Samuel Olusegun Ogunlade

Influence of Mckenzie protocol and two modes of endurance exercises on health-related quality of life of patients with long-term mechanical low-back pain

Introduction Long-term Mechanical Low-Back Pain (LMLBP) negatively impacts on patients’ physical capacity and quality of life. This study investigated the relationship between Health-Related Quality of Life (HRQoL) and pain intensity, and the influence of static and dynamic back extensors’ endurance exercises on HRQoL in Nigerian patients with LMLBP treated with the McKenzie Protocol (MP). Methods A single-blind controlled trial involving 84 patients who received treatment thrice weekly for eight weeks was conducted. Participants were assigned to the MP Group (MPG), MP plus Static Back Endurance Exercise Group (MPSBEEG) or MP plus Dynamic Endurance Exercise Group (MPDBEEG) using permuted randomization. HRQoL and pain was assessed using the Short-Form (SF-36) questionnaire and Quadruple Visual Analogue Scale respectively. Results Sixty seven participants aged 51.8 ± 7.35 years completed the study. A total drop-out rate of 20.2% was observed in the study. Within-group comparison across weeks 0-4, 4-8 and 0-8 of the study revealed significant differences in HRQoL scores (p < 0.05). Treatment Effect Scores (TES) across the groups were significantly different (p = 0.001). MPSBEEG and MPDBEEG were comparable in TES on General Health Perception (GHP) at week 4; and GHP and Physical Functioning at week 8 respectively (p > 0.05). However, MPDEEG had significantly higher TES in the other domains of the SF-36 (p = 0.001). Conclusion HRQoL in patients with LMLBP decreases with pain severity. Each of MP, static and dynamic back extensors endurance exercises significantly improved HRQoL in LMLBP. However, the addition of dynamic back extensors endurance exercise to MP led to greater improvement in HRQoL.

Rehabilitation of Back Extensor Muscles' Inhibition in Patients with Long-Term Mechanical Low-Back Pain

This study investigated the effect of static or dynamic back extensors endurance exercise in combination with McKenzie Protocol (MP) in patients with Long-term Mechanical Low-Back Pain (LMLBP). This randomized controlled trial involved 84 patients, who were assigned into MP Group (MPG), MP plus Static Back Extensors Endurance (SBEE) Exercise Group (MPSBEEG), or MP plus Dynamic Back Extensors’ Endurance (DBEE) Exercise Group (MPDBEEG). Twenty-five, 22, and 20 participants in MPG, MPSBEEG, and MPDBEEG, respectively, completed the thrice weekly eight-week study (drop-out rate = 20.2%) and outcomes were measured in terms of SBEE, DBEE, and Back Muscles Fatigue (BMF) at the 4th and 8th week, respectively. There were significant differences in groups mean change scores on SBEE (, and u2009sec), DBEE (, , and rep), and BMF (, , and ) at week 4, and SBEE (, , and u2009sec), DBEE (, , and reps), BMF (, , and ) at week 8, respectively (). It was concluded that MP alone, or in combination with SBEE or DBEE, exercise was effective in the rehabilitation of back extensors’ endurance and fatigability in patients with LMLBP. However, the addition of SBEE to MP led to significantly higher positive effects.

Comparative efficacy of three active treatment modules on psychosocial variables in patients with long-term mechanical low-back pain: a randomized-controlled trial

BackgroundPsychosocial 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.MethodsA randomized-controlled trial of 67 patients assigned into McKenzie Protocol (MP) group (nu2009=u200925), MP and Static Endurance Exercise Group (MPSEEG; nu2009=u200922); and MP and Dynamic Endurance Exercise Group (MPDEEG; nu2009=u200920) was carried out. Treatment was applied thrice weekly for eight weeks.ResultsThe groups were comparable in general and baseline psychosocial parameters (pu2009>u20090.05). The different regimens had significant effects on all outcome parameters across baseline, 4th and 8th week (pu2009<u20090.05). The regimens were comparable in mean change scores on BPCB and FAB at the 4th and 8th week respectively (pu2009>u20090.05). MPDBEEG had higher mean change in PSEB at the 4th and 8th week respectively.ConclusionsMcKenzie 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.

Incidence of back pain among women of child bearing age and its management during pregnancy

OBJECTIVE: There is a dearth of studies on history of back pain (BP) among women of child bearing age in Nigeria. The aims of this study were to investigate the history of incidence of BP among women of child bearing age and how pregnancy-related BP is being managed among this population. nMETHODS: A survey of 2,187 pregnant women attending ante-natal clinics in selected Medical facilities in Ibadan and Ogbomoso, Nigeria was carried out over a period of 2 years and 3 months using pre-tested close-ended questionnaire. Data obtained was analyzed using both descriptive and inferential statistics. RESULTS: One thousand and eight (52.5%) of the 1919 respondents had back pain during their current pregnancy. The mean age of those with and without back pain was 26.8 ± 5.3 and 27.1 ± 5.4 years respectively. Mean number of pregnancy was higher among respondents with back pain 2.6 ±1.50 than those without back pain 2.4±1.40. Incidence of BP was highest during current pregnancy 52.5%, during menses 341(17.8%) and it was least post-delivery 69(3.6%). Analgesics (50 .4%) and physical approaches (49. 6%) were nearly equally utilized in managing BP among the studied population. Side lying (78.2%) was the most preferred therapeutic position for relieving BP and supine lying was the least favored (22.6 %,) among the respondents in relieving BP. Standing up and walking around was found useful to relieve BP induced or aggravated by prolonged sitting or maintenance of static posture. CONCLUSIONS: Back pain is most prevalent during pregnancy and also troublesome during menses among women of child bearing age. Analgesic and postural modifications were the two major interventions utilised in managing BP among the pregnant women in this study. More treatment options needs to be promoted for holistic management of pregnancy-related back pain. n nKEYWORDS: Incidence, back pain, pregnancy, management.

Plating of Femoral Shaft Fractures: the Experience in an African Teaching Hospital

Background:Femoral shaft fractures are common presentation in our trauma units. It is obvious that all these fractures cannot be treated conservatively due to the pressure on trauma beds and thus a suitable method of internal fixation that is feasible in the environment has had to be adopted.Objective:This study is a report of our experience with plate fixation of femoral shaft fracture in our environment.Design:A retrospective hospital based study.Patient and Method:All patients with femoral shaft fractures stabilized with plates and screws between 1997 and 2004 at the University College Hospital were reviewed. The case notes were retrieved and data extracted from them; all case notes entry gave sufficient information.Results:The fracture pattern showed 56 cases (35.4%) of Type 32-A, 45 cases (28.5%) of Type 32-B and 57 cases (36.1%) of Type 32-C using AO classification. The outcome of treatment was excellent to good in 125 fractures (77.2%). The average time of healing was 20 weeks (range 16–48). Fracture related complications occurred in nine fractures (5.7%) which included deep infection in four fractures (2.5%) and implant failure in five fractures (3.2%).Conclusion:Femoral shaft plating gives good result if the principles of fixation is carefully followed and in developing countries where initial cost of procurement of equipments for closed nailing may not be forth coming, it thus provide a safe efficient and low cost method of fixation of femoral shaft fracture.