A Qualitative study exploring patient's experience of Cauda Equina Syndrome (CES) was carried out. The aim of this study was to identify how Cauda Equina Syndrome symptoms may be more effectively identified by patients and their clinician. Patient's symptoms and experiences of their condition were explored, including issues associated with bladder, bowel and sexual function A summary of the methods used and the results. Via in-depth questions, participants were enabled to share their stories within a confidential setting. Narrative analysis of the patient's story allowed symptom progression and recognition to be explored and language used by participants themselves to describe symptoms identified. Seven themes emerged from the study. The findings were used to develop clinical tools to assist in the consultation process of potential CES patients. Finally the tools were validated by CES patients and clinicians prior to use within a clinical setting The findings of this research have been utilised, working with patients as partners, to establish clear, sensitive and understandable language to use during clinical questioning of potential CES patients. This patient choice of language for sensitive questions has been replicated on a clinical cue card to use during the consultation and on a credit card sized leaflet to give to patients. Working with patients, clear methods of communication have been developed surrounding potentially embarrassing but critical symptoms in order to assist ‘bringing the individual patient and the surgical team together at the earliest practical opportunity’ No conflicts of interest Source of funding; Physiotherapy Research Foundation (Part of the CSP Charitable Trust registered charity 279882)Purposes of the study and background
Conclusion
Larger breasted women are at higher risk of wearing ill-fitting breast-support garments. Failure to support breasts during everyday activity can lead to physiological conditions including back and breast pain. This study aimed to identify initial and short-term (4 weeks) biomechanical change and patient reported outcome measures (PROMS) in larger breasted women with non-specific back pain (NSBP) when wearing different breast-support garments. 20 females (Age: 32.1±9.4 years; Bra sizes: 36DD-32K) with NSBP were recruited using modified red flags screening. Participants were tested initially in their usual bra, followed by the professionally-fitted and Optifit bras, in randomised order. Pre/post assessments comprised an established bra-fit assessment, body chart analysis, frequency of wear and pain, continuous-pain intensity (SF-MPQ-2), back stiffness and discomfort, neck disability and thoracic posture in standing using 3D-movement analysis. 100% of Usual and 90% of professionally-fitted bras failed the bra-fit assessment, compared to 5% with the Optifit. Though worn the least on average, a short-term intervention with the Optifit bra resulted in significant reductions in reported thoracic pain, clinically important reductions in neck disability, back pain frequency, continuous-pain intensity, stiffness and discomfort compared to the other bras. The Optifit and professionally-fitted bras significantly reduced reported lumbosacral pain compare to the usual bra. There was no initial change in thoracic posture with the Optifit bra however, significant improvements in flexion-extension posture were seen post-intervention.Background:
Methods & Results:
Low back pain (LBP) is widespread in all populations and is a worldwide health problem, which poses substantial challenges for clinical management. Individuals with LBP may reduce their symptoms by implementing self-managed at-home interventions. The theoretical design of the LumbaCurve™ promotes the principles of a passive gravity-assisted traction (PGAT) stretch of the lumbar and sacral region in order to reduce LBP. This study aimed to assess the clinical effectiveness of the LumbaCurve™ in the management of LBP when compared to a control group of standardised care. Following a screening form using Red Flags and STarT Back tools, 60 individuals with LBP were recruited to the 4-week intervention. Eligible participants completed a pre-intervention questionnaire and were randomly allocated to either ‘standardised care’ or ‘standardised care PLUS LumbaCurve™’ group. Intervention material was trialled for 4 weeks consecutively, followed by a post-intervention questionnaire. Pre and post assessments applied the Roland Morris Disability Questionnaire (RMDQ), Patient Reported Outcome Measures (PROMS).Background
Methods
Recent studies show massage is effective in reducing back pain and heat and warmth during massage increases an individual's sense of wellbeing. The Ceragem V3 automatic thermal massage bed utilises principles of thermal massage to provide a therapeutic tool for individuals with conditions including diabetes and back pain. Though the brand is well known globally and has much anecdotal evidence, little research has been done on what effect the bed has on individuals with back pain. This study aims to assess subjective experience and function of participants with back pain when using the Ceragem V3. Thirty-two participants (aged 35.2±9.9 years) with back pain (including sciatica) were recruited after screening using the Red Flags and STarT Back tools. The intervention comprised nine treatment sessions over three successive weeks using an automated thermal massage bed (Ceragem V3, Korea) in automatic mode. Body charts, Patient Reported Outcome Measures (PROM) and the Roland Morris Disability Questionnaire (RMDQ) were used to measure participant pain, stiffness, discomfort and disability levels pre and post intervention. Body chart analysis for pain location showed a significant reduction in reported pain in the thoracic and lumbosacral regions (p<0.01). PROMs showed a significant reduction in the number of days back pain was experienced (p<0.000) and clinically important reductions in back pain, stiffness and discomfort (p<0.000). There was also a significant reduction in RMDQ score (p=0.000).Background
Methods & Results
Back Pain is a worldwide problem that often interferes with work, daily activities and sleep. The stress and disability experienced at night by individuals with Low Back Pain (LBP) could be reduced by targeted treatments designed specifically for this period. This study aimed to assess the clinical effectiveness of a spinal alignment cushion in the management of LBP when compared to a control group of standardised care. 71 individuals (30 males, 41 females) with LBP were recruited to the 4-week intervention after screening using the Red Flags and STarT Back tools. Participants were randomly assigned to either the control (standardised care) or intervention group (standardised care plus spinal alignment cushion). Pre and post assessments were taken using the Roland Morris Disability Questionnaire (RMDQ) (0–24), the Core Outcomes Measure Index (COMI) (0–10), and a Pain and Comfort during Sleep VAS Assessment. Each post assessment was analysed using ANCOVA with corresponding pre-assessment as covariate. Significant differences were seen in the RMDQ in favour of the intervention group (P = 0.034) over the four week period. Significant differences were also seen in favour of the intervention group in the COMI score (P=0.008), the frequency (P=0.004) and intensity of back pain (P=0.000), joint/muscle stiffness (P=0.046) and intensity of back stiffness (P=0.022).Background
Methods & Results
Back pain has become a worldwide problem and excessive, repetitive rotation has been shown to cause tissue damage. A sleeping posture similar to that of the foetal position has been suggested to limit unnecessary rotation of the lumbar spine. The Rophi™ cushion, utilises this theory to provide spinal alignment and improved sleeping posture. This study aims to assess the subjective experience and biomechanical effects of the Rophi™ cushion in participants with simple mechanical lower back pain (LBP). Fifteen participants (aged 44 ± 9.7 years) with simple mechanical LBP were recruited using the Red Flags screening form. The kinematics of the pelvis, lower limbs, lumbar and thoracic spine were analysed in six degrees of freedom whilst the participants lay in a semi-foetal position. Visual analogue scales were used to measure participant pain and discomfort levels during sleep pre and post a one week cushion intervention. Kinematic results show the main significant difference in joint angles occurred at the hip in all three planes, and between the lower lumbar region and the pelvis in the coronal plane. Subjective experience showed a reduction in the number of days with poor sleep quality and a significant reduction in frequency and intensity of lower back pain and stiffness when waking.Background
Methods & Results
