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  • 1
    Online Resource
    Online Resource
    Induced leg length inequality affects pelvis orientation during upright standing immediately following a sit-to-stand transfer: a pre-post measurement study
    Springer Science and Business Media LLC ; 2023
    In:  BMC Musculoskeletal Disorders Vol. 24, No. 1 ( 2023-03-17)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 24, No. 1 ( 2023-03-17)
    Abstract: Leg length inequality (LLI) greater than 20 mm has been associated with low back pain (LBP) and its correction is clinically recommended. Much less is known about the biomechanical effects that LLI below 15 mm has on pelvis orientation. Methods Twenty-two adult participants (8 female) aged between 18 and 30 years without LBP were enrolled in the study and completed a series of sit-to-stand trials with no heel-lift (0 mm baseline) and heel-lifts of varying heights (5, 9 and 12 mm) placed in their right shoe. Three-dimensional kinematic data were obtained from the lower extremities, pelvis and thorax. Additional kinematic data were obtained from the left and right sides of the pelvis. The global orientation of the whole pelvis and relative orientation between the left and right sides of the pelvis were obtained in upright standing immediately upon completion of the sit-to-stand movement. Repeated measures ANOVAs were used to detect differences in sample means across the different levels of heel-lift (0, 5, 9, and 12 mm). The tests for within-subject effects determined overall significant differences between the means at the different levels of heel-lift induced LLI. Partial Eta-Squared was used to express the size for the main effect of heel-lift height. For each level of heel-lift, the estimated marginal mean and 95% confidence interval (95%CI) values of pelvis angles were illustrated graphically. Results Left frontal plane rotation of the pelvis increased (p = 0.001), that is, the left side of the pelvis was lower than the right side of the pelvis, and anterior tilt of the pelvis decreased (p = 0.020) with a heel-lift height (applied on the right) as low as 5 mm. A significant main effect of heel-lift was only observed for the norm of rotations about all three axes for relative-pelvis orientation (p = 0.034). Post-hoc analyses did not reveal any statistically significant differences between the heel-lifts and the 0 mm baseline (p≥0.072). Conclusion These findings suggest that correcting leg length inequality below the recommended threshold of 20 mm may influence pelvic orientation. Future work can investigate the effects of the altered orientations on spine loading and the clinical effects of corrections to minor leg length inequality.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-023-06302-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041355-5
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  • 2
    Online Resource
    Online Resource
    How common is imaging for low back pain in primary and emergency care? Systematic review and meta-analysis of over 4 million imaging requests across 21 years
    BMJ ; 2020
    In:  British Journal of Sports Medicine Vol. 54, No. 11 ( 2020-06), p. 642-651
    Details
    In: British Journal of Sports Medicine, BMJ, Vol. 54, No. 11 ( 2020-06), p. 642-651
    Abstract: To (1) estimate the proportion of patients seeking care for low back pain (LBP) who are imaged and (2) explore trends in the proportion of patients who received diagnostic imaging over time. We also examined the effect of study-level factors on estimates of imaging proportion. Data sources Electronic searches of MEDLINE, Embase and CINAHL databases from January 1995 to December 2017. Eligibility criteria for selecting studies Observational designs and controlled trials that reported imaging for patients presenting to primary care or emergency care for LBP. We assessed study quality and calculated pooled proportions by care setting and imaging type, with strength of evidence assessed using the GRADE system. Results 45 studies were included. They represented 19 451 749 consultations for LBP that had resulted in 4 343 919 imaging requests/events over 21 years. Primary care: moderate quality evidence that simple imaging proportion was 16.3% (95% CI 12.6% to 21.1%) and complex imaging was 9.2% (95% CI 6.2% to 13.5%). For any imaging, the pooled proportion was 24.8% (95% CI 19.3%to 31.1%). Emergency care: moderate quality evidence that simple imaging proportion was 26.1% (95% CI 18.2% to 35.8%) and high-quality evidence that complex imaging proportion was 8.2% (95% CI 4.4% to 15.6%). For any imaging, the pooled proportion was 35.6% (95% CI 29.8% to 41.8%). Complex imaging increased from 7.4% (95% CI 5.7% to 9.6%) for imaging requested in 1995 to 11.4% (95% CI 9.6% to 13.5%) in 2015 (relative increase of 53.5%). Between-study variability in imaging proportions was only partially explained by study-level characteristics; there were insufficient data to comment on some prespecified study-level factors. Summary/conclusion One in four patients who presented to primary care with LBP received imaging as did one in three who presented to the emergency department. The rate of complex imaging appears to have increased over 21 years despite guideline advice and education campaigns. Trial registration number CRD42016041987.
    Type of Medium: Online Resource
    ISSN: 0306-3674 , 1473-0480
    URL: Article
    DOI: 10.1136/bjsports-2018-100087
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2003204-3
    SSG: 31
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  • 3
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    Online Resource
    Stressful life events and low back pain in older men: A cross‐sectional and prospective analysis using data from the MrOS study
    Wiley ; 2023
    In:  European Journal of Pain
    Details
    In: European Journal of Pain, Wiley
    Abstract: Stressful life events, such as loss of a partner, loss of a pet or financial problems, are more common with increasing age and may impact the experience of pain. The aim of the current study is to determine the cross‐sectional and prospective association between stressful life events and low back pain reporting in the Osteoporotic Fracture in Men Study, a cohort of older men aged ≥65 years. Methods At a study visit (March 2005–May 2006), 5149 men reported whether they had experienced a stressful life event or low back pain in the prior 12 months. Following that visit, data on low back pain patients were gathered through triannual questionnaires every 4 months for 1 year. Multivariable logistic regression analyses estimated the association of stressful life events with recent past low back pain or future low back pain. Results N  = 2930, (57%) men reported at least one stressful life event. The presence of a stressful life event was associated with greater odds of any low back pain (OR = 1.42 [1.26–1.59]) and activity‐limiting low back pain (OR = 1.74 [1.50–2.01] ) in the same period and of any low back pain (OR = 1.56 [1.39–1.74]) and frequent low back pain (OR = 1.80 [1.55–2.08] ) in the following year. Conclusion In this cohort of men, the presence of stressful life events increased the likelihood of reporting past and future low back pain. Significance Stressful life events such as accident or illness to a partner are common in later life and may impact the experience of pain. We present cross‐sectional and prospective data highlighting a consistent association between stressful life events and low back pain in older men. Further, there is evidence to suggest that this relationship is upregulated by an individual's living situation. This information may be used to strengthen a biopsychosocial perspective of an individual's pain experience.
    Type of Medium: Online Resource
    ISSN: 1090-3801 , 1532-2149
    URL: Article
    DOI: 10.1002/ejp.2174
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2002493-9
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  • 4
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    Online Resource
    Three subgroups of pain profiles identified in 227 women with arthritis: a latent class analysis
    Springer Science and Business Media LLC ; 2017
    In:  Clinical Rheumatology Vol. 36, No. 3 ( 2017-3), p. 625-634
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    In: Clinical Rheumatology, Springer Science and Business Media LLC, Vol. 36, No. 3 ( 2017-3), p. 625-634
    Type of Medium: Online Resource
    ISSN: 0770-3198 , 1434-9949
    URL: Article
    DOI: 10.1007/s10067-016-3343-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 1480901-1
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  • 5
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    Online Resource
    Trajectories of acute low back pain : a latent class growth analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Pain Vol. 157, No. 1 ( 2016-01), p. 225-234
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    In: Pain, Ovid Technologies (Wolters Kluwer Health), Vol. 157, No. 1 ( 2016-01), p. 225-234
    Type of Medium: Online Resource
    ISSN: 0304-3959
    URL: Article
    DOI: 10.1097/j.pain.0000000000000351
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1494115-6
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  • 6
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    Online Resource
    Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: a systematic review
    Springer Science and Business Media LLC ; 2014
    In:  Chiropractic & Manual Therapies Vol. 22, No. 1 ( 2014-12)
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    In: Chiropractic & Manual Therapies, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2014-12)
    Abstract: Numerous clinical tests are used in the diagnosis of anterior cruciate ligament (ACL) injury but their accuracy is unclear. The purpose of this study is to evaluate the diagnostic accuracy of clinical tests for the diagnosis of ACL injury. Methods Study Design: Systematic review. The review protocol was registered through PROSPERO (CRD42012002069). Electronic databases (PubMed, MEDLINE, EMBASE, CINAHL) were searched up to 19th of June 2013 to identify diagnostic studies comparing the accuracy of clinical tests for ACL injury to an acceptable reference standard (arthroscopy, arthrotomy, or MRI). Risk of bias was appraised using the QUADAS-2 checklist. Index test accuracy was evaluated using a descriptive analysis of paired likelihood ratios and displayed as forest plots. Results A total of 285 full-text articles were assessed for eligibility, from which 14 studies were included in this review. Included studies were deemed to be clinically and statistically heterogeneous, so a meta-analysis was not performed. Nine clinical tests from the history (popping sound at time of injury, giving way, effusion, pain, ability to continue activity) and four from physical examination (anterior draw test, Lachman’s test, prone Lachman’s test and pivot shift test) were investigated for diagnostic accuracy. Inspection of positive and negative likelihood ratios indicated that none of the individual tests provide useful diagnostic information in a clinical setting. Most studies were at risk of bias and reported imprecise estimates of diagnostic accuracy. Conclusion Despite being widely used and accepted in clinical practice, the results of individual history items or physical tests do not meaningfully change the probability of ACL injury. In contrast combinations of tests have higher diagnostic accuracy; however the most accurate combination of clinical tests remains an area for future research. Clinical relevance Clinicians should be aware of the limitations associated with the use of clinical tests for diagnosis of ACL injury.
    Type of Medium: Online Resource
    ISSN: 2045-709X
    URL: Article
    DOI: 10.1186/s12998-014-0025-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2590836-4
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  • 7
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    Online Resource
    COVID-19: how has a global pandemic changed manual therapy technique education in chiropractic programs around the world?
    Springer Science and Business Media LLC ; 2021
    In:  Chiropractic & Manual Therapies Vol. 29, No. 1 ( 2021-12)
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    In: Chiropractic & Manual Therapies, Springer Science and Business Media LLC, Vol. 29, No. 1 ( 2021-12)
    Abstract: Manual therapy is a cornerstone of chiropractic education, whereby students work towards a level of skill and expertise that is regarded as competent to work within the field of chiropractic. Due to the COVID-19 pandemic, chiropractic programs in every region around the world had to make rapid changes to the delivery of manual therapy technique education, however what those changes looked like was unknown. Aims The aims of this study were to describe the immediate actions made by chiropractic programs to deliver education for manual therapy techniques and to summarise the experience of academics who teach manual therapy techniques during the initial outbreak of COVID-19 pandemic. Methods A qualitative descriptive approach was used to describe the immediate actions made by chiropractic programs to deliver manual therapy technique education during the COVID-19 pandemic. Chiropractic programs were identified from the webpages of the Councils on Chiropractic Education International and the Council on Chiropractic Education – USA. Between May and June 2020, a convenience sample of academics who lead or teach in manual therapy technique in those programs were invited via email to participate in an online survey with open-ended questions. Responses were entered into the NVivo software program and analysed using a reflexive thematic analysis by a qualitative researcher independent to the data collection. Results Data from 16 academics in 13 separate chiropractic programs revealed five, interconnected themes: Immediate response; Move to online delivery; Impact on learning and teaching; Additional challenges faced by educators; and Ongoing challenges post lockdown. Conclusion This study used a qualitative descriptive approach to describe how some chiropractic programs immediately responded to the initial outbreak of the COVID-19 pandemic in their teaching of manual therapy techniques. Chiropractic programs around the world provided their students with rapid, innovative learning strategies, in an attempt to maintain high standards of chiropractic education; however, challenges included maintaining student engagement in an online teaching environment, psychomotor skills acquisition and staff workload.
    Type of Medium: Online Resource
    ISSN: 2045-709X
    URL: Article
    DOI: 10.1186/s12998-021-00364-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2590836-4
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  • 8
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    Online Resource
    Low back pain: a major global problem for which the chiropractic profession needs to take more care
    Springer Science and Business Media LLC ; 2018
    In:  Chiropractic & Manual Therapies Vol. 26, No. 1 ( 2018-12)
    Details
    In: Chiropractic & Manual Therapies, Springer Science and Business Media LLC, Vol. 26, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 2045-709X
    URL: Article
    DOI: 10.1186/s12998-018-0199-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2590836-4
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  • 9
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    Online Resource
    Current evidence for spinal X-ray use in the chiropractic profession: a narrative review
    Springer Science and Business Media LLC ; 2018
    In:  Chiropractic & Manual Therapies Vol. 26, No. 1 ( 2018-12)
    Details
    In: Chiropractic & Manual Therapies, Springer Science and Business Media LLC, Vol. 26, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 2045-709X
    URL: Article
    DOI: 10.1186/s12998-018-0217-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2590836-4
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  • 10
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    Online Resource
    The bench-top accuracy of the VerteTrack spinal stiffness assessment device
    Springer Science and Business Media LLC ; 2020
    In:  Chiropractic & Manual Therapies Vol. 28, No. 1 ( 2020-12)
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    In: Chiropractic & Manual Therapies, Springer Science and Business Media LLC, Vol. 28, No. 1 ( 2020-12)
    Abstract: The assessment of spinal stiffness by manual palpation in clinical settings has demonstrated both poor accuracy and reliability. More recently, mechanical methods for assessment of spinal stiffness have demonstrated superior accuracy and reliability. However, mechanical methods of spinal stiffness assessment can be expensive, time consuming and/or unsuited to clinical practice. While a new device has been designed to address these issues (VerteTrack), its benchtop performance remains unknown. Aim To measure the bench-top performance of VerteTrack. Methods A series of laboratory-based experiments were conducted in February 2018 to investigate the accuracy (precision and bias) of load and displacement measurements obtained by VerteTrack and then were compared against an appropriate reference standard. Measurements of both multiple-level continuous assessment (multiple spinal levels measured), and single-level assessment (single spinal level measured) were performed on a viscoelastic foam medium (AIREX® balance beam, Switzerland) and the resulting stiffness calculated. Results VerteTrack demonstrated high precision at all loads and displacements. There was minimal systematic measurement bias identified for applied versus reference load (mean bias = − 0.123 N; 95%CI − 0.182 to 0.428 N, p   〈  .001), and no systematic measurement bias for measured versus reference displacement (mean difference = 0.02 mm; 95%CI − 0.09 to 0.14 mm, p   〈  .001). The magnitude of stiffness obtained during multiple-level continuous assessment was on average 0.25 N/mm (2.79%) less than that for single-level assessment (95%CI − 0.67 to 0.17 N/mm, p   〈  .001). Conclusions VerteTrack demonstrated high accuracy (high precision, low bias) under bench-top conditions. The difference in stiffness found between multiple versus single spinal levels should be considered in the research context, but is unlikely to be clinically relevant. The results of this study demonstrate that VerteTrack may be suitable for both single and multi-level spinal stiffness measurements in-vivo.
    Type of Medium: Online Resource
    ISSN: 2045-709X
    URL: Article
    DOI: 10.1186/s12998-020-00331-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2590836-4
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