2 research outputs found
Living conditions, including life style, in primary-care patients with nonacute, nonspecific spinal pain compared with a population-based sample: a cross-sectional study
No full textOdd Lindell, Sven-Erik Johansson, Lars-Erik Strender1Center for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SwedenBackground: Nonspecific spinal pain (NSP), comprising back and/or neck pain, is one of the leading disorders behind long-term sick-listing, including disability pensions. Early interventions to prevent long-term sick-listing require the identification of patients at risk. The aim of this study was to compare living conditions associated with long-term sick-listing for NSP in patients with nonacute NSP, with a nonpatient population-based sample. Nonacute NSP is pain that leads to full-time sick-listing>3 weeks.Methods: One hundred and twenty-five patients with nonacute NSP, 2000–2004, were included in a randomized controlled trial in Stockholm County with the objective of comparing cognitive–behavioral rehabilitation with traditional primary care. For these patients, a cross-sectional study was carried out with baseline data. Living conditions were compared between the patients and 338 nonpatients by logistic regression. The conditions from univariate analyses were included in a multivariate analysis. The nonsignificant variables were excluded sequentially to yield a model comprising only the significant factors (P <0.05). The results are shown as odds ratios (OR) with 95% confidence intervals.Results: In the univariate analyses, 13 of the 18 living conditions had higher odds for the patients with a dominance of physical work strains and Indication of alcohol over-consumption, odds ratio (OR) 14.8 (95% confidence interval [CI] 3.2–67.6). Five conditions qualified for the multivariate model: High physical workload, OR 13.7 (CI 5.9–32.2); Hectic work tempo, OR 8.4 (CI 2.5–28.3); Blue-collar job, OR 4.5 (CI 1.8–11.4); Obesity, OR 3.5 (CI 1.2–10.2); and Low education, OR 2.7 (CI 1.1–6.8).Conclusions: As most of the living conditions have previously been insufficiently studied, our findings might contribute a wider knowledge of risk factors for long-term sick-listing for NSP. As the cross-sectional design makes causal conclusions impossible, our study should be complemented by prospective research.Keywords: nonspecific spinal pain, back pain, neck pain, long-term sick-listing, population-based sample, cross-sectional stud
The role of cervical spine range of motion in recovery from whiplash associated disorders
No full textThis thesis investigates the role of cervical spine Range of Motion in the recovery from
Whiplash Associated Disorders.
In clinical practice, Health Care Professionals attach value to measurements of cervical spine
Range of Motion for diagnostic, prognostic and treatment evaluation purposes. A systematic
literature review found conflicting evidence as to whether cervical spine Range of Motion
was a prognostic factor following a whiplash injury. Greater understanding of prognostic
factors such as this may facilitate improvements in patient management.
A second systematic literature review investigated the reliability and validity of methods for
measuring cervical spine Range of Motion. The Cervical Range Of Motion (CROM) device
was found to be the most rigorously tested and clinimetrically promising method and was
subsequently investigated for intra- and inter-observer reliability in a group of whiplashinjured
individuals and found to be substantially reliable.
The CROM device was utilised in a longitudinal cohort study of 599 whiplash-injured
patients to investigate the prognostic value of cervical spine Range of Motion for neck painrelated
disability and patient-reported recovery at short, medium and long-term follow-up. A
patient-reported version of cervical spine Range of Motion was also evaluated as a
prognostic factor.
Although useful for explaining disability at the time of measurement, active, passive and
patient-reported forms of cervical spine Range of Motion were not significant prognostic
factors for poor outcome when other physical and psychosocial factors were accounted for.
The clinical implication of this research is that if patients are experiencing reduced cervical
spine Range of Motion a few weeks after their whiplash injury they will not necessarily have
a poor outcome in the longer term as is commonly believed at present
