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Biomedical subjects

C D Tollison

Publications and source records attributed to C D Tollison.

At least 19 recordsLinked to original sources
PubMed1993

Compensation status as a predictor of outcome in nonsurgically treated low back injury.

Whether the compensation status of patients injured in occupational accidents influences treatment outcome remains a controversial issue. This article describes the treatment outcome status of compensated versus noncompensated patients who received comprehensive functional restoration treatment of low back pain in a hospital-based, interdisciplinary, occupational rehabilitation and pain management program. Results of this investigation revealed treatment outcome differences between the two groups in two of three measures at discharge (subjective pain intensity and return-to-work), and outcome differences in one of five measures at 6-month follow-up (subjective pain intensity). Interestingly, significant group differences in return-to-work rates noted at the time of treatment discharge were not found during the follow-up period, with no group outcome difference in return-to-work rates noted at 6-month follow-up.

Adult↗
PubMed1993

The comprehensive diagnosis of spinal pain. A new psychodiagnostic instrument.

The psychological assessment of patients suffering back pain has become a standard part of comprehensive diagnostic protocol and an accepted responsibility of the clinical practitioner. This is for good reason, since research confirms the value of psychological evaluation to clinical diagnosis, treatment planning, and the outcomes of both medical and surgical treatment. However, the traditional psychological tests developed for use with psychiatric patients and in mental health settings are not appropriate for nonpsychiatric orthopaedic patients with back pain. However, a psychometric instrument has recently been developed for use with patients in pain. The Post-Traumatic Personality Profile (P-3) is a 48-item, multiple-choice, paper-and-pencil instrument that takes only 15 to 20 minutes. This article discusses the psychometric properties of the P-3 and presents a typical test interpretation.

Back Pain↗
PubMed1990

Interdisciplinary treatment of low back pain. A clinical outcome comparison of compensated versus noncompensated groups.

Whether the compensation status of patients with chronic pain influences treatment outcome remains an issue. This article describes the treatment outcome status of compensated versus non-compensated chronic low back pain patients who received comprehensive functional restoration treatment in a hospital-based, interdisciplinary, industrial medicine and pain management program. Results of this investigation revealed compensated versus noncompensated treatment group outcome differences in three of the five outcome measures (increased physical activity levels, reduced pain intensity, and return to productivity) at discharge. The non-compensated group demonstrated a greater therapeutic response. These group differences appear to have neutralized gradually, with no group outcome differences noted at the three-month follow-up.

Adult↗
PubMed1990

Multiple spine surgical failures. The value of adjunctive psychological assessment.

The results of a retrospective 44-patient study of vocationally disabled patients who had undergone unsuccessful traditional lumbar spine surgical procedures for low back pain and/or lower extremity sciatic pain are presented. It was found that errors in patient selection and patient psychosocial pathology may have been contributory to the failures. If identified preoperatively, these conditions might have contraindicated one or more of the surgical procedures. The 24-month study required the completion of the Minnesota Multiphasic Personality Inventory by each patient; this test aids identification of patients who will be better served by treatment interventions other than surgery, or who may require psychological perioperative care.

Adult↗
PubMed1989

Comprehensive treatment of acute and chronic low back pain: a clinical outcome comparison.

A comparative clinical outcome study was conducted with two groups of physician-referred patients suffering either acute (Group A) or chronic (Group B) low back pain (LBP) and receiving treatment in a hospital-based comprehensive rehabilitation program. Twenty-six patients assigned to the acute-pain group suffered the onset of LBP within the preceding two months prior to treatment. Thirty patients assigned to the chronic pain group suffered the onset of LBP greater than six months prior to treatment. Results at discharge indicated minimal outcome differences between the treatment groups. However, at three-month follow-up the acute LBP group demonstrated a distinctly more favorable clinical outcome in terms of 1) maintenance of increased physical activity, 2) medication elimination, 3) reduction in subjective pain intensity, 4) reduction in healthcare utilization, and 5) return to productivity. Treatment implications regarding conservative versus restorative management approaches are discussed.

Acute Disease↗
PubMed1989

Pain clinic #13. Comprehensive pain center treatment of low back workers' compensation injuries. An industrial medicine clinical outcome follow-up comparison.

A clinical outcome follow-up comparison of treatment and nontreatment groups was conducted to investigate both the clinical and cost effectiveness of a hospital-based industrial medicine division offering inpatient pain treatment clinical services. Eighteen month followup data were collected on 63 patients participating in a pain treatment program and 37 patients referred for treatment but denied participation by their workers' compensation insurance company. Outcome data indicate that the population of workers' compensation low back injured patients participating in pain treatment programs subsequently consumed fewer analgesics, required fewer hospitalizations for additional diagnostics and/or treatment, required fewer additional surgery, and were more likely to return to employment than a comparison group of patients denied comparable treatment.

Adult↗
PubMed1988

Selected tricyclic antidepressants in the management of chronic benign pain.

Depression is often considered a symptom of intractable benign pain and is usually a situational or exogenous subtype. At our four hospital-based pain management centers we have evaluated and treated more than 5,000 patients for chronic pain. The treatment of more than 2,000 of these patients has included the administration of doxepin or amitriptyline. This article reviews the therapeutic use of selected tricyclic antidepressants in the treatment of chronic benign pain and depression, and emphasizes the blockage of serotonin reuptake as the mechanism of action. The benefits of doxepin and amitriptyline include sleep facilitation, low cardiotoxicity and incidence of anticholinergic effects, and anxiolytic properties.

Amitriptyline↗
PubMed1988

Pain clinic #9. Physical exercise in the treatment of low back pain. Part I: A review.

Physical exercise has been advocated as therapeutic in the treatment of low back pain as far back as 1937, when Williams proposed his now famous flexion exercises. Its current widespread use invites two questions: 1) what evidence is there to support this claim, and 2) which exercises have been proven beneficial? In this first paper of a three-part series, the literature is examined for answers to these questions. Subsequent articles will present practical clinical regimens of both stretching and strengthening exercises.

Back Pain↗
PubMed1988

Pain clinic #10. Physical exercise in the treatment of low back pain. Part II: A practical regimen of stretching exercise.

In the first article of this three part series, research evidence for physical exercise in the treatment of low back pain were examined and data documenting significant therapeutic benefits was identified. However, different types and philosophies of exercise abound and, in clinical practice, little research evidence exists for substantiating one approach over another. This article will outline a practical physical stretching program with both empirical and research value in the treatment of over 4,100 patients with complaints of low back pain.

Adult↗
PubMed1988

Pain clinic #11. Physical exercise in the treatment of low back pain. Part III: A practical regimen of strengthening exercise.

The first and second articles in this three-part series reviewed the research evidence for physical exercise in the treatment of low back pain and outlined a specific and practical program of stretching exercise. In this final paper, we will present and illustrate the remaining component of a physical exercise regimen utilized in the treatment of a large population of patients suffering either nonsurgical or postsurgical low back pain.

Back Pain↗
PubMed1985

Chronic low back pain: results of treatment at the Pain Therapy Center.

We evaluated the outcome of 100 consecutive patients with chronic benign low back pain admitted for comprehensive interdisciplinary rehabilitation at the Pain Therapy Center. The average patient had been disabled for nearly two years and had had two unsuccessful operations for pain relief. Seventy-two percent of the patients treated had open claims against their workmen's compensation carriers. Significant improvements were demonstrated in physical strength, stamina, endurance and overall level of physical activity, drug reduction, subjective pain intensity, and return to employment.

Adult↗