Biomedical subjects

Jan Hartvigsen

Publications and source records attributed to Jan Hartvigsen.

24 records · Page 2Linked to original sources

PubMed2002

[The association between physical workload and low back pain clouded by the "healthy worker" effect].

INTRODUCTION: Both physical and psychosocial workplace factors are considered risk factors for low back pain (LBP). However, today, no consensus has been reached regarding the exact role of these factors in the genesis of LBP. MATERIAL AND METHODS: Questionnaire data were collected at baseline for 1,397 (and after five years for 1,163) men and women aged 31-50 years at baseline. LBP (any LBP within the past year; LBP < or = 30 days in total during the past year; LBP > 30 days in total during tha past year) was analysed in relation to physical workload (sedentary, light physical, and heavy physical work) using logistic regression and controlling for age, gender, and social group. The proportions af workers changing between the workload groups over the five-year period were analysed in relation to LBP status. RESULTS: A baseline no statistically significant differences in LBP outcomes were found for workers exposed to sedentary, light physical, or heavy physical work. This was true for both genders and all age and social groups. At follow-up these was a statistically significant dose-response association between any LBP and long-standing LBP during the past year and increasing physical workload at baseline, also after controlling for age, gender and social group. Subjects with a heavy physical workload at baseline changed significantly more often to sedentary work, if they had experienced LBP for more than 30 days out of the past year. DISCUSSION: Having a sedentary job might have a protective or neutral effect in relation to LBP, whereas having a heavy physical job constitutes a significant risk factor. Because og migration between exposure groups (the "healthy worker" effect), longitudinal studies are necessary for investigating the associations between physical workload and LBP.

Adult↗

PubMed2002

[Does sitting at work cause low back pain?].

INTRODUCTION: Low back pain (LBP) is a common condition that, according to standard textbooks and several review articles, is associated with sitting-while-at-work. However, to our knowledge, no meta-analysis or critical systematic literature reviews have been published. MATERIALS AND METHODS: The Medline, Embase, and OSH-ROM databases were searched for articles dealing with sitting at work in relation to low back pain for the years 1985-1997. Original studies were divided into those dealing with sitting-while-working and those dealing with sedentary occupations. Each article was systematically abstracted for core items. The quality of each article was determined on the representativeness of the study sample, response rate, the definition of LBP, and the statistical analysis. RESULTS: Thirty-five reports were identified: 14 dealing with sitting-while-working and 21 with sedentary occupations. Eight studies were found to fulfill the above-mentioned criteria. Regardless of quality, all but one of the studies failed to find a positive association between sitting-while-working and LBP. High quality studies showed a marginally negative association for sitting compared to diverse workplace exposures, for instance standing, driving, lifting, bending, and compared to diverse occupations. One low quality study associated sitting in a poor posture with LBP. DISCUSSION: Out of 35 studies, only eight fulfilled the very basic quality criteria. Nevertheless, both high-quality and low-quality studies are consistently in agreement about the lack of positive association, and we conclude that the extensive recent epidemiological literature does not support the popular opinion that sitting-while-at-work is associated with LBP.

Global Health↗

PubMedDate not supplied

Translation and validation of the danish version of the Bournemouth questionnaire.

OBJECTIVE: Translation, cultural adaptation, and validation of the Danish version of the Bournemouth Questionnaire (BQ). METHODS: Translation/retranslation of the English version of the BQ was done blindly and independently by 4 different individuals and adapted by an expert team. The Danish version of the BQ was tested for face validity in a sample of low-back pain (LBP) patients attending 2 chiropractic clinics. Reproducibility was tested using 28 stable LBP patients attending a hospital outpatient back-pain clinic. Finally, the Danish version of the BQ was tested for external construct validity, external longitudinal construct validity, internal consistency, and sensitivity to change against the Danish versions of the SF-36 and the Roland-Morris Disability Questionnaire (RMDQ) using 118 first-time LBP patients reporting to 1 of 7 chiropractic clinics. RESULTS: Minor changes were made after the face-validity test. Intraclass correlation coefficient of the total score for the BQ based on the 2 administrations was 0.96. Satisfactory values for the external construct validity and the external longitudinal construct validity were found using both Pearson r and Bland-Altman plots. Cronbach alpha's were .89 and .88 for the pretreatment and posttreatment scores, respectively. The Danish version of the BQ showed greater responsiveness than the SF-36 and similar responsiveness when compared with the RMDQ. CONCLUSIONS: The BQ was successfully translated and culturally adapted into Danish. The BQ was successfully tested for validity, consistency, and responsiveness against the Danish version of the SF-36 and RMDQ.

Denmark↗

PubMedDate not supplied

Chiropractic patients in Denmark 2002: an expanded description and comparison with 1999 survey.

OBJECTIVE: The purpose of this study is to provide an expanded description of Danish chiropractic patients and to compare characteristics seen in a survey from 1999 with those seen in 2002. METHODS: All chiropractic clinics in Denmark were asked to collect information on new patients during 1 randomly assigned week in 2002 using a survey questionnaire. All 52 weeks of the year 2002 were represented with an even dispersion of weeks (182 clinics participated). Outcome measures included age, sex, education, occupation, location and duration of chief complaint, pain intensity, limitation of activities of daily living, mode of referral, duration of sick leave, previous treatments, comorbidity, SF-12, smoking habits, and use of x-ray. RESULTS: Eighty-five percent of all chiropractic clinics in Denmark participated in the study, and 1595 patients (81%) filled out a self-administered questionnaire. As in 1999, the most frequent area of complaint was pain related to the lower back and pelvis (49%). Contrary to the 1999 survey, most of the patients (64%) had complaints of less than 4 weeks of duration. Twenty-nine percent of the patients had been off work because of their symptoms; most of these for less than 1 week. Fifty-one percent of all patients were referred to chiropractors in 2002 (doubling since 1999). Referrals from general medical practitioners rose from 11% in 1999 to 17% in 2002. Sixty percent of all patients had similar symptoms in the past, and approximately half had previously received treatment of the same or a similar problem. Thirty percent of first-time chiropractic patients were x-rayed. Compared with general population measures, Danish chiropractic patients had significantly worse physical health status measured by the SF-12. CONCLUSIONS: Most Danish chiropractic patients complain of pain related to the spine, especially the lower back, with duration of symptoms of less than 4 weeks, and many with recurrent back pain. Referrals from general medical practitioners have increased since 1999.

Absenteeism↗

PubMedDate not supplied

Manual examination of the spine: a systematic critical literature review of reproducibility.

OBJECTIVE: Poor reproducibility of spinal palpation has been reported in previously published literature, and authors of recent reviews have posted criticism on study quality. This article critically analyzes the literature pertaining to the inter- and intraobserver reproducibility of spinal palpation to investigate the consistency of study results and assess the level of evidence for reproducibility. METHODS: Systematic review and meta-analysis were performed on relevant literature published from 1965 to 2005, identified using the electronic databases MEDLINE, MANTIS, and CINAHL and checking of reference lists. Descriptive data from included articles were extracted independently by 2 reviewers. A 6-point scale was constructed to assess the methodological quality of original studies. A meta-analysis was conducted among the high-quality studies to investigate the consistency of data, separately on motion palpation, static palpation, osseous pain, soft tissue pain, soft tissue changes, and global assessment. A standardized method was used to determine the level of evidence. RESULTS: The quality score of 48 included studies ranged from 0% to 100%. There was strong evidence that the interobserver reproducibility of osseous and soft tissue pain is clinically acceptable (kappa > or = 0.4) and that intraobserver reproducibility of soft tissue pain and global assessment are clinically acceptable. Other spinal procedures are either not reproducible or the evidence is conflicting or preliminary.

Humans↗

PubMedDate not supplied

Chiropractic patients in Denmark: a short description of basic characteristics.

BACKGROUND: The vast majority of information on chiropractic and chiropractic patients originates from English-speaking countries. Lately, however, reports describing chiropractic patients and practice in other European countries have emerged. OBJECTIVE: To describe basic characteristics of Danish chiropractic patients. DESIGN: Survey questionnaire. All chiropractic clinics in Denmark were asked to collect information on new patients during 1 randomly assigned week in 1999. SETTING: Private chiropractic practice and a nonprofit research institution. OUTCOME MEASURES: Age and sex, location and duration of chief complaint, pain intensity, limitation of activities of daily living from chief complaint, and mode of referral. RESULTS: Eighty-eight percent of all chiropractic clinics in Denmark participated in the study. Out of 2020 patients from the participating clinics, 1897 (94%) filled out a self-administered questionnaire. The mean age of participants was 42 years, and slightly more women than men returned the questionnaire. By far the most frequent area of complaint was pain related to the lower back (50%) followed by pain related to the neck (15%). The majority of patients had complaints in the subacute or chronic category (duration 1-6 months). Patients with sciatica had significantly higher pain scores and limitation in activities of daily living (ADL) than any other group, whereas patients with neck pain tended to score lower. Patients in the subacute category had the highest pain scores and limitation in ADL. For complaints lasting more than 6 months, limitation in ADL remained constant at a low level. Twenty-three percent of all patients were referred to the chiropractor, most frequently by a general medical practitioner. More than half of all patients had previously been treated for the same or similar problems, most frequently by a chiropractor. Fifty-one percent had also received chiropractic care for other types of problems. CONCLUSIONS: Most Danish chiropractic patients complain of pain related to the low back or neck of between 1 and 6 months' duration. This study confirms that chiropractic is fairly well integrated in the Danish primary health care system. There are differences between the chiropractic patient population in Denmark compared with that of Sweden and Holland.

Adolescent↗