Introduction
The aim of the study
Inclusion criteria
Exclusion criteria
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Patients with other causes of back pain like fractures, tumors, high-grade spondylolisthesis, and infections.
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Patients with psychiatric illness.
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Patients who did not receive minimum higher secondary education. (The state of Kerala has a high literacy rate, and a significant proportion of its people have higher secondary education. Trivandrum is the capital city.)
Statistical analysis
Results
Variable | Categories | ODI 1 | ODI 2 | ODI3 | ODI 4 | ODI 5 | ODI 6 | P value | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |||
Age | Below 40 years (n = 42) | 42.4 | 14.7 | 38.4 | 15.2 | 33.8 | 15.1 | 28.4 | 13.9 | 24.5 | 14.4 | 21.1 | 14.9 | 0.761 |
40 or more (n = 31) | 44.9 | 19.0 | 43.1 | 19.9 | 38.7 | 20.1 | 35.7 | 20.4 | 31.9 | 19.8 | 29.3 | 18.9 | ||
Sex | Male (n = 29) | 40.6 | 14.6 | 37.0 | 13.9 | 31.2 | 14.2 | 27.6 | 13.7 | 24.8 | 13.1 | 21.1 | 11.4 | 0.665 |
Female (n = 44) | 45.3 | 17.7 | 42.6 | 19.2 | 39.0 | 18.6 | 34.0 | 18.9 | 29.4 | 19.3 | 26.8 | 19.8 | ||
KSB score | 3 or less (n = 50) | 39.6 | 14.8 | 35.9 | 14.7 | 30.8 | 13.9 | 26.3 | 13.0 | 22.0 | 11.7 | 18.8 | 10.6 | 0.005* |
More than 3 (n = 23) | 52.0 | 17.5 | 50.1 | 19.1 | 46.9 | 19.6 | 42.9 | 19.8 | 39.4 | 20.8 | 37.1 | 21.6 |
Factors associated to rate of reduction of ODI scores (multiple linear regression) | ||
Factor | Standardized beta | P value |
Advancing age | − 0.172 | 0.133 |
High initial ODI score (ODI 1) | + 0.066 | 0.604 |
Lower KSB score | + 0.401 | 0.002* |
Factors associated to final ODI score more than 20 | ||
Factor | Adjusted OR (95% CI) | P value |
Age less than 40 years | 33.79 (2.79–409.80) | 0.006 |
Initial ODI score more than 40 | 21.39 (1.59–287.50) | 0.021 |
KSB Score more than 3 | 19.70 (2.57–151.19) | 0.004 |
Discussion
The concept of core and core stability
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Passive system constitutes the vertebrae, intervertebral discs, zygoapophyseal joints, and ligaments.
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Active system constitutes the muscle and tendon surrounding and acting on the spinal columns.
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Neural system constitutes the nerves and CNS which directly controls the active system in providing dynamic stability [6].