwestern region of the Rosette Nebula in near-infrared and mm. We present NIR JHKs, Paschen beta and H2 2.12 micron observations obtained with the NTT/SOFI and CO observations done with the APEX and Onsala 20m radio telescopes. Combined with Spitzer archival data, we can study the physical properties such as mass, velocity and the visual extinction of the globulettes. We can also identify possible star formation. The Ks and H2 observations suggest fluorescent H2 emission is seen in the region.

The Near-Infrared Ca II Triplet-σ Relation for Bulges of Spiral Galaxies

NASA Astrophysics Data System (ADS)

Falcón-Barroso, Jesús; Peletier, Reynier F.; Vazdekis, Alexandre; Balcells, Marc

2003-05-01

We present measurements of the near-infrared Ca II triplet (CaT, CaT*), Paschen (PaT), and magnesium (Mg I) indices for a well-studied sample of 19 bulges of early to intermediate spiral galaxies. We find that both the CaT* and CaT indices decrease with central velocity dispersion σ with small scatter. This dependence is similar to that recently found by Cenarro for elliptical galaxies, implying a uniform CaT*-σ relation that applies to galaxies from ellipticals to intermediate-type spirals. The decrease of CaT and CaT* with σ contrasts with the well-known increase of another α-element index, Mg2, with σ. We discuss the role of Ca underabundance ([Ca/Fe]<0) and initial mass function variations in the onset of the observed relations.

An archetype hydrogen atmosphere problem

NASA Technical Reports Server (NTRS)

Athay, R. G.; Mihalas, D.; Shine, R. A.

1975-01-01

Populations for the first three bound states and the continuum of hydrogen are determined for an isothermal hydrostatic atmosphere at 20,000 K. The atmosphere is treated as optically thin in the Balmer and Paschen continua and illuminated by continuum radiation at these wavelengths with prescribed radiation temperatures. The atmosphere is optically thick in the 2-1, 3-1, 3-2 and c-1 transitions. Three stages of approximation are treated: (1) radiative detailed balance in the 2-1, 3-1 and 3-2 transitions, (2) radiative detailed balance in the 3-1 and 3-2 transitions, and (3) all transitions out of detailed balance. The solution of this problem is nontrivial and presents sufficient difficulty to have caused the failure of at least one rather standard technique. The problem is thus a good archetype against which new methods or new implementations of old methods may be tested.

Use of the electrosurgical unit in a carbon dioxide atmosphere.

PubMed

Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J; Eidson, Jack L; Paolino, David V

2016-01-01

The electrosurgical unit (ESU) utilizes an electrical discharge to cut and coagulate tissue and is often held above the surgical site, causing a spark to form. The voltage at which the spark is created, termed the breakdown voltage, is governed by the surrounding gaseous environment. Surgeons are now utilizing the ESU laparoscopically with carbon dioxide insufflation, potentially altering ESU operating characteristics. This study examines the clinical implications of altering gas composition by measuring the spark gap distance as a marker of breakdown voltage and use of the ESU on a biologic model, both in room air and carbon dioxide. Paschen's Law predicted a 35% decrease in gap distance in carbon dioxide, while testing revealed an average drop of 37-47% as compared to air. However, surgical model testing revealed no perceivable clinical difference. Electrosurgery can be performed in carbon dioxide environments, although surgeons should be aware of potentially altered ESU performance.

Dependence of hydrogen arcjet operation on electrode geometry

NASA Technical Reports Server (NTRS)

Pencil, Eric J.; Sankovic, John M.; Sarmiento, Charles J.; Hamley, John A.

1992-01-01

The dependence of 2kW hydrogen arcjet performance on cathode to anode electrode spacing was evaluated at specific impulses of 900 and 1000 s. Less than 2 absolute percent change in efficiency was measured for the spacings tested which did not repeat the 14 absolute percent variation reported in earlier work with similar electrode designs. A different nozzle configuration was used to quantify the variation in hydrogen arcjet performance over an extended range of electrode spacing. Electrode gap variation resulted in less than 3 absolute percent change in efficiency. These null results suggested that electrode spacing is decoupled from hydrogen arcjet ignition. The dependence of breakdown voltage on mass flow rate and electrode agreed with Paschen curves for hydrogen. Preliminary characterization of the dependence of hydrogen arcjet ignition on rates of pulse repetition and pulse voltage rise were also included for comparison with previous results obtained using simulated hydrazine.

High Voltage Design Concepts for Launch Vehicles and Orbital Spacecraft Applications

NASA Technical Reports Server (NTRS)

Hall, David K.; Kirkici, Hulya; Hillard, G. Barry; Schweickart, Daniel; Dunbar, Bill

2000-01-01

With the advent of design concepts such as, electromechanical actuation and "more electric" initiatives, has come the need for electrical power buses and electronic equipment to operate at higher than normal dc voltages to meet power requirements while keeping current levels to manageable levels. This new bus voltage has been typically 270 Volts dc nominal for launch vehicles, and 120 Volt dc for the International Space Station. This paper will discuss the new design applications for high voltage dc power in existing and future launch vehicles and spacecraft and the potential problems associated therewith. These new applications must be operational from lift-off, ascent, on orbit and descent in all of the pressure and temperature conditions for each, i.e. through the "Paschen region" twice. This paper will also attempt to stimulate an interest in the academic and professional communities to support and conduct research needed for design data applicable to high voltage dc usage.

The effect of chronic low back pain on tactile suppression during back movements.

PubMed

Van Damme, Stefaan; Van Hulle, Lore; Danneels, Lieven; Spence, Charles; Crombez, Geert

2014-10-01

The aim of the present study was to examine whether tactile suppression, the phenomenon whereby tactile perception is suppressed during movement, would occur in the context of back movements. Of particular interest, it was investigated if tactile suppression in the back would be attenuated in those suffering from chronic low back pain. Individuals with chronic low back pain (N = 30) and a matched control group (N = 24) detected tactile stimuli on three possible locations (back, arm, chest) while performing a back or arm movement, or no movement. We hypothesized that the movements would induce tactile suppression, and that this effect would be largest for low-intense stimuli on the moving body part. We further hypothesized that, during back movements, tactile suppression on the back would be less pronounced in the chronic low back pain group than in the control group. The results showed the expected general tactile suppression effects. The hypothesis of back-specific attenuation of tactile suppression in the chronic low back pain group was not supported. However, back-specific tactile suppression in the chronic low back pain group was less pronounced in those who performed the back movements more slowly. Copyright © 2014 Elsevier B.V. All rights reserved.

Microplasma device architectures with various diamond nanostructures

NASA Astrophysics Data System (ADS)

Kunuku, Srinivasu; Jothiramalingam Sankaran, Kamatchi; Leou, Keh-Chyang; Lin, I.-Nan

2017-02-01

Diamond nanostructures (DNSs) were fabricated from three different morphological diamonds, microcrystalline diamond (MCD), nanocrystalline diamond (NCD), and ultrananocrystalline diamond (UNCD) films, using a reactive ion etching method. The plasma illumination (PI) behavior of microplasma devices using the DNSs and the diamond films as cathode were investigated. The Paschen curve approach revealed that the secondary electron emission coefficient (γ value) of diamond materials is similar irrespective of the microstructure (MCD, NCD, and UNCD) and geometry of the materials (DNSs and diamond films). The diamond materials show markedly larger γ-coefficient than conventional metallic cathode materials such as Mo that resulted in markedly better PI behavior for the corresponding microplasma devices. Moreover, the PI behavior, i.e. the voltage dependence of plasma current density (J pl-V), plasma density (n e-V), and the robustness of the devices, varied markedly with the microstructure and geometry of the cathode materials that was closely correlated to the electron field emission (EFE) properties of the cathode materials. The UNCD nanopillars, possessing good EFE properties, resulted in superior PI behavior, whereas the MCD diamond films with insufficient EFE properties led to inferior PI behavior. Consequently, enhancement of plasma characteristics is the collective effects of EFE behavior and secondary electron emission characteristics of diamond-based cathode materials.

Study of short atmospheric pressure dc glow microdischarge in air

NASA Astrophysics Data System (ADS)

Kudryavtsev, Anatoly; Bogdanov, Eugene; Chirtsov, Alexander; Emelin, Sergey

2011-10-01

The results of experiments and simulations of short (without positive column) atmospheric pressure dc glow discharge in air are presented. We used metal steel electrodes with a gap of 5-100 microns. The experimental voltage-current characteristic's (VAC) have a constant or slightly increasing form at low gap. The most stable microdischarges were burning with a flat cathode and rounded anode, when the length of the discharge is automatically established near the minimum of the Paschen curve by changing their binding on the anode. In this case microdischarge was stable and it had growing VAC. For simulations we used 2D fluid model with kinetic description of electrons. We solved the balance equations for the vibrationally- and the electronically-excited states of a nitrogen and oxygen molecules; nitrogen and oxygen atoms; ozone molecule; and different nitrogen and oxygen ions with different plasmochemical reactions between them. Simulations predicted the main regions of the dc glow discharges including cathode and anode sheath and plasma of negative glow, Faraday dark space and transition region. Gas heating plays an important role in shaping the discharge profiles. The results of experiments and simulations of short (without positive column) atmospheric pressure dc glow discharge in air are presented. We used metal steel electrodes with a gap of 5-100 microns. The experimental voltage-current characteristic's (VAC) have a constant or slightly increasing form at low gap. The most stable microdischarges were burning with a flat cathode and rounded anode, when the length of the discharge is automatically established near the minimum of the Paschen curve by changing their binding on the anode. In this case microdischarge was stable and it had growing VAC. For simulations we used 2D fluid model with kinetic description of electrons. We solved the balance equations for the vibrationally- and the electronically-excited states of a nitrogen and oxygen molecules; nitrogen and oxygen atoms; ozone molecule; and different nitrogen and oxygen ions with different plasmochemical reactions between them. Simulations predicted the main regions of the dc glow discharges including cathode and anode sheath and plasma of negative glow, Faraday dark space and transition region. Gas heating plays an important role in shaping the discharge profiles. This work was supported by the FZP and SPbGU

Continuum modeling of charging process and piezoelectricity of ferroelectrets

NASA Astrophysics Data System (ADS)

Xu, Bai-Xiang; von Seggern, Heinz; Zhukov, Sergey; Gross, Dietmar

2013-09-01

Ferroelectrets in the form of electrically charged micro-porous foams exhibit a very large longitudinal piezoelectric coefficient d33. The structure has hence received wide application interests as sensors particularly in acoustic devices. During charging process, electrical breakdown (Paschen breakdown) takes place in the air pores of the foam and introduces free charge pairs. These charges are separated by electrostatic forces and relocated at the interfaces between the polymer and the electrically broken-down medium, where they are trapped quasistatically. The development of this trapped charge density along the interfaces is key for enabling the piezoelectricity of ferroelectrets. In this article, an internal variable based continuum model is proposed to calculate the charge density development at the interfaces, whereas a Maxwell stress based electromechanical model is used for the bulk behavior, i.e., of the polymer and of the medium where the Paschen breakdown takes place. In the modeling, the electrostatic forces between the separated charge pairs are included, as well as the influence of deformation of the solid layers. The material models are implemented in a nonlinear finite element scheme, which allows a detailed analysis of different geometries. A ferroelectret unit with porous expanded polytetrafluoroethylene (ePTFE) surrounded by fluorinated ethylene propylene is studied first. The simulated hysteresis curves of charge density at the surfaces and the calculated longitudinal piezoelectric constant are in good agreement with experimental results. Simulations show a strong dependency of the interface charge development and thus the remnant charges on the thicknesses of the layers and the permittivity of the materials. According to the calculated relation between d33 and the Young's modulus of ePTFE, the value of the Young's modulus of ePTFE is identified to be around 0.75 MPa, which lies well in the predicted range of 0.45 to 0.80 MPa, determined from the dielectric resonance spectra in the work of Zhang et al. [X. Q. Zhang et al., J. Appl. Phys. 108, 064113 (2010)]. To show the potential of the models, it is also applied to simulation of ferroelectrets with a lens shape. The results indicate that the electrical breakdown happens in a sequential manner, and the local piezoelectric coefficient varies with position. Thereby, the middle point on the surface exhibits the maximum d33. The simulation results obtained by the proposed models will provide insight for device optimization.

Back surface reflectors for solar cells

NASA Technical Reports Server (NTRS)

Chai, A. T.

1980-01-01

Sample solar cells were fabricated to study the effects of various back surface reflectors on the device performance. They are typical 50 micrometers thick, space quality, silicon solar cells except for variations of the back contact configuration. The back surfaces of the sample cells are polished to a mirror like finish, and have either conventional full contacts or grid finger contacts. Measurements and evaluation of various metallic back surface reflectors, as well as cells with total internal reflection, are presented. Results indicate that back surface reflectors formed using a grid finger back contact are more effective reflectors than cells with full back metallization and that Au, Ag, or Cu are better back surface reflector metals than Al.

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

PubMed

Meng, Karin; Peters, Stefan; Faller, Hermann

2017-06-01

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

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

PubMed

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

2007-09-01

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

Space Adaptation Back Pain: A Retrospective Study

NASA Technical Reports Server (NTRS)

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

2008-01-01

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

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

PubMed Central

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

1993-01-01

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

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

PubMed

Kim, Min-Hee; Yoo, Won-Gyu

2014-06-01

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

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.

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

PubMed

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

2016-10-04

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

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

PubMed

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

2016-09-01

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

Systematic review of conservative interventions for subacute low back pain.

PubMed

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

2002-12-01

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

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

PubMed

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

2007-06-01

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

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

PubMed Central

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

2006-01-01

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

The radiofrequency magnetic dipole discharge

NASA Astrophysics Data System (ADS)

Martines, E.; Zuin, M.; Marcante, M.; Cavazzana, R.; Fassina, A.; Spolaore, M.

2016-05-01

This paper describes a novel and simple concept of plasma source, which is able to produce a radiofrequency magnetized discharge with minimal power requirements. The source is based on the magnetron concept and uses a permanent magnet as an active electrode. The dipolar field produced by the magnet confines the electrons, which cause further ionization, thus producing a toroidally shaped plasma in the equatorial region around the electrode. A plasma can be ignited with such scheme with power levels as low as 5 W. Paschen curves have been built for four different working gases, showing that in Helium or Neon, plasma breakdown is easily obtained also at atmospheric pressure. The plasma properties have been measured using a balanced Langmuir probe, showing that the electron temperature is around 3-4 eV and higher in the cathode proximity. Plasma densities of the order of 1016 m-3 have been obtained, with a good positive scaling with applied power. Overall, the electron pressure appears to be strongly correlated with the magnetic field magnitude in the measurement point.

Spectrophotometry of peculiar B and A stars. XIV - 56 Arietis, 41 Tauri, 25 Sextantis, HD 170973, HD 205087, and HD 215441

NASA Astrophysics Data System (ADS)

Adelman, S. J.

1983-03-01

Optical region spectrophotometry of six relatively hot Ap stars is presented. Additional scans of 56 Ari extend the results of an earlier paper in this series. The data for 41 Tau, 25 Sex, HD 170973, and HD 215441 are studied as a function of phase. The observations of HD 205087 are inconclusive about its variability although they show spectrophotometrically that it is a definite Ap star. The observations of HD 215441 show a prominent λ5200 broad, continuum feature with an unusual shape. However, when the data are corrected for interstellar reddening, the energy distribution resembles those of other silicon stars. The λ5200 feature is found to be variable in phase with the U-B and B-V colors and with the magnetic field strength. This feature is strongest when the Balmer jump is smallest, the Paschen continuum the bluest according to B-V, and the surface magnetic field strength the largest.

Empirical calibration of the near-infrared Ca ii triplet - I. The stellar library and index definition

NASA Astrophysics Data System (ADS)

Cenarro, A. J.; Cardiel, N.; Gorgas, J.; Peletier, R. F.; Vazdekis, A.; Prada, F.

2001-09-01

A new stellar library at the near-IR spectral region developed for the empirical calibration of the Caii triplet and stellar population synthesis modelling is presented. The library covers the range λλ8348-9020 at 1.5-Å (FWHM) spectral resolution, and consists of 706 stars spanning a wide range in atmospheric parameters. We have defined a new set of near-IR indices, CaT*, CaT and PaT, which mostly overcome the limitations of previous definitions, the former being specially suited for the measurement of the Caii triplet strength corrected for the contamination from Paschen lines. We also present a comparative study of the new and the previous Ca indices, as well as the corresponding transformations between the different systems. A thorough analysis of the sources of index errors and the procedure to calculate them is given. Finally, index and error measurements for the whole stellar library are provided together with the final spectra.

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

PubMed Central

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

2014-01-01

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

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

PubMed

Sun, Gui-Ping

2007-02-01

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

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

PubMed

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

2007-01-01

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

Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis.

PubMed

Miyamoto, Gisela Cristiane; Lin, Chung-Wei Christine; Cabral, Cristina Maria Nunes; van Dongen, Johanna M; van Tulder, Maurits W

2018-04-20

To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain. Systematic review of economic evaluations. The search was performed in 5 clinical and 3 economic electronic databases. We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed. Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain. Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed. PROSPERO, CRD42017059025. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Space charge deposition in tubular channel ferroelectrets: A combined fluorescence imaging/LIMM study with finite element analysis

NASA Astrophysics Data System (ADS)

Nepal, Neerajan; Altafim, Ruy Alberto Pisani; Mellinger, Axel

2017-06-01

Ferroelectrets, i.e., soft materials with electric charges deposited on the surfaces of internal voids, are well known for their potential in transducer applications and energy harvesting. Due to their regular geometry and optical transparency, tubular channel ferroelectrets (manufactured by laminating polymer films around a polytetrafluoroethylene template which is later removed) are well-suited for studying the process of charge deposition. Understanding how space charges are formed on the internal surfaces will lead to improvements in the charge density and in the piezoelectric performance of these films. In this work, the inception voltage for dielectric barrier discharges (and hence the onset of charge deposition) was measured using two independent techniques, fluorescence imaging and the laser intensity modulation method (LIMM). The results (around 1.4-1.7 kV, depending on the void height) are in agreement within ±50 V. The internal electric field distribution was calculated using finite element analysis (FEA). Combined with Paschen's law, these calculations explained the experimentally observed discharge patterns, starting from the channel edges in thick samples, but glowing more uniformly in films with void heights of 50 μm or less. A time-dependent FEA simulation of the LIMM measurement reproduced the observed thermoelastic resonances and their effect on the LIMM signal, and explained its seemingly erratic behavior. This approach has great potential for analyzing LIMM and thermal pulse data obtained in inhomogeneous materials.

Studies on laser-assisted Penning ionization by the optogalvanic effect in Ne/Eu hollow cathode discharge.

PubMed

Saini, V K; Kumar, P; Dixit, S K; Nakhe, S V

2015-02-01

Laser-assisted Penning ionization (LAPI) is detected in a Ne/Eu hollow cathode (HC) discharge lamp using the pulsed optogalvanic (OG) method. In the Ne/Eu discharge, doubly ionized europium excited energy levels Eu[4f(7)(P(7/2,5/2)6)] lie within the thermal limit (∼kT) from the laser-excited neon's energy level [2p(5)(P3/202)3p or 2p(8) (in Paschen notation)] lying at 149,848  cm(-1). Therefore, Penning ionization (PI) of europium atoms likely to occur into its highly excited ionic states is investigated. To probe the PI of europium, the temporal profiles of its counterpart neon OG signal are studied as a function of discharge current for the transitions (1s(4)→2p(8)) and (1s(2)→2p(2)), corresponding to 650.65 and 659.89 nm wavelengths, respectively. It is observed that PI of europium alters the overall discharge characteristics significantly and, hence, modifies the temporal profile of the OG signals accordingly. The quasi-resonant ionizing energy transfer collisions between laser-excited Ne 2p(8) atoms and electronically excited europium P(9/2)10 atoms are used to explain the LAPI mechanism. Such LAPI studies carried out in HC discharge could be useful for the discharge of a metal-vapor laser with appropriate Penning mixtures.

Prolotherapy: An Effective Treatment for Low Back Pain?

MedlinePlus

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

Visually induced analgesia during massage treatment in chronic back pain patients.

PubMed

Löffler, A; Trojan, J; Zieglgänsberger, W; Diers, M

2017-11-01

Previous findings suggest that watching sites of experimental and chronic pain can exert an analgesic effect. Our present study investigates whether watching one's back during massage increases the analgesic effect of this treatment in chronic back pain patients. Twenty patients with chronic back pain were treated with a conventional massage therapy. During this treatment, patients received a real-time video feedback of their own back. Watching a neutral object, a video of another person of the same sex being massaged, a picture of the own back, and keeping one's eyes closed were used as controls. These conditions were presented in randomized order on five separate days. All conditions yielded significant decreases in habitual pain intensity. The effect of real-time video feedback of the own back on massage treatment was the strongest and differed significantly from the effect of watching a neutral object, but not from the other control conditions, which may have induced slight effects of their own. Repeated real-time video feedback may be useful during massage treatment of chronic pain. This study shows that inducing visual induced analgesia during massage treatment can be helpful in alleviating chronic pain. © 2017 European Pain Federation - EFIC®.

An over-the-counter central sensitization therapy: a chronic back pain registry study of pain relief, medication use and their adverse effects.

PubMed

Staelin, Richard; Koneru, Sree N; Rawe, Ian M

2017-03-01

Back pain, the most prevalent musculoskeletal chronic pain condition, is usually treated with analgesic medications of questionable efficacy and frequent occurrence of adverse side effects. The objective was to determine the effectiveness of the ActiPatch medical devices in reducing chronic back pain, document medication related adverse side effects and establish their impact on quality of life. Upon completing a 7-day trial, subjects were contacted via email with an assessment form using the Constant Contact email program. A total of 1394 responses were collected from subjects who used the device for back pain. Medication adverse effects are common and impact quality of life in the lay population. ActiPatch is an effective intervention for the majority of subjects for treating chronic back pain, although this requires further investigation in randomized clinical trials.

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

NASA Astrophysics Data System (ADS)

Chakrabortty, Shankhadeep; Dey, Tanay K.

2016-05-01

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

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

DTIC Science & Technology

1999-05-01

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

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

PubMed

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

2006-05-01

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

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

PubMed Central

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

2006-01-01

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

Effects of back posture education on elementary schoolchildren's back function.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; Danneels, Lieven; Coorevits, Pascal; Vanderstraeten, Guy; De Clercq, Dirk

2007-06-01

The possible effects of back education on children's back function were never evaluated. Therefore, main aim of the present study was to evaluate the effects of back education in elementary schoolchildren on back function parameters. Since the reliability of back function measurement in children is poorly defined, another objective was to test the selected instruments for reliability in 8-11-year olds. The multi-factorial intervention lasting two school-years consisted of a back education program and the stimulation of postural dynamism in the class. Trunk muscle endurance, leg muscle capacity and spinal curvature were evaluated in a pre-post design including 41 children who received the back education program (mean age at post-test: 11.2 +/- 0.9 years) and 28 controls (mean age at post-test: 11.4 +/- 0.6 years). Besides, test-retest reliability with a 1-week interval was investigated in a separate sample. Therefore, 47 children (mean age: 10.1 +/- 0.5 years) were tested for reliability of trunk muscle endurance and 40 children (mean age: 10.2 +/- 0.7 years) for the assessment of spinal curvatures. Reliability of endurance testing was very good to good for the trunk flexors (ICC = 0.82) and trunk extensors (ICC = 0.63). The assessment of the thoracic (ICC = 0.69) and the lumbar curvature (ICC = 0.52) in seating position showed good to acceptable reliability. Low ICCs were found for the assessment of the thoracic (ICC = 0.39) and the lumbar curvature (ICC = 0.37) in stance. The effects of 2 year back education showed an increase in trunk flexor endurance in the intervention group compared to a decrease in the controls and a trend towards significance for a higher increase in trunk extensor endurance in the intervention group. For leg muscle capacity and spinal curvature no intervention effects were found. The small samples recommend cautious interpretation of intervention effects. However, the present study's findings favor the implementation of back education with focus on postural dynamism in the class as an integral part of the elementary school curriculum in the scope of optimizing spinal loading through the school environment.

Effects of a postpartum back pain relief program for Korean women.

PubMed

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

2007-03-01

Despite the high prevalence of back pain and its subsequent effects in post-partum women, intervention programs are scarce. The purpose of this study was to test the effects of a back-pain-reducing program on post-partum women who experienced low-back pain during pregnancy. A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended a hospital for prenatal check-ups and experienced back pain participated in an intervention program (n=27), and the results were compared with women in a control group from another hospital (n=25). At 8 weeks post-partum, the pain intensity, functional limitations were lower in the intervention group than in the control group. However, differences in mean change of the pain intensity and functional limitations between 36 and 39 weeks of gestation and at 8 weeks post-partum were not statistically significant between the groups. Moreover, the flexibility, post-partum functional status, and post-partum depression did not differ significantly between the groups. A back-pain-relief program in this study was not effective to reduce the back-pain intensity in post-partum women and to decrease the associated functional limitations. The implications for nursing practice and directions for future research are discussed.

Worksite back and core exercise in firefighters: Effect on development of lumbar multifidus muscle size.

PubMed

Mayer, John M; Nuzzo, James L

2015-01-01

Firefighting is a dangerous occupation with a high incidence of low back pain and injury. Abnormal back muscle function and morphology has been linked to low back pain and poor physical performance. The effect of exercise training on back muscle size and symmetry has not been investigated in firefighters. The purpose of this study was to assess the effect of worksite exercise training for eliciting lumbar multifidus muscle hypertrophy in firefighters. A cluster randomized controlled trial was conducted with healthy, career firefighters (n=64) from a medium-sized fire department. Participants were randomized by fire station to exercise training (n=36) (supervised back and core exercise performed on duty, 2X/week, 24 weeks) or control (n=28). The cross-sectional area (CSA) of the L4 and L5 lumbar multifidus muscle was assessed with ultrasonography at baseline and following the intervention. At 24 weeks, no significant differences were noted between the groups in the adjusted (by baseline scores and body mass) L4 and L5 lumbar multifidus muscle CSA and asymmetry values. A worksite exercise training program targeting the back and core is not effective for eliciting hypertrophy of the lumbar multifidus muscle in healthy firefighters.

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

Comparison of low back mobility and stability exercises from Pilates in non-specific low back pain: A study protocol of a randomized controlled trial.

PubMed

Miranda, Iã Ferreira; Souza, Catiane; Schneider, Alexandre Tavares; Chagas, Leandro Campos; Loss, Jefferson Fagundes

2018-05-01

There is some evidence in the literature about the effectiveness of the Pilates methods in the low back pain. Moreover, Pilates focus on exercises that empathizes the stability and/or mobility of the spine. Therefore, it is discussed in the literature whether higher levels of stability or mobility of the lumbar spine generates better results, both in performance and rehabilitation for low back pain. Compare the effects of the low back mobility and stability exercises from Pilates Method on low back pain, disability and movement functionality in individuals with non-specific chronic low back pain. 28 participants will be randomized into two exercise protocol from Pilates methods, one focusing on low back stability and other on low back mobility. Low back pain (visual analogic scale), low back disability (Oswestry) and movement functionality (7 functional movement tasks) will be evaluated before and after 10 sessions of Pilates exercise by the same trained assessor. A mixed designed ANOVA with two factors will be used. This study is the first to compare these outcomes for chronic low back pain participants with two exercises protocol focusing on low back mobility and stability and the results will evaluate what to prioritize with Pilates exercises to give better results for that population. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

PubMed

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

2005-05-03

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

Efficacy of paracetamol, diclofenac and advice for acute low back pain in general practice: design of a randomized controlled trial (PACE Plus).

PubMed

Schreijenberg, M; Luijsterburg, P A J; Van Trier, Y D M; Rizopoulos, D; Koopmanschap, M A; Voogt, L; Maher, C G; Koes, B W

2017-02-01

Low back pain is common and associated with a considerable burden to patients and society. There is uncertainty regarding the relative benefit of paracetamol and diclofenac and regarding the additional effect of pain medication compared with advice only in patients with acute low back pain. This trial will assess the effectiveness of paracetamol, diclofenac and placebo for acute low back pain over a period of 4 weeks. Furthermore, this trial will assess the additional effectiveness of paracetamol, diclofenac and placebo compared with advice only for acute low back pain over a period of 4 weeks. The PACE Plus trial is a multi-center, placebo-blinded, superiority randomized controlled trial in primary care, with a follow-up of 12 weeks. Patients with acute low back pain aged 18-60 years presenting in general practice will be included. Patients are randomized into four groups: 1) Advice only (usual care conforming with the clinical guideline of the Dutch College of General Practitioners); 2) Advice and paracetamol; 3) Advice and diclofenac; 4) Advice and placebo. The primary outcome is low back pain intensity measured with a numerical rating scale (0-10). Secondary outcomes include compliance to treatment, disability, perceived recovery, costs, adverse reactions, satisfaction, sleep quality, co-interventions and adequacy of blinding. Between group differences for low back pain intensity will be evaluated using a repeated measurements analysis with linear effects models. An economic evaluation will be performed using a cost-effectiveness analysis with low back pain intensity and a cost-utility analysis with quality of life. Explorative analyses will be performed to assess effect modification by predefined variables. Ethical approval has been granted. Trial results will be released to an appropriate peer-viewed journal. This paper presents the design of the PACE Plus trial: a multi-center, placebo-blinded, superiority randomized controlled trial in primary care that will assess the effectiveness of advice only, paracetamol, diclofenac and placebo for acute low back pain. Dutch Trial Registration NTR6089 , registered September 14th, 2016. Version 4, June 2016.

Molecular dynamics and information on possible sites of interaction of intramyocellular metabolites in vivo from resolved dipolar couplings in localized 1H NMR spectra

NASA Astrophysics Data System (ADS)

Schröder, Leif; Schmitz, Christian; Bachert, Peter

2004-12-01

Proton NMR resonances of the endogenous metabolites creatine and phosphocreatine ((P)Cr), taurine (Tau), and carnosine (Cs, β-alanyl- L-histidine) were studied with regard to residual dipolar couplings and molecular mobility. We present an analysis of the direct 1H- 1H interaction that provides information on motional reorientation of subgroups in these molecules in vivo. For this purpose, localized 1H NMR experiments were performed on m. gastrocnemius of healthy volunteers using a 1.5-T clinical whole-body MR scanner. We evaluated the observable dipolar coupling strength SD0 ( S = order parameter) of the (P)Cr-methyl triplet and the Tau-methylene doublet by means of the apparent line splitting. These were compared to the dipolar coupling strength of the (P)Cr-methylene doublet. In contrast to the aliphatic protons of (P)Cr and Tau, the aromatic H2 ( δ = 8 ppm) and H4 ( δ = 7 ppm) protons of the imidazole ring of Cs exhibit second-order spectra at 1.5 T. This effect is the consequence of incomplete transition from Zeeman to Paschen-Back regime and allows a determination of SD0 from H2 and H4 of Cs as an alternative to evaluating the multiplet splitting which can be measured directly in high-resolution 1H NMR spectra. Experimental data showed striking differences in the mobility of the metabolites when the dipolar coupling constant D0 (calculated with the internuclear distance known from molecular geometry in the case of complete absence of molecular dynamics and motion) is used for comparison. The aliphatic signals involve very small order parameters S ≈ (1.4 - 3) × 10 -4 indicating rapid reorientation of the corresponding subgroups in these metabolites. In contrast, analysis of the Cs resonances yielded S ≈ (113 - 137) × 10 -4. Thus, the immobilization of the Cs imidazole ring owing to an anisotropic cellular substructure in human m. gastrocnemius is much more effective than for (P)Cr and Tau subgroups. Furthermore, 1H NMR experiments on aqueous model solutions of histidine and N-acetyl- L-aspartate (NAA) enabled the assignment of an additional signal component at δ = 8 ppm of Cs in vivo to the amide group at the peptide bond. The visibility of this proton could result from hydrogen bonding which would agree with the anticipated stronger motional restriction of Cs. Referring to the observation that all dipolar-coupled multiplets resolved in localized in vivo 1H NMR spectra of human m. gastrocnemius collapse simultaneously when the fibre structure is tilted towards the magic angle ( θ ≈ 55°), a common model for molecular confinement in muscle tissue is proposed on the basis of an interaction of the studied metabolites with myocellular membrane phospholipids.

Rigorously Assessing Whether the Data Backs the Back School

PubMed Central

Vinh, David T.; Johnson, Craig W.; Phelps, Cynthia L.

2003-01-01

A rigorous between-subjects methodology employing independent random samples and having broad clinical applicability was designed and implemented to evaluate the effectiveness of back safety and patient transfer training interventions for both hospital nurses and nursing assistants. Effects upon self-efficacy, cognitive, and affective measures are assessed for each of three back safety procedures. The design solves the problem of obtaining randomly assigned independent controls where all experimental subjects must participate in the training interventions. PMID:14728544

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

PubMed Central

van der Roer, Nicole; van Tulder, Maurits W; Barendse, Johanna M; van Mechelen, Willem; Franken, Willemien K; Ooms, Arjan C; de Vet, Henrica CW

2004-01-01

Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available. PMID:15560843

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

PubMed

Nurminen, M

1997-11-01

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

Effectiveness of back-to-back testing

NASA Technical Reports Server (NTRS)

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

1987-01-01

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

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

PubMed

Bigos, S J; Battié, M C

1987-08-01

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

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

PubMed

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

2018-02-01

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

Intracutaneous sterile water for back pain in labour.

PubMed Central

Reynolds, J. L.

1994-01-01

Intracutaneous sterile water appears to be a simple, effective, and harmless technique for relieving back pain. This technique has been used to relieve pain of renal colic, whiplash, and back pain in labour. Family doctors often practise obstetrics in small or isolated units that have limited options for pain relief in labour. This technique is simple, is easy to learn, and appears effective for relieving back pain, which complicates about one third of all labours. Images Figures 1-2 Figures 3-4 PMID:7950471

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

PubMed

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

2015-08-01

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

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

PubMed

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

2008-01-01

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

Position and mode dependent optical detection back-action in cantilever beam resonators

NASA Astrophysics Data System (ADS)

Larsen, T.; Schmid, S.; Dohn, S.; Sader, J. E.; Boisen, A.; Villanueva, L. G.

2017-03-01

Optical detection back-action in cantilever resonant or static detection presents a challenge when striving for state-of-the-art performance. The origin and possible routes for minimizing optical back-action have received little attention in literature. Here, we investigate the position and mode dependent optical back-action on cantilever beam resonators. A high power heating laser (100 µW) is scanned across a silicon nitride cantilever while its effect on the first three resonance modes is detected via a low-power readout laser (1 µW) positioned at the cantilever tip. We find that the measured effect of back-action is not only dependent on position but also the shape of the resonance mode. Relevant silicon nitride material parameters are extracted by fitting finite element (FE) simulations to the temperature-dependent frequency response of the first three modes. In a second round of simulations, using the extracted parameters, we successfully fit the FEM results with the measured mode and position dependent back-action. From the simulations, we can conclude that the observed frequency tuning is due to temperature induced changes in stress. Effects of changes in material properties and dimensions are negligible. Finally, different routes for minimizing the effect of this optical detection back-action are described, allowing further improvements of cantilever-based sensing in general.

Low back cutaneous vibration and its effect on trunk postural control.

PubMed

Cornwall, Adam R; Gregory, Diane E

2017-08-01

The current study investigated the effects of a low back pain (LBP) vibration modality on trunk motor control. Trunk repositioning error and responses to a sudden loading trunk perturbation were evaluated pre- and post-vibration (15min vibration exposure while sitting on a standard chair) as well as when concurrent cutaneous low back vibration was applied. Only minor effects were observed post-vibration when compared to pre-vibration. However, when vibration was applied at the same time as the sudden trunk perturbations, lumbar erector spinae and external oblique muscles were significantly more delayed in activating following the perturbation. In addition, the resting muscle activation prior to the trunk perturbation was higher in both the back extensor and abdominal muscles when concurrent vibration was applied. These findings suggest that cutaneous low back vibration significantly alters motor control responses and this should be considered before implementing cutaneous vibration as a low back pain management strategy. Copyright © 2017. Published by Elsevier B.V.

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

PubMed

Ward, John; Coats, Jesse

2017-01-01

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

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

PubMed

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

2011-12-01

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

[Evaluation of the German new back school: pain-related and psychological characteristics].

PubMed

Borys, C; Nodop, S; Tutzschke, R; Anders, C; Scholle, H C; Strauß, B

2013-12-01

Results related to the outcome of the classical back schools are inconsistent. Accordingly, a reformulation of the program integrating psychological and social aspects was performed as a necessary step for the development of the new back school in Germany. The aim of this study was to assess the effectiveness and sustainability of the new back school in subjects with non-specific back pain in the prevention setting. In a modified waiting design, individuals were investigated with respect to demographical, pain-related and psychological characteristics 3 months before the start, at the start and at the end of the back school and as well as 12 months after completion. In addition, predictors for a successful participation were analyzed. A total of 88 subjects with back pain initially participated in the study. In the short and long-term course, low to moderate effects were detected; however, during follow-up a reduction of pain showed high effects. Depression as assessed by the hospital anxiety and depression scale (HADS) and passive coping strategies assessed using the coping strategies questionnaire (CSQ) were identified as predictors for response to the intervention. On the basis of the sample studied, the new back school proved to be an effective treatment for short and long-term reduction of pain-related stress and associated psychological aspects. Maladaptive, passive coping strategies and higher depression scores were associated with a higher probability of success in terms of pain reduction and functional improvement.

The near-infrared radius-luminosity relationship for active galactic nuclei

NASA Astrophysics Data System (ADS)

Landt, Hermine; Bentz, Misty C.; Peterson, Bradley M.; Elvis, Martin; Ward, Martin J.; Korista, Kirk T.; Karovska, Margarita

2011-05-01

Black hole masses for samples of active galactic nuclei (AGNs) are currently estimated from single-epoch optical spectra. In particular, the size of the broad-line emitting region needed to compute the black hole mass is derived from the optical or ultraviolet continuum luminosity. Here we consider the relationship between the broad-line region size, R, and the near-infrared (near-IR) AGN continuum luminosity, L, as the near-IR continuum suffers less dust extinction than at shorter wavelengths and the prospects for separating the AGN continuum from host-galaxy starlight are better in the near-IR than in the optical. For a relationship of the form R∝Lα, we obtain for a sample of 14 reverberation-mapped AGN a best-fitting slope of α= 0.5 ± 0.1, which is consistent with the slope of the relationship in the optical band and with the value of 0.5 naïvely expected from photoionization theory. Black hole masses can then be estimated from the near-IR virial product, which is calculated using the strong and unblended Paschen broad emission lines (Paα or Paβ).

Differential Ion Mobility Separations in up to 100 % Helium Using Microchips

PubMed Central

Shvartsburg, Alexandre A.; Ibrahim, Yehia M.; Smith, Richard D.

2014-01-01

The performance of differential IMS (FAIMS) analyzers is much enhanced by gases comprising He, especially He/N2 mixtures. However, electrical breakdown has limited the He fraction to ~50 %–75 %, depending on the field strength. By the Paschen law, the threshold field for breakdown increases at shorter distances. This allows FAIMS using chips with microscopic channels to utilize much stronger field intensities (E) than “full-size” analyzers with wider gaps. Here we show that those chips can employ higher He fractions up to 100 %. Use of He-rich gases improves the resolution and resolution/sensitivity balance substantially, although less than for full-size analyzers. The optimum He fraction is ~80 %, in line with first-principles theory. Hence, one can now measure the dependences of ion mobility on E in pure He, where ion-molecule cross section calculations are much more tractable than in other gases that form deeper and more complex interaction potentials. This capability may facilitate quantitative modeling of high-field ion mobility behavior and, thus, FAIMS separation properties, which would enable a priori extraction of structural information about the ions. PMID:24402673

Cyclic evolution of the electron temperature and density in dusty low-pressure radio frequency plasmas with pulsed injection of hexamethyldisiloxane

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

Garofano, V.; Stafford, L., E-mail: luc.stafford@umontreal.ca, E-mail: kremena.makasheva@laplace.univ-tlse.fr; Despax, B.

2015-11-02

Optical emission spectroscopy was used to analyze the very-low-frequency cyclic evolution of the electron energy and density caused by repetitive formation and loss of dust nanoparticles in argon plasmas with pulsed injection of hexamethyldisiloxane (HMDSO, [CH{sub 3}]{sub 6}Si{sub 2}O). After elaborating a Boltzmann diagram for Ar high-lying levels and a collisional-radiative model for Ar 2p (Paschen notation) states, temperatures characterizing the low- and high-energy parts of the electron population were calculated. Relative electron densities were also estimated from relative line emission intensities. Both temperatures increase when the dust occupation increases, and then decrease when dust is lost. The opposite trendmore » was observed for the electron density. Such cyclic behaviors of the electron energy and electron density in the HMDSO-containing plasmas are in good agreement with the evolution processes in dusty plasmas, in which the formation of negative ions followed by an electron attachment on the surfaces of the nanoparticles is a critical phenomenon driving dust growth.« less

The Emergence of Star Clusters

NASA Astrophysics Data System (ADS)

Calzetti, Daniela

2017-08-01

We propose to measure the timescale for the clearing of natal dust by young star clusters. We will augment existing archival UV-to-I imaging data with new WFC3/IR images at J, H, and Paschen-beta for a sample of six nearby star forming galaxies. Under the standard scenario that the clearing is performed by supernovae (> 3 Myr), simulations show that not enough ionizing photons can escape galaxies and reionize the Universe at z>6. However, the actual clearing timescale is poorly established. We will obtain accurate ages and extinctions for the embedded and emergent young clusters in our target galaxies, in order to: (1) determine whether dust clearing occurs before or after 3 Myr, (2) investigate environmental dependencies for the timescale, and (3) establish the principal mechanisms for enabling the escape of ionizing photons from galaxies. Our project provides the physical footing for future JWST observations aimed at determining the sources of reionization of the Universe. The combination of archival and new images will also equip the community with a lasting legacy of homogeneous UV-to-IR coverage for a sample of nearby galaxies.

The Radio to Gamma-ray SED of the Narrow-line Seyfert 1 1H0323+342

NASA Astrophysics Data System (ADS)

Ward, M.

2017-10-01

A sub-set of radio-loud narrow line Seyfert 1s, have been detected in gamma-rays by the Fermi Gamma-Ray satellite. Their gamma-ray emission is thought to arise from a relativistic jet. We have obtained new near-infrared spectra and used the profiles of the Paschen lines to estimate the mass of the black hole. Combining this with results from optical lines and X-ray timing analysis we arrive at a value of 2 x 10**E7 solar masses. From modelling the broad-band SED, we drive an Eddington ratio of 0.5, rising to 1.0 for a spinning black hole (a=0.8). Furthermore, we constrain the external photon field, and use a single-zone leptonic jet model to obtain a range of jet-parameters which are consistent with Compton up-scattering to produce the observed gamma-ray spectrum. This low-redshift very well studied AGN can potentially provide a useful laboratory to further our understanding of the jet/disc connection in extragalactic sources.

Direct comparison of neutral velocity distribution measurements and simulations in the vicinity of an absorbing boundary oblique to a magnetic field

NASA Astrophysics Data System (ADS)

Henriquez, Miguel F.; Thompson, Derek S.; Keniley, Shane; Curreli, Davide; Steinberger, Thomas E.; Caron, David D.; Jemiolo, Andrew J.; McLaughlin, Jacob W.; Dufor, Mikal T.; Neal, Luke A.; Scime, Earl E.; Siddiqui, M. Umair

2017-10-01

Plasma-boundary interactions are strongly affected by the sheath and presheath structures that form near the boundary surface. Recent measurements have observed ion transport across magnetic field lines in regions where the surface is oblique to the background magnetic field (ψ =74°) . In these boundary regions, charge exchange collisions may provide a mechanism through which neutral particles interact with the long distance presheath electric field. We report efforts to directly compare Boltzmann and particle-in-cell simulations with 3D neutral velocity distribution functions (NVDFs) using laser induced fluorescence (LIF) in a magnetized plasma boundary region. We present a novel LIF method for measuring Ar-II metastable velocity distributions, in which we observe the 738.6014 nm fluorescence (2p3 to 1s4 in Paschen's notation), that results from absorption of the 706.9167 nm (1s5 metastable to 2p3) pump laser, providing neutral temperatures and flows. We additionally describe electrostatic probe measurements in the same region.

Investigation of breakdown processes in automotive HID lamps

NASA Astrophysics Data System (ADS)

Bergner, Andre; Hoebing, Thomas; Ruhrmann, Cornelia; Mentel, Juergen; Awakowicz, Peter

2011-10-01

HID lamps are used for applications where high lumen output levels are required. Car headlights are a special field of HID lamp application. For security reasons and lawful regulations these lamps have to have a fast run-up phase and the possibility of hot re-strike. Therefore the background gas pressure amounts to 1.5 MPa xenon. But this high background gas pressure has the disadvantage that the ignition voltage becomes quite high due to Paschen's law. For that reason this paper deals with the investigation of the breakdown process of HID lamps for automotive application. The ignition is investigated by electrical as well as optical methods. Ignition voltage and current are measured on a nanosecond time scale and correlated with simultaneous phase resolved high speed photography done by an ICCD camera. So the ignition process can be observed from the first light emission until to the formation of whole discharge channel. The authors gratefully acknowledge the financial support by BMBF within the European project 'SEEL - Solutions for Energy Efficient Lighting' (FKZ: 13N11265). Furthermore the author would like to thank Philips Lighting (Aachen) for valuable discussions.

Influence of temperature on the ionization coefficient and ignition voltage of the Townsend discharge in an argon-mercury vapor mixture

NASA Astrophysics Data System (ADS)

Bondarenko, G. G.; Fisher, M. R.; Kristya, V. I.

2017-02-01

The kinetics of main types of charged and excited particles present in a low-current discharge in an argon-mercury vapor mixture used in gas-discharge illuminating lamps has been investigated in a wide interval of the reduced electric field strength and temperature. Mechanisms behind the production and loss of ions and metastable atoms have been discovered, and the temperature dependences of their contributions to maintaining their balance have been determined. It has been shown that, when the discharge is initiated in the lamp and the mercury content in the mixture is low, the ionization coefficient exceeds that in pure argon, which is almost exclusively due to the Penning reaction. The influence of this reaction grows with a reduction of the electric field strength in the interelectrode gap. The dependences of the discharge ignition voltage on the interelectrode gap (Paschen curves) for different temperatures of the mixture have been calculated, and the nonmonotonicity of the temperature dependence of the ignition voltage has been explained.

Advances in the Remote Glow Discharge Experiment

NASA Astrophysics Data System (ADS)

Dominguez, Arturo; Zwicker, A.; Rusaits, L.; McNulty, M.; Sosa, Carl

2014-10-01

The Remote Glow Discharge Experiment (RGDX) is a DC discharge plasma with variable pressure, end-plate voltage and externally applied axial magnetic field. While the experiment is located at PPPL, a webcam displays the live video online. The parameters (voltage, magnetic field and pressure) can be controlled remotely in real-time by opening a URL which shows the streaming video, as well as a set of Labview controls. The RGDX is designed as an outreach tool that uses the attractive nature of a plasma in order to reach a wide audience and extend the presence of plasma physics and fusion around the world. In March 2014, the RGDX was made publically available and, as of early July, it has had approximately 3500 unique visits from 107 countries and almost all 50 US states. We present recent upgrades, including the ability to remotely control the distance between the electrodes. These changes give users the capability of measuring Paschen's Law remotely and provides a comprehensive introduction to plasma physics to those that do not have access to the necessary equipment.

Some practical considerations for economical back contact formation on high efficiency solar cells

NASA Technical Reports Server (NTRS)

Lesk, I. A.

1985-01-01

The back contact can detract from solar cell performance in a number of ways: high recombination, barrier, photovoltaic, minority carrier collection, resistance. These effects may act in a nonuniform fashion over the cell area, and complicate the analysis of photovoltaic performance aimed at a better understanding of the effects of device geometry and material and/or processing parameters. The back contact is tested by reproducing it on both sides of a substrate. The objective is to find a back contact which performs well as a back contact, can be applied cheaply to large area solar cells, fits well into a practical process sequence, does not introduce structural damage or undesirable impurities into the silicon substrate, is compatible with an effective front contact technology, permits low temperature solder contacting, adheres well to silicon, and is reliable.

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

PubMed

Anderson, Barton E; Bliven, Kellie C Huxel

2017-09-01

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

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

PubMed

Pait, T Glenn; Dowdy, Justin T

2017-09-01

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

Effects of rearview cameras and rear parking sensors on police-reported backing crashes.

PubMed

Cicchino, Jessica B

2017-11-17

The objective of this study was to examine the effectiveness of rearview cameras, rear parking sensors, and both systems combined in preventing police-reported backing crashes. Negative binomial regression was used to compare rates of police-reported backing crash involvements per insured vehicle year in 22 U.S. states during 2009-2014 between passenger vehicle models with backing technologies and the same vehicle models where the optional systems were not purchased, controlling for other factors affecting crash risk. Rearview cameras were examined from four automakers, rear parking sensors from 2 automakers, and both systems combined from a single automaker. Rearview cameras reduced backing crash involvement rates by 17%. Reductions were larger for drivers 70 and older (36%) than for drivers younger than 70 (16%); however, estimates for older and younger drivers did not differ significantly from one another. The Buick Lucerne's rear parking sensor system reduced backing crash involvement rates significantly by 34%, but the reduction for Mercedes-Benz vehicles fit with a sensor system was small and not statistically significant. When averaged between the 2 automakers, effects were significantly larger for drivers 70 and older (38% reduction) than for drivers younger than 70 (1% increase); effects were significant for older but not younger drivers. Backing crash involvement rates were 13% lower among Mercedes-Benz vehicles with a rearview camera and parking sensors than among vehicles without, but this finding was not significant. Rearview cameras are effective in preventing police-reported backing crashes. Effects of rear parking sensors are less straightforward; it is unclear whether the Buick Lucerne system's benefits are due to the older age of its drivers, characteristics of the vehicle or system, or a combination. Systems may be especially beneficial to older drivers who might have limitations that make backing challenging. Although effect estimates did not differ significantly between older and younger drivers for both system types, the magnitude of the differences was large and the pattern of results was consistent across 6 of the 7 systems examined. When rear visibility systems become required equipment on new passenger vehicles in 2018, rearview cameras can be expected to prevent 1 in 6 backing crashes reported to police that involve equipped vehicles.

The effect of Kinesio Taping on postural control in subjects with non-specific chronic low back pain.

PubMed

Abbasi, Soheila; Rojhani-Shirazi, Zahra; Shokri, Esmaeil; García-Muro San José, Francisco

2018-04-01

The aim of this study was to investigate the possible alterations in postural control during upright standing in subjects with non-specific chronic low back pain and the effect of Kinesio taping on the postural control. Twenty subjects with non-specific chronic low back pain and twenty healthy subjects participated in this study. The center of pressure excursion was evaluated before the intervention for both groups, and immediately after intervention for the low back pain group. Independent sample t-test, Mann-Whitney test and repeated measure ANOVA were used for the statistical analysis of the data. There were significant differences in the center of pressure excursion between the low back pain group versus the healthy group. The results of the ANOVA demonstrated a statistically significant difference in the mean COP displacement and velocity before Kinesio Taping, immediately after, and 24 h after in the low back pain group. There are poor postural control mechanisms in subjects with non-specific chronic low back pain. Kinesio taping seems to change postural control immediately and have lasting effects until the day after. Copyright © 2017 Elsevier Ltd. All rights reserved.

Task-related and person-related variables influence the effect of low back pain on anticipatory postural adjustments.

PubMed

Jacobs, Jesse V; Lyman, Courtney A; Hitt, Juvena R; Henry, Sharon M

2017-08-01

People with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effect of low back pain on anticipatory postural adjustments. Thirteen subjects with and 13 without low back pain performed seated, rapid arm flexion in self-initiated and cued conditions. Mixed-model ANOVA were used to evaluate group and condition effects on APA onset latencies of trunk muscles, arm-raise velocity, and pre-movement cortical potentials. These measures were evaluated for correlation with pain ratings, Fear Avoidance Beliefs Questionnaire scores, and Modified Oswestry Questionnaire scores. Delayed postural adjustments of subjects with low back pain were greater in the cued condition than in the self-initiated condition. The group with low back pain exhibited larger-amplitude cortical potentials than the group without pain, but also significantly slower arm-raise velocities. With arm-raise velocity as a covariate, the effect of low back pain remained significant for the latencies of postural adjustments but not for cortical potentials. Latencies of the postural adjustments significantly correlated with Oswestry and Fear Avoidance Beliefs scores. Delayed postural adjustments with low back pain appear to be influenced by cueing of movement, pain-related disability and fear of activity. These results highlight the importance of subject characteristics, task condition, and task performance when comparing across studies or when developing treatment of people with low back pain. Copyright © 2017 Elsevier B.V. All rights reserved.

16 CFR 1632.8 - Glossary of terms.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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

PubMed

Centrella-Nigro, Andrea M; Alexander, Catherine

2017-01-01

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

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

PubMed

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

2016-09-01

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

A randomized placebo-controlled pilot study of the efficacy and safety of D-cycloserine in people with chronic back pain.

PubMed

Schnitzer, Thomas J; Torbey, Souraya; Herrmann, Kristi; Kaushal, Gagan; Yeasted, Renita; Vania Apkarian, A

2016-01-01

Few effective pharmacological treatment options exist for chronic back pain, the leading cause of disability in the US, and all are associated with significant adverse effects. To determine the efficacy and safety of D-cycloserine, a partial agonist to the N-methyl-D-aspartate receptor, in the treatment of chronic low back pain. A total of 41 participants with chronic back pain who met all inclusion and exclusion criteria were enrolled in a double-blind, placebo-controlled randomized pilot trial of D-cycloserine. Treatment was administered orally for six weeks at escalating daily doses of 100 mg, 200 mg, and 400 mg, each for two weeks. The primary outcome measure was back pain intensity using the Numeric Rating Scale (0-10). Secondary measures were back pain-related questionnaires: McGill Pain Questionnaire short form, painDETECT, PANAS, and BDI. The pre-specified analysis was a two-way repeated measures analysis of variance. A treatment difference was observed between groups treated with D-cycloserine and placebo at six weeks of 1.05 ± 3.1 units on the Numeric Rating Scale, with an effect size of 0.4 and p = 0.14. This trend of better chronic back pain relief with D-cycloserine was also observed in the secondary measures. No safety issues were seen. The difference in mean pain between the D-cycloserine and placebo groups did not reach statistical significance. However, a clinically meaningful effect size in the magnitude of pain relief was observed with a consistent pattern across multiple outcome measures with good safety, supporting further research into the effectiveness of D-cycloserine for chronic back pain. © The Author(s) 2016.

The effectiveness of a stratified care model for non-specific low back pain in Danish primary care compared to current practice: study protocol of a randomised controlled trial.

PubMed

Morso, Lars; Schiøttz-Christensen, Berit; Søndergaard, Jens; Andersen, Nils-Bo de Vos; Pedersen, Flemming; Olsen, Kim Rose; Jensen, Morten Sall; Hill, Jonathan; Christiansen, David Høyrup

2018-06-08

Prior studies indicate that stratified care for low back pain results in better clinical outcome and reduced costs in healthcare compared to current practice. Stratified care may be associated with clinical benefits for patients with low back pain at a lower cost, but evidence is sparse. Hence this study aims to evaluate the clinical effects and cost-effectiveness of stratified care in patients with non-specific low back pain compared to current practice. The study is a two-armed randomised controlled trial in primary care in the Regions of Southern and Central Denmark (2.5 million citizens). Patients with non-specific low back will be recruited by paticpating GPs. Patients are randomised to either (1) stratified care or (2) current practice at participating physiotherapy clinics. In the stratified care arm, the intervention is based on the patient's STarT Back Tool classification and trained accordingly, whereas physiotherapists in the current pratice arm are blinded to the STarT score. Primary outcomes in the trial will be group differences in time off work, improvement in LBP disability measured by the Roland Morris Disability Questionnaire (RMDQ) and patient-reported global change. Secondary measures will be pain intensity, patient satisfaction, data on patient healthcare resource utilisation and quality-adjusted life year based on the EQ-5D-5L. Stratified care that effectively targets treatment to relevant sub-groups of patients has potentially great impact on the treatment pathways of low back pain. Thus, if effective, this could result in better patient outcomes and at the same time reduce the costs for treatment of low back pain. ClinicalTrials.gov , NCT02612467 . Registered on 16 November 2015.

[Which route leads from chronic back pain to depression? A path analysis on direct and indirect effects using the cognitive mediators catastrophizing and helplessness/hopelessness in a general population sample].

PubMed

Fahland, R A; Kohlmann, T; Hasenbring, M; Feng, Y-S; Schmidt, C O

2012-12-01

Chronic pain and depression are highly comorbid; however, the longitudinal link is only partially understood. This study examined direct and indirect effects of chronic back pain on depression using path analysis in a general population sample, focussing on cognitive mediator variables. Analyses are based on 413 participants (aged 18-75 years) in a population-based postal survey on back pain who reported chronic back pain at baseline. Follow-up data were collected after 1 year. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Fear-avoidance-beliefs (FABQ), catastrophizing and helplessness/hopelessness (KRSS) were considered as cognitive mediators. Data were analyzed using path analysis. Chronic back pain had no direct effect on depression at follow-up when controlling for cognitive mediators. A mediating effect emerged for helplessness/hopelessness but not for catastrophizing or fear-avoidance beliefs. These results support the cognitive mediation hypothesis which assumes that psychological variables mediate the association between pain and depression. The importance of helplessness/hopelessness is of relevance for the treatment of patients with chronic back pain.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

The effects of common medical interventions on pain, back function, and work resumption in patients with chronic low back pain: A prospective 2-year cohort study in six countries.

PubMed

Hansson, T H; Hansson, E K

2000-12-01

A prospective cohort study with identical questionnaires and inclusion criteria was performed. To compare in six different countries the frequencies and effects of the common medical interventions used for patients with low back pain who are work incapacitated. Low back pain is a huge problem with increasing costs for health care, industry, and society. Cohorts of employed men and women ages 18 to 59 years who had been sick-listed (100%) for a minimum of 90 days because of low back pain were recruited in Denmark, Germany, Israel, Sweden, the Netherlands, and the United States. The subjects received three separate questionnaires with identical questions after 90 days, 1 year, and 2 years. The questionnaires included separate questions about background factors, treatment, and the like, as well as validated scales such as the Hannover Activities of Daily Living, von Korff pain score, Short Form-36, and Karasek-Theorell. Working status was obtained from registers. Main outcome measures were working/not working, back function, and pain. All three questionnaires were completed by 2080 subjects in the six countries. With few exceptions, there were great similarities in the appointments, examinations, and treatments in the different countries. Considerable differences were found between the back surgery rates, which ranged from 6% in Sweden to 32% in the United States during the first 90 days of the study. Very few of the interventions had any noticeable positive effects on work resumption, pain, or back function. Back surgery in Sweden was a striking exception, positively affecting all three outcome measures. The frequencies of work resumption within the first year ranged from 73% in the Netherlands to 32% in Denmark. Almost none of the commonly occurring and frequently practiced medical interventions for patients who are sick-listed because of low back pain had any positive effects on either the recorded health measures or work resumption.

The effectiveness of back pain and injury prevention programs in the workplace.

PubMed

Gatty, Carolyn M; Turner, Mynde; Buitendorp, Dinice J; Batman, Heather

2003-01-01

Musculoskeletal disorders in the workplace cause thousands of injuries and cost industry billions of dollars yearly. Work injury prevention programs have been developed and implemented as a means for cost containment. A variety of preventive strategies have been investigated in primary research. The purpose of this review article is to examine the effectiveness of back injury and pain prevention programs in the workplace. Nine studies published between 1995 and 2000 were reviewed and analyzed. Studies used primarily one of three types of preventive strategies: 1) back belts, 2) education and task modification, and 3) education and task modification with workstation redesign. The effectiveness of back belts to prevent back pain and injury remains inconclusive. Positive outcomes were associated with studies reporting high compliance that used job-specific and individualized/small group education and training approaches. Themes that arose following a critical review of primary research studies are discussed.

Effects of a two-school-year multifactorial back education program in elementary schoolchildren.

PubMed

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

2006-08-01

A quasi-experimental pre/post design. To investigate effects of a 2-school-year multifactorial back education program on back posture knowledge and postural behavior in elementary schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance beliefs were evaluated. Epidemiologic studies report mounting nonspecific back pain prevalence among youngsters, characterized by multifactorial risk factors. Study findings of school-based interventions are promising. Furthermore, biomechanical discomfort is found in the school environment. The study sample included 193 intervention children and 172 controls (baseline, 9-to-11-year-olds). The multifactorial intervention consisted of a back education program and the stimulation of postural dynamism in the class through support and environmental changes. Evaluation consisted of a questionnaire, an observation of postural behavior in the classroom, and an observation of material handling during a movement session. The intervention resulted in increased back posture knowledge (P < 0.001), improved postural behavior during material handling (P < 0.001), and decreased duration of trunk flexion (P < 0.05) and neck torsion (P < 0.05) during lesson time. The intervention did not change fear-avoidance beliefs. There was a trend for decreased pain reports in boys of the intervention group (P < 0.09). The intervention resulted in improved postural aspects related to spinal loading. The long-term effect of improved postural behavior at young age on back pain prevalence later in life is of interest for future research.

Is low-dose amitriptyline effective in the management of chronic low back pain? Study protocol for a randomised controlled trial.

PubMed

Urquhart, Donna M; Wluka, Anita E; Sim, Malcolm R; van Tulder, Maurits; Forbes, Andrew; Gibson, Stephen J; Arnold, Carolyn; Fong, Chris; Anthony, Shane N; Cicuttini, Flavia M

2016-10-22

Low back pain is a major clinical and public health problem, with limited evidence-based treatments. Low-dose antidepressants are commonly used to treat pain in chronic low back pain. However, their efficacy is unproven. The aim of this pragmatic, double-blind, randomised, placebo-controlled trial is to determine whether low-dose amitriptyline (an antidepressant) is more effective than placebo in reducing pain in individuals with chronic low back pain. One hundred and fifty individuals with chronic low back pain will be recruited through hospital and private medical and allied health clinics, advertising in local media and posting of flyers in community locations. They will be randomly allocated to receive either low-dose amitriptyline (25 mg) or an active placebo (benztropine mesylate, 1 mg) for 6 months. The primary outcome measure of pain intensity will be assessed at baseline, 3 and 6 months using validated questionnaires. Secondary measures of self-reported low back disability, work absence and hindrance in the performance of paid/unpaid work will also be examined. Intention-to-treat analyses will be performed. This pragmatic, double-blind, randomised, placebo-controlled trial will provide evidence regarding the effectiveness of low-dose antidepressants compared with placebo in reducing pain, disability, work absenteeism and hindrance in work performance in individuals with chronic low back pain. This trial has major public health and clinical importance as it has the potential to provide an effective approach to the management of chronic low back pain. Australian New Zealand Clinical Trials Registry: ACTRN12612000131853 ; registered on 30 January 2012.

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

PubMed

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

2016-04-26

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

A NEW PERSPECTIVE OF THE RADIO BRIGHT ZONE AT THE GALACTIC CENTER: FEEDBACK FROM NUCLEAR ACTIVITIES

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

Zhao, Jun-Hui; Morris, Mark R.; Goss, W. M., E-mail: jzhao@cfa.harvard.edu

2016-02-01

New observations of Sgr A have been carried out with the Jansky VLA in the B and C arrays using the broadband (2 GHz) continuum mode at 5.5 GHz. The field of view covers the central 13′ (30 pc) region of the radio-bright zone at the Galactic center. Using the multi-scale and multi-frequency-synthesis (MS-MFS) algorithms in CASA, we have imaged Sgr A with a resolution of 1″, achieving an rms noise of 8 μJy beam{sup −1}, and a dynamic range of 100,000:1. Both previously known and newly identified radio features in this region are revealed, including numerous filamentary sources. The radiomore » continuum image is compared with Chandra X-ray images, with a CN emission-line image obtained with the Submillimeter Array and with detailed Paschen-α images obtained with Hubble Space Telescope/NICMOS. We discuss several prominent features in the radio image. The “Sgr A west Wings” extend 2′ (5 pc) from the NW and SE tips of the Sgr A west H ii region (the “Mini-spiral”) to positions located 2.9 and 2.4 arcmin to the northwest and southeast of Sgr A*, respectively. The NW wing, along with several other prominent features, including the previously identified “NW Streamers,” form an elongated radio lobe (NW lobe), oriented nearly perpendicular to the Galactic plane. This radio lobe, with a size of 6.′3 × 3.′2 (14.4 pc × 7.3 pc), has a known X-ray counterpart. In the outer region of the NW lobe, a row of three thermally emitting rings is observed. A field containing numerous amorphous radio blobs extends for a distance of ∼2 arcmin beyond the tip of the SE wing; these newly recognized features coincide with the SE X-ray lobe. Most of the amorphous radio blobs in the NW and SE lobes have Paschen-α counterparts. We propose that they have been produced by shock interaction of ambient gas concentrations with a collimated nuclear wind or an outflow that originated from within the circumnuclear disk (CND). We also discuss the possibility that the ionized wind or outflow has been launched by radiation force produced by the central star cluster. Finally, we remark on the detailed structure of a prominent radio emission feature located within the shell of the Sgr A east supernova remnant. Because this feature—the “Sigma Front”—correlates well in shape and orientation with the nearby edge of the CND, we propose that it is a reflected shock wave resulting from the impact of the Sgr A east blast wave on the CND.« less

A New Perspective of the Radio Bright Zone at The Galactic Center: Feedback from Nuclear Activities

NASA Astrophysics Data System (ADS)

Zhao, Jun-Hui; Morris, Mark R.; Goss, W. M.

2016-02-01

New observations of Sgr A have been carried out with the Jansky VLA in the B and C arrays using the broadband (2 GHz) continuum mode at 5.5 GHz. The field of view covers the central 13‧ (30 pc) region of the radio-bright zone at the Galactic center. Using the multi-scale and multi-frequency-synthesis (MS-MFS) algorithms in CASA, we have imaged Sgr A with a resolution of 1″, achieving an rms noise of 8 μJy beam-1, and a dynamic range of 100,000:1. Both previously known and newly identified radio features in this region are revealed, including numerous filamentary sources. The radio continuum image is compared with Chandra X-ray images, with a CN emission-line image obtained with the Submillimeter Array and with detailed Paschen-α images obtained with Hubble Space Telescope/NICMOS. We discuss several prominent features in the radio image. The “Sgr A west Wings” extend 2‧ (5 pc) from the NW and SE tips of the Sgr A west H II region (the “Mini-spiral”) to positions located 2.9 and 2.4 arcmin to the northwest and southeast of Sgr A*, respectively. The NW wing, along with several other prominent features, including the previously identified “NW Streamers,” form an elongated radio lobe (NW lobe), oriented nearly perpendicular to the Galactic plane. This radio lobe, with a size of 6.‧3 × 3.‧2 (14.4 pc × 7.3 pc), has a known X-ray counterpart. In the outer region of the NW lobe, a row of three thermally emitting rings is observed. A field containing numerous amorphous radio blobs extends for a distance of ˜2 arcmin beyond the tip of the SE wing; these newly recognized features coincide with the SE X-ray lobe. Most of the amorphous radio blobs in the NW and SE lobes have Paschen-α counterparts. We propose that they have been produced by shock interaction of ambient gas concentrations with a collimated nuclear wind or an outflow that originated from within the circumnuclear disk (CND). We also discuss the possibility that the ionized wind or outflow has been launched by radiation force produced by the central star cluster. Finally, we remark on the detailed structure of a prominent radio emission feature located within the shell of the Sgr A east supernova remnant. Because this feature—the “Sigma Front”—correlates well in shape and orientation with the nearby edge of the CND, we propose that it is a reflected shock wave resulting from the impact of the Sgr A east blast wave on the CND.

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

PubMed

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

2005-10-01

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

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

PubMed Central

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

2008-01-01

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

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

DOEpatents

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

2016-03-08

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

The U.S. Navy Healthy Back Program: Effect on Back Knowledge among Recruits

DTIC Science & Technology

1992-08-01

b) anatomy of the spine including the role of vertebrae, ligaments, discs, and muscles, and (c) exercises and behaviors to protect the back from...exercise, traction, passive mobilization, physical strengthening, physiotherapy, drugs, surgery, hypnosis, psychotherapy, behavior modification, and skills...A recent evaluation of the effectiveness of Navy health education videotapes in changing knowledge and behavior in a nonpatient population indicated

The effect of frequency-dependent microphone directionality on horizontal localization performance in hearing-aid users.

PubMed

Keidser, Gitte; O'Brien, Anna; Hain, Jens-Uwe; McLelland, Margot; Yeend, Ingrid

2009-11-01

Frequency-dependent microphone directionality alters the spectral shape of sound as a function of arrival azimuth. The influence of this on horizontal-plane localization performance was investigated. Using a 360 degrees loudspeaker array and five stimuli with different spectral characteristics, localization performance was measured on 21 hearing-impaired listeners when wearing no hearing aids and aided with no directionality, partial (from 1 and 2 kHz) directionality, and full directionality. The test schemes were also evaluated in everyday life. Without hearing aids, localization accuracy was significantly poorer than normative data. Due to inaudibility of high-frequency energy, front/back reversals were prominent. Front/back reversals remained prominent when aided with omnidirectional microphones. For stimuli with low-frequency emphasis, directionality had no further effect on localization. For stimuli with sufficient mid- and high-frequency information, full directionality had a small positive effect on front/back localization but a negative effect on left/right localization. Partial directionality further improved front/back localization and had no significant effect on left/right localization. The field test revealed no significant effects. The alternative spectral cues provided by frequency-dependent directionality improve front/back localization in hearing-aid users.

Blur Detection is Unaffected by Cognitive Load.

PubMed

Loschky, Lester C; Ringer, Ryan V; Johnson, Aaron P; Larson, Adam M; Neider, Mark; Kramer, Arthur F

2014-03-01

Blur detection is affected by retinal eccentricity, but is it also affected by attentional resources? Research showing effects of selective attention on acuity and contrast sensitivity suggests that allocating attention should increase blur detection. However, research showing that blur affects selection of saccade targets suggests that blur detection may be pre-attentive. To investigate this question, we carried out experiments in which viewers detected blur in real-world scenes under varying levels of cognitive load manipulated by the N -back task. We used adaptive threshold estimation to measure blur detection thresholds at 0°, 3°, 6°, and 9° eccentricity. Participants carried out blur detection as a single task, a single task with to-be-ignored letters, or an N-back task with four levels of cognitive load (0, 1, 2, or 3-back). In Experiment 1, blur was presented gaze-contingently for occasional single eye fixations while participants viewed scenes in preparation for an easy picture recognition memory task, and the N -back stimuli were presented auditorily. The results for three participants showed a large effect of retinal eccentricity on blur thresholds, significant effects of N -back level on N -back performance, scene recognition memory, and gaze dispersion, but no effect of N -back level on blur thresholds. In Experiment 2, we replicated Experiment 1 but presented the images tachistoscopically for 200 ms (half with, half without blur), to determine whether gaze-contingent blur presentation in Experiment 1 had produced attentional capture by blur onset during a fixation, thus eliminating any effect of cognitive load on blur detection. The results with three new participants replicated those of Experiment 1, indicating that the use of gaze-contingent blur presentation could not explain the lack of effect of cognitive load on blur detection. Thus, apparently blur detection in real-world scene images is unaffected by attentional resources, as manipulated by the cognitive load produced by the N -back task.

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

PubMed

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

2018-04-01

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

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2013-06-01

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

Comparison of complementary and alternative medicine with conventional mind–body therapies for chronic back pain: protocol for the Mind–body Approaches to Pain (MAP) randomized controlled trial

PubMed Central

2014-01-01

Background The self-reported health and functional status of persons with back pain in the United States have declined in recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts and coping behaviors have been demonstrated to affect how well patients respond to treatments for back pain, few patients receive treatments that address these factors. Cognitive-behavioral therapy (CBT), which addresses psychosocial factors, has been found to be effective for back pain, but access to qualified therapists is limited. Another treatment option with potential for addressing psychosocial issues, mindfulness-based stress reduction (MBSR), is increasingly available. MBSR has been found to be helpful for various mental and physical conditions, but it has not been well-studied for application with chronic back pain patients. In this trial, we will seek to determine whether MBSR is an effective and cost-effective treatment option for persons with chronic back pain, compare its effectiveness and cost-effectiveness compared with CBT and explore the psychosocial variables that may mediate the effects of MBSR and CBT on patient outcomes. Methods/Design In this trial, we will randomize 397 adults with nonspecific chronic back pain to CBT, MBSR or usual care arms (99 per group). Both interventions will consist of eight weekly 2-hour group sessions supplemented by home practice. The MBSR protocol also includes an optional 6-hour retreat. Interviewers masked to treatment assignments will assess outcomes 5, 10, 26 and 52 weeks postrandomization. The primary outcomes will be pain-related functional limitations (based on the Roland Disability Questionnaire) and symptom bothersomeness (rated on a 0 to 10 numerical rating scale) at 26 weeks. Discussion If MBSR is found to be an effective and cost-effective treatment option for patients with chronic back pain, it will become a valuable addition to the limited treatment options available to patients with significant psychosocial contributors to their pain. Trial registration Clinicaltrials.gov Identifier: NCT01467843. PMID:24906419

Comparison of complementary and alternative medicine with conventional mind-body therapies for chronic back pain: protocol for the Mind-body Approaches to Pain (MAP) randomized controlled trial.

PubMed

Cherkin, Daniel C; Sherman, Karen J; Balderson, Benjamin H; Turner, Judith A; Cook, Andrea J; Stoelb, Brenda; Herman, Patricia M; Deyo, Richard A; Hawkes, Rene J

2014-06-07

The self-reported health and functional status of persons with back pain in the United States have declined in recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts and coping behaviors have been demonstrated to affect how well patients respond to treatments for back pain, few patients receive treatments that address these factors. Cognitive-behavioral therapy (CBT), which addresses psychosocial factors, has been found to be effective for back pain, but access to qualified therapists is limited. Another treatment option with potential for addressing psychosocial issues, mindfulness-based stress reduction (MBSR), is increasingly available. MBSR has been found to be helpful for various mental and physical conditions, but it has not been well-studied for application with chronic back pain patients. In this trial, we will seek to determine whether MBSR is an effective and cost-effective treatment option for persons with chronic back pain, compare its effectiveness and cost-effectiveness compared with CBT and explore the psychosocial variables that may mediate the effects of MBSR and CBT on patient outcomes. In this trial, we will randomize 397 adults with nonspecific chronic back pain to CBT, MBSR or usual care arms (99 per group). Both interventions will consist of eight weekly 2-hour group sessions supplemented by home practice. The MBSR protocol also includes an optional 6-hour retreat. Interviewers masked to treatment assignments will assess outcomes 5, 10, 26 and 52 weeks postrandomization. The primary outcomes will be pain-related functional limitations (based on the Roland Disability Questionnaire) and symptom bothersomeness (rated on a 0 to 10 numerical rating scale) at 26 weeks. If MBSR is found to be an effective and cost-effective treatment option for patients with chronic back pain, it will become a valuable addition to the limited treatment options available to patients with significant psychosocial contributors to their pain. Clinicaltrials.gov Identifier: NCT01467843.

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

PubMed

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

2016-06-01

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

[Nonpharmacological correction of low back pain by single or integrated means of medical rehabilitation and the evaluation of their effectiveness].

PubMed

Sakalauskiene, Giedre

2009-01-01

Low back pain is a global worldwide problem. A great attention is given to correction of this health status by a wide range of rehabilitation specialists. Some single or integrated physical factors, physiotherapy, specific and nonspecific physical exercises, alternative methods of treatment, also the complex of multidisciplinary rehabilitation means are applied in the management of low back pain. The evidence-based data are analyzed in order to identify which nonpharmacological means are effective in pain correction; in addition, the effectiveness of various methods and models of low back pain management are compared in this article. Research data evaluating the impact effectiveness of single or integrated means of rehabilitation are very controversial. There are no evidence-based specific recommendations for the correction of this health status objectively assessing advantages of physiotherapy or physical factors and referring the definite indications of their prescription. It is thought that multidisciplinary rehabilitation is most effective in management of chronic low back pain. The positive results depend on the experience of a physician and other rehabilitation specialists. A patient's motivation to participate in the process of pain control is very important. It is recommended to inform a patient about the effectiveness of administered methods. There is a lack of evidence-based trials evaluating the effectiveness of nonpharmacological methods of pain control in Lithuania. Therefore, the greater attention of researchers and administrative structures of health care should be given to this problem in order to develop the evidence-based guidelines for an effective correction of low back pain.

The effect of acupressure on fatigue among female nurses with chronic back pain.

PubMed

Movahedi, Maryam; Ghafari, Somayeh; Nazari, Fateme; Valiani, Mahboubeh

2017-08-01

To investigate the effect of acupressure on fatigue among female nurses with chronic back pain. Chronic back pain is one of the most common problems among nurses and has numerous physical and psychological effects. One of these effects is fatigue that impairs an individual's life. This randomized single-blind clinical trial was conducted on 50 nurses with chronic back pain working at the selected hospitals in Isfahan, Iran. After convenient sampling, the subjects were randomly allocated, through lottery, to the two groups of experimental (n=25) and sham (n=25). In the experimental group, acupressure techniques were performed during 9 sessions, 3 times a week for 14min for each patient. In the sham group, points within 1cm of the main points were only touched. Data were collected using the Fatigue Severity Scale (FSS), before, and immediately, 2weeks, and 4weeks after the intervention. Data analysis was performed using SPSS software. The mean score of fatigue severity before the intervention was not significantly different between the two groups (P=0.990). However, it was significantly lower in the experimental group than the sham group immediately (P<0.001), 2weeks (P=0.005), and 1month after the intervention (P<0.001). Acupressure on specific points of the foot and back improves back pain so, reduces fatigue. Therefore, acupressure can be used as a drug-free and low-cost approach without side effects to improve fatigue in nurses with chronic back pain. Copyright © 2017. Published by Elsevier Inc.

Impact of back squat training intensity on strength and flexibility of hamstring muscle group.

PubMed

Shariat, Ardalan; Lam, Eddie T C; Shaw, Brandon S; Shaw, Ina; Kargarfard, Mehdi; Sangelaji, Bahram

2017-01-01

True experimental design. The back squat is an integral aspect of any resistance training program to improve athletic performance. It is also used for injury prevention of the lower limbs. The purpose of this study was to examine the effect of back squat training at different intensities on strength and flexibility of the hamstring muscle group (HMG). Twenty-two male recreational bodybuilders with at least two years of experience in resistance training were recruited to participate in a nine-week training program. They were randomly assigned to a heavy back squat group (90-95% of one repetition maximum) or a moderate-intensity back squat group (60-65% of one repetition maximum). The heavy back squat group resulted in a significantly (p < 0.001) increased in one repetition maximum strength but a significant (p < 0.001) reduction in HMG flexibility when compared to their counterparts. The results of the study indicate that while a heavy back squat training program is effective in improving strength, it has an adverse effect on the flexibility of the HMG. The implication of this study is that there is a tradeoff between strength and flexibility and trainers should select the appropriate training protocols for their athletes to maximize athletic performance.

Electrophysiological assessment of the effects of obstructive sleep apnea on cognition.

PubMed

Gelir, Ethem; Başaran, Cenk; Bayrak, Sibel; Yağcıoğlu, Süha; Budak, Murat Timur; Fırat, Hikmet; Ungan, Pekcan

2014-01-01

We used electrophysiological measures to investigate the effects of obstructive sleep apnea on attention, learning, and memory. Thirty subjects (OSA group, n = 15, control group n = 15) participated in n-back tests, accompanied by P300 recordings, to investigate working memory and attention. The mirror-drawing test was used to study procedural memory, and the trail-making test (TMT) was used to evaluate divided attention and executive function. No significant group difference in reaction time was found in the 0-back and 1-back tests. In the 2-back test, reaction times of patients were longer than those of the control group. No P300 wave was obtained in the OSA group in any (0-, 1-, or 2-back) n-back test. In contrast, in the control group, significant P300 waves were recorded except for the 2-back test. The mirror-drawing scores were unaffected by sleep apnea. There was no difference between groups in the TMT-A test on any of the trials. Although no group difference was found in the first or second trials of the TMT-B test, OSA patients were less successful in learning on the third trial. According to our study results, OSA affects attention and executive function adversely however, we could not detect a significant effect on working or procedural memory.

Experimental evaluation of effective atomic number of composite materials using back-scattering of gamma photons

NASA Astrophysics Data System (ADS)

Singh, Inderjeet; Singh, Bhajan; Sandhu, B. S.; Sabharwal, Arvind D.

2017-04-01

A method has been presented for calculation of effective atomic number (Zeff) of composite materials, by using back-scattering of 662 keV gamma photons obtained from a 137Cs mono-energetic radioactive source. The present technique is a non-destructive approach, and is employed to evaluate Zeff of different composite materials, by interacting gamma photons with semi-infinite material in a back-scattering geometry, using a 3″ × 3″ NaI(Tl) scintillation detector. The present work is undertaken to study the effect of target thickness on intensity distribution of gamma photons which are multiply back-scattered from targets (pure elements) and composites (mixtures of different elements). The intensity of multiply back-scattered events increases with increasing target thickness and finally saturates. The saturation thickness for multiply back-scattered events is used to assign a number (Zeff) for multi-element materials. Response function of the 3″ × 3″ NaI(Tl) scintillation detector is applied on observed pulse-height distribution to include the contribution of partially absorbed photons. The reduced value of signal-to-noise ratio interprets the increase in multiply back-scattered data of a response corrected spectrum. Data obtained from Monte Carlo simulations and literature also support the present experimental results.

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.

Graded activity for low back pain in occupational health care: a randomized, controlled trial.

PubMed

Staal, J Bart; Hlobil, Hynek; Twisk, Jos W R; Smid, Tjabe; Köke, Albère J A; van Mechelen, Willem

2004-01-20

Low back pain is a common medical and social problem frequently associated with disability and absence from work. However, data on effective return to work after interventions for low back pain are scarce. To determine the effectiveness of a behavior-oriented graded activity program compared with usual care. Randomized, controlled trial. Occupational health services department of an airline company in the Netherlands. 134 workers who were absent from work because of low back pain were randomly assigned to either graded activity (n = 67) or usual care (n = 67). Graded activity, a physical exercise program based on operant-conditioning behavioral principles, to stimulate a rapid return to work. Outcomes were the number of days of absence from work because of low back pain, functional status (Roland Disability Questionnaire), and severity of pain (11-point numerical scale). The median number of days of absence from work over 6 months of follow-up was 58 days in the graded activity group and 87 days in the usual care group. From randomization onward, graded activity was effective after 50 days of absence from work (hazard ratio, 1.9 [95% CI, 1.2 to 3.2]; P = 0.009). The graded activity group was more effective in improving functional status and pain than the usual care group. The effects, however, were small and not statistically significant. Graded activity was more effective than usual care in reducing the number of days of absence from work because of low back pain.

Effects of general principles of person transfer techniques on low back joint extension moment.

PubMed

Katsuhira, Junji; Yamasaki, Syun; Yamamoto, Sumiko; Maruyama, Hitoshi

2010-01-01

The purpose of this study was to examine the effects of general principles of person transfer techniques specifically on the low back joint extension moment. These effects were examined by the following measurable quantitative parameters: 1) trunk bending angle, 2) knee flexion angle, 3) distance between the centers of gravity (COGs) of the caregiver and patient, representing the distance between the caregiver and patient, and 4) the vertical component of the ground reaction force representing the amount of the weight-bearing load on the caregiver's low back during transfers with and without assistive devices. Twenty students each took the role of caregiver, and one healthy adult simulated a patient. The participants performed three different transfer tasks: without any assistive device, with the patient wearing a low back belt, and with the caregiver using a transfer board. We found that the distance between the COGs and the vertical component of the ground reaction force, but not the trunk bending and knee flexion angles, were the variables that affected the low back joint extension moment. Our results suggest that the general principle of decreasing the distance between COGs is most effective for decreasing the low back joint extension moment during transfers under all conditions.

A Comparison of the Effects of Pilates and McKenzie Training on Pain and General Health in Men with Chronic Low Back Pain: A Randomized Trial.

PubMed

Hasanpour-Dehkordi, Ali; Dehghani, Arman; Solati, Kamal

2017-01-01

Today, chronic low back pain is one of the special challenges in healthcare. There is no unique approach to treat chronic low back pain. A variety of methods are used for the treatment of low back pain, but the effects of these methods have not yet been investigated adequately. The aim of this study was to compare the effects of Pilates and McKenzie training on pain and general health of men with chronic low back pain. Thirty-six patients with chronic low back pain were chosen voluntarily and assigned to three groups of 12 each: McKenzie group, Pilates group, and control group. The Pilates group participated in 1-h exercise sessions, three sessions a week for 6 weeks. McKenzie group performed workouts 1 h a day for 20 days. The control group underwent no treatment. The general health of all participants was measured by the General Health Questionnaire 28 and pain by the McGill Pain Questionnaire. After therapeutic exercises, there was no significant difference between Pilates and McKenzie groups in pain relief ( P = 0.327). Neither of the two methods was superior over the other for pain relief. However, there was a significant difference in general health indexes between Pilates and McKenzie groups. Pilates and McKenzie training reduced pain in patients with chronic low back pain, but the Pilates training was more effective to improve general health.

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

PubMed

Buchbinder, R; Jolley, D; Wyatt, M

2001-12-01

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

Wide abdominal rectus plication abdominoplasty for the treatment of chronic intractable low back pain.

PubMed

Oneal, Robert M; Mulka, Joseph P; Shapiro, Paul; Hing, David; Cavaliere, Christi

2011-01-01

A previous report demonstrated that the wide abdominal rectus plication abdominoplasty is an effective treatment modality in select patients with low back pain who failed to achieve relief with conservative therapy. The authors studied eight female patients who presented with chronic low back pain and marked lower abdominal wall muscular laxity. All had failed to respond to conservative management for their chronic back pain. They all underwent wide abdominal rectus plication abdominoplasty. Patient selection and details of the procedure are discussed. There were no significant complications in this series, and all the patients had prompt and prolonged alleviation of their back pain. Length of follow-up ranged from 2 to 11 years. Changes in the biomechanics of the lower abdominal musculature as a result of the wide abdominal rectus plication abdominoplasty are discussed in the context of increasing spinal stability, leading to an alleviation of chronic low back pain. An argument is made that this abdominoplasty procedure produces a spine-stabilizing effect by (1) tightening the muscles of the lateral abdominal complex and thus increasing intraabdominal pressure and (2) increasing the efficiency of these muscles so that their effectiveness as spine stabilizers is increased. Even though this is a small series, the fact that all the patients sustained long-term alleviation of their preoperative chronic back pain suggests that the wide abdominal rectus plication abdominoplasty should be considered as an option for patients with weak lower abdominal muscles and intractable low back pain who have failed conservative management.

Role of back stress in the creep behavior of particle strengthened alloys

NASA Technical Reports Server (NTRS)

Purushothaman, S.; Tien, J. K.

1978-01-01

Recent developments in the interpolation of high-temperature steady-state creep results have introduced the concept that the stress dependence of the creep rate should be in terms of the effective stress referred to as the applied stress minus a back stress. This paper reports on back stresses taken from data on a gamma-prime-strengthened wrought nickel-base superalloy, an oxide dispersion-strengthened ODS nickel-base solid solution alloy, and an ODS nickel-base superalloy. The effect of air versus vacuum environments and the effect of dynamic changes in the strengthening microstructures on the magnitude of the back stress are assessed. The role of modulus normalization and the back stress correction in determining the true creep activation energy are examined. It is shown that the high values of the apparent stress exponent 'n' of the steady-state creep equation can be easily explained through a relationship between n, the true stress exponent of steady-state creep, and the stress which when subtracted from the applied stress results in the effective driving stress acting on the mobile dislocations during creep.

Blocking the mineralocorticoid receptor improves effectiveness of steroid treatment for low back pain in rats

PubMed Central

Ye, Ling; Xie, Wenrui; Strong, Judith A.; Zhang, Jun-Ming

2014-01-01

Background Localized inflammation of lumbar dorsal root ganglia (DRG) may contribute to low back pain. Local injections of corticosteroids used for low back pain are sometimes ineffective. Many corticosteroids activate not only the target glucocorticoid receptor (GR) but also the mineralocorticoid receptor (MR), which may have pro-inflammatory effects countering the effects of GR activation. Methods A low back pain model was implemented in rats (n = 6 -10 per group) by locally inflaming the L5 DRG. Sensory neuron excitability and mechanical hypersensitivity of the hind paws were measured. Tested steroids were applied locally to the inflamed DRG or orally. Results The selective MR blocker eplerenone reduced pain behaviors when given orally starting at the time of surgery, or starting 7 days later. The highly GR-selective agonist fluticasone, applied locally to the inflamed DRG, was much more effective in reducing mechanical hypersensitivity. The MR/GR agonist 6-α methylprednisolone, commonly injected for low back pain, reduced mechanical hypersensitivity when applied locally to the DRG, but was less effective than fluticasone. Its effectiveness was improved by combining it with local eplerenone. All tested steroids reduced hyperexcitability of myelinated sensory neurons (n = 71 – 220 cells per group) after inflammation, particularly abnormal spontaneous activity. Conclusions This preclinical study indicates the MR may play an important role in low back pain involving inflammation. Some MR effects may occur at the level of the sensory neuron. It may be useful to consider the action of clinically used steroids at the MR as well as at the GR. PMID:24781496

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

PubMed

Caprioglio, Alberto; Beretta, Matteo; Lanteri, Claudio

2011-01-01

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

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

PubMed

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

2017-08-01

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

Experimental recovery of quantum correlations in absence of system-environment back-action

PubMed Central

Xu, Jin-Shi; Sun, Kai; Li, Chuan-Feng; Xu, Xiao-Ye; Guo, Guang-Can; Andersson, Erika; Lo Franco, Rosario; Compagno, Giuseppe

2013-01-01

Revivals of quantum correlations in composite open quantum systems are a useful dynamical feature against detrimental effects of the environment. Their occurrence is attributed to flows of quantum information back and forth from systems to quantum environments. However, revivals also show up in models where the environment is classical, thus unable to store quantum correlations, and forbids system-environment back-action. This phenomenon opens basic issues about its interpretation involving the role of classical environments, memory effects, collective effects and system-environment correlations. Moreover, an experimental realization of back-action-free quantum revivals has applicative relevance as it leads to recover quantum resources without resorting to more demanding structured environments and correction procedures. Here we introduce a simple two-qubit model suitable to address these issues. We then report an all-optical experiment which simulates the model and permits us to recover and control, against decoherence, quantum correlations without back-action. We finally give an interpretation of the phenomenon by establishing the roles of the involved parties. PMID:24287554

The effect of foot reflexology and back massage on hemodialysis patients' fatigue and sleep quality.

PubMed

Unal, Kevser Sevgi; Balci Akpinar, Reva

2016-08-01

The aim of this study is to examine the effectiveness of foot reflexology and back massage on optimizing the sleep quality and reducing the fatigue of hemodialysis patients. The study includes 105 volunteer patients who were registered at a private dialysis clinic and were receiving hemodialysis treatment. Foot reflexology and back massage were administered to the patients two times a week for four weeks. The Visual Analogue Scale for Fatigue and the Pittsburg Sleep Quality Index were used to collect data. The differences between the pretest and posttest score averages of the patients on the Visual Analogue Scale for Fatigue and the Pittsburg Sleep Quality Index were statistically significant (p < 0.001). Foot reflexology and back massage were shown to improve the sleep quality and reduce the fatigue of hemodialysis patients. Compared to back massage, foot reflexology was determined to be more effective. Copyright © 2016 Elsevier Ltd. All rights reserved.

Experimental recovery of quantum correlations in absence of system-environment back-action.

PubMed

Xu, Jin-Shi; Sun, Kai; Li, Chuan-Feng; Xu, Xiao-Ye; Guo, Guang-Can; Andersson, Erika; Lo Franco, Rosario; Compagno, Giuseppe

2013-01-01

Revivals of quantum correlations in composite open quantum systems are a useful dynamical feature against detrimental effects of the environment. Their occurrence is attributed to flows of quantum information back and forth from systems to quantum environments. However, revivals also show up in models where the environment is classical, thus unable to store quantum correlations, and forbids system-environment back-action. This phenomenon opens basic issues about its interpretation involving the role of classical environments, memory effects, collective effects and system-environment correlations. Moreover, an experimental realization of back-action-free quantum revivals has applicative relevance as it leads to recover quantum resources without resorting to more demanding structured environments and correction procedures. Here we introduce a simple two-qubit model suitable to address these issues. We then report an all-optical experiment which simulates the model and permits us to recover and control, against decoherence, quantum correlations without back-action. We finally give an interpretation of the phenomenon by establishing the roles of the involved parties.

Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain.

PubMed

Marshall, Paul W M; Schabrun, Siobhan; Knox, Michael F

2017-01-01

Chronic low back pain is a worldwide burden that is not being abated with our current knowledge and treatment of the condition. The fear-avoidance model is used to explain the relationship between pain and disability in patients with chronic low back pain. However there are gaps in empirical support for pathways proposed within this model, and no evidence exists as to whether physical activity moderates these pathways. This was a cross-sectional study of 218 people with chronic low back pain. Multiple mediation analyses were conducted to determine the role of fear, catastrophizing, depression, and anxiety in the relationship between pain and disability. Separate analyses were performed with physical activity as the moderator. Individuals were classified as performing regular structured physical activity if they described on average once per week for > 30-minutes an activity classified at least moderate intensity (≥ 4-6 METs), activity prescribed by an allied health professional for their back pain, leisure time sport or recreation, or self-directed physical activity such as resistance exercise. Fear, catastrophizing, and depression significantly mediated the relationship between pain and disability (p<0.001). However the mediating effect of catastrophizing was conditional upon weekly physical activity. That is, the indirect effect for catastrophizing mediating the relationship between pain and disability was only significant for individuals reporting weekly physical activity (B = 1.31, 95% CI 0.44 to 2.23), compared to individuals reporting no weekly physical activity (B = 0.21, 95% CI -0.50 to 0.97). Catastrophizing also mediated the relationship between pain and fear (B = 0.37, 95% CI 0.15 to 0.62), with higher scores explaining 53% of the total effect of pain on fear. These results support previous findings about the importance of fear and depression as factors that should be targeted in low back pain patients to reduce back pain related disability. We have also extended understanding for the mediating effect of catastrophizing on back pain related disability. Back pain patients engaged with regular physical activity may require counselling with regards to negative pain perceptions.

Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain

PubMed Central

Marshall, Paul W. M.; Schabrun, Siobhan; Knox, Michael F.

2017-01-01

Background Chronic low back pain is a worldwide burden that is not being abated with our current knowledge and treatment of the condition. The fear-avoidance model is used to explain the relationship between pain and disability in patients with chronic low back pain. However there are gaps in empirical support for pathways proposed within this model, and no evidence exists as to whether physical activity moderates these pathways. Methods This was a cross-sectional study of 218 people with chronic low back pain. Multiple mediation analyses were conducted to determine the role of fear, catastrophizing, depression, and anxiety in the relationship between pain and disability. Separate analyses were performed with physical activity as the moderator. Individuals were classified as performing regular structured physical activity if they described on average once per week for > 30-minutes an activity classified at least moderate intensity (≥ 4–6 METs), activity prescribed by an allied health professional for their back pain, leisure time sport or recreation, or self-directed physical activity such as resistance exercise. Results Fear, catastrophizing, and depression significantly mediated the relationship between pain and disability (p<0.001). However the mediating effect of catastrophizing was conditional upon weekly physical activity. That is, the indirect effect for catastrophizing mediating the relationship between pain and disability was only significant for individuals reporting weekly physical activity (B = 1.31, 95% CI 0.44 to 2.23), compared to individuals reporting no weekly physical activity (B = 0.21, 95% CI -0.50 to 0.97). Catastrophizing also mediated the relationship between pain and fear (B = 0.37, 95% CI 0.15 to 0.62), with higher scores explaining 53% of the total effect of pain on fear. Conclusions These results support previous findings about the importance of fear and depression as factors that should be targeted in low back pain patients to reduce back pain related disability. We have also extended understanding for the mediating effect of catastrophizing on back pain related disability. Back pain patients engaged with regular physical activity may require counselling with regards to negative pain perceptions. PMID:28686644

DESIGN NOTE: On the frustration of back-surface reflection from transparent substrates in ellipsometry

NASA Astrophysics Data System (ADS)

Hayton, D. J.; Jenkins, T. E.

2004-02-01

The effects of back-surface reflection from transparent substrates on ellipsometric measurements are discussed and it is shown that their effects can be minimized by placing the substrate on a commercially available product, Blu-tack. The ellipsometric properties of Blu-tack in the range 250 850 nm are presented and the frustration of the back-surface reflection is discussed in terms of index matching between substrate and Blu-tack.

Study protocol: The back pain outcomes using longitudinal data (BOLD) registry

PubMed Central

2012-01-01

Background Back pain is one of the most important causes of functional limitation, disability, and utilization of health care resources for adults of all ages, but especially among older adults. Despite the high prevalence of back pain in this population, important questions remain unanswered regarding the comparative effectiveness of commonly used diagnostic tests and treatments in the elderly. The overall goal of the Back pain Outcomes using Longitudinal Data (BOLD) project is to establish a rich, sustainable registry to describe the natural history and evaluate prospectively the effectiveness, safety, and cost-effectiveness of interventions for patients 65 and older with back pain. Methods/design BOLD is enrolling 5,000 patients ≥ 65 years old who present to a primary care physician with a new episode of back pain. We are recruiting study participants from three integrated health systems (Kaiser-Permanente Northern California, Henry Ford Health System in Detroit and Harvard Vanguard Medical Associates/ Harvard Pilgrim Health Care in Boston). Registry patients complete validated, standardized measures of pain, back pain-related disability, and health-related quality of life at enrollment and 3, 6 and 12 months later. We also have available for analysis the clinical and administrative data in the participating health systems’ electronic medical records. Using registry data, we will conduct an observational cohort study of early imaging compared to no early imaging among patients with new episodes of back pain. The aims are to: 1) identify predictors of early imaging and; 2) compare pain, functional outcomes, diagnostic testing and treatment utilization of patients who receive early imaging versus patients who do not receive early imaging. In terms of predictors, we will examine patient factors as well as physician factors. Discussion By establishing the BOLD registry, we are creating a resource that contains patient-reported outcome measures as well as electronic medical record data for elderly patients with back pain. The richness of our data will allow better matching for comparative effectiveness studies than is currently possible with existing datasets. BOLD will enrich the existing knowledge base regarding back pain in the elderly to help clinicians and patients make informed, evidence-based decisions regarding their care. PMID:22554166

Photo-electronic current transport in back-gated graphene transistor

NASA Astrophysics Data System (ADS)

Srivastava, Ashok; Chen, Xinlu; Pradhan, Aswini K.

2017-04-01

In this work, we have studied photo-electronic current transport in a back-gated graphene field-effect transistor. Under the light illumination, band bending at the metal/graphene interface develops a built-in potential which generates photonic current at varying back-gate biases. A typical MOSFET type back-gated transistor structure uses a monolayer graphene as the channel layer formed over the silicon dioxide/silicon substrate. It is shown that the photo-electronic current consists of current contributions from photovoltaic, photo-thermoelectric and photo-bolometric effects. A maximum external responsivity close to 0.0009A/W is achieved at 30μW laser power source and 633nm wavelength.

Pharmacotherapy for chronic non-specific low back pain: current and future options.

PubMed

Koes, Bart W; Backes, Daan; Bindels, Patrick J E

2018-04-01

Low back pain is associated with a large burden-of-illness. It is responsible for the most years lived with disability as compared with any other medical condition. A comprehensive overview of the evidence on pharmacological treatment options for chronic low back pain is lacking. This review evaluates the evidence for the benefits and risks of currently available pharmacological treatments for chronic low back pain. Areas covered: The authors focus on the recent (Cochrane) systematic reviews and meta-analyses of randomized clinical trials covering paracetamol (acetaminophen), NSAIDs, muscle relaxants, antidepressants, anticonvulsants, opioids, and other (new) drugs. Expert opinion: The overall impression of the efficacy of pharmacological treatments for patients with chronic low back pain is rather sobering. The effects on pain reduction and improvement of function are commonly small to moderate and short lasting when compared to placebo. At the same time, the various types of drugs are not without side-effects. This holds especially true for serious side-effects associated with (prolonged) use of strong opioids. Future studies on patients with chronic back pain should aim to identify subgroups of patients with good response to specific pharmacological treatment to facilitate personalized care.

Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain.

PubMed

Schaafsma, Frederieke G; Whelan, Karyn; van der Beek, Allard J; van der Es-Lambeek, Ludeke C; Ojajärvi, Anneli; Verbeek, Jos H

2013-08-30

Physical conditioning as part of a return to work strategy aims to improve work status for workers on sick leave due to back pain. This is the second update of a Cochrane Review (originally titled 'Work conditioning, work hardening and functional restoration for workers with back and neck pain') first published in 2003, updated in 2010, and updated again in 2013. To assess the effectiveness of physical conditioning as part of a return to work strategy in reducing time lost from work and improving work status for workers with back pain. Further, to assess which aspects of physical conditioning are related to a faster return to work for workers with back pain. We searched the following databases to March 2012: CENTRAL, MEDLINE (from 1966), EMBASE (from 1980), CINAHL (from 1982), PsycINFO (from 1967), and PEDro. Randomized controlled trials (RCTs) and cluster RCTs that studied workers with work disability related to back pain and who were included in physical conditioning programmes. Two review authors independently extracted data and assessed risk of bias. We used standard methodological procedures expected by The Cochrane Collaboration. We included 41 articles reporting on 25 RCTs with 4404 participants. Risk of bias was low in 16 studies.Three studies involved workers with acute back pain, eight studies workers with subacute back pain, and 14 studies workers with chronic back pain.In 14 studies, physical conditioning as part of a return to work strategy was compared to usual care. The physical conditioning mostly consisted of graded activity with work-related exercises aimed at increasing back strength and flexibility, together with a set date for return to work. The programmes were divided into a light version with a maximum of five sessions, or an intense version with more than five sessions up to full time or as inpatient treatment.For acute back pain, there was low quality evidence that both light and intense physical conditioning programmes made little or no difference in sickness absence duration compared with care as usual at three to 12 months follow-up (3 studies with 340 workers).For subacute back pain, the evidence on the effectiveness of intense physical conditioning combined with care as usual compared to usual care alone was conflicting (four studies with 395 workers). However, subgroup analysis showed low quality evidence that if the intervention was executed at the workplace, or included a workplace visit, it may have reduced sickness absence duration at 12 months follow-up (3 studies with 283 workers; SMD -0.42, 95% CI -0.65 to -0.18).For chronic back pain, there was low quality evidence that physical conditioning as part of integrated care management in addition to usual care may have reduced sickness absence days compared to usual care at 12 months follow-up (1 study, 134 workers; SMD -4.42, 95% CI -5.06 to -3.79). What part of the integrated care management was most effective remained unclear. There was moderate quality evidence that intense physical conditioning probably reduced sickness absence duration only slightly compared with usual care at 12 months follow-up (5 studies, 1093 workers; SMD -0.23, 95% CI -0.42 to -0.03).Physical conditioning compared to exercise therapy showed conflicting results for workers with subacute and chronic back pain. Cognitive behavioural therapy was probably not superior to physical conditioning as an alternative or in addition to physical conditioning. The effectiveness of physical conditioning as part of a return to work strategy in reducing sick leave for workers with back pain, compared to usual care or exercise therapy, remains uncertain. For workers with acute back pain, physical conditioning may have no effect on sickness absence duration. There is conflicting evidence regarding the reduction of sickness absence duration with intense physical conditioning versus usual care for workers with subacute back pain. It may be that including workplace visits or execution of the intervention at the workplace is the component that renders a physical conditioning programme effective. For workers with chronic back pain physical conditioning has a small effect on reducing sick leave compared to care as usual after 12 months follow-up. To what extent physical conditioning as part of integrated care management may alter the effect on sick leave for workers with chronic back pain needs further research.

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

PubMed

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

2015-01-01

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

Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis.

PubMed

Abdel Shaheed, Christina; Maher, Chris G; Williams, Kylie A; Day, Richard; McLachlan, Andrew J

2016-07-01

Opioid analgesics are commonly used for low back pain, however, to our knowledge there has been no systematic evaluation of the effect of opioid dose and use of enrichment study design on estimates of treatment effect. To evaluate efficacy and tolerability of opioids in the management of back pain; and investigate the effect of opioid dose and use of an enrichment study design on treatment effect. Medline, EMBASE, CENTRAL, CINAHL, and PsycINFO (inception to September 2015) with citation tracking from eligible randomized clinical trials (RCTs). Placebo-controlled RCTs in any language. Two authors independently extracted data and assessed risk of bias. Data were pooled using a random effects model with strength of evidence assessed using the grading of recommendations assessment, development, and evaluation (GRADE). The primary outcome measure was pain. Pain and disability outcomes were converted to a common 0 to 100 scale, with effects greater than 20 points considered clinically important. Of 20 included RCTs of opioid analgesics (with a total of 7925 participants), 13 trials (3419 participants) evaluated short-term effects on chronic low back pain, and no placebo-controlled trials enrolled patients with acute low back pain. In half of these 13 trials, at least 50% of participants withdrew owing to adverse events or lack of efficacy. There was moderate-quality evidence that opioid analgesics reduce pain in the short term; mean difference (MD), -10.1 (95% CI, -12.8 to -7.4). Meta-regression revealed a 12.0 point greater pain relief for every 1 log unit increase in morphine equivalent dose (P = .046). Clinically important pain relief was not observed within the dose range evaluated (40.0-240.0-mg morphine equivalents per day). There was no significant effect of enrichment study design. For people with chronic low back pain who tolerate the medicine, opioid analgesics provide modest short-term pain relief but the effect is not likely to be clinically important within guideline recommended doses. Evidence on long-term efficacy is lacking. The efficacy of opioid analgesics in acute low back pain is unknown.

Evaluation and management of lower back pain in young athletes

PubMed Central

Kinsella, Elizabeth

2017-01-01

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

Effects of an intervention based on the Transtheoretical Model on back muscle endurance, physical function and pain in rice farmers with chronic low back pain.

PubMed

Thanawat, Thanakorn; Nualnetr, Nomjit

2017-01-01

Chronic low back pain (LBP) can be managed by exercises which should be tailored to an individual's readiness to behavioral change. To evaluate the effects of an intervention program based on the Transtheoretical Model of behavioral change (TTM) on back muscle endurance, physical function and pain in rice farmers with chronic LBP. In a 32-week study, 126 rice farmers were allocated to the TTM (n= 62) and non-TTM (n= 64) groups. Modified Biering-Sorensen test, Oswestry Disability Questionnaire and visual analogue scale were used for evaluating back muscle endurance, physical function and severity of pain, respectively. The evaluations were performed at baseline and at weeks 8, 20 and 32 of the study. Data were analyzed using repeated measure ANOVA. The back muscle endurance was significantly greater in the TTM group than in the non-TTM group at week 32 (p= 0.025). Physical function and severity of pain were significantly improved in the TTM group when compared with the non-TTM group at weeks 20 and 32 (p< 0.01). A TTM-based intervention could improve back muscle endurance and physical function, and reduce the pain in rice farmers with LBP. Further studies should be considered to explore the long-term effects of this intervention.

A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care.

PubMed

Von Korff, M; Moore, J E; Lorig, K; Cherkin, D C; Saunders, K; González, V M; Laurent, D; Rutter, C; Comite, F

1998-12-01

Randomized, controlled trial. To evaluate a four-session self-management group intervention for patients with pain in primary care, led by trained lay persons with back pain. The intervention was designed to reduce patient worries, encourage self-care, and reduce activity limitations. Randomized trials of educational interventions suggest that activating interventions may improve back pain outcomes. Expert opinion increasingly regards effective self-management of back pain as important in achieving good outcomes. In this study, an educational intervention designed to activate patients and support effective self-management was evaluated. Six to 8 weeks after a primary care visit for back pain, patients were invited to participate in an educational program to improve back pain self-management. Those showing interest by returning a brief questionnaire became eligible for the study. Participants (n = 255) randomly were assigned to either a self-management group intervention or to a usual care control group. The effect of the intervention, relative to usual care, was assessed 3, 6, and 12 months after randomization, controlling for baseline values. The intervention consisted of a four-session group applying problem-solving techniques to back pain self-management, supplemented by educational materials (book and videos) supporting active management of back pain. The groups were led by lay persons trained to implement a fully structured group protocol. The control group received usual care, supplemented by a book on back pain care. Participants randomly assigned to the self-management groups reported significantly less worry about back pain and expressed more confidence in self-care. Roland Disability Questionnaire Scores were significantly lower among participants in the self-management groups relative to the usual care controls at 6 months (P = 0.007), and this difference was sustained at 12 months at borderline significance levels (P = 0.09). Among self-management group participants, 48% showed a 50% or greater reduction in Roland Disability Questionnaire Score at 6 months, compared with 33% among the usual care controls. Self-management groups led by trained lay persons following a structured protocol were more effective than usual care in reducing worries, producing positive attitudes toward self-care, and reducing activity limitations among patients with back pain in primary care.

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

PubMed

Manniche, C

1995-09-01

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

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

DTIC Science & Technology

2011-02-01

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

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

DTIC Science & Technology

2011-02-01

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

Back-Hopping in Spin-Transfer-Torque Devices: Possible Origin and Countermeasures

NASA Astrophysics Data System (ADS)

Abert, Claas; Sepehri-Amin, Hossein; Bruckner, Florian; Vogler, Christoph; Hayashi, Masamitsu; Suess, Dieter

2018-05-01

The effect of undesirable high-frequency free-layer switching in magnetic multilayer systems, referred to as back-hopping, is investigated by means of the spin-diffusion model. A possible origin of the back-hopping effect is found to be the destabilization of the pinned layer, which leads to the perpetual switching of both layers. While the presented mechanism is not claimed to be the only possible reason for back-hopping, we show that it is a fundamental effect that will occur in any spin-transfer-torque device when exceeding a critical current. The influence of different material parameters on the critical switching currents for the free and pinned layer is obtained by micromagnetic simulations. The spin-diffusion model enables an accurate description of the torque on both layers, depending on various material parameters. It is found that the choice of a free-layer material with low polarization β and saturation magnetization Ms and a pinned-layer material with high β and Ms leads to a low free-layer critical current and a high pinned-layer critical current and hence reduces the likelihood of back-hopping. While back-hopping has been observed in various types of devices, there are only a few experiments that exhibit this effect in perpendicularly magnetized systems. However, our simulations suggest that the described effect will also gain importance in perpendicular systems due to the loss of pinned-layer anisotropy for decreasing device sizes.

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

PubMed

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

2014-01-01

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

Study protocol of effectiveness of a biopsychosocial multidisciplinary intervention in the evolution of non-speficic sub-acute low back pain in the working population: cluster randomised trial

PubMed Central

2010-01-01

Background Non-specific low back pain is a common cause for consultation with the general practitioner, generating increased health and social costs. This study will analyse the effectiveness of a multidisciplinary intervention to reduce disability, severity of pain, anxiety and depression, to improve quality of life and to reduce the incidence of chronic low back pain in the working population with non-specific low back pain, compared to usual clinical care. Methods/Design A Cluster randomised clinical trial will be conducted in 38 Primary Health Care Centres located in Barcelona, Spain and its surrounding areas. The centres are randomly allocated to the multidisciplinary intervention or to usual clinical care. Patients between 18 and 65 years old (n = 932; 466 per arm) and with a diagnostic of a non-specific sub-acute low back pain are included. Patients in the intervention group are receiving the recommendations of clinical practice guidelines, in addition to a biopsychosocial multidisciplinary intervention consisting of group educational sessions lasting a total of 10 hours. The main outcome is change in the score in the Roland Morris disability questionnaire at three months after onset of pain. Other outcomes are severity of pain, quality of life, duration of current non-specific low back pain episode, work sick leave and duration, Fear Avoidance Beliefs and Goldberg Questionnaires. Outcomes will be assessed at baseline, 3, 6 and 12 months. Analysis will be by intention to treat. The intervention effect will be assessed through the standard error of measurement and the effect-size. Responsiveness of each scale will be evaluated by standardised response mean and receiver-operating characteristic method. Recovery according to the patient will be used as an external criterion. A multilevel regression will be performed on repeated measures. The time until the current episode of low back pain takes to subside will be analysed by Cox regression. Discussion We hope to provide evidence of the effectiveness of the proposed biopsychosocial multidisciplinary intervention in avoiding the chronification of low back pain, and to reduce the duration of non-specific low back pain episodes. If the intervention is effective, it could be applied to Primary Health Care Centres. Trial Registration ISRCTN21392091 PMID:20067619

Exercise therapy for treatment of non-specific low back pain.

PubMed

Hayden, J A; van Tulder, M W; Malmivaara, A; Koes, B W

2005-07-20

Exercise therapy is widely used as an intervention in low-back pain. To evaluate the effectiveness of exercise therapy in adult non-specific acute, subacute and chronic low-back pain versus no treatment and other conservative treatments. The Cochrane Central Register of Controlled Trials (Issue 3, 2004), MEDLINE, EMBASE, PsychInfo, CINAHL databases to October 2004; citation searches and bibliographic reviews of previous systematic reviews. Randomized controlled trials evaluating exercise therapy for adult non-specific low-back pain and measuring pain, function, return-to-work/absenteeism, and/or global improvement outcomes. Two reviewers independently selected studies and extracted data on study characteristics, quality, and outcomes at short, intermediate, and long-term follow-up. Sixty-one randomized controlled trials (6390 participants) met inclusion criteria: acute (11), subacute (6) and chronic (43) low-back pain (1 unclear). Evidence was found of effectiveness in chronic populations relative to comparisons at all follow-up periods; pooled mean improvement was 7.3 points (95% CI, 3.7 to 10.9) for pain (out of 100), 2.5 points (1.0 to 3.9) for function (out of 100) at earliest follow-up. In studies investigating patients (i.e. presenting to healthcare providers) mean improvement was 13.3 points (5.5 to 21.1) for pain, 6.9 (2.2 to 11.7) for function, representing significantly greater improvement over studies where participants included those recruited from a general population (e.g. with advertisements). There is some evidence of effectiveness of graded-activity exercise program in subacute low-back pain in occupational settings, though the evidence for other types of exercise therapy in other populations is inconsistent. There was evidence of equal effectiveness relative to comparisons in acute populations [pain: 0.03 points (95% CI, -1.3 to 1.4)]. This review largely reflects limitations of the literature, including low quality studies with heterogeneous outcome measures, inconsistent and poor reporting, and possibility of publication bias. Exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic low-back pain, particularly in healthcare populations. In subacute low-back pain there is some evidence that a graded activity program improves absenteeism outcomes, though evidence for other types of exercise is unclear. In acute low-back pain, exercise therapy is as effective as either no treatment or other conservative treatments.

Yoga versus education for Veterans with chronic low back pain: study protocol for a randomized controlled trial.

PubMed

Saper, Robert B; Lemaster, Chelsey M; Elwy, A Rani; Paris, Ruth; Herman, Patricia M; Plumb, Dorothy N; Sherman, Karen J; Groessl, Erik J; Lynch, Susan; Wang, Shihwe; Weinberg, Janice

2016-04-29

Chronic low back pain is the most frequent pain condition in Veterans and causes substantial suffering, decreased functional capacity, and lower quality of life. Symptoms of post-traumatic stress, depression, and mild traumatic brain injury are highly prevalent in Veterans with back pain. Yoga for low back pain has been demonstrated to be effective for civilians in randomized controlled trials. However, it is unknown if results from previously published trials generalize to military populations. This study is a parallel randomized controlled trial comparing yoga to education for 120 Veterans with chronic low back pain. Participants are Veterans ≥18 years old with low back pain present on at least half the days in the past six months and a self-reported average pain intensity in the previous week of ≥4 on a 0-10 scale. The 24-week study has an initial 12-week intervention period, where participants are randomized equally into (1) a standardized weekly group yoga class with home practice or (2) education delivered with a self-care book. Primary outcome measures are change at 12 weeks in low back pain intensity measured by the Defense and Veterans Pain Rating Scale (0-10) and back-related function using the 23-point Roland Morris Disability Questionnaire. In the subsequent 12-week follow-up period, yoga participants are encouraged to continue home yoga practice and education participants continue following recommendations from the book. Qualitative interviews with Veterans in the yoga group and their partners explore the impact of chronic low back pain and yoga on family relationships. We also assess cost-effectiveness from three perspectives: the Veteran, the Veterans Health Administration, and society using electronic medical records, self-reported cost data, and study records. This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities. ClinicalTrials.gov: NCT02224183.

Effectiveness of focused structural massage and relaxation massage for chronic low back pain: protocol for a randomized controlled trial.

PubMed

Cherkin, Daniel C; Sherman, Karen J; Kahn, Janet; Erro, Janet H; Deyo, Richard A; Haneuse, Sebastien J; Cook, Andrea J

2009-10-20

Chronic back pain is a major public health problem and the primary reason patients seek massage treatment. Despite the growing use of massage for chronic low back pain, there have been few studies of its effectiveness. This trial will be the first evaluation of the effectiveness of relaxation massage for chronic back pain and the first large trial of a focused structural form of massage for this condition. A total of 399 participants (133 in each of three arms) between the ages of 20 and 65 years of age who have low back pain lasting at least 3 months will be recruited from an integrated health care delivery system. They will be randomized to one of two types of massage ("focused structural massage" or "relaxation massage"), or continued usual medical care. Ten massage treatments will be provided over 10 weeks. The primary outcomes, standard measures of dysfunction and bothersomeness of low back pain, will be assessed at baseline and after 10, 26, and 52 weeks by telephone interviewers masked to treatment assignment. General health status, satisfaction with back care, days of back-related disability, perceived stress, and use and costs of healthcare services for back pain will also be measured. Outcomes across assigned treatment groups will be compared using generalized estimating equations, accounting for participant correlation and adjusted for baseline value, age, and sex. For both primary outcome measures, this trial will have at least 85% power to detect the presence of a minimal clinically significant difference among the three treatment groups and 91% power for pairwise comparisons. Secondary analyses will compare the proportions of participants in each group that improve by a clinically meaningful amount. Results of this trial will help clarify the value of two types of massage therapy for chronic low back pain.

The short-term effects of graded activity versus physiotherapy in patients with chronic low back pain: A randomized controlled trial.

PubMed

Magalhães, Mauricio Oliveira; Muzi, Luzilauri Harumi; Comachio, Josielli; Burke, Thomaz Nogueira; Renovato França, Fabio Jorge; Vidal Ramos, Luiz Armando; Leão Almeida, Gabriel Peixoto; de Moura Campos Carvalho-e-Silva, Ana Paula; Marques, Amélia Pasqual

2015-08-01

Chronic low back pain is one of the most common problematic health conditions worldwide and is highly associated with disability, quality of life, emotional changes, and work absenteeism. Graded activity programs, based on cognitive behavioral therapy, and exercises are common treatments for patients with low back pain. However, recent evidence has shown that there is no evidence to support graded activity for patients with chronic nonspecific low back pain. to compare the effectiveness of graded activity and physiotherapy in patients with chronic nonspecific low back pain. A total of 66 patients with chronic nonspecific low back pain were randomized to perform either graded activity (moderate intensity treadmill walking, brief education and strength exercises) or physiotherapy (strengthening, stretching and motor control). These patients received individual sessions twice a week for six weeks. The primary measures were intensity of pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire). After six weeks, significant improvements have been observed in all outcome measures of both groups, with a non-significant difference between the groups. For intensity of pain (mean difference = 0.1 points, 95% confidence interval [CI] = -1.1-1.3) and disability (mean difference = 0.8 points, 95% confidence interval [CI] = -2.6-4.2). No differences were found in the remaining outcomes. The results of this study suggest that graded activity and physiotherapy showed to be effective and have similar effects for patients with chronic nonspecific low back pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Manipulation for the control of back pain and curve progression in patients with skeletally mature idiopathic scoliosis: two cases.

PubMed

Tarola, G A

1994-05-01

This report of two cases illustrates the potential effect of chiropractic manipulative therapy on back pain and curve progression in the at-risk, skeletally mature patient with adolescent idiopathic scoliosis. Two patients suffering from lumbar scoliosis and chronic back pain. Both had scoliosis that had progressed after skeletal maturity. Diversified type chiropractic manipulative therapy was used palliatively for back pain relief in one case, and routinely 1-2 times per month in the other case. The manipulation was applied manually, with the patients in the prone and side-posture positions. Vertebral levels manipulated were identified as fixated/dysfunctional segments based on static and/or motion palpation. They were generally applied to areas above and/or below the curve apex. When applied at the apex, cavitation was more easily achieved when the direction of thrust was into the concave side. This was also tolerated better by the patient. No attempt was made to "straighten the curve" by thrusting into the convex side. Gentle manual intersegmental mobilization, stretching and muscle massage techniques were also applied. The case treated palliatively had curve progression consistent with the literature over an 8-yr period. The case treated routinely did not. The procedure was effective in both cases for subjective relief of back pain. Diversified-type CMT has a favorable effect on acute back pain when used palliatively. The procedure may also have a favorable long term effect of preventing recurrence of back pain and on retarding curve progression when used routinely 1-2 times per month.

Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial.

PubMed

van der Roer, Nicole; van Tulder, Maurits; Barendse, Johanna; Knol, Dirk; van Mechelen, Willem; de Vet, Henrica

2008-09-01

Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapists in 49 practices and 114 patients with non-specific low back pain of more than 12 weeks duration participated in the study. In the intensive group training protocol exercise therapy, back school and operant-conditioning behavioural principles are combined. Patients were treated during 10 individual sessions along 20 group sessions. Usual care consisted of physiotherapy according to the Dutch guidelines for Low Back Pain. Main outcome measures were functional disability (Roland Morris disability questionnaire), pain intensity, perceived recovery and sick leave because of low back pain assessed at baseline and after 6, 13, 26 and 52 weeks. Both an intention-to-treat analysis and a per-protocol analysis were performed. Multilevel analysis did not show significant differences between both treatment groups on any outcome measures during the complete follow-up period, with one exception. After 26 weeks the protocol group showed more reduction in pain intensity than the guideline group, but this difference was absent after 52 weeks. We finally conclude that an intensive group training protocol was not more effective than usual physiotherapy for chronic low back pain.

Impact of Fatigue on Positional Movements During Professional Rugby Union Match Play.

PubMed

Tee, Jason C; Lambert, Mike I; Coopoo, Yoga

2017-04-01

In team sports, fatigue is manifested by a self-regulated decrease in movement distance and intensity. There is currently limited information on the effect of fatigue on movement patterns in rugby union match play, particularly for players in different position groups (backs vs forwards). This study investigated the effect of different match periods on movement patterns of professional rugby union players. Global positioning system (GPS) data were collected from 46 professional match participations to determine temporal effects on movement patterns. Total relative distance (m/min) was decreased in the 2nd half for both forwards (-13%, ±8%, ES = very likely large) and backs (-9%, ±7%, ES = very likely large). A larger reduction in high-intensity-running distance in the 2nd half was observed for forwards (-27%, ±16%, ES = very likely medium) than for backs (-10%, ±15%; ES = unclear). Similar patterns were observed for sprint (>6 m/s) frequency (forwards -29%, ±29%, ES = likely small vs backs -13% ±18%, ES = possibly small) and acceleration (>2.75 m/s 2 ) frequency (forwards -27%, ±24%, ES = likely medium vs backs -5%, ±46%, ES = unclear). Analysis of 1st- and 2nd-half quartiles revealed differing pacing strategies for forwards and backs. Forwards display a "slow-positive" pacing strategy, while the pacing strategy of backs is "flat." Forwards suffered progressively greater performance decrements over the course of the match, while backs were able to maintain performance intensity. These findings reflect differing physical demands, notably contact and running loads, of players in different positions.

A systematic review of controlled clinical trials on the prevention of back pain in industry.

PubMed

van Poppel, M N; Koes, B W; Smid, T; Bouter, L M

1997-12-01

To assess the effectiveness of lumbar supports, education, and exercise in the prevention of back pain in industry. A computerised search for controlled clinical trials was conducted. A criteria list was used to assess the methodological quality of the studies. The available evidence for the effectiveness of the interventions was graded with a rating system for the level of evidence. Effect sizes of individual studies were combined if the studies were sufficiently similar. 11 studies were identified for the review. The methodological quality of all studies was low, with a maximum score of three out of seven for internal validity. There was no evidence for the effectiveness of lumbar supports due to contradictory outcomes of the studies. Five of the six studies on education reported no effect. Thus there is limited evidence that education does not help to prevent back pain. All three studies on exercise reported a positive result, indicating limited evidence for the effectiveness of exercise. The combined effect size for exercise was 0.53, which is a medium sized effect. Although widely used, there is little evaluative research on the preventive measures studied here. The review showed that there is limited evidence that exercise has some effect in the prevention of back pain and that education is not effective. No conclusive evidence was found for or against the effectiveness of lumbar supports. Research of higher methodological quality is needed before firm conclusions on the effectiveness of lumbar supports, education, and exercise in the prevention of back pain in industry can be drawn.

Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: A systematic review

PubMed Central

Crow, Edith Meszaros; Jeannot, Emilien; Trewhela, Alison

2015-01-01

Considerable amount of money spent in health care is used for treatments of lifestyle related, chronic health conditions, which come from behaviors that contribute to morbidity and mortality of the population. Back and neck pain are two of the most common musculoskeletal problems in modern society that have significant cost in health care. Yoga, as a branch of complementary alternative medicine, has emerged and is showing to be an effective treatment against nonspecific spinal pain. Recent studies have shown positive outcome of yoga in general on reducing pain and functional disability of the spine. The objective of this study is to conduct a systematic review of the existing research within Iyengar yoga method and its effectiveness on relieving back and neck pain (defined as spinal pain). Database research form the following sources (Cochrane library, NCBI PubMed, the Clinical Trial Registry of the Indian Council of Medical Research, Google Scholar, EMBASE, CINAHL, and PsychINFO) demonstrated inclusion and exclusion criteria that selected only Iyengar yoga interventions, which in turn, identified six randomized control trials dedicated to compare the effectiveness of yoga for back and neck pain versus other care. The difference between the groups on the postintervention pain or functional disability intensity assessment was, in all six studies, favoring the yoga group, which projected a decrease in back and neck pain. Overall six studies with 570 patients showed, that Iyengar yoga is an effective means for both back and neck pain in comparison to control groups. This systematic review found strong evidence for short-term effectiveness, but little evidence for long-term effectiveness of yoga for chronic spine pain in the patient-centered outcomes. PMID:25558128

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis.

PubMed

Beneciuk, Jason M; Hill, Jonathan C; Campbell, Paul; Afolabi, Ebenezer; George, Steven Z; Dunn, Kate M; Foster, Nadine E

2017-01-01

Identification of patient characteristics influencing treatment outcomes is a top low back pain (LBP) research priority. Results from the STarT Back trial support the effectiveness of prognostic stratified care for LBP compared with current best care, however, patient characteristics associated with treatment response have not yet been explored. The purpose of this secondary analysis was to identify treatment effect modifiers within the STarT Back trial at 4-month follow-up (n = 688). Treatment response was dichotomized using back-specific physical disability measured using the Roland-Morris Disability Questionnaire (≥7). Candidate modifiers were identified using previous literature and evaluated using logistic regression with statistical interaction terms to provide preliminary evidence of treatment effect modification. Socioeconomic status (SES) was identified as an effect modifier for disability outcomes (odds ratio [OR] = 1.71, P = .028). High SES patients receiving prognostic stratified care were 2.5 times less likely to have a poor outcome compared with low SES patients receiving best current care (OR = .40, P = .006). Education level (OR = 1.33, P = .109) and number of pain medications (OR = .64, P = .140) met our criteria for effect modification with weaker evidence (.20 > P ≥ .05). These findings provide preliminary evidence for SES, education, and number of pain medications as treatment effect modifiers of prognostic stratified care delivered in the STarT Back Trial. This analysis provides preliminary exploratory findings about the characteristics of patients who might least likely benefit from targeted treatment using prognostic stratified care for LBP. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2018-03-07

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

Low back pain during pregnancy and Kinesio tape application.

PubMed

Reyhan, Aycan Çakmak; Dereli, Elif Elçin; Çolak, Tuğba Kuru

2017-01-01

Low back pain is a common problem during pregnancy. Although the pain usually occurs in the third trimester, it might be seen in the first trimester, too. There are various types of applications for the treatment of low back pain during pregnancy. However, there is a lack of evidence for the effectiveness of each method. If there is not an obvious deficit, bed rest, exercise, conventional physiotherapy, using protective principles for the lumbar area are recommended, since the main and the only complaint is low back pain. It is aimed in the current review to investigate the use of Kinesio tape in the low back pain seen during pregnancy and to review the literature related to this subject. There are only a few studies investigating the effect of Kinesio tape during pregnancy in the literature and they mostly did not aim to study the low back pain, further evidence and studies are needed to investigate the use of Kinesio tape for the low back pain seen during pregnancy as there is not evidence strong enough. Kinesiotape application aims to increase circulation and mobility, and regarding these gains decreased pain and increased performance are expected.

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

PubMed

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

2002-08-01

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

Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta-analysis of randomized controlled trials.

PubMed

Shiri, R; Coggon, D; Falah-Hassani, K

2018-01-01

The effect of exercise in prevention of low back and pelvic girdle pain during pregnancy is uncertain. This study aimed to assess the effect of exercise on low back pain, pelvic girdle pain and associated sick leave. Literature searches were conducted in PubMed, EMBASE, Cochrane Library, Google Scholar, ResearchGate and ClinicalTrials.gov databases from their inception through May 2017. Randomized controlled trials (RCTs) were eligible for inclusion in the review if they compared an exercise intervention with usual daily activities and at least some of the participants were free from low back pain and/or pelvic girdle pain at baseline. Methodological quality of included studies was evaluated using the Cochrane Collaboration's tool. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed. Eleven randomized controlled trials (2347 pregnant women) qualified for meta-analyses. Exercise reduced the risk of low back pain in pregnancy by 9% (pooled risk ratio (RR) = 0.91, 95% CI 0.83-0.99, I 2  = 0%, seven trials, N = 1175), whereas it had no protective effect on pelvic girdle pain (RR = 0.99, CI 0.81-1.21, I 2  = 0%, four RCTs, N = 565) or lumbopelvic pain (RR = 0.96, CI 0.90-1.02, I 2  = 0%, eight RCTs, N = 1737). Furthermore, exercise prevented new episodes of sick leave due to lumbopelvic pain (RR = 0.79, CI 0.64-0.99, I 2  = 0%, three RCTs, N = 1168). There was no evidence of publication bias. Exercise appears to reduce the risk of low back pain in pregnant women, and sick leave because of lumbopelvic pain, but there is no clear evidence for an effect on pelvic girdle pain. Exercise has a small protective effect against low back pain during pregnancy. © 2017 European Pain Federation - EFIC®.

A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: Stepped wedge cluster randomised trial.

PubMed

Rasmussen, Charlotte Diana Nørregaard; Holtermann, Andreas; Jørgensen, Marie Birk; Ørberg, Anders; Mortensen, Ole Steen; Søgaard, Karen

2016-08-01

The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain. A stepped wedge cluster randomised, controlled trial with 594 nurses' aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect. Significant reduction in occupational lifting (-0.35 (95% confidence interval -0.61 to -0.08)), and improvement in two measures of fear avoidance ((-0.75 (95% confidence interval -1.05 to -0.45) and -0.45 (95% confidence interval -0.80 to -0.11)) were found for the intervention group compared to the control. There were no significant effects on physical exertion, muscle strength, support from management, work ability or sickness absence due to low back pain. After the intervention, significant increased physical capacity and improvements in kinesiophobia were found, but no change in need for recovery. CONCLUSIONS THE INTERVENTION WAS SIGNIFICANTLY EFFECTIVE FOR PHYSICAL WORK DEMANDS AND MALADAPTIVE PAIN BEHAVIOURS, BUT NOT FOR WORK ABILITY AND SICKNESS ABSENCE DUE TO LOW BACK PAIN TO IMPROVE WORK ABILITY OR REDUCE SICKNESS ABSENCE DUE TO LOW BACK PAIN MORE SPECIFIC INTERVENTIONS SHOULD PROBABLY BE DEVELOPED. © 2016 the Nordic Societies of Public Health.

Self-management of chronic low back pain and osteoarthritis.

PubMed

May, Stephen

2010-04-01

Chronic low back pain and osteoarthritis are two musculoskeletal problems that are highly prevalent in the general population, are frequently episodic and persistent, and are associated with high costs to society, both direct and indirect. This epidemiological picture provides the background that justifies the use of self-management strategies in managing these problems. For this Review, relevant systematic reviews were included that related to effectiveness; other study designs were included that addressed other aspects of the topic. The accepted definition of self-management includes liaison between health professionals and individuals with these problems, as well as independent health-promotion activities. Independent self-management strategies, such as exercise and self-medication, are practiced by individuals in the general population. Consistent evidence shows that self-management programs for osteoarthritis are effective in addressing pain and function, but effect sizes are small and might be clinically negligible. Educational programs for patients with back pain are effective in an occupational setting and if combined with an exercise program. Exercise is an effective strategy in the management of both chronic low back pain and osteoarthritis, although it is unclear what the optimum exercise is. Exercise, supported by advice and education, should be at the core of self-management strategies for chronic low back pain and osteoarthritis.

A portable back massage robot based on Traditional Chinese Medicine.

PubMed

Wang, Wendong; Liang, Chaohong; Zhang, Peng; Shi, Yikai

2018-05-30

A portable back massage robot which can complete the massage operations such as tapping, kneading and rolling was designed to improve the level of intelligence and massage effect. An efficient full covered path planning algorithm was put forward for a portable back massage robot to improve the coverage. Currently, massage robots has become one of important research focuses with the increasing requirements for healthcare. The massage robot is difficult to be widely accepted as there are problems of massage robot in control, structure, and coverage path planning. The 3D electromagnetic simulation model was established to optimize electromagnetic force. By analyzing the Traditional Chinese Medicine massage operation and the demands, the path planning algorithm models were established. The experimental platform of the massage robot was built. The simulation results show presented path planning algorithm is suitable for back massage, which ensures that the massage robot traverse the entire back area with improved massage coverage. The tested results show that the massage effect is best when the duty cycle is in the range of 1/8 to 1/2, and the massage force increases with the increase of the input voltage. The massage robot eventually achieved the desired massage effect, and the proposed efficient algorithm can effectively improve the coverage and promote the massage effect.

Effect of Stacking Layup on Spring-back Deformation of Symmetrical Flat Laminate Composites Manufactured through Autoclave Processing

NASA Astrophysics Data System (ADS)

Nasir, M. N. M.; Seman, M. A.; Mezeix, L.; Aminanda, Y.; Rivai, A.; Ali, K. M.

2017-03-01

The residual stresses that develop within fibre-reinforced laminate composites during autoclave processing lead to dimensional warpage known as spring-back deformation. A number of experiments have been conducted on flat laminate composites with unidirectional fibre orientation to examine the effects of both the intrinsic and extrinsic parameters on the warpage. This paper extends the study on to the symmetrical layup effect on spring-back for flat laminate composites. Plies stacked at various symmetrical sequences were fabricated to observe the severity of the resulting warpage. Essentially, the experimental results demonstrated that the symmetrical layups reduce the laminate stiffness in its principal direction compared to the unidirectional laminate thus, raising the spring-back warpage with the exception of the [45/-45]S layup due to its quasi-isotropic property.

Back Schools for chronic non-specific low back pain.

PubMed

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

2017-08-03

Many people with low back pain (LBP) become frequent users of healthcare services in their attempt to find treatments that minimise the severity of their symptoms. Back School consists of a therapeutic programme given to groups of people that includes both education and exercise. However, the content of Back School has changed over time and appears to vary widely today. This review is an update of a Cochrane review of randomised controlled trials (RCTs) evaluating the effectiveness of Back School. We split the Cochrane review into two reviews, one focusing on acute and subacute LBP, and one on chronic LBP. The objective of this systematic review was to determine the effect of Back School on pain and disability for adults with chronic non-specific LBP; we included adverse events as a secondary outcome. In trials that solely recruited workers, we also examined the effect on work status. We searched for trials in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, two other databases and two trials registers to 15 November 2016. We also searched the reference lists of eligible papers and consulted experts in the field of LBP management to identify any potentially relevant studies we may have missed. We placed no limitations on language or date of publication. We included only RCTs and quasi-RCTs evaluating pain, disability, and/or work status as outcomes. The primary outcomes for this update were pain and disability, and the secondary outcomes were work status and adverse events. Two review authors independently performed the 'Risk of bias' assessment of the included studies using the 'Risk of bias' assessment tool recommended by The Cochrane Collaboration. We summarised the results for the short-, intermediate-, and long-term follow-ups. We evaluated the overall quality of evidence using the GRADE approach. For the outcome pain, at short-term follow-up, we found very low-quality evidence that Back School is more effective than no treatment (mean difference (MD) -6.10, 95% confidence interval (CI) -10.18 to -2.01). However, we found very low-quality evidence that there is no significant difference between Back School and no treatment at intermediate-term (MD -4.34, 95% CI -14.37 to 5.68) or long-term follow-up (MD -12.16, 95% CI -29.14 to 4.83). There was very low-quality evidence that Back School reduces pain at short-term follow-up compared to medical care (MD -10.16, 95% CI -19.11 to -1.22). Very low-quality evidence showed there to be no significant difference between Back School and medical care at intermediate-term (MD -9.65, 95% CI -22.46 to 3.15) or long-term follow-up (MD -5.71, 95% CI -20.27 to 8.84). We found very low-quality evidence that Back School is no more effective than passive physiotherapy at short-term (MD 1.96, 95% CI -9.51 to 13.43), intermediate-term (MD -16.89, 95% CI -66.56 to 32.79), or long-term follow-up (MD -12.86, 95% CI -61.22 to 35.50). There was very low-quality evidence that Back School is no better than exercise at short- term follow-up (MD -2.06, 95% CI -14.58 to 10.45). There was low-quality evidence that Back School is no better than exercise at intermediate-term (MD -4.46, 95% CI -19.44 to 10.52) and long-term follow-up (MD 4.58, 95% CI -0.20 to 9.36).For the outcome disability, we found very low-quality evidence that Back School is no more effective than no treatment at intermediate-term (MD -5.92, 95% CI -12.08 to 0.23) and long-term follow-up (MD -7.36, 95% CI -22.05 to 7.34); medical care at short-term (MD -1.19, 95% CI -7.02 to 4.64) and long-term follow-up (MD -0.40, 95% CI -7.33 to 6.53); passive physiotherapy at short-term (MD 2.57, 95% CI -15.88 to 21.01) and intermediate-term follow-up (MD 6.88, 95% CI -4.86 to 18.63); and exercise at short-term (MD -1.65, 95% CI -8.66 to 5.37), intermediate-term (MD 1.57, 95% CI -3.86 to 7.00), and long-term follow-up (MD 4.54, 95% CI -4.44 to 13.52). We found very low-quality evidence of a small difference between Back School and no treatment at short-term follow-up (MD -3.38, 95% CI -6.70 to -0.05) and medical care at intermediate-term follow-up (MD -6.34, 95% CI -10.89 to -1.79). Still, at long-term follow-up there was very low-quality evidence that passive physiotherapy is better than Back School (MD 9.60, 95% CI 3.65 to 15.54).Few studies measured adverse effects. The results were reported as means without standard deviations or group size was not reported. Due to this lack of information, we were unable to statistically pool the adverse events data. Work status was not reported. Due to the low- to very low-quality of the evidence for all treatment comparisons, outcomes, and follow-up periods investigated, it is uncertain if Back School is effective for chronic low back pain. Although the quality of the evidence was mostly very low, the results showed no difference or a trivial effect in favour of Back School. There are myriad potential variants on the Back School approach regarding the employment of different exercises and educational methods. While current evidence does not warrant their use, future variants on Back School may have different effects and will need to be studied in future RCTs and reviews.

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

PubMed Central

Gordon, Rebecca; Bloxham, Saul

2016-01-01

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

Spring-back simulation of unidirectional carbon/epoxy L- shaped laminate composites manufactured through autoclave processing

NASA Astrophysics Data System (ADS)

Nasir, M. N. M.; Mezeix, L.; Aminanda, Y.; Seman, M. A.; Rivai, A.; Ali, K. M.

2016-02-01

This paper presents an original method in predicting the spring-back for composite aircraft structures using non-linear Finite Element Analysis (FEA) and is an extension of the previous accompanying study on flat geometry samples. Firstly, unidirectional prepreg lay-up samples are fabricated on moulds with different corner angles (30°, 45° and 90°) and the effect on spring-back deformation are observed. Then, the FEA model that was developed in the previous study on flat samples is utilized. The model maintains the physical mechanisms of spring-back such as ply stretching and tool-part interface properties with the additional mechanism in the corner effect and geometrical changes in the tool, part and the tool-part interface components. The comparative study between the experimental data and FEA results show that the FEA model predicts adequately the spring-back deformation within the range of corner angle tested.

The Effects of Manual Therapy Using Joint Mobilization and Flexion-distraction Techniques on Chronic Low Back Pain and Disc Heights

PubMed Central

Choi, Jioun; Hwangbo, Gak; Park, Jungseo; Lee, Sangyong

2014-01-01

[Purpose] The purpose of this study was to examine the effects of manual therapy using joint mobilization and flexion-distraction techniques on chronic low back pain and disc heights. [Subjects] This study was conducted with 31 chronic low back pain patients who were divided into a manual therapy group (MTG; n=16) and a spinal decompression therapy group (SDTG; n=15). [Methods] The MTG was treated using joint mobilization techniques and flexion-distraction techniques, and the SDTG was treated using spinal decompression therapeutic apparatuses. Conservative physical therapy was used in both groups, and the therapy was implemented three times per week for 6 weeks. The visual analog scale (VAS) was used to measure patient’s low back pain scores, and a picture archiving and communication system was used to measure disc height by comparing and analyzing the images. [Results] In comparisons of the VAS within each of the two groups, both the MTG and the SDTG showed significant decreases. In comparisons of disc height within each of the two groups, the MTG showed statistically significant increases. [Conclusion] Manual therapy using joint mobilization techniques and flexion-distraction techniques is considered an effective intervention for addressing low back pain and disc heights in patients with chronic low back pain. PMID:25202191

Experiments with high-voltage insulators in the presence of tritium

NASA Astrophysics Data System (ADS)

Grisham, L. R.; Falter, H.; Causey, R.; Chrisman, W.; Stevenson, T.; Wright, K.

1991-02-01

During the final deuterium-tritium phases of the TFTR and JET tokamaks half of the neutral injectors will be used to produce tritium neutral beams to maintain an equal mix of deuterium and tritium in the core plasma, and such requirements may also occur in future devices. This will require that the voltage hold off capabilities of the high voltage insulators in the accelerators be unimpaired by any charge buildups associated with the beta decay of adsorbed layers. We report tests in which we measured the drain currents under high dc voltage of TFTR and JET accelerator insulators while they were successively exposed to vacuum, deuterium and tritium. There did not appear to be any substantial reduction in hold-off capability with tritium, although at some voltages there was a small increase in the leakage current. We also compared the breakdown properties of a plastic tubing filled with deuterium and then tritium at varying pressures, since such tubing has been considered as a high-voltage break in the gas feed system for TFTR, and the presence of large numbers of electron-ion pairs might lead to enhanced Paschen breakdown. We found no significant differences in the behavior for the geometry used.

Experimental Investigation of Pseudospark generated electron beam

NASA Astrophysics Data System (ADS)

Kumar, Niraj; Verma, D. K.; Prajapati, J.; Kumar, M.; Meena, B. L.; Tyagi, M. S.; Srivastava, V.; Pal, U. N.

2012-11-01

The pseudospark (PS) discharge is, however, more recently recognized as a different type of discharge which is capable of generating electron beams with the highest combined current density and brightness of any known type of electron source. PS discharge is a specific type of gas discharge, which operates on the left-hand side of the hollow cathode analogy to the Paschen curve with axially symmetric parallel electrodes and central holes on the electrodes. The PS discharge generated electron beam has tremendous applications in plasma filled microwave sources where normal material cathode cannot be used. Analysis of the electron beam profile has been carried out experimentally for different applied voltages. The investigation has been done at different axial and radial location inside the drift tube in argon atmosphere. This paper represents experimentally derived axial and radial variation of the beam current inside the plasma filled drift tube of PS discharge based plasma cathode electron (PCE) gun. With the help of current density estimation the focusing and defocusing point of electron beam in axial direction can be analyzed. It has been further confirmed the successful propagation of electron beam in confined manner without any assistance of external magnetic field.

Nickel aluminide-copper backing for butt joint welding

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

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

1996-12-31

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

Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review.

PubMed

Lawford, Belinda J; Walters, Julie; Ferrar, Katia

2016-06-01

To establish the effectiveness of walking alone and walking compared to other non-pharmacological management methods to improve disability, quality of life, or function in adults with chronic low back pain. A systematic search of the following databases was undertaken: Medline, Embase, CINAHL, Scopus, Pedro, SportDiscus, Cochrane Central Register of Controlled Trials. The following keywords were used: 'back pain' or 'low back pain' or 'chronic low back pain' and 'walk*' or 'ambulation' or 'treadmill*' or 'pedometer*' or 'acceleromet*' or 'recreational' and 'disability' or 'quality of life' or 'function*'. Primary research studies with an intervention focus that investigated walking as the primary intervention compared to no intervention or any other non-pharmacological method in adults with chronic low back pain (duration >3 months). Seven randomised controlled trials involving 869 participants were included in the review. There was no evidence that walking was more effective than other management methods such as usual care, specific strength exercises, medical exercise therapy, or supervised exercise classes. One study found over-ground walking to be superior to treadmill walking, and another found internet-mediated walking to be more beneficial than non-internet-mediated walking in the short term. There is low quality evidence to suggest that walking is as effective as other non-pharmacological management methods at improving disability, function, and quality of life in adults with chronic low back pain. © The Author(s) 2015.

Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care (YES) trial.

PubMed

Sherman, Karen J; Cherkin, Daniel C; Cook, Andrea J; Hawkes, Rene J; Deyo, Richard A; Wellman, Robert; Khalsa, Partap S

2010-03-31

Back pain, one of the most prevalent conditions afflicting American adults, is the leading reason for using complementary and alternative medicine (CAM) therapies. Yoga is an increasingly popular "mind-body" CAM therapy often used for relieving back pain and several small studies have found yoga effective for this condition. This study will assess whether yoga is effective for treating chronic low back pain compared with self care and exercise and will explore the mechanisms responsible for any observed benefits. A total of 210 participants with low back pain lasting at least 3 months will be recruited from primary care clinics of a large healthcare system based in Seattle. They will be randomized in a 2:2:1 ratio to receive 12 weekly yoga classes, 12 weekly conventional therapeutic exercise classes of comparable physical exertion, or a self-care book. Interviewers masked to participants' treatment group will assess outcomes at baseline and 6, 12 and 26 weeks after randomization. Primary outcomes will be back-related dysfunction and symptom bothersomeness. In addition, data will be collected on physical measurements (e.g., flexion) at baseline and 12 weeks and saliva samples will be obtained at baseline, 6 and 12 weeks. Information will be collected on specific physical, psychological, and physiological factors to allow exploration of possible mechanisms of action through which yoga could relieve back pain and dysfunction. The effectiveness of yoga will be assessed using analysis of covariance (using general estimating equations - GEE) within an intention-to-treat context. If yoga is found effective, further analyses will explore whether yoga's benefits are attributable to physical, psychological and/or physiological factors. This study will provide the clearest evidence to date about the value of yoga as a therapeutic option for treating chronic back pain, and if the results are positive, will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study.

Racial differences in the incidence of acute low back pain in United States military service members.

PubMed

Knox, Jeffrey B; Orchowski, Joseph R; Owens, Brett

2012-09-01

An epidemiological study. To determine the effect of race on the incidence of acute low back pain, resulting in a health care encounter in active duty military service members. Although racial differences in the incidence of low back pain have been documented in previous studies, currently no consensus exists on the relative risk between these groups. A query was performed using the Armed Forces Health Surveillance Center database for the International Classification of Diseases, Ninth Revision code for low back pain (724.20). A total of 12,399,276 person-years of data were analyzed and stratified by age, race, and sex. Incidence rates were calculated and compared using the multivariate Poisson regression analysis. A total of 467,950 cases of low back pain resulted in a visit to a health care provider in our population, with an overall incidence rate of 37.74 per 1000 person-years. Asians/Pacific Islanders had the lowest incidence rate of 30.7 and blacks had the highest with 43.7. Female sex and older age were also significant risk factors but with significantly different effect sizes between racial groups. Native Americans/Alaskan Natives demonstrated the greatest effect of age on low back pain incidence rates, with a 126% increase between the youngest and oldest age groups compared with a 36% difference in whites. Race, sex, and age were all found to be significant risk factors for acute low back pain. The highest rates were identified in blacks followed by whites, Hispanics, and American Indian/Alaskan Native, and the lowest rates were identified in Asians/Pacific Islanders. Significant differences in the effect of sex and age were identified between the different racial groups.

Understanding the characteristics of effective mass media campaigns for back pain and methodological challenges in evaluating their effects.

PubMed

Buchbinder, Rachelle; Gross, Douglas P; Werner, Erik L; Hayden, Jill A

2008-01-01

Workshop at the Low Back Pain Forum VIII: Primary Care Research on Low Back Pain held in Amsterdam in June 2006. The aim of the workshop was to 1) describe and compare characteristics and outcomes of back pain media campaigns that have taken place internationally; 2) examine general theories of health behavior change from the mass media literature to determine whether it is possible to develop a theoretical framework to explain the observed outcomes; 3) describe the outcome of discussion and expert consensus around lessons learned from these campaigns that may inform the planning and evaluation of future campaigns; and 4) identify priorities for future research. Mass media campaigns designed to alter societal views about back pain have now been performed in several countries. Although these types of campaigns are an established strategy for delivering preventive health messages, there is limited empirical understanding of the characteristics of effective (or ineffective) health campaigns. We reviewed the content and outcome of back pain mass media campaigns conducted in Australia, Norway, and Canada using the Cochrane Effective Practice and Organization of Care Review Group data collection checklist. We also reviewed models of health behavior change that could be used to guide the design, planning, and evaluation of future campaigns. The draft article was reviewed by a group of international back pain experts before forming the basis for discussion at the workshop. Expert comments and those of workshop participants were synthesized and incorporated into the final manuscript. The outcome of discussion and expert consensus around lessons learned from these campaigns are described. Our article may help to inform the planning and evaluation of future campaigns and identify priorities for future research.

Netguns: a technique for capturing Black-backed Woodpeckers

Treesearch

Chad P. Lehman; Dylan C. Kesler; Christopher T. Rota; Mark A. Rumble; Eric M. Seckinger; Thomas M. Juntti; Joshua J. Millspaugh

2011-01-01

Effective capture techniques are essential for studying bird populations, but commonly used techniques have proven ineffective for capturing Black-backed Woodpeckers (Picoides arcticus) during the nonbreeding period. As a result, little is known about the winter ecology of Black-backed Woodpeckers. We used two netguns, one powered with a 0.308 cartridge and another...

Core strength training for patients with chronic low back pain.

PubMed

Chang, Wen-Dien; Lin, Hung-Yu; Lai, Ping-Tung

2015-03-01

[Purpose] Through core strength training, patients with chronic low back pain can strengthen their deep trunk muscles. However, independent training remains challenging, despite the existence of numerous core strength training strategies. Currently, no standardized system has been established analyzing and comparing the results of core strength training and typical resistance training. Therefore, we conducted a systematic review of the results of previous studies to explore the effectiveness of various core strength training strategies for patients with chronic low back pain. [Methods] We searched for relevant studies using electronic databases. Subsequently, we evaluated their quality by analyzing the reported data. [Results] We compared four methods of evaluating core strength training: trunk balance, stabilization, segmental stabilization, and motor control exercises. According to the results of various scales and evaluation instruments, core strength training is more effective than typical resistance training for alleviating chronic low back pain. [Conclusion] All of the core strength training strategies examined in this study assist in the alleviation of chronic low back pain; however, we recommend focusing on training the deep trunk muscles to alleviate chronic low back pain.

Effect of vacuum thermal annealing on a molybdenum bilayer back contact deposited by radio-frequency magnetron sputtering for chalcogenide- and kesterite-based solar cells

NASA Astrophysics Data System (ADS)

Liu, Xiaolei; Cui, Hongtao; Hao, Xiaojing; Huang, Shujuan; Conibeer, Gavin

2017-12-01

Molybdenum (Mo) thin films are still a dominant choice for the back contact layer of Cu(In,Ga)Se2 (CIGS) and Cu2ZnSnS4 (CZTS) solar cells. This paper presents a review of Mo back contacts for CIGS and CZTS solar cells, including the requirements for a good back contact, the reason for the choice of Mo, and post-treatment. Additionally, a Mo bilayer back contact was fabricated by varying the argon (Ar) pressure during sputtering to provide both low resistivity and good adhesion to the soda-lime glass substrate. The effects of vacuum thermal annealing on the electrical, morphological and structural properties of the Mo bilayer were also investigated. Vacuum thermal annealing was seen to densify the Mo bilayer, reduce the sheet resistance, and improve the bilayer's adhesion to the soda-lime glass. The Mo bilayer back contact with a low sheet resistance of 0.132 Ω/□ and strong adhesion was made for chalcogenide- and kesterite-based solar cells.

For what illnesses is a disease management program most effective?

PubMed

Jutkowitz, Eric; Nyman, John A; Michaud, Tzeyu L; Abraham, Jean M; Dowd, Bryan

2015-02-01

We examined the impact of a disease management (DM) program offered at the University of Minnesota for those with various chronic diseases. Differences-in-differences regression equations were estimated to determine the effect of DM participation by chronic condition on expenditures, absenteeism, hospitalizations, and avoidable hospitalizations. Disease management reduced health care expenditures for individuals with asthma, cardiovascular disease, congestive heart failure, depression, musculoskeletal problems, low back pain, and migraines. Disease management reduced hospitalizations for those same conditions except for congestive heart failure and reduced avoidable hospitalizations for individuals with asthma, depression, and low back pain. Disease management did not have any effect for individuals with diabetes, arthritis, or osteoporosis, nor did DM have any effect on absenteeism. Employers should focus on those conditions that generate savings when purchasing DM programs. This study suggests that the University of Minnesota's DM program reduces hospitalizations for individuals with asthma, cardiovascular disease, depression, musculoskeletal problems, low back pain, and migraines. The program also reduced avoidable hospitalizations for individuals with asthma, depression, and low back pain.

The role of sleep in adolescents' daily stress recovery: Negative affect spillover and positive affect bounce-back effects.

PubMed

Chue, Amanda E; Gunthert, Kathleen C; Kim, Rebecca W; Alfano, Candice A; Ruggiero, Aria R

2018-07-01

The present study examined the role of sleep in daily affective stress recovery processes in adolescents. Eighty-nine American adolescents recorded their emotions and stress through daily surveys and sleep with Fitbit devices for two weeks. Results show that objectively measured sleep (sleep onset latency and sleep debt) moderated negative affective responses to previous-day stress, such that stress-related negative affect spillover effects became more pronounced as amount of sleep decreased. Total sleep time and sleep debt moderated cross-day positive affect "bounce-back" effects. With more sleep, morning positive affect on days following high stress tended to bounce back to the levels that were common following low stress days. Conversely, if sleep was short following high stress days, positive affect remained low the next morning. No evidence for subjective sleep quality as a moderator of spillover/bounce-back effects was found. This research suggests that sleep quantity could relate to overnight affective stress recovery. Copyright © 2018. Published by Elsevier Ltd.

Understanding how pain education causes changes in pain and disability: protocol for a causal mediation analysis of the PREVENT trial.

PubMed

Lee, Hopin; Moseley, G Lorimer; Hübscher, Markus; Kamper, Steven J; Traeger, Adrian C; Skinner, Ian W; McAuley, James H

2015-07-01

Pain education is a complex intervention developed to help clinicians manage low back pain. Although complex interventions are usually evaluated by their effects on outcomes, such as pain or disability, most do not directly target these outcomes; instead, they target intermediate factors that are presumed to be associated with the outcomes. The mechanisms underlying treatment effects, or the effect of an intervention on an intermediate factor and its subsequent effect on outcome, are rarely investigated in clinical trials. This leaves a gap in the evidence for understanding how treatments exert their effects on outcomes. Mediation analysis provides a method for identifying and quantifying the mechanisms that underlie interventions. To determine whether the effect of pain education on pain and disability is mediated by changes in self-efficacy, catastrophisation and back pain beliefs. Causal mediation analysis of the PREVENT randomised controlled trial. Two hundred and two participants with acute low back pain from primary care clinics in the Sydney metropolitan area. Participants will be randomised to receive either 'pain education' (intervention group) or 'sham education' (control group). All outcome measures (including patient characteristics), primary outcome measures (pain and disability), and putative mediating variables (self-efficacy, catastrophisation and back pain beliefs) will be measured prior to randomisation. Putative mediators and primary outcome measures will be measured 1 week after the intervention, and primary outcome measures will be measured 3 months after the onset of low back pain. Causal mediation analysis under the potential outcomes framework will be used to test single and multiple mediator models. A sensitivity analysis will be conducted to evaluate the robustness of the estimated mediation effects on the influence of violating sequential ignorability--a critical assumption for causal inference. Mediation analysis of clinical trials can estimate how much the total effect of the treatment on the outcome is carried through an indirect path. Using mediation analysis to understand these mechanisms can generate evidence that can be used to tailor treatments and optimise treatment effects. In this study, the causal mediation effects of a pain education intervention for acute non-specific low back pain will be estimated. This knowledge is critical for further development and refinement of interventions for conditions such as low back pain. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Effects of chronic low back pain, age and gender on vertical spinal creep.

PubMed

Kanlayanaphotporn, R; Trott, P; Williams, M; Fulton, I

2003-05-15

This study investigated the effect of chronic low back pain, age, gender, and time of measurement on the magnitude of vertical spinal creep (VSC) and its recovery. A mixed design, involving three independent variables (chronic low back pain, age, and gender) and one repeated variable (time), was used. One hundred and six subjects of both genders, with and without chronic low back pain, aged between 20 and 60 years, participated in the study. The measurement of VSC and its recovery was performed using a seated stadiometer that allowed continuous measurement of VSC without changing the subject's posture over 25 min. Unloaded VSC was measured during the initial 5 min, followed by 10 min with an additional load of 15% of the subject's body weight and then for a further 10 min after the removal of the load. Subjects were grouped into one of eight categories according to the presence of chronic low back pain, age (20-39 years or 40-60 years) and gender. Repeated measures analysis of variance was computed. A significant increase in VSC with time of measurement was observed (p<0.001). No significant main effects for chronic low back pain, age, or gender were found at any time during the 25-min VSC testing protocol. Significant interactions were found between age and gender during the loaded (p=0.02) and unloaded (p=0.02) phases. A significant interaction was found between chronic low back pain and gender at the end of the unloaded phase (p=0.04). These findings suggest a combined influence of chronic low back pain, age, and gender on VSC and its recovery and that the dominance of each variable changed with the time of the measurement. Thus, subjects who differ in the presence of chronic low back pain, age, and gender should not be combined for statistical analysis of VSC and its recovery.

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.

Effectiveness and safety of moxibustion treatment for non-specific lower back pain: protocol for a systematic review.

PubMed

Leem, Jungtae; Lee, Seunghoon; Park, Yeoncheol; Seo, Byung-Kwan; Cho, Yeeun; Kang, Jung Won; Lee, Yoon Jae; Ha, In-Hyuk; Lee, Hyun-Jong; Kim, Eun-Jung; Lee, Sanghoon; Nam, Dongwoo

2017-06-23

Many patients experience acute lower back pain that becomes chronic pain. The proportion of patients using complementary and alternative medicine to treat lower back is increasing. Even though several moxibustion clinical trials for lower back pain have been conducted, the effectiveness and safety of moxibustion intervention is controversial. The purpose of this study protocol for a systematic review is to evaluate the effectiveness and safety of moxibustion treatment for non-specific lower back pain patients. We will conduct an electronic search of several databases from their inception to May 2017, including Embase, PubMed, Cochrane Central Register of Controlled Trial, Allied and Complementary Medicine Database, Wanfang Database, Chongqing VIP Chinese Science and Technology Periodical Database, China National Knowledge Infrastructure Database, Korean Medical Database, Korean Studies Information Service System, National Discovery for Science Leaders, Oriental Medicine Advanced Searching Integrated System, the Korea Institute of Science and Technology, and KoreaMed. Randomised controlled trials investigating any type of moxibustion treatment will be included. The primary outcome will be pain intensity and functional status/disability due to lower back pain. The secondary outcome will be a global measurement of recovery or improvement, work-related outcomes, radiographic improvement of structure, quality of life, and adverse events (presence or absence). Risk ratio or mean differences with a 95% confidence interval will be used to show the effect of moxibustion therapy when it is possible to conduct a meta-analysis. This review will be published in a peer-reviewed journal and will be presented at an international academic conference for dissemination. Our results will provide current evidence of the effectiveness and safety of moxibustion treatment in non-specific lower back pain patients, and thus will be beneficial to patients, practitioners, and policymakers. CRD42016047468 in PROSPERO 2016. © 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.

The effectiveness of a back school program in lowerlimb amputees: a randomized controlled study.

PubMed

Anaforoğlu, Bahar; Erbahçeci, Fatih; Aksekili, Mehmet Atıf Erol

2016-06-23

A few studies have been carried out in lower limb amputees (LLAs) and they examined the incidence of and reasons for low back pain. The aim of this study was to assess the effectiveness of a back school program in LLAs with mechanical low back pain (MLBP). Forty male unilateral transfemoral amputees with MLBP were randomly allocated into two groups. A back school program was applied to Group 1 over 2 weeks. A booklet for home use was given to each participant in Group 2. Pain was assessed using a visual analogue scale. Spinal flexibility measurements were obtained. For the assessment of back pain-related disability, the Oswestry Disability Index was used. Patients were assessed at baseline, at month 1, and at month 3. At the month 1 assessment, a reduction in pain intensity and disability, and increase in spinal flexibility measurements were detected in Group 1 only (P < 0.05). At the month 3 assessment, there were improvements in all measured parameters in both groups(P < 0.05). Group 1 had better results in all parameters compared with Group 2. The back school program, combined with an exercise program, decreased pain and disability and improved the spinal flexibility significantly in LLAs with MLBP.

Field-scale forward and back diffusion through low-permeability zones

NASA Astrophysics Data System (ADS)

Yang, Minjune; Annable, Michael D.; Jawitz, James W.

2017-07-01

Understanding the effects of back diffusion of groundwater contaminants from low-permeability zones to aquifers is critical to making site management decisions related to remedial actions. Here, we combine aquifer and aquitard data to develop recommended site characterization strategies using a three-stage classification of plume life cycle based on the solute origins: aquifer source zone dissolution, source zone dissolution combined with back diffusion from an aquitard, and only back diffusion. We use measured aquitard concentration profile data from three field sites to identify signature shapes that are characteristic of these three stages. We find good fits to the measured data with analytical solutions that include the effects of advection and forward and back diffusion through low-permeability zones, and linearly and exponentially decreasing flux resulting from source dissolution in the aquifer. Aquifer contaminant time series data at monitoring wells from a mature site were well described using analytical solutions representing the combined case of source zone and back diffusion, while data from a site where the source had been isolated were well described solely by back diffusion. The modeling approach presented in this study is designed to enable site managers to implement appropriate remediation technologies at a proper timing for high- and low-permeability zones, considering estimated plume life cycle.

Field-scale forward and back diffusion through low-permeability zones.

PubMed

Yang, Minjune; Annable, Michael D; Jawitz, James W

2017-07-01

Understanding the effects of back diffusion of groundwater contaminants from low-permeability zones to aquifers is critical to making site management decisions related to remedial actions. Here, we combine aquifer and aquitard data to develop recommended site characterization strategies using a three-stage classification of plume life cycle based on the solute origins: aquifer source zone dissolution, source zone dissolution combined with back diffusion from an aquitard, and only back diffusion. We use measured aquitard concentration profile data from three field sites to identify signature shapes that are characteristic of these three stages. We find good fits to the measured data with analytical solutions that include the effects of advection and forward and back diffusion through low-permeability zones, and linearly and exponentially decreasing flux resulting from source dissolution in the aquifer. Aquifer contaminant time series data at monitoring wells from a mature site were well described using analytical solutions representing the combined case of source zone and back diffusion, while data from a site where the source had been isolated were well described solely by back diffusion. The modeling approach presented in this study is designed to enable site managers to implement appropriate remediation technologies at a proper timing for high- and low-permeability zones, considering estimated plume life cycle. Copyright © 2017 Elsevier B.V. All rights reserved.

A Study on Factors Affecting Low Back Pain and Safety and Efficacy of NSAIDs in Acute Low Back Pain in a Tertiary Care Hospital of Western Nepal

PubMed Central

Bhattarai, Srijana; Chhetri, Himal Paudel; Alam, Kadir; Thapa, Pabin

2013-01-01

Introduction: Low back pain is characterized by a range of symptoms which include pain, muscle tension or stiffness, and is localized between the shoulder blades and the folds of the buttocks, with or without spreading to the legs. Non-Steroidal Anti Inflammatory Drugs (NSAIDs) are the drugs of choice which provide an analgesic effect for acute low back pain. Aim: To study the factors affecting low back pain, efficacy and safety of different non-steroidal anti-inflammatory drugs (aceclofenac, diclofenac, naproxen and nimesulide) in low back pain. Methodology: Data collection form and numeric pain rating scale were used as study tools for studying patients’ demographies and severities of pain respectively. Patients prescribed with aceclofenac 100 mg , diclofenac 100 mg, naproxen 500 mg and nimesulide 100 mg for acute low back pain at Orthopaedics Outpatients Department of Manipal Teaching Hospital, Nepal, were enrolled in this study. The decrease in pain scores was recorded on 5th and 10th days of follow-up and pain scores were calculated. Descriptive statistics and Kruskal Wallis non parametric test were used for analysis. Results: Among 150 patients, 67.3% were females (n=101). Low back pain was more prevalent (24.7%) in age-group of 59-68 years and a positive correlation was seen. Similarly, low back pain was found to be high among people involved in agriculture, heavy weight lifters and non smokers. The decrease in average pain scores was more in the patients treated with aceclofenac (4.83 ± 0.537), followed by that in those who were treated with naproxen (4.13 ± 0.067) and diclofenac (3.84 ± 0.086). The decrease in pain scores was found to be lowest among patients who were treated with nimesulide (2.11 ± 0.148). Nimesulide presented more number of side-effects than the comparative drugs. Conclusion: Different factors affect low back pain, such as age, gender, personal habit, posture, occupation, weight lifting. Aceclofenac showed greater decrease in pain scores with lesser number of side-effects. PMID:24551630

Prevention of low back pain and its consequences among nurses’ aides in elderly care: a stepped-wedge multi-faceted cluster-randomized controlled trial

PubMed Central

2013-01-01

Background A high prevalence of low back pain has persisted over the years despite extensive primary prevention initiatives among nurses’ aides. Many single-faceted interventions addressing just one aspect of low back pain have been carried out at workplaces, but with low success rate. This may be due to the multi-factorial origin of low back pain. Participatory ergonomics, cognitive behavioral training and physical training have previously shown promising effects on prevention and rehabilitation of low back pain. Therefore, the main aim of this study is to examine whether a multi-faceted workplace intervention consisting of participatory ergonomics, physical training and cognitive behavioral training can prevent low back pain and its consequences among nurses’ aides. External resources for the participating workplace and a strong commitment from the management and the organization support the intervention. Methods/design To overcome implementation barriers within usual randomized controlled trial designed workplace interventions, this study uses a stepped-wedge cluster-randomized controlled trial design with 4 groups. The intervention is delivered to the groups at random along four successive time periods three months apart. The intervention lasts three months and integrates participatory ergonomics, physical training and cognitive behavioral training tailored to the target group. Local physiotherapists and occupational therapists conduct the intervention after having received standardized training. Primary outcomes are low back pain and its consequences measured monthly by text messages up to three months after initiation of the intervention. Discussion Intervention effectiveness trials for preventing low back pain and its consequences in workplaces with physically demanding work are few, primarily single-faceted, with strict adherence to a traditional randomized controlled trial design that may hamper implementation and compliance, and have mostly been unsuccessful. By using a stepped wedge design, and obtain high management commitment and support we intend to improve implementation and aim to establish the effectiveness of a multi-faceted intervention to prevent low back pain. This study will potentially provide knowledge of prevention of low back pain and its consequences among nurses’ aides. Results are expected to be published in 2015–2016. Trial registration The study is registered as ISRCTN78113519. PMID:24261985

Assessment of chiropractic treatment for active duty, U.S. military personnel with low back pain: study protocol for a randomized controlled trial.

PubMed

Goertz, Christine M; Long, Cynthia R; Vining, Robert D; Pohlman, Katherine A; Kane, Bridget; Corber, Lance; Walter, Joan; Coulter, Ian

2016-02-09

Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of pain and function within a civilian population is spinal manipulative therapy provided by doctors of chiropractic. Chiropractic care, delivered within a multidisciplinary framework in military healthcare settings, has the potential to help improve clinical outcomes for military personnel with low back pain. However, its effectiveness in a military setting has not been well established. The primary objective of this study is to evaluate changes in pain and disability in active duty service members with low back pain who are allocated to receive usual medical care plus chiropractic care versus treatment with usual medical care alone. This pragmatic comparative effectiveness trial will enroll 750 active duty service members with low back pain at three military treatment facilities within the United States (250 from each site) who will be allocated to receive usual medical care plus chiropractic care or usual medical care alone for 6 weeks. Primary outcomes will include the numerical rating scale for pain intensity and the Roland-Morris Disability Questionnaire at week 6. Patient reported outcomes of pain, disability, bothersomeness, and back pain function will be collected at 2, 4, 6, and 12 weeks from allocation. Because low back pain is one of the leading causes of disability among U.S. military personnel, it is important to find pragmatic and conservative treatments that will treat low back pain and preserve low back function so that military readiness is maintained. Thus, it is important to evaluate the effects of the addition of chiropractic care to usual medical care on low back pain and disability. The trial discussed in this article was registered in ClinicalTrials.gov with the NCT01692275 Date of registration: 6 September 2012.

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

PubMed

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

2017-04-01

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

Nonspecific lower-back pain: surgical versus nonsurgical treatment.

PubMed

Nordin, Margareta; Balagué, Federico; Cedraschi, Christine

2006-02-01

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

Allee effect from parasite spill-back.

PubMed

Krkošek, Martin; Ashander, Jaime; Frazer, L Neil; Lewis, Mark A

2013-11-01

The exchange of native pathogens between wild and domesticated animals can lead to novel disease threats to wildlife. However, the dynamics of wild host-parasite systems exposed to a reservoir of domesticated hosts are not well understood. A simple mathematical model reveals that the spill-back of native parasites from domestic to wild hosts may cause a demographic Allee effect in the wild host population. A second model is tailored to the particulars of pink salmon (Oncorhynchus gorbuscha) and salmon lice (Lepeophtheirus salmonis), for which parasite spill-back is a conservation and fishery concern. In both models, parasite spill-back weakens the coupling of parasite and wild host abundance-particularly at low host abundance-causing parasites per host to increase as a wild host population declines. These findings show that parasites shared across host populations have effects analogous to those of generalist predators and can similarly cause an unstable equilibrium in a focal host population that separates persistence and extirpation. Allee effects in wildlife arising from parasite spill-back are likely to be most pronounced in systems where the magnitude of transmission from domestic to wild host populations is high because of high parasite abundance in domestic hosts, prolonged sympatry of domestic and wild hosts, a high transmission coefficient for parasites, long-lived parasite larvae, and proximity of domesticated populations to wildlife migration corridors.

Pain relief by transcutaneous electric nerve stimulation with bidirectional modulated sine waves in patients with chronic back pain: a randomized, double-blind, sham-controlled study.

PubMed

Shimoji, Koki; Takahashi, Norio; Nishio, Yasuyuki; Koyanagi, Mika; Aida, Sumihisa

2007-01-01

Objectives.  Newly developed bidirectional modulated sine waves (BMW) might provide some derived benefit to patients with low back pain. Pain relief by transcutaneous electric nerve stimulation (TENS) with BMWs was tested. Materials and Methods.  Analgesic effects of BMWs and conventional bidirectional pulsed waves on chronic back pain in 28 patients were compared, and effects of repeated TENS using BMWs on chronic back pain were investigated in 21 patients by means of a randomized double-blind, sham-controlled, parallel-group method. Pain intensity was assessed using numerical rating scale (NRS). Results.  There was significant immediate reduction in NRS in patients receiving BMWs, and 60 min after treatment compared to sham TENS. Weekly repeated treatments using massage and TENS with BMWs for 5 weeks resulted in a decrease of NRS, but there were no significant differences between the TENS plus massage and sham TENS plus massage groups. Conclusions.  This study shows that TENS with BMWs significantly inhibits chronic back pain, and treatment effects are attained within a day. The results also suggest that there were no statistically significant long-term effects of TENS with BMW in the repeated treatment.

Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials.

PubMed

Pittler, M H; Karagülle, M Z; Karagülle, M; Ernst, E

2006-07-01

Low back pain is a major public health concern and complementary treatments are frequently used for this condition. The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain. Systematic searches were conducted on Medline, Embase, Amed Cochrane Central, the UK National Research Register and ClincalTrials.gov (all until July 2005). Hand searches were performed and experts contacted. Methodological quality was assessed using a standard scale. Five randomized clinical trials met all inclusion criteria. Quantitative data synthesis was performed. The data for spa therapy, assessed on a 100 mm visual analogue scale (VAS), suggest significant beneficial effects compared with waiting list control groups (weighted mean difference 26.6 mm, 95% confidence interval 20.4-32.8, n=442) for patients with chronic low back pain. For balneotherapy the data, assessed on a 100 mm VAS, also suggest beneficial effects compared with control groups (weighted mean difference 18.8 mm, 95% confidence interval 10.3-27.3, n=138). Even though the data are scarce, there is encouraging evidence suggesting that spa therapy and balneotherapy may be effective for treating patients with low back pain. These data are not compelling but warrant rigorous large-scale trials.

The effects of cannabidiol on impulsivity and memory during abstinence in cigarette dependent smokers.

PubMed

Hindocha, C; Freeman, T P; Grabski, M; Crudgington, H; Davies, A C; Stroud, J B; Das, R K; Lawn, W; Morgan, C J A; Curran, H V

2018-05-15

Acute nicotine abstinence in cigarette smokers results in deficits in performance on specific cognitive processes, including working memory and impulsivity which are important in relapse. Cannabidiol (CBD), the non-intoxicating cannabinoid found in cannabis, has shown pro-cognitive effects and preliminary evidence has indicated it can reduce the number of cigarettes smoked in dependent smokers. However, the effects of CBD on cognition have never been tested during acute nicotine withdrawal. The present study therefore aimed to investigate if CBD can improve memory and reduce impulsivity during acute tobacco abstinence. Thirty, non-treatment seeking, dependent, cigarette smokers attended two laboratory-based sessions after overnight abstinence, in which they received either 800 mg oral CBD or placebo (PBO), in a randomised order. Abstinence was biologically verified. Participants were assessed on go/no-go, delay discounting, prose recall and N-back (0-back, 1-back, 2-back) tasks. The effects of CBD on delay discounting, prose recall and the N-back (correct responses, maintenance or manipulation) were null, confirmed by a Bayesian analysis, which found evidence for the null hypothesis. Contrary to our predictions, CBD increased commission errors on the go/no-go task. In conclusion, a single 800 mg dose of CBD does not improve verbal or spatial working memory, or impulsivity during tobacco abstinence.

Performance of back-primed and factory-finished hardboard lap siding in southern Florida

Treesearch

Charles. Carll; Mark. Knaebe; Vyto. Malinauskas; Peter. Sotos; Anton. TenWolde

2000-01-01

Because of performance problems with hardboard siding in southern Florida, the U.S. Department of Housing and Urban Development (HUD) proposed a local standard requiring prefinishing of siding and priming of all siding surfaces, including the back. However, the effectiveness of these practices was questioned. To determine if back-priming or factory finishing improves...

Effects of backing board materials on wood combustion performance

Treesearch

Mathew J. Hagge; Kenneth M. Bryden; Mark A. Dietenberger

2004-01-01

Cone calorimeter tests show that backing board materials do not affect the ignition time, initial heat release rate, or the total heat released of combustion for redwood slabs. However, it has been observed that backing board materials alter combustion performance by altering the secondary heat release peak observed when the pyrolysis reaction front nears the unheated...

Determination of effective atomic number of biomedical samples using Gamma ray back-scattering

NASA Astrophysics Data System (ADS)

Singh, Inderjeet; Singh, Bhajan; Sandhu, B. S.; Sabharwal, Arvind D.

2018-05-01

The study of effective atomic number of biomedical sample has been carried out by using a non-destructive multiple back-scattering technique. Also radiation characterization method is used to compare the tissue equivalent material as human tissue. Response function of 3″ × 3″ NaI(Tl) scintillation detector is implemented on recorded pulse-height distribution to boost the counts under the photo-peak and help to reduce the uncertainty in the experimental result. Monte Carlo calculation for multiple back-scattered events supports the reported experimental work.

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

Age-differences in the temporal properties of proactive interference in working memory.

PubMed

Samrani, George; Bäckman, Lars; Persson, Jonas

2017-12-01

The inability to suppress irrelevant information has been suggested as a primary cause of proactive interference (PI), and this deficit may be enhanced in aging. The current study examines age differences and temporal boundaries of PI, by manipulating lure distances in a verbal 2-back working memory task. Both younger and older adults showed effects of interference for proximal 3- and 4-back lures, and this effect was greater for older adults. Whereas younger adults showed less interference during 4-back compared to 3-back lures, in both reaction times and accuracy, older adults improved only in accuracy. For distant lures, when the time between the 1st presentation of an item to its reappearance as a lure item was longer (e.g., 5- to 10-back lures), younger adults were no longer affected by PI. However, older adults were affected by PI throughout all distant lures, up to the most distant lure (9-/10-back). The results suggest that older adults were less successful in resolving interference from both proximal and distant familiar lures. Further, younger adults were able to overcome the effects of PI completely after a specific lure distance. The age differences in temporal properties of PI may therefore highlight a unique component linked to impaired interference control and aging. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Effectiveness of Behavioral Therapy for Chronic Low Back Pain: A Component Analysis.

ERIC Educational Resources Information Center

Turner, Judith A.; And Others

1990-01-01

Evaluated effects of group behavioral therapy including aerobic exercise, behavioral therapy alone, and aerobic exercise alone on pain and physical and psychological disability among mildly disabled chronic low-back-pain patients (n=96). The combined behavioral therapy and exercise group improved significantly more pretreatment to posttreatment…

A randomized controlled trial on the long-term effects of proprioceptive neuromuscular facilitation training, on pain-related outcomes and back muscle activity, in patients with chronic low back pain.

PubMed

Areeudomwong, Pattanasin; Wongrat, Witchayut; Neammesri, Nertnapa; Thongsakul, Thanaporn

2017-09-01

The role of exercise therapy in improving pain-related clinical outcomes and trunk muscle activity in patients with chronic low back pain (CLBP) has been widely reported. There is little information on the effect of proprioceptive neuromuscular facilitation (PNF) training in patients with CLBP. The purpose of the present study was therefore to investigate the persistence of the effects of PNF training on pain intensity, functional disability, patient satisfaction, health-related quality of life (HRQOL) and lower back muscle activity in patients with CLBP. Forty-two participants with CLBP were randomly assigned either to 4-week PNF training or to a control group receiving a Low back pain educational booklet. Pain-related outcomes, including pain intensity, functional disability, patient satisfaction, HRQOL and lumbar erector spinae (LES) muscle activity, were measured before and after the intervention, and at a follow-up session 12 weeks after the last intervention session. Compared with the control group, after undergoing a 4-week PNF training intervention, participants showed a significant reduction in pain intensity and functional disability, and improved patient satisfaction and HRQOL (p < 0.01). These effects were still significant at the 12-week follow-up assessment (p < 0.01). LES muscle activity in the PNF training group was significantly increased throughout the measurement periods compared with controls (p < 0.01). The study found that 4-week PNF training has positive long-term effects on pain-related outcomes, and increases lower back muscle activity in patients with CLBP. Copyright © 2016 John Wiley & Sons, Ltd.

Effect of a high-density foam seating wedge on back pain intensity when used by 14 to 16-year-old school students: a randomised controlled trial.

PubMed

Candy, Elizabeth A; Farewell, Daniel; Jerosch-Herold, Christina; Shepstone, Lee; Watts, Richard A; Stephenson, Richard C

2012-12-01

No previous randomised controlled trials had been undertaken investigating the effect of school seating on back pain in 14 to 16 year olds. This study was designed to test the effect of the use of a high-density foam wedge on normal school seating on the intensity of back pain. Randomised controlled trial. Suffolk, a predominantly rural county in eastern England. One hundred and eighty-five students with back pain were recruited from 12 schools. Randomisation was stratified by school. The control and intervention groups included 92 and 83 students, respectively. Following a 1-week baseline observation period, each student in the intervention group was given a wedge to use on their school chairs. The primary outcome measure was pain intensity (numerical rating scale, 0 to 10) recorded in pain diaries over 4 weeks. Random effects models were used to analyse the pain intensity data. Ninety-seven students (46 control group, 51 intervention group) completed the trial. For the intervention group, pain intensity was reduced significantly over the 3 weeks of wedge use. The average reduction in pain intensity was estimated to be 0.709 points (95% confidence interval 0.341 to 1.077), representing a 58% reduction in back pain for those in the intervention group. Use of a wedge reduced the intensity of back pain significantly, especially in the evenings. The results suggest that further research into the longer-term effect of seating on pain intensity in adolescents should be considered. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Paraspinous Lidocaine Injection for Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial.

PubMed

Imamura, Marta; Imamura, Satiko Tomikawa; Targino, Rosa Alves; Morales-Quezada, León; Onoda Tomikawa, Luis C; Onoda Tomikawa, Luis G; Alfieri, Fabio M; Filippo, Thais R; da Rocha, Ivan D; Neto, Raul Bolliger; Fregni, Felipe; Battistella, Linamara Rizzo

2016-05-01

In this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in subjects with chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1, LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2, SH-INJ); and analgesics and exercises (group 3, STD-TTR). A blinded rater assessed the study outcomes at 3 time points: baseline, after treatment, and after 3 months of follow-up. There were increased frequency of pain responses and better low back functional scores in the LID-INJ group compared with the SH-INJ and STD-TTR groups. These effects remained at the 3-month follow-up but differed between all 3 groups. There were significant changes in pain threshold immediately after treatment, supporting the effects of this intervention in reducing central sensitization. Paraspinous lidocaine injection therapy is not associated with a higher risk of adverse effects compared with conventional treatment and sham injection. Its effects on hyperalgesia might correlate with changes in central sensitization. NCT02387567. There are few data to support paraspinous lidocaine injection use in patients with nonspecific chronic low back pain. Our results show that this therapy when combined with standard therapy significantly increases the number of responders versus standard treatment alone. Its effects on hyperalgesia might correlate with a change in central sensitization. Copyright © 2016. Published by Elsevier Inc.

Cost effectiveness of a multi-stage return to work program for workers on sick leave due to low back pain, design of a population based controlled trial [ISRCTN60233560].

PubMed

Steenstra, Ivan A; Anema, Johannes R; Bongers, Paulien M; de Vet, Henrica C W; van Mechelen, Willem

2003-11-21

To describe the design of a population based randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing participative ergonomics interventions between 2-8 weeks of sick leave and Graded Activity after 8 weeks of sick leave with usual care, in occupational back pain management. An RCT and cost-effectiveness evaluation in employees sick-listed for a period of 2 to 6 weeks due to low back pain. Interventions used are 1. Communication between general practitioner and occupational physician plus Participative Ergonomics protocol performed by an ergonomist. 2. Graded Activity based on cognitive behavioural principles by a physiotherapist. 3. Usual care, provided by an occupational physician according to the Dutch guidelines for the occupational health management of workers with low back pain. The primary outcome measure is return to work. Secondary outcome measures are pain intensity, functional status and general improvement. Intermediate variables are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs due to low back pain. The outcome measures are assessed before randomization (after 2-6 weeks on sick leave) and 12 weeks, 26 weeks and 52 weeks after first day of sick leave. The combination of these interventions has been subject of earlier research in Canada. The results of the current RCT will: 1. crossvalidate the Canadian findings in an different sociocultural environment; 2. add to the cost-effectiveness on treatment options for workers in the sub acute phase of low back pain. Results might lead to alterations of existing (inter)national guidelines.

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

PubMed

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

2017-07-01

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

Relative importance of expertise, lifting height and weight lifted on posture and lumbar external loading during a transfer task in manual material handling.

PubMed

Plamondon, André; Larivière, Christian; Delisle, Alain; Denis, Denys; Gagnon, Denis

2012-01-01

The objective of this study was to measure the effect size of three important factors in manual material handling, namely expertise, lifting height and weight lifted. The effect of expertise was evaluated by contrasting 15 expert and 15 novice handlers, the effect of the weight lifted with a 15-kg box and a 23-kg box and the effect of lifting height with two different box heights: ground level and a 32 cm height. The task consisted of transferring a series of boxes from a conveyor to a hand trolley. Lifting height and weight lifted had more effect size than expertise on external back loading variables (moments) while expertise had low impact. On the other hand, expertise showed a significant effect of posture variables on the lumbar spine and knees. All three factors are important, but for a reduction of external back loading, the focus should be on the lifting height and weight lifted. The objective was to measure the effect size of three important factors in a transfer of boxes from a conveyor to a hand trolley. Lifting height and weight lifted had more effect size than expertise on external back loading variables but expertise was a major determinant in back posture.

Strain on the back in concrete reinforcement work.

PubMed Central

Wickström, G; Niskanen, T; Riihimäki, H

1985-01-01

To investigate the long term effect of heavy construction work on the back the occurrence of postures, lifting, carrying, and accidents in concrete reinforcement work and in maintenance house painting were measured. The 32 620 observations covering 272 work hours showed that reinforcement work necessitated stooped postures and heavy lifting more often than did painting. Reported minor back accidents were more than ten times as common in reinforcement work than in painting (1.3 compared with 0.11 accidents per man-year, p less than 0.001). Accidents of the musculoskeletal system, registered by the insurance companies, were also several times more common in reinforcement work (81 compared with 25 per 1000 man-years, p less than 0.001). The premature development of lumbar degeneration detected in the clinical study of the reinforcement workers was evidently due to the occupational strain on the back. The different types of hazardous back loads probably potentiate the effects of each other. PMID:3978042

A narrative review of evidence-based recommendations for the physical examination of the lumbar spine, sacroiliac and hip joint complex.

PubMed

Wong, C K; Johnson, E K

2012-09-01

Non-specific low back pain is a frequent complaint in primary care, but the differential diagnosis for low back pain can be complex. Despite advances in diagnostic imaging, a specific pathoanatomical source of low back pain can remain elusive in up to 85% of individuals. Best practice guidelines recommend that clinicians conduct a focused physical examination to help to identify patients with non-specific low back pain and an evidence-based course of clinical management. The use of sensitive and specific clinical methods to assess the lumbar spine, sacroiliac and hip joints is critical for effective physical examination. Psychosocial factors also play an important role in the evaluation of individuals with low back pain, but are not included in this narrative review of physical examination methods. Physical examination of the lumbar spine, sacroiliac and hip joints is presented, organized around patient position for efficient and effective clinical assessment. Copyright © 2012 John Wiley & Sons, Ltd.

Effectiveness of the addition of therapeutic alliance with minimal intervention in the treatment of patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors: a study protocol for a randomized controlled trial (TalkBack trial).

PubMed

Fagundes, Felipe Ribeiro Cabral; de Melo do Espírito Santo, Caique; de Luna Teixeira, Francine Mendonça; Tonini, Thaís Vanelli; Cabral, Cristina Maria Nunes

2017-01-31

The stratified model of care has been an effective approach for the treatment of low back pain. However, the treatment of patients with low risk of psychosocial-factor involvement is unclear. The addition of the therapeutic alliance to a minimal intervention may be an option for the treatment of low back pain. This paper reports on the rationale, design and protocol for a randomized controlled trial with blind assessor to assess the effectiveness of the addition of therapeutic alliance with minimal intervention on pain and disability in patients with chronic, nonspecific low back pain. Two hundred and twenty-two patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors will be assessed and randomly allocated into three groups (n = 74 patients per group). The Positive Therapeutic Alliance group will receive counseling and guidance with an emphasis on therapeutic alliance and empathy. The Usual Treatment group will receive the same information and counseling with limited interaction with the therapist. The Control group will not receive any intervention. The treatment will be composed by two intervention sessions with a 1-week interval. A blinded assessor will collect the following outcomes at baseline, 1 month, 6 months and 12 months after randomization: pain intensity (Pain Numerical Rating Scale), specific disability (Patient-specific Functional Scale), general disability (Oswestry Disability Index), global perceived effect (Global Perceived Effect Scale), empathy (Consultation and Relational Empathy Measure), credibility and expectations related to treatment. The analysis will be performed using linear mixed models. This will be the first study to understand the effect of combining enhanced therapeutic alliance to a treatment based on counseling, information and advice (minimal intervention). The addition of the therapeutic alliance to minimal intervention may improve the treatment of chronic, nonspecific low back pain. ClinicalTrials.gov, NCT 02497625. Registered on 10 July 2015.

Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

PubMed

Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

2017-01-01

Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment. The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with non-specific low back pain.

Short-term effect of back school based on cognitive behavioral therapy involving multidisciplinary collaboration.

PubMed

Motoya, Ryo; Otani, Koji; Nikaido, Takuya; Ono, Yoko; Matsumoto, Takatomo; Yamagishi, Ryohei; Yabuki, Shoji; Konno, Shin-Ichi; Niwa, Shin-Ichi; Yabe, Hirooki

2017-08-09

ObjectivesThe purpose of this study was to develop a comprehensive back school program that included elements of CBT (Cognitive Behavioral Therapy), implement this through multidisciplinary collaboration, and ascertain its effectiveness as a pilot study. DesignThis school was implemented in the form of five 90-minute group sessions held every other week.MethodsParticipants comprised 7 chronic low back pain patients with poor improvement in the usual treatment. Practitioners were orthopaedic surgeon, physical therapist, and a clinical psychologist. This school contents were patient education, self-monitoring, back exercise, relaxation, stress management, cognitive restructuring, activity pacing, and exposure. ResultsFrom the Wilcoxon signed-rank test, each score of four scales or items (sense of control, PCS (pain catastrophizing), PASS-20 (escape/avoidance), FFD (finger-floor distance)) after this program significantly improved. Results of calculating the effect size, sense of control (d=0.55) is 'moderate', the PCS (d=1.12) and the PASS-20 (d=1.64) were 'large'.ConclusionsThis back school may be useful for physical function and psychological variables which much related to pain management and daily disabilities in patients with poor respond to standard orthopaedic treatment.

Effects of pilates on patients with chronic non-specific low back pain: a systematic review

PubMed Central

Lin, Hui-Ting; Hung, Wei-Ching; Hung, Jia-Ling; Wu, Pei-Shan; Liaw, Li-Jin; Chang, Jia-Hao

2016-01-01

[Purpose] To evaluate the effects of Pilates on patients with chronic low back pain through a systematic review of high-quality articles on randomized controlled trials. [Subjects and Methods] Keywords and synonyms for “Pilates” and “Chronic low back pain” were used in database searches. The databases included PubMed, Physiotherapy Evidence Database (PEDro), Medline, and the Cochrane Library. Articles involving randomized controlled trials with higher than 5 points on the PEDro scale were reviewed for suitability and inclusion. The methodological quality of the included randomized controlled trials was evaluated using the PEDro scale. Relevant information was extracted by 3 reviewers. [Results] Eight randomized controlled trial articles were included. Patients with chronic low back pain showed statistically significant improvement in pain relief and functional ability compared to patients who only performed usual or routine health care. However, other forms of exercise were similar to Pilates in the improvement of pain relief and functional capacity. [Conclusion] In patients with chronic low back pain, Pilates showed significant improvement in pain relief and functional enhancement. Other exercises showed effects similar to those of Pilates, if waist or torso movement was included and the exercises were performed for 20 cumulative hours. PMID:27821970

Analgesic effect of clobazam in chronic low-back pain but not in experimentally induced pain.

PubMed

Schliessbach, J; Vuilleumier, P H; Siegenthaler, A; Bütikofer, L; Limacher, A; Juni, P; Zeilhofer, H U; Arendt-Nielsen, L; Curatolo, M

2017-09-01

Chronic pain is frequently associated with hypersensitivity of the nervous system, and drugs that increase central inhibition are therefore a potentially effective treatment. Benzodiazepines are potent modulators of GABAergic neurotransmission and are known to exert antihyperalgesic effects in rodents, but translation into patients are lacking. This study investigates the effect of the benzodiazepine clobazam in chronic low-back pain in humans. The aim of this study is to explore the effect of GABA modulation on chronic low-back pain and on quantitative sensory tests. In this double-blind cross-over study, 49 patients with chronic low-back pain received a single oral dose of clobazam 20 mg or active placebo tolterodine 1 mg. Pain intensity on the 0-10 numeric rating scale and quantitative sensory tests were assessed during 2 h after drug intake. Pain intensity in the supine position was significantly reduced by clobazam compared to active placebo (60 min: 2.9 vs. 3.5, p = 0.008; 90 min: 2.7 vs. 3.3, p = 0.024; 120 min: 2.4 vs. 3.1, p = 0.005). Pain intensity in the sitting position was not significantly different between groups. No effects on quantitative sensory tests were observed. This study suggests that clobazam has an analgesic effect in patients with chronic low-back pain. Muscle relaxation or sedation may have contributed to the effect. Development of substances devoid of these side effects would offer the potential to further investigate the antihyperalgesic action of GABAergic compounds. Modulation of GABAergic pain-inhibitory pathways may be a potential future therapeutic target. © 2017 European Pain Federation - EFIC®.

Short-Term Effects of Kinesio Taping in Women with Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.

PubMed

Kaplan, Şeyhmus; Alpayci, Mahmut; Karaman, Erbil; Çetin, Orkun; Özkan, Yasemin; İlter, Server; Şah, Volkan; Şahin, Hanım Güler

2016-04-18

BACKGROUND Pregnancy-related low back pain is a common condition during pregnancy. Kinesio tape is a drug-free elastic therapeutic tape used for treating various musculoskeletal problems. The aim of this study was to investigate the short-term effects of lumbar Kinesio taping on pain intensity and disability in women with pregnancy-related low back pain. MATERIAL AND METHODS A total of 65 patients with pregnancy-related low back pain were randomly allocated into either Kinesio taping (n=33) or control (n=32) groups. The intervention group was treated with paracetamol plus Kinesio taping, while the control group received only paracetamol. Kinesio taping was applied in the lumbar flexion position, and four I-shaped bands were used. Two bands were attached horizontally, with space correction technique. The remaining 2 bands, 1 on each side of the lumbar spine, were placed vertically, with inhibition technique. Low back pain intensity was measured on a 10-cm visual analogue scale (VAS), and the Roland-Morris Disability Questionnaire (RMDQ) was used for evaluation of disability. RESULTS Pain intensity and RMDQ scores improved significantly in both groups at 5 days compared with baseline. Considering the degree of treatment effect (the change from baseline to day 5), the Kinesio taping group was significantly superior than the control group in all outcome measures (for all, P<0.001). CONCLUSIONS The results of this study indicate that Kinesio taping can be used as a complementary treatment method to achieve effective control of pregnancy-related low back pain.

A Meta-Analysis of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain.

PubMed

Jauregui, Julio J; Cherian, Jeffrey J; Gwam, Chukwuweike U; Chughtai, Morad; Mistry, Jaydev B; Elmallah, Randa K; Harwin, Steven F; Bhave, Anil; Mont, Michael A

2016-04-01

Transcutaneous electrical nerve stimulation (TENS) may provide a safe alternative to current side-effect-heavy narcotics and anti-inflammatories utilized in chronic low back pain. Therefore, we performed a meta-analysis to evaluate the efficacy of TENS for the treatment of chronic low back pain. We included randomized controlled trials (RCTs), cohort studies, and randomized crossover studies on TENS for the management of low back pain. We utilized a visual analogue scale (VAS) for pain as our primary outcome. Effectiveness of treatment was quantified using improvement in outcome scores for each study. Of the studies that met the criteria, 13 allowed for calculation of weighted mean differences in pain reduction. We used a random model effect to evaluate changes in pain produced by the intervention. Included were nine level I and four level II, encompassing 267 patients (39% male) who had a mean follow-up of seven weeks (range; 2 to 24 weeks). The mean duration of treatment was six weeks (range; 2 to 24 weeks). The standardized mean difference in pain from pre- to post-treatment for TENS was 0.844, which demonstrated significant improvement of TENS on pain reduction. When subdividing treatment duration, patients that were treated for < 5 weeks had significant effects on pain, while those treated for > 5 weeks did not. Treatment of chronic low back pain with TENS demonstrated significant pain reduction. The application of TENS may lead to less pain medication usage and should be incorporated into the treatment armamentarium for chronic low back pain.

Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial.

PubMed

Magalhaes, Mauricio Oliveira; França, Fábio Jorge Renovato; Burke, Thomaz Nogueira; Ramos, Luiz Armando Vidal; de Moura Campos Carvalho e Silva, Ana Paula; Almeida, Gabriel Peixoto Leao; Yuan, Susan Lee King; Marques, Amélia Pasqual

2013-01-21

Low back pain is a relevant public health problem, being an important cause of work absenteeism worldwide, as well as affecting the quality of life of sufferers and their individual functional performances. Supervised active physical routines and of cognitive-behavioral therapies are recommended for the treatment of chronic Low back pain, although evidence to support the effectiveness of different techniques is missing. Accordingly, the aim of this study is to contrast the effectiveness of two types of exercises, graded activity or supervised, in decreasing symptoms of chronic low back pain. Sample will consist of 66 patients, blindly allocated into one of two groups: 1) Graded activity which, based on an operant approach, will use time-contingent methods aiming to increase participants' activity levels; 2) Supervised exercise, where participants will be trained for strengthening, stretching, and motor control targeting different muscle groups. Interventions will last one hour, and will happen twice a week for 6  weeks. Outcomes (pain, disability, quality of life, global perceived effect, return to work, physical activity, physical capacity, and kinesiophobia) will be assessed at baseline, at treatment end, and three and six months after treatment end. Data collection will be conducted by an investigator blinded to treatment allocation. This project describes the randomisation method that will be used to compare the effectiveness of two different treatments for chronic low back pain: graded activity and supervised exercises. Since optimal approach for patients with chronic back pain have yet not been defined based on evidence, good quality studies on the subject are necessary. NCT01719276.

Biomechanical effects of sitting with adjustable ischial and lumbar support on occupational low back pain: evaluation of sitting load and back muscle activity

PubMed Central

Makhsous, Mohsen; Lin, Fang; Bankard, James; Hendrix, Ronald W; Hepler, Matthew; Press, Joel

2009-01-01

Background Compared to standing posture, sitting decreases lumbar lordosis, increases low back muscle activity, disc pressure, and pressure on the ischium, which are associated with occupational LBP. A sitting device that reduces spinal load and low back muscle activities may help increase sitting comfort and reduce LBP risk. The objective of this study is to investigate the biomechanical effect of sitting with a reduced ischial support and an enhanced lumbar support (Off-Loading) on load, interface pressure and muscle activities. Methods A laboratory test in low back pain (LBP) and asymptomatic subjects was designed to test the biomechanical effect of using the Off-Loading sitting posture. The load and interface pressure on seat and the backrest, and back muscle activities associated with usual and this Off-Loading posture were recorded and compared between the two postures. Results Compared with Normal (sitting upright with full support of the seat and flat backrest) posture, sitting in Off-Loading posture significantly shifted the center of the force and the peak pressure on the seat anteriorly towards the thighs. It also significantly decreased the contact area on the seat and increased that on the backrest. It decreased the lumbar muscle activities significantly. These effects are similar in individuals with and without LBP. Conclusion Sitting with reduced ischial support and enhanced lumbar support resulted in reduced sitting load on the lumbar spine and reduced the lumbar muscular activity, which may potentially reduce sitting-related LBP. PMID:19193245

The Relationship between N-Back Performance and Matrix Reasoning--Implications for Training and Transfer

ERIC Educational Resources Information Center

Jaeggi, Susanne M.; Studer-Luethi, Barbara; Buschkuehl, Martin; Su, Yi-Fen; Jonides, John; Perrig, Walter J.

2010-01-01

We have previously demonstrated that training on a dual n-back task results in improvements in fluid intelligence ("Gf") as measured by matrix reasoning tasks. Here, we explored the underlying mechanisms of this transfer effect in two studies, and we evaluated the transfer potential of a single n-back task. In the first study, we demonstrated that…

Whole body vibration exercise for chronic low back pain: study protocol for a single-blind randomized controlled trial.

PubMed

Wang, Xue-Qiang; Pi, Yan-Lin; Chen, Pei-Jie; Chen, Bin-Lin; Liang, Lei-Chao; Li, Xin; Wang, Xiao; Zhang, Juan

2014-04-02

Low back pain affects approximately 80% of people at some stage in their lives. Exercise therapy is the most widely used nonsurgical intervention for low back pain in practice guidelines. Whole body vibration exercise is becoming increasingly popular for relieving musculoskeletal pain and improving health-related quality of life. However, the efficacy of whole body vibration exercise for low back pain is not without dispute. This study aims to estimate the effect of whole body vibration exercise for chronic low back pain. We will conduct a prospective, single-blind, randomized controlled trial of 120 patients with chronic low back pain. Patients will be randomly assigned into an intervention group and a control group. The intervention group will participate in whole body vibration exercise twice a week for 3 months. The control group will receive general exercise twice a week for 3 months. Primary outcome measures will be the visual analog scale for pain, the Oswestry Disability Index and adverse events. The secondary outcome measures will include muscle strength and endurance of spine, trunk proprioception, transversus abdominis activation capacity, and quality of life. We will conduct intention-to-treat analysis if any participants withdraw from the trial. Important features of this study include the randomization procedures, single-blind, large sample size, and a standardized protocol for whole body vibration in chronic low back pain. This study aims to determine whether whole body vibration exercise produces more beneficial effects than general exercise for chronic low back pain. Therefore, our results will be useful for patients with chronic low back pain as well as for medical staff and health-care decision makers. Chinese Clinical Trial Registry: ChiCTR-TRC-13003708.

Assessing self-reported disability in a low-literate population with chronic low back pain: cross-cultural adaptation and psychometric testing of Igbo Roland Morris disability questionnaire.

PubMed

Igwesi-Chidobe, Chinonso N; Obiekwe, Chinwe; Sorinola, Isaac O; Godfrey, Emma L

2017-12-14

Cross-culturally adapt and validate the Igbo Roland Morris Disability Questionnaire. Cross-cultural adaptation, test-retest, and cross-sectional psychometric testing. Roland Morris Disability Questionnaire was forward and back translated by clinical/non-clinical translators. An expert committee appraised the translations. Twelve participants with chronic low back pain pre-tested the measure in a rural Nigerian community. Internal consistency using Cronbach's alpha; test-retest reliability using intra-class correlation coefficient and Bland-Altman plot; and minimal detectable change were investigated in a convenient sample of 50 people with chronic low back pain in rural and urban Nigeria. Pearson's correlation analyses using the eleven-point box scale and back performance scale, and exploratory factor analysis were used to examine construct validity in a random sample of 200 adults with chronic low back pain in rural Nigeria. Ceiling and floor effects were investigated in the two samples. Modifications gave the option of interviewer-administration and reflected Nigerian social context. The measure had excellent internal consistency (α = 0.91) and intraclass correlation coefficient (ICC =0.84), moderately high correlations (r > 0.6) with performance-based disability and pain intensity, and a predominant uni-dimensional structure, with no ceiling or floor effects. Igbo Roland Morris Disability Questionnaire is a valid and reliable measure of pain-related disability. Implications for rehabilitation Low back pain is the leading cause of years lived with disability worldwide, and is particularly prevalent in rural Nigeria, but there are no self-report measures to assess its impact due to low literacy rates. This study describes the cross-cultural adaptation and validation of a core self-report back pain specific disability measure in a low-literate Nigerian population. The Igbo Roland Morris Disability Questionnaire is a reliable and valid measure of self-reported disability in Igbo populations as indicated by excellent internal consistency (α = 0.91) and intra-class correlation coefficient (ICC =0.84), moderately high correlations (r > 0.6) with performance-based disability and pain intensity that supports a pain-related disability construct, a predominant one factor structure with no ceiling or floor effects. The measure will be useful for researchers and clinicians examining the factors associated with low back pain disability or the effects of interventions on low back pain disability in this culture. This measure will support global health initiatives concurrently involving people from several cultures or countries, and may inform cross-cultural disability research in other populations.

Limitations associated with managing chronic low back pain.

PubMed

Beland, Paul

2016-04-20

Non-specific chronic low back pain is an occupational hazard for nurses. It may result in persistent and disabling pain for some people. There are many techniques for investigating, assessing and treating chronic low back pain. However, research to support some of these interventions and the assumptions that underlie them is limited. Interventions that may be beneficial are not always available to those who need them. Changes to service provision are required to rectify this situation and provide effective treatment for patients with non-specific chronic low back pain.

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

NASA Technical Reports Server (NTRS)

Laughlin, Mitzi S.; Murray, Jocelyn D.; Wear, Mary L.; Van Baalen, Mary

2016-01-01

Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors.

Exploring N-Back Cognitive Training for Children With ADHD.

PubMed

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

2018-06-01

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

Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care (YES) trial

PubMed Central

2010-01-01

Background Back pain, one of the most prevalent conditions afflicting American adults, is the leading reason for using complementary and alternative medicine (CAM) therapies. Yoga is an increasingly popular "mind-body" CAM therapy often used for relieving back pain and several small studies have found yoga effective for this condition. This study will assess whether yoga is effective for treating chronic low back pain compared with self care and exercise and will explore the mechanisms responsible for any observed benefits. Methods/Design A total of 210 participants with low back pain lasting at least 3 months will be recruited from primary care clinics of a large healthcare system based in Seattle. They will be randomized in a 2:2:1 ratio to receive 12 weekly yoga classes, 12 weekly conventional therapeutic exercise classes of comparable physical exertion, or a self-care book. Interviewers masked to participants' treatment group will assess outcomes at baseline and 6, 12 and 26 weeks after randomization. Primary outcomes will be back-related dysfunction and symptom bothersomeness. In addition, data will be collected on physical measurements (e.g., flexion) at baseline and 12 weeks and saliva samples will be obtained at baseline, 6 and 12 weeks. Information will be collected on specific physical, psychological, and physiological factors to allow exploration of possible mechanisms of action through which yoga could relieve back pain and dysfunction. The effectiveness of yoga will be assessed using analysis of covariance (using general estimating equations - GEE) within an intention-to-treat context. If yoga is found effective, further analyses will explore whether yoga's benefits are attributable to physical, psychological and/or physiological factors. Conclusions This study will provide the clearest evidence to date about the value of yoga as a therapeutic option for treating chronic back pain, and if the results are positive, will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study. Trial registration This trial is registered in ClinicalTrials.gov, with the ID number of NCT00447668. PMID:20356395

The association between physical activity and neck and low back pain: a systematic review.

PubMed

Sitthipornvorakul, Ekalak; Janwantanakul, Prawit; Purepong, Nithima; Pensri, Praneet; van der Beek, Allard J

2011-05-01

The effect of physical activity on neck and low back pain is still controversial. No systematic review has been conducted on the association between daily physical activity and neck and low back pain. The objective of this study was to evaluate the association between physical activity and the incidence/prevalence of neck and low back pain. Publications were systematically searched from 1980 to June 2009 in several databases. The following key words were used: neck pain, back pain, physical activity, leisure time activity, daily activity, everyday activity, lifestyle activity, sedentary, and physical inactivity. A hand search of relevant journals was also carried out. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. Seventeen studies were included in this review, of which 13 were rated as high-quality studies. Of high-quality studies, there was limited evidence for no association between physical activity and neck pain in workers and strong evidence for no association in school children. Conflicting evidence was found for the association between physical activity and low back pain in both general population and school children. Literature with respect to the effect of physical activity on neck and low back pain was too heterogeneous and more research is needed before any final conclusion can be reached.

Effects of a wearable type lumbosacral support for low back pain among hospital workers: A randomized controlled trial.

PubMed

Hagiwara, Yoshihiro; Yabe, Yutaka; Yamada, Hiroyuki; Watanabe, Takashi; Kanazawa, Kenji; Koide, Masashi; Sekiguchi, Takuya; Hatano, Hirokazu; Itoi, Eiji

2017-03-28

To examine the effects of a new wearable type of lumbosacral support on low back pain. A total of 121 healthcare workers participated in this study. They were randomly allocated into the experimental and control groups and the former wore the support with signals of compression on the back by poor posture for the first 3 months. The control group remained on a waiting list for the first 3 months. Medical history, musculoskeletal symptoms, feeling in good posture, sleep habits, psychological distress, Roland-Morris Disability Questionnaire, and Somatosensory Amplification Scale (SSAS) were evaluated. The range of motion (ROM) in the shoulder and hip joints as well as spinal alignment were evaluated. Our primary concern was the difference in the change of low back pain measured by visual analog scale (VAS) between the two groups. A total of 54 participants in the experimental and 53 participants in the control groups were analyzed. VAS and SSAS scores as well as lumbar spinal ROM in the experimental group significantly decreased. Low back pain (OR=0.401, 95% CI=0.168-0.954) and neck pain in the experimental group (OR=0.198, 95% CI=0.052-0.748) significantly decreased. The new lumbar support reduced VAS and SSAS scores, lumbar spinal ROM, low back pain, and neck pain. This new type of lumbar support reduced low back pain among healthcare workers.

An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial.

PubMed

Shnayderman, Ilana; Katz-Leurer, Michal

2013-03-01

To assess the effect of aerobic walking training as compared to active training, which includes muscle strengthening, on functional abilities among patients with chronic low back pain. Randomized controlled clinical trial with blind assessors. Outpatient clinic. Fifty-two sedentary patients, aged 18-65 years with chronic low back pain. Patients who were post surgery, post trauma, with cardiovascular problems, and with oncological disease were excluded. Experimental 'walking' group: moderate intense treadmill walking; control 'exercise' group: specific low back exercise; both, twice a week for six weeks. Six-minute walking test, Fear-Avoidance Belief Questionnaire, back and abdomen muscle endurance tests, Oswestry Disability Questionnaire, Low Back Pain Functional Scale (LBPFS). Significant improvements were noted in all outcome measures in both groups with non-significant difference between groups. The mean distance in metres covered during 6 minutes increased by 70.7 (95% confidence interval (CI) 12.3-127.7) in the 'walking' group and by 43.8 (95% CI 19.6-68.0) in the 'exercise' group. The trunk flexor endurance test showed significant improvement in both groups, increasing by 0.6 (95% CI 0.0-1.1) in the 'walking' group and by 1.1 (95% CI 0.3-1.8) in the 'exercise' group. A six-week walk training programme was as effective as six weeks of specific strengthening exercises programme for the low back.

Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial.

PubMed

Miyamoto, Gisela Cristiane; Moura, Katherinne Ferro; Franco, Yuri Rafael dos Santos; Oliveira, Naiane Teixeira Bastos de; Amaral, Diego Diulgeroglo Vicco; Branco, Amanda Nery Castelo; Silva, Maria Liliane da; Lin, Christine; Cabral, Cristina Maria Nunes

2016-03-01

The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness. The aim of this study will be to investigate the effectiveness and cost-effectiveness of the Pilates method with different weekly frequencies in the treatment of patients with nonspecific low back pain. This is a randomized controlled trial with blinded assessor. This study will be conducted at a physical therapy clinic in São Paulo, Brazil. Two hundred ninety-six patients with nonspecific low back pain between the ages of 18 and 80 years will be assessed and randomly allocated to 4 groups (n=74 patients per group). All groups will receive an educational booklet. The booklet group will not receive additional exercises. Pilates group 1 will follow a Pilates-based program once a week, Pilates group 2 will follow the same program twice a week, and Pilates group 3 will follow the same program 3 times a week. The intervention will last 6 weeks. A blinded assessor will evaluate pain, quality-adjusted life-years, general and specific disability, kinesiophobia, pain catastrophizing, and global perceived effect 6 weeks, 6 months, and 12 months after randomization. Therapists and patients will not be blinded. This will be the first study to investigate different weekly frequencies of treatment sessions for nonspecific low back pain. The results of this study will contribute to a better definition of treatment programs for this population. © 2016 American Physical Therapy Association.

Carbon Back Sputter Modeling for Hall Thruster Testing

NASA Technical Reports Server (NTRS)

Gilland, James H.; Williams, George J.; Burt, Jonathan M.; Yim, John Tamin

2016-01-01

Lifetime requirements for electric propulsion devices, including Hall Effect thrusters, are continually increasing, driven in part by NASA's inclusion of this technology in it's exploration architecture. NASA will demonstrate high-power electric propulsion system on the Solar Electric Propulsion Technology Demonstration Mission (SEP TDM). The Asteroid Redirect Robotic mission is one candidate SEP TDM, which is projected to require tens of thousands of thruster life. As thruster life is increased, for example through the use of improved magnetic field designs, the relative influence of facility effects increases. One such effect is the sputtering and redeposition, or back sputter, of facility materials by the high energy thruster plumes. In support of wear testing for the Hall Effect Rocket with Magnetic Shielding (HERMeS) project, the back sputter from a Hall effect thruster plume has been modeled for the NASA Glenn Research Center's Vacuum Facility 5. The predicted wear at a near-worst case condition of 600 V, 12.5 kW was found to be on the order of 1 micron/kh in a fully carbon-lined chamber. A more detailed numerical Monte Carlo code was also modified to estimate back sputter for a detailed facility and pumping configuration. This code demonstrated similar back sputter rate distributions, but is not yet accurately modeling the magnitudes. The modeling has been benchmarked to recent HERMeS wear testing, using multiple microbalance measurements. These recent measurements have yielded values on the order of 1.5 - 2 micron/kh at 600 V and 12.5 kW.

Conservative care with or without manipulative therapy in the management of back and neck pain in Danish children aged 9-15. Study protocol for a randomized controlled trial.

PubMed

Dissing, Kristina Boe; Hartvigsen, Jan; Wedderkopp, Niels; Hestbæk, Lise

2016-01-01

Complaints in the musculoskeletal system often start early in life and back and neck pain in children are well-established predictors for similar problems in adulthood. Despite lack of evidence of effectiveness, manipulative therapy is one of the most commonly used treatment modalities for back and neck pain in children. The primary objective of this study is to evaluate the effectiveness of manipulative therapy when added to an approach consisting of manual soft tissue treatment, exercises and advice as needed, in children aged 9-15 complaining of back and neck pain. The project is nested in the Childhood Health, Activity and Motor Performance School Study, which includes around 1200 children aged 9-15, who were all invited to participate in this randomized controlled trial in case they experienced back and/or neck pain during the two year inclusion period. Parents received text messages (SMS) on a weekly basis inquiring about the child's musculoskeletal pain. If pain was reported, the child was evaluated for inclusion into the trial and, if eligible, randomized into one of two intervention groups:Pragmatic advice, manual soft tissue treatment and exercisesThe above plus manipulative therapy By the end of data collection 237 children were included in the study. The primary outcome measure is number of recurrences of back and neck pain during the follow-up period (3-27 months). Secondary outcome measures are average duration of complaint time for each episode, total duration of complaint time, global perceived effect after two weeks, and change in pain intensity after 2 weeks. Baseline information includes quality of life, expectations to treatment, expectations to future course, age, gender, social class and physical education at school. For most common non-traumatic musculoskeletal complaints no standardized and evidence based treatment strategy exists. We want to evaluate the effectiveness of manipulative therapy in addition to an approach consisting of manual soft tissue treatment, exercises and advice as needed, in children aged 9-15 complaining of back and neck pain. To our knowledge this is the first large scale randomized controlled trial investigating the effectiveness of commonly used treatments for back and neck pain in children. ClinicalTrials NCT01504698.

Chiropractic care for back pain

MedlinePlus

... this page: //medlineplus.gov/ency/patientinstructions/000416.htm Chiropractic care for back pain To use the sharing ... discussed in your first session. What Conditions Does Chiropractic Treat Best? Chiropractic treatment is most effective for: ...

Physical activity associate low back pain and intervention program: Review

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

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

PubMed

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

2007-12-01

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

Managing chronic back pain: impact of an interdisciplinary team approach.

PubMed

Flavell, H A; Carrafa, G P; Thomas, C H; Disler, P B

1996-09-02

To evaluate the effectiveness of a six-week outpatient program in pain management for patients with chronic back pain. Retrospective review. Rehabilitation Clinical Business Unit, Essendon campus of the Royal Melbourne Hospital. 138 consecutive patients who participated in the unit's Chronic Back Pain Programme between 1991 and 1993. Multidisciplinary program that promoted pain management rather than "cure", with two six-hour group sessions per week for six weeks. Patient assessments before the program and at program completion and at three months' follow-up, with the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) and a four-minute walk test. At program completion, the WHYMPI showed significant decreases in the amount pain interfered with life and significant increases in patient sense of control and activity level. However, severity of pain remained the same. All these effects were maintained three months later. A brief outpatient program was effective in improving pain management in a group of chronic back pain sufferers. This seems a useful and relatively inexpensive option in managing this problematic group of patients.

Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?

PubMed

Shaw, William S; Linton, Steven J; Pransky, Glenn

2006-12-01

To assess, from the review literature, the extent to which effective strategies for reducing work absence after acute low back pain (LBP) match empirical risk factors. From 17 recent review articles (2000-2005), disability risk factors and interventions were cross-tabulated to assess levels of relative concordance. Potentially modifiable risk factors included 23 variables describing 3 workplace and 3 personal domains. Effective interventions included 25 strategies that were personal (physical or behavioral), engineering, or administrative in nature. There was a strong risk factor concordance for workplace technical and organizational interventions, graded activity exposure, and cognitive restructuring of pain beliefs. There was less risk factor concordance for exercise, back education, and RTW coordination. Few interventions focused on relieving emotional distress or improving job dissatisfaction, two well-supported risk factors. Gaps between the epidemiological and intervention research of back disability prevention could be reduced by testing mediators of intervention effects or by stratifying outcomes according to pre-intervention risk factors.

The Effect of Topical Rosa damascena (Rose) Oil on Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.

PubMed

Shirazi, Mahbobeh; Mohebitabar, Safieh; Bioos, Sodabeh; Yekaninejad, Mir Saeed; Rahimi, Roja; Shahpiri, Zahra; Malekshahi, Farhad; Nejatbakhsh, Fatemeh

2017-01-01

The study aimed to assess the efficacy of topical rose oil in women with pregnancy-related low back pain. A randomized controlled clinical trial was conducted on 120 women with pregnancy-related low back pain. Patients were allocated to 3 parallel groups to receive topical rose oil (in the carrier of almond oil), placebo (carrier oil), or no intervention. All groups were followed for 4 weeks. All participants were evaluated by Visual Analog Scale and the Roland-Morris Disability Questionnaires to assess the pain intensity and its impact on daily activities before and after the intervention. Significant decrease in pain intensity compared to carrier oil or no intervention was observed. The rose oil also improves the functional ability of these patients in contrast with no intervention, while its effect on function is not significant compared to carrier oil. Rose oil reduced pregnancy-related low back pain intensity without any significant adverse effect. © The Author(s) 2016.

The association between static pelvic asymmetry and low back pain.

PubMed

Levangie, P K

1999-06-15

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

Effectiveness of Back School program versus hydrotherapy in elderly patients with chronic non-specific low back pain: a randomized clinical trial.

PubMed

Costantino, Cosimo; Romiti, Davide

2014-06-24

Chronic low back pain (CLBP) is a major cause of disability, for which clinical practice guidelines suggest exercise programs, such as Back School program (stretching and selective muscle reinforcement techniques) and Hydrotherapy technique, as an effective treatment to reduce pain intensity and disability. We enrolled 56 elderly individuals, affected by non-specific CLBP, whose pain had worsened in the last three months, which were randomly allocated to Back School (group A) or to Hydrotherapy program (group B). Each group underwent two one-hour-treatment sessions per week, over a 12-week period. Each patient was evaluated using the Roland Morris Disability Questionnaire (RMDQ) and the 36-Item Short Form Health Survey (SF-36) V2.0 at the beginning (T0), at the end of treatment (T1) and at the 3-month follow-up (T2). At T1 and T2 we observed a highly significant statistical difference in the values measured  in both groups: at T1 in group A RMDQ improvement of 3.26±1.02 (p<0.001) and SF-36 of 13.30±1.44 (p<0.001); in group B RMDQ improvement of 4.96±0.71 (p<0.001) and SF-36 of 14.19±1.98 (p<0.001). We have also evaluated the difference in effectiveness of the two programs and no significant statistical differences were found between the two groups. Back School program and Hydrotherapy could be valid treatment options in the rehabilitation of non-specific CLBP in elderly people. Both therapies proved to be effective and can be used in association with other rehabilitation programs. We believe that Back School program should be favored for its simplicity and the small number of resources required. 

Mini-intervention for subacute low back pain: a randomized controlled trial.

PubMed

Karjalainen, Kaija; Malmivaara, Antti; Pohjolainen, Timo; Hurri, Heikki; Mutanen, Pertti; Rissanen, Pekka; Pahkajärvi, Helena; Levon, Heikki; Karpoff, Hanna; Roine, Risto

2003-03-15

Randomized controlled trial. To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain. There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain. A total of 164 patients with subacute low back pain were randomized to a mini-intervention group (A), a work site visit group (B), or a usual care group (C). Groups A (n = 56) and B (n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls (n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups. During follow-up, fewer subjects had daily pain in Groups A and B than in Group C (Group A Group C, = 0.002; Group B Group C, = 0.030). In Group A, pain was less bothersome (Group A Group C, = 0.032) and interfered less with daily life (Group A Group C, = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C (Group A Group C, = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group. Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.

Effect of Back Massage Intervention on Anxiety, Comfort, and Physiologic Responses in Patients with Congestive Heart Failure

PubMed Central

Chen, Wei-Ling; Liu, Gin-Jen; Chiang, Ming-Chu; Fu, Mao-Young; Hsieh, Yuan-Kai

2013-01-01

Abstract Background Patients suffering from congestive heart failure (CHF) frequently feel physical suffering and anxiety. Objectives The researchers investigated whether back massage could reduce anxiety, discomfort, and physical suffering in patients with CHF. The effects of gender and severity-dependent response of back massage on anxiety and discomfort in patients were also analyzed. Design The study used a quasi-experimental design with one group pretest and posttest. Participants Sixty-four participants were recruited in southern Taiwan. Outcome measures The modified State Anxiety Inventory, the discomfort Visual Analogue Scale, electronic blood pressure (BP) gauges, stethoscopes and the pulse oximetry were used in this study. Results The participants' systolic BP (F (3, 189)=18.91, p<0.01), diastolic BP (F (3, 189)=13.40, p<0.01), heart rate (F (3, 189)=26.28, p<0.01), and respiratory rates (F (3, 189)=5.77, p<0.01) were significantly decreased after back massage. Oxygen saturation levels showed significant increases (F (3, 189)=42.82, p<0.01). Male participants revealed a more significant reduction in anxiety than the female participants (F (1, 50)=7.27, p=0.01). Those with more severe heart failure and greater levels of anxiety (F (2, 61)=4.31, p=0.02) and systolic BP (F (2, 61)=3.86, p=0.03) demonstrated significantly greater responses to back massage. Conclusions Back massage significantly reduced anxiety in the study population. Systolic BP decreased to a greater degree in the male participants, particularly in those with severe heart failure and greater levels of anxiety and higher systolic BP. This study was conducted without a control group. Randomized clinical trials are needed to validate the effectiveness of back massage on patients with CHF. PMID:23186129

Effect of back massage intervention on anxiety, comfort, and physiologic responses in patients with congestive heart failure.

PubMed

Chen, Wei-Ling; Liu, Gin-Jen; Yeh, Shu-Hui; Chiang, Ming-Chu; Fu, Mao-Young; Hsieh, Yuan-Kai

2013-05-01

Patients suffering from congestive heart failure (CHF) frequently feel physical suffering and anxiety. The researchers investigated whether back massage could reduce anxiety, discomfort, and physical suffering in patients with CHF. The effects of gender and severity-dependent response of back massage on anxiety and discomfort in patients were also analyzed. The study used a quasi-experimental design with one group pretest and posttest. Sixty-four participants were recruited in southern Taiwan. The modified State Anxiety Inventory, the discomfort Visual Analogue Scale, electronic blood pressure (BP) gauges, stethoscopes and the pulse oximetry were used in this study. The participants' systolic BP (F (3, 189)=18.91, p<0.01), diastolic BP (F (3, 189)=13.40, p<0.01), heart rate (F (3, 189)=26.28, p<0.01), and respiratory rates (F (3, 189)=5.77, p<0.01) were significantly decreased after back massage. Oxygen saturation levels showed significant increases (F (3, 189)=42.82, p<0.01). Male participants revealed a more significant reduction in anxiety than the female participants (F (1, 50)=7.27, p=0.01). Those with more severe heart failure and greater levels of anxiety (F (2, 61)=4.31, p=0.02) and systolic BP (F (2, 61)=3.86, p=0.03) demonstrated significantly greater responses to back massage. Back massage significantly reduced anxiety in the study population. Systolic BP decreased to a greater degree in the male participants, particularly in those with severe heart failure and greater levels of anxiety and higher systolic BP. This study was conducted without a control group. Randomized clinical trials are needed to validate the effectiveness of back massage on patients with CHF.

Effect of single-dose imipramine on chronic low-back and experimental pain. A randomized controlled trial

PubMed Central

Siegenthaler, Andreas; Bütikofer, Lukas; Limacher, Andreas; Juni, Peter; Vuilleumier, Pascal H.; Stamer, Ulrike; Arendt-Nielsen, Lars; Curatolo, Michele

2018-01-01

Antidepressants are frequently prescribed as co-analgesics in chronic pain. While their efficacy is well documented for neuropathic pain, the evidence is less clear in musculoskeletal pain conditions. The present study therefore evaluated the effect of the tricyclic antidepressant imipramine on chronic low-back pain in a randomized, double-blinded placebo-controlled design. To explore the mechanisms of action and the influence of drug metabolism, multimodal quantitative sensory tests (QST) and genotyping for cytochrome P450 2D6 (CYP2D6) were additionally performed. A single oral dose of imipramine 75 mg was compared to active placebo (tolterodine 1 mg) in 50 patients (32 females) with chronic non-specific low-back pain. Intensity of low-back pain was assessed on a 0–10 numeric rating scale at baseline and every 30 minutes after drug intake. Multimodal QST were performed at baseline and in hourly intervals for 2 hours. Pharmacogenetic influences of cytochrome P450 were addressed by CYP2D6 genotyping. No significant analgesic effect was detected neither on low-back pain nor on any of the sensory tests in the overall analyses. However, evidence for an interaction of the imipramine effect and CYP2D6 genotype was found for electrical and for pressure pain detection thresholds. Intermediate but not extensive metabolizers had a 1.20 times greater electrical pain threshold (95%-CI 1.10 to 1.31) and a 1.10 times greater pressure pain threshold (95%-CI 1.01 to 1.21) 60 minutes after imipramine than after placebo (p<0.001 and p = 0.034, respectively). The present study failed to demonstrate an immediate analgesic effect of imipramine on low-back pain. Anti-nociceptive effects as assessed by quantitative sensory tests may depend on CYP2D6 genotype, indicating that metabolizer status should be accounted for when future studies with tricyclic antidepressants are undertaken. PMID:29742109

High-level physical activity in childhood seems to protect against low back pain in early adolescence.

PubMed

Wedderkopp, N; Kjaer, P; Hestbaek, L; Korsholm, L; Leboeuf-Yde, C

2009-02-01

The evidence on the impact of physical activity on back pain in children and adolescents has been contradicting. It has also been shown that the physical activity cannot accurately be estimated in children using questionnaires. The aim of this study was to establish if physical activity in childhood had any impact on back pain reporting in early adolescence (3 years later), using an objective instrumental measurement of physical activity. Prospective cohort study. Representative random sample of Danish children from the city of Odense sampled at age 9 years and followed-up at age 12 years. The 1-month period prevalence of back pain (neck pain, mid back pain, and low back pain) was established using a structured interview. Physical activity was assessed with the MTI-accelerometer. The accelerometer provides a minute-by-minute measure of the physical activity performed. An overall measure of physical activity and time spent in high activity were studied in relation to back pain using logistic regression. The analyses were performed on the total sample and then stratified on back pain (yes/no) at baseline. High physical activity (HPA) levels seem to protect against future low back pain and appear to actually "treat" and reduce the odds of future mid back pain. When comparing the least active children to the most active children, the least active had a multivariate odds ratio of 3.3 of getting low back pain and 2.7 of getting mid back pain 3 years later. When stratified on back pain at baseline, this effect on mid back pain was especially noticeable in children who had had mid back pain already at baseline, with an odds ratio of 7.2. HPA in childhood seems to protect against low back pain and mid back pain in early adolescence. Larger prospective studies with repetitive follow-ups and preferably intervention studies should be performed, to see if these findings can be reproduced.

One-shot percutaneous electrical nerve stimulation vs. transcutaneous electrical nerve stimulation for low back pain: comparison of therapeutic effects.

PubMed

Hsieh, Ru-Lan; Lee, Wen-Chung

2002-11-01

To investigate the therapeutic effects of one shot of low-frequency percutaneous electrical nerve stimulation one shot of transcutaneous electrical nerve stimulation in patients with low back pain. In total, 133 low back pain patients were recruited for this randomized, control study. Group 1 patients received medication only. Group 2 patients received medication plus one shot of percutaneous electrical nerve stimulation. Group 3 patients received medication plus one shot of transcutaneous electrical nerve stimulation. Therapeutic effects were measured using a visual analog scale, body surface score, pain pressure threshold, and the Quebec Back Pain Disability Scale. Immediately after one-shot treatment, the visual analog scale improved 1.53 units and the body surface score improved 3.06 units in the percutaneous electrical nerve stimulation group. In the transcutaneous electrical nerve stimulation group, the visual analog scale improved 1.50 units and the body surface score improved 3.98 units. The improvements did not differ between the two groups. There were no differences in improvement at 3 days or 1 wk after the treatment among the three groups. Simple one-shot treatment with percutaneous electrical nerve stimulation or transcutaneous electrical nerve stimulation provided immediate pain relief for low back pain patients. One-shot transcutaneous electrical nerve stimulation treatment is recommended due to the rarity of side effects and its convenient application.

Using quality indicators in anaesthesia: feeding back data to improve care.

PubMed

Benn, J; Arnold, G; Wei, I; Riley, C; Aleva, F

2012-07-01

After recent UK policy developments, considerable attention has been focused upon how clinical specialties measure and report on the quality of care delivered to patients. Defining the right indicators alone is insufficient to close the feedback loop. This narrative review aims to describe and synthesize a diverse body of research relevant to the question of how information from quality indicators can be fed back and used effectively to improve care. Anaesthesia poses certain challenges in the identification of valid outcome indicators sensitive to variations in anaesthetic care. Metrics collected during the immediate post-anaesthetic recovery period, such as patient temperature, patient-reported quality of recovery, and pain and nausea, provide potentially useful information for the anaesthetist, yet this information is not routinely fed back. Reviews of the effects of feeding back performance data to healthcare providers suggest that this may result in small to moderate positive effects upon outcomes and professional practice, with stronger effects where feedback is integrated within a broader quality improvement strategy. The dominant model for use of data within quality improvement is based upon the industrial process control approach, in which care processes are monitored continuously for process changes which are rapidly detectable for corrective action. From this review and experience of implementing these principles in practice, effective feedback from quality indicators is timely, credible, confidential, tailored to the recipient, and continuous. Considerable further work is needed to understand how information from quality indicators can be fed back in an effective way to clinicians and clinical units, in order to support revalidation and continuous improvement.

[Roof folding and rotary pushing for the treatment of back to back fractures of distal radius and ulna in children].

PubMed

Xu, Ping; Dong, Xiao-jun; Lu, Zhou-tong; Wang, Gongjun; Zhang, Han-qing; Chen, Xuan-ning; Li, Dong

2015-09-01

To evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back". From January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function. All patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist. Using the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

Carbon Back Sputter Modeling for Hall Thruster Testing

NASA Technical Reports Server (NTRS)

Gilland, James H.; Williams, George J.; Burt, Jonathan M.; Yim, John T.

2016-01-01

In support of wear testing for the Hall Effect Rocket with Magnetic Shielding (HERMeS) program, the back sputter from a Hall effect thruster plume has been modeled for the NASA Glenn Research Centers Vacuum Facility 5. The predicted wear at a near-worst case condition of 600 V, 12.5 kW was found to be on the order of 3 4 mkhour in a fully carbon-lined chamber. A more detailed numerical monte carlo code was also modified to estimate back sputter for a detailed facility and pumping configuration. This code demonstrated similar back sputter rate distributions, but is not yet accurately modeling the magnitudes. The modeling has been benchmarked to recent HERMeS wear testing, using multiple microbalance measurements. These recent measurements have yielded values, on the order of 1.5- 2 microns/khour.

Effects of unstable shoes on chronic low back pain in health professionals: a randomized controlled trial.

PubMed

Armand, Stéphane; Tavcar, Ziva; Turcot, Katia; Allet, Lara; Hoffmeyer, Pierre; Genevay, Stéphane

2014-12-01

The aim of this study was to evaluate the effectiveness of unstable shoes in reducing low back pain in health professionals. Of a volunteer sample of 144 participants, 40 with nonspecific chronic low back pain were eligible and enrolled in this study. Participants were randomized to an intervention group, who wore unstable shoes (model MBT Fora), or a control group, who wore conventional sports shoes (model Adidas Bigroar). The participants had to wear the study shoes during their work hours, and at least 6 hours per workday, over a period of 6 weeks. The primary outcome was low back pain assessed on a Visual Analog Scale. The secondary outcomes were patient satisfaction, disability evaluated using Roland-Morris questionnaire and quality of life evaluated using EQ-VAS. The intervention group showed a significant decrease in pain scores compared to the control group. The rate of satisfaction was higher in the intervention group (79%) compared to the control group (25%). There was no significant difference for the Roland-Morris disability questionnaire score and the EQ-VAS scale. The results of this clinical trial suggest that wearing unstable shoes for 6 weeks significantly decreases low back pain in patients suffering from chronic low back pain but had no significant effect on quality of life and disability scores. Copyright © 2014 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Effectiveness of Back Massage on Sleep Pattern among Patients with Congestive Cardiac Failure.

PubMed

Sable, Amol; Sivabalan, Thangaraj; Shetti, Akshaya Narayan

2017-01-01

Sleep plays an important role in congestive cardiac failure (CCF). Back massage reduces anxiety, discomfort, and physical suffering in CCF patients. Study objective is to assess sleep pattern in CCF patients before and after back massage. A quasi-experimental study was conducted in Pravara Rural hospital, Loni, India over 4 months in 2016. Thirty CCF patients were included in the study with purposive sampling. Nurse investigator performed 20-min back massage thrice daily, 5 min for each step from the day of admission till discharge. In back massage, effleurage, stroking, kneading, and assessment of effectiveness was recorded using the Pittsburg sleep quality index. Thirty CCF patients were included, out of which individuals aged >65, 56-65, and 35-45 years age group were 40%, 24%, and 13%, respectively. Twenty-four had left and 6 had right heart failure. Distribution of mean and standard deviation of pretest for sleep quality was 9.50 (3.14), indicating poor sleep quality. Posttest, the mean score was 4.47 (0.89), indicating good quality sleep. Eleven patients had >8 h of sleep, 15 patients had 6-8 h of sleep, whereas 4 patients had less than 6 h of sleep pretest. Posttest, 22 patients had >8 h and the remaining had 6-8 h of sleep. Back massage technique is safe and cost-effective in CCF patients, by which the quality and duration of sleep is improved. It can be a part of the standard treatment.

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

PubMed

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

2013-11-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-08-01

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

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

PubMed

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

2018-06-08

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

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

PubMed

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

2015-11-12

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

Determination of 2p Excitation Transfer Rate Coefficient in Neon Gas Discharges

NASA Astrophysics Data System (ADS)

Smith, D. J.; Stewart, R. S.

2001-10-01

We will discuss our theoretical modelling and application of an array of four complementary optical diagnostic techniques for low-temperature plasmas. These are cw laser collisionally-induced fluorescence (LCIF), cw optogalvanic effect (OGE), optical emission spectroscopy (OES) and optical absorption spectroscopy (OAS). We will briefly present an overview of our investigation of neon positive column plasmas for reduced axial electric fields ranging from 3x10-17 Vcm2 to 2x10-16 Vcm2 (3-20 Td), detailing our determination of five sets of important collisional rate coefficients involving the fifteen lowest levels, the 1S0 ground state and the 1s and 2p excited states (in Paschen notation), hence information on several energy regions of the electron distribution function (EDF). The discussion will be extended to show the new results obtained from analysis of the argon positive column over similar reduced fields. Future work includes application of our multi-diagnostic technique to more complex systems, including the addition of molecules for EDF determination. array of four complementary optical diagnostic techniques OGE LCIF determination of five sets of important collisional rate coefficients

Energy Transport Effects in Flaring Atmospheres Heated by Mixed Particle Beams

NASA Astrophysics Data System (ADS)

Zharkova, Valentina; Zharkov, Sergei; Macrae, Connor; Druett, Malcolm; Scullion, Eamon

2016-07-01

We investigate energy and particle transport in the whole flaring atmosphere from the corona to the photosphere and interior for the flaring events on the 1st July 2012, 6 and 7 September 2011 by using the RHESSI and SDO instruments as well as high-resolution observations from the Swedish 1-metre Solar Telescope (SST3) CRISP4 (CRisp Imaging Spectro-polarimeter). The observations include hard and soft X-ray emission, chromospheric emission in both H-alpha 656.3 nm core and continuum, as well as, in the near infra-red triplet Ca II 854.2 nm core and continuum channels and local helioseismic responses (sunquakes). The observations are compared with the simulations of hard X-ray emission and tested by hydrodynamic simulations of flaring atmospheres of the Sun heated by mixed particle beams. The temperature, density and macro-velocity variations of the ambient atmospheres are calculated for heating by mixed beams and the seismic response of the solar interior to generation of supersonic shocks moving into the solar interior. We investigate the termination depths of these shocks beneath the quiet photosphere levels and compare them with the parameters of seismic responses in the interior, or sunquakes (Zharkova and Zharkov, 2015). We also present an investigation of radiative conditions modelled in a full non-LTE approach for hydrogen during flare onsets with particular focus on Balmer and Paschen emission in the visible, near UV and near IR ranges and compare them with observations. The links between different observational features derived from HXR, optical and seismic emission are interpreted by different particle transport models that will allow independent evaluation of the particle transport scenarios.

IS THE POST-AGB STAR SAO 40039 MILDLY HYDROGEN-DEFICIENT?

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

Rao, S. Sumangala; Pandey, Gajendra; Giridhar, Sunetra

2011-08-10

We have conducted an LTE abundance analysis for SAO 40039, a warm post-AGB star whose spectrum is known to show surprisingly strong He I lines for its effective temperature and has been suspected of being H-deficient and He-rich. High-resolution optical spectra are analyzed using a family of model atmospheres with different He/H ratios. Atmospheric parameters are estimated from the ionization equilibrium set by neutral and singly ionized species of Fe and Mg, the excitation of Fe I and Fe II lines, and the wings of the Paschen lines. On the assumption that the He I lines are of photospheric andmore » not chromospheric origin, a He/H ratio of approximately unity is found by imposing the condition that the adopted He/H ratio of the model atmosphere must equal the ratio derived from the observed He I triplet lines at 5876, 4471, and 4713 A, and singlet lines at 4922 and 5015 A. Using the model with the best-fitting atmospheric parameters for this He/H ratio, SAO 40039 is confirmed to exhibit mild dust-gas depletion, i.e., the star has an atmosphere deficient in elements of high condensation temperature. The star appears to be moderately metal-deficient with [Fe/H] = -0.4 dex. But the star's intrinsic metallicity as estimated from Na, S, and Zn, elements of a low condensation temperature, is [Fe/H]{sub o} {approx_equal} -0.2 ([Fe/H]{sub o} refers to the star's intrinsic metallicity). The star is enriched in N and perhaps O as well, changes reflecting the star's AGB past and the event that led to He enrichment.« less

A Theoretical Investigation of Optical Emission in Solar Flares

NASA Astrophysics Data System (ADS)

Abbett, William Paul

A dynamic theoretical model of a flare loop from its footpoints in the photosphere to its apex in the corona is presented, and the effects of non-thermal heating of the lower atmosphere by accelerated electrons and soft X-ray irradiation from the flare heated transition region and corona are investigated. Important transitions of hydrogen, helium, and singly ionized calcium and magnesium are treated in non-LTE. Three main conclusions are drawn from the models. First, even the strongest of impulsive events can be described as having two phases: a gentle phase characterized by a state of near equilibrium, and an explosive phase characterized by large material flows, and strong hydrodynamic waves and shocks. During the gentle phase, one or possibly two temperature 'plateaus' form in the upper chromosphere. The line emission generated in these regions produces profiles that are generally symmetric and undistorted, in contrast to emission produced during the explosive phase, where large velocity gradients that occur in the upper atmosphere produce line profiles that are highly asymmetric and show large emission peaks and troughs. Second, a significant continuum (or 'white light') brightening results from increased hydrogen recombination radiation in the upper chromosphere at the point where the accelerated electrons deposit the bulk of their energy. Third, there exists a measurable time lag between the brightening of the near wings of Hα and the brightening of the Paschen continuum. This delay is controlled by the amount of time it takes for electron densities in the upper chromosphere to become high enough, and the densities of hydrogen atoms in high energy bound states to become low enough, to allow the number of recombinations to dominate the number of photoionizations in the region.

The SMC B-type supergiant AzV322: a g-mode pulsator with a circumstellar disc

NASA Astrophysics Data System (ADS)

Mennickent, R. E.; Kołaczkowski, Z.; Soszyński, I.; Cabezas, M.; Garrido, H. E.

2018-01-01

We present a photometric and spectroscopic study of AzV322, an emission line object located in the Small Magellanic Cloud previously classified between O9 and B0. We analyse 17.5 yr of I- and V-band OGLE-II, -III and -IV light curves and find four significant frequencies, viz. f1 = 0.386 549 ± 0.000 003, f2 = 0.101 177 ± 0.000 005, f3 = 0.487 726 ± 0.000 015 and f4 = 0.874 302 ± 0.000 020 cycles d-1 . The f1 frequency (period 2.587 00 ± 0.000 02 d) provides the stronger periodogram peak and gives a single wave light curve of full amplitude 0.066 mag in the I band. High-resolution optical spectroscopy confirms the early B-type spectral type and reveals prominent double peak Balmer, Paschen, O I 8446 and He I 5875 emissions. The spectral energy distribution shows significant colour excess towards long wavelengths possibly attributed to free-free emission in a disc -like envelope. Our analysis yields Teff = 23 000 ± 1500 K, log g = 3.0 ± 0.5, M = 16 ± 1 M⊙, R = 31.0 ± 1.1 R⊙ and Lbol = 104.87 ± 0.06 L⊙. AzV322 might be a member of the new class of slowly pulsating B supergiants introduced by Saio et al. and documented by Lefever, Puls & Aerts; however its circumstellar disc makes it an hither to unique object. Furthermore, we notice that an O-C analysis for f1 reveals quasi-cyclic changes for the times of maximum in a time-scale of 20 yr, which might indicate a light-travel time effect in a very wide orbit binary with an undetected stellar component.

A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain.

PubMed

Deyo, R A; Walsh, N E; Martin, D C; Schoenfeld, L S; Ramamurthy, S

1990-06-07

A number of treatments are widely prescribed for chronic back pain, but few have been rigorously evaluated. We examined the effectiveness of transcutaneous electrical nerve stimulation (TENS), a program of stretching exercises, or a combination of both for low back pain. Patients with chronic low back pain (median duration, 4.1 years) were randomly assigned to receive daily treatment with TENS (n = 36), sham TENS (n = 36), TENS plus a program of exercises (n = 37), or sham TENS plus exercises (n = 36). After one month no clinically or statistically significant treatment effect of TENS was found on any of 11 indicators of outcome measuring pain, function, and back flexion; there was no interactive effect of TENS with exercise. Overall improvement in pain indicators was 47 percent with TENS and 42 percent with sham TENS (P not significant). The 95 percent confidence intervals for group differences excluded a major clinical benefit of TENS for most outcomes. By contrast, after one month patients in the exercise groups had significant improvement in self-rated pain scores, reduction in the frequency of pain, and greater levels of activity as compared with patients in the groups that did not exercise. The mean reported improvement in pain scores was 52 percent in the exercise groups and 37 percent in the nonexercise groups (P = 0.02). Two months after the active intervention, however, most patients had discontinued the exercises, and the initial improvements were gone. We conclude that for patients with chronic low back pain, treatment with TENS is no more effective than treatment with a placebo, and TENS adds no apparent benefit to that of exercise alone.

Acute Effects of Back Squats on Countermovement Jump Performance Across Multiple Sets of A Contrast Training Protocol in Resistance-Trained Males.

PubMed

Bauer, Pascal; Sansone, Pierpaolo; Mitter, Benedikt; Makivic, Bojan; Seitz, Laurent B; Tschan, Harald

2018-01-03

The present study was designed to evaluate the voluntary post-activation potentiation (PAP) effects of moderate (MI) or high intensity (HI) back squat exercises on countermovement jump (CMJ) performance across multiple sets of a contrast training protocol. Sixty resistance-trained male subjects (age, 23.3 ± 3.3 y; body mass, 86.0 ± 13.9 kg; parallel back squat 1-repetition maximum [1-RM], 155.2 ± 30.0 kg) participated in a randomized, cross-over study. After familiarization, the subjects visited the laboratory on three separate occasions. They performed a contrast PAP protocol comprising three sets of either MI (6×60% of 1-RM) or HI back squats (4x90% of 1-RM) or 20 s of recovery (CTRL) alternated with seven CMJs that were performed at 15 s, and 1, 3, 5, 7, 9 and 11 min after the back squats or recovery. Jump height and relative peak power output recorded with a force platform during MI and HI conditions were compared to those recorded during control condition to calculate the voluntary PAP effect. CMJ performance was decreased immediately after the squats but increased across all three sets of MI and HI between 3 - 7 minutes post-recovery. However, voluntary PAP effects were small or trivial and no difference between the three sets could be found. These findings demonstrate that practitioners can use MI and HI back squats to potentiate CMJs across a contrast training protocol, but a minimum of 3 min of recovery after the squats is needed to benefit from voluntary PAP.

Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial

PubMed Central

2013-01-01

Background Low back pain is a relevant public health problem, being an important cause of work absenteeism worldwide, as well as affecting the quality of life of sufferers and their individual functional performances. Supervised active physical routines and of cognitive-behavioral therapies are recommended for the treatment of chronic Low back pain, although evidence to support the effectiveness of different techniques is missing. Accordingly, the aim of this study is to contrast the effectiveness of two types of exercises, graded activity or supervised, in decreasing symptoms of chronic low back pain. Methods/design Sample will consist of 66 patients, blindly allocated into one of two groups: 1) Graded activity which, based on an operant approach, will use time-contingent methods aiming to increase participants’ activity levels; 2) Supervised exercise, where participants will be trained for strengthening, stretching, and motor control targeting different muscle groups. Interventions will last one hour, and will happen twice a week for 6 weeks. Outcomes (pain, disability, quality of life, global perceived effect, return to work, physical activity, physical capacity, and kinesiophobia) will be assessed at baseline, at treatment end, and three and six months after treatment end. Data collection will be conducted by an investigator blinded to treatment allocation. Discussion This project describes the randomisation method that will be used to compare the effectiveness of two different treatments for chronic low back pain: graded activity and supervised exercises. Since optimal approach for patients with chronic back pain have yet not been defined based on evidence, good quality studies on the subject are necessary. Trial registration NCT01719276 PMID:23336703

Parametric investigation on the effect of nitrogen to reduce SF6 content in spark gap

NASA Astrophysics Data System (ADS)

Raj, Avinash; Khaidir, Nur; Ishak, Sanuri; Ghani, Basri Abdul; Chakrabarty, Chandan; Permal, Navitharshaani; Ahmad, Harizan

2017-03-01

Almost all the MV and HV switchgears used by power utilities for interrupting faults are Sulphur Hexaflouride SF6 gas circuit breakers as this gas has the best dielectric properties to quench the onset of an arc in the event of fault. However due to strong dissociating properties of this gas when in contact with air that can release fluorine into the atmosphere, the Kyoto protocol has mandated to reduce the usage of SF6 in the future. SF6 is a greenhouse gas and it's about 3000 more severe than CO2. And that's the reason for replacing this gas. A close match in the quenching properties to SF6 that is now being intensively researched is nitrogen N2. This gas is considered to be an inert gas, and its release into the atmosphere has no harmful effects (except for asphyxiation - which can be easily handled with awareness). As the need for a replacement of SF6 becomes critical in the near future, the urgency to find the right gas is immediate. Hence the proposed work in this paper is to make a comprehensive parametric investigation of N2 gas in vacuum spark-gap. The spark-gap is chosen due to flexibility in changing the gap distance and easily be housed in vacuum. The parameters to be investigated are pure N2 and N2/ SF6 mix. The settling-time of the electrical break-down voltage and current are measured using voltage probe and Pearson probe. This time is paramount as it determines the speed of breaking the circuit. A faster breaking time ensures the safety of other HV equipment in the circuit. A comparative study between the various parameters will be conducted to obtain the best recipe (gas mix and gap distance) that gives the shortest settling time the breakdown using N2/ SF6/Mixture gas was successfully conducted and a Paschen curve has been established.

A Critical Review of the Effectiveness of "Teach-Back" Technique in Teaching COPD Patients Self-Management Using Respiratory Inhalers

ERIC Educational Resources Information Center

Dantic, Dennis Emralino

2014-01-01

Objective: To examine and discuss the evidence base behind the effectiveness of the "teach-back" technique as an educational intervention for chronic obstructive pulmonary disease (COPD) patient self-management using respiratory inhalers. Design: A systematic literature review Method: A search was conducted through Medline, CINAHL…

WS-BP: An efficient wolf search based back-propagation algorithm

NASA Astrophysics Data System (ADS)

Nawi, Nazri Mohd; Rehman, M. Z.; Khan, Abdullah

2015-05-01

Wolf Search (WS) is a heuristic based optimization algorithm. Inspired by the preying and survival capabilities of the wolves, this algorithm is highly capable to search large spaces in the candidate solutions. This paper investigates the use of WS algorithm in combination with back-propagation neural network (BPNN) algorithm to overcome the local minima problem and to improve convergence in gradient descent. The performance of the proposed Wolf Search based Back-Propagation (WS-BP) algorithm is compared with Artificial Bee Colony Back-Propagation (ABC-BP), Bat Based Back-Propagation (Bat-BP), and conventional BPNN algorithms. Specifically, OR and XOR datasets are used for training the network. The simulation results show that the WS-BP algorithm effectively avoids the local minima and converge to global minima.

The influence of communication and information sources upon decision-making around complementary and alternative medicine use for back pain among Australian women aged 60-65 years.

PubMed

Murthy, Vijayendra; Adams, Jon; Broom, Alex; Kirby, Emma; Refshauge, Kathryn M; Sibbritt, David

2017-01-01

This study examined factors influencing decision-making on complementary and alternative medicine (CAM) use for back pain and back pain sufferers' communication about CAM use. A cross-sectional postal survey was conducted in 2011/2012 as a sub-study of the Australian Longitudinal Study on Women's Health (ALSWH). The sample contained 1620 women from the 1945-1951 cohort of the ALSWH, aged 60-65 years who were eligible for the sub-study, as they had experienced back pain during 12 months prior to the survey. Of these, 1310 (80.9%) returned completed questionnaires. A significant proportion of women consulted a CAM practitioner (76%, n = 1001) and/or had self-prescribed CAM treatment (75%, n = 985). Of the women who used CAM for their back pain, 20% consulted their general practitioner (GP) prior to using CAM and 34% always informed their GP following CAM use. Forty-three per cent of the women were influenced by their doctors, 39% by friends/colleagues, 36% by family/relatives, 33% by their partner, 30% by a CAM practitioner, 20% by a pharmacist, 16% by a book/magazine, 11% by mass media, 10% by an allied health worker and 6% by the Internet. Our results show that information sources used by women for their decision-making on CAM use differed according to the symptoms. While non-professional information sources (e.g. family/relatives) positively influenced women in their decision to use CAM for a range of back pain-related symptoms (e.g. headaches/migraines), doctors and allied health workers (e.g. nurses) negatively influenced women in their decision to consult a CAM practitioner for a range of back pain-related symptoms (e.g. headaches/migraines, neck pain). Women seek information from a wide range of professional and non-professional sources with regard to their decision-making around CAM use for back pain. Back pain care providers need to ensure effective communication with their back pain patients regarding safe, effective and co-ordinated back pain care options. © 2015 John Wiley & Sons Ltd.

Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial.

PubMed

Inani, Sumit B; Selkar, Sohan P

2013-01-01

Low Back Pain (LBP) results in significant level of disability, producing significant restriction on usual activity such as an inability to work. Nearly two third of the adults are affected by non-specific low back pain at some point in their lives. The purpose of the study was to determine the effect of core stabilization exercises in comparison with conventional exercises on pain, functional status in patients with non-specific LBP. Thirty patients diagnosed with non-specific LBP participated with age group between 20-50 years and divided in to 2 groups, one with core stabilization exercises and other conventional exercises, 15 subjects each. Three months study, pre and post treatment outcome measures used were VAS for pain intensity and Modified Oswestry Low Back Pain Disability Index for functional status (disability). Data were analyzed using student 't' test (paired and unpaired). Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (p<0.001) improvements regarding pain and functional status for experimental group compared to control group. Core stabilization exercises were found to be more effective in reducing pain and improving functional status by decreasing disability of patients with non-specific low back pain in comparison with conventional exercises.

Effects of Motor Control Exercise Vs Muscle Stretching Exercise on Reducing Compensatory Lumbopelvic Motions and Low Back Pain: A Randomized Trial.

PubMed

Park, Kyue-Nam; Kwon, Oh-Yun; Yi, Chung-Hwi; Cynn, Heon-Seock; Weon, Jong-Hyuck; Kim, Tae-Ho; Choi, Houng-Sik

2016-10-01

The purpose of this study was to investigate the effectiveness of a 6-week motor control exercise (MCE) vs stretching exercise (SE) on reducing compensatory pelvic motion during active prone knee flexion (APKF) and intensity of low back pain. Thirty-six people in the lumbar-rotation-extension subgroup were randomly assigned equally into 2 exercise groups (18 people in each an MCE or SE group). A 3-dimensional motion-analysis system was used to measure the range and onset time of pelvic motion and knee flexion during APKF. Surface electromyography was used to measure the muscle activity and onset time of the erector spinae and the hamstrings during APKF. The level of subjective low back pain was measured using a visual analog scale. The MCE group had more significant decreases in and delay of anterior pelvic tilt, pelvic rotation, and erector spinae muscle activity during APKF, as well as reduced intensity of low back pain compared with the SE group (P < .05). For rehabilitation in patients in the lumbar-rotation-extension subgroup, MCE was more effective than SE in reducing compensatory pelvic motion and muscle activity during APKF and minimizing low back pain. Copyright © 2016. Published by Elsevier Inc.

The evaluation of team lifting on physical work demands and workload in ironworkers.

PubMed

van der Molen, Henk F; Visser, Steven; Kuijer, P Paul F M; Faber, Gert; Hoozemans, Marco J M; van Dieën, Jaap H; Frings-Dresen, Monique H W

2012-01-01

Lifting and carrying heavy loads occur frequently among ironworkers and result in high prevalence and incidence rates of low back complaints, injuries and work-disability. From a health perspective, little information is available on the effect of team lifting on work demands and workload. Therefore, the objective of this study was to compare the effects of team lifting of maximally 50 kg by two ironworkers (T50) with team lifting of maximally 100 kg by four ironworkers (T100). This study combined a field and laboratory study with the following outcome measures: duration and frequency of tasks and activities, energetic workload, perceived discomfort and maximal compression forces (Fc peak) on the low back. The physical work demands and workload of an individual iron worker during manual handling of rebar materials of 100 kg with four workers did not differ from the manual handling of rebar materials of 50 kg with two workers, with the exception of low back discomfort and Fc peak. The biomechanical workload of the low back exceeded for both T50 and T100 the NIOSH threshold limit of 3400N. Therefore, mechanical transport or other effective design solutions should be considered to reduce the biomechanical workload of the low back and the accompanying health risks among iron workers.

Clinical effectiveness of behavioral signs for screening chronic low-back pain patients in a work-oriented physical rehabilitation program.

PubMed

Werneke, M W; Harris, D E; Lichter, R L

1993-12-01

This prospective study investigated the relationship between behavioral sign scores (from Waddell) and the return to work status of chronic low-back pain patients who completed a work-oriented physical rehabilitation program without formal facility-related psychologic or social services. Further, the authors monitored the effect of this program on changing these scores. The program consisted of physical reconditioning through resistive exercises, flexibility and aerobic training, posture and body mechanics education, and progressive work simulation tasks and activities of daily living. One hundred eighty-three nonworking or partially disabled low-back pain patients with an average duration of 8.7 months' disability were included in the study. The presence of each of eight behavioral signs was tested for on entry and again on completion of the program. Analysis showed a significant drop in behavioral sign scores for patients who successfully returned to work. There was no significant reduction in scores for patients who did not return to work. The results suggest these signs may predict the effectiveness of treating chronic low-back pain patients in a return-to-work physical rehabilitation program. Conversely, screening for behavioral signs may identify low-back pain patients who would benefit from intensive behavioral and psychiatric testing and intervention efforts.

Negativly streched premixed flames

NASA Astrophysics Data System (ADS)

Krikunova, A. I.; Saveliev, A. S.; Son, E. E.

2018-01-01

An experimental study of gravity effect on the blow-off and flash-back borders of the conical methane-air flame (normal and ring-stabilized) was performed. The influence of the preferential diffusion on the flame behavior in vicinity of flash-back boundaries was observed. Under conditions at Lewis number Le > 1, the radius of curvature of the flame tip increased gradually approaching flash-back boundaries while for the lean methane-air flames (Le < 1) the radius decreased abruptly. It was shown that the burning velocity for lean flames is less than that for reach ones, so the flash-back occurs at higher strains.

Effect of electromigration-induced back stress gradient on nanoindentation marker movement in SnAgCu solder joints

NASA Astrophysics Data System (ADS)

Xu, Luhua; Pang, John H. L.; Tu, K. N.

2006-11-01

The electromigration-induced back stress in Pb-free SnAgCu solder was studied by an area array of nanoindentation markers on the cross section of a solder joint. The marker movements driven by combined electron wind force and electromigration-induced back stress gradient were measured at different locations. The back stress gradient was determined from the observation of marker motion using the proposed model. With the applied current density of 104A/cm2 at 125°C, the stress gradient near the anode is 97kPa/μm.

Effects of intermittent flow and irradiance level on back reef Porites corals at elevated seawater temperatures

USGS Publications Warehouse

Smith, L.W.; Birkeland, C.

2007-01-01

Corals inhabiting shallow back reef habitats are often simultaneously exposed to elevated seawater temperatures and high irradiance levels, conditions known to cause coral bleaching. Water flow in many tropical back reef systems is tidally influenced, resulting in semi-diurnal or diurnal flow patterns. Controlled experiments were conducted to test effects of semi-diurnally intermittent water flow on photoinhibition and bleaching of the corals Porites lobata and P. cylindrica kept at elevated seawater temperatures and different irradiance levels. All coral colonies were collected from a shallow back reef pool on Ofu Island, American Samoa. In the high irradiance experiments, photoinhibition and bleaching were less for both species in the intermittent high-low flow treatment than in the constant low flow treatment. In the low irradiance experiments, there were no differences in photoinhibition or bleaching for either species between the flow treatments, despite continuously elevated seawater temperatures. These results suggest that intermittent flow associated with semi-diurnal tides, and low irradiances caused by turbidity or shading, may reduce photoinhibition and bleaching of back reef corals during warming events. ?? 2006 Elsevier B.V. All rights reserved.

The effects of long-term stress on neural dynamics of working memory processing: An investigation using ERP

PubMed Central

Yuan, Yiran; Leung, Ada W. S.; Duan, Hongxia; Zhang, Liang; Zhang, Kan; Wu, Jianhui; Qin, Shaozheng

2016-01-01

This study examined the neural dynamics of working memory (WM) processing under long-term stress. Forty participants who had been exposed to a long period of major exam preparation (six months) and twenty-one control participants performed a numerical n-back task (n = 1, 2) while electroencephalograms were recorded. Psychological and endocrinal measurements confirmed significantly higher levels of long-term stress for participants in the exam group. The exam group showed significantly increased P2 amplitude in the frontal-central sites in the 1-back and 2-back conditions, whereas other ERP components, including the P1, N1 and P3 and behavioral performance, were unchanged. Notably, the P2 effect was most pronounced in participants in the exam group who reported perceiving high levels of stress. The perceived stress scores positively correlated with the P2 amplitude in the 1-back and 2-back conditions. These results suggest that long-term stress has an impact on attention and the initiation of the updating process in WM. PMID:27000528

A research program to reduce interior noise in general aviation airplanes: Noise reduction through a cavity-backed flexible plate

NASA Technical Reports Server (NTRS)

Roskam, J.; Vandam, C. P. G.

1978-01-01

A prediction method is reported for noise reduction through a cavity-backed panel. The analysis takes into account only cavity modes in one direction. The results of this analysis were to find the effect of acoustic stiffness of a backing cavity on the panel behavior. The resulting changes in the noise reduction through the panel are significant.

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.

Gluteus medius coactivation response in field hockey players with and without low back pain.

PubMed

Bussey, Melanie D; Kennedy, James E; Kennedy, Gavin

2016-01-01

To examine the effect of prolonged standing on gluteus medius coactivation and to observe whether the changes in gluteus medius coactivation over time were related to the development of low back pain in elite female field hockey players. Prospective cohort design. Participants were 39 elite female field hockey players (14 with a history of low back pain). Before the prolonged stand, maximal hip abduction strength, side bridge hold endurance and hip abduction range of motion were measured bilaterally. Surface electromyography was collected from the gluteus medius for coactivation analysis during a prolonged stand for 70 min. Low back pain was rated every 10 min on a visual analogue scale. Fourteen of 39 participants developed low back pain. The Time effect was significant for gluteus medius coactivation response (p = 0.003) and visual analogue scale score (p < 0.001). There were no significant group × time interactions. Yet athletes who developed pain had higher coactivation for the majority of the stand task. While female field hockey players have high agonist-antagonist coactivation patterns during prolonged standing, stand task is a useful tool to predict low back pain occurrence in players with and without history of pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

An update of a systematic review of controlled clinical trials on the primary prevention of back pain at the workplace.

PubMed

van Poppel, Mireille N M; Hooftman, Wendela E; Koes, Bart W

2004-08-01

To update the evidence on the effectiveness of lumbar supports, education and exercise in the primary prevention of low back pain at the workplace. A computerized search for controlled clinical trials published between 1997 and 2002 was conducted, and the methodological quality of the studies was assessed using a criteria list. The available evidence was graded with a rating system for the level of evidence. Effect sizes of individual studies were combined if the studies were sufficiently similar. Five new papers were identified for the update. These trials were added to the previously available trials (n = 11). The methodological quality of most studies was low. Since three of four RCTs on lumbar supports reported no effect, there is no evidence for the effectiveness of lumbar supports. No evidence for education could be found either, since all six RCTs showed negative results. The four RCTs on exercise consistently reported a positive effect, indicating limited evidence for the effectiveness of exercise. There is no evidence for the effectiveness of lumbar supports or education in the primary prevention of low back pain at the workplace. There is limited evidence for the efficacy of exercise, and the effect that can be obtained is moderate. There is still a need for methodologically sound studies and studies on the cost-effectiveness of exercise. Also the possible effect of lumbar supports in the treatment of back pain needs further investigation.

Investigation of Back-Projection Uncertainties with M6 Earthquakes

NASA Astrophysics Data System (ADS)

Fan, W.; Shearer, P. M.

2017-12-01

We investigate possible biasing effects of inaccurate timing corrections on teleseismic P-wave back-projection imaging of large earthquake ruptures. These errors occur because empirically-estimated time shifts based on aligning P-wave first arrivals are exact only at the hypocenter and provide approximate corrections for other parts of the rupture. Using the Japan subduction zone as a test region, we analyze 46 M6-7 earthquakes over a ten-year period, including many aftershocks of the 2011 M9 Tohoku earthquake, performing waveform cross-correlation of their initial P-wave arrivals to obtain hypocenter timing corrections to global seismic stations. We then compare back-projection images for each earthquake using its own timing corrections with those obtained using the time corrections for other earthquakes. This provides a measure of how well sub-events can be resolved with back-projection of a large rupture as a function of distance from the hypocenter. Our results show that back-projection is generally very robust and that sub-event location errors average about 20 km across the entire study region ( 700 km). The back-projection coherence loss and location errors do not noticeably converge to zero even when the event pairs are very close (<20 km). This indicates that most of the timing differences are due to 3D structure close to each of the hypocenter regions, which limits the effectiveness of attempts to refine back-projection images using aftershock calibration, at least in this region.

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

PubMed

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

2013-10-15

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

Is back-electron transfer process in Betaine-30 coherent?

NASA Astrophysics Data System (ADS)

Rafiq, Shahnawaz; Scholes, Gregory D.

2017-09-01

The possible role of coherent vibrational motion in ultrafast photo-induced electron transfer remains unclear despite considerable experimental and theoretical advances. We revisited this problem by tracking the back-electron transfer (bET) process in Betaine-30 with broadband pump-probe spectroscopy. Dephasing time constant of certain high-frequency vibrations as a function of solvent shows a trend similar to the ET rates. In the purview of Bixon-Jortner model, high-frequency quantum vibrations bridge the reactant-product energy gap by providing activationless vibronic channels. Such interaction reduces the effective coupling significantly and thereby the coherence effects are eliminated due to energy gap fluctuations, making the back-electron transfer incoherent.

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

PubMed Central

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

2013-01-01

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

Optimal back-to-front airplane boarding.

PubMed

Bachmat, Eitan; Khachaturov, Vassilii; Kuperman, Ran

2013-06-01

The problem of finding an optimal back-to-front airplane boarding policy is explored, using a mathematical model that is related to the 1+1 polynuclear growth model with concave boundary conditions and to causal sets in gravity. We study all airplane configurations and boarding group sizes. Optimal boarding policies for various airplane configurations are presented. Detailed calculations are provided along with simulations that support the main conclusions of the theory. We show that the effectiveness of back-to-front policies undergoes a phase transition when passing from lightly congested airplanes to heavily congested airplanes. The phase transition also affects the nature of the optimal or near-optimal policies. Under what we consider to be realistic conditions, optimal back-to-front policies lead to a modest 8-12% improvement in boarding time over random (no policy) boarding, using two boarding groups. Having more than two groups is not effective.

Percutaneous and Endoscopic Adhesiolysis in Managing Low Back and Lower Extremity Pain: A Systematic Review and Meta-analysis.

PubMed

Helm, Standiford; Racz, Gabor B; Gerdesmeyer, Ludger; Justiz, Rafael; Hayek, Salim M; Kaplan, Eugene D; El Terany, Mohamed Ahamed; Knezevic, Nebojsa Nick

2016-02-01

Chronic refractory low back and lower extremity pain is frustrating to treat. Percutaneous adhesiolysis and spinal endoscopy are techniques which can treat chronic refractory low back and lower extremity pain.Percutaneous adhesiolysis is performed by placing the catheter into the tissue plane at the ventrolateral aspect of the foramen so that medications can be injected. Adhesiolysis is used both for pain caused by scarring which is not resistant to catheter placement and other sources of pain, including inflammation in the absence of scarring.Mechanical lysis of scars with a catheter may or may not be necessary for percutaneous adhesiolysis to be effective. Spinal endoscopy allows direct visualization of the epidural space and has the possibility to use laser energy to treat pathology. A systematic review of the effectiveness of percutaneous adhesiolysis and spinal endoscopic adhesiolysis to treat chronic refractory low back and lower extremity pain. To evaluate and update the effectiveness of percutaneous adhesiolysis and spinal endoscopic adhesiolysis to treat chronic refractory low back and lower extremity pain. The available literature on percutaneous adhesiolysis and spinal endoscopic adhesiolysis in treating persistent low back and leg pain was reviewed. The quality of each article used in this analysis was assessed. The level of evidence was classified on a 5-point scale from strong, based upon multiple randomized controlled trials to weak, based upon consensus, as developed by the U.S. Preventive Services Task Force (USPSTF) and modified by ASIPP. Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2015, and manual searches of the bibliographies of known primary and review articles. Pain relief of at least 50% and functional improvement of at least 40% were the primary outcome measures. Short-term efficacy was defined as improvement of 6 months or less; whereas, long-term efficacy was defined more than 6 months. For this systematic review, 45 studies were identified. Of these, for percutaneous adhesiolysis there were 7 randomized controlled trials and 3 observational studies which met the inclusion criteria. For spinal endoscopy, there was one randomized controlled trial and 3 observational studies. Based upon 7 randomized controlled trials showing efficacy, with no negative trials, there is Level I or strong evidence of the efficacy of percutaneous adhesiolysis in the treatment of chronic refractory low back and lower extremity pain. Based upon one high-quality randomized controlled trial, there is Level II to III evidence supporting the use of spinal endoscopy in treating chronic refractory low back and lower extremity pain. The evidence is Level I or strong that percutaneous adhesiolysis is efficacious in the treatment of chronic refractory low back and lower extremity pain. Percutaneous adhesiolysis may be considered as a first-line treatment for chronic refractory low back and lower extremity pain. The evidence is Level II to III that spinal endoscopy is effective in the treatment of chronic refractory low back and lower extremity pain. Spinal pain, chronic low back pain, post lumbar surgery syndrome, epidural scarring, adhesiolysis, endoscopy, radicular pain.

Streamlining the Evaluation of Low Back Pain in Children

PubMed Central

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

2008-01-01

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

Rehabilitation of Low Back Pain in Golfers

PubMed Central

Finn, Christopher

2013-01-01

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

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

PubMed

Kim, Gye-Woong; Kim, Hack-Youn

2017-01-01

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

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

PubMed Central

2017-01-01

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

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

PubMed

Lonzaga, Joel B

2016-06-01

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

Predictors of pain relief following spinal cord stimulation in chronic back and leg pain and failed back surgery syndrome: a systematic review and meta-regression analysis.

PubMed

Taylor, Rod S; Desai, Mehul J; Rigoard, Philippe; Taylor, Rebecca J

2014-07-01

We sought to assess the extent to which pain relief in chronic back and leg pain (CBLP) following spinal cord stimulation (SCS) is influenced by patient-related factors, including pain location, and technology factors. A number of electronic databases were searched with citation searching of included papers and recent systematic reviews. All study designs were included. The primary outcome was pain relief following SCS, we also sought pain score (pre- and post-SCS). Multiple predictive factors were examined: location of pain, history of back surgery, initial level of pain, litigation/worker's compensation, age, gender, duration of pain, duration of follow-up, publication year, continent of data collection, study design, quality score, method of SCS lead implant, and type of SCS lead. Between-study association in predictive factors and pain relief were assessed by meta-regression. Seventy-four studies (N = 3,025 patients with CBLP) met the inclusion criteria; 63 reported data to allow inclusion in a quantitative analysis. Evidence of substantial statistical heterogeneity (P < 0.0001) in level of pain relief following SCS was noted. The mean level of pain relief across studies was 58% (95% CI: 53% to 64%, random effects) at an average follow-up of 24 months. Multivariable meta-regression analysis showed no predictive patient or technology factors. SCS was effective in reducing pain irrespective of the location of CBLP. This review supports SCS as an effective pain relieving treatment for CBLP with predominant leg pain with or without a prior history of back surgery. Randomized controlled trials need to confirm the effectiveness and cost-effectiveness of SCS in the CLBP population with predominant low back pain. © 2013 The Authors Pain Practice Published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.

Reddening and He i{sup ∗} λ 10830 Absorption Lines in Three Narrow-line Seyfert 1 Galaxies

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

Zhang, Shaohua; Zhou, Hongyan; Shi, Xiheng

We report the detection of heavy reddening and the He i* λ 10830 absorption lines at the active galactic nucleus (AGN) redshift in three narrow-line Seyfert 1 galaxies: SDSS J091848.61+211717.0, SDSS J111354.66+124439.0, and SDSS J122749.13+321458.9. They exhibit very red optical to near-infrared colors, narrow Balmer/Paschen broad emission lines and He i* λ 10830 absorption lines. The ultraviolet-optical-infrared nucleus continua are reddened by the SMC extinction law of E ( B − V ) ∼ 0.74, 1.17, and 1.24 mag for three objects, which are highly consistent with the values obtained from the broad-line Balmer decrements, but larger than those ofmore » narrow emission lines. The reddening analysis suggests that the extinction dust simultaneously obscures the accretion disk, the broad emission-line region, and the hot dust from the inner edge of the torus. It is possible that the dust obscuring the AGN structures is the dusty torus itself. Furthermore, the Cloudy analysis of the He i* λ 10830 absorption lines proposes the distance of the absorption materials to be the extend scale of the torus, which greatly increases probabilities of the obscure and absorption materials being the dusty torus.« less

Analysis of small droplets with a new detector for liquid chromatography based on laser-induced breakdown spectroscopy

NASA Astrophysics Data System (ADS)

Janzen, Christoph; Fleige, Rüdiger; Noll, Reinhard; Schwenke, Heinrich; Lahmann, Wilhelm; Knoth, Joachim; Beaven, Peter; Jantzen, Eckard; Oest, Andreas; Koke, Peter

2005-08-01

The miniaturization of analytical techniques is a general trend in speciation analytics. We have developed a new analytical technique combining high pressure liquid chromatography (HPLC) with laser-induced breakdown spectroscopy (LIBS). This enables a molecule-specific separation followed by an element-specific analysis of smallest amounts of complex samples. The liquid flow coming from a HPLC pump is transformed into a continuous stream of small droplets (diameter 50-100 μm, volume 65-500 pl) using a piezoelectric pulsed nozzle. After the detection of single droplets with a droplet detector, a Q-switched Nd:YAG Laser is triggered to emit a synchronized laser pulse that irradiates a single droplet. The droplets are evaporated and transformed to the plasma state. The spectrum emitted from the plasma is collected by a spherical mirror and directed through the entrance slit of a Paschen-Runge spectrometer equipped with channel photomultipliers. The spectrometer detects 31 elements simultaneously covering a spectral range from 120 to 589 nm. Purging the measurement chamber with argon enables the detection of vacuum-UV lines. Since the sample is transferred to the plasma state without dilution, very low flow rates in the sub-μl/min range can be realised.

Ultra High Voltage Propellant Isolators and Insulators for JIMO Ion Thrusters

NASA Technical Reports Server (NTRS)

Banks, Bruce A.; Gaier, James R.; Hung, Ching-Cheh; Walters, Patty A.; Sechkar, Ed; Panko, Scott; Kamiotis, Christina A.

2004-01-01

Within NASA's Project Prometheus, high specific impulse ion thrusters for electric propulsion of spacecraft for the proposed Jupiter Icy Moon Orbiter (JIMO) mission to three of Jupiter's moons: Callisto, Ganymede and Europa will require high voltage operation to meet mission propulsion. The anticipated approx.6,500 volt net ion energy will require electrical insulation and propellant isolation which must exceed that used successfully by the NASA Solar Electric Propulsion Technology Readiness (NSTAR) Deep Space 1 mission thruster by a factor of approx.6. Xenon propellant isolator prototypes that operate at near one atmosphere and prototypes that operate at low pressures (<100 Torr) have been designed and are being tested for suitability to the JIMO mission requirements. Propellant isolators must be durable to Paschen breakdown, sputter contamination, high temperature, and high voltage while operating for factors longer duration than for the Deep Space 1 Mission. Insulators used to mount the thrusters as well as those needed to support the ion optics have also been designed and are under evaluation. Isolator and insulator concepts, design issues, design guidelines, fabrication considerations and performance issues are presented. The objective of the investigation was to identify candidate isolators and insulators that are sufficiently robust to perform durably and reliably during the proposed JIMO mission.

A Moderate Resolution NIR Spectral Library of Weak-Lined T Tauri Stars

NASA Astrophysics Data System (ADS)

Cooper, Rachel; Covey, K. R.

2013-01-01

We present a spectral library of high-quality moderate resolution (R ~ 3500) NIR spectra for 44 weak-lined T Tauri Stars (WTTS) in the Taurus-Auriga Molecular Cloud. These spectra, obtained with the TripleSpec spectrograph on the Astrophysical Research Consortium (ARC) 3.5 meter telescope, provide full coverage of the J, H, and K near-infrared bands in a single epoch. Analyzing these spectra, along with those of dwarf and giant spectral type standards from the SpeX Spectral Library, we have identified several elemental and molecular absorption lines that vary in strength with respect to each star's spectral type and luminosity class. Calibrating each of these features as a spectral type indicator, we provide a detailed characterization for each of the WTTSs in our sample, identifying each star's NIR spectral type and line-of-sight extinction, estimated both from the shape of the overall continuum and from the fluxes of the Paschen beta and Brackett gamma emission lines. In addition to improving our understanding of the properties of these WTTSs, this well characterized spectral library will be a valuable resource for analyses of the NIR continuum veiling and line emission present in the spectra of accreting classical T Tauri stars. This research was made possible by NSF Grant AST-1004107.

The effect of motor control exercise versus placebo in patients with chronic low back pain [ACTRN012605000262606

PubMed Central

Maher, Chris G; Latimer, Jane; Hodges, Paul W; Refshauge, Kathryn M; Moseley, G Lorimer; Herbert, Robert D; Costa, Leonardo OP; McAuley, James

2005-01-01

Background While one in ten Australians suffer from chronic low back pain this condition remains extremely difficult to treat. Many contemporary treatments are of unknown value. One potentially useful therapy is the use of motor control exercise. This therapy has a biologically plausible effect, is readily available in primary care and it is of modest cost. However, to date, the efficacy of motor control exercise has not been established. Methods This paper describes the protocol for a clinical trial comparing the effects of motor control exercise versus placebo in the treatment of chronic non-specific low back pain. One hundred and fifty-four participants will be randomly allocated to receive an 8-week program of motor control exercise or placebo (detuned short wave and detuned ultrasound). Measures of outcomes will be obtained at follow-up appointments at 2, 6 and 12 months after randomisation. The primary outcomes are: pain, global perceived effect and patient-generated measure of disability at 2 months and recurrence at 12 months. Discussion This trial will be the first placebo-controlled trial of motor control exercise. The results will inform best practice for treating chronic low back pain and prevent its occurrence. PMID:16271149

What mediates the inverse association between education and occupational disability from back pain?--A prospective cohort study from the Nord-Trøndelag health study in Norway.

PubMed

Hagen, Kåre Birger; Tambs, Kristian; Bjerkedal, Tor

2006-09-01

Low education is consistently associated with an increased risk of back pain disability, but the underlying mechanisms for this relationship are poorly understood. In a seven-year prospective observational study of 38,426 employed men and women between 25 and 59 years in Norway, we investigated to what extent occupational class, working conditions and individual lifestyle mediated the effect of formal education on disability pensioning from back pain. Each additional year of formal education was associated with decreased risk for disability pensioning from back pain for both men [age adjusted Hazard Ratio (HR) 0.77; (95% Confidence Interval, 0.72-0.82)] and women [HR 0.76(0.71-0.82)]. Adjustment for occupational class and factors related to working conditions (authority to plan own work, physically demanding work, concentration and attention and job satisfaction) and individual lifestyle (smoking, body mass index, physical exercise and alcohol consumption) reduced the effect of education by 39% [HR 0.86(0.79-0.93)] for men and by 21% [HR 0.81(0.73-0.89)] for women. Working conditions contributed most to the explanation for men, while occupational class, working conditions and life style factors contributed equally for women. Subgroup analyses indicate small differences between full-time and part-time employees, while some differences were found between subcategories of back diseases. The study indicates that there is a strong and unexplained effect of education on back pain disability pensioning, which is not mediated by occupational class, working conditions or individual lifestyle.

Efficacy of acupuncture and electroacupuncture in patients with nonspecific low back pain: study protocol for a randomized controlled trial.

PubMed

Comachio, Josielli; Oliveira Magalhães, Mauricio; Nogueira Burke, Thomaz; Vidal Ramos, Luiz Armando; Peixoto Leão Almeida, Gabriel; Silva, Ana Paula M C C; Ferreira de Meneses, Sarah Rúbia; Costa-Frutuoso, Jecilene Rosana; Santos Miotto Amorim, Cinthia; Pasqual Marques, Amélia

2015-10-15

Previous studies have shown that acupuncture and electroacupuncture (EA) are effective in the treatment of patients with low back pain. However, there is little evidence to support the use of one intervention over the other. The aim of this study is to compare the effect of acupuncture and electroacupuncture in the treatment of pain and disability in patients with chronic nonspecific low back pain. The study design is a randomized controlled trial. Patients with nonspecific chronic low back pain of more than three months duration are recruited at Rehabilitation Center of Taboao da Serra - SP (Brazil). After examination, sixty-six patients will be randomized into one of two groups: acupuncture group (AG) (n = 33) and electroacupuncture group (EG) (n = 33). Interventions will last one hour, and will happen twice a week for 6 weeks. The primary clinical outcomes will be pain intensity as measured and functional disability. quality of pain, quality of life. perception of the overall effect, depressive state, flexibility and kinesiophobia. All the outcomes will be assessed will be assessed at baseline, at treatment end, and three months after treatment end. Significance level will be determined at the 5 % level. Results of this trial will help clarify the value of acupuncture and electroacupuncture as a treatment for chronic low back pain and if they are different. Results of this trial will help clarify the value of acupuncture needling and electroacupuncture stimulation of specific points on the body as a treatment for chronic low back pain. Clinicaltrials.gov: NCT02039037 . Register October 30, 2013.

SU-E-T-13: Comparison of Dose Rates with and without Gold Backing of USC #9 Radioactive Eye Plaque Using MCNP5.

PubMed

Aryal, P; Molloy, J

2012-06-01

To show the effect of gold backing on dose rates for the USC #9 radioactive eye plaque. An I125 source (IsoAid model IAI-125A) and gold backing was modeled using MCNP5 Monte Carlo code. A single iodine seed was simulated with and without gold backing. Dose rates were calculated in two orthogonal planes. Dose calculation points were structured in two orthogonal planes that bisect the center of the source. A 2×2 cm matrix of spherical points of radius 0.2 mm was created in a water phantom of 10 cm radius. 0.2 billion particle histories were tracked. Dose differences with and without the gold backing were analyzed using Matlab. The gold backing produced a 3% increase in the dose rate near the source surface (<1mm) relative to that without the backing. This was presumably caused by fluorescent photons from the gold. At distances between 1 and 2 cm, the gold backing reduced the dose rate by up to 12%, which we attribute to a lack of scatter resulting from the attenuation from the gold. Dose differences were most pronounced in the radial direction near the source center but off axis. The dose decreased by 25%, 65% and 81% at 1, 2, and 3 mm off axis at a distance of 1 mm from the source surface. These effects were less pronounced in the perpendicular dimension near the source tip, where maximum dose decreases of 2% were noted. I 125 sources embedded directly into gold troughs display dose differences of 2 - 90%, relative to doses without the gold backing. This is relevant for certain types of plaques used in treatment of ocular melanoma. Large dose reductions can be observed and may have implications for scleral dose reduction. © 2012 American Association of Physicists in Medicine.

Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain

PubMed Central

Moon, Jong Hoon; Jung, Jin-Hwa; Won, Young Sik; Cho, Hwi-Young

2017-01-01

[Purpose] The purpose of this study was to analyze the effect of Graston Technique on hamstring extensibility and pain intensity in patients with nonspecific low back pain. [Subjects and Methods] Twenty-four patients with nonspecific low back pain (27–46 years of age) enrolled in the study. All participants were randomly assigned to one of two groups: Graston technique group (n=12) and a static stretching group (n=12). The Graston Technique was used on the hamstring muscles of the experimental group, while the static stretching group performed static stretching. Hamstring extensibility was recorded using the sit and reach test, and a visual analog scale was used to measure pain intensity. [Results] Both groups showed a significant improvement after intervention. In comparison to the static stretching group, the Graston technique group had significantly more improvement in hamstring extensibility. [Conclusion] The Graston Technique is a simple and effective intervention in nonspecific low back pain patients to improve hamstring extensibility and lower pain intensity, and it would be beneficial in clinical practice. PMID:28265144

Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain.

PubMed

Moon, Jong Hoon; Jung, Jin-Hwa; Won, Young Sik; Cho, Hwi-Young

2017-02-01

[Purpose] The purpose of this study was to analyze the effect of Graston Technique on hamstring extensibility and pain intensity in patients with nonspecific low back pain. [Subjects and Methods] Twenty-four patients with nonspecific low back pain (27-46 years of age) enrolled in the study. All participants were randomly assigned to one of two groups: Graston technique group (n=12) and a static stretching group (n=12). The Graston Technique was used on the hamstring muscles of the experimental group, while the static stretching group performed static stretching. Hamstring extensibility was recorded using the sit and reach test, and a visual analog scale was used to measure pain intensity. [Results] Both groups showed a significant improvement after intervention. In comparison to the static stretching group, the Graston technique group had significantly more improvement in hamstring extensibility. [Conclusion] The Graston Technique is a simple and effective intervention in nonspecific low back pain patients to improve hamstring extensibility and lower pain intensity, and it would be beneficial in clinical practice.

On the Feed-back Mechanism of Chinese Stock Markets

NASA Astrophysics Data System (ADS)

Lu, Shu Quan; Ito, Takao; Zhang, Jianbo

Feed-back models in the stock markets research imply an adjustment process toward investors' expectation for current information and past experiences. Error-correction and cointegration are often used to evaluate the long-run relation. The Efficient Capital Market Hypothesis, which had ignored the effect of the accumulation of information, cannot explain some anomalies such as bubbles and partial predictability in the stock markets. In order to investigate the feed-back mechanism and to determine an effective model, we use daily data of the stock index of two Chinese stock markets with the expectational model, which is one kind of geometric lag models. Tests and estimations of error-correction show that long-run equilibrium seems to be seldom achieved in Chinese stock markets. Our result clearly shows the common coefficient of expectations and fourth-order autoregressive disturbance exist in the two Chinese stock markets. Furthermore, we find the same coefficient of expectations has an autoregressive effect on disturbances in the two Chinese stock markets. Therefore the presence of such feed-back is also supported in Chinese stock markets.

Nonlinear Dichroism in Back-to-Back Double Ionization of He by an Intense Elliptically Polarized Few-Cycle Extreme Ultraviolet Pulse.

PubMed

Ngoko Djiokap, J M; Manakov, N L; Meremianin, A V; Hu, S X; Madsen, L B; Starace, Anthony F

2014-11-28

Control of double ionization of He by means of the polarization and carrier-envelope phase (CEP) of an intense, few-cycle extreme ultraviolet (XUV) pulse is demonstrated numerically by solving the six-dimensional two-electron, time-dependent Schrödinger equation for He interacting with an elliptically polarized XUV pulse. Guided by perturbation theory (PT), we predict the existence of a nonlinear dichroic effect (∝I^{3/2}) that is sensitive to the CEP, ellipticity, peak intensity I, and temporal duration of the pulse. This dichroic effect (i.e., the difference of the two-electron angular distributions for opposite helicities of the ionizing XUV pulse) originates from interference of first- and second-order PT amplitudes, allowing one to probe and control S- and D-wave channels of the two-electron continuum. We show that the back-to-back in-plane geometry with unequal energy sharing is an ideal one for observing this dichroic effect that occurs only for an elliptically polarized, few-cycle attosecond pulse.

Silk textile with antimicrobial AEM5772/5 (Dermasilk): a pilot study with positive influence on acne vulgaris on the back.

PubMed

Schaunig, Caroline; Kopera, Daisy

2017-05-01

The use of special silk textiles (Dermasilk) has shown positive effects on chronic inflammatory diseases like lichen sclerosus et atrophicus, atopic dermatitis, diabetic ulcerations, and vulvovaginal candidiasis. Wearing T-shirts of this particular fabric could be useful in the management of patients with acne vulgaris on the back and trunk. Dermasilk T-shirts were given to 14 patients with acne vulgaris papulopustulosa on the back. The patients wore these shirts every night for 6 weeks, and their acne lesions were monitored. Dermasilk represents a polymerisate of fibroin, a silk protein, and antimicrobial AEM5772/5, an unsoluble colorless, odorless ammonium with antifungal and antibacterial ability. Photographic documentation before and after 6 weeks showed a clinically significant reduction in acne lesions on the back without any concomitant treatment or change in lifestyle and living conditions. The use of Dermasilk textiles in other subacute-chronic inflammatory skin diseases has shown positive effects. This is the first report on their safe and effective use in the management of acne vulgaris papulopustulosa corporis. © 2017 The International Society of Dermatology.

Anger Suppression and Subsequent Pain Behaviors among Chronic Low Back Pain Patients: Moderating Effects of Anger Regulation Style

PubMed Central

Quartana, Phillip; Bruehl, Stephen

2013-01-01

Background Suppression of anger is linked to subsequent pain intensity among chronic low back patients, but it is not clear whether anger regulation style (trait anger-out, anger-in) moderates these effects or if aroused anger accounts for links between anger regulation style and pain. Method Chronic low back pain patients (N=58) were assigned to Suppression or No Suppression conditions for a task with harassing confederate and then underwent structured pain behavior procedures. Spielberger Anger Expression Inventory tapped trait anger-out (AOS) and anger-in (AIS). Results Regressions tested Emotion Regulation condition × AOS and AIS effects on outcomes. AOS was related to grimacing and sighing for Suppression condition patients. AIS was related negatively to guarding and bracing for Suppression condition patients. Anger report partly mediated effects for AOS and AIS. Conclusions Anger regulation style moderated effects of state anger suppression on subsequent pain behaviors, effects that were partly explained by aroused anger. PMID:21544702

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

PubMed

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

2014-01-01

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

Bauschinger Effect and Back Stress in Gradient Cu-Ge Alloy

NASA Astrophysics Data System (ADS)

Hu, Xianzhi; Jin, Shenbao; Zhou, Hao; Yin, Zhe; Yang, Jian; Gong, Yulan; Zhu, Yuntian; Sha, Gang; Zhu, Xinkun

2017-09-01

Using surface mechanical attrition treatment (SMAT), a gradient structure composed of two gradient structure (GS) layers and a coarse grain (CG) layer was generated from a Cu-5.7 wt pct Ge alloy, significantly improving the yield strength of the sample. Unloading-reloading tests showed an unusual Bauschinger effect in these GS samples. The back stresses caused by the accumulated geometrically necessary dislocations (GNDs) on the GS/CG border increased with increasing strain. As found by electron backscatter diffraction (EBSD), the GNDs are mainly distributed in the gradient structured layer, and the density of the GNDs increase with increasing SMAT time. The effect of the back stress increased with increasing SMAT processing time due to the increase in the strain gradient. The pronounced Bauschinger effect in a GS sample can improve the resistance to forward plastic flow and finally contributes to the high strength of GS samples.

Reevaluating the effectiveness of n-back training on transfer through the Bayesian lens: Support for the null.

PubMed

Dougherty, Michael R; Hamovitz, Toby; Tidwell, Joe W

2016-02-01

A recent meta-analysis by Au et al. Psychonomic Bulletin & Review, 22, 366-377, (2015) reviewed the n-back training paradigm for working memory (WM) and evaluated whether (when aggregating across existing studies) there was evidence that gains obtained for training tasks transferred to gains in fluid intelligence (Gf). Their results revealed an overall effect size of g = 0.24 for the effect of n-back training on Gf. We reexamine the data through a Bayesian lens, to evaluate the relative strength of the evidence for the alternative versus null hypotheses, contingent on the type of control condition used. We find that studies using a noncontact (passive) control group strongly favor the alternative hypothesis that training leads to transfer but that studies using active-control groups show modest evidence in favor of the null. We discuss these findings in the context of placebo effects.

Cost-effectiveness of early interventions for non-specific low back pain: a randomized controlled study investigating medical yoga, exercise therapy and self-care advice.

PubMed

Aboagye, Emmanuel; Karlsson, Malin Lohela; Hagberg, Jan; Jensen, Irene

2015-02-01

To evaluate the cost-effectiveness of medical yoga as an early intervention compared with evidence-based exercise therapy and self-care advice for non-specific low back pain. Randomized controlled trial with a cost-effectiveness analysis. A total of 159 participants randomized into the medical yoga group (n = 52), the exercise therapy group (n = 52) and the self-care advice group (n = 55). The health outcome measure EQ-5D was applied to measure quality of life data combined with cost data collected from treatment groups from baseline to 12 months follow-up. Outcome measure was health-related quality of life (HRQL). Incremental cost per quality adjusted life year (QALY) was also calculated. Cost-effectiveness analysis was conducted primarily from the societal and employer perspectives. Medical yoga is cost-effective compared with self-care advice if an employer considers the significant improvement in the HRQL of an employee with low back pain justifies the additional cost of treatment (i.e. in this study EUR 150). From a societal perspective, medical yoga is a cost-effective treatment compared with exercise therapy and self-care advice if an additional QALY is worth EUR 11,500. Sensitivity analysis suggests that medical yoga is more cost-effective than its alternatives. Six weeks of uninterrupted medical yoga thera-py is a cost-effective early intervention for non-specific low back pain, when treatment recommendations are adhered to.

Implementation of a guideline for low back pain management in primary care: a cost-effectiveness analysis.

PubMed

Becker, Annette; Held, Heiko; Redaelli, Marcus; Chenot, Jean F; Leonhardt, Corinna; Keller, Stefan; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Basler, Heinz-Dieter; Kochen, Michael M; Donner-Banzhoff, Norbert; Strauch, Konstantin

2012-04-15

Cost-effectiveness analysis alongside a cluster randomized controlled trial. To study the cost-effectiveness of 2 low back pain guideline implementation (GI) strategies. Several evidence-based guidelines on management of low back pain have been published. However, there is still no consensus on the effective implementation strategy. Especially studies on the economic impact of different implementation strategies are lacking. This analysis was performed alongside a cluster randomized controlled trial on the effectiveness of 2 GI strategies (physician education alone [GI] or physician education in combination with motivational counseling [MC] by practice nurses)--both compared with the postal dissemination of the guideline (control group, C). Sociodemographic data, pain characteristics, and cost data were collected by interview at baseline and after 6 and 12 months. low back pain-related health care costs were valued for 2004 from the societal perspective. For the cost analysis, 1322 patients from 126 general practices were included. Both interventions showed lower direct and indirect costs as well as better patient outcomes during follow-up compared with controls. In addition, both intervention arms showed superiority of cost-effectiveness to C. The effects attenuated when adjusting for differences of health care utilization prior to patient recruitment and for clustering of data. Trends in cost-effectiveness are visible but need to be confirmed in future studies. Researchers performing cost-evaluation studies should test for baseline imbalances of health care utilization data instead of judging on the randomization success by reviewing non-cost parameters like clinical data alone.

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

PubMed

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

2018-03-20

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

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

PubMed

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

2014-10-01

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

Back-illuminate fiber system research for multi-object fiber spectroscopic telescope

NASA Astrophysics Data System (ADS)

Zhou, Zengxiang; Liu, Zhigang; Hu, Hongzhuan; Wang, Jianping; Zhai, Chao; Chu, Jiaru

2016-07-01

In the telescope observation, the position of fiber will highly influence the spectra efficient input in the fiber to the spectrograph. When the fibers were back illuminated on the spectra end, they would export light on the positioner end, so the CCD cameras could capture the photo of fiber tip position covered the focal plane, calculates the precise position information by light centroid method and feeds back to control system. A set of fiber back illuminated system was developed which combined to the low revolution spectro instruments in LAMOST. It could provide uniform light output to the fibers, meet the requirements for the CCD camera measurement. The paper was introduced the back illuminated system design and different test for the light resource. After optimization, the effect illuminated system could compare with the integrating sphere, meet the conditions of fiber position measurement.Using parallel controlled fiber positioner as the spectroscopic receiver is an efficiency observation system for spectra survey, has been used in LAMOST recently, and will be proposed in CFHT and rebuilt telescope Mayall. In the telescope observation, the position of fiber will highly influence the spectra efficient input in the fiber to the spectrograph. When the fibers were back illuminated on the spectra end, they would export light on the positioner end, so the CCD cameras could capture the photo of fiber tip position covered the focal plane, calculates the precise position information by light centroid method and feeds back to control system. After many years on these research, the back illuminated fiber measurement was the best method to acquire the precision position of fibers. In LAMOST, a set of fiber back illuminated system was developed which combined to the low revolution spectro instruments in LAMOST. It could provide uniform light output to the fibers, meet the requirements for the CCD camera measurement and was controlled by high-level observation system which could shut down during the telescope observation. The paper was introduced the back illuminated system design and different test for the light resource. After optimization, the effect illuminated system could compare the integrating sphere, meet the conditions of fiber position measurement.

Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial.

PubMed

Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D; Long, Cynthia R; Andresen, Andrew A; Jones, Mark E; Lyons, Kevin J; Hondras, Maria A; Killinger, Lisa Z; Wolinsky, Fredric D; Wallace, Robert B

2013-01-16

Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content analysis of clinical trial notes. This pragmatic, pilot randomized controlled trial uses a mixed method approach to evaluate the clinical effectiveness, feasibility, and participant and provider perceptions of collaborative care between medical doctors and doctors of chiropractic in the treatment of older adults with low back pain.

Effect of Fixed Versus Adjusted Transcutaneous Electrical Nerve Stimulation Amplitude on Chronic Mechanical Low Back Pain.

PubMed

Elserty, Noha; Kattabei, Omaima; Elhafez, Hytham

2016-07-01

This study aimed to investigate the effect of adjusting pulse amplitude of transcutaneous electrical nerve stimulation versus fixed pulse amplitude in treatment of chronic mechanical low back pain. Randomized clinical trial. El-sahel Teaching Hospital, Egypt. Forty-five patients with chronic low back pain assigned to three equal groups. Their ages ranged from 20 to 50 years. The three groups received the same exercise program. Group A received transcutaneous electrical nerve stimulation with fixed pulse amplitude for 40 minutes. Group B received transcutaneous electrical nerve stimulation with adjusted pulse amplitude for 40 minutes, with the pulse amplitude adjusted every 5 minutes. Group C received exercises only. Treatment sessions were applied three times per week for 4 weeks for the three groups. A visual analogue scale was used to assess pain severity, the Oswestry Disability Index was used to assess functional level, and a dual inclinometer was used to measure lumbar range of motion. Evaluations were performed before and after treatment. Visual analogue scale, Oswestry Disability Index, and back range of motion significantly differed between the two groups that received transcutaneous electrical nerve stimulation and the control group and did not significantly differ between fixed and adjusted pulse amplitude of transcutaneous electrical nerve stimulation. Adjusting pulse amplitude of transcutaneous electrical nerve stimulation does not produce a difference in the effect of transcutaneous electrical nerve stimulation used to treat chronic low back pain.

Cerebellar tDCS does not affect performance in the N-back task.

PubMed

van Wessel, Brenda W V; Claire Verhage, M; Holland, Peter; Frens, Maarten A; van der Geest, Jos N

2016-01-01

The N-back task is widely used in cognitive research. Furthermore, the cerebellum's role in cognitive processes is becoming more widely recognized. Studies using transcranial direct current stimulation (tDCS) have demonstrated effects of cerebellar stimulation on several cognitive tasks. Therefore, the aim of this study was to investigate the effects of cerebellar tDCS on cognitive performance by using the N-back task. The cerebellum of 12 participants was stimulated during the task. Moreover, the cognitive load was manipulated in N = 2, N = 3, and N = 4. Every participant received three tDCS conditions (anodal, cathodal, and sham) divided over three separated days. It was expected that anodal stimulation would improve performance on the task. Each participant performed 6 repetitions of every load in which correct responses, false alarms, and reaction times were recorded. We found significant differences between the three levels of load in the rate of correct responses and false alarms, indicating that subjects followed the expected pattern of performance for the N-back task. However, no significant differences between the three tDCS conditions were found. Therefore, it was concluded that in this study cognitive performance on the N-back task was not readily influenced by cerebellar tDCS, and any true effects are likely to be small. We discuss several limitations in task design and suggest future experiments to address such issues.

The effects of therapeutic climbing in patients with chronic low back pain: a randomized controlled study.

PubMed

Engbert, Kai; Weber, Michaela

2011-05-15

A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain-related disability [FFbH-R]). Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy. Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise. Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being. For the Hannover Functional Ability Questionnaire for measuring back pain-related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception. The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.

The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study

NASA Astrophysics Data System (ADS)

Tamás, Gáti; Katalin, Tefner Ildikó; Lajos, Kovács; Katalin, Hodosi; Tamás, Bender

2018-01-01

The aim of this study was to investigate the effects of balneotherapy on chronic low back pain. This is a minimized, follow-up study evaluated according to the analysis of intention to treat. The subjects included in the study were 105 patients suffering from chronic low back pain. The control group (n = 53) received the traditional musculoskeletal pain killer treatment, while the target group (n = 52) attended thermal mineral water treatment for 3 weeks for 15 occasions on top of the usual musculoskeletal pain killer treatment. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: the level of low back pain in rest and the level during activity are tested using the Visual Analog Scale (VAS); specific questionnaire on the back pain (Oswestry); and a questionnaire on quality of life (EuroQual-5D). All of the investigated parameters improved significantly (p < 0.001) in the target group by the end of the treatment compared to the base period, and this improvement was persistent during the follow-up period. There were no significant changes in the measured parameters in the control group. Based on our results, balneotherapy might have favorable impact on the clinical parameters and quality of life of patients suffering from chronic low back pain.

Evaluation of habitat quality for selected wildlife species associated with back channels.

USGS Publications Warehouse

Anderson, James T.; Zadnik, Andrew K.; Wood, Petra Bohall; Bledsoe, Kerry

2013-01-01

The islands and associated back channels on the Ohio River, USA, are believed to provide critical habitat features for several wildlife species. However, few studies have quantitatively evaluated habitat quality in these areas. Our main objective was to evaluate the habitat quality of back and main channel areas for several species using habitat suitability index (HSI) models. To test the effectiveness of these models, we attempted to relate HSI scores and the variables measured for each model with measures of relative abundance for the model species. The mean belted kingfisher (Ceryle alcyon) HSI was greater on the main than back channel. However, the model failed to predict kingfisher abundance. The mean reproduction component of the great blue heron (Ardea herodias) HSI, total common muskrat (Ondatra zibethicus) HSI, winter cover component of the snapping turtle (Chelydra serpentina) HSI, and brood-rearing component of the wood duck (Aix sponsa) HSI were all greater on the back than main channel, and were positively related with the relative abundance of each species. We found that island back channels provide characteristics not found elsewhere on the Ohio River and warrant conservation as important riparian wildlife habitat. The effectiveness of using HSI models to predict species abundance on the river was mixed. Modifications to several of the models are needed to improve their use on the Ohio River and, likely, other large rivers.

Assessment of the effectiveness of head only and back-of-the-head electrical stunning of chickens

PubMed Central

Gibson, T. J.; Taylor, A. H.; Gregory, N. G.

2016-01-01

Abstract The study assesses the effectiveness of reversible head-only and back-of-the-head electrical stunning of chickens using 130–950 mA per bird at 50 Hz AC.Three trials were conducted to compare both stunning systems: (a) behavioural assessment of return of consciousness, (b) insensibility to thermal pain, and (c) assessment of return of brain activity with visually evoked potentials (VEPs).Assessment of behaviour suggested that the period of unconsciousness following head-only electrical stunning was shorter in hens compared to broilers.Stunning across the back-of-the-head delayed the time to return of brainstem function compared to stunning with standard head-only electrodes. Additionally, back-of-the-head stunning produced a more prolonged period of electroanalgesia compared to head-only.Based on examination of return of brain function with VEPs in hens, back-of-the-head stunning produced a shorter-lasting stun than standard head-only. However, even for standard head-only, the stun was notably shorter than previously reported. In some birds, brain function had returned within 9 s after the end of stunning.The results suggest that some birds may recover consciousness prior to or during the neck cut. Based on these findings, back-of-the-head stunning and standard head-only stunning of hens should not be recommended without further development. PMID:27023411

Flow-Centric, Back-in-Time Debugging

NASA Astrophysics Data System (ADS)

Lienhard, Adrian; Fierz, Julien; Nierstrasz, Oscar

Conventional debugging tools present developers with means to explore the run-time context in which an error has occurred. In many cases this is enough to help the developer discover the faulty source code and correct it. However, rather often errors occur due to code that has executed in the past, leaving certain objects in an inconsistent state. The actual run-time error only occurs when these inconsistent objects are used later in the program. So-called back-in-time debuggers help developers step back through earlier states of the program and explore execution contexts not available to conventional debuggers. Nevertheless, even Back-in-Time Debuggers do not help answer the question, “Where did this object come from?” The Object-Flow Virtual Machine, which we have proposed in previous work, tracks the flow of objects to answer precisely such questions, but this VM does not provide dedicated debugging support to explore faulty programs. In this paper we present a novel debugger, called Compass, to navigate between conventional run-time stack-oriented control flow views and object flows. Compass enables a developer to effectively navigate from an object contributing to an error back-in-time through all the code that has touched the object. We present the design and implementation of Compass, and we demonstrate how flow-centric, back-in-time debugging can be used to effectively locate the source of hard-to-find bugs.

Early intervention for acute back injury: can we finally develop an evidence-based approach?

PubMed

Smith, Daphne; McMurray, Nancy; Disler, Peter

2002-02-01

Several reviews of the treatment of acute low back pain have been published in the past and have formed the basis of clinical guidelines. However, these lack consistency in some areas and valid data in others. As the literature in this field has continued to expand, the present review was undertaken to establish whether the guidelines in current use are supported by more recently published, scientifically rigorous research, and whether additional consensus regarding treatment of acute low back injury has been forthcoming in recent years. A review, and critical analysis, of literature relating to the treatment of acute low back pain that has been published since the production of the currently used clinical guidelines. The guidelines have been reviewed to assess whether their recommendations remain supportable. Recent research appears to support current clinical guidelines, i.e. exercise may have a positive effect while bed rest is ineffective and may be harmful, simple analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) have short-term benefits, and spinal manipulation may be effective in the first four weeks; no evidence was found for traction or back schools. However, we need more randomized controlled trials of treatments shown to be successful with the chronic population, e.g. focused on understanding psychological determinants, and using a multidisciplinary biopsychosocial approach. In the future this may help us to prevent acute low back progressing to the chronic state.

Balneotherapy for chronic low back pain: a randomized, controlled study.

PubMed

Kesiktas, Nur; Karakas, Sinem; Gun, Kerem; Gun, Nuran; Murat, Sadiye; Uludag, Murat

2012-10-01

A large number of treatments were used for patients with chronic low back pain. Frequent episodes have been reported very high. Although balneotherapy was found effective in this disease, there are not well-designed studies. We aimed to determine the effectiveness of balneotherapy versus physical therapy in patients with chronic low back pain. Exercise was added to both treatment programs. Sixty patients with chronic low back pain were randomly divided into two groups. Physical modalities plus exercise were applied to group 1, and group 2 was received balneotherapy plus exercise for ten sessions. The following parameters were measured: visual analogue scale at rest and movement for pain, paracetamol dose, manual muscle test for lumber muscles, modified Schoeber' test, Oswestry disability index, and Short-Form 36 at the beginning and end of the therapies and at the 3 months follow-up. The statistical analyses were performed using the SPSS 10.0 program. Both groups achieved significant improvements within themselves. But balneotherapy groups were improved at back extensor muscle test (P < 0.05), modified Schoeber's test (P < 0.03), Oswestry disability index, and the some scores of SF 36 (energy vitality, social function, role limitations related to physical problems, and general health P < 0.05). Balneotherapy combined with exercise therapy had advantages than therapy with physical modalities plus exercise in improving quality of life and flexibility of patients with chronic low back pain.

The effects of the calcium-magnesium-bicarbonate content in thermal mineral water on chronic low back pain: a randomized, controlled follow-up study

NASA Astrophysics Data System (ADS)

Gáti, Tamás; Tefner, Ildikó Katalin; Kovács, Lajos; Hodosi, Katalin; Bender, Tamás

2018-05-01

The aim of this study was to investigate the effects of balneotherapy on chronic low back pain. This is a minimized, follow-up study evaluated according to the analysis of intention to treat. The subjects included in the study were 105 patients suffering from chronic low back pain. The control group ( n = 53) received the traditional musculoskeletal pain killer treatment, while the target group ( n = 52) attended thermal mineral water treatment for 3 weeks for 15 occasions on top of the usual musculoskeletal pain killer treatment. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: the level of low back pain in rest and the level during activity are tested using the Visual Analog Scale (VAS); specific questionnaire on the back pain (Oswestry); and a questionnaire on quality of life (EuroQual-5D). All of the investigated parameters improved significantly ( p < 0.001) in the target group by the end of the treatment compared to the base period, and this improvement was persistent during the follow-up period. There were no significant changes in the measured parameters in the control group. Based on our results, balneotherapy might have favorable impact on the clinical parameters and quality of life of patients suffering from chronic low back pain.

NICMOS FINDS A GOLDEN RING AT THE HEART OF A GALAXY

NASA Technical Reports Server (NTRS)

2002-01-01

The revived Near Infrared Camera and Multi-Object Spectrometer (NICMOS) aboard NASA's Hubble Space Telescope has pierced the dusty disk of the 'edge-on' galaxy NGC 4013 and peered all the way to the galactic core. To the surprise of astronomers, NICMOS found a brilliant band-like structure, that may be a ring of newly formed stars [yellow band in middle photo] seen edge-on. In the visible-light view of the galaxy [top photo], the star-forming ring cannot be seen because it is embedded in dust. The most prominent feature in the visible-light image -- taken by the Wide Field and Planetary Camera 2 (WFPC2) -- is the thin, dark band of gas and dust, which is about 500 light-years thick. NICMOS enables the Hubble telescope to see in near-infrared wavelengths of light, so that it can penetrate the dust that obscures the inner hub of the galaxy. The ring-like structure spied by NICMOS encircles the core and is about 720 light-years wide, which is the typical size of most star-forming rings found in disk galaxies. The small ring is churning out stars at a torrid pace. The Milky Way Galaxy, for example, is more than 10,000 times larger than the ring. If the Milky Way produced stars at the same rate, it would be making 1,000 times more stars a year. The human eye cannot see infrared light, so colors have been assigned to correspond with near-infrared wavelengths. The blue light represents shorter near-infrared wavelengths and the red light corresponds to longer wavelengths. The ring-like structure is seen more clearly in the photo at bottom. This picture, taken with a filter sensitive to hydrogen, shows the glow of stars and gas. Astronomers used this information to calculate the rate of star formation in the ring-like structure. The extremely bright star near the center of each picture is a nearby foreground star belonging to our own Milky Way. Rings of developing stars are common in barred spiral galaxies, which have 'bars' of stars and gas slicing across their disks. The bars funnel gas to the galactic cores. But gravitational disturbances near the cores cause gas to accumulate into a lane or a ring. The gas then condenses to form stars. Because NGC 4013 is seen edge-on, astronomers don't know whether a bar of gas or some other mechanism formed the ring-like structure. NGC 4013, which looks similar to our Milky Way Galaxy, resides in the constellation Ursa Major, 55 million light-years from Earth. The middle picture is a color composite image that was made by combining photographs taken with the J-band, H-band, and Paschen-alpha filters. The bottom picture was taken with the Paschen-alpha filter. The images were taken on May 12. Credits for NICMOS images: NASA, the NICMOS Group (STScI, ESA), and the NICMOS Science Team (University of Arizona) Credits for WFPC2 image: NASA, the Hubble Heritage Team (STScI/AURA) and ESA

An effective write policy for software coherence schemes

NASA Technical Reports Server (NTRS)

Chen, Yung-Chin; Veidenbaum, Alexander V.

1992-01-01

The authors study the write behavior and evaluate the performance of various write strategies and buffering techniques for a MIN-based multiprocessor system using the simple software coherence scheme. Hit ratios, memory latencies, total execution time, and total write traffic are used as the performance indices. The write-through write-allocate no-fetch cache using a write-back write buffer is shown to have a better performance than both write-through and write-back caches. This type of write buffer is effective in reducing the volume as well as bursts of write traffic. On average, the use of a write-back cache reduces by 60 percent the total write traffic generated by a write-through cache.

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

Is standing balance altered in individuals with chronic low back pain? A systematic review.

PubMed

Berenshteyn, Yevgeniy; Gibson, Kelsey; Hackett, Gavin C; Trem, Andrew B; Wilhelm, Mark

2018-01-30

To examine the static standing balance of individuals with chronic low back pain when compared to a healthy control group. A search of available literature was done using PubMed, SPORTDiscus, CINAHL, and Scopus databases. Studies were included if they contained the following: (1) individuals with chronic low back pain 3 months or longer; (2) healthy control group; (3) quantified pain measurement; and (4) center of pressure measurement using a force plate. Two authors independently reviewed articles for inclusion, and assessed for quality using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross Sectional Studies. Cohen's d effect size was calculated to demonstrate the magnitude of differences between groups. Nine articles were included in this review. Quality scores ranged from 5/8 to 8/8. Although center of pressure measures were nonhomogeneous, subjects with chronic low back pain had poorer performance overall compared to healthy controls. Despite inconsistencies in statistical significance, effect sizes were frequently large, indicating a lack of sufficient power in the included studies. Data were insufficiently reported among certain studies, limiting the ability of direct study comparison. Results suggest that balance is impaired in individuals with chronic low back pain when compared to healthy individuals. Implications for rehabilitation Static balance is affected in individuals with chronic low back pain. Balance assessments should be completed for individuals with chronic low back pain. Results from balance assessments should be used to indicate areas of improvement and help guide the course of treatment, as well as reassess as treatment progresses.

Flow topology of rare back flow events and critical points in turbulent channels and toroidal pipes

NASA Astrophysics Data System (ADS)

Chin, C.; Vinuesa, R.; Örlü, R.; Cardesa, J. I.; Noorani, A.; Schlatter, P.; Chong, M. S.

2018-04-01

A study of the back flow events and critical points in the flow through a toroidal pipe at friction Reynolds number Re τ ≈ 650 is performed and compared with the results in a turbulent channel flow at Re τ ≈ 934. The statistics and topological properties of the back flow events are analysed and discussed. Conditionally-averaged flow fields in the vicinity of the back flow event are obtained, and the results for the torus show a similar streamwise wall-shear stress topology which varies considerably for the spanwise wall-shear stress when compared to the channel flow. The comparison between the toroidal pipe and channel flows also shows fewer back flow events and critical points in the torus. This cannot be solely attributed to differences in Reynolds number, but is a clear effect of the secondary flow present in the toroidal pipe. A possible mechanism is the effect of the secondary flow present in the torus, which convects momentum from the inner to the outer bend through the core of the pipe, and back from the outer to the inner bend through the pipe walls. In the region around the critical points, the skin-friction streamlines and vorticity lines exhibit similar flow characteristics with a node and saddle pair for both flows. These results indicate that back flow events and critical points are genuine features of wall-bounded turbulence, and are not artifacts of specific boundary or inflow conditions in simulations and/or measurement uncertainties in experiments.

Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine.

PubMed

Itz, Coen J; Willems, Paul C; Zeilstra, Dick J; Huygen, Frank J

2016-01-01

When conservative therapies such as pain medication or exercise therapy fail, invasive treatment may be indicated for patients with lumbosacral spinal pain. The Dutch Society of Anesthesiologists, in collaboration with the Dutch Orthopedic Association and the Dutch Neurosurgical Society, has taken the initiative to develop the guideline "Spinal low back pain," which describes the evidence regarding diagnostics and invasive treatment of the most common spinal low back pain syndromes, that is, facet joint pain, sacroiliac joint pain, coccygodynia, pain originating from the intervertebral disk, and failed back surgery syndrome. The aim of the guideline is to determine which invasive treatment intervention is preferred for each included pain syndrome when conservative treatment has failed. Diagnostic studies were evaluated using the EBRO criteria, and studies on therapies were evaluated with the Grading of Recommendations Assessment, Development and Evaluation system. For the evaluation of invasive treatment options, the guideline committee decided that the outcome measures of pain, function, and quality of life were most important. The definition, epidemiology, pathophysiological mechanism, diagnostics, and recommendations for invasive therapy for each of the spinal back pain syndromes are reported. The guideline committee concluded that the categorization of low back pain into merely specific or nonspecific gives insufficient insight into the low back pain problem and does not adequately reflect which therapy is effective for the underlying disorder of a pain syndrome. Based on the guideline "Spinal low back pain," facet joint pain, pain of the sacroiliac joint, and disk pain will be part of a planned nationwide cost-effectiveness study. © 2015 World Institute of Pain.

Alendronate is more effective than elcatonin in improving pain and quality of life in postmenopausal women with osteoporosis.

PubMed

Iwamoto, J; Makita, K; Sato, Y; Takeda, T; Matsumoto, H

2011-10-01

A randomized controlled trial was performed to compare the short-term effects of alendronate (ALN) and ECT on pain and quality of life (QOL) in postmenopausal women with osteoporosis. Back pain and QOL [Short-Form Health Survey (SF-8)] significantly improved at 1, 3, and 6 months in both groups, with greater improvements in the ALN group than in the ECT group. These results suggested that ALN reduced back pain and improved QOL more markedly than ECT in postmenopausal osteoporotic women with back pain. Intramuscular ECT is known to reduce pain via the central nervous system. A multicenter randomized controlled trial was performed to compare the short-term effects of ALN and ECT on pain and QOL in postmenopausal women with osteoporosis. One hundred and 94 postmenopausal osteoporotic women with back pain (mean age 79.8 years, range 60-96 years) were randomly divided into two groups: the ALN group (35 mg weekly) and the ECT group (intramuscular 20 units a week). The duration of the study was 6 months. The trial was completed in 97 (100%) women of the ALN group and 96 (99.0%) women of the ECT group. Urinary levels of cross-linked N-terminal telopeptide of type I collagen (NTX), serum alkaline phosphatase (ALP), face scale score (FSS, back pain), and SF-8 (QOL) were monitored. Urinary NTX levels significantly decreased at 3 months in the ALN group, but not in the ECT group. Serum ALP levels significantly decreased at 6 months in the both groups, with a greater reduction in the ALN group. The FSS and SF-8 significantly improved at 1, 3, and 6 months in both groups, with greater improvements in the ALN group than in the ECT group. ALN suppressed bone turnover, reduced back pain, and improved QOL more markedly than ECT in postmenopausal osteoporotic women with back pain.

Discharge destination's effect on bounce-back risk in Black, White, and Hispanic acute ischemic stroke patients.

PubMed

Kind, Amy J H; Smith, Maureen A; Liou, Jinn-Ing; Pandhi, Nancy; Frytak, Jennifer R; Finch, Michael D

2010-02-01

To determine whether racial and ethnic effects on bounce-back risk (ie, movement to settings of higher care intensity within 30 d of hospital discharge) in acute stroke patients vary depending on initial posthospital discharge destination. Retrospective analysis of administrative data. Four hundred twenty-two hospitals, southern/eastern United States. All Medicare beneficiaries 65 years or more with hospitalization for acute ischemic stroke within one of the 422 target hospitals during the years 1999 or 2000 (N=63,679). Not applicable. Adjusted predicted probabilities for discharge to and for bouncing back from each initial discharge site (ie, home, home with home health care, skilled nursing facility [SNF], or rehabilitation center) by race (ie, black, white, and Hispanic). Models included sociodemographics, comorbidities, stroke severity, and length of stay. Blacks and Hispanics were significantly more likely to be discharged to home health care (blacks=21% [95% confidence interval (CI), 19.9-22.8], Hispanic=19% [17.1-21.7] vs whites=16% [15.5-16.8]) and less likely to be discharged to SNFs (blacks=26% [95% CI, 23.6-29.3], Hispanics=28% [25.4-31.6] vs whites=33% [31.8-35.1]) than whites. However, blacks and Hispanics were significantly more likely to bounce back when discharged to SNFs than whites (blacks=26% [95% CI, 24.2-28.6], Hispanics=28% [24-32.6] vs whites=21% [20.3-21.9]). Hispanics had a lower risk of bouncing back when discharged home than either blacks or whites (Hispanics=14% [95% CI, 11.3-17] vs blacks=20% [18.4-22.2], whites=18% [16.8-18.3]). Patients discharged to home health care or rehabilitation centers demonstrated no significant differences in bounce-back risk. Racial/ethnic bounce-back risk differs depending on initial discharge destination. Additional research is needed to fully understand this variation in effect. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Chiropractic and self-care for back-related leg pain: design of a randomized clinical trial

PubMed Central

2011-01-01

Background Back-related leg pain (BRLP) is a common variation of low back pain (LBP), with lifetime prevalence estimates as high as 40%. Often disabling, BRLP accounts for greater work loss, recurrences, and higher costs than uncomplicated LBP and more often leads to surgery with a lifetime incidence of 10% for those with severe BRLP, compared to 1-2% for those with LBP. In the US, half of those with back-related conditions seek CAM treatments, the most common of which is chiropractic care. While there is preliminary evidence suggesting chiropractic spinal manipulative therapy is beneficial for patients with BRLP, there is insufficient evidence currently available to assess the effectiveness of this care. Methods/Design This study is a two-site, prospective, parallel group, observer-blinded randomized clinical trial (RCT). A total of 192 study patients will be recruited from the Twin Cities, MN (n = 122) and Quad Cities area in Iowa and Illinois (n = 70) to the research clinics at WHCCS and PCCR, respectively. It compares two interventions: chiropractic spinal manipulative therapy (SMT) plus home exercise program (HEP) to HEP alone (minimal intervention comparison) for patients with subacute or chronic back-related leg pain. Discussion Back-related leg pain (BRLP) is a costly and often disabling variation of the ubiquitous back pain conditions. As health care costs continue to climb, the search for effective treatments with few side-effects is critical. While SMT is the most commonly sought CAM treatment for LBP sufferers, there is only a small, albeit promising, body of research to support its use for patients with BRLP. This study seeks to fill a critical gap in the LBP literature by performing the first full scale RCT assessing chiropractic SMT for patients with sub-acute or chronic BRLP using important patient-oriented and objective biomechanical outcome measures. Trial Registration ClinicalTrials.gov NCT00494065 PMID:21426558

Holding Back, Intimacy, and Psychological and Relationship Outcomes Among Couples Coping With Prostate Cancer

PubMed Central

Manne, Sharon L.; Zaider, Talia; Lee, David; Kissane, David; Kashy, Deborah; Heckman, Carolyn; Virtue, Shannon Myers

2016-01-01

The present study evaluated intimacy as a mechanism for the effects of holding back sharing concerns about cancer on couples’ psychological distress, well-being, and marital satisfaction using the actor-partner interdependence model (APIM), and evaluated 2 possible moderators of these associations: the number of patient and spouse cancer concerns. We had 139 men treated for localized prostate cancer in the past year and their spouses complete surveys about holding back sharing cancer concerns, intimacy, distress, and relationship satisfaction, as well as patient and spouse cancer concerns. APIM-indicated that the association between holding back sharing concerns, and patient and spouse distress, well-being, and relationship satisfaction could be partially accounted for by their influence on patient and spouse perceptions of relationship intimacy. The number of cancer concerns did not moderate the mediational model. Holding back has strong associations with both partners’ well-being and distress. Holding back sharing concerns was particularly detrimental for couples’ intimacy and relationship satisfaction. PMID:26192132

Reducing mechanical cross-coupling in phased array transducers using stop band material as backing

NASA Astrophysics Data System (ADS)

Henneberg, J.; Gerlach, A.; Storck, H.; Cebulla, H.; Marburg, S.

2018-06-01

Phased array transducers are widely used for acoustic imaging and surround sensing applications. A major design challenge is the achievement of low mechanical cross-coupling between the single transducer elements. Cross-coupling induces a loss of imaging resolution. In this work, the mechanical cross-coupling between acoustic transducers is investigated for a generic model. The model contains a common backing with two bending elements bonded on top. The dimensions of the backing are small; thus, wave reflections on the backing edges have to be considered. This is different to other researches. The operating frequency in the generic model is set to a low kHz range. Low operating frequencies are typical for surround sensing applications. The influence of the backing on cross-coupling is investigated numerically. In order to reduce mechanical cross-coupling a stop band material is designed. It is shown numerically that a reduction in mechanical cross-coupling can be achieved by using stop band material as backing. The effect is validated with experimental testing.

Clustering of arc volcanoes caused by temperature perturbations in the back-arc mantle

PubMed Central

Lee, Changyeol; Wada, Ikuko

2017-01-01

Clustering of arc volcanoes in subduction zones indicates along-arc variation in the physical condition of the underlying mantle where majority of arc magmas are generated. The sub-arc mantle is brought in from the back-arc largely by slab-driven mantle wedge flow. Dynamic processes in the back-arc, such as small-scale mantle convection, are likely to cause lateral variations in the back-arc mantle temperature. Here we use a simple three-dimensional numerical model to quantify the effects of back-arc temperature perturbations on the mantle wedge flow pattern and sub-arc mantle temperature. Our model calculations show that relatively small temperature perturbations in the back-arc result in vigorous inflow of hotter mantle and subdued inflow of colder mantle beneath the arc due to the temperature dependence of the mantle viscosity. This causes a three-dimensional mantle flow pattern that amplifies the along-arc variations in the sub-arc mantle temperature, providing a simple mechanism for volcano clustering. PMID:28660880

Clustering of arc volcanoes caused by temperature perturbations in the back-arc mantle.

PubMed

Lee, Changyeol; Wada, Ikuko

2017-06-29

Clustering of arc volcanoes in subduction zones indicates along-arc variation in the physical condition of the underlying mantle where majority of arc magmas are generated. The sub-arc mantle is brought in from the back-arc largely by slab-driven mantle wedge flow. Dynamic processes in the back-arc, such as small-scale mantle convection, are likely to cause lateral variations in the back-arc mantle temperature. Here we use a simple three-dimensional numerical model to quantify the effects of back-arc temperature perturbations on the mantle wedge flow pattern and sub-arc mantle temperature. Our model calculations show that relatively small temperature perturbations in the back-arc result in vigorous inflow of hotter mantle and subdued inflow of colder mantle beneath the arc due to the temperature dependence of the mantle viscosity. This causes a three-dimensional mantle flow pattern that amplifies the along-arc variations in the sub-arc mantle temperature, providing a simple mechanism for volcano clustering.

A randomized clinical trial of the effectiveness of mechanical traction for sub-groups of patients with low back pain: study methods and rationale

PubMed Central

2010-01-01

Background Patients with signs of nerve root irritation represent a sub-group of those with low back pain who are at increased risk of persistent symptoms and progression to costly and invasive management strategies including surgery. A period of non-surgical management is recommended for most patients, but there is little evidence to guide non-surgical decision-making. We conducted a preliminary study examining the effectiveness of a treatment protocol of mechanical traction with extension-oriented activities for patients with low back pain and signs of nerve root irritation. The results suggested this approach may be effective, particularly in a more specific sub-group of patients. The aim of this study will be to examine the effectiveness of treatment that includes traction for patients with low back pain and signs of nerve root irritation, and within the pre-defined sub-group. Methods/Design The study will recruit 120 patients with low back pain and signs of nerve root irritation. Patients will be randomized to receive an extension-oriented treatment approach, with or without the addition of mechanical traction. Randomization will be stratified based on the presence of the pre-defined sub-grouping criteria. All patients will receive 12 physical therapy treatment sessions over 6 weeks. Follow-up assessments will occur after 6 weeks, 6 months, and 1 year. The primary outcome will be disability measured with a modified Oswestry questionnaire. Secondary outcomes will include self-reports of low back and leg pain intensity, quality of life, global rating of improvement, additional healthcare utilization, and work absence. Statistical analysis will be based on intention to treat principles and will use linear mixed model analysis to compare treatment groups, and examine the interaction between treatment and sub-grouping status. Discussion This trial will provide a methodologically rigorous evaluation of the effectiveness of using traction for patients with low back pain and signs of nerve root irritation, and will examine the validity of a pre-defined sub-grouping hypothesis. The results will provide evidence to inform non-surgical decision-making for these patients. Trial Registration This trial has been registered with http://ClinicalTrials.gov: NCT00942227 PMID:20433733

A pilot study on using acupuncture and transcutaneous electrical nerve stimulation to treat chronic non-specific low back pain.

PubMed

Itoh, Kazunori; Itoh, Satoko; Katsumi, Yasukazu; Kitakoji, Hiroshi

2009-02-01

The present study tests whether a combined treatment of acupuncture and transcutaneous electrical nerve stimulation (TENS) is more effective than acupuncture or TENS alone for treating chronic low back pain (LBP). Thirty-two patients with chronic LBP were randomly allocated to four groups. The acupuncture group (ACP) received only acupuncture treatment at selected acupoints for low back pain; the TENS group (TENS) received only TENS treatment at pain areas; the acupuncture and TENS group (A&T) received both acupuncture and TENS treatments; the control group (CT) received topical poultice (only when necessary). Each group received specific weekly treatment five times during the study. Outcome measures were pain intensity in terms of visual analogue scale (VAS) and QOL of low back in terms of Roland-Morris Disability Questionnaire (RDQ). The ACP, TENS and A&T groups all reported lower VAS and RDQ scores. Significant reduction in pain intensity (P<0.008) and significant improvement in QOL (P<0.008) were shown in the A&T group. Combined acupuncture and TENS treatment is effective in pain relief and QOL of low back improvement for the sampled patients suffering from chronic LBP.

A micro-machined piezoelectric flexural-mode hydrophone with air backing: a hydrostatic pressure-balancing mechanism for integrity preservation.

PubMed

Choi, Sungjoon; Lee, Haksue; Moon, Wonkyu

2010-09-01

Although an air-backed thin plate is an effective sound receiver structure, it is easily damaged via pressure unbalance caused by external hydrostatic pressure. To overcome this difficulty, a simple pressure-balancing module is proposed. Despite its small size and relative simplicity, with proper design and operation, micro-channel structure provides a solution to the pressure-balancing problem. If the channel size is sufficiently small, the gas-liquid interface may move back and forth without breach by the hydrostatic pressure since the surface tension can retain the interface surface continuously. One input port of the device is opened to an intermediate liquid, while the other port is connected to the air-backing chamber. As the hydrostatic pressure increases, the liquid in the micro-channel compresses the air, and the pressure in the backing chamber is then equalized to match the external hydrostatic pressure. To validate the performance of the proposed mechanism, a micro-channel prototype is designed and integrated with the piezoelectric micro-machined flexural sensor developed in our previous work. The working principle of the mechanism is experimentally verified. In addition, the effect of hydrostatic pressure on receiving sensitivity is evaluated and compared with predicted behavior.

A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy.

PubMed

Close, Ciara; Sinclair, Marlene; Liddle, S Dianne; Madden, Elaine; McCullough, Julie E M; Hughes, Ciara

2014-08-01

To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013). Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice. © 2014 John Wiley & Sons Ltd.

Pharmacoeconomic Analysis of Pain Medications Used to Treat Adult Patients with Chronic Back Pain in the United States.

PubMed

Shah, Drishti; Anupindi, Vamshi Ruthwik; Vaidya, Varun

2016-12-01

Chronic back pain is an extremely common health problem. The largest category for pain therapy costs includes nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. However, there has been limited evidence outlining their effectiveness in terms of quality of life for the treatment of chronic back pain. The authors performed a comparative pharmacoeconomic analysis of chronic back pain patients using NSAIDs versus those using opioids alone or combination opioid analgesics. This pharmacoeconomic evaluation was conducted using the Medical Expenditure Panel Survey (MEPS). Adults ≥18 years with chronic back pain diagnosis were included in the study. Individuals using opioids were matched in 1:1 ratio with those using only NSAIDs using propensity scores. All direct medical costs were included, and utility scores from Short Form 6D (SF-6D) were used to calculate QALYs (quality-adjusted life years). Monte Carlo probabilistic simulation technique was employed to determine the cost-effectiveness acceptability curve. After matching, there were 1109 patients in each cohort. The total mean annual cost was found to be $6137.41 for NSAIDs and $8982.28 for opioids. The mean utility gain for NSAIDs was found to be 0.661, whereas for opioids it was 0.633. Probabilistic sensitivity analysis showed that at all willingness-to-pay thresholds, the probability of NSAIDs being cost-effective was higher than the probability of the opioids being cost-effective. The authors found NSAIDs to be a dominant strategy as compared with opioids. Considering the higher cost associated with opioids/combination opioid analgesics, it might be cost-effective if they are used in patients who did not respond to the NSAIDs.

Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.

PubMed

van der Roer, Nicole; van Tulder, Maurits; van Mechelen, Willem; de Vet, Henrica

2008-02-15

Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain. The intensive group training protocol combines exercise therapy, back school, and behavioral principles. Two studies found a significant reduction in absenteeism for a graded activity program in occupational health care. This program has not yet been evaluated in a primary care physiotherapy setting. Participating physical therapists in primary care recruited 114 patients with chronic nonspecific low back pain. Eligible patients were randomized to either the protocol group or the guideline group. Outcome measures included functional status (Roland Morris Disability Questionnaire), pain intensity (11-point numerical rating scale), general perceived effect and quality of life (EuroQol-5D). Cost data were measured with cost diaries and included direct and indirect costs related to low back pain. After 52 weeks, the direct health care costs were significantly higher for patients in the protocol group, largely due to the costs of the intervention. The mean difference in total costs amounted to [Euro sign] 233 (95% confidence interval: [Euro sign] -2.185; [Euro sign] 2.764). The cost-effectiveness planes indicated no significant differences in cost effectiveness between the 2 groups. The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.

Design Trade Study for a 4-Meter Off-Axis Primary Mirror Substrate and Mount for the Habitable-Zone Exoplanet Direct Imaging Mission

NASA Technical Reports Server (NTRS)

Arnold, William R.; Stahl, H. Philip

2017-01-01

An extensive trade study was conducted to evaluate primary mirror substrate design architectures for the HabEx mission baseline 4-meter off-axis telescope. The study’s purpose is not to produce a final design, but rather to established a design methodology for matching the mirror’s properties (mass and stiffness) with the mission’s optical performance specifications (static dynamic wavefront error, WFE). The study systematically compares the effect of proven design elements (closed-back vs. open-back vs. partial-back; meniscus vs. flat back vs. shaped back; etc.), which can be implemented with proven space mirror materials (ULE and Zerodur), on static and dynamic WFE. Additionally, the study compares static and dynamic WFE of each substrate point design integrated onto three and six point mounts.

Design trade study for a 4-meter off-axis primary mirror substrate and mount for the Habitable-zone Exoplanet Direct Imaging Mission

NASA Astrophysics Data System (ADS)

Arnold, William R.; Stahl, H. Philip

2017-09-01

An extensive trade study was conducted to evaluate primary mirror substrate design architectures for the HabEx mission baseline 4-meter off-axis telescope. The study's purpose is not to produce a final design, but rather to established a design methodology for matching the mirror's properties (mass and stiffness) with the mission's optical performance specifications (static dynamic wavefront error, WFE). The study systematically compares the effect of proven design elements (closed-back vs open-back vs partial-back; meniscus vs flat back vs shaped back; etc.), which can be implemented with proven space mirror materials (ULE and Zerodur), on static and dynamic WFE. Additionally, the study compares static and dynamic WFE of each substrate point design integrated onto three and six point mounts.

Small mammal mycophagy response to variations in green-tree retention

Treesearch

Katherine M. Jacobs; Daniel L. Luoma

2007-01-01

We studied the effects of six green-tree retention levels and patterns on the diets of northern flying squirrels (Glaucomys sabrinus), Townsend's chipmunks (Tamias townsendii), Siskiyou chipmunks (T. siskiyou), western red-backed voles (Myodes calijamicus), and southern red-backed voles (...

Water and Melting in Back-arc Basins: New perspectives from the Eastern Lau Spreading Center

NASA Astrophysics Data System (ADS)

Langmuir, C. H.; Bezos, A.; Escrig, S.; Michael, P. J.

2007-12-01

Since the work of Stolper and Newman (EPSL, 1994) it has been well recognized that water and extent of melting correlate positively in back-arc basin basalts. Quantification of this effect has been used to determine the effect of water content in the source on extent of melting. The slope of the relationship δF/δH2Oo is linear, and varies from one back-arc basin to another. MELTS and other modeling (Hirschmann et al., J. Petrol., 1999; Gaetani and Grove, Contrib. Mineral. Pet. 1998; Geophys. Mon., 2003; Kelley et al., JGR, 2006) has led to the suggestion that the slope varies regularly with mantle temperature, and that water has a much larger effect on melting at higher compared to lower temperatures. This modeling has been done in the context of isothermal, isobaric addition of water. For back-arcs worldwide, a critical aspect of the data is that more hydrous basalts have very low Fe contents, even when corrected appropriately for hydrous fractionation. This leads to clear negative correlations between Fe and H2O corrected back to mantle values at Fo90. The 3 wt.% variations in Fe content are not compatible with isobaric models, and require very different melting conditions for hydrous basalts as compared to anhydrous back-arc basalts. Back-arc basin basalts also plot on the global correlations of axial depth and Na8.0, and this relationship has been used to estimate mantle temperatures in back-arc basins, which on this basis extend to very high values. New data on major elements, trace elements and water from the Eastern Lau Spreading Center (ELSC), along with a re-evaluation of global back-arc data and modeling of mantle melting in the context of a polybaric spreading center environment (Langmuir et al., Geophys. Mon., 2006) provide new perspectives on these issues. The ELSC1 segment has a lower δF/δH2Oo than both the Mariana and Manus Basins, which would suggest the lowest temperature. However, its extent of melting inferred from its "F" intercept (on a plot of F vs. water in the source) is similar to the Marianas, suggesting a similar temperature, and its Na contents are as low as Manus, suggesting a high temperature. These inconsistent results can be understood from quantitative models and a more realistic melting process beneath back-arc spreading centers. δF/δH2Oo does not change with mantle temperature. In the back-arc environment, there are two independent halves of the melting regime, the "dry side" and the "wet side." The dry side undergoes polybaric fractional melting like other ocean ridges. The wet side (somehow) produces low pressure equilibrium hydrous melts with high water and low Fe contents. Mixing between the two creates the back-arc arrays. Large variations of Fe and Ti that anti-correlate linearly with water reflect this two component mixing in the back-arc. Both Ti and Na are mobile in the back-arc mantle, and source depletion and enrichment is an essential factor for evaluation of mantle temperature variations. Despite the low Na contents in the Lau Basin does not appear to be particularly hot, and instead is derived from a depleted mantle with low Na contents at only modestly elevated potential temperatures of 1400 degrees.

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

PubMed

Arial, Marc; Benoît, Damien; Wild, Pascal

2014-07-01

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

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

PubMed

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

2010-09-13

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

Effects of first formant onset frequency on [-voice] judgments result from auditory processes not specific to humans.

PubMed

Kluender, K R; Lotto, A J

1994-02-01

When F1-onset frequency is lower, longer F1 cut-back (VOT) is required for human listeners to perceive synthesized stop consonants as voiceless. K. R. Kluender [J. Acoust. Soc. Am. 90, 83-96 (1991)] found comparable effects of F1-onset frequency on the "labeling" of stop consonants by Japanese quail (coturnix coturnix japonica) trained to distinguish stop consonants varying in F1 cut-back. In that study, CVs were synthesized with natural-like rising F1 transitions, and endpoint training stimuli differed in the onset frequency of F1 because a longer cut-back resulted in a higher F1 onset. In order to assess whether earlier results were due to auditory predispositions or due to animals having learned the natural covariance between F1 cut-back and F1-onset frequency, the present experiment was conducted with synthetic continua having either a relatively low (375 Hz) or high (750 Hz) constant-frequency F1. Six birds were trained to respond differentially to endpoint stimuli from three series of synthesized /CV/s varying in duration of F1 cut-back. Second and third formant transitions were appropriate for labial, alveolar, or velar stops. Despite the fact that there was no opportunity for animal subjects to use experienced covariation of F1-onset frequency and F1 cut-back, quail typically exhibited shorter labeling boundaries (more voiceless stops) for intermediate stimuli of the continua when F1 frequency was higher. Responses by human subjects listening to the same stimuli were also collected. Results lend support to the earlier conclusion that part or all of the effect of F1 onset frequency on perception of voicing may be adequately explained by general auditory processes.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of support conditions on vertical whole-body vibration of the seated human body.

PubMed

M-Pranesh, Anand; Rakheja, Subhash; Demont, Richard

2010-01-01

The vibration transmission to the lumbar and thoracic segments of seated human subjects exposed to whole body vibration of a vehicular nature have been mostly characterised without the back and hand supports, which is not representative of general driving conditions. This non-invasive experimental study investigated the transmission of vertical seat vibration to selected vertebrae and the head along the vertical and fore-aft axes of twelve male human subjects seated on a rigid seat and exposed to random vertical excitation in the 0.5-20 Hz range. The measurements were performed under four different sitting postures involving combinations of back support conditions and hands positions, and three difference magnitudes of vertical vibration (0.25, 0.5 and 1.0 m/s(2) rms acceleration). The results showed significant errors induced by sensor misalignment and skin effects, which required appropriate correction methodologies. The averaged corrected responses revealed that the back support attenuates vibration in the vertical axis to all the body locations while increasing the fore-aft transmissibility at the C7 and T5. The hands position generally has a relatively smaller effect, showing some influences on the C7 and L5 vibration. Sitting without a back support resulted in very low magnitude fore-aft vibration at T5, which was substantially higher with a back support, suggestive of a probable change in the body's vibration mode. The effect of back support was observed to be very small on the horizontal vibration of the lower thoracic and lumbar regions. The results suggest that distinctly different target body-segment biodynamic functions need to be defined for different support conditions in order to represent the unique contribution of the specific support condition. These datasets may then be useful for the development of biodynamic models.

Efficacy of core muscle strengthening exercise in chronic low back pain patients.

PubMed

Kumar, Tarun; Kumar, Suraj; Nezamuddin, Md; Sharma, V P

2015-01-01

Low back pain is a common health problem in human being and about 5 to 15% will develop chronic low back pain (CLBP). The clinical findings of CLBP suggest that lumbar mobility is decreased and recruitment order of core muscles is altered. In literature, there is no data about the effect of core muscles strengthening in the chronicity (short duration, long duration) of CLBP. This study evaluated the effect of core muscle strengthening intervention on chronicity of chronic low back pain. Thirty patients were recruited from the outpatient department of the National Institute for the Orthopaedically Handicapped. These 30 patients divided into two groups: A and B on the basis of duration of low back pain. Group-A patients complain about pain duration for more than twelve months and Group B complains about pain duration from three to twelve months. Both the groups were received same intervention for six weeks. Assessment was done pre intervention and post intervention after six weeks for both the groups. %For both the groups the assessment was done after six weeks for pre and post intervention. The result described both the groups showed improvement in all the outcome measures including pain as well as in function using Numerical pain rating scale, Oswestry Disability Index, Sorensen test, Gluteus Maximus Strength, Activation of transversus abdominis and Modified-Modified Schober's Test. The improvement was statistically non-significant with inter groups and significant within group. This study concludes that core muscle strengthening exercise along with lumbar flexibility and gluteus maximus strengthening is an effective rehabilitation technique for all chronic low back pain patients irrespective of duration (less than one year and more than one year) of their pain.

Modification and performance evaluation of a mono-valve engine

NASA Astrophysics Data System (ADS)

Behrens, Justin W.

A four-stroke engine utilizing one tappet valve for both the intake and exhaust gas exchange processes has been built and evaluated. The engine operates under its own power, but has a reduced power capacity than the conventional 2-valve engine. The reduction in power is traced to higher than expected amounts of exhaust gases flowing back into the intake system. Design changes to the cylinder head will fix the back flow problems, but the future capacity of mono-valve engine technology cannot be estimated. The back flow of exhaust gases increases the exhaust gas recirculation (EGR) rate and deteriorates combustion. Intake pressure data shows the mono-valve engine requires an advanced intake valve closing (IVC) time to prevent back flow of charge air. A single actuation camshaft with advanced IVC was tested in the mono-valve engine, and was found to improve exhaust scavenging at TDC and nearly eliminated all charge air back flow at IVC. The optimum IVC timing is shown to be approximately 30 crank angle degrees after BDC. The mono-valve cylinder head utilizes a rotary valve positioned above the tappet valve. The open spaces inside the rotary valveand between the rotary valve and tappet valve represent a common volume that needs to be reduced in order to reduce the base EGR rate. Multiple rotary valve configurations were tested, and the size of the common volume was found to have no effect on back flow but a direct effect on the EGR rate and engine performance. The position of the rotary valve with respect to crank angle has a direct effect on the scavenging process. Optimum scavenging occurs when the intake port is opened just after TDC.

Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain.

PubMed

Paungmali, Aatit; Joseph, Leonard H; Sitilertpisan, Patraporn; Pirunsan, Ubon; Uthaikhup, Sureeporn

2017-11-01

Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain. A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions. Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident. Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain. © 2017 World Institute of Pain.

The effect of Kinesio® taping on pain, functionality, mobility and endurance in the treatment of chronic low back pain: A randomized controlled study.

PubMed

Köroğlu, Fahri; Çolak, Tuğba Kuru; Polat, M Gülden

2017-09-22

Low back pain is one of the most important causes of morbidity. This study was designed to evaluate the effect of Kinesio® taping on pain, functionality, mobility and endurance in chronic low back pain treatment. Patients with chronic low back pain were randomly divided into three groups. Therapeutic ultrasound, hot packs, and transcutaneous electrical nerve stimulation were applied to each group for ten sessions during two weeks, and therapeutic exercises were applied in the clinic under physiotherapist supervision starting from the sixth session. Kinesio® tape was applied to the patients in the first group after each treatment session, and placebo tape was applied to the patients in the second group. No taping was applied to the third group, which constituted the control group. All the patients were evaluated pre and post-treatment in respect of pain, functional status (Oswestry scale), flexibility and endurance. The study included 60 patients (32 females). When the initial demographic and clinical characteristics of the groups were evaluated, all assessment results, except the Oswestry scores, were similar (p= 0.000). When the average changes in the clinical evaluations were evaluated after the treatment, a statistically significant improvement demonstrating the superiority of the taping group was observed in pain, functionality, flexibility and endurance values (p= 0.000, 0.000, 0.000, 0.000). Kinesio® taping in chronic low back pain is an easy and effective method which increases the effectiveness of the treatment significantly in a short period when applied in addition to exercise and electrotherapy methods.

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2017-12-01

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

Effects of different frequencies (2-3 days/week) of aquatic therapy program in adults with chronic low back pain. A non-randomized comparison trial.

PubMed

Baena-Beato, Pedro Angel; Arroyo-Morales, Manuel; Delgado-Fernández, Manuel; Gatto-Cardia, Maria Claudia; Artero, Enrique G

2013-01-01

To study the effects of an aquatic therapy program with different frequencies (2 vs 3 days per week) in chronic low back pain. [corrected] Non-randomized comparison trial. Sport and spa community health club. Fifty-four adults with chronic low back pain (48.9 ± 10.0 years). Eight-week aquatic therapy program. Pain (visual analog scale [VAS]), disability (Oswestry Disability Index), and quality of life (Short-Form Health Survey 36), body composition (weight, body mass index, body fat mass, body fat percentage, and skeletal muscle mass), and health-related fitness (sit and reach, handgrip strength, curl-up, Rockport 1-mile test). Both experimental groups presented significant improvements in low back pain and disability (P < 0.001) compared with control group. The 3 days/week group showed significantly greater benefits at VAS flexion and disability (P < 0.001) than the 2 days/week group. Regarding quality of life, both intervention groups presented significant differences for Physical Role (P < 0.05), Bodily Pain (P < 0.001), General Health (P = 0.012), and Standardized Physical Component (P < 0.001) compared with control group. Both experimental groups significantly improved all health-related fitness parameters (P < 0.01). The 3 days/week group showed significantly greater benefits at curl-up and heart rate (P < 0.001) than the 2 days/week group. No significant changes between treatment groups and control were found in body composition. Eight weeks of aquatic therapy program decrease levels of back pain and disability, increase quality of life, and improve health-related fitness in adults with chronic low back pain without effects in body composition. A dose-response effect was observed in some parameters, with greater benefits when exercising 3 days per week compared with 2 days. Wiley Periodicals, Inc.

The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences

PubMed Central

Eghbali, Maryam; Safari, Reza; Nazari, Fatemeh; Abdoli, Samereh

2012-01-01

Background: Humans have been involved with the phenomena of pain and pain relief from the ancient times. Back pain is the most common pain. In fact, eight out of ten people experience it in their lifetime. However, individuals with specific jobs, including nurses, are faced with this problem more. Nursing is in the top ten careers suffering from the most severe musculoskeletal injuries. There are non-pharmacologic and pharmacologic treatments to relieve back pain. One of the non-medical treatments of pain is called reflexology which is a branch of complementary and alternative therapies. This research has been conducted to investigate the effect of reflexology on chronic low back pain intensity. Materials and Methods: This study was a double-blind clinical trial. The study population consisted of 50 female and male nurses suffering from chronic low back pain working in hospitals affiliated with Isfahan University of Medical Sciences. The participants were divided into two groups of reflexology and non-specific massage. A questionnaire was completed through interviews and a 40 minute sessions of interventions were performed three times a week for two weeks. Pain intensity was measured by Numerical Analogue Scale for pain before and after the intervention. Descriptive and inferential statistics, including independent t-test and chi-square test, were used to analyze the data. Findings: The results showed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention as compared with the non-specific massage group. However, the non-specific massage was also significantly effective in reducing pain. Conclusions: Reflexology can be effective in reducing the severity of chronic back pain, i.e. it is able to reduce pain from moderate to mild. Thus, this technique is recommended to be performed by nurses as a complementary therapy in patient care. PMID:23833620

The Effect Dry Cupping Therapy at Acupoint BL23 on the Intensity of Postpartum Low Back Pain in Primiparous Women Based on Two Types of Questionnaires, 2012; A Randomized Clinical Trial.

PubMed

Akbarzadeh, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Azizi, Amir; Mohagheghzadeh, Abdolali

2014-04-01

Continuous low back pain is associated with the symptoms of the pregnancy period. In spite of the improvement of low back pain within 6 months after the delivery, some women may develop chronic problems. This study aimed to investigate the effect of dry cupping therapy at BL23 point on the intensity of low back pain in primiparous women.  In the present randomized clinical trial, 100 samples were randomly allocated to either the cupping therapy or the control group (each containing 50 subjects). Cupping therapy was performed for 15-20 minutes every day up to 4 consecutive times. Visual Analogue Scale (VAS) and short-form McGill pain questionnaire were completed by the two groups before the intervention and immediately, 24 hours, and 2 weeks after that. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using chi-square test and repeated measures ANOVA. According to VAS, the mean intensity of low back pain in the cupping therapy group decreased from 7.8±2.7 before the intervention to 3.7±1.8, 2.5±1.7, and 1.4±1.4 immediately, 24 hours, and 2 weeks after the intervention, respectively. Besides, these measures were respectively obtained as 31.8±10.8, 9.0±6.7, 7.5±6.6, and 3.6±4.1 in the short-form McGill pain questionnaire. According to repeated measures ANOVA, a significant difference was observed among the various stages of follow-up (P=0.01). The study results showed cupping therapy to be effective in sedation of pain. Thus, it can be used as an effective treatment for reducing the low back pain. 2013072611944N3.

The Effect Dry Cupping Therapy at Acupoint BL23 on the Intensity of Postpartum Low Back Pain in Primiparous Women Based on Two Types of Questionnaires, 2012; A Randomized Clinical Trial

PubMed Central

Akbarzadeh, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Azizi, Amir; Mohagheghzadeh, Abdolali

2014-01-01

Background: Continuous low back pain is associated with the symptoms of the pregnancy period. In spite of the improvement of low back pain within 6 months after the delivery, some women may develop chronic problems. This study aimed to investigate the effect of dry cupping therapy at BL23 point on the intensity of low back pain in primiparous women.  Methods: In the present randomized clinical trial, 100 samples were randomly allocated to either the cupping therapy or the control group (each containing 50 subjects). Cupping therapy was performed for 15-20 minutes every day up to 4 consecutive times. Visual Analogue Scale (VAS) and short-form McGill pain questionnaire were completed by the two groups before the intervention and immediately, 24 hours, and 2 weeks after that. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using chi-square test and repeated measures ANOVA. Results: According to VAS, the mean intensity of low back pain in the cupping therapy group decreased from 7.8±2.7 before the intervention to 3.7±1.8, 2.5±1.7, and 1.4±1.4 immediately, 24 hours, and 2 weeks after the intervention, respectively. Besides, these measures were respectively obtained as 31.8±10.8, 9.0±6.7, 7.5±6.6, and 3.6±4.1 in the short-form McGill pain questionnaire. According to repeated measures ANOVA, a significant difference was observed among the various stages of follow-up (P=0.01). Conclusion: The study results showed cupping therapy to be effective in sedation of pain. Thus, it can be used as an effective treatment for reducing the low back pain. Trial Registration Number: 2013072611944N3 PMID:25349852

A bio-psycho-social exercise program (RÜCKGEWINN) for chronic low back pain in rehabilitation aftercare--study protocol for a randomised controlled trial.

PubMed

Hentschke, Christian; Hofmann, Jana; Pfeifer, Klaus

2010-11-17

There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours). Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent. This study aims to examine the efficacy of a specially developed bio-psycho-social chronic back pain specific aftercare intervention (RÜCKGEWINN) in comparison to the current usual aftercare (IRENA) and a control group that is given an educational booklet addressing pain-conditioned functional ability and back pain episodes. Overall rehabilitation effects as well as predictors for compliance to the aftercare programs are analysed. Therefore, a multicenter prospective 3-armed randomised controlled trial is conducted. 456 participants will be consecutively enrolled in inpatient and outpatient rehabilitation and assigned to either one of the three study arms. Outcomes are measured before and after rehabilitation. Aftercare programs are assessed at ten month follow up after dismissal form rehabilitation. Special methodological and logistic challenges are to be mastered in this trial, which accrue from the interconnection of aftercare interventions to their residential district and the fact that the proportion of patients who take part in aftercare programs is low. The usability of the aftercare program is based on the transference into the routine care and is also reinforced by developed manuals with structured contents, media and material for organisation assistance as well as training manuals for therapists in the aftercare.

Back muscle response to sudden trunk loading can be modified by training among healthcare workers.

PubMed

Pedersen, Mogens Theisen; Essendrop, Morten; Skotte, Jørgen H; Jørgensen, Kurt; Schibye, Bente; Fallentin, Nils

2007-06-01

Experimental study of the effect of physical training on the reaction to sudden back loading. To investigate the effect and sustainability of "on the job training" on the reaction to sudden back loading among employees at a geriatric ward. Available data suggest that a delayed muscle reflex response to sudden trunk loading may increase the risk of low back injuries. We have previously shown that training may alter the response to sudden trunk loading in healthy subjects and decrease the time elapsed until stopping of the forward movement of the trunk (stopping time). Data on the possibilities of a training-induced improvement in the reflex response among workers exposed to sudden trunk loading on the job are, however, nonexistent, and there is no evidence of long-term benefits, i.e., the sustainability of a positive training effect. The study included 23 participants and 14 controls. All were healthy without prior history of low back pain (LBP). The training group participated in a total of 18 training sessions during a 9-week period. The training focused on reactions to a variety of sudden trunk loadings. Before and after the training intervention and at a 1-year follow-up, all subjects were tested for their reaction to expected and unexpected sudden trunk loading by applying a horizontal force of 58 N to the upper back of the subjects and measuring the electromyographic (EMG) response from the erector spinae muscles. In the training group, the stopping time and the distance moved after unexpected sudden trunk loading decreased significantly (13%-19%, P = 0.02). The improved stopping time was associated with marked changes in the time-wise distribution of the EMG signal after training. In addition, the follow-up study showed a high sustainability of the training effect. The results demonstrated a training-induced improvement of the response to sudden trunk loading that may be beneficial in workers, such as nurses, who are exposed to sudden trunk perturbations during patient handling.

Interventions for preventing and treating low-back and pelvic pain during pregnancy.

PubMed

Liddle, Sarah D; Pennick, Victoria

2015-09-30

More than two-thirds of pregnant women experience low-back pain and almost one-fifth experience pelvic pain. The two conditions may occur separately or together (low-back and pelvic pain) and typically increase with advancing pregnancy, interfering with work, daily activities and sleep. To update the evidence assessing the effects of any intervention used to prevent and treat low-back pain, pelvic pain or both during pregnancy. We searched the Cochrane Pregnancy and Childbirth (to 19 January 2015), and the Cochrane Back Review Groups' (to 19 January 2015) Trials Registers, identified relevant studies and reviews and checked their reference lists. Randomised controlled trials (RCTs) of any treatment, or combination of treatments, to prevent or reduce the incidence or severity of low-back pain, pelvic pain or both, related functional disability, sick leave and adverse effects during pregnancy. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included 34 RCTs examining 5121 pregnant women, aged 16 to 45 years and, when reported, from 12 to 38 weeks' gestation. Fifteen RCTs examined women with low-back pain (participants = 1847); six examined pelvic pain (participants = 889); and 13 examined women with both low-back and pelvic pain (participants = 2385). Two studies also investigated low-back pain prevention and four, low-back and pelvic pain prevention. Diagnoses ranged from self-reported symptoms to clinicians' interpretation of specific tests. All interventions were added to usual prenatal care and, unless noted, were compared with usual prenatal care. The quality of the evidence ranged from moderate to low, raising concerns about the confidence we could put in the estimates of effect. For low-back painResults from meta-analyses provided low-quality evidence (study design limitations, inconsistency) that any land-based exercise significantly reduced pain (standardised mean difference (SMD) -0.64; 95% confidence interval (CI) -1.03 to -0.25; participants = 645; studies = seven) and functional disability (SMD -0.56; 95% CI -0.89 to -0.23; participants = 146; studies = two). Low-quality evidence (study design limitations, imprecision) also suggested no significant differences in the number of women reporting low-back pain between group exercise, added to information about managing pain, versus usual prenatal care (risk ratio (RR) 0.97; 95% CI 0.80 to 1.17; participants = 374; studies = two). For pelvic painResults from a meta-analysis provided low-quality evidence (study design limitations, imprecision) of no significant difference in the number of women reporting pelvic pain between group exercise, added to information about managing pain, and usual prenatal care (RR 0.97; 95% CI 0.77 to 1.23; participants = 374; studies = two). For low-back and pelvic painResults from meta-analyses provided moderate-quality evidence (study design limitations) that: an eight- to 12-week exercise program reduced the number of women who reported low-back and pelvic pain (RR 0.66; 95% CI 0.45 to 0.97; participants = 1176; studies = four); land-based exercise, in a variety of formats, significantly reduced low-back and pelvic pain-related sick leave (RR 0.76; 95% CI 0.62 to 0.94; participants = 1062; studies = two).The results from a number of individual studies, incorporating various other interventions, could not be pooled due to clinical heterogeneity. There was moderate-quality evidence (study design limitations or imprecision) from individual studies suggesting that osteomanipulative therapy significantly reduced low-back pain and functional disability, and acupuncture or craniosacral therapy improved pelvic pain more than usual prenatal care. Evidence from individual studies was largely of low quality (study design limitations, imprecision), and suggested that pain and functional disability, but not sick leave, were significantly reduced following a multi-modal intervention (manual therapy, exercise and education) for low-back and pelvic pain.When reported, adverse effects were minor and transient. There is low-quality evidence that exercise (any exercise on land or in water), may reduce pregnancy-related low-back pain and moderate- to low-quality evidence suggesting that any exercise improves functional disability and reduces sick leave more than usual prenatal care. Evidence from single studies suggests that acupuncture or craniosacral therapy improves pregnancy-related pelvic pain, and osteomanipulative therapy or a multi-modal intervention (manual therapy, exercise and education) may also be of benefit.Clinical heterogeneity precluded pooling of results in many cases. Statistical heterogeneity was substantial in all but three meta-analyses, which did not improve following sensitivity analyses. Publication bias and selective reporting cannot be ruled out.Further evidence is very likely to have an important impact on our confidence in the estimates of effect and change the estimates. Studies would benefit from the introduction of an agreed classification system that can be used to categorise women according to their presenting symptoms, so that treatment can be tailored accordingly.

Effectiveness of a Seat Pad in Reducing Back Pain in Long-Distance Drivers Deployed to Kuwait, October 2008-May 2009

DTIC Science & Technology

2009-12-01

Bovenzi and Hulshof , 199970 ) Summary Prevalence Odds Summary Incidence I Disorder Studies (n) Ratio (Vibration Exposed! Density Ratio (Vibration...Ratios for Low Back Pain among Tractor Drivers as a Function of Whole Body Vibration Exposure (Bovenzi and Hulshof 19997°) (c) The most recent...Tiemessen I.J.H., Hulshof C.T.l, and Frings-Dresen M.H.W. 2008. Low back pain in drivers exposed to whole body vibration: analysis of a dose-response

On measurements of Effective Residual Ink Concentration (ERIC) of deinked papers using Kubelka-Munk theory

Treesearch

D.W. Vahey; J.Y. Zhu; C.J. Houtman

2006-01-01

The measurement of effective residual ink concentration (ERIC) in recycled papers depends on their opacity. For opacity less than 97.0%, the method is based on application of the Kubelka-Munk theory to diffuse reflection from papers measured once with a black backing and again with a thick backing of the same papers. At opacities above 97.0%, the two reflection values...

The effectiveness of Cognitive Behavioral Therapy (CBT) with general exercises versus general exercises alone in the management of chronic low back pain.

PubMed

Khan, Muhammad; Akhter, Saeed; Soomro, Rabail Rani; Ali, Syed Shahzad

2014-07-01

To evaluate the effectiveness of Cognitive Behavioural Therapy (CBT) along with General exercises and General exercises alone in chronic low back pain. Total 54 patients with chronic low back pain who fulfilled inclusion criteria were recruited from Physiotherapy, Department of Alain Poly Clinic Karachi and Institute of Physical Medicine & Rehabilitation Dow University of Health Sciences Karachi. Selected patients were equally divided and randomly assigned into two groups with simple randomisation method. The Cognitive Behavioural Therapy (CBT) and General exercises group received Operant model of CBT and General Exercises whereas General exercises group received General exercises only. Both groups received a home exercise program as well. Patients in both groups received 3 treatment sessions per week for 12 consecutive weeks. Clinical assessment was performed using Visual Analogue Scale (VAS) and Ronald Morris Disability Questionnaire at baseline and after 12 weeks. Both study groups showed statistically significant improvements in both outcomes measures p=0.000. However, mean improvements in post intervention VAS score and Ronald Morris score was better in CBT and exercises group as compared to General exercise group. In conclusion, both interventions are effective in treating chronic low back pain however; CBT & General exercises are clinically more effective than General exercises alone.

A Novel Nitronyl Nitroxide with Salicylic Acid Framework Attenuates Pain Hypersensitivity and Ectopic Neuronal Discharges in Radicular Low Back Pain.

PubMed

Han, Wen-Juan; Chen, Lei; Wang, Hai-Bo; Liu, Xiang-Zeng; Hu, San-Jue; Sun, Xiao-Li; Luo, Ceng

2015-01-01

Evidence has accumulated that reactive oxygen species and inflammation play crucial roles in the development of chronic pain, including radicular low back pain. Nonsteroid anti-inflammatory drugs (NSAIDs), for example, salicylic acid, aspirin, provided analgesic effects in various types of pain. However, long-term use of these drugs causes unwanted side effects, which limits their implication. Stable nitronyl (NIT) nitroxide radicals have been extensively studied as a unique and interesting class of new antioxidants for protection against oxidative damage. The present study synthesized a novel NIT nitroxide radical with salicylic acid framework (SANR) to provide synergistic effect of both antioxidation and antiinflammation. We demonstrated for the first time that both acute and repeated SANR treatment exerted dramatic analgesic effect in radicular low back pain mimicked by chronic compression of dorsal root ganglion in rats. This analgesic potency was more potent than that produced by classical NSAIDs aspirin and traditional nitroxide radical Tempol alone. Furthermore, SANR-induced behavioral analgesia is found to be mediated, at least in partial, by a reduction of ectopic spontaneous discharges in injured DRG neurons. Therefore, the synthesized NIT nitroxide radical coupling with salicylic acid framework may represent a novel potential therapeutic candidate for treatment of chronic pain, including radicular low back pain.

A crystallographic model for the tensile and fatigue response for Rene N4 at 982 C

NASA Technical Reports Server (NTRS)

Sheh, M. Y.; Stouffer, D. C.

1990-01-01

An anisotropic constitutive model based on crystallographic slip theory was formulated for nickel-base single-crystal superalloys. The current equations include both drag stress and back stress state variables to model the local inelastic flow. Specially designed experiments have been conducted to evaluate the existence of back stress in single crystals. The results showed that the back stress effect of reverse inelastic flow on the unloading stress is orientation-dependent, and a back stress state variable in the inelastic flow equation is necessary for predicting inelastic behavior. Model correlations and predictions of experimental data are presented for the single crystal superalloy Rene N4 at 982 C.

Anisotropic constitutive modeling for nickel base single crystal superalloys using a crystallographic approach

NASA Technical Reports Server (NTRS)

Stouffer, D. C.; Sheh, M. Y.

1988-01-01

A micromechanical model based on crystallographic slip theory was formulated for nickel-base single crystal superalloys. The current equations include both drag stress and back stress state variables to model the local inelastic flow. Specially designed experiments have been conducted to evaluate the effect of back stress in single crystals. The results showed that (1) the back stress is orientation dependent; and (2) the back stress state variable in the inelastic flow equation is necessary for predicting anelastic behavior of the material. The model also demonstrated improved fatigue predictive capability. Model predictions and experimental data are presented for single crystal superalloy Rene N4 at 982 C.

Emotional Disturbance and Chronic Low Back Pain.

ERIC Educational Resources Information Center

McCreary, Charles P.; And Others

1980-01-01

Patients high in alientation and distrust may be poor compliers. Because only the somatic concern dimension predicted outcome, a single scale that measures this characteristic may be sufficient for effective identification of the potential good v poor responders to conservative treatment of low back pain. (Author)

EFFECTIVE CONTROL SYSTEMS

EPA Science Inventory

One commonly used approach to CSO pollution abatement is to rely on a storm-event based design of storage-tank volume to capture CSO for pump-back and/or bleed-back (gravity flow) to the existing WWTP for treatment. However, this approach may not be by itself the most economical...

[Occupational low back pain in nursing workers: massage versus pain].

PubMed

Borges, Talita Pavarini; Kurebayashi, Leonice Fumiko Sato; Silva, Maria Júlia Paes da

2014-08-01

To assess the efficacy of massage for decreasing occupational low back pain in workers of a Nursing team in an Emergency Room. A randomized controlled trial, using a socio-demographic/morbidity questionnaire and a Pain Numeric Scale. Forty-five subjects were randomly allocated for intervention (G1 - Massage by acupressure), placebo group (G2 - application of Garlium Arseneid Laser 904 nm turned off) and control (G3 - no intervention). The main triggering factor, as well as the worsening of pain, was the patient manipulation, both with a prevalence of 34.9%. The main treatment for low back pain before this research was the use of medication, with a prevalence of 44.2%. In accordance with a variance analysis, only G1 presented a significant statistical difference, with a better result after 12 sessions. Massage presented an enormous effect (d = 4.59), corresponding to 86% of reduction in the pain level. Massage was effective to decrease occupational low back pain of those Nursing workers.

Working height, block mass and one- vs. two-handed block handling: the contribution to low back and shoulder loading during masonry work.

PubMed

Faber, G S; Kingma, I; Kuijer, P P F M; van der Molen, H F; Hoozemans, M J M; Frings-Dresen, M H W; van Dieën, J H

2009-09-01

The goal of this study was to compare the effects of the task variables block mass, working height and one- vs. two-handed block handling on low back and shoulder loading during masonry work. In a mock-up of a masonry work site, nine masonry workers performed one- and two-handed block-lifting and block-placing tasks at varying heights (ranging from floor to shoulder level) with blocks of varying mass (ranging from 6 to 16 kg). Kinematics and ground reaction forces were measured and used in a 3-D linked segment model to calculate low back and shoulder loading. Increasing lifting height appeared to be the most effective way to reduce low back loading. However, working at shoulder level resulted in relatively high shoulder loading. Therefore, it was recommended to organise masonry work in such a way that blocks are handled with the hands at about iliac crest height as much as possible.

Regulation of Cognitive Resources During an N-Back Task in Youth-Onset Psychosis and Attention-Deficit/Hyperactivity Disorder (ADHD)

PubMed Central

Karatekin, Canan; Bingham, Christopher; White, Tonya

2009-01-01

The goals of the current study were to use behavioral and pupillary measures to examine working memory on a spatial n-back task in 8-20-year-olds with youth-onset psychosis or ADHD (Combined subtype) and healthy controls to determine the contribution of different attentional factors to spatial working memory impairments, and to examine if age-related changes in performance differed across groups. Although both clinical groups had lower perceptual sensitivity on both 0- and 1-back, there was no evidence of an impairment in spatial working memory or differential order effects on the 0-back. Instead, results suggest that both clinical groups had difficulty encoding the stimuli. They also appeared to have difficulty maintaining attention and/or readiness to respond, and, to a lesser extent, recruiting resources on a trial-to-trial basis. It is likely that these attentional problems prevented the clinical groups from encoding the stimuli effectively and contributed to their general performance deficits. PMID:19427339

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.

Epidural steroid injections are useful for the treatment of low back pain and radicular symptoms: pro.

PubMed

Sethee, Jai; Rathmell, James P

2009-02-01

Epidural steroid injection has been used to treat low back pain for many decades. Numerous randomized trials have examined the efficacy of this approach. This review details the findings of older systematic reviews, newer randomized controlled trials, and two recent systematic reviews that examine the effectiveness of this treatment. Collectively, studies in acute radicular pain due to herniated nucleus pulposus have failed to show that epidural steroid injection reduces long-term pain or obviates the need for surgery. Similarly, there is scant evidence that epidural steroids have any beneficial effect in those with acute low back pain without leg pain or in those with chronic low back or leg pain. However, most studies have demonstrated more rapid resolution of leg pain in those who received epidural steroid injections versus those who did not. The role of epidural steroid injections in the management of acute radicular pain due to herniated nucleus pulposus is simply to provide earlier pain relief.

A randomized controlled trial of intensive neurophysiology education in chronic low back pain.

PubMed

Moseley, G Lorimer; Nicholas, Michael K; Hodges, Paul W

2004-01-01

Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. This study was a blinded randomized controlled trial. Individual education sessions on neurophysiology of pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal "drawing-in" task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.

I-125 ROPES eye plaque dosimetry: Validation of a commercial 3D ophthalmic brachytherapy treatment planning system and independent dose calculation software with GafChromic{sup ®} EBT3 films

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

Poder, Joel; Corde, Stéphanie

Purpose: The purpose of this study was to measure the dose distributions for different Radiation Oncology Physics and Engineering Services, Australia (ROPES) type eye plaques loaded with I-125 (model 6711) seeds using GafChromic{sup ®} EBT3 films, in order to verify the dose distributions in the Plaque Simulator™ (PS) ophthalmic 3D treatment planning system. The brachytherapy module of RADCALC{sup ®} was used to independently check the dose distributions calculated by PS. Correction factors were derived from the measured data to be used in PS to account for the effect of the stainless steel ROPES plaque backing on the 3D dose distribution.Methods:more » Using GafChromic{sup ®} EBT3 films inserted in a specially designed Solid Water™ eye ball phantom, dose distributions were measured three-dimensionally both along and perpendicular to I-125 (model 6711) loaded ROPES eye plaque's central axis (CAX) with 2 mm depth increments. Each measurement was performed in full scatter conditions both with and without the stainless steel plaque backing attached to the eye plaque, to assess its effect on the dose distributions. Results were compared to the dose distributions calculated by Plaque Simulator™ and checked independently with RADCALC{sup ®}.Results: The EBT3 film measurements without the stainless steel backing were found to agree with PS and RADCALC{sup ®} to within 2% and 4%, respectively, on the plaque CAX. Also, RADCALC{sup ®} was found to agree with PS to within 2%. The CAX depth doses measured using EBT3 film with the stainless steel backing were observed to result in a 4% decrease relative to when the backing was not present. Within experimental uncertainty, the 4% decrease was found to be constant with depth and independent of plaque size. Using a constant dose correction factor of T= 0.96 in PS, where the calculated dose for the full water scattering medium is reduced by 4% in every voxel in the dose grid, the effect of the plaque backing was accurately modeled in the planning system. Off-axis profiles were also modeled in PS by taking into account the three-dimensional model of the plaque backing.Conclusions: The doses calculated by PS and RADCALC{sup ®} for uniformly loaded ROPES plaques in full and uniform scattering conditions were validated by the EBT3 film measurements. The stainless steel plaque backing was observed to decrease the measured dose by 4%. Through the introduction of a scalar correction factor (0.96) in PS, the dose homogeneity effect of the stainless steel plaque backing was found to agree with the measured EBT3 film measurements.« less

I-125 ROPES eye plaque dosimetry: validation of a commercial 3D ophthalmic brachytherapy treatment planning system and independent dose calculation software with GafChromic® EBT3 films.

PubMed

Poder, Joel; Corde, Stéphanie

2013-12-01

The purpose of this study was to measure the dose distributions for different Radiation Oncology Physics and Engineering Services, Australia (ROPES) type eye plaques loaded with I-125 (model 6711) seeds using GafChromic(®) EBT3 films, in order to verify the dose distributions in the Plaque Simulator™ (PS) ophthalmic 3D treatment planning system. The brachytherapy module of RADCALC(®) was used to independently check the dose distributions calculated by PS. Correction factors were derived from the measured data to be used in PS to account for the effect of the stainless steel ROPES plaque backing on the 3D dose distribution. Using GafChromic(®) EBT3 films inserted in a specially designed Solid Water™ eye ball phantom, dose distributions were measured three-dimensionally both along and perpendicular to I-125 (model 6711) loaded ROPES eye plaque's central axis (CAX) with 2 mm depth increments. Each measurement was performed in full scatter conditions both with and without the stainless steel plaque backing attached to the eye plaque, to assess its effect on the dose distributions. Results were compared to the dose distributions calculated by Plaque Simulator™ and checked independently with RADCALC(®). The EBT3 film measurements without the stainless steel backing were found to agree with PS and RADCALC(®) to within 2% and 4%, respectively, on the plaque CAX. Also, RADCALC(®) was found to agree with PS to within 2%. The CAX depth doses measured using EBT3 film with the stainless steel backing were observed to result in a 4% decrease relative to when the backing was not present. Within experimental uncertainty, the 4% decrease was found to be constant with depth and independent of plaque size. Using a constant dose correction factor of T = 0.96 in PS, where the calculated dose for the full water scattering medium is reduced by 4% in every voxel in the dose grid, the effect of the plaque backing was accurately modeled in the planning system. Off-axis profiles were also modeled in PS by taking into account the three-dimensional model of the plaque backing. The doses calculated by PS and RADCALC(®) for uniformly loaded ROPES plaques in full and uniform scattering conditions were validated by the EBT3 film measurements. The stainless steel plaque backing was observed to decrease the measured dose by 4%. Through the introduction of a scalar correction factor (0.96) in PS, the dose homogeneity effect of the stainless steel plaque backing was found to agree with the measured EBT3 film measurements.

The treatment effect of hamstring stretching and nerve mobilization for patients with radicular lower back pain

PubMed Central

Lee, Ju-hyun; Kim, Tae-ho

2017-01-01

[Purpose] In this paper, hamstring stretching and nerve mobilization are conducted on patients with radicular lower back pain, and changes to pain levels, pressure thresholds, angles of knee joint extension, and disorder levels of lower back pain were studied. [Subjects and Methods] The subjects were divided into two groups: one group conducted hamstring stretches and was comprised of 6 male and 5 female subjects, and the other group received nerve mobilization treatment and was comprised of 5 male and 6 female subjects. [Results] Pain level and the disorder index of lower back pain were significantly alleviated after the intervention in both groups. Pressure threshold and angles of knee extension were significantly increased after the intervention in both groups. Comparing the two groups, the alleviation of pain was more significant in the nerve mobilization group. [Conclusion] Patients with radicular lower back pain showed significant differences in pain level, pressure threshold, knee extension angle, and disorder index of lower back pain for both the hamstring stretching group and nerve mobilization group after the treatment. Hamstring stretching and nerve mobilization can be usefully applied for the therapy of patients with radicular lower back pain. PMID:28931991

Back pain and exposure to whole body vibration in helicopter pilots.

PubMed

Bongers, P M; Hulshof, C T; Dijkstra, L; Boshuizen, H C; Groenhout, H J; Valken, E

1990-08-01

In a questionnaire survey the prevalence of back pain in 163 helicopter pilots was compared to that in a control group of 297 non-flying air force officers who underwent the same pre-employment medical examination. Since pilots document their hours of flight in a personal flight log, an accurate estimate of the duration of exposure could be made. In addition, vibration levels of the helicopters were measured and an accumulative vibration dose was calculated for each pilot. 'Transient' back pain of a short duration was more frequent amongst the pilots compared to the control group, and the prevalence of 'chronic' back pain of a persistent nature was also higher amongst the helicopter pilots. Transient back pain seemed to be most strongly related to the average hours of flight per day, whereas chronic back pain was more closely related to total hours of flight or the accumulative vibration dose. A significant higher prevalence of this chronic back pain was observed only after 2000 hours of flight or a vibration dose of 400 m2h/s4. The observed health effects may be due to vibration or constrained posture but are most likely due to concomitant exposure to both factors.

Low-cost, high-speed back-end processing system for high-frequency ultrasound B-mode imaging.

PubMed

Chang, Jin Ho; Sun, Lei; Yen, Jesse T; Shung, K Kirk

2009-07-01

For real-time visualization of the mouse heart (6 to 13 beats per second), a back-end processing system involving high-speed signal processing functions to form and display images has been developed. This back-end system was designed with new signal processing algorithms to achieve a frame rate of more than 400 images per second. These algorithms were implemented in a simple and cost-effective manner with a single field-programmable gate array (FPGA) and software programs written in C++. The operating speed of the back-end system was investigated by recording the time required for transferring an image to a personal computer. Experimental results showed that the back-end system is capable of producing 433 images per second. To evaluate the imaging performance of the back-end system, a complete imaging system was built. This imaging system, which consisted of a recently reported high-speed mechanical sector scanner assembled with the back-end system, was tested by imaging a wire phantom, a pig eye (in vitro), and a mouse heart (in vivo). It was shown that this system is capable of providing high spatial resolution images with fast temporal resolution.

Low-Cost, High-Speed Back-End Processing System for High-Frequency Ultrasound B-Mode Imaging

PubMed Central

Chang, Jin Ho; Sun, Lei; Yen, Jesse T.; Shung, K. Kirk

2009-01-01

For real-time visualization of the mouse heart (6 to 13 beats per second), a back-end processing system involving high-speed signal processing functions to form and display images has been developed. This back-end system was designed with new signal processing algorithms to achieve a frame rate of more than 400 images per second. These algorithms were implemented in a simple and cost-effective manner with a single field-programmable gate array (FPGA) and software programs written in C++. The operating speed of the back-end system was investigated by recording the time required for transferring an image to a personal computer. Experimental results showed that the back-end system is capable of producing 433 images per second. To evaluate the imaging performance of the back-end system, a complete imaging system was built. This imaging system, which consisted of a recently reported high-speed mechanical sector scanner assembled with the back-end system, was tested by imaging a wire phantom, a pig eye (in vitro), and a mouse heart (in vivo). It was shown that this system is capable of providing high spatial resolution images with fast temporal resolution. PMID:19574160

Effectiveness of diadynamic currents and transcutaneous electrical nerve stimulation in disc disease lumbar part of spine.

PubMed

Ratajczak, Barbara; Hawrylak, Arletta; Demidaś, Aneta; Kuciel-Lewandowska, Jadwiga; Boerner, Ewa

2011-01-01

Back pain has multi-factorial etiology and is modified by environmental influences, character of work, and individual predispositions. The aim of this study was to compare the efficiency of analgesic DD current therapy and TENS in low back discopathy. Eighty patients (age, 45-60 years) with diagnosed low back pain syndrome due to discopathy were subjected to therapy. In the first group (DD) of 40 people, DD current therapy was applied. In the second group (TENS) of 40 people, TENS was applied. The third group of 40 people was a control group in which a functional fitness test was performed for comparison purposes. The control group was in this case an equivalent to a norm. Before the beginning and on the completion of therapy in all patients, a pain level measurement and functional fitness test were performed. On the basis of research conducted it was stated that both therapies reduce pain level effectively. Obtained analyzed results conclude that both therapies applied have an analgesic effect. DD current and TENS therapies in low back discopathy have an analgesic impact and improve functional fitness. The applied therapies have a comparable impact on researched parameters.

[The effects of hand acupuncture therapy on pain, ROM, ADL and depression among elders with low back pain and knee joint pain].

PubMed

Yang, Jin-Hyang

2009-02-01

The purpose of this study was to identify the effects of hand acupuncture therapy on pain, ROM, ADL, and depression among older people with low back pain and knee joint pain. The research was a quasi-experimental design using a non-equivalent control group pre-post test. The participants were 40 patients, 18 in the experimental group and 22 in the control group. A pretest and 2 posttest were conducted to measure the main variables. For the experimental group, hand acupuncture therapy, consisting of hand acupuncture and press-pellets based on corresponding points, was given. There were statistically significant differences in pain, ROM in knee joint, and ADL in the experimental group but not in depression compared to the control group over two different times. The hand acupuncture therapy was effective for low back pain, knee joint pain, ROM in knee joint and ADL among the elders in this study. Therefore, the hand acupuncture therapy can be utilized in the field of geriatric nursing as a nursing intervention for older people with low back pain and knee joint pain.

The effects of a graded activity intervention for low back pain in occupational health on sick leave, functional status and pain: 12-month results of a randomized controlled trial.

PubMed

Hlobil, Hynek; Staal, J Bart; Twisk, Jos; Köke, Albere; Ariëns, Geertje; Smid, Tjabe; van Mechelen, Willem

2005-12-01

Behaviorally oriented graded activity interventions have been suggested for sick-listed workers with low back pain on return to work, but have not been extensively evaluated. One hundred and thirty-four workers were randomly assigned to either a graded activity intervention (n = 67) or usual care (n = 67) and followed-up for 12 months. The graded activity group returned back to work faster with a median of 54 days compared to 67 days in the usual care group. The graded activity intervention was more effective after approximately 50 days post-randomization (HRR = 1.9, CI = 1.2-3.1, p = 0.01). Differences between the groups in number of recurrent episodes, total number of days of sick leave due to low back pain, and total number of days of sick leave due to all diagnoses, were in favor of the graded activity group, although not statistically significant. No effects of the graded activity intervention were found for functional status or pain. Graded activity intervention is a valuable strategy to enhance short-term return to work outcomes.

The effectiveness of balneotherapy in chronic low back pain.

PubMed

Onat, Şule Şahin; Taşoğlu, Özlem; Güneri, Fulya Demircioğlu; Özişler, Zuhal; Safer, Vildan Binay; Özgirgin, Neşe

2014-01-01

The aim of this study is to determine the effectiveness of balneotherapy plus physical therapy versus only physical therapy in patients with chronic low back pain. In this trial, 81 patients with low back pain were followed up in two groups. Patients in group I (n = 44) were treated with physical therapy alone. Patients in group II (n = 37) were treated with balneotherapy in addition to the same physical therapy protocol in group I. Patients in both groups were given a home-based standardized exercise program. The following parameters were measured: visual analog scale (0-10 cm), fingertip-to-floor distance (cm), Oswestry Disability Index, and Short Form 36 quality of life scale. First evaluations were done at the time of enrollment, and second evaluations were done after accomplishment of a 3-week treatment program. There were no significant differences between the two groups for the sociodemographic features. All of the measured parameters improved in both groups. However, improvements in pain, functionality, and quality of life scores were found to be superior in the balneotherapy plus physical therapy group. For the patients with chronic low back pain, balneotherapy plus physical therapy is more effective, compared to physical therapy alone.

Local body cooling to improve sleep quality and thermal comfort in a hot environment.

PubMed

Lan, L; Qian, X L; Lian, Z W; Lin, Y B

2018-01-01

The effects of local body cooling on thermal comfort and sleep quality in a hot environment were investigated in an experiment with 16 male subjects. Sleep quality was evaluated subjectively, using questionnaires completed in the morning, and objectively, by analysis of electroencephalogram (EEG) signals that were continuously monitored during the sleeping period. Compared with no cooling, the largest improvement in thermal comfort and sleep quality was observed when the back and head (neck) were both cooled at a room temperature of 32°C. Back cooling alone also improved thermal comfort and sleep quality, although the effects were less than when cooling both back and head (neck). Mean sleep efficiency was improved from 84.6% in the no cooling condition to 95.3% and 92.8%, respectively, in these conditions, indicating good sleep quality. Head (neck) cooling alone slightly improved thermal comfort and subjective sleep quality and increased Stage N3 sleep, but did not otherwise improve sleep quality. The results show that local cooling applied to large body sections (back and head) could effectively maintain good sleep and improve thermal comfort in a hot environment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review.

PubMed

McCaskey, Michael A; Schuster-Amft, Corina; Wirth, Brigitte; Suica, Zorica; de Bruin, Eling D

2014-11-19

Proprioceptive training (PrT) is popularly applied as preventive or rehabilitative exercise method in various sports and rehabilitation settings. Its effect on pain and function is only poorly evaluated. The aim of this systematic review was to summarise and analyse the existing data on the effects of PrT on pain alleviation and functional restoration in patients with chronic (≥ 3 months) neck- or back pain. Relevant electronic databases were searched from their respective inception to February 2014. Randomised controlled trials comparing PrT with conventional therapies or inactive controls in patients with neck- or low back pain were included. Two review authors independently screened articles and assessed risk of bias (RoB). Data extraction was performed by the first author and crosschecked by a second author. Quality of findings was assessed and rated according to GRADE guidelines. Pain and functional status outcomes were extracted and synthesised qualitatively and quantitatively. In total, 18 studies involving 1380 subjects described interventions related to PrT (years 1994-2013). 6 studies focussed on neck-, 12 on low back pain. Three main directions of PrT were identified: Discriminatory perceptive exercises with somatosensory stimuli to the back (pPrT, n=2), multimodal exercises on labile surfaces (mPrT, n=13), or joint repositioning exercise with head-eye coordination (rPrT, n=3). Comparators entailed usual care, home based training, educational therapy, strengthening, stretching and endurance training, or inactive controls. Quality of studies was low and RoB was deemed moderate to high with a high prevalence of unclear sequence generation and group allocation (>60%). Low quality evidence suggests PrT may be more effective than not intervening at all. Low quality evidence suggests that PrT is no more effective than conventional physiotherapy. Low quality evidence suggests PrT is inferior to educational and behavioural approaches. There are few relevant good quality studies on proprioceptive exercises. A descriptive summary of the evidence suggests that there is no consistent benefit in adding PrT to neck- and low back pain rehabilitation and functional restoration.

Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain.

PubMed

Pedersen, Mogens Theisen; Andersen, Christoffer H; Zebis, Mette K; Sjøgaard, Gisela; Andersen, Lars L

2013-10-09

Previous studies have shown positive effects of physical exercise at the workplace on musculoskeletal disorders. However, long-term adherence remains a challenge. The present study evaluates long-term adherence and effects of a workplace strength training intervention on back, neck and upper extremity pain among laboratory technicians. Cluster-randomized controlled trial involving 537 industrial laboratory technicians. Subjects were randomized at the cluster level to one of two groups: training group 1 (TG1, n = 282) performing supervised strength training from February to June 2009 (round one) or training group 2 (TG2, n = 255) performing supervised strength training from August to December 2009 (round two). The outcome measures were changes in self-reported pain intensity (0-9) in the back, neck and upper extremity as well as Disability of the Arm, Shoulder and Hand (DASH, 0-100). Regular adherence, defined as at least one training session per week, was achieved by around 85% in both groups in the supervised training periods. In the intention-to-treat analyses there were significant group by time effects for pain in the neck, right shoulder, right hand and lower back and DASH-resulting in significant reductions in pain (mean 0.3 to 0.5) and DASH (mean 3.9) in the scheduled training group compared to the reference group. For TG1 there were no significant changes in pain in round two, i.e. they maintained the pain reduction achieved in round one. Subgroup analyses among those with severe pain (> = 3 on a scale of 0-9) showed a significant group by time effect for pain in the neck, right shoulder, upper back and lower back. For these subgroups the pain reduction in response to training ranged from 1.1 to 1.8. Specific strength training at the workplace can lead to significant long-term reductions in spinal and upper extremity pain and DASH. The pain reductions achieved during the intensive training phase with supervision appears to be maintained a half year later.

Comparing spatially static and dynamic vibrotactile take-over requests in the driver seat.

PubMed

Petermeijer, S M; Cieler, S; de Winter, J C F

2017-02-01

Vibrotactile stimuli can be effective as warning signals, but their effectiveness as directional take-over requests in automated driving is yet unknown. This study aimed to investigate the correct response rate, reaction times, and eye and head orientation for static versus dynamic directional take-over requests presented via vibrating motors in the driver seat. In a driving simulator, eighteen participants performed three sessions: 1) a session involving no driving (Baseline), 2) driving a highly automated car without additional task (HAD), and 3) driving a highly automated car while performing a mentally demanding task (N-Back). Per session, participants received four directional static (in the left or right part of the seat) and four dynamic (moving from one side towards the opposite left or right of the seat) take-over requests via two 6×4 motor matrices embedded in the seat back and bottom. In the Baseline condition, participants reported whether the cue was left or right, and in the HAD and N-Back conditions participants had to change lanes to the left or to the right according to the directional cue. The correct response rate was operationalized as the accuracy of the self-reported direction (Baseline session) and the accuracy of the lane change direction (HAD & N-Back sessions). The results showed that the correct response rate ranged between 94% for static patterns in the Baseline session and 74% for dynamic patterns in the N-Back session, although these effects were not statistically significant. Steering wheel touch and steering input reaction times were approximately 200ms faster for static patterns than for dynamic ones. Eye tracking results revealed a correspondence between head/eye-gaze direction and lane change direction, and showed that head and eye-gaze movements where initiated faster for static vibrations than for dynamic ones. In conclusion, vibrotactile stimuli presented via the driver seat are effective as warnings, but their effectiveness as directional take-over requests may be limited. The present study may encourage further investigation into how to get drivers safely back into the loop. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effectiveness of Ayurvedic Massage (Sahacharadi Taila) in Patients with Chronic Low Back Pain: A Randomized Controlled Trial.

PubMed

Kumar, Syal; Rampp, Thomas; Kessler, Christian; Jeitler, Michael; Dobos, Gustav J; Lüdtke, Rainer; Meier, Larissa; Michalsen, Andreas

2017-02-01

Ayurveda is one of the oldest comprehensive healthcare systems worldwide. Ayurvedic massage and physical therapy are frequently used to treat patients with chronic pain syndromes and disorders of the musculoskeletal system. This study aimed to evaluate the effectiveness of Ayurvedic massage in nonspecific chronic low back pain by means of a randomized clinical trial. Sixty-four patients (mean age, 54.8 years; 49 women and 15 men) with chronic low back pain who scored >40 mm on a 100-mm visual analogue scale (VAS) were randomly assigned to a 2-week massage group with 6 hours of Ayurvedic massage and external treatment (n = 32) or to a 2-week local thermal therapy group (n = 32). The study observation period was 4 weeks, consisting of a 2-week intervention phase followed by a 2-week follow-up phase. Primary outcome measure was the change of mean pain (VAS) from baseline to week 4. Secondary outcomes included pain-related bothersomeness, the Roland Disability Questionnaire, quality of life (Medical Outcomes Study 36-Item Short Form), the Hanover Functional Ability Questionnaire for measuring back pain-related disability, and psychological outcomes. Outcomes were assessed at baseline and after 2 and 4 weeks. Mean back pain (primary outcome) at week 2 was significantly reduced from 53.4 ± 18.5 to 21.6 ± 18.2 in the massage group and from 55.3 ± 12.9 to 41.8 ± 19.8 in the standard thermal therapy group (mean group difference, -18.7; 95% confidence interval, -28.7 to -8.7; p < 0.001). While beneficial effects on pain-related bothersomeness and psychological well-being were also apparent, the Ayurvedic intervention did not improve function or disability in the short-term observation period. Both programs were safe and well tolerated. Ayurvedic external treatment is effective for pain-relief in chronic low back pain in the short term. Further studies with longer observation periods are needed to evaluate the long-term effects of the Ayurvedic external treatment approach on function and disability.

Physiotherapy for sleep disturbance in chronic low back pain: a feasibility randomised controlled trial

PubMed Central

2010-01-01

Background Sleep disturbance is becoming increasingly recognised as a clinically important symptom in people with chronic low back pain (CLBP, low back pain >12 weeks), associated with physical inactivity and depression. Current research and international clinical guidelines recommend people with CLBP assume a physically active role in their recovery to prevent chronicity, but the high prevalence of sleep disturbance in this population may be unknowingly limiting their ability to participate in exercise-based rehabilitation programmes and contributing to poor outcomes. There is currently no knowledge concerning the effectiveness of physiotherapy on sleep disturbance in people with chronic low back pain and no evidence of the feasibility of conducting randomized controlled trials that comprehensively evaluate sleep as an outcome measure in this population. Methods/Design This study will evaluate the feasibility of a randomised controlled trial (RCT), exploring the effects of three forms of physiotherapy (supervised general exercise programme, individualized walking programme and usual physiotherapy, which will serve as the control group) on sleep quality in people with chronic low back pain. A presenting sample of 60 consenting patients will be recruited in the physiotherapy department of Beaumont Hospital, Dublin, Ireland, and randomly allocated to one of the three groups in a concealed manner. The main outcomes will be sleep quality (self-report and objective measurement), and self-reported functional disability, pain, quality of life, fear avoidance, anxiety and depression, physical activity, and patient satisfaction. Outcome will be evaluated at baseline, 3 months and 6 months. Qualitative telephone interviews will be embedded in the research design to obtain feedback from a sample of participants' about their experiences of sleep monitoring, trial participation and interventions, and to inform the design of a fully powered future RCT. Planned analysis will explore trends in the data, effect sizes and clinically important effects (quantitative data), and thematic analysis (qualitative data). Discussion This study will evaluate the feasibility of a randomised controlled trial exploring the effects of three forms of physiotherapy (supervised general exercise programme, individualized walking programme and usual physiotherapy, which will serve as the control group) on sleep quality in people with chronic low back pain. Trial Registration Current controlled trial ISRCTN54009836 PMID:20398349

Entropic Analysis of Electromyography Time Series

NASA Astrophysics Data System (ADS)

Kaufman, Miron; Sung, Paul

2005-03-01

We are in the process of assessing the effectiveness of fractal and entropic measures for the diagnostic of low back pain from surface electromyography (EMG) time series. Surface electromyography (EMG) is used to assess patients with low back pain. In a typical EMG measurement, the voltage is measured every millisecond. We observed back muscle fatiguing during one minute, which results in a time series with 60,000 entries. We characterize the complexity of time series by computing the Shannon entropy time dependence. The analysis of the time series from different relevant muscles from healthy and low back pain (LBP) individuals provides evidence that the level of variability of back muscle activities is much larger for healthy individuals than for individuals with LBP. In general the time dependence of the entropy shows a crossover from a diffusive regime to a regime characterized by long time correlations (self organization) at about 0.01s.

Intradiscal platelet-rich plasma (PRP) injections for discogenic low back pain: an update.

PubMed

Monfett, Michael; Harrison, Julian; Boachie-Adjei, Kwadwo; Lutz, Gregory

2016-06-01

The aim of this article is to provide an overview of clinical and translational research on intradiscal platelet-rich plasma (PRP) as a minimally invasive treatment for discogenic low back pain. A literature review of in vitro, in vivo, and clinical studies was performed. There is strong in vitro evidence that supports the use of intradiscal PRP for discogenic low back pain. There are also promising findings in select preclinical animal studies. A clinical study of 29 participants who underwent intradiscal PRP injections for discogenic low back pain found statistically and clinically significant improvements in pain and function through two years of follow-up. Intradiscal PRP is a safe and a possibly effective treatment for discogenic low back pain. Future studies are warranted to determine the best candidates for this treatment, what the optimal injectate is and what relationships exist between patient-reported outcomes and radiological findings.

Rapid effective trace-back capability value: a case study of foot-and-mouth in the Texas High Plains.

PubMed

Hagerman, Amy D; Ward, Michael P; Anderson, David P; Looney, J Chris; McCarl, Bruce A

2013-07-01

In this study our aim was to value the benefits of rapid effective trace-back capability-based on a livestock identification system - in the event of a foot and mouth disease (FMD) outbreak. We simulated an FMD outbreak in the Texas High Plains, an area of high livestock concentration, beginning in a large feedlot. Disease spread was simulated under different time dependent animal tracing scenarios. In the specific scenario modeled (incursion of FMD within a large feedlot, detection within 14 days and 90% effective tracing), simulation suggested that control costs of the outbreak significantly increase if tracing does not occur until day 10 as compared to the baseline of tracing on day 2. In addition, control costs are significantly increased if effectiveness were to drop to 30% as compared to the baseline of 90%. Results suggest potential benefits from rapid effective tracing in terms of reducing government control costs; however, a variety of other scenarios need to be explored before determining in which situations rapid effective trace-back capability is beneficial. Copyright © 2012 Elsevier B.V. All rights reserved.

The effects of muscle weakness on degenerative spondylolisthesis: A finite element study.

PubMed

Zhu, Rui; Niu, Wen-Xin; Zeng, Zhi-Li; Tong, Jian-Hua; Zhen, Zhi-Wei; Zhou, Shuang; Yu, Yan; Cheng, Li-Ming

2017-01-01

Whether muscle weakness is a cause, or result, of degenerative spondylolisthesis is not currently well understood. Little biomechanical evidence is available to offer an explanation for the mechanism behind exercise therapy. Therefore, the aim of this study is to investigate the effects of back muscle weakness on degenerative spondylolisthesis and to tease out the biomechanical mechanism of exercise therapy. A nonlinear 3-D finite element model of L3-L5 was constructed. Forces representing global back muscles and global abdominal muscles, follower loads and an upper body weight were applied. The force of the global back muscles was reduced to 75%, 50% and 25% to simulate different degrees of back muscle weakness. An additional boundary condition which represented the loads from other muscles after exercise therapy was set up to keep the spine in a neutral standing position. Shear forces, intradiscal pressure, facet joint forces and von Mises equivalent stresses in the annuli were calculated. The intervertebral rotations of L3-L4 and L4-L5 were within the range of in vitro experimental data. The calculated intradiscal pressure of L4-L5 for standing was 0.57MPa, which is similar to previous in vivo data. With the back muscles were reduced to 75%, 50% and 25% force, the shear force moved increasingly in a ventral direction. Due to the additional stabilizing force and moment provided by boundary conditions, the shear force varied less than 15%. Reducing the force of global back muscles might lead to, or aggravate, degenerative spondylolisthesis with forward slipping from biomechanical point of view. Exercise therapy may improve the spinal biomechanical environment. However, the intrinsic correlation between back muscle weakness and degenerative spondylolisthesis needs more clinical in vivo study and biomechanical analysis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women.

PubMed

Sinaki, M; Itoi, E; Wahner, H W; Wollan, P; Gelzcer, R; Mullan, B P; Collins, D A; Hodgson, S F

2002-06-01

The long-term protective effect of stronger back muscles on the spine was determined in 50 healthy white postmenopausal women, aged 58-75 years, 8 years after they had completed a 2 year randomized, controlled trial. Twenty-seven subjects had performed progressive, resistive back-strengthening exercises for 2 years and 23 had served as controls. Bone mineral density, spine radiographs, back extensor strength, biochemical marker values, and level of physical activity were obtained for all subjects at baseline, 2 years, and 10 years. Mean back extensor strength (BES) in the back-exercise (BE) group was 39.4 kg at baseline, 66.8 kg at 2 years (after 2 years of prescribed exercises), and 32.9 kg at 10 years (8 years after cessation of the prescribed exercises). Mean BES in the control (C) group was 36.9 kg at baseline, 49.0 kg at 2 years, and 26.9 kg at 10 years. The difference between the two groups was still statistically significant at 10 year follow-up (p = 0.001). The difference in bone mineral density, which was not significant between the two groups at baseline and 2 year follow-up, was significant at 10 year follow-up (p = 0.0004). The incidence of vertebral compression fracture was 14 fractures in 322 vertebral bodies examined (4.3%) in the C group and 6 fractures in 378 vertebral bodies examined (1.6%) in the BE group (chi-square test, p = 0.0290). The relative risk for compression fracture was 2.7 times greater in the C group than in the BE group. To our knowledge, this is the first study reported in the literature demonstrating the long-term effect of strong back muscles on the reduction of vertebral fractures in estrogen-deficient women.

Bot fly parasitism of the red-backed vole: host survival, infection risk, and population growth.

PubMed

Lemaître, Jérôme; Fortin, Daniel; Montiglio, Pierre-Olivier; Darveau, Marcel

2009-03-01

Parasites can play an important role in the dynamics of host populations, but empirical evidence remains sparse. We investigated the role of bot fly (Cuterebra spp.) parasitism in red-backed voles (Myodes gapperi) by first assessing the impacts of the parasite on the probability of vole survival under stressful conditions as well as on the reproductive activity of females. We then identified the main factors driving both the individual risk of infection and the abundance of bot flies inside red-backed voles. Finally, we evaluated the impacts of bot fly prevalence on the growth rate of vole populations between mid-July and mid-August. Thirty-six populations of red-backed voles were sampled in the boreal forest of Québec, Canada. The presence and the abundance of parasites in voles, two host life history traits (sex and body condition), three indices of habitat complexity (tree basal area, sapling basal area, coarse woody debris volume), and vole abundance were considered in models evaluating the effects of bot flies on host populations. We found that the probability of survival of red-backed voles in live traps decreased with bot fly infection. Both the individual risk of infection and the abundance of bot flies in red-backed voles were driven mainly by vole abundance rather than by the two host life history traits or the three variables of habitat complexity. Parasitism had population consequences: bot fly prevalence was linked to a decrease in short-term growth rate of vole populations over the summer. We found that bot flies have the potential to reduce survival of red-backed voles, an effect that may apply to large portions of populations.

Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials.

PubMed

Juch, Johan N S; Maas, Esther T; Ostelo, Raymond W J G; Groeneweg, J George; Kallewaard, Jan-Willem; Koes, Bart W; Verhagen, Arianne P; van Dongen, Johanna M; Huygen, Frank J P M; van Tulder, Maurits W

2017-07-04

Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was -0.18 (95% CI, -0.76 to 0.40) in the facet joint trial; -0.71 (95% CI, -1.35 to -0.06) in the sacroiliac joint trial; and -0.99 (95% CI, -1.73 to -0.25) in the combination trial. In 3 randomized clinical trials of participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources. trialregister.nl Identifier: NTR3531.

The efficacy of conventional radiofrequency denervation in patients with chronic low back pain originating from the facet joints: a meta-analysis of randomized controlled trials.

PubMed

Lee, Chang-Hyun; Chung, Chun Kee; Kim, Chi Heon

2017-11-01

Radiofrequency denervation is commonly used for the treatment of chronic facet joint pain that has been refractory to more conservative treatments, although the evidence supporting this treatment has been controversial. We aimed to elucidate the precise effects of radiofrequency denervation in patients with low back pain originating from the facet joints relative to those obtained using control treatments, with particular attention to consistency in the denervation protocol. A meta-analysis of randomized controlled trials was carried out. Adult patients undergoing radiofrequency denervation or control treatments (sham or epidural block) for facet joint disease of the lumbar spine comprised the patient sample. Visual analog scale (VAS) pain scores were measured and stratified by response of diagnostic block procedures. We searched PubMed, Embase, Web of Science, and the Cochrane Database for randomized controlled trials regarding radiofrequency denervation and control treatments for back pain. Changes in VAS pain scores of the radiofrequency group were compared with those of the control group as well as the minimal clinically important difference (MCID) for back pain VAS. Meta-regression model was developed to evaluate the effect of radiofrequency treatment according to responses of diagnostic block while controlling for other variables. We then calculated mean differences and 95% confidence intervals (CIs) using random-effects models. We included data from seven trials involving 454 patients who had undergone radiofrequency denervation (231 patients) and control treatments such as sham or epidural block procedures (223 patients). The radiofrequency group exhibited significantly greater improvements in back pain score when compared with the control group for 1-year follow-up. Although the average improvement in VAS scores exceeded the MCID, the lower limit of the 95% CI encompassed the MCID. A subgroup of patients who responded very well to diagnostic block procedures demonstrated significant improvements in back pain relative to the control group at all times. When placed into our meta-regression model, the response to diagnostic block procedure was responsible for a statistically significant portion of treatment effect. Studies published over the last two decades revealed that radiofrequency denervation reduced back pain significantly in patients with facet joint disease compared with the MCID and control treatments. Conventional radiofrequency denervation resulted in significant reductions in low back pain originating from the facet joints in patients showing the best response to diagnostic block over the first 12 months when compared with sham procedures or epidural nerve blocks. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

Okeahialam, Basil N; Adeniyi, Michael A

2017-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

Buvanendran, Asokumar; Lubenow, Timothy J

2008-01-01

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

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

PubMed

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

2014-01-01

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

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

PubMed

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

2017-06-08

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

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

PubMed

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

2016-01-01

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

Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative.

PubMed

Bussières, André E; Stewart, Gregory; Al-Zoubi, Fadi; Decina, Philip; Descarreaux, Martin; Haskett, Danielle; Hincapié, Cesar; Pagé, Isabelle; Passmore, Steven; Srbely, John; Stupar, Maja; Weisberg, Joel; Ornelas, Joseph

2018-05-01

The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention. The panel updated the search strategies in Medline. We assessed admissible systematic reviews and randomized controlled trials for each question using A Measurement Tool to Assess Systematic Reviews and Cochrane Back Review Group criteria. Evidence profiles were used to summarize judgments of the evidence quality and link recommendations to the supporting evidence. Using the Evidence to Decision Framework, the guideline panel determined the certainty of evidence and strength of the recommendations. Consensus was achieved using a modified Delphi technique. The guideline was peer reviewed by an 8-member multidisciplinary external committee. For patients with acute (0-3 months) back pain, we suggest offering advice (posture, staying active), reassurance, education and self-management strategies in addition to SMT, usual medical care when deemed beneficial, or a combination of SMT and usual medical care to improve pain and disability. For patients with chronic (>3 months) back pain, we suggest offering advice and education, SMT or SMT as part of a multimodal therapy (exercise, myofascial therapy or usual medical care when deemed beneficial). For patients with chronic back-related leg pain, we suggest offering advice and education along with SMT and home exercise (positioning and stabilization exercises). A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain. Copyright © 2018. Published by Elsevier Inc.

Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial.

PubMed

Babina, R; Mohanty, P P; Pattnaik, M

2016-02-19

Altered respiratory function has been found to be associated with back pain. Limited chest excursion in subjects with chronic low back pain (CLBP) may be due to co-contraction or bracing of erector spinae and abdominal muscles; their flexed spinal posture; and/or their compromised spinal stability resulting from dysfunctional transversus abdominis. To check for the effects of thoracic mobilization on respiratory parameters in subjects with chronic non-specific low back pain. Sixty-two subjects (excluding 11 dropouts) with CLBP of age group 30-60 were randomly allocated to two groups. Both groups received individualized treatment for low back pain (LBP) and HEP (home exercise program) regime of breathing exercises. In addition, group 1 received Maitland's Central postero-anterior vertebral pressure for thoracic spine (T1-T8). Total treatment duration was 10 sessions in 2 weeks (5 sessions/week). Results showed significant improvement in respiratory parameters viz. Forced Vital Capacity (FVC), Sustained Maximal Inspiratory Pressure (SMIP) and Chest Wall Expansion (CWE) and Oswestry Disability Index (ODI) in both groups (p< 0.05) at end of 2 weeks of intervention. However, improvement was significantly more in group 1 (p < 0.05) receiving additional thoracic mobilization. Subjects with non-specific chronic low back pain with or without radiation to lower limbs when treated with thoracic central PA mobilization, in addition to LBP specific treatment and breathing exercises, show an improvement in respiratory parameters and reduction in disability.

Effects of functional resistance training on fitness and quality of life in females with chronic nonspecific low-back pain.

PubMed

Cortell-Tormo, Juan M; Sánchez, Pablo Tercedor; Chulvi-Medrano, Ivan; Tortosa-Martínez, Juan; Manchado-López, Carmen; Llana-Belloch, Salvador; Pérez-Soriano, Pedro

2018-02-06

Exercise is important as adjuvant in the chronic low back pain (CLBP) treatment. Functional training could involve benefits for low back pain (LBP) patients. To evaluate the effects of a 12-week period of functional resistance training on health-related quality of life (HRQOL), disability, body pain, and physical fitness in CLBP females. Nineteen females CLBP were recruited according to Paris Task Force on Back Pain criteria. Participants were randomly assigned to an exercise group (EG); and a control group (CG). Subjects were tested at baseline and at week 12 after 24 sessions, 2 days per week. Body pain was assessed using visual analog scale (VAS), disability with Oswestry Disability Index (ODI) and HRQOL with Short Form 36 questionnaire. Physical fitness was measured using: flamingo test, back endurance test, side bridge test, abdominal curl-up tests, and 60-s squat test. EG showed significant improvements in physical function (10%; p< 0.05), body pain (42%; p< 0.05), vitality (31%; p< 0.05), physical component scale (15%; p< 0.05), VAS (62.5%; p< 0.01), ODI (61.3%; p< 0.05), balance (58%; p< 0.05), curl-up (83%; p< 0.01), squat (22%; p< 0.01), static back (67%; p< 0.01), and side bridge (56%; p< 0.01). Periodized functional resistance training decreased pain and disability and improved HRQOL, balance and physical fitness in females with CLBP, and can thus be used safely in this population.

People with chronic low back pain have poorer balance than controls in challenging tasks.

PubMed

da Silva, Rubens A; Vieira, Edgar R; Fernandes, Karen B P; Andraus, Rodrigo A; Oliveira, Marcio R; Sturion, Leandro A; Calderon, Mariane G

2018-06-01

To compare the balance of individuals with and without chronic low back pain during five tasks. The participants were 20 volunteers, 10 with and 10 without nonspecific chronic low back pain, mean age 34 years, 50% females. The participants completed the following balance tasks on a force platform in random order: (1) two-legged stance with eyes open, (2) two-legged stance with eyes closed, (3) semi-tandem with eyes open, (4) semi-tandem with eyes closed and (5) one-legged stance with eyes open. The participants completed three 60-s trials of tasks 1-4, and three 30-s trials of task 5 with 30-s rests between trials. The center of pressure area, velocity and frequency in the antero-posterior and medio-lateral directions were computed during each task, and compared between groups and tasks. Participants with chronic low back pain presented significantly larger center of pressure area and higher velocity than the healthy controls (p < 0.001). There were significant differences among tasks for all center of pressure variables (p < 0.001). Semi-tandem (tasks 3 and 4) and one-leg stance (task 5) were more sensitive to identify balance impairments in the chronic low back pain group than two-legged stance tasks 1 and 2 (effect size >1.37 vs. effect size <0.64). There were no significant interactions between groups and tasks. Individuals with chronic low back pain presented poorer postural control using center of pressure measurements than the healthy controls, mainly during more challenging balance tasks such as semi-tandem and one-legged stance conditions. Implications for Rehabilitation People with chronic low back had poorer balance than those without it. Balance tasks need to be sensitive to capture impairments. Balance assessments during semi-tandem and one-legged stance were the most sensitive tasks to determine postural control deficit in people with chronic low back. Balance assessment should be included during rehabilitation programs for individuals with chronic low back pain for better clinical decision making related to balance re-training as necessary.

Nordic Walking and chronic low back pain: design of a randomized clinical trial

PubMed Central

Morsø, Lars; Hartvigsen, Jan; Puggaard, Lis; Manniche, Claus

2006-01-01

Background Low Back Pain is a major public health problem all over the western world. Active approaches including exercise in the treatment of low back pain results in better outcomes for patients, but it is not known exactly which types of back exercises are most beneficial or whether general physical activity provide similar benefits. Nordic Walking is a popular and fast growing type of exercise in Northern Europe. Initial studies have demonstrated that persons performing Nordic Walking are able to exercise longer and harder compared to normal walking thereby increasing their cardiovascular metabolism. Until now no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to low back pain. The primary aim of this study is to investigate whether supervised Nordic Walking can reduce pain and improve function in a population of chronic low back pain patients when compared to unsupervised Nordic Walking and advice to stay active. In addition we investigate whether there is an increase in the cardiovascular metabolism in persons performing supervised Nordic Walking compared to persons who are advised to stay active. Finally, we investigate whether there is a difference in compliance between persons receiving supervised Nordic Walking and persons doing unsupervised Nordic Walking. Methods One hundred and fifty patients with low back pain for at least eight weeks and referred to a specialized secondary sector outpatient back pain clinic are included in the study. After completion of the standard back centre treatment patients are randomized into one of three groups: A) Nordic Walking twice a week for eight weeks under supervision of a specially trained instructor; B) Unsupervised Nordic Walking for eight weeks after one training session with an instructor; C) A one hour motivational talk including advice to stay active. Outcome measures are pain, function, overall health, cardiovascular ability and activity level. Results No results available at this point. Discussion This study will investigate the effect of Nordic Walking on pain and function in a population of people with chronic LBP. Trial Registration registration # NCT00209820 PMID:17014731

Radiation Effects On Emerging Electronic Materials And Devices

DTIC Science & Technology

2010-01-17

RADIATION EFFECTS ON EMERGING ELECTRONIC MATERIALS AND DEVICES FINAL PERFORMANCE REPORT PREPARED FOR: Kitt Reinhardt AFOSR/NE 875 N...and the other with metal gates and a high-K gate dielectric. These devices were programmed using both back-gate pulse and gate induced drain leakage... metal gate process GIDL method Fig. 1. Sensing margin as a function of total ionizing dose for nMOS 1T-DRAM cells programmed by back-gate pulse and

Thermodynamic dislocation theory: Bauschinger effect

NASA Astrophysics Data System (ADS)

Le, K. C.; Tran, T. M.

2018-04-01

The thermodynamic dislocation theory developed for nonuniform plastic deformations is used here to simulate the stress-strain curves for crystals subjected to antiplane shear-controlled load reversal. We show that the presence of the positive back stress during the load reversal reduces the magnitude of shear stress required to pull excess dislocations back to the center of the specimen. There, the excess dislocations of opposite signs meet and annihilate each other leading to the Bauschinger effect.

43 Management of acute low back pain in the ED: a systematic review.

PubMed

Ashbrook, Jane; Rodgdakis, Nikos; Goodwin, Peter; Yeowell, Gill; Callaghan, Michael

2017-12-01

There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review.Trials were included if the population studied were adults with acute low back pain in an emergency setting. All diagnostic tests and therapeutic interventions were evaluated.Methodological quality and risk of bias was appraised using the Downs and Black checklist. 19 articles were identified including 1896 patients that were sub-grouped according to management.In the pharmacological subgroup corticosteroids were effective in patients with radicular pain, NSAIDs were as effective as other medication with less adverse events, Phenyramidol was not superior to placebo, promethazine and morhpine combined was not more effective than morphine alone and ketamine was no more effective than morphine but had a worse adverse effect profile.In the emergency transport group TENS and active warming both showed effects in reducing pain, anxiety and heart rate.In the physical therapy management group less pain and greater satisfaction were reported.In the adjunct interventions group showed a trend towards pain reduction in the use of heat/ice packs and short term pain relief in acupuncture and auricular acupuncture. More high quality trials are needed to determine an evidence-based management protocol for the treatment of acute low back pain in the ED. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

PubMed

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

2016-08-01

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

Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence.

PubMed

Karagülle, Mine; Karagülle, Müfit Zeki

2015-02-01

In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects.

Dialogizing Response in the Writing Classroom: Students Answer Back.

ERIC Educational Resources Information Center

Gay, Pamela

1998-01-01

Notes that while informed teachers of writing have moved toward more dialogic approaches, they still have colonial tendencies when responding to student writing. Suggests an activity that invites students to talk back to the teacher-reader as a means of helping them move more effectively toward revision. (PA)

Late bedtimes, short sleeping time, and longtime video-game playing are associated with low back pain in school-aged athletes.

PubMed

Yabe, Yutaka; Hagiwara, Yoshihiro; Sekiguchi, Takuya; Momma, Haruki; Tsuchiya, Masahiro; Kuroki, Kaoru; Kanazawa, Kenji; Koide, Masashi; Itaya, Nobuyuki; Itoi, Eiji; Nagatomi, Ryoichi

2018-05-01

Low back pain is a significant problem for school-aged athletes. Although some risk factors relating to sports activities have been reported, the effect of lifestyles on low back pain in school-aged athletes is not clear. The purpose of this study was to elucidate the association between lifestyles, such as wake-up time, bedtime, sleeping time, and TV-viewing or video-game-playing time per day and low back pain of school-aged athletes. A cross-sectional study was conducted with school-aged athletes (aged 6-15 years, n = 6441) using a self-reported questionnaire and multivariate logistic regression models were used for analyses. Variables considered in the models were gender, age, body mass index, team levels, number of days in practice per week, number of hours in practice per day, and lifestyles. The frequency of low back pain was 5.0% (n = 322). Late bedtime, short sleeping time, and long video-game-playing time per day were significantly associated with low back pain. There was no significant association between low back pain and wake-up time or TV-viewing time per day. Unhealthy life-style choices, such as late bedtimes, short sleeping time, and longtime video-game playing, were associated with low back pain in school-aged athletes.

Feed‐backs among inbreeding, inbreeding depression in sperm traits, and sperm competition can drive evolution of costly polyandry

PubMed Central

Bocedi, Greta; Reid, Jane M.

2017-01-01

Abstract Ongoing ambitions are to understand the evolution of costly polyandry and its consequences for species ecology and evolution. Emerging patterns could stem from feed‐back dynamics between the evolving mating system and its genetic environment, defined by interactions among kin including inbreeding. However, such feed‐backs are rarely considered in nonselfing systems. We use a genetically explicit model to demonstrate a mechanism by which inbreeding depression can select for polyandry to mitigate the negative consequences of mating with inbred males, rather than to avoid inbreeding, and to elucidate underlying feed‐backs. Specifically, given inbreeding depression in sperm traits, costly polyandry evolved to ensure female fertility, without requiring explicit inbreeding avoidance. Resulting sperm competition caused evolution of sperm traits and further mitigated the negative effect of inbreeding depression on female fertility. The evolving mating system fed back to decrease population‐wide homozygosity, and hence inbreeding. However, the net overall decrease was small due to compound effects on the variances in sex‐specific reproductive success and paternity skew. Purging of deleterious mutations did not eliminate inbreeding depression in sperm traits or hence selection for polyandry. Overall, our model illustrates that polyandry evolution, both directly and through sperm competition, might facilitate evolutionary rescue for populations experiencing sudden increases in inbreeding. PMID:28895138

A novel approach to spinal 3-D kinematic assessment using inertial sensors: Towards effective quantitative evaluation of low back pain in clinical settings.

PubMed

Ashouri, Sajad; Abedi, Mohsen; Abdollahi, Masoud; Dehghan Manshadi, Farideh; Parnianpour, Mohamad; Khalaf, Kinda

2017-10-01

This paper presents a novel approach for evaluating LBP in various settings. The proposed system uses cost-effective inertial sensors, in conjunction with pattern recognition techniques, for identifying sensitive classifiers towards discriminate identification of LB patients. 24 healthy individuals and 28 low back pain patients performed trunk motion tasks in five different directions for validation. Four combinations of these motions were selected based on literature, and the corresponding kinematic data was collected. Upon filtering (4th order, low pass Butterworth filter) and normalizing the data, Principal Component Analysis was used for feature extraction, while Support Vector Machine classifier was applied for data classification. The results reveal that non-linear Kernel classification can be adequately employed for low back pain identification. Our preliminary results demonstrate that using a single inertial sensor placed on the thorax, in conjunction with a relatively simple test protocol, can identify low back pain with an accuracy of 96%, a sensitivity of %100, and specificity of 92%. While our approach shows promising results, further validation in a larger population is required towards using the methodology as a practical quantitative assessment tool for the detection of low back pain in clinical/rehabilitation settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pain perception and low back pain functional disability after a 10-week core and mobility training program: A pilot study.

PubMed

Lima, Vicente Pinheiro; de Alkmim Moreira Nunes, Rodolfo; da Silva, Jurandir Baptista; Paz, Gabriel Andrade; Jesus, Marco; de Castro, Juliana Brandão Pinto; Dantas, Estélio Henrique Martin; de Souza Vale, Rodrigo Gomes

2018-03-02

The aim of this study was to evaluate the effects of a 10-week core and mobility training program on pain perception and low back disability score in professors, students and employees of a university. Twenty-four individuals of a university who previously reported pain and low back disability were randomly assigned to an experimental group (EG; n= 8) that received 2 weekly sessions of 50 minutes of core and mobility training for 10 weeks; or to a control group (CG; n= 16). Both groups received a guideline to adopt ergonomic postures during work and activities of daily living. The visual analog pain scale (VAS) and the Roland-Morris questionnaire (RMQ) were applied pre and post intervention. Significant reductions in the pain intensity perception (p= 0.014) and low back functional disability (p= 0.011) were noted in the EG pre and post measures. However, no significant difference was observed in the CG. Thus, there was a significant difference between the EG and the CG in the post-intervention measures (p= 0.001). Core and mobility training and home-ergonomic instructions were effective to reduce the pain intensity perception and low back functional disability in the EG.

Formal analysis and evaluation of the back-off procedure in IEEE802.11P VANET

NASA Astrophysics Data System (ADS)

Jin, Li; Zhang, Guoan; Zhu, Xiaojun

2017-07-01

The back-off procedure is one of the media access control technologies in 802.11P communication protocol. It plays an important role in avoiding message collisions and allocating channel resources. Formal methods are effective approaches for studying the performances of communication systems. In this paper, we establish a discrete time model for the back-off procedure. We use Markov Decision Processes (MDPs) to model the non-deterministic and probabilistic behaviors of the procedure, and use the probabilistic computation tree logic (PCTL) language to express different properties, which ensure that the discrete time model performs their basic functionality. Based on the model and PCTL specifications, we study the effect of contention window length on the number of senders in the neighborhood of given receivers, and that on the station’s expected cost required by the back-off procedure to successfully send packets. The variation of the window length may increase or decrease the maximum probability of correct transmissions within a time contention unit. We propose to use PRISM model checker to describe our proposed back-off procedure for IEEE802.11P protocol in vehicle network, and define different probability properties formulas to automatically verify the model and derive numerical results. The obtained results are helpful for justifying the values of the time contention unit.

Suppression of back-to-back hadron pairs at forward rapidity in d+Au collisions at √s(NN)=200 GeV.

PubMed

Adare, A; Afanasiev, S; Aidala, C; Ajitanand, N N; Akiba, Y; Al-Bataineh, H; Alexander, J; Angerami, A; Aoki, K; Apadula, N; Aramaki, Y; Atomssa, E T; Averbeck, R; Awes, T C; Azmoun, B; Babintsev, V; Bai, M; Baksay, G; Baksay, L; Barish, K N; Bassalleck, B; Basye, A T; Bathe, S; Baublis, V; Baumann, C; Bazilevsky, A; Belikov, S; Belmont, R; Bennett, R; Berdnikov, A; Berdnikov, Y; Bhom, J H; Blau, D S; Bok, J S; Boyle, K; Brooks, M L; Buesching, H; Bumazhnov, V; Bunce, G; Butsyk, S; Campbell, S; Caringi, A; Chen, C-H; Chi, C Y; Chiu, M; Choi, I J; Choi, J B; Choudhury, R K; Christiansen, P; Chujo, T; Chung, P; Chvala, O; Cianciolo, V; Citron, Z; Cole, B A; Conesa del Valle, Z; Connors, M; Csanád, M; Csörgo, T; Dahms, T; Dairaku, S; Danchev, I; Das, K; Datta, A; David, G; Dayananda, M K; Denisov, A; Deshpande, A; Desmond, E J; Dharmawardane, K V; Dietzsch, O; Dion, A; Donadelli, M; Drapier, O; Drees, A; Drees, K A; Durham, J M; Durum, A; Dutta, D; D'Orazio, L; Edwards, S; Efremenko, Y V; Ellinghaus, F; Engelmore, T; Enokizono, A; En'yo, H; Esumi, S; Fadem, B; Fields, D E; Finger, M; Finger, M; Fleuret, F; Fokin, S L; Fraenkel, Z; Frantz, J E; Franz, A; Frawley, A D; Fujiwara, K; Fukao, Y; Fusayasu, T; Garishvili, I; Glenn, A; Gong, H; Gonin, M; Goto, Y; Granier de Cassagnac, R; Grau, N; Greene, S V; Grim, G; Grosse Perdekamp, M; Gunji, T; Gustafsson, H-Å; Haggerty, J S; Hahn, K I; Hamagaki, H; Hamblen, J; Han, R; Hanks, J; Haslum, E; Hayano, R; He, X; Heffner, M; Hemmick, T K; Hester, T; Hill, J C; Hohlmann, M; Holzmann, W; Homma, K; Hong, B; Horaguchi, T; Hornback, D; Huang, S; Ichihara, T; Ichimiya, R; Ikeda, Y; Imai, K; Inaba, M; Isenhower, D; Ishihara, M; Issah, M; Isupov, A; Ivanischev, D; Iwanaga, Y; Jacak, B V; Jia, J; Jiang, X; Jin, J; Johnson, B M; Jones, T; Joo, K S; Jouan, D; Jumper, D S; Kajihara, F; Kamin, J; Kang, J H; Kapustinsky, J; Karatsu, K; Kasai, M; Kawall, D; Kawashima, M; Kazantsev, A V; Kempel, T; Khanzadeev, A; Kijima, K M; Kikuchi, J; Kim, A; Kim, B I; Kim, D J; Kim, E J; Kim, Y-J; Kinney, E; Kiss, Á; Kistenev, E; Kochenda, L; Komkov, B; Konno, M; Koster, J; Král, A; Kravitz, A; Kunde, G J; Kurita, K; Kurosawa, M; Kwon, Y; Kyle, G S; Lacey, R; Lai, Y S; Lajoie, J G; Lebedev, A; Lee, D M; Lee, J; Lee, K B; Lee, K S; Leitch, M J; Leite, M A L; Li, X; Lichtenwalner, P; Liebing, P; Linden Levy, L A; Liška, T; Litvinenko, A; Liu, H; Liu, M X; Love, B; Lynch, D; Maguire, C F; Makdisi, Y I; Malakhov, A; Malik, M D; Manko, V I; Mannel, E; Mao, Y; Masui, H; Matathias, F; McCumber, M; McGaughey, P L; Means, N; Meredith, B; Miake, Y; Mibe, T; Mignerey, A C; Miki, K; Milov, A; Mitchell, J T; Mohanty, A K; Moon, H J; Morino, Y; Morreale, A; Morrison, D P; Moukhanova, T V; Murakami, T; Murata, J; Nagamiya, S; Nagle, J L; Naglis, M; Nagy, M I; Nakagawa, I; Nakamiya, Y; Nakamura, K R; Nakamura, T; Nakano, K; Nam, S; Newby, J; Nguyen, M; Nihashi, M; Nouicer, R; Nyanin, A S; Oakley, C; O'Brien, E; Oda, S X; Ogilvie, C A; Oka, M; Okada, K; Onuki, Y; Oskarsson, A; Ouchida, M; Ozawa, K; Pak, R; Pantuev, V; Papavassiliou, V; Park, I H; Park, S K; Park, W J; Pate, S F; Pei, H; Peng, J-C; Pereira, H; Peresedov, V; Peressounko, D Yu; Petti, R; Pinkenburg, C; Pisani, R P; Proissl, M; Purschke, M L; Qu, H; Rak, J; Ravinovich, I; Read, K F; Reygers, K; Riabov, V; Riabov, Y; Richardson, E; Roach, D; Roche, G; Rolnick, S D; Rosati, M; Rosen, C A; Rosendahl, S S E; Rukoyatkin, P; Ružička, P; Sahlmueller, B; Saito, N; Sakaguchi, T; Sakashita, K; Samsonov, V; Sano, S; Sato, T; Sawada, S; Sedgwick, K; Seele, J; Seidl, R; Seto, R; Sharma, D; Shein, I; Shibata, T-A; Shigaki, K; Shimomura, M; Shoji, K; Shukla, P; Sickles, A; Silva, C L; Silvermyr, D; Silvestre, C; Sim, K S; Singh, B K; Singh, C P; Singh, V; Slunečka, M; Soltz, R A; Sondheim, W E; Sorensen, S P; Sourikova, I V; Stankus, P W; Stenlund, E; Stoll, S P; Sugitate, T; Sukhanov, A; Sziklai, J; Takagui, E M; Taketani, A; Tanabe, R; Tanaka, Y; Taneja, S; Tanida, K; Tannenbaum, M J; Tarafdar, S; Taranenko, A; Themann, H; Thomas, D; Thomas, T L; Togawa, M; Toia, A; Tomášek, L; Torii, H; Towell, R S; Tserruya, I; Tsuchimoto, Y; Vale, C; Valle, H; van Hecke, H W; Vazquez-Zambrano, E; Veicht, A; Velkovska, J; Vértesi, R; Virius, M; Vrba, V; Vznuzdaev, E; Wang, X R; Watanabe, D; Watanabe, K; Watanabe, Y; Wei, F; Wei, R; Wessels, J; White, S N; Winter, D; Woody, C L; Wright, R M; Wysocki, M; Yamaguchi, Y L; Yamaura, K; Yang, R; Yanovich, A; Ying, J; Yokkaichi, S; You, Z; Young, G R; Younus, I; Yushmanov, I E; Zajc, W A; Zhou, S; Zolin, L

2011-10-21

Back-to-back hadron pair yields in d+Au and p+p collisions at √s(NN)=200 GeV were measured with the PHENIX detector at the Relativistic Heavy Ion Collider. Rapidity separated hadron pairs were detected with the trigger hadron at pseudorapidity |η|<0.35 and the associated hadron at forward rapidity (deuteron direction, 3.0<η<3.8). Pairs were also detected with both hadrons measured at forward rapidity; in this case, the yield of back-to-back hadron pairs in d+Au collisions with small impact parameters is observed to be suppressed by a factor of 10 relative to p+p collisions. The kinematics of these pairs is expected to probe partons in the Au nucleus with a low fraction x of the nucleon momenta, where the gluon densities rise sharply. The observed suppression as a function of nuclear thickness, p(T), and η points to cold nuclear matter effects arising at high parton densities. © 2011 American Physical Society

Effects of a single session of posterior-to-anterior spinal mobilization and press-up exercise on pain response and lumbar spine extension in people with nonspecific low back pain.

PubMed

Powers, Christopher M; Beneck, George J; Kulig, Kornelia; Landel, Robert F; Fredericson, Michael

2008-04-01

Posterior-to-anterior (PA) mobilization and press-up exercises are common physical therapy interventions used to treat low back pain. The purpose of this study was to examine the immediate effects of PA mobilization and a press-up exercise on pain with standing extension and lumbar extension in people with nonspecific low back pain. The study participants were 30 adults (19 women and 11 men) who were 18 to 45 years of age and had a diagnosis of nonspecific low back pain. Lumbar segmental extension during a press-up maneuver was measured by dynamic magnetic resonance imaging prior to and immediately following a single session of either PA spinal mobilization or a press-up exercise. Pain scores before and after intervention were recorded with a visual analog scale. Differences between the treatment groups in pain and total lumbar extension were compared over time by use of a 2-way analysis of variance. Following both interventions, there was a significant reduction in the average pain scores for both groups (significant main effect for time, no interaction). Similarly, total lumbar extension significantly increased in both the PA mobilization group and the press-up group (significant main effect for time, no interaction). No significant differences between the 2 interventions in pain or lumbar extension were found. The findings of this study support the use of PA mobilization and a press-up exercise for improving lumbar extension in people with nonspecific low back pain. Although statistically significant within-group changes in pain were detected, the clinical meaningfulness of these changes is questionable.

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain.

PubMed

Little, Paul; Lewith, George; Webley, Fran; Evans, Maggie; Beattie, Angela; Middleton, Karen; Barnett, Jane; Ballard, Kathleen; Oxford, Frances; Smith, Peter; Yardley, Lucy; Hollinghurst, Sandra; Sharp, Debbie

2008-08-19

To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain. Factorial randomised trial. 64 general practices in England. 579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription. Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling. Roland Morris disability score (number of activities impaired by pain) and number of days in pain. Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks was lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported. One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons. National Research Register N0028108728.

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain.

PubMed

Little, Paul; Lewith, George; Webley, Fran; Evans, Maggie; Beattie, Angela; Middleton, Karen; Barnett, Jane; Ballard, Kathleen; Oxford, Frances; Smith, Peter; Yardley, Lucy; Hollinghurst, Sandra; Sharp, Debbie

2008-12-01

To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain. Factorial randomised trial. Setting 64 general practices in England. 579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription. Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling. Roland Morris disability score (number of activities impaired by pain) and number of days in pain. Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks were lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported. One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.

Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline.

PubMed

Chou, Roger; Atlas, Steven J; Stanos, Steven P; Rosenquist, Richard W

2009-05-01

Systematic review. To systematically assess benefits and harms of nonsurgical interventional therapies for low back and radicular pain. Although use of certain interventional therapies is common or increasing, there is also uncertainty or controversy about their efficacy. Electronic database searches on Ovid MEDLINE and the Cochrane databases were conducted through July 2008 to identify randomized controlled trials and systematic reviews of local injections, botulinum toxin injection, prolotherapy, epidural steroid injection, facet joint injection, therapeutic medial branch block, sacroiliac joint injection, intradiscal steroid injection, chemonucleolysis, radiofrequency denervation, intradiscal electrothermal therapy, percutaneous intradiscal radiofrequency thermocoagulation, Coblation nucleoplasty, and spinal cord stimulation. All relevant studies were methodologically assessed by 2 independent reviewers using criteria developed by the Cochrane Back Review Group (for trials) and by Oxman (for systematic reviews). A qualitative synthesis of results was performed using methods adapted from the US Preventive Services Task Force. For sciatica or prolapsed lumbar disc with radiculopathy, we found good evidence that chemonucleolysis is moderately superior to placebo injection but inferior to surgery, and fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief. We found fair evidence that spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. We found good or fair evidence that prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective. Insufficient evidence exists to reliably evaluate other interventional therapies. Few nonsurgical interventional therapies for low back pain have been shown to be effective in randomized, placebo-controlled trials.

Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

PubMed

Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

2012-11-01

Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

Untangling nociceptive, neuropathic and neuroplastic mechanisms underlying the biological domain of back pain.

PubMed

Hush, Julia M; Stanton, Tasha R; Siddall, Philip; Marcuzzi, Anna; Attal, Nadine

2013-05-01

SUMMARY Current clinical practice guidelines advocate a model of diagnostic triage for back pain, underpinned by the biopsychosocial paradigm. However, limitations of this clinical model have become apparent: it can be difficult to classify patients into the diagnostic triage categories; patients with 'nonspecific back pain' are clearly not a homogenous group; and mean effects of treatments based on this approach are small. In this article, it is proposed that the biological domain of the biopsychosocial model needs to be reconceptualized using a neurobiological mechanism-based approach. Recent evidence about nociceptive and neuropathic contributors to back pain is outlined in the context of maladaptive neuroplastic changes of the somatosensory system. Implications for clinical practice and research are discussed.

An algorithmic programming approach for back pain symptoms in failed back surgery syndrome using spinal cord stimulation with a multicolumn surgically implanted epidural lead: a multicenter international prospective study.

PubMed

Rigoard, Philippe; Jacques, Line; Delmotte, Alexandre; Poon, Katherine; Munson, Russell; Monlezun, Olivier; Roulaud, Manuel; Prevost, Audrey; Guetarni, Farid; Bataille, Benoit; Kumar, Krishna

2015-03-01

Many studies have demonstrated the efficacy and the medical/economic value of epidural spinal cord stimulation for the treatment of "failed back surgery syndrome" (FBSS). However, the back pain component of FBSS has been recalcitrant. Recent clinical trials have suggested that multicolumn surgically implanted leads combined with enhanced programming capabilities in the newer implantable pulse generators demonstrate the ability to treat the back pain component of FBSS. The objective of our present international multicentre study is to prospectively evaluate these findings in a larger population. We conducted a prospective, nonrandomized, observational study on 76 patients with refractory FBSS, consecutively implanted with multicolumn spinal cord stimulation (SCS) between 2008 and 2011 in three neurosurgical pain management centers (Poitiers, France; Montréal, Canada; and Regina, Canada). The primary objective of this study was to prospectively analyze the effect of multicolumn lead programming on paresthesia coverage for the back pain region in these patients. The secondary objective was to assess the analgesic efficacy of this technique on the global and back pain components. Paresthesia could be induced in the lower extremities in the majority of patients with at least one of the configurations tested. Bilateral low back paresthesia was induced in 53.5% of patients, while unilateral low back paresthesia was induced in 78.9% of patients. Multicolumn configurations were statistically more effective than monocolumn configurations for all anatomic regions studied. At 6 months, 75.4% of patients receiving multicolumn stimulation (n = 57) obtained at least a 30% improvement of the back pain VAS score, while 42.1% of patients obtained at least a 50% improvement of the back pain VAS score. This study confirms the hypothesis that multicolumn SCS should be considered as an important tool in the treatment of radicular and axial pain in FBSS patients. The efficacy of this modality is based on a rigorous patient selection process, access to new generation lead technologies, but most importantly an algorithmic programming approach for optimal stimulation and electrical field shaping. With over 40 million potential programming combinations associated with 16 contact leads to achieve paresthesia coverage, optimal stimulation is often missed as either the patient or the clinician become exhausted or overwhelmed during the course of therapy programming and optimization session. © 2014 World Institute of Pain.

Cellular and Physiological Effects of Anthrax Exotoxin and Its Relevance to Disease

PubMed Central

Lowe, David E.; Glomski, Ian J.

2012-01-01

Bacillus anthracis, the causative agent of anthrax, secretes a tri-partite exotoxin that exerts pleiotropic effects on the host. The purification of the exotoxin components, protective antigen, lethal factor, and edema factor allowed the rapid characterization of their physiologic effects on the host. As molecular biology matured, interest focused on the molecular mechanisms and cellular alterations induced by intoxication. Only recently have researchers begun to connect molecular and cellular knowledge back to the broader physiological effects of the exotoxin. This review focuses on the progress that has been made bridging molecular knowledge back to the exotoxin’s physiological effects on the host. PMID:22919667

Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content analysis of clinical trial notes. Discussion This pragmatic, pilot randomized controlled trial uses a mixed method approach to evaluate the clinical effectiveness, feasibility, and participant and provider perceptions of collaborative care between medical doctors and doctors of chiropractic in the treatment of older adults with low back pain. Trial registration This trial registered in ClinicalTrials.gov on 04 March 2011 with the ID number of NCT01312233. PMID:23324133

Communication style and exercise compliance in physiotherapy (CONNECT): a cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients' adherence to physiotherapists' recommendations: study rationale, design, and methods.

PubMed

Lonsdale, Chris; Hall, Amanda M; Williams, Geoffrey C; McDonough, Suzanne M; Ntoumanis, Nikos; Murray, Aileen; Hurley, Deirdre A

2012-06-15

Physical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist's recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients' autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists' recommendations). The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists' autonomy-supportive communication on low back pain patients' adherence to physical activity and exercise therapy recommendations. This study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12) in Dublin, Ireland (population = 1.25 million) will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics) will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics) will not receive this training. Participants (N = 292) with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as they will not be told if their physiotherapist has received the communication skills training. Outcome assessors will also be blinded.We will use linear mixed modeling to test between arm differences both in the mean levels and the rates of change of the outcome variables. We will employ structural equation modeling to examine the process of change, including hypothesized mediation effects. This trial will be the first to test the effect of a self-determination theory-based communication skills training program for physiotherapists on their low back pain patients' adherence to rehabilitation recommendations.

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

PubMed

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

2017-12-01

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

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

PubMed

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

1999-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-06-01

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

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

PubMed

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

2007-10-01

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

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

PubMed

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

2017-06-01

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

Randomised controlled trial comparing the effectiveness of electroacupuncture and TENS for low back pain: a preliminary study for a pragmatic trial.

PubMed

Tsukayama, Hiroshi; Yamashita, Hitoshi; Amagai, Hitoshi; Tanno, Yasuo

2002-12-01

The objective of this study was to compare the effectiveness of electroacupuncture and TENS for low back pain when the electroacupuncture is applied in a clinically realistic manner. The study was designed as an evaluator-blinded randomised controlled trial (RCT). The study was performed at the Tsukuba College of Technology Clinic in Japan. Twenty subjects, who suffered from low back pain (LBP) without sciatica, were recruited, using leaflets in Tsukuba city. Subjects were allocated to either an electroacupuncture (EA) group (10 patients) or a transcutaneous electrical nerve stimulation (TENS) group (10 patients). The procedure for EA was in accordance with standard practice at our clinic. The main outcome measures were a pain relief scale (100 mm visual analogue scale: VAS) and a LBP score recommended by the Japanese Orthopaedic Association (JOA Score). Mean VAS value during the 2-weeks experimental period of the EA group was significantly smaller than that of the TENS group (65 mm vs 86 mm; 95% CI, 4.126 - 37.953). JOA Score in the EA group improved significantly while that in the TENS group showed no change. Although some placebo effect may be included, EA appeared more useful than TENS in the short-term effect on low back pain. We suggest that more realistic acupuncture interventions based on standard practice should be employed in pragmatic RCTs.

Effects of back massage on chemotherapy-related fatigue and anxiety: supportive care and therapeutic touch in cancer nursing.

PubMed

Karagozoglu, Serife; Kahve, Emine

2013-11-01

This quasi-experimental and cross-sectional study was carried out to determine the efficacy of back massage, a nursing intervention, on the process of acute fatigue developing due to chemotherapy and on the anxiety level emerging in cancer patients receiving chemotherapy during this process. The study was conducted on 40 patients. To collect the data, the Personal Information Form, the State Anxiety part of Spielberger State-Trait Anxiety Inventory and the Brief Fatigue Inventory were used. In our study, it was determined that mean anxiety scores decreased in the intervention group patients after chemotherapy. The level of fatigue in the intervention group decreased statistically significantly on the next day after chemotherapy (p=.020; effect size=0.84). At the same time, the mean anxiety scores of the patients in the intervention group decreased right after the massage provided during chemotherapy (p=.109; effect size=0.37) and after chemotherapy. In line with our study findings, it can be said that back massage given during chemotherapy affects anxiety and fatigue suffered during the chemotherapy process and that it significantly reduces state anxiety and acute fatigue. Therefore, the effective use of back massage in the process of chemotherapy by oncology nurses who have a key role in cancer treatment and care can make it more modulated. © 2013.

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

PubMed

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

2018-04-01

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