There is a need for non-radiographic, objective outcome measures for children with Adolescent Idiopathic Scoliosis (AIS). Standing balance and stability is altered in children with AIS. The Margin of Stability (MoS) has been used to compare gait stability in clinical populations. Our objective was to compare the MoS in anterior-posterior (MoSAP) and mediolateral (MoSML) directions in girls with AIS to Controls. Girls with AIS and healthy girls walked at three speeds on an instrumented treadmill wearing retroreflective markers, surrounded by motion capture cameras. The MoSAP/ML was calculated at left and right heel strike. Data was processed in Visual 3D. A two-way ANOVA was used to compare MoSAP/ML between group, speed and the interaction between group and speed. Pearson's correlation coefficient was used to compare the MoS to Cobb angle. Statistical significance was accepted when A priori power analysis suggested 12 participants per group. Three Cases and four Controls were recruited. Girls with AIS all had right-sided main thoracic curves (Lenke type 1a, 61.3° ± 10.0°). MoSAP was significantly bigger for Cases compared to Controls on the left ( Girls with Lenke type 1a AIS are more stable in the AP direction and less stable in the ML direction than Controls during treadmill walking. AP stability increases and ML stability decreases with increasing Cobb angle. This research suggests that the MoS could be used as an outcome measure for children with AIS. Continued work is required to increase the power of this study. Further work could consider these changes during walking overground, measuring an MoS or MoS-like measure using a wearable device, and in different curve types.
Traditional physiotherapy methods utilised in the management of NSCLBP have small effects on pain and disability and this is reflected by data previously collected by the host physiotherapy service. O'Sullivan has validated a novel classification system and matching treatment strategy known as Classification Based–Cognitive Functional Therapy (CB-CFT) for people with NSCLBP. Briefly, CB-CFT is a behavioural and functional management approach to NSCLBP. A recent RCT employing CB-CFT has demonstrated superior outcomes in comparison to traditional physiotherapy methods advocated by clinical practice guidelines. It was unknown if CB-CFT improved outcomes for people with NSCLBP attending an NHS physiotherapy service, therefore an evaluation of practice was proposed. People referred to physiotherapy with NSCLBP were assessed and treated by a physiotherapist trained in the delivery of CB-CFT. Primary outcomes of interest included the Oswestry Disability Index (ODI) and Numerical Pain Rating Scale (NPRS). A retrospective evaluation was performed for sixty-one people referred to physiotherapy with NSCLBP. Statistically significant improvements in disability (ODI p<0.001) and pain (NPRS p<0.001) were demonstrated. 88% of people achieved minimum clinically important change, defined as >10 points for the ODI and 75% of people achieved minimum clinically important change, defined as >2 on NPRS. Mean improvement of 24.7 points for the ODI and 3.0 for NPRS was observed immediately following CB-CFT, demonstrating large effect sizes of 1.56 and 1.21 respectively.Purpose and Background
Methods and Results
Previous work( EMG data was recorded from 192 subjects across two years (initial contact, 12 months and 24 months). The data were analysed and SCMs produced. The 30 second test data was split into 30 one second epochs. Colour values were scaled to the individual data set maximum and divided into 12 bands according to frequency strength at a particular point. Median Frequency values were calculated for each epoch and a line of best fit added to the colour map to further aid the diagnosis process. Maps with faulty recordings were excluded and 20 data sets from each group (BP and no BP) selected at random. Four observers were given only 5 minutes instruction and then asked to indicate whether they thought each map belonged to the LBP or no LBP group.Introduction
Methods
Herniated intervertebral disc tissue has been shown to produce a number of proinflammatory mediators and cytokines, but there have been no similar studies using discs from patients with discogenic low back pain. We have compared the levels of production of interleukin-6 (IL-6), interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in disc tissue from patients undergoing discectomy for sciatica (63) with that from patients undergoing fusion for discogenic low back pain (20) using an enzyme-linked immunoabsorbent assay. There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p <
0.006 and p <
0.003, respectively). The high levels of proinflammatory mediator found in disc tissue from patients undergoing fusion suggest that production of proinflammatory mediators within the nucleus pulposus may be a major factor in the genesis of a painful lumbar disc.
