Advertisement for orthosearch.org.uk
Results 1 - 9 of 9
Results per page:
Applied filters
Spine

Include Proceedings
Dates
Year From

Year To
Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_9 | Pages 32 - 32
1 Oct 2022
Astek A Sparkes V Sheeran L
Full Access

Background

Chronic low back pain (CLBP) is the leading cause of disability worldwide. Immersive virtual reality (IVR) can be delivered using head mounted display (HMD) to interact with 3D virtual environment (VE). IVR has shown promising results in management of chronic pain conditions, using different mechanisms (e.g., exposure to movement and distraction). However, it has not been widely tested for CLBP. Future development of IVR intervention needs inputs from gatekeepers to determine key considerations, facilitators and barriers. This qualitative study aimed to explore views and opinions of physiotherapists about IVR intervention for adults with CLBP.

Methods

Four focus groups were conducted online, with 16 physiotherapists. A demonstration of existing IVR mechanisms was presented. The data were transcribed and analysed through descriptive thematic analysis.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_10 | Pages 31 - 31
1 Oct 2019
Kyrou K Sheeran L
Full Access

Background and Purpose

Non-specific chronic low back pain (NSCLBP) poses a significant disability and economic burden worldwide. Fear avoidance is suggested to contribute to its chronicity and reduced treatment effect. National guidelines recommend exercise as a component of multidisciplinary rehabilitation but its interaction with fear avoidance is ambiguous.

This systematic review examined the effect of exercise-based interventions (EBIs) on fear avoidance NSCLBP.

Methods and Results

RCTs comparing EBIs to usual care in adults with NSCLBP were included. A systematic search of CINAHL, Medline, EMBASE, Web of Science, Scopus and Cochrane Library (up to January 2019) revealed 10 eligible trials. Following risk of bias assessment, 6 studies were included for data extraction and narrative synthesis. EBIs were not found superior to usual care in reducing fear avoidance at any follow-up. There was evidence that reducing fear avoidance is probably not the mechanism through which EBIs affect pain and disability. In adherent patients, EBIs did not result in greater clinically relevant improvements in pain or disability than usual care, in the short- or intermediate-term.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_10 | Pages 16 - 16
1 Oct 2019
Hemming R Rose AD Sheeran L van Deursen R Sparkes V
Full Access

Background

Trunk muscle activity and thoraco-lumbar kinematics have been shown to discriminate non-specific chronic low back pain (NSCLBP) subgroups from healthy controls. Thoracic spine kinematics and muscle activity whilst intuitively associated with NSCLBP, has received less attention and the possibility of intra-regional interactions remains an area for exploration.

Purpose

Determine relationships between muscle activation and kinematics in active extension pattern (AEP) and flexion pattern (FP) subgroups and no-low back pain controls during a sagittal bending task.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_10 | Pages 46 - 46
1 Oct 2019
Rathnayake A Sparkes V Sheeran L
Full Access

Purpose of the study and background

The preliminary study aimed to establish clinical and research expert opinion with regards to the key components of an assessment of a person with Mechanical Low Back Pain (MLBP). We aimed to identify the key subjective questions and objective tests which would be helpful for clinicians to develop the most appropriate self-management exercise programme. This is the first part of the study to develop the ‘Back-to-Fit’ digital tool offering personalised self-management exercise solutions for people with MLBP.

Summary of the methods

A Bristol online survey which included a questionnaire with a series of open and closed questions was developed using the literature and was distributed among clinicians/researchers with a background in the clinical management of MLBP. The questionnaire included 6 demographic questions followed by sections related to subjective questions and objective tests of the MLBP assessment. 71 participants responded to the survey.

Results

In the subjective assessment component, ≥80% level of agreement was obtained for 17 of 26 proposed subjective questions and 05 of the 21 suggested objective tests. Two more questions and two objective tests to be included in the assessment had been suggested by the partcipants.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_10 | Pages 5 - 5
1 Oct 2019
Alothman D Sheeran L Sparkes V
Full Access

Purpose of the Study

To assess the test-retest reliability, construct validity and determine the cut-off scoret of BACKonLINE™ for people with LBP.

Background

Appropriate treatment for Low back pain (LBP) is vital, however patients can wait for 14–24 weeks on NHS Physiotherapy lists. Many factors contribute to LBP and initially can be due to peripheral tissue damage. However, persistent LBP is associated with amplification in pain processing in the central nervous system (central sensitisation-CS). CS often results in poorer outcomes and often requires longer management making timely assessment and appropriate management crucial.

An online self-assessment and self-management tool (BACKonLINE™) for discerning between characteristics of predominantly centrally (CD) or peripherally (PD) driven LBP was developed using a Delphi study.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_9 | Pages 40 - 40
1 Sep 2019
Sheeran L Robling M
Full Access

Purposes of the study and background

Clinical assessment of spinal function is a routine part of low back pain (LBP) assessment, yet there is no clear consensus on what constitutes ‘spinal dysfunction’ and how this informs treatment. This study's aims to develop a spinal function classification framework by gaining expert academic and clinical consensus on (i) spinal function assessment tests (ii) encountered LBP motor control/movement impairment (MCI/MI) sub-types (iii) their characteristics and (iii) exercises and feedback for each sub-type.

Methods and Results

An online 2-round Delphi-survey of 4 world-leading academic experts and 36 clinical physiotherapists world-wide was employed. A five-point response scale was used to rate level of agreement on 174 items with a priori consensus defined by a ≠>80% level of agreement (LOA). Out of 15 spinal function assessment tests, 5 reached consensus with forward bend and sitting/standing tests highest scoring. 7 MCI/MI sub-types reached consensus as clinically encountered. 12 out of 128 of posture/movement descriptors within the 7 sub-types reached consensus. 7 exercises gained consensus in being considered as ‘important’ or ‘very important’ with exercises involving sitting, standing, forward bend scoring highest. Consensus was reached on MCI/MI sub-type specific exercises, compensation strategies and feedback to remedy these compensations.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 10 - 10
1 Feb 2018
Alothman D Sheeran L Sparkes V
Full Access

Purpose of the Study

To develop an online self-assessment and self-management tool (BACKonLINE™) for discerning between people with characteristics of predominantly centrally (CD) or peripherally (PD) driven LBP.

Background

Low back pain (LBP) may worsen with time, making appropriate treatment important. In the NHS Physiotherapy services LBP patients may wait for 14–24 weeks for treatments. Many factors contribute to LBP, but it is predominantly initially viewed as a result of peripheral tissue damage. However, evidence show that persistent LBP is associated with amplification in pain processing in the central nervous system (central sensitisation). Sometimes, this may drive symptoms, resulting in poorer outcomes and requiring longer management. Timely assessment and appropriate management is therefore paramount.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_2 | Pages 17 - 17
1 Feb 2015
Hemming R Sheeran L van Deursen R Sparkes V
Full Access

Background and Purpose of Study:

Differences in regional lumbar angles in sitting have been observed between subgroups of NSCLBP patients exhibiting motor control impairments (MCI) (O'Sullivan, 2005; Dankaerts et al, 2006). However, differences in standing posture and other spinal regions are unknown. This study aimed to compare regional spinal angles in healthy and MCI subgroups in sitting and standing.

Methods:

An observational, cross-sectional study investigated spinal kinematics of 28 Flexion Pattern (FP), 23 Active Extension Pattern (AEP) (O'Sullivan, 2005) and 28 healthy controls using 3D motion analysis (Vicon) during usual sitting and standing. Mean sagittal angle for Total Lumbar (TotLx), Total Thoracic (TotTx), Upper Thoracic (UTx), Lower Thoracic (LTx), Upper Lumbar (ULx) and Lower Lumbar (LLx) regions between groups were compared using one-way ANOVA.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_4 | Pages 35 - 35
1 Feb 2014
Sheeran L Hemming R Sparkes V
Full Access

Background

CB-CFT targeting specific pain provoking posture/movements in NSCLBP patients was shown more beneficial than current best practice. Resources for such interventions are substantial and so modifications for today's NHS are warranted. This study investigated feasibility and effect of CB-CFT delivered in a group setting (CB-CFT/G).

Methods

Twenty three patients referred to Physiotherapy with NSCLBP undertook (i) 6 week CB-CFT/G(n=13) or (ii) current best practice (C)(n=10). Outcomes: Oswestry Disability Questionnaire (ODQ), pain (VAS), fear avoidance (Tampa Scale of Kinaesiophobia;TSK), physical activity (International Physical Activity Questionnaire;IPAQ), distress&risk assessment (DRAM), StarTBack and satisfaction. Unpaired t-tests assessed between-group difference in mean change of each outcome (p<0.05).