OBJECTIVES: Chronic back pain is the most common cause of incapacity for work. The purpose of the study was to determine the effectiveness for activating the function of the deep stabilization system (DSS) in patients with chronic low back pain. METHODS: The effectiveness of three different methods was compared: Pilates method (PM), dynamic neuromuscular stabilization and balance aids on deep stabilization system function and pain perception in the lumbar spine. The group consisted of 75 patients. RESULTS: The results show differences in the effectiveness of the methods depending on the observed characteristics. The least significant differences were observed when comparing the Pilates method to balance aids. No statistically significant difference was observed in four out of five areas. The only area where a statistically significant effect of the exercise method got recorded was the intra-abdominal pressure test (p < 0.05). The lowest change was recorded in the measured values using the intra-abdominal pressure test at PM, and the highest change was recorded in Thomayer's values at dynamic neuromuscular stabilization. CONCLUSION: By comparing the three methods it was noted that each of them has its own positive reaction to the pain and the muscular apparatus. The most appropriate method to affect DSS function appears the dynamic neuromuscular stabilization (DNS) concept, where was the most significant improvement in DSS activation and the most significant reduction in chronic low back pain.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * therapy   rehabilitation   physiopathology   MeSH
• Pain Measurement MeSH
• Exercise Movement Techniques * methods   MeSH
• Exercise Therapy * methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Chronic low back pain (CLBP) is one of the most common musculoskeletal problems worldwide. Even though regular exercise is recommended as the primary conservative approach in treating this condition, significant part of patients lead sedentary lifestyle. Motivation to exercise is one of the variables that effects the adherence of exercise-based treatments. This study aimed to characterize the motives for exercise, as posited by self-determination theory, in persons with CLBP, and to identify subgroups (clusters) of motivational profiles in combination with socioeconomic and clinical characteristics using k-means cluster analysis. METHODS: Data were collected between September 2022 and September 2023. A total of 103 adults with CLBP completed the paper-pencil Exercise Self-Regulation Questionnaire (SRQ-E) and provided self-reported measures on anthropometric and socio-economic characteristics. Inclusion criteria were age (≥ 18 years) and non-specific CLBP (lasting longer than 12 weeks). Exclusion criteria included specific lumbar spine pathology (e.g., fracture, cancer), worsening neurological symptoms, recent injection therapy (within 3 months), and current alcohol or drug misuse. RESULTS: Three distinct motivational clusters were identified among the 103 participants: two clusters were characterized by predominantly autonomous motivation (moderately motivated cluster: 31.1%; highly motivated cluster: 54.4%), while one cluster (controlled convinced cluster: 14.6%) showed a higher level of controlled motivation. Associations were observed between the controlled cluster and factors such as higher disability scores, longer duration of pain, greater number of completed physiotherapy sessions, and elevated BMI. Notably, the controlled motivation cluster was linked with poorer clinical outcomes. CONCLUSIONS: This study provides insights into the exercise motivation of patients with CLBP, revealing that while most patients were primarily autonomously motivated, a notable subgroup exhibited lower, controlled motivation. The presence of controlled motivation was associated with worse functioning, longer pain duration, and increased utilization of physiotherapy services. Although these findings suggest a link between motivational profiles and clinical outcomes, the cross-sectional design limits causal inferences. Further research is needed to explore these relationships longitudinally. TRIAL REGISTRATION: ClinicalTrials.Gov Identifier: NCT05512338 (22.8.2022, NCT05512338).

• MeSH
• Chronic Pain * psychology   therapy   rehabilitation   MeSH
• Exercise psychology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * psychology   therapy   rehabilitation   MeSH
• Motivation * MeSH
• Surveys and Questionnaires MeSH
• Aged MeSH
• Exercise Therapy * methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Osteoartróza je multifaktoriáloní onemocnění, které postihuje velkou část populace. Uvádí se, že obraz osteoartrózy je při RTG vyšetření viditelný až u 60 % vyšetřovaných osob nad 65 let. Jedná se o jednu z nejčastějších příčin nemocnosti. Osteoartróza je až ve 20 % důvodem návštěvy ordinace praktického lékaře. U mladších osob může být příčinou vzniku invalidity. Jde o multifaktoriální degenerativní onemocnění kloubů, při kterém dochází k poruše obnovy kloubní chrupavky. Kloubní chrupavka ztrácí lesk, měkne a na jejím povrchu vznikají fisury. Postupně se stává chrupavka méně odolnou a dochází k jejím ztrátám. Subchondrální kost sklerotizuje a na okrajích kloubu se tvoří osteofyty. Druhotně jsou postiženy okolní měkké tkáně, zejména vazy. Osteoartróza kolenního kloubu (gonartróza) může postihovat mediální, laterální femorotibiální nebo femoropatelární oblast. Způsobuje bolest, typicky na začátku pohybu, bolest se stupňuje a je ovlivňována počasím. Pohyb je omezený a často jsou viditelné osové deformity. Rozlišujeme čtyři stupně gonartrózy dle RTG nálezu. Léčba zahrnuje režimová opatření, farmakoterapii a chirurgickou léčbu. Z analgetik lze použít nesteroidní antiflogistika, ostatní neopioidní a případně i opioidní analgetika. Často nejúčinnější je léčba nesteroidními antiflogistiky, které potlačují zánětlivou komponentu procesu. Vhodným zástupcem ze skupiny analgetik s protizánětlivými účinky je aceklofenak, preferenčně působící na COX-2 (1). Užívá se perorálně, rychle se absorbuje a jeho biologická dostupnost je téměř 100 % (2). Aceklofenak je dobře tolerován, je šetrnější pro GIT ve srovnání s většinou NSAIDs (3, 4). Kazuistika ilustruje postup léčby u polymorbidní pacientky s gonatrózou a chronickým vertebrogenním algickým syndromem lumbálního úseku páteře.

Osteoarthritis is a multifactorial disease that affects a large portion of the population. It is reported that the image of osteoarthritis is visible in X-ray examinations in up to 60% of examined individuals over 65. It is one of the most common causes of morbidity. Osteoarthritis accounts for up to 20% of visits to a general practitioner's office. In younger individuals, it can be a cause of disability. It is a multifactorial degenerative joint disease in which there is a disruption in the renewal of joint cartilage. The joint cartilage loses its luster, softens, and fissures form on its surface. Gradually, the cartilage becomes less resilient and losses occur. The subchondral bone becomes sclerotic, and osteophytes form at the edges of the joint. Secondarily, surrounding soft tissues, especially ligaments, are affected. Knee osteoarthritis (gonarthrosis) can affect the medial, lateral femorotibial, or femoropatellar area. It causes pain, typically at the beginning of movement, the pain intensifies and is influenced by the weather. Movement is limited, and axial deformities are often visible. We distinguish four degrees of gonarthrosis based on X-ray findings. Treatment includes regimen measures, pharmacotherapy, and surgical treatment. Analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs), other non-opioid, and possibly opioid analgesics can be used. The most effective treatment is often with NSAIDs, which suppress the inflammatory component of the process. A suitable representative from the group of analgesics with anti-inflammatory effects is aceclofenac, which preferentially acts on COX-2. It is taken orally, quickly absorbed, and its bioavailability is almost 100%. Aceclofenac is well tolerated and is gentler on the gastrointestinal tract compared to most NSAIDs. The case study illustrates the treatment procedure for a poly morbid patient with gonarthrosis and chronic vertebrogenic algic syndrome of the lumbar spine.

• Keywords
• aceklofenak,
• MeSH
• Anti-Inflammatory Agents, Non-Steroidal administration & dosage   therapeutic use   MeSH
• Osteoarthritis, Knee * drug therapy   pathology   MeSH
• Drug Therapy, Combination MeSH
• Comorbidity * MeSH
• Humans MeSH
• Low Back Pain drug therapy   MeSH
• Analgesics, Opioid MeSH
• Aged MeSH
• Tramadol administration & dosage   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• Keywords
• magnetostimulace,
• MeSH
• Adult MeSH
• Humans MeSH
• Low Back Pain rehabilitation   MeSH
• Pelvic Floor physiopathology   MeSH
• Urinary Incontinence, Stress * rehabilitation   MeSH
• Physical Therapy Modalities MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

BACKGROUND: Maladaptive fear of movement in individuals with low back pain may be associated with worse clinical outcomes. OBJECTIVE: To explore beliefs about the perceived dangers regarding different spinal postures within the Czech Republic. DESIGN: Exploratory cross-sectional study including physiotherapists and members of the general public. METHODS: Self-reported perceived safety/danger of "straight" and "flexed" spinal postures regarding 1) sitting, 2) lifting of light and 3) heavy object from the floor based on three pairs of photographs was measured using numeric rating scales (0-10, safe to dangerous) without any given context and in the context of low back pain. The sum of differences between the ratings of flexed and straight postures were used to calculate Bending Safety Beliefs Thermometer (BSBThermometer) total score potentially ranging -60‒60 (higher values indicates evaluation of flexed spinal postures as more dangerous in comparison to straight postures). RESULTS: 760 participants were included in the analysis. The mean BSBThermometer total score was 31.1 (SD 16.1) and higher scores were positively associated with being women (b = 14.8, 95% CI [9.9-19.8]); non-medical profession (b = 24.7, 95% CI [15.2-34.2]); age (b = 0.38, 95% CI [0.16-0.6]; and their interactions. There was no significant association with current low back pain status or history of low back pain. CONCLUSIONS: On average, participants evaluated "flexed" spinal postures as significantly more dangerous when compared with "straight" spinal postures, with only subgroups of physiotherapists scoring lower than the general public. Clinically, these beliefs could be targeted by individualized education, exposure-based interventions and public campaigns; however, further research is required.

• MeSH
• Adult MeSH
• Physical Therapists * psychology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * physiopathology   psychology   MeSH
• Posture * physiology   MeSH
• Cross-Sectional Studies MeSH
• Aged MeSH
• Fear psychology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

PURPOSE: The Core Outcome Measures Index (COMI) is a short, multidimensional instrument translated into several languages that covers five domains recommended in the assessment of outcome in patients with low-back and neck pain. The purpose of this study was to cross-culturally adapt the COMI from English to Czech language and to test the face and construct validity and reproducibility of its results in patients with low-back and neck pain. METHODS: Participants (n = 125) were included from primary and secondary care. The participants reported moderate pain and disability levels. All participants filled in the COMI forms before and after surgery. Descriptive statistics, Wilcoxon paired test, Crombach's alpha, principal component analysis and information entropy calculation were used. RESULTS: The instrument was successfully forward and back-translated. It can be seen that the questionnaire applied as part of our intervention study produces answers with a sufficient degree of variability and with a satisfactory degree of representation of extreme values. It can be also seen that the questionnaire can diagnose an objectively occurring change associated with the surgeon within the intervention procedure. Our other findings support the idea of ​​a possible reduction in the number of questions that measure the same latent variable. Our investigations also showed that it is possible to reduce the range of the point scale of the perception of pain to 5 degrees of intensity and thus unify the range with the other questions. CONCLUSION: The Czech COMI shows acceptable properties and is thus suitable to use as a short instrument for measuring important domains in patients with low-back and neck pain.

• MeSH
• Neck Pain * diagnosis   MeSH
• Adult MeSH
• Outcome Assessment, Health Care methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * diagnosis   MeSH
• Pain Measurement methods   MeSH
• Disability Evaluation MeSH
• Surveys and Questionnaires standards   MeSH
• Reproducibility of Results MeSH
• Aged MeSH
• Cross-Cultural Comparison * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

AIM: This study aimed to analyse cross-cultural differences in the prevalence of low back pain (LBP) and other back pain of general nurses in direct inpatient care in the Czech Republic (CZ) and Great Britain (GB). METHODS: The survey was used using an extended standardized Nordic Musculoskeletal Questionnaire and self-created additional questions. The data were analysed with Stata 15 using a significance level of 0.05. RESULTS: The data analysis was based on 1043 questionnaires. We identified statistically significant differences in the LBP prevalence between the respondents (CZ 93% and GB 85%) over a period of 12 months. Nurses in both countries stated a higher prevalence of LBP compared to pain in the neck, shoulders or upper back. LBP increases in relation to age, length of work experience, body mass index (BMI) and university education (BSc). Age, length of work experience, BMI and education (nursing college and master's degree) were confirmed as significant risks contributing to the increased prevalence of other back pain as well. Respondents reported a reduction in work performance, leisure activities and the need to change profession in relation to LBP. CONCLUSION: The results of the study confirm that LBP is a frequent occupational health issue in the general nurses working in direct inpatient care in both countries.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * epidemiology   MeSH
• Occupational Diseases epidemiology   MeSH
• Pilot Projects MeSH
• Prevalence MeSH
• Surveys and Questionnaires MeSH
• Cross-Cultural Comparison * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic MeSH
• United Kingdom MeSH

OBJECTIVES: This project aimed to promote running as the best treatment for lower back pain (LBP) in an outpatient setting. INTRODUCTION: LBP is one of the most prevalent conditions worldwide. Sixty-two percent of all Germans experience episodes of non-specific back pain at least once a year, with one-fifth developing chronic conditions. Intervertebral disc (IVD) degeneration is a natural process, contributing to periods of acute LBP. However, the scientific literature and guidelines partially overlook the significance of water management in IVD. This implementation project sought to address this gap by educating patients about this process. Running and/or walking were chosen as general approaches for treatment rather than specific disease-related approaches. METHODS: This implementation project was conducted in an outpatient physiotherapy clinic in Brandenburg, Germany, utilizing the JBI Evidence Implementation Framework. An evidence-informed clinical audit and feedback strategy was used to measure compliance with ten audit criteria. Five physiotherapists and 20 patients took part in the audits. RESULTS: At baseline, only 20% of participating physiotherapists screened for yellow flags regarding psychological issues. However, after project implementation, this criterion scored 100% compliance. Some patients performed exercises independently, but confusion persisted regarding the choice of beneficial exercises. Patients continued running, but those who took a break due to pain expressed uncertainty about resuming. CONCLUSIONS: The project highlighted the effectiveness of collaborative efforts between patients and therapists to address the issue. The project team's conviction in action and solution strategies serves as the foundation for this collaboration. This implementation strategy provided "running" patients with the confidence to either resume or reintegrate running after an extended break. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A222.

• MeSH
• Running * MeSH
• Adult MeSH
• Evidence-Based Practice MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * therapy   MeSH
• Physical Therapy Modalities * MeSH
• Exercise Therapy methods   MeSH
• Patient Education as Topic methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Germany MeSH

OBJECTIVE: Chronic low back pain, affecting up to 58% of the population, often stems from intervertebral disc degeneration. Although magnetic resonance imaging (MRI) is commonly used for diagnostics, challenges arise in pinpointing pain sources due to frequent asymptomatic findings. Single-photon emission tomography (SPECT) integrated with computed tomography (CT) offers a promising approach, enhancing sensitivity and specificity. METHODS: In this retrospective study, spanning 2016 to 2022, SPECT/CT imaging was performed on 193 patients meeting specific criteria. We correlated SPECT/CT findings with lumbar MRI results, utilizing Pfirrmann and Rajasekaran classifications for disc degeneration and endplate damage assessment. Logistic regression analysis adjusted for age and sex evaluated associations. RESULTS: Of 965 spinal levels assessed, SPECT/CT positivity strongly correlated with higher Pfirrmann grades and Rajasekaran endplate classifications. Notably, Modic changes (MCs) on MRI displayed a nonsignificant relationship with SPECT/CT positivity. Significant associations were observed in older patients with positive MCs, Pfirrmann grades, and Rajasekaran classifications. CONCLUSIONS: This comprehensive study, the largest of its kind, establishes a significant link between SPECT/CT positivity and advanced lumbar degenerative changes. Higher Pfirrmann grades and increased Rajasekaran endplate damage demonstrated substantial correlations with SPECT/CT positivity. Notably, MCs did not exhibit such association. Our findings underscore the potential of SPECT/CT in identifying pain generators in degenerative spinal conditions, offering valuable insights for future interventions.

• MeSH
• Lumbar Vertebrae diagnostic imaging   MeSH
• Chronic Pain diagnostic imaging   etiology   MeSH
• Intervertebral Disc Degeneration * diagnostic imaging   complications   MeSH
• Adult MeSH
• Tomography, Emission-Computed, Single-Photon methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * diagnostic imaging   etiology   MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Single Photon Emission Computed Tomography Computed Tomography methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: The Dynamic Neuromuscular Stabilization (DNS) diaphragm test and intra-abdominal pressure regulation test (IAPRT) are qualitative clinical tests that assess postural stability provided by the diaphragm. OBJECTIVE: Evaluate the inter-rater reliability of the diaphragm test and IAPRT between an experienced and novice DNS clinician among individuals with non-specific low back pain (LBP) and neck pain. METHODS: Forty-five participants with non-specific LBP and/or neck pain were assessed by an experienced and novice DNS physiotherapist in the diaphragm test and IAPRT, and scored on a visual analog scale (VAS) according to five different criteria. RESULTS: Moderate reliability was noted when assessing LBP and neck pain patients in the diaphragm test and IAPRT (p < 0.001). Moderate reliability also existed when assessing only LBP (p < 0.001) or neck pain (p = 0.002, p = 0.009) independently. Patients with lower pain (NPRS score of 5 or < ) demonstrated lower intra-class correlation coefficients, yet still moderate reliability in the diaphragm test (p = 0.004) and IAPRT (p = 0.001). Patients with higher pain (NPRS score of 6 or > ) demonstrated greater intra-class correlation coefficients, with the diaphragm test resulting in good reliability (p < 0.001). CONCLUSIONS: The diaphragm test and IAPRT demonstrate moderate reliability between an experienced and novice DNS clinician when evaluating LBP and neck pain patients, with a greater degree of reliability noted in patients suffering from higher reported pain.

• MeSH
• Neck Pain * physiopathology   diagnosis   MeSH
• Diaphragm * physiopathology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Low Back Pain * physiopathology   diagnosis   MeSH
• Pain Measurement methods   MeSH
• Observer Variation MeSH
• Postural Balance physiology   MeSH
• Reproducibility of Results MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH