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Jiang W, Glaeser JD, Kaneda G, Sheyn J, Wechsler JT, Stephan S, Salehi K, Chan JL, Tawackoli W, Avalos P, Johnson C, Castaneda C, Kanim LEA, Tanasansomboon T, Burda JE, Shelest O, Yameen H, Perry TG, Kropf M, Cuellar JM, Seliktar D, Bae HW, Stone LS, Sheyn D. Intervertebral disc human nucleus pulposus cells associated with back pain trigger neurite outgrowth in vitro and pain behaviors in rats. Sci Transl Med 2023; 15:eadg7020. [PMID: 38055799 DOI: 10.1126/scitranslmed.adg7020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/06/2023] [Indexed: 12/08/2023]
Abstract
Low back pain (LBP) is often associated with the degeneration of human intervertebral discs (IVDs). However, the pain-inducing mechanism in degenerating discs remains to be elucidated. Here, we identified a subtype of locally residing human nucleus pulposus cells (NPCs), generated by certain conditions in degenerating discs, that was associated with the onset of discogenic back pain. Single-cell transcriptomic analysis of human tissues showed a strong correlation between a specific cell subtype and the pain condition associated with the human degenerated disc, suggesting that they are pain-triggering. The application of IVD degeneration-associated exogenous stimuli to healthy NPCs in vitro recreated a pain-associated phenotype. These stimulated NPCs activated functional human iPSC-derived sensory neuron responses in an in vitro organ-chip model. Injection of stimulated NPCs into the healthy rat IVD induced local inflammatory responses and increased cold sensitivity and mechanical hypersensitivity. Our findings reveal a previously uncharacterized pain-inducing mechanism mediated by NPCs in degenerating IVDs. These findings could aid in the development of NPC-targeted therapeutic strategies for the clinically unmet need to attenuate discogenic LBP.
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Affiliation(s)
- Wensen Jiang
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Juliane D Glaeser
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Giselle Kaneda
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Julia Sheyn
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jacob T Wechsler
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Stephen Stephan
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Khosrowdad Salehi
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Julie L Chan
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Wafa Tawackoli
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Pablo Avalos
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Christopher Johnson
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Chloe Castaneda
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Linda E A Kanim
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Teerachat Tanasansomboon
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Joshua E Burda
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Oksana Shelest
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Haneen Yameen
- Department of Biomedical Engineering, Israeli Institute of Technology Technion, Haifa 3200003, Israel
| | - Tiffany G Perry
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Michael Kropf
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jason M Cuellar
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Dror Seliktar
- Department of Biomedical Engineering, Israeli Institute of Technology Technion, Haifa 3200003, Israel
| | - Hyun W Bae
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Laura S Stone
- Department of Biomedical Engineering, Israeli Institute of Technology Technion, Haifa 3200003, Israel
| | - Dmitriy Sheyn
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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2
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Carrière JS, Donayre Pimentel S, Bou Saba S, Boehme B, Berbiche D, Coutu MF, Durand MJ. Recovery expectations can be assessed with single-item measures: findings of a systematic review and meta-analysis on the role of recovery expectations on return-to-work outcomes after musculoskeletal pain conditions. Pain 2023; 164:e190-e206. [PMID: 36155605 PMCID: PMC10026834 DOI: 10.1097/j.pain.0000000000002789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT The objective of this systematic review is to quantify the association between recovery expectations and return-to-work outcomes in adults with musculoskeletal pain conditions. In addition, this review has the second objective to compare the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Relevant articles were selected from Embase, PsycINFO, PubMed, Cochrane, and manual searches. Studies that assessed recovery expectations as predictors of return-to-work outcomes in adults with musculoskeletal pain conditions were eligible. Data were extracted on study characteristics, recovery expectations, return-to-work outcomes, and the quantitative association between recovery expectations and return-to-work outcomes. Risk of bias was assessed using the Effective Public Health Practice Project. Odds ratios were pooled to examine the effects of recovery expectations on return-to-work outcomes. Chi-square analyses compared the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Thirty studies on a total of 28,741 individuals with musculoskeletal pain conditions were included in this review. The odds of being work disabled at follow-up were twice as high in individuals with low recovery expectations (OR = 2.06 [95% CI 1.20-2.92] P < 0.001). Analyses also revealed no significant differences in the predictive value of validated and nonvalidated single-item measures of recovery expectations on work disability (χ 2 = 1.68, P = 0.19). There is strong evidence that recovery expectations are associated with return-to-work outcomes. The results suggest that single-item measures of recovery expectations can validly be used to predict return-to-work outcomes in individuals with musculoskeletal pain conditions.
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Affiliation(s)
- Junie S. Carrière
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | | | - Sabine Bou Saba
- School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
| | - Blake Boehme
- Department of Psychology, University of Regina, Regina, Saskatchewan
| | - Djamal Berbiche
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Coutu
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marie-José Durand
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
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3
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Vad VB, Madrazo-Ibarra A, Estrin D, Pollak JP, Carroll KM, Vojta D, Vad A, Trapness C. "Back Rx, a personalized mobile phone application for discogenic chronic low back pain: a prospective pilot study". BMC Musculoskelet Disord 2022; 23:923. [PMID: 36261825 PMCID: PMC9580128 DOI: 10.1186/s12891-022-05883-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 10/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Intervertebral disc pathology is the most common identifiable cause of chronic lower back pain (CLBP). There are limited conservative alternatives to treat discogenic axial CLBP. Back Rx is a mobile application (app) developed to treat patients with this condition, following the Back Rx exercise program, assisted by a virtual coach. Methods Patients 18 to 65 years of age, with axial CLBP (more than 3 months), and evidence of lumbar disc pathology by magnetic resonance imaging (MRI) were enrolled to the study. Patients’ symptomatology was prospectively evaluated at baseline and after 3 months of using the Back Rx app. The main outcome of the study was back pain evaluated using the visual analog scale (VAS) for pain. Secondary outcomes were the patient's functionality, the weekly pain medication intake, the patients’ adherence to the app, and the patients´ satisfaction rate. Results Seventy-five patients with CLBP were enrolled in the study. All patients had a statistically significant improvement from baseline to final follow-up in the average VAS scores, and the functionality evaluations. Average VAS scores decreased from 5.17 ± 2.1 at baseline to 3.8 ± 2.6 at final follow-up (P = 0.016). Patients showed a significant decrease in the number of pain medications taken during a week (P = 0.001). Overall compliance with the app was 52%, and 65% of the patients rated the overall experience as good or excellent. Conclusion The Back Rx app decreased pain and increased function in patients with discogenic axial CLBP compared to their baseline status. Further measures are needed to increase patients' compliance with the app and the Back Rx program. Trial registration Retrospectively registered in 2/2/2017 NCT03040310 (ClinicalTrials.gov). Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05883-9.
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Affiliation(s)
- Vijay B Vad
- Assistant Professor, Hospital for Special Surgery, New York, NY, USA
| | - Antonio Madrazo-Ibarra
- Hospital for Special Surgery, Research Fellow, New York, NY, USA. .,Research Fellow, Department of Physiatry, Hospital for Special Surgery, 519 E 72nd St, New York, NY, 10021, USA.
| | - Deborah Estrin
- Associate Dean of Computer Science, Cornell Tech, New York, NY, USA
| | - John P Pollak
- Cornell Tech, Senior Research-in-Residence, New York, NY, USA
| | | | - Deneen Vojta
- Executive Vice President, UnitedHealth Group Research & Development, Minnetonka, MN, USA
| | - Amoli Vad
- Hospital for Special Surgery, Research Assistant, New York, NY, USA
| | - Camilla Trapness
- Hospital for Special Surgery, Research Coordinator, New York, NY, USA
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4
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Jiang W, Glaeser JD, Salehi K, Kaneda G, Mathkar P, Wagner A, Ho R, Sheyn D. Single-cell atlas unveils cellular heterogeneity and novel markers in human neonatal and adult intervertebral discs. iScience 2022; 25:104504. [PMID: 35754733 PMCID: PMC9213722 DOI: 10.1016/j.isci.2022.104504] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/03/2022] [Accepted: 05/26/2022] [Indexed: 11/19/2022] Open
Abstract
The origin, composition, distribution, and function of cells in the human intervertebral disc (IVD) have not been fully understood. Here, cell atlases of both human neonatal and adult IVDs have been generated and further assessed by gene ontology pathway enrichment, pseudo-time trajectory, histology, and immunofluorescence. Comparison of cell atlases revealed the presence of two subpopulations of notochordal cells (NCs) and their associated markers in both the neonatal and adult IVDs. Developmental trajectories predicted 7 different cell states that describe the developmental process from neonatal to adult cells in IVD and analyzed the NC’s role in the IVD development. A high heterogeneity and gradual transition of annulus fibrosus cells (AFCs) in the neonatal IVD was detected and their potential relevance in IVD development assessed. Collectively, comparing single-cell atlases between neonatal and adult IVDs delineates the landscape of IVD cell biology and may help discover novel therapeutic targets for IVD degeneration. Compared scRNA-seq between human neonatal and adult IVD Identified two notochordal cell populations in adults and their novel markers Notochordal cells preserved their identity and functions into adulthood Unveiled heterogeneity of nucleus pulposus and annulus fibrosus cells in human IVD
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Affiliation(s)
- Wensen Jiang
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Juliane D. Glaeser
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Khosrowdad Salehi
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Giselle Kaneda
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Pranav Mathkar
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Anton Wagner
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ritchie Ho
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Center for Neural Sciences and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Dmitriy Sheyn
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Corresponding author
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5
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Ju DG, Kanim LE, Bae HW. Is There Clinical Improvement Associated With Intradiscal Therapies? A Comparison Across Randomized Controlled Studies. Global Spine J 2022; 12:756-764. [PMID: 33047622 PMCID: PMC9344499 DOI: 10.1177/2192568220963058] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Post hoc comparison using single-site data from 4 multicenter randomized controlled trials. OBJECTIVES Discogenic back pain is associated with significant morbidity and medical cost. Several terminated, unreported randomized controlled trials have studied the effect of intradiscal biologic injections. Here we report single-center outcomes from these trials to determine if there is clinical improvement associated with these intradiscal injections. METHODS Post hoc comparison was performed using single-site data from 4 similar multi-center randomized controlled trials. All trials evaluated an injectable therapy (growth factor, fibrin sealant, or stem cells) for symptomatic lumbar disc disease with near-identical inclusion and exclusion criteria. Demographics and patient reported outcomes were analyzed across treatment arms postinjection. RESULTS A total of 38 patients were treated with biologic agents and 12 were treated with control saline injections. There was a significant decrease in visual analogue score (VAS) pain for both the investigational and saline groups up to 12 months postinjection (P < .01). There was no significant difference in VAS scores between the saline and investigational groups at 12 months. Similarly, there was significant improvement in patient-reported disability scores in both the investigational and saline groups at all time points. There were no significant differences in disability score improvement between the saline and investigational treatment groups at 12 months postinjection. CONCLUSIONS A single-center analysis of 4 randomized controlled studies demonstrated no difference in outcomes between therapeutic intradiscal agents (growth factor, fibrin sealant, or stem cells) and control saline groups. In all groups, patient reported pain and disability scores decreased significantly. Future studies are needed to evaluate the therapeutic benefit of any intradiscal injections.
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Affiliation(s)
- Derek G. Ju
- Cedars-Sinai Medical Center, Los
Angeles, CA, USA
| | | | - Hyun W. Bae
- Cedars-Sinai Medical Center, Los
Angeles, CA, USA,Hyun W. Bae, Cedars-Sinai Medical Center,
444 South San Vicente Boulevard, Suite 901, Los Angeles, CA, USA.
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6
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Laasik R, Lankinen P, Kivimäki M, Neva MH, Aalto V, Oksanen T, Vahtera J, Mäkelä KT. Return to work after lumbar disc herniation surgery: an occupational cohort study. Acta Orthop 2021; 92:638-643. [PMID: 34269643 PMCID: PMC8635580 DOI: 10.1080/17453674.2021.1951010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Lumbar disc herniation is a common surgically treated condition in the working-age population. We assessed health-related risk factors for return to work (RTW) after excision of lumbar disc herniation. Previous studies on the subject have had partly contradictory findings.Patients and methods - RTW of 389 (n = 111 male, n = 278 female; mean age 46 years, SD 8.9) employees who underwent excision of lumbar disc herniation was assessed based on the Finnish Public Sector Study (FPS). Baseline information on occupation, preceding health, and health-risk behaviors was derived from linkage to national health registers and FPS surveys before the operation. The likelihood of RTW was analyzed using Cox proportional hazard univariable and multivariable modelling.Results - 95% of the patients had returned to work at 12 months after surgery, after on average 78 days of sickness absence. Faster RTW in the univariable Cox model was associated with a small number of sick leave days (< 30 days) before operation (HR 1.3, 95% CI 1.1-1.6); high occupational position (HR 1.6, CI 1.2-2.1); and age under 40 years (HR 1.5, CI 1.1-1.9). RTW was not associated with sex or the health-related risk factors obesity, physical inactivity, smoking, heavy alcohol consumption, poor self-rated health, psychological distress, comorbid conditions, or purchases of pain or antidepressant medications in either the univariable or multivariable model.Interpretation - Almost all employees returned to work after excision of lumbar disc herniation. Older age, manual job, and prolonged sick leave before the excision of lumbar disc herniation were risk factors for delayed return to work after the surgery.
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Affiliation(s)
- Raul Laasik
- Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - Petteri Lankinen
- Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland;,Satakunta Central Hospital, Pori, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland;,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland;,Department of Epidemiology and Public Health, University College London, London, UK
| | - Marko H Neva
- Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland;,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, and Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Keijo T Mäkelä
- Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland;,Correspondence: Keijo T Mäkelä Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland
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7
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Calvet B, Vézina N, Laberge M, Nastasia I, Sultan-Taïeb H, Toulouse G, Rubiano P, Durand MJ. Integrative prevention and coordinated action toward primary, secondary and tertiary prevention in workplaces: A scoping review. Work 2021; 70:893-908. [PMID: 34744036 DOI: 10.3233/wor-213609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Integrated approaches are valued in several occupational health strategic programmatic orientations. A better understanding of the use of integrative prevention in coordinating measures is needed to develop its use in workplaces. OBJECTIVE Identify workplace integrative prevention approaches and definitions of prevention (primary, secondary and tertiary) in the literature. METHODS A scoping review was conducted following Arksey and O'Malley (2005). The literature search was carried out in three databases without date restrictions. In order to be retained, the articles needed to address at least two levels of prevention using an integrative approach in a workplace setting. A qualitative analysis was conducted. RESULTS The review yielded 16 published articles between 1995 and 2017. The articles addressed mental health, musculoskeletal disorder prevention and comprehensive approaches. Integrative prevention approaches are diverse and are not always named as such. Prevention definitions are not homogenous. CONCLUSIONS This review identified some of the integrative prevention characteristics aimed at coordinated action for prevention in the workplace and to clarify measures taken at different levels of prevention. Further studies are needed to elaborate on the implementation of integrative prevention in the workplace.
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Affiliation(s)
- Bénédicte Calvet
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et l'Environnement (CINBIOSE), Université du Québec à Montréal, Montréal, QC, Canada
| | - Nicole Vézina
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et l'Environnement (CINBIOSE), Université du Québec à Montréal, Montréal, QC, Canada
| | - Marie Laberge
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et l'Environnement (CINBIOSE), Université du Québec à Montréal, Montréal, QC, Canada.,Université de Montréal, Montréal, QC, Canada.,Université de Sherbrooke, Longueuil, QC, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, Montréal, QC, Canada
| | - Hélène Sultan-Taïeb
- ESG-UQAM School of Management, Université du Québec à Montréal, Montréal, QC, Canada
| | - Georges Toulouse
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, Montréal, QC, Canada
| | - Paula Rubiano
- Centre de Recherche Interdisciplinaire sur le Bien-être, la Santé, la Société et l'Environnement (CINBIOSE), Université du Québec à Montréal, Montréal, QC, Canada
| | - Marie-José Durand
- Université de Sherbrooke, Longueuil, QC, Canada.,CHU Ste-Justine Research Centre, Montréal, QC, Canada
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8
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Prevalence of Self-Reported Work-Related Lower Back Pain and Its Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:6633271. [PMID: 34603457 PMCID: PMC8486508 DOI: 10.1155/2021/6633271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 11/21/2022]
Abstract
Introduction Low back pain is the commonest musculoskeletal disorder affecting every socioeconomic group of the world's population. The lifetime risk of developing low back pain is about 60%–80%. The pooled prevalence and associated factors of low back pain have not yet been determined in Ethiopia. Thus, this study was aimed at assessing the overall prevalence of low back pain and its associated factors in Ethiopia. Methods A systematic search of PubMed, Scopus, Science Direct, and Google Scholar for observational studies reporting data on the prevalence and associated factors of low back pain was conducted. Relevant data were extracted with a standardized data extraction excel form. Stata 14 was employed for the meta-analysis. Heterogeneity was assessed by Cochran's Q test and I2 values of a forest plot. Publication bias was checked using a funnel plot and Egger's test. A random-effects model was used in the analysis. Result A total of thirty-two studies were included for the systematic review. Twenty-four and sixteen studies were used to pool the overall low back pain prevalence and associated factors, respectively. The overall pooled annual prevalence of low back pain in Ethiopia was estimated to be 54.05% (95% CI: 48.14–59.96). Age, sex, body mass index, work experience, working hours, lack of safety training, awkward working posture, work shift, prolonged standing, lifting heavy objects, sleeping disturbance, history of back trauma, previous medical history of musculoskeletal disorder, and lack of adequate rest interval at work were significantly associated with low back pain. Conclusion The current systematic review and meta-analysis revealed a higher prevalence of lower back pain in Ethiopia. Most of the low back pain epidemiological studies conducted in Ethiopia focused on specific occupational settings, making pooling of data and comparison with other countries challenging. Thus, further general population studies are recommended.
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Kostadinović S, Milovanović N, Jovanović J, Tomašević-Todorović S. Efficacy of the lumbar stabilization and thoracic mobilization exercise program on pain intensity and functional disability reduction in chronic low back pain patients with lumbar radiculopathy: A randomized controlled trial. J Back Musculoskelet Rehabil 2021; 33:897-907. [PMID: 32675390 DOI: 10.3233/bmr-201843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Exercise programs in the treatment of chronic lumbar pain are quite diverse, but it has been proven that stabilization exercises are the most effective. OBJECTIVE We compared the lumbar stabilization exercise program in a closed and open kinetic chain (LSCO) and lumbar stabilization exercises and thoracic mobilization program in a closed kinetic chain (LSTMC), and evaluated the clinical effectiveness of each program. METHODS Prospective, randomized, controlled trial in 80 chronic low back pain (CLBP) patients with lumbar radiculopathy of both sexes (35 male, 45 female), average age (48.45 ± 10.22 years), divided in two groups that performed different sets of exercises. Participants were given laser therapy, transcutaneous electro-nerve stimulation and an eight-week kinesiotherapy that included exercises to strengthen the deep lumbar spine stabilizers. Retesting was done after four and eight weeks. RESULTS Statistically significant (p< 0.05) superior recovery of the LSTMC group subjects compared to the LSCO group was achieved at all measurement intervals in the pain intensity and functional disability parameters. CONCLUSION Patients who performed the lumbar stabilization and thoracic mobilization exercise program in a closed kinetic chain had the most effective reduction of pain intensity and functional disability.
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Affiliation(s)
- Stefan Kostadinović
- Medical Faculty, University of Novi Sad, Clinical Research, Novi Sad, Serbia
| | - Nenad Milovanović
- Rehabilitation Clinic "Dr. Miroslav Zotović" Belgrade, University of Belgrade, School of Medicine, Belgrade, Serbia
| | - Jelena Jovanović
- Rehabilitation Clinic "Dr. Miroslav Zotović" Belgrade, University of Belgrade, School of Medicine, Belgrade, Serbia
| | - Snežana Tomašević-Todorović
- Medical Faculty, University of Novi Sad, Medical Rehabilitation Clinic, Clinical Centre of Vojvodina, Novi Sad, Serbia
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Wang HY, Feng YT, Wang JJ, Lim SW, Ho CH. Incidence of low back pain and potential risk factors among pharmacists: A population-based cohort study in Taiwan. Medicine (Baltimore) 2021; 100:e24830. [PMID: 33655945 PMCID: PMC7939216 DOI: 10.1097/md.0000000000024830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/23/2021] [Indexed: 01/04/2023] Open
Abstract
Low back pain (LBP) is one of the most common symptoms of work-related musculoskeletal disorders in pharmacists. This can impede the physical functions of the body and lead to incapacitation, resulting in significant social and economic burden. This study aimed to investigate the incidence and risk factors that correlate with LBP in Taiwanese pharmacists.A retrospective cohort study was conducted among all registered pharmacists aged 20 to 40 years using the National Health Insurance Research Database (2000-2013) in Taiwan. The LBP diagnosis was confirmed with one episode of hospitalization or at least three claimed outpatient visits for LBP. Data on workplace characteristics as well as comorbidities were also collected for the analyses. A Cox proportional hazard regression was used to estimate the risk factors for LBP.The incidence rate of LBP among pharmacists was 16.60% in this study. Older pharmacists (28.49%; P < .01) and those who worked at district hospitals (23.51%; P < .01) showed a higher proportion of LBP. Furthermore, after adjustment for selected potential confounding factors, female pharmacists [adjusted hazard ratio (aHR): 1.12, 95% confidence interval (95% CI): 1.01-1.24, P = .0354] and pharmacists with diabetes (aHR: 1.55; 95% CI: 1.20-2.01; P = .0008) and gout (aHR: 1.70; 95% CI: 1.37-2.09; P < .0001) had significantly higher risks of LBP.In conclusion, age was positively correlated with LBP, and the workplace was an important factor in the development of LBP in pharmacists. We suggest that pharmacists who work in district hospitals should pay more attention to the development of LBP.
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Affiliation(s)
- Hue-Yu Wang
- Department of Pharmacy, Chi-Mei Medical Center
- Department of Pharmacy
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan
| | - Yu-Tung Feng
- Graduate Institute of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung
| | - Jhi-Joung Wang
- Department of Medical Research
- Department of Anesthesiology, Chi Mei Medical Center, Tainan
- Allied AI Biomed Center, Southern Taiwan University of Science and Technology
| | - Sher-Wei Lim
- Department of Neurosurgery, Chi-Mei Medical Center, Chiali
- Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan
- Department of Medical Research
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Abstract
STUDY DESIGN Single-center prospective non-randomized matched cohort comparison. OBJECTIVE To compare elective lumbar spine surgery outcomes for cases triaged through a multidisciplinary spine pathway versus conventional referral processes. SUMMARY OF BACKGROUND DATA Many health care systems have facilitated low back pain (LBP) guidelines into primary care practice by creating local or regional "pathways" with the goal of enhanced quality of care, improved patient satisfaction and optimal resource utilization, particularly for imaging and surgery. Few comparative outcomes exist for LBP pathways, particularly for surgical outcomes. METHODS One-hundred-fifty patients (SSP group n = 75; conventional group n = 75) undergoing elective lumbar surgery for degenerative conditions between 2011 and 2016 were analyzed with 1-year follow-up. Patient self-reported outcomes included the Oswestry disability index (ODI), visual analogue pain scores (VAS) for back and leg, and EuroQol Group 5-Dimension self-report (EQ-5D). We also assessed baseline clinical features, indications for surgery, therapies received prior to surgery, type of surgery, wait times, and overall patient satisfaction. RESULTS The groups had equivalent baseline demographics, body mass index, Saskatchewan Spine Pathway (SSP) classification of pain pattern, pain scores, functional scores, quality of life scores, indication for surgery, and type of surgery (instrumented or non-instrumented). There was no difference with respect to wait times to see the surgeon or for surgery. Wait time for magnetic resonance imaging (MRI) was significantly shorter for the SSP group (16.8 vs. 63.0 days, P < 0.001). Patients triaged through the SSP were significantly more likely to utilize multiple nonoperative treatment strategies prior to seeing the surgeon (P < 0.04). Patient satisfaction was significantly higher for SSP patients prior to surgical assessment (P = 0.03) but did not differ between groups after surgery. CONCLUSION The SSP facilitates significantly shorter wait times for MRI and promotes nonoperative treatment strategies. Preoperative patient satisfaction is significantly higher among SSP patients, but there were no significant differences in surgical outcomes.Level of Evidence: 3.
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Hirase T, Jack RA, Sochacki KR, Harris JD, Weiner BK. Systematic Review: Is Intradiscal Injection of Bone Marrow Concentrate for Lumbar Disc Degeneration Effective? Cureus 2020; 12:e9045. [PMID: 32782864 PMCID: PMC7410505 DOI: 10.7759/cureus.9045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Current studies evaluating the outcomes of an intradiscal injection of bone marrow concentrate (BMC) for lumbar disc degeneration are limited. The purpose of this review was to determine if an intradiscal injection of BMC for lumbar disc degeneration results in a statistically significant improvement in clinical outcomes. A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Levels I-IV investigations of intradiscal BMC injections in symptomatic lumbar disc degeneration were included in the analysis. Modified Coleman Methodology Scores (MCMS) were used to analyze study methodological quality. Only outcome measurements used by more than 50% of included studies, with a minimum follow-up of 12 months, were eligible for final data analysis. Pre-injection and post-injection visual analog scale (VAS) and Oswestry disability index (ODI) were compared using two-sample Z-tests. Seven articles (97 subjects (47 males, 38 females, 12 unspecified), mean age 33.9 ± 14.3 years, mean follow-up 44.4 ± 25.4 months) were analyzed. Six articles were level IV evidence and one article was level II. Mean MCMS was 56.6 ± 9.1. All subjects received single injections into the nucleus pulposus of one or more affected discs. VAS (66.0 mm to 20.9 mm; p<0.001) and ODI (44.4 to 19.1; p<0.001) significantly improved following the intradiscal BMC injection. One patient (1.0%) experienced herniated nucleus pulposus (HNP) following treatment. No other complications or re-injections were reported. In conclusion, despite our skepticism regarding the efficacy of the procedure, intradiscal injection of BMC for lumbar disc degeneration resulted in statistically significant improvement in VAS and ODI with low re-injection and complication rates in the studies assessed. Given that this study is limited to level IV evidence, the findings suggest that further randomized controlled studies may be worthwhile to evaluate the true efficacy of this treatment.
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Affiliation(s)
- Takashi Hirase
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Robert A Jack
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Kyle R Sochacki
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Joshua D Harris
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Bradley K Weiner
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
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Hirase T, Jack Ii RA, Sochacki KR, Harris JD, Weiner BK. Systemic Review: Is an Intradiscal Injection of Platelet-Rich Plasma for Lumbar Disc Degeneration Effective? Cureus 2020; 12:e8831. [PMID: 32607308 PMCID: PMC7320640 DOI: 10.7759/cureus.8831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Current studies evaluating the outcomes of intradiscal platelet-rich plasma (PRP) injections in degenerative disc disease (DDD) are limited. The purpose of this review was to determine if an intradiscal injection of PRP for degenerative discs results in a statistically significant improvement in clinical outcomes. A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Level I-IV investigations of intradiscal PRP injections in DDD were sought in multiple databases. The Modified Coleman Methodology Score (MCMS) was used to analyze the methodological quality of the study. Only the outcome measurements used by more than 50% of the studies were included in the data analysis. The study heterogeneity and nature of evidence (mostly retrospective, non-comparative) precluded meta-analysis. Pre and post-injection pain visual analog scales (VAS) were compared using two sample Z-tests. Five articles (90 subjects, mean age 43.6 ± 7.7 years, mean follow-up 8.0 ± 3.6 months) were analyzed. Four articles were level IV evidence and one article was level II. Mean MCMS was 56.0 ± 10.3. There were 43 males and 37 females (10 unidentified). Pain VAS significantly improved following lumbar intradiscal PRP injection (69.7 mm to 43.3 mm; p<0.01). Two patients (2.2%) experienced lower extremity paresthesia after treatment. One patient (1.1%) underwent re-injection. No other complications were reported. In conclusion, intradiscal injection of PRP for degenerative discs resulted in statistically significant improvement in VAS with low re-injection and complication rates in this systematic review. It is unclear whether the improvements were clinically significant given the available evidence. The low level of evidence available (level IV) does not allow for valid conclusions regarding efficacy; however, the positive results suggest that further higher-quality studies might be of value.
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Affiliation(s)
- Takashi Hirase
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Robert A Jack Ii
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Kyle R Sochacki
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Joshua D Harris
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Bradley K Weiner
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
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14
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Glaeser JD, Tawackoli W, Ju DG, Yang JH, Kanim LEA, Salehi K, Yu V, Saidara E, Vit J, Khnkoyan Z, NaPier Z, Stone LS, Bae HW, Sheyn D. Optimization of a rat lumbar IVD degeneration model for low back pain. JOR Spine 2020; 3:e1092. [PMID: 32613167 PMCID: PMC7323460 DOI: 10.1002/jsp2.1092] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/16/2020] [Accepted: 05/03/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Intervertebral disc (IVD) degeneration is often associated with low back pain and radiating leg pain. The purpose of this study is to develop a reproducible and standardized preclinical model of painful lumbar IVD degeneration by evaluation of structural and behavioral changes in response to IVD injury with increasing needle sizes. This model can be used to develop new therapies for IVD degeneration. METHODS Forty-five female Sprague Dawley rats underwent anterior lumbar disc needle puncture at levels L4-5 and L5-6 under fluoroscopic guidance. Animals were randomly assigned to four different experimental groups: needle sizes of 18 Gauge (G), 21G, 23G, and sham control. To monitor the progression of IVD degeneration and pain, the following methods were employed: μMRI, qRT-PCR, histology, and biobehavioral analysis. RESULTS T1- and T2-weighted μMRI analysis showed a correlation between the degree of IVD degeneration and needle diameter, with the most severe degeneration in the 18G group. mRNA expression of markers for IVD degeneration markers were dysregulated in the 18G and 21G groups, while pro-nociceptive markers were increased in the 18G group only. Hematoxylin and Eosin (H&E) and Alcian Blue/Picrosirius Red staining confirmed the most pronounced IVD degeneration in the 18G group. Randall-Selitto and von Frey tests showed increased hindpaw sensitivity in the 18G group. CONCLUSION Our findings demonstrate that anterior disc injury with an 18G needle creates severe IVD degeneration and mechanical hypersensitivity, while the 21G needle results in moderate degeneration with no increased pain sensitivity. Therefore, needle sizes should be selected depending on the desired phenotype for the pre-clinical model.
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Affiliation(s)
- Juliane D. Glaeser
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Wafa Tawackoli
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Biomedical Imaging Research InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Derek G. Ju
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Jae H. Yang
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of Orthopedic SurgeryKorea University Guro HospitalSeoulSouth Korea
| | - Linda EA Kanim
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Khosrowdad Salehi
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Victoria Yu
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Evan Saidara
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Jean‐Phillipe Vit
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Zhanna Khnkoyan
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Zachary NaPier
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Laura S. Stone
- McGill University, Faculty of DentistryAlan Edwards Centre for Research on PainMontrealCanada
| | - Hyun W. Bae
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Dmitriy Sheyn
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
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15
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Yolcu YU, Moinuddin FM, Wahood W, Alvi MA, Qu W, Bydon M. Use of regenerative treatments in treatment of lumbar Degenerative Disc Disease: A systematic review. Clin Neurol Neurosurg 2020; 195:105916. [PMID: 32442808 DOI: 10.1016/j.clineuro.2020.105916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
Low back pain due to lumbar Degenerative Disc Disease (DDD) is one of the most common causes of disability and morbidity, particularly among older adults. Current research efforts in lumbar DDD management are shifting towards identifying and correcting the pathology in intervertebral discs without any external manipulation. Herein, we present a systematic review of current literature regarding regenerative treatments for lumbar DDD. An electronic search of databases including PubMed, Ovid/MEDLINE, Cochrane and Scopus was conducted for articles in all available years. Studies that investigated treatment for discogenic pain in lumbar DDD, including any type of stem cell or bone marrow concentrate as the treatment agent and studies that report both baseline and follow-up pain and Oswestry Disability Index (ODI) scores were included in the review. Changes in pain and ODI scores were calculated for 3-month, 6-month and 12-month periods. Six studies with a total of 93 patients were evaluated. Mean (SD) age of the pooled sample was 40.0(8.1) and 39.5% (32/81) of patients were female. Pain improvement was reported in 38.8% of patients at 3-month, 40.8% at 6-month and 44.1% at 12-month follow-up. Average improvement in ODI score for 3-month, 6-month and 12-month follow-ups was calculated to be 24.0, 26.5 and 25.7, respectively. Regenerative treatments are being increasingly employed across all spectrums of medicine. Review of six single arm studies revealed a potential positive impact in the preliminary results. However, these promising 'preliminary' results should not be interpreted as the definite treatment and should be validated with further prospective studies.
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Affiliation(s)
- Yagiz Ugur Yolcu
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - F M Moinuddin
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Waseem Wahood
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL, USA
| | - Mohammed Ali Alvi
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Wenchun Qu
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
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Rodrigues dos Santos BM, Mendes C. Manual therapy and its role in occupational health: Reducing absenteeism and presenteeism by treating chronic pain with spinal manipulation and mobilization in the workplace. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
STUDY DESIGN Review article. OBJECTIVE A review of the literature on current strategies utilized in intervertebral regeneration and repair efforts. METHODS A review of the literature and analysis of the data to provide an updated review on current concepts of intervertebral disc repair and regeneration efforts. RESULTS Multiple regenerative strategies for intervertebral disc regeneration are being employed to reduce pain and improve quality of life. Current promising strategies include molecular therapy, gene therapy, cell-based therapy, and augmentation with biomaterials. Multiple clinical trials studying biologic, cell-based, and scaffold-based injectable therapies are currently being investigated. CONCLUSION Low back pain due to intervertebral disc disease represents a significant health and societal burden. Current promising strategies include molecular therapy, gene therapy, cell-based therapy, and augmentation with biomaterials. To date, there are no Food and Drug Administration-approved intradiscal therapies for discogenic back pain, and there are no large randomized trials that have shown clinically significant improvement with any investigational regenerative treatment. Multiple clinical trials studying biologic, cell-based, or scaffold-based injectable therapies are being currently investigated.
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Affiliation(s)
- Derek G. Ju
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Hyun W. Bae
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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18
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Kallewaard JW, Edelbroek C, Terheggen M, Raza A, Geurts JW. A Prospective Study of Dorsal Root Ganglion Stimulation for Non-Operated Discogenic Low Back Pain. Neuromodulation 2020; 23:196-202. [PMID: 30821901 DOI: 10.1111/ner.12937] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/02/2019] [Accepted: 01/09/2019] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Disruptions of lumbar intervertebral discs may lead to severe discogenic low back pain (LBP). Severe pain has a deleterious effect on physical function and quality of life. Spinal cord stimulation (SCS) is a robust treatment for many neuropathic pain conditions. New innovations may be well-suited to treat neuropathic chronic LBP, including discogenic pain. The aim of this prospective study was to determine the effect of dorsal root ganglion (DRG) stimulation for a well-selected group of patients with discogenic LBP with no history of previous back surgeries. METHODS Twenty subjects with confirmed discogenic LBP and no prior history of back surgery underwent trials of DRG stimulation and, if successful with at least 50% pain reduction, were permanently implanted. Subjects rated their pain, disability, quality of life, and mood at baseline, and 14 subjects were followed through 12 months of treatment. RESULTS Treatment with DRG stimulation reduced LBP ratings (68.3% reduction), from mean 7.20 ± 1.3 at baseline to 2.29 ± 2.1 after 12 months (p = < 0.001). Oswestry ratings of disability significantly decreased (p = < 0.001) from 42.09 ± 12.9 at baseline to 21.54 ± 16.4 after six months of treatment and to 20.1 ± 16.6 after 12 months. The average quality of life EQ-5D index score at baseline was 0.61 ± 0.12 and 0.84 ± 0.13 after 12 months. DISCUSSION DRG stimulation treatment for discogenic LBP improved the level of pain, function, and quality of life. Further research is necessary into efficacy of DRG stimulation in patients with chronic discogenic LBP and to determine the place of SCS in the treatment algorithm.
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Affiliation(s)
- Jan Willem Kallewaard
- Department of Anesthesiology and Pain Medicine, Rijnstate Hospital Arnhem, Velp, The Netherlands
| | - Caro Edelbroek
- Department of Anesthesiology and Pain Medicine, Rijnstate Hospital Arnhem, Velp, The Netherlands
| | - Michel Terheggen
- Department of Anesthesiology and Pain Medicine, Rijnstate Hospital Arnhem, Velp, The Netherlands
| | | | - Jose W Geurts
- Department of Anesthesiology and Pain Medicine, Rijnstate Hospital Arnhem, Velp, The Netherlands
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Li H, Du W, Ivanov K, Yang Y, Zhan Y, Wang L. The EEG Analysis of Actual Left/Right Lateral Bending Movements in Patient of Lumbar Disc Herniation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4707-4711. [PMID: 31946913 DOI: 10.1109/embc.2019.8857620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this study was to investigate surface EEG of two groups (lumbar disc herniation (LDH) patients and healthy controls (HC)) when they performed real smooth movements (left/right lateral bending) with the maximum voluntary movement without pain. Thirty female LDH patients and thirty healthy controls volunteered to participate in the experiment. We also tested a healthy participant's motion imaginery (MI) of left/right lateral bending movement for over 200 times. We used Daubechies 4 (db4) wavelet to decompose EEG signal and we extracted δ, θ, α and β rhythms of the EEG signal. Wavelet entropy and sample entropy (SampEn) of four frequency bands were calculated. The results showed that there was significant difference of wavelet entropy EEG in T7, O2, and AF4 channels between the LDH and the healthy group when they did real left lateral bending. The topographic map also showed that SampEn value of four rhythms of the MI right lateral bending were significantly less than the values of the MI left lateral motion in healthy participant. Classification and Regression Trees (CART), Logistic regression (LR), Support Vector Machine (SVM), K-nearest neighbors (KNN), and the Linear discrimination analysis (LDA) classifiers showed averaged accuracies more than 96% for MI of left/right lateral bending.
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20
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Applebaum KM, Asfaw A, O’Leary PK, Busey A, Tripodis Y, Boden LI. Suicide and drug-related mortality following occupational injury. Am J Ind Med 2019; 62:733-741. [PMID: 31298756 PMCID: PMC7485601 DOI: 10.1002/ajim.23021] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/15/2019] [Accepted: 06/18/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Drug overdoses and suicides have been rising since 2000 and are major contributors to a 3-year decline in US life expectancy. Studies suggest that injured workers have elevated rates of depression and opioid use, but no studies have measured excess mortality related to these risks. MATERIALS AND METHODS We linked New Mexico workers' compensation data for 100 806 workers injured in 1994 through 2000 with Social Security Administration earnings and mortality data through 2013 and National Death Index cause of death data. We then estimated the association between receiving lost-time workers' compensation benefits and mortality hazard ratios (HRs) and 95% confidence intervals (CIs) based on Fine and Gray cause-specific subdistribution hazards for common causes of death and for drug-related, suicide, and alcohol-related mortality. RESULTS There was almost a 3-fold increase in combined drug-related and suicide mortality hazard among women (HR = 2.63, 95% CI = 1.91-3.64) and a substantial increase among men (HR = 1.42, 95% CI = 1.13-1.79). Circulatory disease mortality hazard was elevated for men (HR = 1.25, 95% CI = 1.05-1.50). CONCLUSION Workplace injuries severe enough to require more than a week off work may impair workers' long-term health and well-being. Drug-related deaths and suicides may be important contributors to the long-term excess mortality of injured workers. Improved workplace conditions, improved pain treatment, better treatment of substance use disorders, and treatment of postinjury depression may substantially reduce mortality consequent to workplace injuries.
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Affiliation(s)
- Katie M. Applebaum
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Abay Asfaw
- Economic Research and Support Office, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, District of Columbia
| | - Paul K. O’Leary
- Office of Retirement and Disability Policy, US Social Security Administration, Washington, District of Columbia
| | - Andrew Busey
- Department of Economics, Boston University, Boston, Massachusetts
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Leslie I. Boden
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
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21
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Lee JJ, Nguyen ET, Harrison JR, Gribbin CK, Hurwitz NR, Cheng J, Boachie-Adjei K, Bogner EA, Moley PJ, Wyss JF, Lutz GE. Fluoroscopically guided caudal epidural steroid injections for axial low back pain associated with central disc protrusions: a prospective outcome study. INTERNATIONAL ORTHOPAEDICS 2019; 43:1883-1889. [PMID: 31168645 DOI: 10.1007/s00264-019-04350-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/21/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To determine if axial low back pain (LBP) associated with central disc protrusions can be improved by caudal epidural steroid injections (ESIs). METHODS Adults with chronic (> 3 months) moderate-to-severe axial LBP with L4-5 and/or L5-S1 central disc protrusions were enrolled in this prospective study. Participants underwent caudal ESIs under standard-of-care practice. The numerical rating scale (NRS) pain score, modified North American Spine Society satisfaction, and Roland Morris Disability Questionnaire (RMDQ) were collected at one week, one month, three months, six months, and one year post-injection. Pre-injection magnetic resonance images were assessed by a musculoskeletal radiologist. RESULTS Sixty-eight participants (42 males, 26 females) were analyzed. There were statistically significant improvements in all outcome measures at all follow-up time points, with the exception of NRS best pain at six months. Clinically significant improvements in outcomes were observed at various time points: at three months and one year for current pain; at one week, one month, three months, six months, and one year for worst pain; and at one month and one year for RMDQ. The proportion of satisfied participants ranged from 57 to 69% throughout the study. No adverse events were observed. CONCLUSIONS This study demonstrated significant improvements in pain and function following caudal ESIs in a cohort of axial LBP with associated central disc protrusions. Further studies, including the use of randomized controlled trials, are needed to determine the ideal subset of candidates for this treatment and to explore additional applications that caudal ESIs may have for chronic LBP.
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Affiliation(s)
- James J Lee
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - Elizabeth T Nguyen
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - Julian R Harrison
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - Caitlin K Gribbin
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - Nicole R Hurwitz
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - Jennifer Cheng
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | | | - Eric A Bogner
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
| | - Peter J Moley
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - James F Wyss
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
| | - Gregory E Lutz
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA.
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22
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Salaffi F, Di Carlo M, Carotti M, Farah S, Ciapetti A, Gutierrez M. The impact of different rheumatic diseases on health-related quality of life: a comparison with a selected sample of healthy individuals using SF-36 questionnaire, EQ-5D and SF-6D utility values. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 89:541-557. [PMID: 30657123 PMCID: PMC6502108 DOI: 10.23750/abm.v89i4.7298] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/08/2018] [Indexed: 11/26/2022]
Abstract
Background: Given the high prevalence of rheumatic diseases, there is a need to determine which conditions have the greatest impact on health-related quality of life (HRQoL). The main aim of this study was to explore the HRQoL scores among 14 different rheumatic diseases and to compare them with the results of a selecting sample of healthy controls. Methods: 2633 patients of an ongoing cohort have been enrolled. Rheumatic diseases were classified into five diagnostic groups: inflammatory rheumatic diseases, connective tissue disorders, symptomatic peripheral osteoarthritis, soft tissue disorders, and osteoporosis. For comparison were used 649 healthy controls. The HRQoL was evaluated with the Medical Outcomes Study Short-Form 36 Health Survey (SF-36), the EuroQol five Dimensions (EQ-5D) questionnaire, and the Short-Form six Dimensions (SF-6D) questionnaire. Results: The five major rheumatic disease groups, compared to healthy people, significantly impaired all eight health concepts of the SF-36 (p <0.0001). Similar results were found for EQ-5D and SF-6D. The patients with inflammatory rheumatic diseases have poorer self-reported health status than those without arthritis in all domains of living, but particularly with respect to scales measuring aspects of physical functioning or mobility, role limitation due to physical health problems and usual activities, and bodily pain. Rheumatoid arthritis had the largest negative impact on HRQoL, followed by fibromyalgia, vertebral fractures due to osteoporosis, hip osteoarthritis, and systemic sclerosis. Conclusions: Our results indicate that rheumatic diseases have a clearly detrimental effect on the HRQoL, and physical domain is more impaired than mental and social ones. (www.actabiomedica.it)
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Affiliation(s)
- Fausto Salaffi
- Rheumatology Department, Università Politecnica delle Marche, Jesi (Ancona), Italy.
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23
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Elabd C, Ichim TE, Miller K, Anneling A, Grinstein V, Vargas V, Silva FJ. Comparing atmospheric and hypoxic cultured mesenchymal stem cell transcriptome: implication for stem cell therapies targeting intervertebral discs. J Transl Med 2018; 16:222. [PMID: 30097061 PMCID: PMC6086019 DOI: 10.1186/s12967-018-1601-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 08/04/2018] [Indexed: 02/07/2023] Open
Abstract
Background Mesenchymal stem cells (MSCs) represent an attractive avenue for cellular therapies targeting degenerative diseases. MSC in vitro expansion is required in order to obtain therapeutic numbers during the manufacturing process. It is known that culture conditions impact cellular properties and behavior after in vivo transplantation. In this study, we aimed at evaluating the benefit of hypoxic culturing of human bone marrow derived mesenchymal stem cells on cell fitness and whole genome expression and discussed its implication on cellular therapies targeting orthopedic diseases such as chronic lower back pain. Methods Human bone marrow mesenchymal stem cells (hBMMSCs) were isolated from fresh human anticoagulated whole bone marrow and were cultured side by side in atmospheric (20% O2) and hypoxic (5% O2) oxygen partial pressure for up to 3 passages. Stem cell fitness was assessed by clonogenic assay, cell surface marker expression and differentiation potential. Whole genome expression was performed by mRNA sequencing. Data from clonogenic assays, cell surface marker by flow cytometry and gene expression by quantitative PCR were analyzed by two-tailed paired Student’s t-test. Data from mRNA sequencing were aligned to hg19 using Tophat-2.0.13 and analyzed using Cufflinks-2.1.1. Results Hypoxic culturing of hBMMSCs had positive effects on cell fitness, as evidenced by an increased clonogenicity and improved differentiation potential towards adipocyte and chondrocyte lineages. No difference in osteoblast differentiation or in cell surface markers were observed. Only a small subset of genes (34) were identified by mRNA sequencing to be significantly dysregulated by hypoxia. When clustered by biological function, these genes were associated with chondrogenesis and cartilage metabolism, inflammation and immunomodulation, cellular survival, migration and proliferation, vasculogenesis and angiogenesis. Conclusions Hypoxic culturing positively impacted hBMMSCs fitness and transcriptome, potentially improving inherent properties of these cells that are critical for the development of successful cellular therapies. Hypoxic culturing should be considered for the in vitro expansion of hBMMSCs during manufacturing of cellular therapies targeting orthopedic disorders such as lower back pain.
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Affiliation(s)
- C Elabd
- BioRestorative Therapies, Inc., 40 Marcus Drive, Suite 1, Melville, NY, 11747, USA
| | - T E Ichim
- Immune Advisors, LLC, La Jolla, CA, 92037, USA
| | - K Miller
- BioRestorative Therapies, Inc., 40 Marcus Drive, Suite 1, Melville, NY, 11747, USA
| | - A Anneling
- BioRestorative Therapies, Inc., 40 Marcus Drive, Suite 1, Melville, NY, 11747, USA
| | - V Grinstein
- BioRestorative Therapies, Inc., 40 Marcus Drive, Suite 1, Melville, NY, 11747, USA
| | - V Vargas
- BioRestorative Therapies, Inc., 40 Marcus Drive, Suite 1, Melville, NY, 11747, USA
| | - F J Silva
- BioRestorative Therapies, Inc., 40 Marcus Drive, Suite 1, Melville, NY, 11747, USA.
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Ghasemi M, Khoshakhlagh AH, Ghanjal A, Yazdanirad S, Laal F. The impacts of rest breaks and stretching exercises on lower back pain among commercial truck drivers in Iran. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 26:662-669. [DOI: 10.1080/10803548.2018.1459093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Mohammad Ghasemi
- Lifestyle Institute, Baqiyatallah University of Medical Sciences, Iran
| | - Amir Hossein Khoshakhlagh
- School of Public Health, Tehran University of Medical Sciences, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Iran
| | - Ali Ghanjal
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Iran
| | - Saeid Yazdanirad
- School of Public Health, Tehran University of Medical Sciences, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Iran
| | - Fereydoon Laal
- School of Public Health, Shahid Beheshti University of Medical Sciences, Iran
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25
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Centeno C, Markle J, Dodson E, Stemper I, Williams CJ, Hyzy M, Ichim T, Freeman M. Treatment of lumbar degenerative disc disease-associated radicular pain with culture-expanded autologous mesenchymal stem cells: a pilot study on safety and efficacy. J Transl Med 2017; 15:197. [PMID: 28938891 PMCID: PMC5610473 DOI: 10.1186/s12967-017-1300-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/14/2017] [Indexed: 12/17/2022] Open
Abstract
Background Degenerative disc disease (DDD) is a common cause of lower back pain with radicular symptoms and has a significant socioeconomic impact given the associated disability. Limited effective conservative therapeutic options result in many turning to surgical alternatives for management, which vary in the rate of success and also carry an increased risk of morbidity and mortality associated with the procedures. Several animal based studies and a few human pilot studies have demonstrated safety and suggest efficacy in the treatment of DDD with mesenchymal stem cells (MSCs). The use of bone marrow-derived MSCs for the treatment of DDD is promising and in the present study we report on the safety and efficacy findings from a registry based proof of concept study using a percutaneous intradiscal injection of cultured MSCs for the management of DDD with associated radicular symptoms. Methods Thirty-three patients with lower back pain and disc degeneration with a posterior disc bulge diagnosed on magnetic resonance imaging (MRI) met the inclusion criteria and were treated with culture-expanded, autologous, bone marrow-derived MSCs. Prospective registry data was obtained at multiple time intervals up to 6 years post-treatment. Collected outcomes included numeric pain score (NPS), a modified single assessment numeric evaluation (SANE) rating, functional rating index (FRI), measurement of the intervertebral disc posterior dimension, and adverse events. Results Three patients reported pain related to procedure that resolved. There were no serious adverse events (i.e. death, infection, or tumor) associated with the procedure. NPS change scores relative to baseline were significant at 3, 36, 48, 60, and 72 months post-treatment. The average modified SANE ratings showed a mean improvement of 60% at 3 years post-treatment. FRI post-treatment change score averages exceeded the minimal clinically important difference at all time points except 12 months. Twenty of the patients treated underwent post-treatment MRI and 85% had a reduction in disc bulge size, with an average reduction size of 23% post-treatment. Conclusions Patients treated with autologous cultured MSCs for lower back pain with radicular symptoms in the setting of DDD reported minor adverse events and significant improvements in pain, function, and overall subjective improvement through 6 years of follow-up. NCT03011398. A Clinical Registry of Orthobiologics Procedures. https://clinicaltrials.gov/ct2/show/NCT03011398?term=orthobiologics&rank=1
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Affiliation(s)
- Christopher Centeno
- Centeno-Schultz Clinic, Broomfield, CO, 80021, USA.,Regenerative Sciences, LLC, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA
| | - Jason Markle
- Centeno-Schultz Clinic, Broomfield, CO, 80021, USA
| | - Ehren Dodson
- Regenerative Sciences, LLC, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA.
| | - Ian Stemper
- Regenerative Sciences, LLC, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA
| | | | - Matthew Hyzy
- Centeno-Schultz Clinic, Broomfield, CO, 80021, USA
| | | | - Michael Freeman
- CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
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Ghofrani M, Olyaei G, Talebian S, Bagheri H, Kazemi P. Reliability of SEMG measurements for trunk muscles during lifting variable loads in healthy subjects. J Bodyw Mov Ther 2017; 21:711-718. [DOI: 10.1016/j.jbmt.2016.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 11/30/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
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Abegglen S, Hoffmann-Richter U, Schade V, Znoj HJ. Work and Health Questionnaire (WHQ): A Screening Tool for Identifying Injured Workers at Risk for a Complicated Rehabilitation. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:268-283. [PMID: 27393558 DOI: 10.1007/s10926-016-9654-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose Unintentional injuries occur frequently and many of the accident survivors suffer from temporary or permanent disabilities. Although most accident victims recover quickly, a significant fraction of them shows a complicated recovery process and accounts for the majority of disability costs. Thus, early identification of vulnerable persons may be beneficial for compensation schemes, government bodies, as well as for the worker themselves. Here we present the Work and Health Questionnaire (WHQ), a screening tool that is already implemented in the case management process of the Swiss Accident Insurance Fund (Suva). Moreover, we demonstrate its prognostic value for identifying workers at risk of a complicated recovery process. Methods A total of 1963 injured workers answered the WHQ within the first 3 months after their accident. All of them had minor to moderate accidental injuries; severely injured workers were excluded from the analyses. The anonymized individual-level data were extracted from insurance databases. We examined construct validity by factorial analyses, and prognostic validity by hierarchical multiple regression analyses on days of work disability. Further, we evaluated well-being and job satisfaction 18 months post-injury in a subsample of 192 injured workers (9.8 %) Results Factor analyses supported five underlying factors (Job Design, Work Support, Job Strain, Somatic Condition/Pain, and Anxiety/Worries). These subscales were moderately correlated, thus indicating that different subscales measured different aspects of work and health-related risk factors of injured workers. Item analysis and reliability analysis showed accurate psychometric properties. Each subscale was predictive at least for one of the evaluated outcomes 18 months post-injury. Conclusion The WHQ shows good psychometric qualities with high clinical utility to identify injured persons with multiple psychosocial risk factors. Thus, the questionnaire appears to be suitable for exploring different rehabilitation needs among minor to moderate injured workers.
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Affiliation(s)
- Sandra Abegglen
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.
| | - Ulrike Hoffmann-Richter
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Volker Schade
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Hans-Jörg Znoj
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
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LIN CJ, CHENG CF. Lifting speed preferences and their effects on the maximal lifting capacity. INDUSTRIAL HEALTH 2017; 55:27-34. [PMID: 27383532 PMCID: PMC5285311 DOI: 10.2486/indhealth.2016-0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
The objectives of this study were to evaluate how lifting capacity and subjective preferences are affected by different lifting speeds. The maximum lifting capacity of lift was determined with three independent variables, lifting speed, lifting technique, and lifting height. Questionnaires were evaluated after the experiment by the participants for the lifting speed preferences. This study found that the lifting speed was a significant factor in the lifting capacity (p<0.001); and the lifting height (p<0.001) and the interaction of lifting speed and lifting height (p=0.005) affected the lifting capacity significantly. The maximal lifting capacity was achieved around the optimal speed that was neither too fast nor too slow. Moreover, the participants' preferred lifting speeds were consistently close to the optimal lifting speed. The results showed that the common lifting practice guideline to lift slowly might make the worker unable to generate a large lifting capacity.
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Affiliation(s)
- Chiuhsiang Joe LIN
- Department of Industrial Management, National Taiwan University of Science and Technology, Taiwan
| | - Chih-Feng CHENG
- Department of Industrial Management, National Taiwan University of Science and Technology, Taiwan
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Bruls VEJ, Jansen NWH, de Bie RA, Bastiaenen CHG, Kant IJ. Towards a preventive strategy for complaints of arm, neck and/or shoulder (CANS): the role of help seeking behaviour. BMC Public Health 2016; 16:1199. [PMID: 27894287 PMCID: PMC5126821 DOI: 10.1186/s12889-016-3853-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/18/2016] [Indexed: 11/11/2022] Open
Abstract
Background When developing an effective early preventive strategy for employees and students with CANS (Complaints of Arm, Neck or Shoulder, not caused by acute trauma or systemic disease), insight in help seeking behaviour and knowledge of factors associated with help seeking behaviour within the target population, is a prerequisite. The aim of this study was to examine whether perceived hindrance is associated with help seeking behaviour, specifically in employees and students identified with CANS. Additionally, the associations of factors related to functioning and participation, work-environment and demographics with help seeking behaviour were explored in these groups. Methods A cross-sectional survey was conducted among employees and students of two universities in the South of the Netherlands. The questionnaire included questions to assess (1) demographics, work/study and activity related factors (2) experience of CANS (3) perceived hindrance (4) help seeking behaviour. A subpopulation of the survey, consisting of those employees and students with self-reported CANS, received additional questionnaires to examine the impact of (1) participant characteristics (2) complaint and health related variables (3) functioning and participation (4) work-environment and social support, on help seeking behaviour. Results 37.3% of the employees and 41.4% of the students reported CANS. Of these, respectively 43.3% and 45.5%, did not seek help and had no intention to seek help either. Employees and students who had not sought help reported less hindrance, less perceived disabilities and shorter duration of complaints, compared those who did seek help. Employees and students within this group who had also no intention to seek help, perceived fewer disabilities and reported shorter duration of complaints. Conclusion The absence of help seeking behaviour in respondents with CANS is a bottleneck for implementation of preventive strategies. In employees and students with CANS, help seeking behaviour is primarily determined by factors related to experienced hindrance. Our findings emphasize the need to tailor preventive strategies, in order to optimize screening and participation in early interventions for CANS.
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Affiliation(s)
- Vivian E J Bruls
- Department of Epidemiology, Care And Public Health Research Institute, Maastricht University, Universiteitssingel 40, Maastricht, MD, 6200, The Netherlands.
| | - Nicole W H Jansen
- Department of Epidemiology, Care And Public Health Research Institute, Maastricht University, Universiteitssingel 40, Maastricht, MD, 6200, The Netherlands
| | - Rob A de Bie
- Department of Epidemiology, Care And Public Health Research Institute, Maastricht University, Universiteitssingel 40, Maastricht, MD, 6200, The Netherlands
| | - Caroline H G Bastiaenen
- Department of Epidemiology, Care And Public Health Research Institute, Maastricht University, Universiteitssingel 40, Maastricht, MD, 6200, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, Care And Public Health Research Institute, Maastricht University, Universiteitssingel 40, Maastricht, MD, 6200, The Netherlands
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Lee YC, Zotti MGT, Osti OL. Operative Management of Lumbar Degenerative Disc Disease. Asian Spine J 2016; 10:801-19. [PMID: 27559465 PMCID: PMC4995268 DOI: 10.4184/asj.2016.10.4.801] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/15/2016] [Indexed: 12/12/2022] Open
Abstract
Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term.
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Affiliation(s)
- Yu Chao Lee
- Spinal Surgery Unit, Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia
| | | | - Orso Lorenzo Osti
- Calvary Health Care, North Adelaide Campus, North Adelaide, SA, Australia
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Nelson DA, Wolcott VL, Kurina LM. Prediction of all-cause occupational disability among US Army soldiers. Occup Environ Med 2016; 73:442-51. [DOI: 10.1136/oemed-2015-103436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/13/2016] [Indexed: 11/04/2022]
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Intradiscal platelet-rich plasma (PRP) injections for discogenic low back pain: an update. INTERNATIONAL ORTHOPAEDICS 2016; 40:1321-8. [DOI: 10.1007/s00264-016-3178-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/27/2016] [Indexed: 02/07/2023]
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Brouwer S, Amick BC, Lee H, Franche RL, Hogg-Johnson S. The Predictive Validity of the Return-to-Work Self-Efficacy Scale for Return-to-Work Outcomes in Claimants with Musculoskeletal Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:725-32. [PMID: 25990375 PMCID: PMC4636988 DOI: 10.1007/s10926-015-9580-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE To examine the predictive validity of the Return-to-Work Self-Efficacy (RTWSE) Scale in terms of the scale's baseline absolute values and of changes in self-efficacy scores, with the outcome of return-to-work (RTW) status in a sample of injured workers with upper extremity and back musculoskeletal disorders. METHODS RTWSE was measured with a 10-item scale assessing Overall RTWSE and three self-efficacy subdomains: (1) ability to cope with pain, (2) ability to obtain help from supervisor and (3) ability to obtain help from co-workers. Outcome measures included RTW status (yes/no) measured at 6- and 12-month follow-up. RTWSE improvement was defined as an increase in self-efficacy scores between baseline and 6-month follow-up time points. Logistic regression analyses were performed with RTW status as the dependent variable and adjusted for age, gender, educational level, personal income, pain site, pain severity, functional status, and depressive symptoms, and for baseline RTWSE scores in the improvement score analyses. RESULTS A total of 632 claimants completed the baseline telephone interview 1 month post-injury; 446 subjects completed the 6-month interview (71 %) and 383 subjects completed the 12-month interview (61 %). The baseline Pain RTWSE scores were found to be useful to predict RTW status 6 months post-injury, with a trend for baseline Overall RTWSE. Improvements over time in Overall RTWSE and in Co-worker RTWSE were found to be useful to predict 12-month RTW status, with trends for improvements in Supervisor RTWSE and Pain RTWSE. CONCLUSION The study found evidence supporting the predictive validity of the RTWSE scale within 12 months after injury. The RTWSE scale may be a potentially valuable scale in research and in managing work disabled claimants with musculoskeletal disorders.
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Affiliation(s)
- Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Building 3217, Room 620, 9713 AV, Groningen, The Netherlands.
- Institute for Work & Health, Toronto, ON, Canada.
| | - Benjamin C Amick
- Institute for Work & Health, Toronto, ON, Canada
- Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, Miami, FL, USA
| | - Hyunmi Lee
- Institute for Work & Health, Toronto, ON, Canada
| | - Renée-Louise Franche
- Institute for Work & Health, Toronto, ON, Canada
- WorkSafe BC, Vancouver, BC, Canada
- Simon Fraser University, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Sheilah Hogg-Johnson
- Institute for Work & Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Tuakli-Wosornu YA, Terry A, Boachie-Adjei K, Harrison JR, Gribbin CK, LaSalle EE, Nguyen JT, Solomon JL, Lutz GE. Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study. PM R 2015; 8:1-10; quiz 10. [DOI: 10.1016/j.pmrj.2015.08.010] [Citation(s) in RCA: 211] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 11/28/2022]
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Qin Z, Armijo-Olivo S, Woodhouse LJ, Gross DP. An investigation of the validity of the Work Assessment Triage Tool clinical decision support tool for selecting optimal rehabilitation interventions for workers with musculoskeletal injuries. Clin Rehabil 2015; 30:277-87. [PMID: 25828092 DOI: 10.1177/0269215515578696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 02/28/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the concurrent validity of a clinical decision support tool (Work Assessment Triage Tool (WATT)) developed to select rehabilitation treatments for injured workers with musculoskeletal conditions. DESIGN Methodological study with cross-sectional and prospective components. SETTING Data were obtained from the Workers' Compensation Board of Alberta rehabilitation facility in Edmonton, Canada. SUBJECTS A total of 432 workers' compensation claimants evaluated between November 2011 and June 2012. MAIN MEASURES Percentage agreement between the Work Assessment Triage Tool and clinician recommendations was used to determine concurrent validity. In claimants returning to work, frequencies of matching were calculated and compared between clinician and Work Assessment Triage Tool recommendations and the actual programs undertaken by claimants. The frequency of each intervention recommended by clinicians, Work Assessment Triage Tool, and case managers were also calculated and compared. RESULTS Percentage agreement between clinician and Work Assessment Triage Tool recommendations was poor (19%) to moderate (46%) and Kappa = 0.37 (95% CI -0.02, 0.76). The Work Assessment Triage Tool did not improve upon clinician recommendations as only 14 out of 31 claimants returning to work had programs that contradicted clinician recommendations, but were consistent with Work Assessment Triage Tool recommendations. Clinicians and case managers were inclined to recommend functional restoration, physical therapy, or no rehabilitation while the Work Assessment Triage Tool recommended additional evidence-based interventions, such as workplace-based interventions. CONCLUSIONS Our findings do not provide evidence of concurrent validity for the Work Assessment Triage Tool compared with clinician recommendations. Based on these results, we cannot recommend further implementation of the Work Assessment Triage Tool. However, the Work Assessment Triage Tool appeared more likely than clinicians to recommend interventions supported by evidence; thus warranting further research.
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Affiliation(s)
- Ziling Qin
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Linda J Woodhouse
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada Alberta Health Services Bone and Joint Health Strategic Clinical Network, Edmonton, AB, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
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Franklin GM, Wickizer TM, Coe NB, Fulton-Kehoe D. Workers' compensation: poor quality health care and the growing disability problem in the United States. Am J Ind Med 2015; 58:245-51. [PMID: 25331746 DOI: 10.1002/ajim.22399] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2014] [Indexed: 11/07/2022]
Abstract
The proportion of working age citizens permanently removed from the workforce has dramatically increased over the past 30 years, straining both Federal and State disability systems designed as a safety net to protect them. Almost one-third of these rapidly emerging disabilities are related to musculoskeletal disorders, and three of the top five diagnoses associated with the longest Years Lived with Disability are back, neck and other musculoskeletal disorders. The failure of Federal and state workers' compensation systems to provide effective health care to treat non-catastrophic injuries has been largely overlooked as a principal source of permanent disablement and corresponding reduced labor force participation. Innovations in workers' compensation health care delivery, and in use of evidence-based coverage methods such as prospective utilization review, are effective secondary prevention efforts that, if more widely adopted, could substantially prevent avoidable disability and provide more financial stability for disability safety net programs.
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Affiliation(s)
- Gary M Franklin
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health and Community Medicine, Seattle, Washington; Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, Washington; Department of Neurology, University of Washington School of Medicine, Seattle, Washington
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Taylor JB, Goode AP, George SZ, Cook CE. Incidence and risk factors for first-time incident low back pain: a systematic review and meta-analysis. Spine J 2014; 14:2299-319. [PMID: 24462537 DOI: 10.1016/j.spinee.2014.01.026] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 11/12/2013] [Accepted: 01/14/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND CONTEXT Great effort has been made toward limiting low back pain (LBP). Recent focus has included factors involved with secondary and tertiary prevention, with less attention given to primary prevention. PURPOSE This review provided a current estimate of the incidence of LBP and risk factors associated with either first-time LBP or transition to LBP from a baseline of a pain-free state. STUDY DESIGN A systematic review and meta-analyses were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT SAMPLE Studies included subjects aged 18 years or older, from longitudinal, observational, cohort designs that included baseline risk factors to an outcome of either first-time LBP or transition to LBP from a baseline of a pain-free state. OUTCOME MEASURES Risk factors and incidence rates were reported using descriptive analysis and the PRISMA guidelines. METHODS Electronic search strategies in PubMed, CINAHL/SPORTDiscus, and Cochrane Central Register of Controlled Trials were combined with a hand search to identify articles for inclusion. Studies were classified based on the population studied (community vs. occupational based) and type of LBP outcome (first ever vs. transition from a baseline pain-free state). RESULTS A total of 41 studies were included for review. Meta-analytical incidence rates for first-time LBP and transition to pain from a pain-free state were similar (∼25%), regardless of community or occupational populations. Risk factors for first-time LBP or transition to LBP from a baseline of a pain-free state were psychosocial and physically related. No consistent risk factor emerged as predictive of first-time LBP, although prior LBP was a consistent predictor of future incident LBP. Significant heterogeneity was found across studies in most models, which limits these findings. CONCLUSIONS The results of this study suggest that incidence of LBP is similar in community and occupational settings regardless of LBP definition. There were multiple diverse physical and psychosocial risk factors for first-time LBP. A history of LBP was the most consistent risk factor for transition to LBP from a baseline of a pain-free state.
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Affiliation(s)
- Jeffrey B Taylor
- Department of Physical Therapy, High Point University, 833 Montlieu Ave., High Point, NC 27262, USA.
| | - Adam P Goode
- Department of Community and Family Medicine, Duke University, Durham, NC 27707, USA
| | - Steven Z George
- Department of Physical Therapy, University of Florida, 355 Tigert Hall, Gainesville, FL 32611, USA
| | - Chad E Cook
- Department of Physical Therapy, Walsh University, 2020 East Maple St, North Canton, OH 44720, USA
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Relationship between daily physical activity level and low back pain in young, female desk-job workers. Int J Occup Med Environ Health 2014; 27:863-70. [PMID: 25261333 DOI: 10.2478/s13382-014-0315-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 07/01/2014] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the relationship between daily physical activity (PA) level and low back pain (LBP) in young women. MATERIAL AND METHODS Two hundred forty three female, desk-job workers aged 20-40 voluntarily participated in the study. The participants were assessed by the use of Oswestry Disability Index for measuring LBP disability and by the use of the short version of the International Physical Activity Questionnaire for PA assessment. The 1-way ANOVA test was used for comparing the mean values according to the physical activity level groups. Correlations between the average LBP disability score and all the other variables were obtained using Pearson's correlation analysis. The level of statistical significance was p < 0.05. RESULTS Significant differences were found for LBP disability score between the results of 3 different PA groups (p < 0.05) (low, moderate and high PA groups). The correlation between the average LBP disability score and body weight (r = 0.187, p < 0.01), body mass index (r = 0.165, p < 0.01), vigorous MET score (r = 0.247, p < 0.01) and total PA MET score (r = 0.131, p < 0.01) were significant. CONCLUSIONS The main finding of this study is that there is a U-shaped relationship between PA and LBP disability score in young women. A moderate level of daily physical activity and preventing body weight and fat gain should be recommended in young, female desk-job workers in order to prevent and manage low back pain.
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Hough PA, Van Rooyen FC, Bredenkamp E, Brough K, Ferreira M, Myburgh H, Snyman C, Van Niekerk C. Guidelines prescribed by general practitioners to patients with acute low back pain regarding ‘return to work’. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2006.10873476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Driscoll T, Jacklyn G, Orchard J, Passmore E, Vos T, Freedman G, Lim S, Punnett L. The global burden of occupationally related low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014; 73:975-81. [PMID: 24665117 DOI: 10.1136/annrheumdis-2013-204631] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The study was part of the Global Burden of Disease 2010 study and aimed to quantify the burden arising from low back pain (LBP) due to occupational exposure to ergonomic risk factors. METHODS Exposure prevalence was based on occupation distribution; estimates of relative risk came from a meta-analysis of relevant published literature. The work-related burden was estimated as disability-adjusted life years (DALYs). Estimates were made for each of 21 world regions and 187 countries, separately for 1990 and 2010 using consistent methods. RESULTS Worldwide, LBP arising from ergonomic exposures at work was estimated to cause 21.7 million DALYs in 2010. The overall population attributable fraction was 26%, varying considerably with age, sex and region. 62% of LBP DALYs were in males-the largest numbers were in persons aged 35-55 years. The highest relative risk (3.7) was in the agricultural sector. The largest number of DALYs occurred in East Asia and South Asia, but on a per capita basis the biggest burden was in Oceania. There was a 22% increase in overall LBP DALYs arising from occupational exposures between 1990 and 2010 due to population growth; rates dropped by 14% over the same period. CONCLUSIONS LBP arising from ergonomic exposures at work is an important cause of disability. There is a need for improved information on exposure distributions and relative risks, particularly in developing countries.
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Affiliation(s)
- T Driscoll
- Sydney School of Public Health, University of Sydney, , Sydney, New South Wales, Australia
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Abstract
The term 'problematic pain' is relatively new and has been the recent source of much debate, especially among primary and community care pain clinicians. In this article, we review the concept of problematic pain, highlighting how it fits in the context of acute, sub-acute and chronic pain. We also examine how risk for the development of chronicity can be assessed using current data and screening tools. The use of ultra-short screening tools for other conditions has previously been evaluated in the literature, and we propose a new tool, to open discussion for the assessment of problematic pain. This is especially relevant in the short consultation where it can be difficult to capture meaningful information quickly. Finally, we focus upon new initiatives currently in progress in the arena of problematic pain in the United Kingdom.
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Affiliation(s)
- Chris Barker
- Community Pain Service, Ainsdale Centre for Health and Wellbeing, Southport and Ormskirk NHS Trust, Ainsdale, UK ; Primary and Community Care Special Interest Group, British Pain Society, London, UK
| | - Ann Taylor
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff University, Cardiff, UK
| | - Martin Johnson
- Clinical Champion for Pain, Royal College of General Practitioners, London, UK
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Bindra S, Sinha AGK, Benjamin AI. Questionnaire for low back pain in the garment industry workers. Indian J Occup Environ Med 2014; 17:48-57. [PMID: 24421591 PMCID: PMC3877447 DOI: 10.4103/0019-5278.123162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Low back pain affects up to 90% of the world's population at some point in their lives. Until date no questionnaire has been designed for back pain in the garment industry workers. Therefore, the objective of this study is to design a questionnaire to determine the prevalence, risk factors, impact, health care service utilization and back pain features in the garment industry workers and gain preliminary experience of its use. The content validity and reliability of the questionnaire was established. Items showing acceptable internal consistency and moderate to high test re-test reliability were retained in the questionnaire. Items showing unacceptable internal consistency, low test re-test reliability or poor differentiation were reworded, redrafted and re-tested on the workers. It took 20 min to complete one interview schedule. Environmental factors such as the absence of the garment industry owner/supervisor or co-workers at the time of the interview and interview during leisure hours need to be standardized. Thus, final questionnaire is ready for use after necessary amendments and will be used on the larger sample size in the main study.
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Affiliation(s)
- Supreet Bindra
- Department of Physiotherapy, Punjabi University, Patiala, Punjab, India
| | - A G K Sinha
- Department of Physiotherapy, Punjabi University, Patiala, Punjab, India
| | - A I Benjamin
- Department of Community Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India
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Gross DP, Zhang J, Steenstra I, Barnsley S, Haws C, Amell T, McIntosh G, Cooper J, Zaiane O. Development of a computer-based clinical decision support tool for selecting appropriate rehabilitation interventions for injured workers. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:597-609. [PMID: 23468410 DOI: 10.1007/s10926-013-9430-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To develop a classification algorithm and accompanying computer-based clinical decision support tool to help categorize injured workers toward optimal rehabilitation interventions based on unique worker characteristics. METHODS Population-based historical cohort design. Data were extracted from a Canadian provincial workers' compensation database on all claimants undergoing work assessment between December 2009 and January 2011. Data were available on: (1) numerous personal, clinical, occupational, and social variables; (2) type of rehabilitation undertaken; and (3) outcomes following rehabilitation (receiving time loss benefits or undergoing repeat programs). Machine learning, concerned with the design of algorithms to discriminate between classes based on empirical data, was the foundation of our approach to build a classification system with multiple independent and dependent variables. RESULTS The population included 8,611 unique claimants. Subjects were predominantly employed (85 %) males (64 %) with diagnoses of sprain/strain (44 %). Baseline clinician classification accuracy was high (ROC = 0.86) for selecting programs that lead to successful return-to-work. Classification performance for machine learning techniques outperformed the clinician baseline classification (ROC = 0.94). The final classifiers were multifactorial and included the variables: injury duration, occupation, job attachment status, work status, modified work availability, pain intensity rating, self-rated occupational disability, and 9 items from the SF-36 Health Survey. CONCLUSIONS The use of machine learning classification techniques appears to have resulted in classification performance better than clinician decision-making. The final algorithm has been integrated into a computer-based clinical decision support tool that requires additional validation in a clinical sample.
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Affiliation(s)
- Douglas P Gross
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada,
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Roesler ML, Glendon AI, O'Callaghan FV. Recovering from traumatic occupational hand injury following surgery: a biopsychosocial perspective. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:536-546. [PMID: 23400585 DOI: 10.1007/s10926-013-9422-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Significant differences occur in the return-to-work (RTW) period amongst workers with an acute traumatic occupational hand injury. This study aimed to develop and test a comprehensive multivariate conceptual biopsychosocial model to predict RTW outcome. METHOD Patients presenting with an occupational hand injury were interviewed 7-10 days after their injury (N = 192) and again at 4 weeks after their injury (n = 150). Potential determinants from biomedical, work-related, demographic and psychosocial categories were studied simultaneously. RESULTS A small sub-set of workers with an acute traumatic hand injury experienced chronic disability beyond 12 weeks. Analyzing the relationship between predictor variables and work absence resulted in the identification of the most important determinants of recovery. During the acute stages of recovery, injury severity, pain, self-efficacy, and living alone were the most important determinants of delayed RTW outcome. At 4 weeks post-injury, locus of control, injury severity, negative affect and living alone were the most important predictors of delayed RTW. CONCLUSION A number of prognostic variables were identified that influenced RTW outcome, which offer new and unique contributions to the field. Injury severity was not the most important determinant of RTW outcome; neither were factors identified in previous hand injury research, such as attribution of blame, significant predictors. Factors not examined in previous research, such as negative affect, were more important determinants of delayed RTW.
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Affiliation(s)
- Michelle Louise Roesler
- Behavioral Basis of Health, School of Applied Psychology, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia,
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Abstract
Standing is one of the most preferred working postures in the manufacturing field as it provides a large degree of physical freedom and mobility to the human operators. In addition, the cognitive perceptions of the increase in work effectiveness and productivity rate among the human operators are the reasons this working posture is practiced. However, to stand erect for a long period of time or otherwise known as Prolonged Standing often leads to physiological discomfort, fatigue and even health issues such as Musculoskeletal Disorders (MSDs). The aim of this paper is to review on the effects resulting from Prolonged Standing and disseminates the information on the ergonomic interventions to relieve standing fatigue. Selected journals and research papers related to Prolonged Standing were reviewed and the findings showed that varying the floor conditions such as installing anti-fatigue mat and using shoes with soles would help in relieving discomfort associated with the cumulative effects of Prolonged Standing. Nevertheless, further research is needed to truly quantify the effectiveness of these suggested ergonomics interventions in real world implementations such as in the manufacturing industry.
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Gillard DM, Corenman DS, Dornan GJ. Failed less invasive lumbar spine surgery as a predictor of subsequent fusion outcomes. INTERNATIONAL ORTHOPAEDICS 2013; 38:811-5. [PMID: 24252972 DOI: 10.1007/s00264-013-2167-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 10/23/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE It is not uncommon for patients to undergo less invasive spine surgery (LISS) prior to succumbing to lumbar fusion; however, the effect of failed LISS on subsequent fusion outcomes is relatively unknown. The aim of this study was to test the hypothesis that patients who suffered failed LISS would afford inferior subsequent fusion outcomes when compared to patients who did not have prior LISS. METHODS After IRB approval, registry from a spine surgeon was queried for consecutive patients who underwent fusion for intractable low back pain. The 47 qualifying patients were enrolled and split into two groups based upon a history for prior LISS: a prior surgery group (PSG) and a non-prior surgery group (nPSG). RESULTS Typical postoperative outcome questionnaires, which were available in 80.9% of the patients (38/47) at an average time point of 40.4 months (range, 13.5-66.1 months), were comparatively analysed and failed to demonstrate significant difference between the groups, e.g. PSG v. nPSG: ODI--14.6 ± 10.9 vs. 17.2 ± 19.4 (P = 0.60); SF12-PCS--10.9 ± 11.0 vs. 8.7 ± 12.4 (p = 0.59); bNRS--3.0 (range -2-7) vs. 2.0 (range -3-8) (p = 0.91). Patient satisfaction, return to work rates, peri-operative complications, success of fusion and rate of revision surgery were also not different. CONCLUSIONS Although limited by size and retrospective design, the results of this rare investigation suggest that patients who experience a failed LISS prior to undergoing fusion will not suffer inferior fusion outcomes when compared to patients who did not undergo prior LISS.
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Affiliation(s)
- Douglas M Gillard
- Spine Research, The Steadman Philippon Research Institute, Vail, USA,
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A Health- and Resource-Oriented Perspective on NSLBP. ISRN PAIN 2013; 2013:640690. [PMID: 27335880 PMCID: PMC4893409 DOI: 10.1155/2013/640690] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/04/2013] [Indexed: 12/19/2022]
Abstract
Nonspecific low back pain (NSLBP) is an important health issue of our time. Personal as well as economic factors, like suffering pain and experiencing disability on the one hand and enormous and still increasing costs to the economy and society on the other hand, display the importance of the matter. Tremendous research has been conducted in the last few decades on NSLBP. A PubMed search (June 17, 2013) on “low back pain” provided 22,980 hits, and when specifying for “low back pain, systematic review,” 3,134 hits were still generated. Most research has been done examining the development, risk factors, or therapeutic measures of NSLBP, but hardly any literature exists on resources related to NSLBP. The aims of this review are twofold. In order to shade light on the salutogenetic approach of NSLBP, and thus to focus on health instead of illness, the first aim is to facilitate the understanding of which therapeutic measures enhance the ability to cope with chronic NSLBP and enable (more) normal functioning in life. The second aim is to stimulate the understanding of resources protecting against the onset of NSLBP or against the development of chronic NSLBP and its resulting work absence.
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Fogel A. Better or Worse: a Study of Day-to-Day Changes over Five Months of Rosen Method Bodywork Treatment for Chronic Low Back Pain. Int J Ther Massage Bodywork 2013; 6:14-24. [PMID: 24000305 PMCID: PMC3757229 DOI: 10.3822/ijtmb.v6i3.200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Fluctuations of good days and bad days—in physical symptoms and emotional states—are common for individuals with chronic illness. This pilot study examines these fluctuations during bodywork treatment. Purpose We analyzed changes in daily self-reports over a period of five months for five individuals who received weekly treatments of Rosen Method Bodywork (RMB), which uses touch and words to enhance body awareness of physical sensations and emotional states. Subjects and Design Five subjects (aged 31–56) who had chronic low back pain (CLBP) received 16 weekly treatments given by three experienced RMB practitioners. Measures Pre- and posttreatment assessments covered demographics, disability, and pain. Clients also completed daily bedtime assessments of pain, fatigue, emotional state, and sense of control during the entire treatment period. Results All clients reported reductions in pain and/or disability in post- compared to pretreatment. In spite of a high level of day-to-day variability in the daily assessments, there were significant reductions in pain and fatigue, and significant increases in positive emotional state and sense of control across the treatment period. In reaching this end, however, some clients had slow and steady improvements, some improved more rapidly, while others got worse before they got better. Conclusions The natural course of healing—with its inevitable fluctuations in symptoms—is part of a process leading to successful treatment outcomes. Rosen Method Bodywork may be especially helpful in developing and accepting both sensory and emotional body awareness changes that facilitate overall improvement.
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Affiliation(s)
- Alan Fogel
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Hettinga DM, Jackson A, Moffett JK, May S, Mercer C, Woby SR. A systematic review and synthesis of higher quality evidence of the effectiveness of exercise interventions for non-specific low back pain of at least 6 weeks' duration. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331907x222958] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mu J, Ge W, Zuo X, Chen Y, Huang C. Analysis of association between IL-1β, CASP-9, and GDF5 variants and low-back pain in Chinese male soldier: clinical article. J Neurosurg Spine 2013; 19:243-7. [PMID: 23725396 DOI: 10.3171/2013.4.spine12782] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Recent studies have suggested that genetic risk factors play an important role in the occurrence of low-back pain (LBP) and lumbar disc disease. The authors' study aimed to assess the association between 3 single-nucleotide polymorphisms (SNPs) and susceptibility to LBP related to military training. METHODS In this case-control study, data from 892 Chinese male soldiers were retrospectively reviewed. The case group was made up of 305 soldiers with LBP related to military training and a control group of 587 soldiers without constant LBP for more than 2 weeks. Genomic DNA was extracted from peripheral blood leukocytes of all subjects and polymerase chain reaction products were genotyped. RESULTS No association was found between the SNP of interleukin-1β (IL-1β; +3954C/T) and LBP at both the genotypic (p = 0.104) and the allelic (p = 0.098) level. However, the G allele of caspase-9 (CASP-9) and the T allele of growth differentiation factor 5 (GDF5) were more common in patients with LBP than in patients without LBP (p < 0.001). CONCLUSIONS The findings in a Chinese military cohort indicated that CASP-9 (-1263A/G) and GDF5 (+104T/C) polymorphisms are associated with a susceptibility to LBP related to military training.
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Affiliation(s)
- Jihong Mu
- Institute of Orthopedics, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
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