Abstract:
STUDY DESIGN:Pragmatic randomized clinical trial. OBJECTIVE:This study investigated differences in the clinical outcomes of public physiotherapy (public PT) versus private physiotherapy (private PT) for general practitioner-referred patients with acute and chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA:Health care setting (i.e., public or private) has been found to influence the course and clinical outcome of common diseases. Despite the international burden of LBP, the effect of health care setting on clinical outcomes has not been investigated in this population. METHODS:One hundred sixty consenting patients, who were referred for physiotherapy for LBP by their general practitioner, completed the Roland Morris Disability Questionnaire (primary outcome), Short-Form 36 v2, Fear Avoidance Beliefs Questionnaire, Back Beliefs Questionnaire, EuroQol EQ5D, and Patient Satisfaction Questionnaires. The patients were stratified (acute LBP: ≤ 3 months, n = 55; chronic LBP: > 3 months, n = 105), randomly allocated to receive public PT (n = 3 hospitals) or private PT (n = 12 clinics), and followed up at 3, 6, and 12 months postrandomization. RESULTS:Repeated measures analysis of variance showed significant improvement over time for 9 predominantly biomedical outcomes: (i) Roland Morris Disability Questionnaire at 3 and 6 months, (ii) Short-Form 36 v2 Physical Component Score, Bodily Pain, Role Physical, General Health, Vitality, EQ5D visual analogue scale, and weighted health index scores at 3 months, and (iii) the Back Beliefs Questionnaire at 6 months. The remaining 7 biopsychosocial outcomes showed no change over time, and the "between within" repeated measures analysis of variance showed no significant differences between groups over time for any outcome measures (P > 0.05). Independent samples t tests found no significant differences between groups in the mean changes in outcome measures from baseline at 12 months, apart from SF-36 v2 Role Physical (mean difference, 95% CI = 5.64 [0.860-10.428]; t = 2.337; P = 0.021) in favor of the private PT group. There were significantly higher levels of satisfaction with outcome of treatment in the private PT group (median [IQR]: public PT: 5.0 [2.0]; private PT: 6.0 [2.0]; Mann-Whitney U test = 1324.50; P = 0.020), but no differences in satisfaction with treatment or global perceived improvement (P > 0.05). The private PT group had a significantly shorter waiting time (mean difference = 39.79 days; 95% CI: 26.88-52.69; t = 6.121; P < 0.001) and treatment duration (mean difference: 23.48 days; 95% CI: 7.43-39.52; t = 2.909; P = 0.005) than public PT. Participants in both groups were treated with advice/education, manipulative therapy, and exercise therapy, with minimal use of cognitive behavioral approaches in either group. Physiotherapists in the private PT group had significantly more experience and more postgraduate qualifications than the public PT group (P < 0.005). CONCLUSION:Despite differences between public and private PT regarding waiting times for treatment and therapist experience, there were no significant differences between groups in the majority of clinical outcome measure scores at follow-up, apart from SF-36 Role Physical and satisfaction with treatment outcome in favor of the private PT group.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Casserley-Feeney SN,Daly L,Hurley DAdoi
10.1097/BRS.0b013e3182127457subject
Has Abstractpub_date
2012-01-15 00:00:00pages
85-96issue
2eissn
0362-2436issn
1528-1159journal_volume
37pub_type
杂志文章,多中心研究,随机对照试验相关文献
SPINE文献大全abstract:STUDY DESIGN:An experimental animal study. OBJECTIVE:To investigate the relationship between pain-related behavior and the expression of neurotrophic factors in the dorsal root ganglion (DRG) and spinal cord (SC) using a nucleus pulposus (NP) rat model. SUMMARY OF BACKGROUND DATA:Neurotrophic factors are released fro...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002223
更新日期:2018-01-01 00:00:00
abstract:STUDY DESIGN:Case report (level V evidence). OBJECTIVE:We report a case of a 33-year-old man with Marfan syndrome that visited our clinic for left knee pain and stiffness. Radiographs of the left knee and lumbar spine demonstrated a spinal rod in the posterolateral left knee and its origin being a broken rod from his ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000003804
更新日期:2021-02-01 00:00:00
abstract:STUDY DESIGN:Cross-sectional study to evaluate the thoracic and lumbar spine in patients with diastrophic dysplasia (DD). OBJECTIVES:To find the causative factors behind the spinal deformities and restricted mobility of the spine. SUMMARY OF BACKGROUND DATA:Typical findings in this skeletal dysplasia are short-limbed...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200101150-00014
更新日期:2001-01-15 00:00:00
abstract::This study evaluated the effect of angled insertion of halo pins on the biomechanical characteristics of the halo pin-calvarium complex. Halo pins were inserted into isolated calvarium sections at 90 degrees, 75 degrees, and 60 degrees to the surface of the bone at an insertional torque of 0.68 N-m (6 inch-pounds). In...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198908000-00001
更新日期:1989-08-01 00:00:00
abstract:STUDY DESIGN:A case report. OBJECTIVES:To describe the unique challenges and novel surgical approach to treatment of vertebral osteosarcoma involving the dura as a margin. SUMMARY OF BACKGROUND DATA:Osteosarcoma of the vertebral column is a rare, malignant osseous tumor, carrying a poor prognosis. Currently, best ava...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000153396.39009.a3
更新日期:2005-02-15 00:00:00
abstract:STUDY DESIGN:A retrospective clinical study. OBJECTIVE:To evaluate the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) as the primary graft material for the surgical treatment of vertebral osteomyelitis. SUMMARY OF BACKGROUND DATA:The clinical and radiographic results using allograft, autograft, and v...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0b013e3181657ee3
更新日期:2008-03-01 00:00:00
abstract:STUDY DESIGN:We used the Climent Quality of Life for Spinal Deformities Scale prospectively in a nonrandomized prospective comparative cohort of operative versus observational management of adolescent idiopathic scoliosis. OBJECTIVE:To compare the change in disease-specific quality of life associated with operating on...
journal_title:Spine
pub_type: 临床试验,杂志文章
doi:10.1097/BRS.0b013e31815a51cd
更新日期:2007-11-15 00:00:00
abstract:STUDY DESIGN:Retrospective clinical study. OBJECTIVE:The aim of this study was to examine whether the Tokuhashi score correlates with the neurologic outcome in early surgical treatment in metastatic spinal cord compression (MSCC). A retrospective analysis of 35 consecutive incomplete tetraplegic and paraplegic patient...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318188b98f
更新日期:2008-11-15 00:00:00
abstract:STUDY DESIGN:The effect of intravenous administration of hypertonic saline on leukocyte adhesion after compression injury of the spinal cord was evaluated. OBJECTIVES:To investigate changes in leukocyte adhesion after spinal cord injury and to evaluate the effect of hypertonic saline on this process. SUMMARY OF BACKG...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199811150-00018
更新日期:1998-11-15 00:00:00
abstract:STUDY DESIGN:A case of cervical myelopathy with a severe nape and upper arm pain caused by anomalous bilateral vertebral arteries is reported. OBJECTIVE:To report over six and a half years results of a microsurgical decompression for high cervical myelopathy with a severe pain of nape and upper arm resulting from spin...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31817c6c17
更新日期:2008-08-01 00:00:00
abstract:STUDY DESIGN:A prospective multicenter cohort study. OBJECTIVE:To establish the relationship between preoperative quantitative magnetic resonance imaging (MRI) parameters and clinical presentation and postoperative outcomes in patients with cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA:Correlation of ma...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0000000000000436
更新日期:2014-08-15 00:00:00
abstract:STUDY DESIGN:A three-dimensional finite element investigation. OBJECTIVES:To create a three-dimensional finite element model of the cervical spinal cord enlargement and to simulate a hyperextension injury of the cervical cord. SUMMARY OF BACKGROUND DATA:Experimental studies are difficult to simulate the complex mecha...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31819e2af1
更新日期:2009-05-15 00:00:00
abstract:STUDY DESIGN:Cross-sectional study. OBJECTIVE:To examine the demographic characteristics, etiology, and the type and degree of disability of both traumatic and nontraumatic spinal cord injuries (SCIs) managed in a tertiary care hospital in Malaysia. SUMMARY OF BACKGROUND DATA:There is a lack of data on the epidemiolo...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31826ef594
更新日期:2013-03-01 00:00:00
abstract:STUDY DESIGN:A report of a patient in whom progressive symptomatic thoracolumbar scoliosis developed after breast reconstruction with a latissimus dorsi myocutaneous flap. OBJECTIVES:To present the first reported case of progressive symptomatic scoliosis after breast reconstruction with a latissimus dorsi myocutaneous...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200003010-00014
更新日期:2000-03-01 00:00:00
abstract:STUDY DESIGN:This was a population-based retrospective study. OBJECTIVE:To fully estimate the costs of the Hong Kong scoliosis screening program through a large, population-based study. SUMMARY OF BACKGROUND DATA:School screening for scoliosis has often been criticized for having high costs. In fact, the screening co...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181cbcc10
更新日期:2010-12-15 00:00:00
abstract:STUDY DESIGN:A prospective assessment, performed using the Health Status Questionnaire, of the outcomes for 28 patients with cervical radiculopathy treated with one- or two-level anterior cervical discectomy and fusion. OBJECTIVE:To assess patient outcome using the Health Status Questionnaire after one- or two-level a...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200004010-00007
更新日期:2000-04-01 00:00:00
abstract:STUDY DESIGN:Analysis of a prospective multicenter database. OBJECTIVE:To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002717
更新日期:2018-10-15 00:00:00
abstract:STUDY DESIGN:Mixed-method. OBJECTIVE:To evaluate the association between objective and subjective cervical range of motion (ROM) among patients with neck pain, and to assess the awareness of impairments. SUMMARY OF BACKGROUND DATA:Cervical ROM is frequently used to evaluate neck pain, but it is also important to know...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002627
更新日期:2018-09-15 00:00:00
abstract:STUDY DESIGN:Laboratory investigation, ex vivo. OBJECTIVE:Postoperative complications are common after spinal implantation procedures, and magnetic resonance imaging (MRI) would be the ideal modality to image these patients. Unfortunately, the implants cause artifacts that can render MRI nondiagnostic. The WARP-turbo ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182a58b14
更新日期:2013-11-15 00:00:00
abstract::Diagnostic cervical medial branch blocks and zygapophysial joint blocks were used to test the hypothesis that the cervical zygapophyseal joints can be the source of pain in patients with idiopathic neck pain. Complete temporary relief of all symptoms was obtained in 17 out of 24 consecutive patients. Two major groups ...
journal_title:Spine
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:STUDY DESIGN:Cylindrical cages and pedicle screw fixation (PSF) have been used for the setting of a lumbar interbody fusion. OBJECTIVE:To investigate the effects of PSF-nut loosening on lumbar interbody fusion based on the elasto-plateau plasticity of bone characteristics. SUMMARY OF BACKGROUND DATA:The stress-strain...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181b6258a
更新日期:2010-03-15 00:00:00
abstract:STUDY DESIGN:Retrospective analysis using kinetic magnetic resonance images (MRIs). OBJECTIVE:To investigate the relationship of changes in the sagittal alignment of the cervical spine on the kinematics of the functional motion unit and disc degeneration. SUMMARY OF BACKGROUND DATA:Normal lordotic alignment is one of...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181839733
更新日期:2008-11-01 00:00:00
abstract:STUDY DESIGN:A case of primary Ewing sarcoma of the lumbar spine is presented. OBJECTIVE:To present and review a rare case of primary Ewing sarcoma of the lumbar spine that required differentiation from spinal infection. SUMMARY OF BACKGROUND DATA:Primary Ewing sarcoma originating from the spinal column is very rare....
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181995ec2
更新日期:2009-04-20 00:00:00
abstract::The clinical features of many cases of low back pain is inadequately explained by anatomic abnormalities alone. A pathophysiologic mechanism that includes a combination of mechanical and biochemical factors is an alternative explanation that is accompanied by less paradox than a purely structural paradigm. A potential...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/00007632-199508150-00013
更新日期:1995-08-15 00:00:00
abstract::A nerve root impingement within a stenotic neuroforamen is a common sequela of cervical degenerative arthritis and herniated nucleus pulposus. Understanding of the effects of cervical position on foraminal size is important in the assessment of pathology and injury, for selection of a provocative maneuver to elicit sy...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199210000-00001
更新日期:1992-10-01 00:00:00
abstract:STUDY DESIGN:A retrospective assessment of 12 patients with pyogenic spondylitis accompanied by iliopsoas abscess treated by continuous irrigation with our new method between March 2003 and July 2005. OBJECTIVES:To present our method of treatment and to evaluate outcomes of 12 patients undergoing it. SUMMARY OF BACKG...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318067e35e
更新日期:2007-06-15 00:00:00
abstract:STUDY DESIGN:A case of intradural venous varix producing a mass-like lesion in the lumbar spine is reported. OBJECTIVE:To present a rare cause of an intradural mass lesion along the cauda equina. To present radiologic findings of this entity and to offer a hypothesis for its formation. SUMMARY OF BACKGROUND DATA:Epid...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.BRS.0000085359.59829.44
更新日期:2003-10-15 00:00:00
abstract:STUDY DESIGN:This is a prospective, randomized, double-blinded comparison of tranexamic acid (TXA), epsilon aminocaproic acid (EACA), and placebo used intraoperatively in patients with adult spinal deformity. OBJECTIVE:The purpose of this study was to provide high-quality evidence regarding the comparative efficacies ...
journal_title:Spine
pub_type: 杂志文章,随机对照试验
doi:10.1097/BRS.0000000000000799
更新日期:2015-04-15 00:00:00
abstract:STUDY DESIGN:Prospective study of the sagittal plane alignment of the spine and pelvis in the normal pediatric population. OBJECTIVES:To document the sagittal alignment of the spine and pelvis and its change during growth in the normal pediatric population. SUMMARY OF BACKGROUND DATA:Pelvic morphology as well as sagi...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000132312.78469.7b
更新日期:2004-08-01 00:00:00
abstract:STUDY DESIGN:Retrospective cohort study. OBJECTIVE:To validate the precision of four predictive scoring systems for spinal metastatic disease and evaluate whether they underestimate or overestimate survival. SUMMARY OF BACKGROUND DATA:Metastatic spine disease is a common complication to malignancies. Several scoring ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000003289
更新日期:2020-03-15 00:00:00