1,720,961 research outputs found
Effectiveness of communicative and educative strategies in chronic low back pain patients: A systematic review
Objective: To investigate the effectiveness of communicative and educative strategies on 1) patient's low back pain awareness/knowledge, 2) maladaptive behavior modification and 3) compliance with exercise in patients with chronic low back pain. Methods: A systematic review was conducted. Searches were performed on 13 databases. Only randomized controlled trials enrolling patients ≥ 18 years of age were included. Risk of bias was assessed with the Cochrane Collaboration's tool and interrater agreement between authors for full-texts selection was evaluated with Cohen's Kappa. No meta-analysis was performed and qualitative analysis was conducted. Results: 24 randomized controlled trials which intervention included communicative and educative strategies were selected. Most of the studies were judged as low risk of bias and Cohen's Kappa was excellent ( = 0.822). Interventions addressed were cognitive behavioral therapy as unique treatment or combined with other treatments (multimodal interventions), coaching, mindfulness, pain science education, self-management, graded activity and graded exposure. Conclusions, practice implication: Patient's low back pain awareness/knowledge is still a grey area of literature. Pain science education, graded exposure and multimodal interventions are the most effective for behavior modification and compliance with exercise with benefits also in the long-term, while self-management, graded activity and coaching provide only short-term or no benefits
Applicability of pain neuroscience education: Where are we now?
BACKGROUND: Explaining pain to patients through pain neuroscience education (PNE) is currently a widespread treatment studied in the musculoskeletal context. Presently, there is sufficient evidence supporting the effectiveness of PNE in patients with chronic musculoskeletal disorders. However, clinicians must pay attention to the actual possibility to transfer research findings in their specific clinical context. OBJECTIVE: We analysed the applicability of results of studies focused on PNE, which has not been done previously. METHODS: A detailed discussion on PNE applicability is provided, starting from published randomized controlled trials that investigated the effectiveness of PNE. RESULTS: This paper markedly points out the awareness of clinicians on the need for an accurate contextualization when choosing PNE as an intervention in clinical practice
Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Prevalence and incidence of low back pain among runners: A systematic review
Background: Running is one of the most popular sports worldwide. Despite low back pain (LBP) represents the most common musculoskeletal disorder in population and in sports, there is currently sparse evidence about prevalence, incidence and risk factors for LBP among runners. The aims of this systematic review were to investigate among runners: prevalence and incidence of LBP and specific risk factors for the onset of LBP. Methods: A systematic review has been conducted according to the guidelines of the PRISMA statement. The research was conducted in the following databases from their inception to 31st of July 2019: PubMed; CINAHL; Google Scholar; Ovid; PsycINFO; PSYNDEX; Embase; SPORTDiscus; Scientific Electronic Library Online; Cochrane Library and Web of Science. The checklists of The Joanna Briggs Institute Critical Appraisal tools were used to investigate the risk of bias of the included studies. Results: Nineteen studies were included and the interrater agreement for full-text selection was good (K = 0.78; 0.61-0.80 IC 95%). Overall, low values of prevalence (0.7-20.2%) and incidence (0.3-22%) of LBP among runners were reported. Most reported risk factors were: running for more than 6 years; body mass index > 24; higher physical height; not performing traditional aerobics activity weekly; restricted range of motion of hip flexion; difference between leg-length; poor hamstrings and back flexibility. Conclusions: Prevalence and incidence of LBP among runners are low compared to the others running related injuries and to general, or specific population of athletes. View the low level of incidence and prevalence of LBP, running could be interpreted as a protective factor against the onset of LBP. Systematic review registration: PROSPERO CRD42018102001
Knowledge and management of low back pain as running-related injuries among Italian physical therapists: findings from a national survey
Objectives: To investigate the beliefs, knowledge, attitudes, behavior, and the clinical management procedures of the Italian physical therapists specialized in orthopedic manipulative physical therapy (OMPT) toward running and its correlation with low back pain (LBP). Design: A cross-sectional online survey was conducted in 2019, according to the Checklist for Reporting Results of Internet E‐Surveys (CHERRIES) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Setting: Italy. Participants: One thousand two hundred and eighteen Italian OMPTs. Methods: Survey Monkey software was used to administer the survey. The questionnaire was self-reported and included 26 questions. Descriptive statistics were used and related to the effective respondents for each question. Results: One thousand two hundred and eighteen questionnaires (60.9%) were included in the analysis. A considerable cohort of OMPTs working in private practice clinical settings (n = 845; 69.4%; 95% CI 66.7–71.9) has indicated running not to be a relevant risk factor for the onset of LBP (n = 806; 66.2%; 95% CI 63.4–68.8). Moreover, most of the participants (n = 679; 55.7%; 95% CI 52.9–58.5) adopted a combination of manual therapy techniques and therapeutic exercise for the management of runners with LBP. Conclusions: Widespread knowledge of clinical and theoretical management of LBP in runners-patients has emerged among Italian OMPTs. The OMPTs’ academic background agrees with the recent literature and therefore highlights the paucity of studies related to LBP as running-related injuries
The diagnostic value of Red Flags in thoracolumbar pain: a systematic review
Purpose: Red Flags (RFs) are signs and symptoms related to the screening of serious underlying pathologies mimicking a musculoskeletal pain. The current literature wonders about the usefulness of RFs, due to high false-positive rates and low diagnostic accuracy. The aims of this systematic review are: (a) to identify and (b) to evaluate the most important RFs that could be found by a health care professional during the assessment of patients with low and upper back pain (named as thoracolumbar pain (TLP)) to screen serious pathologies. Materials and methods: A systematic review of the literature was conducted. Searches were performed on seven databases (Pubmed, Web of Science, Cochrane Library, Pedro, Scielo, CINAHL, and Google Scholar) between March 2019 and June 2020, using a search string which included synonyms of low back pain (LBP), chest pain (CP), differential diagnosis, RF, and serious disease. Only observational studies enrolling patients with LBP or CP were included. Risk of bias was assessed with the Newcastle Ottawa Scale and inter-rater agreement between authors for full-text selection was evaluated with Cohen’s Kappa. Where possible the diagnostic accuracy was recorded for sensitivity (Sn), specificity (Sp), and positive/negative likelihood ratio (LR+/LR–). Results: Forty full-texts were included. Most of the included observational studies were judged as low risk of bias, and Cohen’s Kappa was good (=0.78). The identified RFs were: advanced age; neurological signs; history of trauma; malignancy; female gender; corticosteroids use; night pain; unintentional weight loss; bladder or bowel dysfunction; loss of anal sphincter tone; saddle anaesthesia; constant pain; recent infection; family or personal history of heart or pulmonary diseases; dyspnoea; fever; postprandial CP; typical reflux symptoms; haemoptysis; sweating; pain radiated to upper limbs; hypotension; retrosternal pain; exertional pain; diaphoresis; and tachycardia. The diagnostic accuracy of RFs as self-contained screening tool was low, while the combination of multiple RFs showed to increase the probability to identify serious pathologies. Conclusions: Despite the use of single RF should not be recommended for the screening process in clinical practice, the combination of multiple RFs to enhance diagnostic accuracy is promising. Moreover, the identified RFs could be a baseline to develop a screening tool for patients with TLP.Implications for rehabilitation Differential diagnosis and screening for referral are mandatory skills for each healthcare professional in direct access clinical settings, and should be the primary step for an appropriate management of a patient with signs and symptoms mimicking serious pathologies in thoracolumbar region. Clinical reasoning and decision-making processes are essential throughout all phases of a patient’s pathway of care. By which, the use of single Red Flag (RF) as a self-contained screening tool should not be recommended. The combination of multiple RFs promises to increase diagnostic accuracy and could grow into an excellent screening tool for thoracolumbar pain
Variations on the Author
“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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