Purpose: The aim of this study was to describe sociodemographic factors and the occurrence of diseases and disabilities among a representative sample of clients who were using community occupational ...therapy services in Norway. Method: A postal survey of occupational therapists about their last clients (n=168) was carried out in 2001. A survey questionnaire based on the International Classification of Functioning, Disability, and Health (ICF) was developed. Diagnoses were coded according to the International Classification of Primary Care (ICPC-2). Results: This study showed that more than half of the clients were adults, youths, or children. Only 17% of adults participated in "ordinary working life", and of those approximately 10% were on sick leave and 62% were on disablement pension. A predominance of neurological diseases such as multiple sclerosis and Parkinson's disease was found (24%). Stroke was the most common principal diagnosis (19%). Musculoskeletal (16%) and mental diseases (13%) were also frequently reported. "Movement impairments" (96%) were most common in the body function component. Frequent problems in several domains of the activity and participation components were reported, in particular in "education, work and employment" (93-94%) and "recreation and leisure" (94%). Conclusion: Clients using community occupational therapy in Norway had numerous types of chronic and severe diseases, and a high occurrence of musculoskeletal impairment, activity limitations, and participation restrictions.
A prospective, randomized, controlled trial with a stratification block design in which a Mensendieck exercise program was compared with the experience of a control group.
To evaluate the effect of a ...Mensendieck program on the incidence of recurrent episodes of low back pain in patients with a history of the condition who currently are working.
One episode of low back pain increases the risk of further episodes of the condition. The Mensendieck approach combines education and exercise. This approach has been used for many years in Scandinavia and the Netherlands. However, the effects on low back pain have not been evaluated previously in a randomized, controlled trial.
A total of 77 men and women, mean age 39.6 years (range, 21.2-49.8 years), who had finished treatment for a low back pain episode, were stratified according to incidence of low back pain episodes and symptoms of sciatica over the preceding 3 years. The patients were assigned at random to either the Mensendieck program or a control group. The Mensendieck group received 20 group sessions of exercises and ergonomic education in 13 weeks. At 5- and 12-month follow-up examinations, the patients were assessed for recurrence of low back pain, days of sick leave, low back pain, and functional scores.
After 12 months, there was a significant reduction in recurrent low back pain episodes in the Mensendieck group compared with the control group (P < 0.05). There was a trend toward fewer days of sick leave because of low back pain in the Mensendieck group, but no significant differences between the groups. There was reduction in pain and improvement in function in both groups, with no significant differences between the groups.
A secondary prophylaxis Mensendieck exercise program of 20 group sessions significantly reduced the incidence of low back pain recurrences in a population with history of the condition. However, there were no differences between the groups with regard to days of sick leave, low back pain, and function.
What is the effectiveness of physiotherapistdirected exercise, advice, or both for subacute low back pain?
Randomised controlled trial.
7 university hospitals and primary care clinics in Australia ...and New Zealand.
259 persons with non-specific, subacute low back pain lasting for at least 6 weeks, but no longer than 12 weeks.
Participants were randomised to four groups: exercise and advice, exercise and sham advice, sham exercise and advice, or sham exercise and sham advice. 12 exercise or sham exercise sessions were delivered over 6 weeks. The exercise program included an individualised, progressive, submaximal program of aerobic exercise, stretches, functional activities, activities to build speed, endurance and co-ordination, and trunk and limb-strengthening exercises. Participants also received a home exercise program. The sham exercise intervention consisted of sham shortwave diathermy and sham pulsed ultrasosound. In weeks 1, 2 and 4 participants received advice or sham advice. Advice sessions aimed to encourage a graded return to normal activities. During the sham advice sessions the patients talked about their problems but received no advice. Participants were not informed whether their group allocation was active or sham for either intervention.
Primary outcomes were average pain over the last week (0 to 10 scale), global perceived effect (–5 to 5 scale) and function (Patient Specific Functional Scale, 0 to 10) at 6 weeks and 12 months.
The effect of exercise (the adjusted difference in outcomes between exercise and sham exercise groups) at 6 weeks was –0.8 points (95% CI –1.3 to –0.3 points) on the pain scale and 0.5 points (95% CI 0.1 to 1.0 points) on the global perceived effect scale. The effect of advice at 6 weeks was –0.7 points (95% CI –1.2 to –0.2 points) on the pain scale and 0.8 points (95% CI 0.3 to 1.2 points) on the global perceived effect scale. The effect of advice on the function scale was significant at 6 weeks and 12 months. For pain, function, and global perceived effect, the effect of combined treatments was larger than the effect of exercise or advice alone.
Physiotherapydirected exercise and advice was slightly more effective than placebo at 6 weeks. The effect was greatest when the interventions were combined. At 12 months a small effect on participant-reported function was still reported.
BackgroundYoung adulthood is a sensitive life period where development of musculoskeletal neck pain may be established and impact future health. MethodWe conducted a systematic review according to ...the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement investigating risk factors for neck pain in young adults (18-29 years). Systematic searches were conducted in six databases in January 2019. Prospective cohorts and registry studies were included. Participants had to be 18-29 years old at baseline, at follow-up and/or both. The Quality in Prognosis Studies tool was used for quality assessment. A modification of the Grading of Recommendations Assessments, Development and Evaluation was used to assess the overall quality of the evidence. Searches yielded 4221 articles, of which six matched the eligibility criteria. ResultsFifty-six potential risk factors were investigated in the six studies, covering a broad range of domains. Five risk factors were investigated in more than one study (female sex, body mass index (BMI), physical activity, duration of computer use and perceived stress). Physical activity and BMI showed no association with neck pain, and inconsistent results were found for female sex, duration of daily computer use and perceived stress. Risk of bias was moderate or high in all studies, and the overall quality of evidence was very low for all identified factors. ConclusionThe studies included many potential risk factors, but none of them showed consistent associations. This might be because of heterogeneity and the paucity of high quality studies investigating risk factors for neck pain in young adults.
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