Evidence-informed management of chronic low back pain with back schools, brief education, and fear-avoidance training.

The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient.

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

Background: Seven previous systematic reviews (SRs) have evaluated back schools, and one has evaluated brief education, with the latest SR including studies until November 2004. The effectiveness of fear-avoidance training has not been assessed.

Purpose: To assess the effectiveness of back schools, brief education, and fear-avoidance training for chronic low back pain (CLBP).

Bronchial airflow limitation, smoking, body mass index, and statin use are strongly associated with the C-reactive protein level in the elderly. The Tromsø Study 2001.

Background: Bronchial airflow limitation is a known predictor of raised C-reactive protein (CRP) level. The aim of this study was to explore this association in an elderly population, as well as the influence of other known and possible predictors of the CRP level, like smoking and the use of statins and inhaled corticosteroids.

Population And Methods: The study population consists of 3877 Norwegians aged 60 years or more who took part in the fifth Tromsø study in 2001, a cross-sectional study.

Idiopathic scoliosis treated with Cotrel-Dubousset instrumentation: evaluation 10 years after surgery.

Study Design: Prospective cohort study with 10-year follow-up.

Objective: To evaluate long-term results after operative treatment with Cotrel-Dubousset (CD) instrumentation for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Limited knowledge exists in the evaluation of long-term function with quality of life measures after CD instrumentation in patients with AIS.

Enhanced incorporation of n-3 fatty acids from fish compared with fish oils.

This work was undertaken to study the impact of the source of n-3 FA on their incorporation in serum, on blood lipid composition, and on cellular activation. A clinical trial comprising 71 volunteers, divided into five groups, was performed. Three groups were given 400 g smoked salmon (n = 14), cooked salmon (n = 15), or cooked cod (n = 13) per week for 8 wk.

Reliability, validity and responsiveness of the fear-avoidance beliefs questionnaire: methodological aspects of the Norwegian version.

Objective: To evaluate reliability, validity and responsiveness of the Fear-Avoidance Beliefs Questionnaire (FABQ) for use in Norwegian patients with low back pain.

Design: A prospective cohort study with 2 groups.

Patients: The questionnaire was tested in 123 patients with acute low back pain and 50 patients with chronic low back pain.

Prognostic factors for chronic neck pain in persons with minor or moderate injuries in traffic accidents.

Prognostic factors for chronic neck pain were identified in a prospective Norwegian insurance cohort comprising 636 persons with minor or moderate traffic injuries. One questionnaire was used at baseline and another at 3 years post-injury. Daily severe or very severe neck pain at three years follow up was defined as chronic neck pain.

The reliability of selected motion- and pain provocation tests for the sacroiliac joint.

The objective of the study was to assess inter-rater reliability of one palpation and six pain provocation tests for pain of sacroiliac origin. The sacroiliac joint (SIJ) is a potential source of low back and pelvic girdle pain. Diagnosis is made primarily by physical examination using palpation and pain provocation tests.

Screening for yellow flags in first-time acute low back pain: reliability and validity of a Norwegian version of the Acute Low Back Pain Screening Questionnaire.

Objectives: The purpose of this study was to evaluate the reliability and construct and predictive validity of the Norwegian version of the Acute Low Back Pain Screening Questionnnaire (ALBPSQ).

Methods: A prospective study with a 12-month follow-up was conducted on 123 patients with acute low back pain (LBP) seeking help in primary health care for the first time and 50 patients with chronic LBP for more than 3 months.

Results: Test-retest reliability was high with intraclass correlation coefficients of 0.

Prognostic factors in first-time care seekers due to acute low back pain.

There is limited knowledge on prognostic factors for developing chronic low back pain (LBP) at an early stage of LBP. The objectives of this study were to investigate the clinical course of pain and disability, and prognostic factors for non-recovery after 1-year, in patients seeking help for the first time due to acute LBP. An inception cohort study included 123 patients with acute LBP lasting less than 3 weeks and consulting primary care for the first time.

Clinical course and impact of fear-avoidance beliefs in low back pain: prospective cohort study of acute and chronic low back pain: II.

Study Design: Prospective inception cohort study.

Objectives: To compare the clinical course of fear-avoidance beliefs in acute and chronic low back pain (LBP) and investigate the contribution of fear-avoidance beliefs to predict pain and disability after 1 year.

Summary Of Background Data: Fear-avoidance beliefs are involved in disability development.

Serum osteoprotegerin is inversely associated with carotid plaque echogenicity in humans.

Osteoprotegerin (OPG) is a member of the tumour necrosis factor superfamily involved in the regulation of bone metabolism and vascular calcification. High serum values of OPG are associated with cardiovascular disease in humans. The purpose was to investigate serum OPG levels in subclinical carotid atherosclerosis and the relation between OPG levels and plaque morphology.

Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: a prospective randomized controlled study.

The effectiveness of lumbar fusion for chronic low back pain after surgery for disc herniation has not been evaluated in a randomized controlled trial. The aim of the present study was to compare the effectiveness of lumbar fusion with posterior transpedicular screws and cognitive intervention and exercises. Sixty patients aged 25-60 years with low back pain lasting longer than 1 year after previous surgery for disc herniation were randomly allocated to the two treatment groups.

C-reactive protein and alcohol consumption: Is there a U-shaped association? Results from a population-based study in Russia. The Arkhangelsk study.

Background: Little is known about association between markers of inflammation and alcohol consumption in Russian population where binge drinking pattern is prevalent.

Methods And Results: C-reactive protein was measured by a highly sensitive particle-enhanced immunoturbidimetric assay (hsCRP) in 1963 men and 1734 women, aged 18-90 years, in a population-based cross-sectional study. Total alcohol consumption consisted mainly of binge vodka intake.

Predictors of return to work in patients sick listed for sub-acute low back pain: a 12-month follow-up study.

Objective: To investigate whether personal and work-related factors, physical performance and back-specific questionnaires predict return to work. A prospective study identifying prognostic factors for return to work.

Subjects: Ninety-three patients sick-listed for 8-12 weeks for non-specific sub-acute low back pain included in a randomized controlled trial.

Health-related quality of life and sickness absence in community nursing home employees: randomized controlled trial of physical exercise.

Background: It is a common belief that physical exercise at the workplace decreases subjective health complaints and reduces sickness absence, but this is not supported by previous randomized studies.

Aims: To evaluate the effectiveness of physical exercise at the workplace.

Methods: One hundred and twenty-nine employees in a community-based nursing home for the elderly were randomized into physical exercise or control groups.

Social and lifestyle determinants of depression, anxiety, sleeping disorders and self-evaluated quality of life in Russia--a population-based study in Arkhangelsk.

Background: The paper investigates social and lifestyle determinants of depression, anxiety, sleeping disorders and self-evaluated low quality of life in a population sample from the northwest of Russia.

Methods: Altogether 1968 men and 1737 women aged 18-90 years participated in a population-based study in Arkhangelsk, Russia, in the period 1999-2000. Depression, anxiety, and sleeping disorders were evaluated by a questionnaire with the formulations that have been previously used in population studies in Northern Norway.

Clinical course and prognostic factors in acute low back pain: patients consulting primary care for the first time.

Study Design: Inception cohort study.

Objectives: To examine the clinical course of acute low back pain and to evaluate prognostic factors for nonrecovery.

Summary Of Background Data: Few studies have explored clinical course and prognostic factors in patients who consult primary care for their first time because of an episode of low back pain of <3 weeks duration.

Alcohol consumption and its relation to risk factors for cardiovascular disease in the north-west of Russia: the Arkhangelsk study.

Background: To explore indicators and levels of alcohol consumption in a Russian population, and to elaborate these in relation to risk factors for cardiovascular disease.

Methods: A total of 1963 men and 1734 women, aged 18-75 years, consecutively recruited at their compulsory annual medical check-up at the Semashko outpatient clinic, Arkhangelsk, participated in a cross-sectional health survey. The survey comprised a physical examination, a six-page questionnaire on health and lifestyle, and blood tests.

Disability, pain, psychological factors and physical performance in healthy controls, patients with sub-acute and chronic low back pain: a case-control study.

Objective: To compare measures of disability, psychological factors, pain and physical performance in healthy controls, and patients with sub-acute and chronic low back pain. To evaluate the concept of the deconditioning syndrome and to explore factors that may contribute to chronicity.

Design: Case-control study.

Functional status and disability questionnaires: what do they assess? A systematic review of back-specific outcome questionnaires.

Study Design: A systematic literature review of outcome questionnaires designed for assessing functional status or disability in patients with low back pain.

Objectives: To provide a comprehensive overview of all functioning/disability questionnaires used in recent years and to explore how the main concept(s) was described or defined in the original paper, the content or the domains of disability, and the measurement properties of the questionnaires.

Summary Of Background Data: A number of clinical tools designed for evaluating the functional status of patients with low back pain have been developed.

Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain.

Patients with chronic low back pain (LBP) frequently demonstrate high scores for fear-avoidance beliefs and distress. We need better knowledge about fear-avoidance beliefs and distress in early stages of LBP. The objectives of this study were to compare the level of fear-avoidance beliefs and distress in patients with acute LBP to patients with chronic LBP, and to assess the relationship of fear-avoidance beliefs and distress to disability in acute and chronic LBP.