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Bone & Joint Open
Vol. 4, Issue 11 | Pages 873 - 880
17 Nov 2023
Swaby L Perry DC Walker K Hind D Mills A Jayasuriya R Totton N Desoysa L Chatters R Young B Sherratt F Latimer N Keetharuth A Kenison L Walters S Gardner A Ahuja S Campbell L Greenwood S Cole A

Aims

Scoliosis is a lateral curvature of the spine with associated rotation, often causing distress due to appearance. For some curves, there is good evidence to support the use of a spinal brace, worn for 20 to 24 hours a day to minimize the curve, making it as straight as possible during growth, preventing progression. Compliance can be poor due to appearance and comfort. A night-time brace, worn for eight to 12 hours, can achieve higher levels of curve correction while patients are supine, and could be preferable for patients, but evidence of efficacy is limited. This is the protocol for a randomized controlled trial of ‘full-time bracing’ versus ‘night-time bracing’ in adolescent idiopathic scoliosis (AIS).

Methods

UK paediatric spine clinics will recruit 780 participants aged ten to 15 years-old with AIS, Risser stage 0, 1, or 2, and curve size (Cobb angle) 20° to 40° with apex at or below T7. Patients are randomly allocated 1:1, to either full-time or night-time bracing. A qualitative sub-study will explore communication and experiences of families in terms of bracing and research. Patient and Public Involvement & Engagement informed study design and will assist with aspects of trial delivery and dissemination.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_10 | Pages 25 - 25
1 Oct 2019
Saunders B Hill J Foster N Cooper V Protheroe J Chudyk A Chew-Graham C Campbell P Bartlam B
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Background

Improving primary care management of musculoskeletal (MSK) pain is a priority. A pilot cluster RCT tested prognostic stratified care for patients with common MSK pain presentations, including low back pain, in 8 UK general practices (4 stratified care; 4 usual care) with 524 patients. GPs in stratified care practices were asked to use i) the Keele STarT MSK tool for risk-stratification and ii) matched treatment options for patients at low-, medium- and high-risk of persistent pain. A linked qualitative process evaluation explored patients' and GPs' views and experiences of stratified care.

Methods

Individual ‘stimulated-recall’ interviews with patients and GPs in the stratified care arm (n=10 patients; 10 GPs), prompted by consultation-recordings. Data were analysed thematically and mapped onto the COM-B behaviour change model; exploring the Opportunity, Capability and Motivation GPs and patients had to engage with stratified care.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_9 | Pages 25 - 25
1 Sep 2019
Williams F Palmer M Tsepilov Y Freidin M Boer C Yau M Evans D Gelemanovic A Bartz T Nethander M Arbeeva L Karssen L Neogi T Campbell A Mellstrom D Ohlsson C Marshall L Orwoll E Uitterlinden A Rotter J Lauc G Psaty B Karlsson M Lane N Jarvik G Polasek O Hochberg M Jordan J van Meurs J Jackson R Nielson C Mitchell B Smith B Hayward C Smith N Aulchenko Y Suri P
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Purpose

Back pain is the primary cause of disability worldwide yet surprisingly little is known of the underlying pathobiology. We conducted a genome-wide association study (GWAS) meta-analysis of chronic back pain (CBP). Adults of European ancestry from 15 cohorts in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and UK Biobank were studied.

Methods

CBP cases were defined as reporting back pain present for ≥3–6 months; non-cases were included as comparisons (“controls”). Each cohort conducted genotyping followed by imputation. GWAS used logistic regression with additive genetic effects adjusting for age, sex, study-specific covariates, and population substructure. Suggestive (p<5×10–7) & genome-wide significant (p<5×10–8) variants were carried forward for replication in an independent sample of UK Biobank participants. Discovery sample n = 158,025 individuals, including 29,531 CBP cases.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 1 - 1
1 Feb 2018
Chen Y Campbell P Strauss V Foster N Jordan K Dunn K
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Background and objectives

Low back pain (LBP) is a major health challenge globally. Research has identified common trajectories of pain over time. We aimed to investigate whether trajectories described in one primary care cohort can be confirmed in another, and to determine the prognostic value of factors collected 5 years prior to the identification of the trajectory.

Methods and results

The study was carried out on 281 patients who had consulted primary care for LBP, at that point completed a baseline questionnaire, and then returned a questionnaire at 5-years follow-up plus at least 3 (of 6) subsequent monthly questionnaires. Baseline factors were measured using validated tools. Pain intensity scores from the 5-year follow-up and monthly questionnaires were used to cluster participants into 4 previously derived pain trajectories (no or occasional mild, persistent mild, fluctuating, persistent severe), using latent class analysis. Posterior probabilities of belonging to each cluster were estimated for each participant. The posterior probabilities for the assigned clusters were very high (>0.90) for each cluster except for the smallest ‘fluctuating’ cluster (0.74). Lower social class (OR 2.9; 95% CI 1.2, 7.0), higher pain intensity (1.6 per unit; 1.2, 2.2), and pain duration greater than 3 years (2.7; 1.0, 7.3), were significantly associated with a more severe trajectory 5-years later, as were higher physical disability, emotional impact of pain, and perception pain will last a long time.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_6 | Pages 5 - 5
1 Feb 2016
Beneciuk J Hill J Campbell P George S Afolabi E Dunn K Foster N
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Purpose and Background:

To identify treatment effect modifiers within the STarT Back Trial which demonstrated prognostic stratified care was effective in comparison to standard care for patients with low back pain.

Methods:

Secondary analysis of the STarT Back Trial using 688 patients with available 4-month follow-up data. Disability (baseline and 4 months) was assessed using the Roland Morris Disability Questionnaire (RMDQ) using continuous and dichotomized (>7) outcome scores. Potential treatment effect modifiers were evaluated with group x predictor interaction terms using linear and logistic regression models. Modifiers included: age, gender, education, socio-economic status (SES), employment status, work satisfaction, episode duration, general health (SF-12), number of pain medications, and treatment expectations.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_2 | Pages 16 - 16
1 Feb 2015
Campbell C Kerr D McDonough S Murphy M Tully M
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Background and purpose

To identify methods used to measure free living sedentary behaviour in people with back pain and review the validity and reliability of identified measures.

Methods

Databases including CINAHL, EMBASE, MEDLINE, AMED, PsycINFO, SPORTDiscus and the Sedentary Behaviour and Research Network website (www.sedentarybehaviour.org) were searched for relevant published articles up to June 2014. Studies which measured sedentary behaviour in people with back pain were included. Quality of the included studies was assessed using the Newcastle Ottawa Scale. The Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) Checklist was used to assess psychometric properties.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVII | Pages 16 - 16
1 Jun 2012
Campbell R Epelman M Flynn J Mayer O Panitch H Nance M Blinman T McDonough J Udapa J Deardorff M Rendon N Mong A Finkel R Singh D
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Introduction

Children with early-onset scoliosis (EOS) with rib hump chest-wall distortion or fused/absent ribs have thoracic insufficiency syndrome (TIS). Commonly, respiration is adversely affected by loss of lung volume from chest-wall constriction and clinical loss of active rib cage expansion. The dynamic thoracic components of diaphragm or rib cage lung expansion during respiration is poorly characterised by radiograph or CT scan. Pulmonary function tests indicate only hemithorax performance. Dynamic lung MRI, however, can visualise both chest-wall and diaphragm motion, allowing assessment of each individual hemithorax performance, so that a dynamic classification system of the thoracic function can be developed.

Methods

Ten patients with TIS underwent dynamic lung MRI testing as part of the routine clinical preoperative work-up. Each hemithorax was graded: 1=intact motion of both chest wall and diaphragm; 2=primarily loss of chest-wall motion with minimal diaphragm abnormality; 3=substantial loss of diaphragm excursion with minimal loss or compensatory hyperkinesis of chest wall; and 4=substantial loss of both diaphragm and chest-wall motion. The grades for each hemithorax were added and averaged to form the thoracic function score. Ranges of scores were grouped into levels of clinical thoracic performance: level I (score 1–1·5); level II (>1·5–2·5); level III (>2·5–3·5); and level IV(>3·5–4·0).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_I | Pages 16 - 16
1 Jan 2012
Campbell P Jordan K Dunn K
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Background

Social context may be important in chronic pain. One focus is reactions to pain between persons with LBP and their partners. Researchers have investigated partner reactions and found influences on pain levels and psychological outcomes, but little is known about factors underpinning these reactions.

Aim

To investigate the associations of relationship quality and perceived partner responses with LBP intensity and disability.