Chronic low back pain is a highly prevalent condition, which is associated with high direct and indirect costs to the society. Although this condition is highly prevalent, it is still extremely ...difficult to treat. Two potentially useful treatments for patients with chronic low back pain are called the McKenzie and Back School treatment programs. These programs have good biological plausibility, are widely available and have a modest cost. Although these treatments are already available for patients, the evidence that supports their use is largely based on low quality methodological studies. Therefore, a high-quality randomised controlled trial is required to compare, for the first time, the effectiveness of these treatments in patients with chronic low back pain.
One hundred and forty-eight patients will be randomly allocated to a four-week treatment program based upon the McKenzie or Back School principles. Clinical outcomes (pain intensity, disability, quality of life, and trunk flexion range of motion) will be obtained at follow-up appointments at 1, 3 and 6 months after randomisation. The data will be collected by an assessor who will be blinded to the group allocation.
This will be the first study aimed to compare the McKenzie and Back School approaches in patients with chronic low back pain. The results of this trial may help in the decision-making process of allied health providers for the treatment of chronic low back pain and reduce the health-related costs of this condition.
ACTRN12610000435088.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose
The use of internet for health-related purposes has increased in the past years; however, the overabundance of information led the world to a health “infodemic”. Little is known about the ...ways public health users seek health information online and how it influences the relationship between patients and healthcare practitioners. We aimed to investigate how public health users seek health information online and how this practice affects health encounters.
Methods
We conducted a qualitative study in a public secondary level healthcare facility. Thirty participants were interviewed using a semi-structured grid designed upon the definition of digital health literacy. Participants were mostly women with an average age of 50 years old and educational level equal to or lower than high school degree. Traditionally and digitally illiterate participants participated in the study. Data analysis was performed using a reflexive thematic analysis underpinned by critical theory.
Results
We identified three interrelated themes: (1) failing to be a digitally engaged patient, (2) health information on the internet resonates better with individuals’ literacy, and (3) vulnerability is welcomed on the internet. Themes explored power dynamics that appeared to be mediated by formal knowledge, sociocultural contexts, use of technical language, and the presence of emotional and affective domains.
Conclusion
Our findings suggest that health information online might facilitate the understanding of technical terms and fill an emotional gap often overlooked by healthcare practitioners. Findings may assist health professionals in developing ways of considering health information online as part of the health encounter.
The present work aimed to study the genotype by environment interaction for nine important agronomic traits as a support for the indication of common bean cultivars for the Southern region of Brazil, ...identifying cultivars that possess high adaptability/stability. We carried out 25 field trials, in the rainy and dry sowing seasons, at different locals in the states of Paraná and Santa Catarina, from 2008 to 2010. The trials included 17 cultivars. Data were obtained for agronomic traits and subjected to variance analyses, and to adaptability and stability analyses according to the Nunes method. The genotype by environment interaction is important for different agronomic traits. There is genetic variation among cultivars and it was identified a different number of superior cultivars for each trait. Considering the means and adaptability and stability scores, 88% of the cultivars were superior for rust, 53% for anthracnose, 41% for grain yield, plant architecture and cycle, 30% for fusarium wilt and lodging, and 18% for angular leaf spot and common bacterial blight. For some of these traits, like angular leaf spot, common bacterial blight, fusarium wilt and lodging, it is necessary to intensify the efforts to provide more cultivars with high resistance or tolerance level, adaptability and stability. BRS Esplendor, a black-seeded cultivar, CNFC 10431 and BRS Sublime, both carioca-seeded cultivars, presented superiority for six of nine traits, being indicated to be used in the Southern region of Brazil. Other cultivars presented advantages for fewer traits and must be used in environments which these traits present greater importance.
...probably more importantly, it is injudicious to dismiss the use of summary scores or endorse the use of individual scale items based on an analysis of a small and unrepresentative sample of just ...15 trials. ...that research is completed, we think either approach is reasonable.
•Interferential current probably reduces pain intensity and disability immediately post-treatment compared to placebo in patients with chronic non-specific low back pain.•Interferential current may ...reduce pain, but not disability, immediately post-treatment compared to other interventions in patients with chronic non-specific low back pain.•Interferential current combined with other intervention (massage or exercises) may not further reduce pain intensity and disability compared to other interventions provided in isolation immediately post-treatment in patients with chronic non-specific low back pain.
There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain.
To investigate the effectiveness of IC in patients with chronic non-specific low back pain.
The databases PUBMED, EMBASE, PEDro, Cochrane Library, CINAHL, and SCIELO were searched. Randomized controlled trials reporting pain intensity and disability in patients with chronic non-specific low back pain, in which IC was applied were included. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence.
Thirteen RCTs were considered eligible for this systematic review (pooled n = 1367). Main results showed moderate-quality evidence and moderate effect sizes that IC probably reduces pain intensity and disability compared to placebo immediately post-treatment (Pain: MD = -1.57 points; 95% CI -2.17, -0.98; Disability: MD = -1.51 points; 95% CI -2.57, -0.46), but not at intermediate-term follow-up. Low-quality evidence with small effect size showed that IC may reduce pain intensity (SMD = -0.32; 95% CI -0.61, -0.03, p = 0.03) compared to TENS immediately post-treatment, but not for disability. There is very low-quality evidence that IC combined with other interventions (massage or exercises) may not further reduce pain intensity and disability compared to the other interventions provided in isolation immediately post-treatment.
Moderate-quality evidence shows that IC is probably better than placebo for reducing pain intensity and disability immediately post-treatment in patients with chronic non-specific low back pain.
To systematically review the available evidence on the efficacy of the Pilates method in patients with chronic nonspecific low back pain.
Searches were performed in MEDLINE, EMBASE, PEDro, SciELO, ...LILACS, CINAHL and CENTRAL in March 2013. Randomized controlled trials that tested the effectiveness of the Pilates method (against a nontreatment group, minimal intervention or other types of interventions) in adults with chronic low back pain were included regardless the language of publication. The outcome data were extracted from the eligible studies and were combined using a meta-analysis approach.
The searches identified a total of 1,545 articles. From these, eight trials were considered eligible, and seven trials were combined in the meta-analysis. The comparison groups were as follows: Pilates versus other types of exercises (n=2 trials), and Pilates versus no treatment group or minimal intervention (n=4 trials) for short term pain; Pilates versus minimal intervention for short-term disability (n=4).We determined that Pilates was not better than other types of exercises for reducing pain intensity. However, Pilates was better than a minimal intervention for reducing short-term pain and disability (pain: pooled mean difference=1.6 points; 95% CI 1.4 to 1.8; disability: pooled mean difference=5.2 points; 95% CI 4.3 to 6.1).
Pilates was better than a minimal intervention for reducing pain and disability in patients with chronic low back pain. Pilates was not better than other types of exercise for short-term pain reduction.
While the number of reports of randomized controlled trials in physical therapy has increased substantially in the last decades, the quality and reporting of randomized trials have never been ...systematically investigated in the subdiscipline of cardiothoracic physical therapy. The primary aim was to determine the methodological quality and completeness of reporting of cardiothoracic physical therapy trials. Secondary aims were to investigate the range of clinical conditions investigated in these trials and the degree of association between trial characteristics and quality.
All reports of randomized trials indexed on the Physiotherapy Evidence Database (PEDro) and coded as being relevant to cardiothoracic physical therapy were surveyed. PEDro scale individual items and total score were downloaded, and some characteristics included in the Consolidated Standards of Reporting Trials (CONSORT) statement were extracted for each trial report.
The mean ± SD total PEDro score for the 2,970 included reports of cardiothoracic trials was 4.7 ± 1.4, with 27% being of moderate to high quality. The clinical conditions studied included chronic lung diseases (32% of the trials), cardiac diseases (20%), cardiovascular surgical conditions (5%), sleep disorders (5%), peripheral vascular disease (4%), acute lung disease (4%), critical illness (3%), and other surgical conditions (3%). The multivariate linear regression analysis revealed that endorsement of the CONSORT statement by the publishing journal, time since publication, evidence of trial registration, sources of funding, description of the sample size calculation, and identification of the primary outcome(s) had associations with the total PEDro score.
There is great potential to improve the quality of the conduct and reporting of trials evaluating the effects of cardiothoracic physical therapy.
We aim to determine the effectiveness of meditation for adults with non-specific low back pain.
We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for ...randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability.
We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = -0.22; 95% CI = -0.42 to -0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = -0.28; 95% CI = -0.54 to -0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period.
We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.
•The Psychosomatic Questionnaire for Children and Adolescents was easily understood.•The Psychosomatic Questionnaire for Children and Adolescents had good reliability and validity.•The Psychosomatic ...Questionnaire for Children and Adolescents can be used with Brazilian-Portuguese speaking children and adolescents with musculoskeletal pain.
Psychosomatic symptoms seem to influence both the onset and development of pain. There is lack of Brazilian-Portuguese questionnaires that measure psychosomatic symptoms in children and adolescents.
To translate and cross-culturally adapt the Psychosomatic Questionnaire for Children and Adolescents into Brazilian-Portuguese and English and test the measurement properties of the Brazilian-Portuguese version.
The translation and cross-cultural adaptation (from Dutch to Brazilian-Portuguese and English) followed six steps. Interviews were conducted in 33 Brazilian children and adolescents. We also recruited 107 children and adolescents with musculoskeletal pain from schools to test the measurement properties of the Brazilian-Portuguese version. The questionnaire was completed twice with a 7-day interval. Ceiling and floor effects, missing data, internal consistency, reliability, measurement error and construct validity were assessed.
We recruited 140 children and adolescents from public and private schools. During the cross-cultural adaptation process, no major difficulty answering and understanding the questionnaire were reported by children and adolescents. The questionnaire did not show ceiling or floor effects and had minimal missing data (0.37%). Internal consistency by the Cronbach's Alpha was 0.69. Test-retest reliability by the Intraclass Correlation Coefficient was 0.75 (95% CI: 0.64, 0.84). The smallest detectable change was 6.5 points out of 18 points. We observed a moderate correlation of 0.54 (p<0.01) with the Spence Children's Anxiety Scale, consistent with our a-priori hypothesis.
The Brazilian-Portuguese version of the Psychosomatic Questionnaire for Children and Adolescents has acceptable measurement properties and is a good option for assessing psychosomatic symptoms in clinical practice and research.
Kinesio Taping® has been widely used in clinical practice. However, it is unknown whether this type of tape is more effective than placebo taping in patients with chronic lower back pain.
To compare ...the effectiveness of Kinesio Taping® in patients with chronic non-specific low back pain against a placebo tape and a control group.
This is a 3-arm, randomized controlled trial with a blinded assessor. Sixty patients with chronic non-specific low back pain were randomized into one of the three groups: Kinesio Taping® group (n=20), Micropore® (placebo) group (n=20) and control group (n=20). Patients allocated to both the Kinesio Taping® group and the placebo group used the different types of tape for a period of 48 hours. The control group did not receive any intervention. The outcomes measured were pain intensity (measured by an 11-point numerical rating scale) and disability (measured by the 24-item Roland Morris Disability Questionnaire). A blinded assessor measured the outcomes at baseline, 48 hours and 7 days after randomization.
After 48 hours, there was a statistically significant difference between the Kinesio Taping® group versus the control group (mean between-group difference = -3.1 points, 95% CI=-5.2 to -1.1, p=0.003), but no difference when compared to the placebo group (mean between-group difference= 1.9 points, 95% CI=-0.2 to 3.9, p=0.08). For the other outcomes no differences were observed.
The Kinesio Taping® is not better than placebo (Micropore®) in patients with chronic low back pain.
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