Medicine and Health Sciences Commons^™

The Impact Of Covid-19 On The Utilization Of Early Magnetic Resonance Imaging (Emri) In The Assessment Of Acute Uncomplicated Low Back Pain (Lbp) And The Subsequent Effect On Health Care Service Utilization And Patient Outcomes, Kimberly Radcliffe

MUSC Theses and Dissertations

OBJECTIVES: To examine changes in MRI rates between Pre-COVID-19 period (Feb-April 2019) and COVID-19 period (Feb-April 2020) among commercially insured patients aged 18-60 with a diagnosis of acute LBP, and to analyze differences in patient characteristics and outcomes between the time periods. Additionally, to examine the impact of eMRI on patient outcomes and health care costs for patients in the COVID-19 period.

DESIGN/METHODS: Using IBM® MarketScan® Commercial Database (MarketScan) we performed a quantitative pre-post comparative retrospective observational study of 117,150 total patients to examine adjusted differences in patient characteristics and rates of MRIs between time periods. We analyzed 49,020 patients …

Mirror Therapy Rehabilitation In Low Back Pain Patients, Claudia L. Altergott

Honors Capstones

Low back pain is a common occurrence experienced by many individuals. An estimated 75-85% of Americans experience some form of back pain during their lives [1]. While low back pain can be uncomfortable and debilitating, approximately 90% of cases are temporary and can resolved without surgery; however, 50% of patients will experience recurrent episodes of back pain. Low back pain that has persisted for more than twelve weeks is considered chronic low back pain [1]. Many researchers and therapists have been seeking the optimal treatment plans for individuals suffering from low back pain. Mirror therapy (MT) is a type of …

Lumbopelvic Biomechanics And Muscle Performance In Individuals With Unilateral Transfemoral Amputation: Implications For Lower Back Pain, Jason Ciccotelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many people with lower extremity amputation (LEA) experience lower back pain (LBP). The amount of pain they experienced can be debilitating and severely interferes with activities of daily living. Previous studies have explored LBP in populations without LEA, and the evidence is also growing within the limb loss population. However, the mechanism for the high prevalence of LBP after LEA remains unclear. The lower back muscles, specifically the multifidi muscles, play an important role in stabilization of the spine during motion, and LBP has been associated with decreased mobility in patient populations, but the degree of dysfunction in the spinal …

Mechanisms Of Simulated-Spinal Manipulative Therapy In Animal Models Of Low Back Pain, Carla Rigo Lima

All ETDs from UAB

Low back pain (LBP), a condition characterized by pain experienced between the 12th rib margin and gluteal folds, is a prevalent health problem that affects an ever-increasing population worldwide. First-line treatment for LBP often involves non-pharmacological approaches, including spinal manipulative therapy (SMT), which has demonstrated mild-to-moderate clinical efficacy. However, despite its therapeutic benefits, the physiological mechanisms underlying the analgesic effects of SMT in LBP are still not well understood. Recent evidence suggests that sensitization of peripheral and central nervous system structures contribute to the progression and maintenance of LBP with inflammatory cytokines, reactive glial cells, and/or aberrant muscle spindle activity …

Prevalence Of Low Back Pain Amongst Occupational Therapy And Physiotherapy Students In India, Its Influence On Educational Engagement, Pham Ngoc Dat Mr.

Manipal College of Health Professions, Manipal Theses and Dissertations

No abstract provided.

The Relationship Between The Population's Perception Of Herniated Intervertebral Disks And Their Known Physical Presentation, Jonah D. Gant

Honors Undergraduate Theses

The second most common lumbosacral diagnosis in the United States is a herniation or prolapse of the intervertebral disc. Individuals with herniated discs can have a wide variety of clinical presentations, ranging from asymptomatic to severe spinal cord compression and pain. Studies suggest that an individual’s pre-existing perception of a condition is likely to influence their course of recovery. Currently, perceptions the general public holds regarding the consequences of disc herniation is unknown. Therefore, the purpose of this study was to assess current views regarding disc herniations in the general population with their reported prevalence and clinical outcome. This was …

The General Population's Perception Of Factors Associated With Positive Or Negative Perceptions Of Physical Therapy Care In Those With Low Back Pain, Jada M. Strowbridge

Honors Undergraduate Theses

Low back pain (LBP) has a global impact on health and is a substantial contributor to long term disability. The economic burden of LBP is immense and it is advancing annually. Costs attributing to LBP in the United States is about $84.1 to $624.8 billion. Physical therapy is commonly recommended for those with LBP since it is linked to improved clinical outcomes. However, patient perceptions can influence how this treatment approach is perceived. It is unclear if these perceptions can influence outcomes for patients suffering from LBP. Therefore, the purpose of this study is to identify the factors associated with …

Analysis Of Pelvic Alignment Patterns Utilizing The Postural Restoration Institution Approach, Marisa Mills

West Chester University Master’s Theses

Background: Low back pain is a common problem that can include injury to the sacroiliac joint (SIJ) with 15-30% of cases arising from LBP. Treatment for SIJ includes muscle energy. A newer approach from Postural Restoration Institution (PRI) centered around pelvic patterns alignment has also been used. There’s limited research found describing the prevalence of pelvic patterns within populations with PRI method.

Purpose: To examine prevalence of pelvic patterns and investigate a relationship of low back pain. Furthermore, to explore the specific patterns closely and the ability to re-align pelvic patterns by utilizing PRI repositioning exercises.

Study Design: Cross …

Analysis Of Time-Dependent Adaptations Of Lumbar Intervertebral Disc Morphology During Standing-Induced Symptoms Of Low Back Pain, Donald Aboytes

McKelvey School of Engineering Theses & Dissertations

Low back pain (LBP) is a traumatic impairment for individuals with staggering socioeconomic burden. The etiology of LBP is exceedingly complex and confounded by comorbidities. The source of pain is difficult to pin-point because the offending stimuli are not always known. One promising avenue is to investigate the progression of LBP symptoms in young and otherwise healthy individuals. The population that exhibits preclinical LBP in prolonged standing may be particularly suitable for understanding the anatomical changes that occur during the progression of the symptoms. Since the pain symptoms subside upon exiting the standing position, they are an ideal demographic to …

Movement Patterns During Functional Activities In People With Chronic Low Back Pain, Quenten Lowell Hooker

Arts & Sciences Electronic Theses and Dissertations

People with chronic LBP display an altered movement pattern where the lumbar spine moves more readily than other joints that can contribute to the activity. The pattern is of particular clinical relevance because across multiple studies the magnitude of altered pattern is associated with LBP and function. One session of motor skill training (MST) during functional activities can improve the altered pattern. However, of the few studies investigating MST for people with LBP, none have examined the short-term or long-term effects of MST on the altered pattern. Additionally, no study has systematically examined if person-specific characteristics moderate the altered pattern …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Pain-Related Injustice Appraisal And Chronic Low Back Pain Among Arabs In The United States, Albatool Homoud Alnojeidi

All ETDs from UAB

Pain-related injustice appraisal has emerged as a psychosocial predictor of deleterious chronic low back pain (CLBP) outcomes. The appraisal is defined as the individual’s perception regarding the magnitude and irreparability of pain-related loss and suffering, externalized blame, and unfairness. Research in diverse samples revealed racial differences in pain-related injustice appraisal, suggesting that it may reflect broader racial/ethnic, sociocultural, and socioeconomic factors. This agrees with theories recognizing the role of ethnic and cultural characteristics in ethnic minorities’ health. Despite global data showing that Arabs represent the population with the second-highest prevalence of CLBP worldwide, a reliable characterization of CLBP among Arabs …

Using Observations From The Uaw-Ford Ergonomic Assessment Tool To Predict Low Back Musculoskeletal Disorders, Colins Nwafor

USF Tampa Graduate Theses and Dissertations

Musculoskeletal disorders of the low back are common injuries found in many work environments. Some of the risk factors that workers experience include the weight of object being lifted during a task, frequency, duration, posture, distance the object is lifted, how well the worker can grasp the object, and the degree to which the worker may have to twist and turn their body during a lift. There are many tools that have been developed that are used to assess risk of a worker developing low back pain. The purpose of this study is to determine if the UAW-Ford Ergonomic Surveillance …

Financial Impact Associated With Implementation Of The Low Back Pain Clinical Practice Guideline In Outpatient Physical Therapist Practice, Heidi Kosakowski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Dysfunction and disability arising from low back pain (LBP) affects more people than any other condition globally, and results in changes to the quality of life for many individuals. The financial burden of managing low back pain is among the highest both in the United States and globally. Clinical practice guidelines (CPGs) provide recommendations on patient management strategies and have the potential to simultaneously improve patient outcomes and lower health care costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs that are incurred after physical therapist care. A retrospective observational study was conducted that examined …

Neurophysiological Effects Of Dry Needling To The Thoracolumbar Junction Multifidi In Subjects With Low Back Pain And Decreased Hamstring Length, Nicole Ginette Clark

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: Dry needling is becoming increasingly popular in the treatment of neuromusculoskeletal conditions. The neurophysiological effect of treatment, specifically those related to the sympathetic nervous system (SNS) is considered a relevant physiological mechanism contributing to a patient’s rehabilitation. The primary purpose of this study was toinvestigate the neurophysiological effects of dry needling, as measured by sympathetic outflow and muscular flexibility. A secondary purpose of this study was to determine if changes in SNS activity correlate with clinically meaningful improvements in pain and disability. Design: This was a prospective, double-blind randomized clinical trial. Subjects: The study sample consisted of …

Is Low-Level Laser Therapy Effective For Pain Reduction In Patients With Chronic Low Back Pain?, Eric D. Dipasquale

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not lowlevel laser therapy is effective for pain reduction in patients with chronic low back pain.

STUDY DESIGN: Two randomized controlled trials published in 2010 and 2017 and one nonrandomized placebo-controlled clinical trial published in 2018.

DATA SOURCES: Sources were written in English and published in peer-reviewed journal articles comparing low-level laser therapy (LLLT) to groups consisting of a combined laser therapy regimen or placebo in patients with chronic low back pain, found using PubMed.

OUTCOMES MEASURED: Low back pain was assessed using the visual analog scale …

Is Yoga Therapy Effective In Reducing Chronic Lower Back Pain In Adults?, Stephen G. Osowski

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is yoga therapy effective in reducing chronic lower back pain in adults.”

Study Design: Systematic review of 2 randomized controlled trials (RCT), 1 randomized clinical trial, published after January 2017, and in English language.

Data Sources: Both RCTs and the randomized clinical trial were published in peerreviewed journals, found through the PubMed database, and were selected based on relevance to the clinical question and if outcomes were patient oriented (POEMS).

Outcome(s) measured: All 3 studies measured pain, using a variety of pain measurement scales such as …

Biopsychosocial Variables Associated With The Development Of Chronic Low Back Pain In Healthcare Workers, Jena Pauli

Theses and Dissertations

ABSTRACT

Purpose: Worldwide the incidence and prevalence of acute low back injury with pain (ALBIP) is increasing in healthcare workers (HCW). Approximately 27% of ALBIP result in chronic low back pain (CLBP). The primary aim of this study was to identify biopsychosocial factors that contribute to the development of CLBP. A secondary aim was to examine the predictive value of reliable and valid screening instruments to identify individuals at highest risk for CLBP.

Significance: Low back pain is the second most commonly reported pain condition in the United States, one of the leading causes of sick leave and …

Structural And Tissue-Level Adaptations Of Lumbar Intervertebral Discs In Humans With Inducible Low Back Pain Symptoms, Christian Isaiah Weber

McKelvey School of Engineering Theses & Dissertations

Low back pain (LBP) is a devastating musculoskeletal ailment that impacts majority of the global population. Up to 95% of cases are considered nonspecific where the origin is unclear. Although there is a diagnosis with these cases, there lacks specificity that would help individuals with treatment and pain management. Imaging techniques such as magnetic resonance imaging (MRI) are primarily utilized in the diagnosis of LBP as it illuminates internal structures of the spine. One important structure clearly identified with MRI is the intervertebral disc (IVD) that is susceptible to injury and disease. Further, diagnostic imaging is performed lying down where …

Spine Kinematics And Muscle Activities In Non-Specific Chronic Low Back Pain Subgroups In Sitting, Mansoor Ahmed Alameri

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Although, non-specific chronic low back pain (NSCLBP) has been associated with motor control impairments, little is known about the possible driving mechanisms of pain development overtime during prolonged sitting period. Therefore, the purpose of this study was to examine the differences in lumbosacral postures and muscle activities in adults with and without NSCLBP, and their role on pain development during a 1-hour of prolonged sitting task.

Methods: Twenty NSCLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern (FP) disorder, and 10 with active extension pattern (AEP) disorder], and 10 healthy controls participated in …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes Of Paraspinal Muscle Performance After Lumbar Multifidus Intramuscular Fine Wire Electrode Insertion, Anthony Duong, Vincent Dinglasan, Russell Totten

UNLV Theses, Dissertations, Professional Papers, and Capstones

STUDY DESIGN: Case control study. BACKGROUND: Recurrent low back pain (RLBP) is associated with paraspinal muscle dysfunction. Intramuscular electromyography (EMG) is a common tool for studying activation of the deep lumbar paraspinal muscles such as multifidi muscles, but it is currently currently unclear how muscle performance and activation are affected by the pain and micro-injury associated with intramuscular fine-wire electrode (IFWE) insertion and how it interacts with the presence of RLBP. OBJECTIVES: The purpose of this study was to examine how IFWE insertion into the lumbar multifidus affects paraspinal muscle strength and endurance in subjects with and without RLBP. METHODS: …

Is Wet Cupping Effective In Decreasing Persistent Nonspecific Low Back Pain In Adults?, Emily C. Marshall

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is wet cupping effective in decreasing persistent nonspecific low back pain in adults?”

Study Design: Review of 3 RCTs published between 2009- current, all in the English language.

Data Sources: Three RCTs analyzed the effectiveness of wet cupping on the reduction of persistent nonspecific low back pain (PNSLBP) compared to a control group using other various analgesic therapies. All studies were found on EBSCOhost and were selected based on relevance to the question and being a POEM.

Outcomes measured: All of the articles analyzed the effectiveness …

Does Resistance Training Reduce Low Back Pain?, Lauren N. Carosi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not resistance training reduces low back pain.

STUDY DESIGN: Review of three English language primary studies published in 2011, 2014, and 2015.

DATA SOURCES: Randomized controlled and clinical trials comparing resistance training (kettlebell training, graded activity, TOTRX, LEXT) to physiotherapy exercise and no exercise intervention, found using PubMed.

OUTCOME MEASURED: Severity of pain in the low-back area, measured using Pain Numerical Rating Scale (NRSpain) and pain visual-analog scale.

RESULTS: Two out of three studies found that resistance training reduced low back pain in comparison to a control …

Chronic Low Back Pain- A Needs Assessment For Practice Change, Chukwudi Oduah

Walden Dissertations and Doctoral Studies

There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for …

Examining The Lumbar Movement Pattern During Functional Activities In People With Low Back Pain, Andrej Vincent Marich

Arts & Sciences Electronic Theses and Dissertations

Low back pain (LBP) is a highly prevalent condition that is often characterized by persistent pain and limitations in the performance of daily functional activities. The repeated use of altered movement patterns during the performance of daily functional activities is proposed to contribute to the development and course of LBP. Specifically, in the case of LBP, the proposed alteration of movement is one in which the lumbar spine moves more readily than other joints that can contribute to the movement. This altered movement pattern is proposed to contribute to accumulation of localized tissue stress, micro- and macro-trauma of lumbar spine …

A Novel Distractive And Mobility-Enabling Lumbar Spinal Orthosis For Treating Mechanical Low Back Pain, Daniel Clay Hillyard

Theses and Dissertations (ETD)

Introduction: Lumbar spinal orthoses (LSOs) are often used as non-surgical treatment and serve to support the spine and alleviate low back pain. More recently, dynamic orthoses claiming to decompress the spine have been introduced. Currently, there is an unserved population of people that suffer from mechanical low back pain (LBP) conditions, such as degenerative disc disease or lumbar foraminal stenosis, that would benefit from spinal decompression and mobility. A previously-developed prototype of dynamic mobility orthosis (DMO1) was designed that provided a distractive load across the lumbar spine but required higher sagittal bending moments and was unable to maintain spinal off-loading …

Return To Full Duty Work: Determining The Ideal Time To Refer Occupationally Isolated Acute Low Back Pain Patients To Physical Therapy, Aletha Mae Stephenson

Walden Dissertations and Doctoral Studies

Employees who develop and report nontraumatic acute low back pain that occurs while performing work duties, or shortly thereafter, are classified as having occupational isolated acute low back pain (OIALBP). The purpose of this project was to identify and implement an evidence- based time frame to refer occupational isolated acute low back pain patients (OIALBPPs) to physical therapy (PT) that returns them to full duty work (FDW) more quickly. The diffusion of innovation theory aided the project leader and health care providers to develop strategies to overcome barriers in implementing the project's results into the practice. A total of 932 …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Rehabilitative Management Of A 66-Year-Old Female With Chronic Low Back Pain: A Case Report, Rachael Matthews

All Capstone Projects

Background and Purpose: There is a lack of research demonstrating standardization of treatment protocols for patients with chronic low back pain and lumbar spinal stenosis. The purpose of this case report was to examine the effectiveness of a physical therapy rehabilitation program for a 66-year-old female referred for lumbar radiculopathy and lumbar spinal stenosis.

Case Description: This case report contained interventions focused on lumbar extension exercises, upper and lower extremity and postural control exercises, aerobic training, and modalities, in order to achieve the patient’s goals and to improve quality of life. To measure the outcomes the following tests and measures …

The Effects Of A Mckenzie-Based Approach Combined With Functional Training For A Patient With Low Back Pain And Multiple Sclerosis: A Case Report, Mitchell Cronk

All Capstone Projects

Background and Purpose: The purpose of this case report is to describe the outcome of a McKenzie-based intervention plan combined with functional training for a patient with low back pain and multiple sclerosis.

Case Description: CS was a 58-year-old female who presented to therapy with primary complaints of low back and calf pain. Also, the patient was diagnosed with relapsing-remitting multiple sclerosis in 2009. The patient ambulates with a significantly increased base of support. A CT-scan in 2012 revealed a bulging disc at the L5-S1 vertebral junction. The patient swims 3x a week for 30 minutes.

Outcomes: All of the …