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Factors affecting physical performance. Modified after Wormgoor and Björholt 1994. Terms from the ICF Classification (WHO 2001) are added to illustrate the multiplicity covered by the physical performance tests. Impairments are problems with body functions, e.g. muscular endurance, coordination or motivation. Activity limitations are problems such as fear avoidance behaviour.
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... In addition, the reliability of the measurement technique is seldom mentioned. 16,19,25,26 In clinical practice, it is also important to have a clinically applicable manner of testing NME. ...
This study evaluates age- and sex-specific reference values for neck muscle endurance (NME).
In this cross-sectional study, 116 randomly selected, healthy volunteers (ages 25-64 years) stratified according to age and gender participated. Dorsal and ventral NME was measured in seconds until exhaustion in a laying-down position. A weight of 4 kg for men or 2 kg for women was used in the dorsal procedure. The ventral procedure was performed without external load. Background and physical activity data were obtained and used in the analysis of NME performance.
Mean values for dorsal and ventral NME were about 7 and 2.5 minutes for men and 8.5 and 0.5 minutes for women, respectively. The cutoff values for subnormal dorsal and ventral NME were 157 and 56 seconds for men and 173 and 23 seconds for women, respectively. Women's NME was 122% of men's NME in the dorsal (P = .17) and 24% of men's NME in the ventral (P < .0001) procedure. There were no significant differences among age groups. In multiple regression analysis, physical activity explained 4% of variability in the performance of the dorsal NME; and sex explained 37% of the variability in the performance of ventral NME.
The reference values and the cutoff points obtained could be used in clinical practice to identify patients with a subnormal NME. Sex is an important consideration when using both the test procedure and the reference values.
... The natural history of non-specific low-back pain is that it is a recurrent problem, eventually during a long time span [177] affecting the ability to function in work and personal life [101]. As the word chronic might be associated with negative expectations the word long-term is preferred [84]. Low-back pain is a complex disorder where pain, anatomical, physiological, psychological and social aspects are involved. ...
Background:
Psychosocial factors precipitate and perpetuate the risk of developing long-term Low-Back Pain (LBP) with resultant disability. However, management of psychosocial aspects of LBP still remains a major challenge. This study investigated the effect of static or dynamic back extensors endurance exercise on psychosocial variables of Fear-Avoidance Behaviour (FAB), Pain Self-Efficacy Belief (PSEB) and Back Pain Consequences Belief (BPCB) in patients with LBP.
Methods:
A randomized-controlled trial of 67 patients assigned into McKenzie Protocol (MP) group (n = 25), MP and Static Endurance Exercise Group (MPSEEG; n = 22); and MP and Dynamic Endurance Exercise Group (MPDEEG; n = 20) was carried out. Treatment was applied thrice weekly for eight weeks.
Results:
The groups were comparable in general and baseline psychosocial parameters (p > 0.05). The different regimens had significant effects on all outcome parameters across baseline, 4th and 8th week (p < 0.05). The regimens were comparable in mean change scores on BPCB and FAB at the 4th and 8th week respectively (p > 0.05). MPDBEEG had higher mean change in PSEB at the 4th and 8th week respectively.
Conclusions:
McKenzie Protocol alone, or in combination with static or dynamic back extensors endurance exercise has comparable effect on FAB, PSEB and BPCB in patients with LBP. The addition of dynamic endurance exercise to the MP led to significantly higher positive effects on PSEB.
The aims of the study were to compare the relative electromyographic (EMG) activity of the extensor muscles at three different locations of the spine (cervical, thoracic and lumbar) during three different dorsal neck muscle endurance test procedures, in order to determine the procedure in which the dorsal neck muscles are maximally activated in asymptomatic individuals. The reliability for one of these test procedures was evaluated using an endurance test expressed in seconds in both healthy volunteers and patients with neck discomfort. Surface EMG activity of the spinal extensor muscles was acquired in three different locations during three different test procedures: the “extended neck lift”, and “straight neck lift” with light and heavy loads in 12 healthy volunteers. The “extended neck lift” was assessed for intra-rater reliability in 30 healthy volunteers and 10 patients with neck disorders and for inter-rater reliability in another 30 healthy volunteers and nine patients with neck disorders. EMG activation of the spinal extensor muscles was generally low. Only during the “extended neck lift” was there a slight tendency that cervical extensors were more activated compared with thoracic extensors. The reliability was good (ICC 0.80–0.94); however, the maximal intra-individual differences and the measurement error were large. The different test procedures used are comparable but there was a slight tendency for “the extended neck lift” to be a more selective measurement for the cervical extensors. The “extended neck lift” is reliable and could be appropriate for evaluating groups of patients.
Non-specific spinal pain (NSP), comprising back and/or neck pain, is one of the leading disorders in long-term sick-listing. During 2000-2004, 125 Swedish primary-care patients with non-acute NSP, full-time sick-listed 6 weeks-2 years, were included in a randomized controlled trial to compare a cognitive-behavioural programme with traditional primary care. This prospective cohort study is a re-assessment of the data from the randomized trial with the 2 treatment groups considered as a single cohort. The aim was to investigate which baseline variables predict a stable return-to-work during a 2-year period after baseline: objective variables from function tests, socioeconomic, subjective and/or treatment variables. Stable return-to-work was a return-to-work lasting for at least 1 month from the start of follow-up.
Stable return-to-work was the outcome variable, the above-mentioned factors were the predictive variables in multiple-logistic regression models, one per follow-up at 6, 12, 18 and 24 months after baseline. The factors from univariate analyzes with a p-value of at most .10 were included. The non-significant variables were excluded stepwise to yield models comprising only significant factors (p < .05). As the comparatively few cases made it risky to associate certain predictors with certain time-points, we finally considered the predictors which were represented in at least 3 follow-ups. They are presented with odds ratios (OR) and 95% confidence intervals.
Three variables qualified, all of them represented in 3 follow-ups: Low total prior sick-listing (including all diagnoses) was the strongest predictor in 2 follow-ups, 18 and 24 months, OR 4.8 [1.9-12.3] and 3.8 [1.6-8.7] respectively, High self prediction (the patients' own belief in return-to-work) was the strongest at 12 months, OR 5.2 [1.5-17.5] and Young age (max 44 years) the second strongest at 18 months, OR 3.5 [1.3-9.1].
In primary-care patients with non-acute NSP, the strong predictors of stable return-to-work were 2 socioeconomic variables, Low total prior sick-listing and Young age, and 1 subjective variable, High self-prediction. Objective variables from function tests and treatment variables were non-predictors. Except for Young age, the predictors have previously been insufficiently studied, and so our study should widen knowledge within clinical practice.
The aims of this study were to compare the aerobic fitness level of working patients who have recurrent low back pain with those of healthy age- and gender-matched controls, and to investigate the relationship of aerobic fitness level with pain intensity, general health, perceived disability, fear-avoidance beliefs and self-efficacy.
A total of 57 patients with recurrent low back pain, with a mean of 10 years' pain duration and 57 healthy controls performed a sub-maximal Astrand cycle test. Predicted maximum oxygen consumption was calculated and compared. Correlations between the low back pain patients' predicted aerobic fitness level and the assessed variables were calculated.
The women with low back pain had lower predicted aerobic fitness levels than the healthy women (p<0.05). For the men there was no such difference. Multiple regression analysis showed that age, gender, body mass index and self-efficacy were associated with the predicted aerobic fitness level.
This study suggests no overall difference in predicted aerobic fitness level for a sample of subjects with recurrent low back pain compared with healthy controls. This is perhaps because all the patients were still at work despite the pain. The results indicate, however, that the factors associated with aerobic fitness differ between men and women.
