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Fors, M., Abbott, A., Enthoven, P. & Öberg, B. (2019). Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: Secondary outcomes of the PREPARE randomised controlled trial. BMC Musculoskeletal Disorders, 20(1), Article ID 468.
Open this publication in new window or tab >>Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: Secondary outcomes of the PREPARE randomised controlled trial
2019 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 20, no 1, p. 1article id 468Article in journal (Refereed) Published
Abstract [en]

Background

Degenerative lumbar spine disorders are common among musculoskeletal disorders. When disabling pain and radiculopathy persists after adequate course of rehabilitation and imaging confirms compressive pathology, surgical decompression is indicated. Prehabilitation aiming to augment functional capacity pre-surgery may improve physical function and activity levels pre and post-surgery. This study aims to evaluate the effect and dose-response of pre-surgery physiotherapy on quadriceps femoris strength and walking ability in patients with degenerative lumbar spine disorders compared to waiting-list controls and their association with postoperative physical activity level.

Method

In this single blinded, 2-arm randomised controlled trial, 197 patients were consecutively recruited. Inclusion criteria were: MRI confirmed diagnosis and scheduled for surgery due to disc herniation, lumbar spinal stenosis, degenerative disc disease or spondylolisthesis, ages 25-80 years. Patients were randomised to 9 weeks of pre-surgery physiotherapy or to waiting-list. Patient reported physical activity level, walking ability according to Oswestry Disability Index item 4, walking distance according to the SWESPINE national register and physical outcome measures including the timed ten-meter walk test, maximum voluntary isometric quadriceps femoris muscle strength, patient-rated were collected at baseline and follow-up. Parametric or non-parametric within and between group comparisons as well as multivariate regression was performed.

Results

Patients who received pre-surgery physiotherapy significantly improved in all variables from baseline to follow-up (p < 0.001 – p < 0.05) and in comparison to waiting-list controls (p < 0.001 – p < 0.028). Patients adhering to ≥12 treatment sessions significantly improved in all variables (p < 0.001 – p < 0.032) and those receiving 0-11 treatment session in only normal walking speed (p0.035) but there were no significant differences when comparing dosages. Physical outcome measures after pre-surgery physiotherapy together significantly explain 27.5% of the variation in physical activity level 1 year after surgery with pre-surgery physical activity level having a significant multivariate association.

Conclusion

Pre-surgery physiotherapy increased walking ability and lower extremity strength in patients with degenerative lumbar spine disorders compared to waiting-list controls. A clear treatment dose-response response relationship was not found. These results implicate that pre-surgery physiotherapy can influence functional capacity before surgical treatment and has moderate associations with maintained postoperative physical activity levels mostly explained by physical activity level pre-surgery.

Trial registration

NCT02454400. Trial registration date: August 31st 2015, retrospectively registered.

Place, publisher, year, edition, pages
BioMed Central, 2019. p. 1
Keywords
Degenerative lumbar spine disorder, Low Back pain, Physiotherapy, Rehabilitation, Exercise, Walking ability, Strength
National Category
Medical and Health Sciences Physiotherapy
Identifiers
urn:nbn:se:liu:diva-161361 (URN)10.1186/s12891-019-2850-3 (DOI)31651299 (PubMedID)2-s2.0-85074073670 (Scopus ID)
Note

Funding agencies: Ostergotland region public health care research grant

Available from: 2019-10-30 Created: 2019-10-30 Last updated: 2019-11-19Bibliographically approved
Diarbakerli, E., Grauers, A., Danielsson, A., Abbott, A. & Gerdhem, P. (2019). Quality of life in males and females with idiopathic scoliosis. Spine, 44(6), 404-410
Open this publication in new window or tab >>Quality of life in males and females with idiopathic scoliosis
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2019 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 44, no 6, p. 404-410Article in journal (Refereed) Published
Abstract [en]

Study Design. Cross-sectional.

Objective. To describe quality of life in males and females with idiopathic scoliosis.

Summary of Background Data. Idiopathic scoliosis is a three-dimensional deformity affecting the growing spine. The prevalence of larger curves, requiring treatment, is higher in females.

Methods. This cross-sectional study comprised 1519 individuals with idiopathic scoliosis (211 males) with a mean (SD) age of 35.3 (14.9) years. They all answered the Scoliosis Research Society 22 revised (SRS-22r) questionnaire and EuroQol 5-dimension-index (EQ-5D). Five hundred twenty eight were surgically treated (78 males), 535 were brace treated (50 males), and 456 were untreated (83 males). The SRS-22r subscore (excluding the satisfaction domain), the SRS-22r domains and the EQ-5D index score were calculated. Subgroup analyses based on treatment and age were performed. Statistical comparisons were performed using analysis of covariance with adjustments for age and treatment. A P-value less than 0.05 was considered as statistical significant.

Results. The mean (SD) SRS-22r subscore was 4.19 (0.61) in males and 4.05 (0.61) in females (P = 0.010). The males had higher scores on the SRS-22r domains function (4.56 vs. 4.42), pain (4.20 vs. 4.00), and mental health (4.14 vs. 3.92) (all P < 0.05). The mean (SD) EQ-5D index score was 0.85 (0.22) for males and 0.81 (0.21) for females (P = 0.10). There were minor differences when comparing males and females in treatment and age groups, but both treated and untreated groups had reduced quality of life compared with the national norms.

Conclusion. When compared with females, males with idiopathic scoliosis tend to have slightly higher scores in the scoliosis specific SRS-22r but not in the generic quality of life measurement EQ-5D. Quality of life is overall similar between males and females in treatment and age groups, but reduced in comparison with the general population.

Level of Evidence: 3

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-152018 (URN)10.1097/BRS.0000000000002857 (DOI)000467740500013 ()30180148 (PubMedID)
Note

Funding agencies:  Vetenskapsradet (SE) [K2013-99X-22268-01-3]; H.K.H. Kronprinsessan Lovisas Forening for Barnasjukvard; Swedish Society of Spinal Surgeons

Available from: 2018-10-15 Created: 2018-10-15 Last updated: 2019-10-30Bibliographically approved
Dufvenberg, M., Adeyemi, F., Rajendran, I., Öberg, B. & Abbott, A. (2018). Does postural stability differ between adolescents with idiopathic scoliosis and typically developed?: A systematic literature review and meta-analysis. Scoliosis and Spinal Disorders, 13(1), Article ID 19.
Open this publication in new window or tab >>Does postural stability differ between adolescents with idiopathic scoliosis and typically developed?: A systematic literature review and meta-analysis
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2018 (English)In: Scoliosis and Spinal Disorders, ISSN 2397-1789, Vol. 13, no 1, article id 19Article, review/survey (Refereed) Published
Abstract [en]

Background

Postural stability deficits have been proposed to influence the onset and progression of adolescent idiopathic scoliosis (AIS). This study aimed to systematically identify, critically evaluate and meta-analyse studies assessing postural stability during unperturbed stance with posturography in AIS compared to typically developed adolescents.

Methods

Studies from four electronic databases (PubMed, Scopus, CINAHL, PEDro) were searched and case-control methodological quality assessed using a risk-of-bias assessment tool and a posturography methodological quality checklist. Pooled data regarding centre of pressure (COP) parameters such as sway area, Mediolateral (ML) and Anteroposterior (AP) position and range were compared for AIS and typically developed adolescents using Cohen’s d effect size (ES) and homogeneity estimates.

Results

Eighteen studies for quality analysis and 9 of these for meta-analysis were identified from 971 records. Risk-of-bias assessment identified 6 high, 10 moderate and 2 low risk-of-bias studies. The posturography methodological quality checklist identified 4 low, 7 moderate and 7 high-quality studies. Meta-analysis was performed for sway area whereas ML and AP are presented in three different meta-analyses due to divergent measurement units used in the studies: ML position 1 (MLP1), ML position 2 (MLP2) and ML range (MLR); AP position 1 (APP1), AP position 2 (APP2) and AP range (APR). Cohen’s d showed a medium ES difference in sway area 0.65, 95% CI (0.49–0.63), whereas ML showed no (MLP1, MLP2) and large (MLR) ES differences; MLP1 0.15, 95% CI (0.08–0.22); MLP2 0.14, 95% CI (0.08–0.19); and MLR 0.94, 95% CI (0.83–1.04). Cohen’s d for AP showed small ES (APP1) and large ES difference (APP2 and APR); APP1 0.43, 95% CI (0.31–0.54); APP2 0.85, 95% CI (0.72–0.97); and APR 0.98, 95% CI (0.87–1.09). Cochran’s Q and Higgins I2 showed homogeneity between studies.

Conclusions

There is moderate quality evidence for decreased postural stability in AIS measured as COP parameters sway area, ML and AP range with a positional shift posteriorly in the sagittal plane. The findings support studying postural stability in early stage AIS and also prospectively identify cause and effect of the curvature as well as effectiveness of postural control interventions in the prevention of scoliosis progression.

Keywords
Adolescent idiopathic scoliosis, Postural balance, Postural control, Postural stability, Posturography, Force plate, Centre of pressure, Sway area, Anteroposterior, Mediolateral
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-152577 (URN)10.1186/s13013-018-0163-1 (DOI)
Available from: 2018-11-08 Created: 2018-11-08 Last updated: 2019-04-17
Folmli, B., Turman, B., Johnson, P. & Abbott, A. (2018). Dose-response of somatosensory cortex repeated anodal transcranial direct current stimulation on vibrotactile detection: A randomized sham controlled trial. Journal of Neurophysiology
Open this publication in new window or tab >>Dose-response of somatosensory cortex repeated anodal transcranial direct current stimulation on vibrotactile detection: A randomized sham controlled trial
2018 (English)In: Journal of Neurophysiology, ISSN 0022-3077, E-ISSN 1522-1598Article in journal (Refereed) Published
Abstract [en]

This randomized sham-controlled trial investigated anodal transcranial direct current stimulation (tDCS) over the somatosensory cortex contralateral to hand dominance for dose-response (1mA-20 minutes x 5 days) effects on vibrotactile detection thresholds (VDT). VDT was measured before and after tDCS on days 1,3&5 for low (30hz) and high (200hz) frequency vibrations on the dominant and non-dominant hands in 29 healthy adults (mean age = 22.86; 15 males, 14 females). Only the dominant hand 200Hz VDT displayed statistically significant medium effect size improvement for mixed model analysis of variance time x group interaction for active tDCS compared to sham. Post Hoc contrasts were statistically significant for dominant hand 200Hz VDT on day 5 after tDCS compared to day 1 before tDCS , day 1 after tDCS and day 3 before tDCS. There was a linear dose-response improvement with dominant hand 200Hz VDT mean difference decreasing from day 1 before tDCS peaking at -15.5% (SD=34.9%) on day 5 after tDCS. Both groups showed learning effect trends over time for all VDT test conditions but only the non-dominant hand 30Hz VDT was statistically significant (p=0.03) though Post Hoc contrasts were non-significant after Sidak adjustment. No adverse effects for tDCS were reported. In conclusion, anodal tDCS 1mA-20 minutes x 5 days on the dominant sensory cortex can modulate a linear improvement of dominant hand high frequency VDT but not for low frequency or non-dominant hand VDT.

Place, publisher, year, edition, pages
Bethesda, United States: American Physiological Society, 2018
Keywords
Transcranial direct current stimulation, primary somatosensory cortex, vibrotactile detection threshold
National Category
Physiology
Identifiers
urn:nbn:se:liu:diva-147878 (URN)10.1152/jn.00926.2017 (DOI)000441195200019 ()29726731 (PubMedID)
Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-08-24Bibliographically approved
Abbott, A., Schröder, K., Enthoven, P., Nilsen, P. & Öberg, B. (2018). Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial. BMJ Open, 8(4), Article ID e019906.
Open this publication in new window or tab >>Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 4, article id e019906Article in journal (Refereed) Published
Abstract [en]

Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP.

Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context.

Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated.

Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and implementation in Sweden and associated national quality register data collection are potential future developments of the project.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-147879 (URN)10.1136/bmjopen-2017-019906 (DOI)000435176700106 ()29691246 (PubMedID)
Note

Funding agencies: Research Council in Southeast Sweden [FORSS<SUP>star</SUP>660371]; Swedish Research Council [2017<SUP>star</SUP>01444]

Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2019-04-10Bibliographically approved
Lindbäck, Y., Tropp, H., Enthoven, P., Abbott, A. & Öberg, B. (2018). PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial. The spine journal, 18(8), 1347-1355
Open this publication in new window or tab >>PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial
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2018 (English)In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 8, p. 1347-1355Article in journal (Refereed) Published
Abstract [en]

Background Context

Surgery because of disc herniation or spinal stenosis results mostly in large improvement in the short-term, but mild to moderate improvements for pain and disability at long-term follow-up. Prehabilitation has been defined as augmenting functional capacity before surgery, which may have beneficial effect on outcome after surgery.

Purpose

The aim was to study if presurgery physiotherapy improves function, pain, and health in patients with degenerative lumbar spine disorder scheduled for surgery.

Study Design

A single-blinded, two-arm, randomized controlled trial (RCT).

Patient Sample

A total of 197 patients were consecutively included at a spine clinic. The inclusion criteria were patients scheduled for surgery because of disc herniation, spinal stenosis, spondylolisthesis, or degenerative disc disease (DDD), 25–80 years of age.

Outcome Measures

Primary outcome was Oswestry Disability Index (ODI). Secondary outcomes were pain intensity, anxiety, depression, self-efficacy, fear avoidance, physical activity, and treatment effect.

Methods

Patients were randomized to either presurgery physiotherapy or standardized information, with follow-up after the presurgery intervention as well as 3 and 12 months post surgery. The study was funded by regional research funds for US$77,342. No conflict of interest is declared.

Results

The presurgery physiotherapy group had better ODI, visual analog scale (VAS) back pain, EuroQol-5D (EQ-5D), EQ-VAS, Fear Avoidance Belief Questionnaire-Physical Activity (FABQ-PA), Self-Efficacy Scale (SES), and Hospital Anxiety and Depression Scale (HADS) depression scores and activity level compared with the waiting-list group after the presurgery intervention. The improvements were small, but larger than the study-specific minimal clinical important change (MCIC) in VAS back and leg pain, EQ-5D, and FABQ-PA, and almost in line with MCIC in ODI and Physical Component Summary (PCS) in the physiotherapy group. Post surgery, the only difference between the groups was higher activity level in the physiotherapy group compared with the waiting-list group.

Conclusions

Presurgery physiotherapy decreases pain, risk of avoidance behavior, and worsening of psychological well-being, and improves quality of life and physical activity levels before surgery compared with waiting-list controls. These results were maintained only for activity levelspost surgery. Still, presurgery selection, content, dosage of exercises, and importance of being active in a presurgery physiotherapy intervention is of interest to study further to improve long-term outcome.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Disc herniation, Function, Physiotherapy, Spinal stenosis, Stratification, Surgery
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-147620 (URN)10.1016/j.spinee.2017.12.009 (DOI)000443585000006 ()29253630 (PubMedID)2-s2.0-85044627865 (Scopus ID)
Available from: 2018-04-27 Created: 2018-04-27 Last updated: 2019-05-01Bibliographically approved
Lindbäck, Y., Tropp, H., Enthoven, P., Gerdle, B., Abbott, A. & Öberg, B. (2017). Altered somatosensory profile according to quantitative sensory testing in patients with degenerative lumbar spine disorders scheduled for surgery. BMC Musculoskeletal Disorders, 18, Article ID 264.
Open this publication in new window or tab >>Altered somatosensory profile according to quantitative sensory testing in patients with degenerative lumbar spine disorders scheduled for surgery
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2017 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, article id 264Article in journal (Refereed) Published
Abstract [en]

Background: Somatosensory profiling in affected and non-affected body regions can strengthen our insight regarding the underlying pain mechanisms, which can be valuable in treatment decision making and to improve outcomes, in patients with degenerative lumbar spine disorders pre-surgery. The aim was to describe somatosensory profiles in patients with degenerative lumbar spine disorders, to identify the proportion with altered somatosensory profile, and to analyze demographic characteristics, self-reported function, pain, and health pre- and 3 months post-surgery. Methods: In this prospective cohort study in a Spine Clinic, 105 patients scheduled for surgery for spinal stenosis, disc herniation, degenerative disc disease, or spondylolisthesis were consecutively recruited. Exclusion criteria were; indication for acute surgery or previous surgery at the same spinal level or severe grade of pathology. Quantitative sensory testing (QST) and self-reported function, pain, and health was measured pre- and 3 months post-surgery. The somatosensory profile included cold detection threshold, warmth detection threshold, cold pain threshold, heat pain threshold and pressure pain threshold in affected and non-affected body regions. Results: On a group level, the patients somatosensory profiles were within the 95% confidence interval (CI) from normative reference data means. On an individual level, an altered somatosensory profile was defined as having two or more body regions (including a non-affected region) with QST values outside of normal ranges for reference data. The 23 patients (22%) with altered somatosensory profiles, with mostly loss of function, were older (P = 0.031), more often female (P = 0.005), had higher back and leg pain (P = 0.016, 0.020), lower mental health component summary score (SF 36 MCS) (P = 0.004) and larger pain distribution (P = 0.047), compared to others in the cohort. Post-surgery there was a tendency to worse pain, function and health in the group with altered somatosensory profile pre-surgery. Conclusions: On a group level, patients with degenerative lumbar spine disorders scheduled for surgery were within normal range for the QST measurements compared to reference values. On an individual level, an altered somatosensory profile outside of normal range in both affected and non-affected body regions occurred in 22% of patients, which may indicate disturbed somatosensory function. Those patients had mostly loss of sensory function and had worse self-reported outcome pre-surgery, compared to the rest of the cohort. Future prospective studies are needed to further examine whether these dimensions can be useful in predicting post-surgery outcome and guide need of additional treatments.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2017
Keywords
Disc herniation; Spinal stenosis; Spondylolisthesis; Degenerative disc disease; Spine surgery; Quantitative sensory testing; Outcome
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-139285 (URN)10.1186/s12891-017-1581-6 (DOI)000403494900001 ()28623897 (PubMedID)
Note

Funding Agencies|Swedish Research Council [521-2019-3578]; Faculty of Medicine and Health, Linkoping University; County Council of Ostergotland, Linkoping, Sweden

Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2018-08-28
Theis, J. C., Grauers, A., Diarbakerli, E., Savvides, P., Abbott, A. & Gerdhem, P. (2017). An observational study on surgically treated adult idiopathic scoliosis patients' quality of life outcomes at 1- and 2-year follow-ups and comparison to controls.. Scoliosis and spinal disorders, 12(11)
Open this publication in new window or tab >>An observational study on surgically treated adult idiopathic scoliosis patients' quality of life outcomes at 1- and 2-year follow-ups and comparison to controls.
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2017 (English)In: Scoliosis and spinal disorders, ISSN 2397-1789, Vol. 12, no 11Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Prospective data on health-related quality of life in patients with idiopathic scoliosis treated surgically as adults is needed. We compared preoperative and 1- and 2-year follow-up data in surgically treated adults with idiopathic scoliosis with juvenile or adolescent onset. Results were compared to untreated adults with scoliosis and population normative data.

METHODS: A comparison of preoperative and 1- and 2-year follow-up data of 75 adults surgically treated for idiopathic scoliosis at a mean age of 28 years (range 18 to 69) from a prospective national register study, as well as a comparison with age- and sex-matched data from 75 untreated adults with less severe scoliosis and 75 adults without scoliosis, was made. Outcome measures were EuroQol-5 dimensions (EQ-5D) and Scoliosis Research Society (SRS)-22r questionnaire.

RESULTS: In the surgically treated, EQ-5D and SRS-22r scores had statistically significant improvements at both 1- and 2-year follow-ups (all p  < 0.015). The effect size of surgery on EQ-5D at 1-year follow-up was large (r = -0.54) and small-medium (r = -0.20) at 2-year follow-up. The effect size of surgery on SRS-22r outcomes was medium-large at 1- and 2-year follow-ups (r = -0.43 and r = -0.42 respectively). At the 2-year follow-up, the EQ-5D score and the SRS-22r subscore were similar to the untreated scoliosis group (p = 0.56 and p = 0.91 respectively), but lower than those in the adults without scoliosis (p < 0.001 for both comparisons).

CONCLUSIONS: Adults with idiopathic scoliosis experience an increase in health-related quality of life following surgery at 2-year follow-up, approaching the health-related quality of life of untreated individuals with less severe scoliosis, but remain lower than normative population data.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Adults, Idiopathic, Scoliosis, Surgery
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-136689 (URN)10.1186/s13013-017-0118-y (DOI)28413830 (PubMedID)
Available from: 2017-05-12 Created: 2017-05-12 Last updated: 2018-01-13Bibliographically approved
Lindbäck, Y., Tropp, H., Enthoven, P., Gerdle, B., Abbott, A. & Öberg, B. (2017). Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis.. European spine journal, 26(10), 2581-2588
Open this publication in new window or tab >>Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis.
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2017 (English)In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 26, no 10, p. 2581-2588Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate the association between pain sensitivity in the hand pre-surgery, and patient-reported outcomes (PROs) in function, pain and health pre- and post-surgery in patients with disc herniation or spinal stenosis.

METHODS: This is a prospective cohort study with 82 patients. Associations between pressure-, cold- and heat pain threshold (PPT, CPT, HPT) in the hand pre-surgery and Oswestry, VAS pain, EQ-5D, HADS, and Self-Efficacy Scale, pre- and three months post-surgery; were investigated with linear regression.

RESULTS: Patients with disc herniation more sensitive to pressure pain pre-surgery showed lower function and self-efficacy, and higher anxiety and depression pre-surgery, and lower function, and self-efficacy, and higher pain post-surgery. Results for cold pain were similar. In patients with spinal stenosis few associations with PROs were found and none for HPT and PROs.

CONCLUSIONS: Altered pain response in pressure- and cold pain in the hand, as a sign of widespread pain pre-surgery had associations with higher pain, lower function and self-efficacy post-surgery in patients with disc herniation.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Disc herniation, Quantitative sensory testing, Spinal stenosis, Spinal surgery, Widespread pain
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-136688 (URN)10.1007/s00586-017-4979-9 (DOI)000412841000013 ()28168345 (PubMedID)2-s2.0-85011710070 (Scopus ID)
Note

Funding agencies: Swedish Research Council [521-2019-3578]; Faculty of Medicine and Health, Linkoping University; County Council of Ostergotland, Linkoping, Sweden

Available from: 2017-05-12 Created: 2017-05-12 Last updated: 2018-08-27Bibliographically approved
Prowse, A., Aslaksen, B., Kierkegaard, M., Furness, J., Gerdhem, P. & Abbott, A. (2017). Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis.. World Journal of Orthopedics, 8(1), 68-76
Open this publication in new window or tab >>Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis.
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2017 (English)In: World Journal of Orthopedics, ISSN 2218-5836, E-ISSN 2218-5836, Vol. 8, no 1, p. 68-76Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate the reliability and concurrent validity of the Baseline(®) Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes.

METHODS: This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25° ± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline(®) Body Level/Scoliosis meter. Spearman's correlation analyses were used to estimate concurrent validity between the Baseline(®) Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer.

RESULTS: There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627).

CONCLUSION: The Baseline(®) Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.

Place, publisher, year, edition, pages
Baishideng Publishing Group Co., Limited, 2017
Keywords
Assessment, Posture, Reliability, Scoliosis, Validity
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-136687 (URN)10.5312/wjo.v8.i1.68 (DOI)28144582 (PubMedID)2-s2.0-85010505519 (Scopus ID)
Available from: 2017-05-12 Created: 2017-05-12 Last updated: 2017-06-06Bibliographically approved
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