Introduction The differences in sagittal spino-pelvic alignment between adults with chronic low back pain (LBP) and the normal population are still poorly understood. In particular, it is still unknown if particular patterns of sagittal spino-pelvic alignment are more prevalent in chronic LBP. The current study helps to better understand the relationship between sagittal alignment and low back pain. Materials and methods To compare the sagittal spinopelvic alignment of patients with chronic LBP with a cohort of asymptomatic adults. Sagittal spino-pelvic alignment was evaluated in prospective cohorts of 198 patients with chronic LBP and 709 normal subjects. The two cohorts were compared with respect to the sacral slope
This paper notes that a careful case definition of workers with previous history of low-back pain (LBP) is needed to better characterize sub-groups based on their recurrences profile. Workers with highly recurrent LBP may require a stepped secondary prevention in order to prevent recurrences and sick leave. The value of a workplace component reducing physical and psychosocial risks in secondary prevention of LBP must be explored.
Aim
To describe coping strategies in children and adolescents with cerebral palsy (CP), relative to age.
Method
Patients were prospectively recruited from two paediatric rehabilitation centres in France. The Pediatric Pain Coping Inventory – French and Structured Pain Questionnaire were completed by an experienced professional for each child.
Results
One hundred and forty‐two children with CP were included (80 males, 62 females; median age 12y; IQR=8–15y). They generally used fewer coping strategies than typically developing children (‘Seeks social support and action’: 12.47 vs 12.85, p=0.477; ‘Cognitive self‐instruction’: 9.28 vs 10.90, p<0.001; ‘Distraction’: 4.89 vs 7.00, p<0.001; ‘Problem solving’: 4.43 vs 5.19, p<0.001). In the CP group, ‘Seeks social support and action’ decreased with age (p=0.021) and ‘Cognitive self‐instruction’ increased with age (p<0.001). ‘Problem solving’ and ‘Distraction’ did not change with age. Coping strategies were influenced by Gross Motor Function Classification System level (p=0.022) and history of surgery (p=0.002).
Interpretation
Children with CP generally used fewer coping strategies than typically developing children and tended to rely on social support. Use of active strategies increased with age; however, they appeared later than in typically developing children and were used to a lesser extent.
What this paper adds
Children with cerebral palsy (CP) use fewer pain‐coping strategies than typically developing children.
Children with CP tend to use social support to cope with pain.
Children with CP learn more appropriate strategies from previous painful experiences.
Active coping strategies appear later but remain underused in children with CP.
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