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Effect of Additional Lumbosacral Corset on the Outcome of Patients With Non-Specific Acute Low Back Pain at the Aga Khan University Hospital, Nairobi

Thesis Info

Author

Mwenda, Stanley Aruyaru

Department

General Surgery (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2016

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728046520

Similar


Introduction: Low back pain (LBP) is a common problem world over affecting 60-90% of the population in their lifetime. It is a leading reason for hospital admission, healthcare spending, workplace absenteeism and years lived with disability. Up to 90% of patients suffering from low back pain do not have a serious pathology warranting imaging or further intervention besides symptom relief. These are categorized as having non- specific low back pain. This has a good prognosis running a short course of 3 to 6 weeks. The management of non-specific acute LBP entails analgesia and non-pharmacologic interventions (back school and physical therapy). Many modalities of physical therapy are often employed for non-specific acute LBP. The use of lumbosacral corset as a physical therapy for non-specific acute LBP has not been clearly supported with scientific evidence. However, it is commonly prescribed for this category of patients. It is important to assess the effect of this modality on the outcome of patients with non- specific acute LBP. Objective: To assess the outcome (change in back specific disability) of patients with non-specific acute low back pain treated with a lumbosacral corset in addition to a standard analgesic protocol compared to those on a standard analgesic protocol alone over a 3- week duration at the Aga Khan University Hospital, Nairobi, Kenya. Methods: A two-arm single blinded randomized controlled trial was carried out involving 82 consecutively sampled patients. Patients were randomized to analgesic protocol alone or analgesic protocol and a lumbosacral corset and followed up weekly for three weeks. Back specific disability was assessed using the Oswestry Disability Index (ODI). The primary outcome was the mean change in the ODI score between the two arms. We analyzed the data by use of repeated masures ANOVA. Results: Seventy-nine patients were analysed. The baseline characteristics were similar. There was a significant effect of time on the ODI (F=(1.38, 106.56)=207.89, P=.000). There was a statistically significant difference in ODI score between the two arms favouring the intervention arm ( F (1, 27)=4.23, p=.043). The difference in pain score and days off duty was not statistically significant. The number of days off duty was comparable between the two arms. Compliance to use of lumbosacral corset was good with mean of 1 day off the corset. The maximal change in both ODI and pain score occurred between the first and second reviews indicating maximum clinical improvement with the first week. Conclusion: Compared
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۲۳۔ گلِ امید

گلِ امید

 الفاظ کے نشتر میری سماعتوں کو چیرتے ہوئے

میرے دل میں پیوست ہو رہے تھے

یوں لگ رہا تھا جیسے

میرے احساسات کسی راہِ پُر خار سے گزر رہے ہوں 

میری تھر تھراتی ہوئی زبان کچھ بھی کہنے سے قاصر تھی

نجانے کتنے ہی جملے زباں کی نوک تک آتے آتے دم توڑ گئے

میں حواس باختہ یوں بیٹھا تھا

جیسے کوئی بہرا…صدائوں سے بہت دور

 خیالات نے ہر چیز کو ’’لا‘‘ کے پیمانے پر رکھ دیا تھا

من خصائص النصانية القرآنية: النسخ

Since the “text” has received attention of all modern and post modern scholars and linguists, it has been changed. This “text” has different segments, some of them are applicable to Holy Qur’ān on the one hand, on the other hand there are some un-applicable too in connection of two textual boundaries of the “text”; bounded and un-bounded. From here many scholars declare that modern defined textual theory is totally un-applicable to Holy Qur’ān. Therefore, many Qur’ānic commentators and scholars refused “Intertextuality” with its all aspects. Anyhow some other scholars allow “Intertextuality” to be applied to Holy Qur’ān because of many Qur’ānic scholars have been interpreting this sacred text using the structural methods upon which contextual and intertextual phenomena and all the relevant conceptual components of this are based, this research intends elaboration of such dimensions of Qur’ānic “Intertextulaity” and “Textuality”, in particular, the Qur’ānic textulaity; “al-Nasḵ”; abolition, deletion and abrogation.

Development of a Model of Organizational Citizenship Behavior Ocb : A Comparative Study of University Teachers from a Developing and a Developed Country

Extra-role behavior also called organizational citizenship behavior is critical for organizational effectiveness. The purpose of this study is to develop and test an integrated model of organizational citizenship behavior based on the framework of organizational effectiveness suggested by Katz (1964) in the specific context of university teachers. The study is specifically aimed at finding the individual and joint direct and indirect effect of human resource management practices (HRP) and transformational leadership style (TSF) on affective organizational commitment (AC) and organizational citizenship behavior (OCB) of university teachers in Pakistan (developing country) and England (developed country). No other study has modeled these variables together. Data was collected through mailed and self-administered questionnaires consisting of standardized scales. Two samples of university teachers, one from Pakistan (n=402) and other from England (n=188), based on complex probability sampling were used in the study. One-way ANOVA was used to find the association of demographic factors (public and private nature of university, designation, qualification, tenure, gender, marital status and age) with affective commitment and citizenship behavior of university teachers. It was found that most of demographic characteristics caused significant variation in both affective commitment and citizenship behavior of teachers in both Pakistan and England. Correlation analysis showed significant positive associations among all four study variables. Stepwise multiple regression analysis was used to find direct effect of predictors (HRP and TSF) on mediating (AC) and dependent (OCB) variables and indirect effect of predictors on dependent variable with mediation of affective commitment both jointly and individually. It was found that HRP and TSF have significant direct effects on both AC and OCB in Pakistan and England individually as well as jointly. AC is also significantly related to OCB in both Pakistan and England but variation explained by AC in OCB in England is substantially higher than in Pakistan. AC is also found perfectly mediating the relationship between both predictors and OCB in all three cases (1. HRP-AC-OCB, 2. TSF-AC-OCB, 3. HRP,TSF-AC-OCB) in England while in Pakistan mediation of AC is just partial in all of these cases. Results have been discussed in the light of past studies and implications for managers and researchers have also been suggested.