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T Bendix

Publications and source records attributed to T Bendix.

At least 19 recordsLinked to original sources
PubMed2000

[Predictive factors of the effect of multidisciplinary, intensive rehabilitation of back pain. Demographic, socioeconomic and physical factors].

In order to identify possible predictive factors for success from rehabilitation in a functional restoration (FR) program for patients with chronic low back pain, pre-treatment baseline variables were correlated to different outcome parameters following treatment in either a FR program or control programs. A prospective clinical trial involving 816 patients was carried out. Of the total cohort 621 patients participated in a FR program and 195 in control groups. The results showed that different factors could be identified as useful in predicting outcome from a FR program, but most of these factors were also shown to predict success for controls of shorter outpatient programs or of no treatment.

Adult↗
PubMed1998

Can it be predicted which patients with chronic low back pain should be offered tertiary rehabilitation in a functional restoration program? A search for demographic, socioeconomic, and physical predictors.

STUDY DESIGN: A prospective clinical trial was conducted that involved six groups of patients with chronic low back pain selected from a large cohort (N = 816). OBJECTIVES: To correlate pretreatment baseline variables with outcome parameters after treatment in a functional restoration program or in control programs, to identify possible factors predictive of the need for functional restoration. SUMMARY OF BACKGROUND DATA: Since the functional restoration program was first described, research has focused on identifying patients who will or will not benefit from such a program. The value of previous studies is limited, however, because predictive factors from a control group were not "subtracted." METHODS: Eight hundred sixteen patients with chronic low back disability were included. All had a structured medical examination, including various physical tests before participation in either a functional restoration program (n = 621) or shorter "control" outpatient programs (n = 144). A smaller group of the cohort (n = 51) had no treatment and served as a pure control group. Six groups were selected from the cohort: Three underwent an identical functional restoration program and three underwent different outpatient control programs. Several baseline demographic, physical, and socioeconomic variables were correlated to 1-year outcome parameters. RESULTS: Age, days of sick leave, connection to the work force, and back pain intensity, were significantly correlated to success 1 year after entry into the study in all groups, no matter what kind of treatment was administered. Back muscle endurance, sports activity, activity of daily living scores, and vibrations were of importance in some outcome parameters for success after functional restoration. Smoking was positively correlated to disability pension. Days of sick leave and, in functional restoration, ability to work were the only factors that were correlative with statistics for people who withdrew. CONCLUSIONS: Different factors can be identified as predictive of outcome in a functional restoration program, but most of these factors were also shown to predict success for shorter control outpatient programs or of no treatment.

Activities of Daily Living↗
PubMed1998

Functional restoration for chronic low back pain. Two-year follow-up of two randomized clinical trials.

STUDY DESIGN: Two randomized, prospective clinical trials involving 238 chronic low back disability patients were carried out. Results at 2-year follow-up are presented. OBJECTIVES: To compare the clinical outcomes of a multidisciplinary functional restoration program with a nontreated control group (Project A) and with two less intensive but different training programs (Project B). SUMMARY OF BACKGROUND DATA: The effectiveness of functional restoration programs has not been firmly established. Results from trials carried out in the United States differ from those in trials conducted in other countries. Only a few of these studies have been carried out as prospective and randomized clinical studies. METHODS: Two hundred thirty-eight patients with chronic low back disability of at least 6 months' duration were included. There were 106 patients in project A and 132 patients in project B. Two years after completion of treatment patients were mailed a questionnaire that included questions regarding their work status, pain and disability levels, number of sick leave days, number of medical care contacts, medication use, physical activity levels, and subjective overall assessment of their "back life situation." RESULTS: Patients in both studies were comparable at inclusion, except that patients in Project A were recruited from all of Denmark, whereas those in Project B were from the greater Copenhagen area. Thirteen patients did not report for treatment after randomization. Of the remaining 225 patients, 20 (9%) did not complete treatment. The questionnaire response rate was 94%. In Project A, those patients receiving treatment (functional restoration) reported significantly less contact with the health care system, fewer sick leave days, and a less disabled life style during the follow-up period, compared with reports of patients in the control group. Other effect parameters did not demonstrate a significant difference between the two groups. In Project B, all effect parameters reported, except leg pain and medication usage, were significantly in favor of functional restoration, compared with reports from the less intensively treated groups. CONCLUSIONS: The functional restoration program seems effective in various parameters compared with the less intensive programs, but the differences in outcome in the two parallel studies indicate the necessity of testing a treatment program in different settings, in that the statistical variation may be a major factor in results of different studies.

Adult↗
PubMed1998

Intensive training, physiotherapy, or manipulation for patients with chronic neck pain. A prospective, single-blinded, randomized clinical trial.

STUDY DESIGN: A randomized, prospective clinical study was conducted that included 119 patients with chronic neck pain of greater than 3 months' duration. OBJECTIVES: To compare the relative effectiveness of intensive training of the cervical musculature, a physiotherapy treatment regimen, and chiropractic treatment on this patient group. SUMMARY OF BACKGROUND DATA: There are only a few studies involving chronic neck pain patients representative of those seeking care in primary health care centers. Mobilization techniques and intensive training have been shown to be useful, but cervical manipulation has not been assessed. Clinical results involving these commonly used therapies have not been compared. METHODS: A total of 167 consecutive patients were screened. One hundred nineteen patients were admitted to the study and were randomized according to Taves' minimization principles. Primary outcome measures included self-reported pain, disability, medication use, patients' perceived effect, and physician's global assessment. Patients were assessed at enrollment and at completion of the study. Postal questionnaires were used to carry out 4- and 12-month follow-up assessments. Secondary outcome measures included active range of motion of the cervical spine as well as strength and endurance measurements of the cervical musculature. These measurements were carried out at enrollment and completion of the study. RESULTS: A total of 88% of the patients completed the study. Of these, 97% completed the 4-month questionnaire and 93% the 12-month questionnaire. Patients from all three groups demonstrated significant improvements regarding self-reported pain and disability on completion of the study. Improvements were maintained throughout the follow-up period. Medication use was also significantly reduced in all groups. There was, however, no significant difference between groups at any assessment period. Physician's and patients' assessments were also positive, and again group scores were essentially equal. Patients who underwent intensive training demonstrated significantly greater endurance levels at the completion of treatment. CONCLUSIONS: There was no clinical difference between the three treatments. All three treatment interventions demonstrated meaningful improvement in all primary effect parameters. Improvements were maintained at 4- and 12-month follow-up. However, whether this was a result of the treatments or simply a result of time is unknown. Future studies will be necessary to delineate ideal treatment strategies.

Adult↗
PubMed1998

A prospective, randomized 5-year follow-up study of functional restoration in chronic low back pain patients.

A functional restoration (FR) program, dealing with a combination of intensive physical and ergonomic training, psychological pain management, and patient education, was tested in two randomized, parallel group studies. In one of these patients following the FR program were compared with a non-treated control group (project A), and in the other with patients on two less intensive treatment programs (project B). A total of 238 chronic low back pain patients participated in the two studies, 106 entering project A and 132 project B. Patients from the two projects were comparable except that the patients in project A were recruited from all over the country, whereas patients in project B all were living in and around Copenhagen. Thirteen patients never started any treatment, and 20 patients (9%) dropped out during the treatment period. Of the 207 who completed treatment, 89% returned a mailed questionnaire 5 years later. This was the case for 55% of the drop-outs. The questions referred to work situation, pain level, activities of daily living, days of sick leave, contact with health care professionals, physical activity, use of medication, and a subjective overall assessment. The results show that in project A the treated group reported significantly fewer contacts with the health care system and significantly fewer days of sick leave over the 5-year follow-up period compared to the control group. In all other parameters, including work ability, there was no statistically significant difference between the two groups. In project B, patients treated in the FR program did significantly better in most measured parameters, except in leg pain, use of pain medication and sport activity, where no significant differences were found between groups. The overall result shows a positive long-term effect of the FR program, but it also shows the necessity of testing a given treatment in different projects and designs, among other things due to statistical variations.

Absenteeism↗
PubMed1998

[Back pain--from the viewpoint of medical technology. Danish National Board of Health].

The appearance of various consensus reports, guidelines, Cochrane Centers, and other evidence-based medicine initiatives during the past decade has resulted in marked improvement in the rational utilisation of available knowledge of attitudes toward the issue of low back pain (LBP). Moreover, owing to the ready access to updated data bases, this knowledge has been disseminated with incredible speed. In the spring of 1995, the Danish National Board of Health in Denmark convinced a multidisciplinary team of back specialists to tailor data available in the international reports for Danish needs. The article outlines the findings of this team, the major recommendations being that providing information is preferable to treatment, that patients should be encouraged to remain active, that physical exercise should be kept up except during the acute phases, that most episodes of LBP are to be considered life events rather than automatic reasons to seek treatment, and that passive treatment should be minimised, though manipulation may be helpful in the short term.

Evidence-Based Medicine↗
PubMed1997

Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one-year follow-up.

In a randomized, blinded study, we compared the outcome from a full-time functional restoration program with the outcome from shorter active rehabilitation programs for patients with chronic, disabling low back pain. The study initially included 132 patients, randomized into one of three treatment programs: (1) an intensive 3-week multidisciplinary program; (2) active physical training and back school; or (3) psychological pain management and active physical training. Nine of the randomized patients never started in any program, so the studied population consisted of 123 patients. Of these, 14 patients (11%) dropped out. The results presented here are at 1 year following treatment, where we achieved a 92% response rate, including the drop-outs. The functional restoration program was superior to the shorter programs as to work-ready rate, health care contacts, back pain level, disability level, staying physically active, and reduction in analgesics. There was no significant difference between Programs 2 and 3 in most of these parameters. As for sick leave and leg pain, there was no significant difference between Programs 1 and 2, although a difference was observed when comparing Program 3 with each of the other two. Conclusively, it seems that there is human, as well as economical, benefit from a functional restoration program compared to less intensive programs for these patients.

Adolescent↗
PubMed1996

What does a backrest actually do to the lumbar spine?

It is generally believed that a backrest facilitates lumbar lordosis. To test this, the spontaneously adopted postures of 12 healthy subjects were measured by a statometric method during 2-h sitting periods on three types of chairs in a stratified sequence. The only difference between the three workstations regarded backrest: 'A' had no backrest; 'B' had a vertical lumbar backrest; and 'C' had an anteriorly curved backrest. In general, the most lordotic postures were assumed with backrest C, whereas backrest B rather facilitated kyphosis as compared with sitting without a backrest. However, when specifically considering passive sitting, i.e. reading, both types of backrest facilitated kyphosis. Moreover, spinal shrinkage was evaluated by measuring exact height before and after each 2-h sitting period. This was done to assess spinal load. From this perspective, backrest C induced the greatest load on the spine. In conclusion, the traditional conception that a backrest facilitates lordosis is apparently not true. It seems rather that backrests actually facilitate the opportunity for the user to stabilize their lumbar spines by providing their lower backs with support, resulting in relative kyphotic increases. The practical ergonomic applications from this study are unclear. However, traditional concepts in backrest ergonomy should be re-considered.

Adult↗
PubMed1996

Functional restoration in chronic low back pain.

Conventional treatments have not slowed down the ever expanding low back pain (LBP) problem. Traditional treatment has most probably contributed to the growth of the problem. Therefore, in a search for new solutions, 'functional restoration' has been devised. In connection with chronic LBP the term has been associated with a full-day program lasting from 3 to 5 weeks. It includes multidisciplinary treatment of patients in groups with intensive physical and ergonomic training, psychological pain management, back school, as well as teaching in social/work related issues. The key concepts are 'acceptance of the pain', 'activity', 'self-responsibility', 'multidisciplinary' and 'quantitative functional evaluation (QFE)'. The latter is aimed so that the participants can feel the physical improvement, encouraging them to be able to go back to work, or at least to lead a more active life style. Several controlled studies suggest a lasting effect in terms of regaining their ability to work and improving pain behavior for a good part of disabled chronic LBP patients. However, it is noteworthy that randomized studies seemingly show poorer results than studies not employing randomized controls.

Ergonomics↗
PubMed1996

[Low back pain].

Explore the source record for details and available documents.

Humans↗
PubMed1995

Active treatment programs for patients with chronic low back pain: a prospective, randomized, observer-blinded study.

Several new studies have indicated that an active approach to patients with chronic disabling low back pain (LBP) seems effective. Some of these studies emphasize the importance of dealing with the patient's total situation in comprehensive multidisciplinary programs--the bio-psycho-social model. However, these programs are expensive. The aim of this study was to evaluate the rehabilitation outcome from three different active programs in terms of: (1) return-to-work rate, (2) days of sick leave, (3) health-care contacts, (4) pain and disability scores, and (5) staying physically active. The subjects included 132 patients randomized to the study, of whom 123 started one of the treatment programs. They had all had at least 6 months of chronic LBP. The patients were randomized into one of three programs: group 1--a full-time, intensive 3-week multidisciplinary program, including active physical and ergonomic training and psychological pain management, followed by 1 day weekly for the subsequent 3 weeks; group 2--active physical training, twice a week for 6 weeks, for a total of 24h; group 3--psychological pain management combined with active physical training, twice a week for 6 weeks, also for a total of 24h. The results presented here are based on data collected 4 months following treatment, which shows an 86% response rate. The initial examination and the follow-up evaluation were performed by a blinded observer. The results show that 4 months after treatment, the intensive multidisciplinary program is superior to the less intensive programs in terms of return-to-work rate, health-care contacts, pain and disability scores, and staying physically active.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMed1995

Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial.

The purpose of this randomized patient- and observer-blinded cross-over trial was to evaluate the efficacy of chiropractic treatment in the management of chronic asthma when combined with pharmaceutical maintenance therapy. The trial was conducted at the National University Hospital's Out-patient Clinic in Copenhagen, Denmark. Thirty-one patients aged 18-44 years participated, all suffering from chronic asthma controlled by bronchodilators and/or inhaled steroids. Patients, or who had received chiropractic treatment for asthma within the last 5 years, who received oral steroids and immunotherapy, were not eligible. Patients were randomized to receive either active chiropractic spinal manipulative treatment or sham chiropractic spinal manipulative treatment twice weekly for 4 weeks, and then crossed over to the alternative treatment for another 4 weeks. Both phases were preceded and followed by a 2-week period without chiropractic treatment. The main outcome measurements were forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), daily use of inhaled bronchodilators, patient-rated asthma severity and non-specific bronchial reactivity (n-BR). Using the cross-over analysis, no clinically important or statistically significant differences were found between the active and sham chiropractic interventions on any of the main or secondary outcome measures. Objective lung function did not change during the study, but over the course of the study, non-specific bronchial hyperreactivity (n-BR) improved by 36% (P = 0.01) and patient-rated asthma severity decreased by 34% (P = 0.0002) compared with the baseline values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Intensive multidisciplinary treatment of back pain--2 controlled prospective studies].

The aim of this study was to evaluate an intensive, multidisciplinary functional restoration program for people with chronic low back pain. The program was compared to a non-treated control group in project A, and to less intensive treatment programs in project B. Both projects were randomized and observer blinded. Two hundred and thirty-eight patients were included, 106 entering project A and 132 project B. All had had chronic low back disability of at least six months duration, with an average of one year's sick leave due to low back pain over the last three years. Their average age was 41 years. The results at follow-up (conducted four months after treatment, follow-up rate 90% in project A and 86% in project B) showed that 67% of the treated patients in project A were able to work compared to 28% in the control group. In project B, 75% of the patients treated in the functional restoration program were able to work, the corresponding numbers from the less intensive programs being 48% and 40%. Numbers of days of sick leave, contacts to the health-care system and pain- and disability-scores were significantly lower for the patients treated in the functional restoration program compared to the other groups in both projects. Functional restoration is more expensive to carry out, but the long-term benefits in form of reductions in pensions, sick leave and contacts to the health-care system, not to mention reduced pain for the patients, seems to justify this expenditure.

Adult↗
PubMed1993

Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain. A randomized, observer-blind trial.

In a randomized, observer-blind trial, 150 men and women, aged 21-64 years, with chronic/subchronic low-back pain, followed one of these three treatment regimens: 1) intensive, dynamic back-muscle exercises; 2) conventional physiotherapy, including isometric exercises for the trunk and leg muscles; and 3) placebo-control treatment involving semihot packs and light traction. Eight treatment sessions were given during the course of 4 weeks, each session lasting 1 hour. The short-term effect was evaluated at the end of the treatment period and 1 month later, and the long-term effect at 6 and 12 months. The evaluations included recording of changes in pain level and assessment of overall treatment effect, which were indicated on visual interval scales. Subgroups of patients could be identified according to their treatment responses: physiotherapy was the superior treatment for the male participants, whereas the intensive back exercises appeared to be most efficient for the female participants. Patients with moderate or hard physical occupations tended toward a better response with physiotherapy, whereas intensive back exercises seemed most effective for those with sedentary/light job functions.

Adult↗
PubMed1993

[Why intensive rehabilitation of patients with chronic back problems?].

When patients with chronic back trouble are improved after intensive rehabilitation, in all likelihood it is due more to changes in pain behaviour than to physiological effects of treatment. The Copenhagen Spine Center at the Danish national hospital, Rigshospitalet has launched an eight hours a day, three-week programme of cardiovascular fitness, progressive weight training, stretching, ergonomics, psychology and an extended back school, with a view to modifying the self-image and pain behaviour of long term sick-certificated patients with back problems, in order to enable them to return to work.

Denmark↗