摘要:

The authors conducted a prospective study of risk factors for Industrial back pain complaints among 3,020 aircraft manufacturing employees. The study subjects completed a cardiovascular risk questionnaire, and were asked about their smoking status and past medical history, Including previous back problems. Premorbid submaximal treadmill testing to predict maximum oxygen uptake (VO2max) was completed In 2,434 subjects who were not excluded from testing due to cardiovascular risk screening. During several years of subsequent follow-up, 279 subjects reported back problems. Those who reported smoking at the time of the premorbid examination were significantly more likely to report a subsequent back problem than nonsmokers (P= 0.002). When controlling for sex and age, cardiovascular fitness, as measured through VO2max, was not predictive of future back Injury reports (P= 0.26).

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The aim of this Intervention was to evaluate the effect of training on patient-handling skills and prospectively to assess the effect of skill on subsequent back pain and back injuries in nursing. Of a total of 255 nurses, 199 were assessed for their skill in patient-handling. One-half (control group) received traditional training in patient-handling, and the other half (trained group) received a curriculum of instruction totaling 40 hours. The skills of both groups were assessed on graduation. The control group was rated as less competent in patient-handling. Nurses in both groups were questioned about the prevalence of back pain and incidence of back injuries in the first year after graduation. In multiple regression analysis, the major risk Indicators for back injuries were poor patient-handling skill, low numbers of repetitions in the sit-up test, and high work-load scores. High score on the hysteria scale of Middlesex Hospital Questionnaire was a risk Indicator for all kinds of back pain. Though back pain was Independent of patient-handling skill, those rated as “bad” or “poor” had more back injuries (24%) than those who had been rated as “good” or “excellent” (2%) (P< 0.001), but the difference between the trained and control groups was not statistically significant. It was concluded that back Injuries may be prevented by the teaching of patient-handling skills.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Patients with chronic disabling low-back pain have poor prospects of returning to work. The authors tested a treatment program of functional restoration with behavioral support through 1 year prospective observation of patients disabled for an average of 19 months without evidence of surgically correctable disease. Ninety patients were studied: 59 program graduates, five program dropouts, 17 patients denied program authorization by their Insurance carriers, and six crossover patients. Three patients were admitted but refused to participate in the treatment program. Initial demographic, physical, and self-assessment attributes were similar for all four groups. At year's end, 81% of program graduates, 40% of the dropouts, and 29% of those denied the program had returned to work. All six crossover patients were working 6 months after treatment. Program graduates showed significant improvements in self-assessed pain, disability, and depression, and in physical capacities after 3 weeks of treatment. These improvements were maintained through the year except for partial decreases in frequent lifting, cycling endurance, and isokinetic trunk extension strength. Functional restoration with behavioral support is an effective treatment for patients with chronic, disabling low-back pain, as measured by self-assessments, physical capacities, and return to work.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Twenty-five patients (21 females and 4 males) with sacroiliac joint disorders were studied with roentgen stereophotogrammetry in physiologic positions as well as in the extreme of physiologic positions. There was a constant pattern of motion with different load, especially around the transverse axis. The rotations were small and in mean between extreme position 2.5° (0.8°-3.9°). The translation was, mean, 0.7 mm (0.1-1.6 mm). There was no difference between symptomatic and asymptomatic joints.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The cartilaginous end-plate is thought to play an important role in the nutrition of the intervertebral disc, and hence may be of significance in the etiology of back pain. The present study describes the biochemical and histologic properties of the end-plate and adjacent tissues in the young human adult lumbar spine. Thus, a datum is established in which to demonstrate variation with location and relationships between properties of different tissues. Results of the chemical analyses show a change in composition through the end-plate with that at the outer annulus and nearer the bone, having higher collagen but lower proteoglycan and water contents, than the end-plate nearest the disc at the nucleus. Histology demonstrated numerous disruptions along the end-plate, with Schmorl's nodes being present in several specimens. Where these occurred, the disc, and in some cases the end-plate, showed loss of proteoglycan compared with the surrounding tissue.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Length changes in the ligaments of human lumbar spine motion segments were investigated in order to find conditions under which unusual stress or stress reduction is found in the longitudinal ligaments and facet joint capsules. Flexibility measurements were performed under load. Increasing load and height reduction in the motion segment increases the flexibility. The anterior and posterior longitudinal ligament normally operate in the elastic part of their stress-strain curve. Destruction of the intervertebral disc leads to a dislocation of the centers of rotation in the motion segment. Two types of facet joint capsules were observed. Height reduction in the motion segment leads to abnormal strains in one type sooner than in the other, which can be normalized by slight flexion. Injection of a silicone compound into the disc normalizes many of the changes in the motion segment due to height reduction.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Magnetic Resonance Imaging (MRI) is a new multiplanar imaging technique that clearly demonstrates soft tissue anatomy. The lumbar spines of 26 males have been scanned. From the transverse scans, the position and cross-sectional areas of the muscles of the lumbar region were recorded. Regression analysis was performed to relate these values to trunk measurements and body weight. Sagittal scans were used to measure the angles to the vertical of the lumbar discs and of the skin overlying the spinous processes. The position of each lumbar disc relative to two skin points was measured. These parameters can then be used in biomechanical calculations of low-back forces.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The human spinal column, devoid of musculature, is incapable of carrying normal physiologic loads. In an in vitro experiment, the effect of simulated intersegmental muscle forces on spinal Instability was investigated. Intact and sequentially Injured fresh lumbar functional spinal units were subjected to three-dimensional biomechanical tests with Increasing muscle forces. With the application of muscle forces, range of motion (ROM) increased and neutral zone (NZ) decreased in flexion loading, while both ROM and NZ decreased in extension loading. In lateral bending, ROM and NZ were unaffected by the application of the muscle forces. In axial rotation, ROM decreased significantly, while NZ decrease was statistically insignificant. It was concluded that the action of the Intersegmental muscle forces is to maintain or decrease intervertebral motions after injury, with the exception of the flexion ROM, which increased with the application of muscle forces. In addition, the study suggested that Neutral Zone is a better Indicator of spinal instability than Range of Motion.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The cadaveric lumbar spines of nine young men killed in road accidents were subjected to a range of mechanical tests, and the results compared with the men's occupational and recreational histories. It was found that the compressive strength of the spines tended to increase with the level of physical activity in life, but the increase was significant only in the eight spines aged 18 or over. Compressive failure usually occurred in the vertebral body, but in three cases, the disc prolapsed into the vertebral canal; these discs came from three of the four most physically active individuals. It is concluded that physical activity strengthens both the vertebrae and the discs. A high level of activity can cause vertebral strength to exceed that of the discs.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The frequency of sciatic pain, lumbago, and nonspecific low-back pain (LBP) and factors related to these symptoms were determined among men occupied in machine operating (541 longshoremen and 311 earthmover operators), dynamic physical work (696 carpenters), and sedentary work (674 municipal office workers). Sciatic pain was more common among machine operators and carpenters than among office workers, and also more frequent among machine operators than among carpenters. The occupational differences were considerably smaller with regard to lumbago and nonspecific LBP. In multivariate analysis, occupation, age, reported back accidents, and postural load showed significant independent effects on the occurrence of sciatic pain. Allowing for other risk indicators, the relative risk was 1.3 contrasting machine operators with both office workers and carpenters, but carpenters had no excess risk as compared with office workers.

ISSN:0362-2436    

出版商:OVID    

年代:1989

数据来源: OVID