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  1. Article ; Online: Perceptual Access Reasoning (PAR) in Developing a Representational Theory of Mind.

    Fabricius, William V / Gonzales, Christopher R / Pesch, Annelise / Weimer, Amy A / Pugliese, John / Carroll, Kathleen / Bolnick, Rebecca R / Kupfer, Anne S / Eisenberg, Nancy / Spinrad, Tracy L

    Monographs of the Society for Research in Child Development

    2021  Volume 86, Issue 3, Page(s) 7–154

    Abstract: An important part of children's social and cognitive development is their understanding that people are psychological beings with internal, mental states including desire, intention, perception, and belief. A full understanding of people as psychological ...

    Abstract An important part of children's social and cognitive development is their understanding that people are psychological beings with internal, mental states including desire, intention, perception, and belief. A full understanding of people as psychological beings requires a representational theory of mind (ToM), which is an understanding that mental states can faithfully represent reality, or misrepresent reality. For the last 35 years, researchers have relied on false-belief tasks as the gold standard to test children's understanding that beliefs can misrepresent reality. In false-belief tasks, children are asked to reason about the behavior of agents who have false beliefs about situations. Although a large body of evidence indicates that most children pass false-belief tasks by the end of the preschool years, the evidence we present in this monograph suggests that most children do not understand false beliefs or, surprisingly, even true beliefs until middle childhood. We argue that young children pass false-belief tasks without understanding false beliefs by using perceptual access reasoning (PAR). With PAR, children understand that seeing leads to knowing in the moment, but not that knowing also arises from thinking or persists as memory and belief after the situation changes. By the same token, PAR leads children to fail true-belief tasks. PAR theory can account for performance on other traditional tests of representational ToM and related tasks, and can account for the factors that have been found to correlate with or affect both true- and false-belief performance. The theory provides a new laboratory measure which we label the belief understanding scale (BUS). This scale can distinguish between a child who is operating with PAR versus a child who is understanding beliefs. This scale provides a method needed to allow the study of the development of representational ToM. In this monograph, we report the outcome of the tests that we have conducted of predictions generated by PAR theory. The findings demonstrated signature PAR limitations in reasoning about the mind during the ages when children are hypothesized to be using PAR. In Chapter II, secondary analyses of the published true-belief literature revealed that children failed several types of true-belief tasks. Chapters III through IX describe new empirical data collected across multiple studies between 2003 and 2014 from 580 children aged 4-7 years, as well as from a small sample of 14 adults. Participants were recruited from the Phoenix, Arizona metropolitan area. All participants were native English-speakers. Children were recruited from university-sponsored and community preschools and daycare centers, and from hospital maternity wards. Adults were university students who participated to partially fulfill course requirements for research participation. Sociometric data were collected only in Chapter IX, and are fully reported there. In Chapter III, minor alterations in task procedures produced wide variations in children's performance in 3-option false-belief tasks. In Chapter IV, we report findings which show that the developmental lag between children's understanding ignorance and understanding false belief is longer than the lag reported in previous studies. In Chapter V, children did not distinguish between agents who have false beliefs versus agents who have no beliefs. In Chapter VI, findings showed that children found it no easier to reason about true beliefs than to reason about false beliefs. In Chapter VII, when children were asked to justify their correct answers in false-belief tasks, they did not reference agents' false beliefs. Similarly, in Chapter VIII, when children were asked to explain agents' actions in false-belief tasks, they did not reference agents' false beliefs. In Chapter IX, children who were identified as using PAR differed from children who understood beliefs along three dimensions-in levels of social development, inhibitory control, and kindergarten adjustment. Although the findings need replication and additional studies of alternative interpretations, the collection of results reported in this monograph challenges the prevailing view that representational ToM is in place by the end of the preschool years. Furthermore, the pattern of findings is consistent with the proposal that PAR is the developmental precursor of representational ToM. The current findings also raise questions about claims that infants and toddlers demonstrate ToM-related abilities, and that representational ToM is innate.
    MeSH term(s) Adult ; Child ; Child Development ; Child, Preschool ; Cognition ; Female ; Humans ; Infant ; Pregnancy ; Problem Solving ; Theory of Mind
    Language English
    Publishing date 2021-09-28
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 414392-9
    ISSN 1540-5834 ; 0037-976X
    ISSN (online) 1540-5834
    ISSN 0037-976X
    DOI 10.1111/mono.12432
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Methadone overdose and cardiac arrhythmia potential: findings from a review of the evidence for an American Pain Society and College on Problems of Drug Dependence clinical practice guideline.

    Chou, Roger / Weimer, Melissa B / Dana, Tracy

    The journal of pain : official journal of the American Pain Society

    2014  Volume 15, Issue 4, Page(s) 338–365

    Abstract: Unlabelled: The number of deaths associated with methadone use increased dramatically in parallel with marked increases in its use, particularly for treatment of chronic pain. To develop a clinical guideline on methadone prescribing to reduce potential ... ...

    Abstract Unlabelled: The number of deaths associated with methadone use increased dramatically in parallel with marked increases in its use, particularly for treatment of chronic pain. To develop a clinical guideline on methadone prescribing to reduce potential harms, the American Pain Society commissioned a review of various aspects related to methadone safety. This article summarizes evidence related to unintentional overdose due to methadone and harms related to cardiac arrhythmia potential. We searched Ovid MEDLINE, the Cochrane Library, and PsycINFO databases through January 2014 for studies assessing harms associated with methadone use; we judged 70 studies to be relevant and to meet inclusion criteria. The majority of studies on overdose and cardiac arrhythmia risk are observational and provide weak evidence on which to base clinical guidelines. In patients prescribed methadone for treatment of opioid dependence, data suggest that mortality benefits related to reduction in illicit drug use outweigh harms. Despite epidemiologic data showing marked increases in the numbers of methadone-related deaths that have been primarily attributed to increased use of methadone for chronic pain, evidence on methadone and mortality risk in this population has been somewhat contradictory. There is some evidence that recent initiation of methadone, psychiatric admissions, and concomitant use of benzodiazepines are associated with a higher risk for overdose. Evidence on cardiac risks is primarily limited to case reports of torsades de pointes, primarily in patients on high doses of methadone, and to studies showing an association between methadone use and prolongation of QTc intervals. Research is needed to understand the effectiveness of dosing methods, electrocardiogram monitoring, and other risk mitigation strategies in patients prescribed methadone.
    Perspective: This systematic review synthesizes the evidence related to methadone use and risk for overdose and cardiac arrhythmia. Findings regarding the association between methadone use and QTc interval prolongation and risk factors for methadone-associated overdose suggest potential targets for risk mitigation strategies, though research is needed to determine the effectiveness of such strategies at reducing adverse outcomes.
    MeSH term(s) Arrhythmias, Cardiac/chemically induced ; Chronic Pain/drug therapy ; Drug Overdose/complications ; Humans ; Methadone/poisoning ; Opioid-Related Disorders/drug therapy ; Practice Guidelines as Topic
    Chemical Substances Methadone (UC6VBE7V1Z)
    Language English
    Publishing date 2014-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2018789-0
    ISSN 1528-8447 ; 1526-5900
    ISSN (online) 1528-8447
    ISSN 1526-5900
    DOI 10.1016/j.jpain.2014.01.495
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Neuropathy following laparoscopic adjustable gastric banding: treatment with plasmapheresis.

    Weimer, Tracy / Nance, Christopher / Watson, David

    The West Virginia medical journal

    2013  Volume 109, Issue 1, Page(s) 16–17

    Abstract: Laparoscopic adjustable gastric banding is being increasingly utilized for therapy of obesity in the United States. It is a relatively newer technique and little is known about neurologic complications resulting from this procedure. We present a case of ... ...

    Abstract Laparoscopic adjustable gastric banding is being increasingly utilized for therapy of obesity in the United States. It is a relatively newer technique and little is known about neurologic complications resulting from this procedure. We present a case of disabling peripheral neuropathy occurring after gastric banding. While this type of complication has seen following older weight loss techniques, it has only rarely been documented following adjustable gastric banding. The patient was treated with adjustment of the lap band in combination with plasmapheresis. Plasmapheresis is a novel therapy for treatment of this type of neuropathy and resulted in significant improvement in the patients' strength and functioning.
    MeSH term(s) Adult ; Anti-Inflammatory Agents/therapeutic use ; Female ; Gastroplasty/adverse effects ; Humans ; Laparoscopy ; Mobility Limitation ; Muscle Weakness/etiology ; Obesity/surgery ; Peripheral Nervous System Diseases/etiology ; Peripheral Nervous System Diseases/therapy ; Plasmapheresis ; Prednisone/therapeutic use
    Chemical Substances Anti-Inflammatory Agents ; Prednisone (VB0R961HZT)
    Language English
    Publishing date 2013-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 431705-1
    ISSN 0043-3284
    ISSN 0043-3284
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Neurosurgical therapy for central area status epilepticus.

    Weimer, Tracy / Boling, Warren / Palade, Adrianna

    The West Virginia medical journal

    2012  Volume 108, Issue 5, Page(s) 20–23

    Abstract: The authors report a case of status epilepticus localized to sensorimotor cortex that was successfully treated with surgical resection and multiple subpial transections (MST). A 43 year old woman presented in status epilepticus emanating from a right ... ...

    Abstract The authors report a case of status epilepticus localized to sensorimotor cortex that was successfully treated with surgical resection and multiple subpial transections (MST). A 43 year old woman presented in status epilepticus emanating from a right central area focus as verified by subdural grid and strip electrodes. The seizures were medically intractable but were successfully aborted after surgical intervention. The authors describe their case and review the literature on central area status epilepticus.
    MeSH term(s) Adult ; Cerebral Cortex/physiopathology ; Cerebral Cortex/surgery ; Electroencephalography ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Neurosurgical Procedures/methods ; Status Epilepticus/diagnosis ; Status Epilepticus/physiopathology ; Status Epilepticus/surgery
    Language English
    Publishing date 2012-09
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 431705-1
    ISSN 0043-3284
    ISSN 0043-3284
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline.

    Chou, Roger / Deyo, Richard / Friedly, Janna / Skelly, Andrea / Weimer, Melissa / Fu, Rochelle / Dana, Tracy / Kraegel, Paul / Griffin, Jessica / Grusing, Sara

    Annals of internal medicine

    2017  Volume 166, Issue 7, Page(s) 480–492

    Abstract: Background: A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available.: Purpose: To review the current evidence on systemic pharmacologic therapies for ... ...

    Abstract Background: A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available.
    Purpose: To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain.
    Data sources: Ovid MEDLINE (January 2008 through November 2016), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and reference lists.
    Study selection: Randomized trials that reported pain, function, or harms of systemic medications versus placebo or another intervention.
    Data extraction: One investigator abstracted data, and a second verified accuracy; 2 investigators independently assessed study quality.
    Data synthesis: The number of trials ranged from 9 (benzodiazepines) to 70 (nonsteroidal anti-inflammatory drugs). New evidence found that acetaminophen was ineffective for acute low back pain, nonsteroidal anti-inflammatory drugs had smaller benefits for chronic low back pain than previously observed, duloxetine was effective for chronic low back pain, and benzodiazepines were ineffective for radiculopathy. For opioids, evidence remains limited to short-term trials showing modest effects for chronic low back pain; trials were not designed to assess serious harms. Skeletal muscle relaxants are effective for short-term pain relief in acute low back pain but caused sedation. Systemic corticosteroids do not seem to be effective. For effective interventions, pain relief was small to moderate and generally short-term; improvements in function were generally smaller. Evidence is insufficient to determine the effects of antiseizure medications.
    Limitations: Qualitatively synthesized new trials with prior meta-analyses. Only English-language studies were included, many of which had methodological shortcomings. Medications injected for local effects were not addressed.
    Conclusion: Several systemic medications for low back pain are associated with small to moderate, primarily short-term effects on pain. New evidence suggests that acetaminophen is ineffective for acute low back pain, and duloxetine is associated with modest effects for chronic low back pain.
    Primary funding source: Agency for Healthcare Research and Quality. (PROSPERO: CRD42014014735).
    MeSH term(s) Acetaminophen/therapeutic use ; Acute Pain/drug therapy ; Acute Pain/etiology ; Adrenal Cortex Hormones/therapeutic use ; Analgesics, Non-Narcotic/therapeutic use ; Analgesics, Opioid/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Anticonvulsants/therapeutic use ; Antidepressive Agents/therapeutic use ; Benzodiazepines/therapeutic use ; Chronic Pain/drug therapy ; Chronic Pain/etiology ; Humans ; Low Back Pain/drug therapy ; Low Back Pain/etiology ; Neuromuscular Agents/therapeutic use ; Radiculopathy/complications
    Chemical Substances Adrenal Cortex Hormones ; Analgesics, Non-Narcotic ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Anticonvulsants ; Antidepressive Agents ; Neuromuscular Agents ; Benzodiazepines (12794-10-4) ; Acetaminophen (362O9ITL9D)
    Language English
    Publishing date 2017-02-14
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M16-2458
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Feasibility of a mHealth Approach to Nutrition Counseling in an Appalachian State.

    Olfert, Melissa D / Barr, Makenzie L / Hagedorn, Rebecca L / Long, Dustin M / Haggerty, Treah S / Weimer, Mathew / Golden, Joseph / Maurer, Mary Ann / Cochran, Jill D / Hendershot, Tracy / Whanger, Stacey L / Mason, Jay D / Hodder, Sally L

    Journal of personalized medicine

    2019  Volume 9, Issue 4

    Abstract: West Virginia is a rural state with an aging population that may experience barriers to accessing nutritional and lifestyle counseling. This study examined feasibility of an online personalized nutrition tracking application, Good Measures (GM), with ... ...

    Abstract West Virginia is a rural state with an aging population that may experience barriers to accessing nutritional and lifestyle counseling. This study examined feasibility of an online personalized nutrition tracking application, Good Measures (GM), with patients at seven health care clinics throughout the state. Fourteen healthcare providers and 64 patients 18 years or older with a Body Mass Index (BMI) greater than or equal to 30 and access to the Internet were recruited for this 12-week feasibility study. Patient participants logged meals and exercise into the GM application via smart phone, tablet, or computer and virtually engaged with a Registered Dietitian Nutritionist (RDN) in one-on-one sessions. The primary endpoint was to examine feasibility of the program by usage of the application and feedback questions regarding the benefits and challenges of the application. Participants were predominately white (92%) and female (76%). Minimal improvements in weight and systolic blood pressure were found. Participant attitude survey data declined from 4-weeks to 12-weeks of the intervention. Interestingly though, patients in a rural clinic had lesser declines in attitudes than peri-urban participants. Qualitative feedback data identified participants predominately had a positive overall feeling toward the approach. Participants expressed favorability of RDN access, the variety of foods, but did give suggestions for in-person meetings and more updating of the application. Implementing a technology approach to nutrition in rural areas of West Virginia using a mobile application with RDN access may be one strategy to address public health issues such as obesity.
    Language English
    Publishing date 2019-11-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm9040050
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Temporal lobectomy for refractory status epilepticus in a case of limbic encephalitis.

    Weimer, Tracy / Boling, Warren / Pryputniewicz, David / Palade, Adriana

    Journal of neurosurgery

    2008  Volume 109, Issue 4, Page(s) 742–745

    Abstract: The authors report a case of status epilepticus secondary to limbic encephalitis that was successfully treated with temporal lobectomy. A 45-year-old woman presented in status epilepticus refractory to high-dose suppressive medical therapy. Magnetic ... ...

    Abstract The authors report a case of status epilepticus secondary to limbic encephalitis that was successfully treated with temporal lobectomy. A 45-year-old woman presented in status epilepticus refractory to high-dose suppressive medical therapy. Magnetic resonance imaging of the brain showed T2- and FLAIR-weighted hyperintensities in the right temporal lobe, left and right frontal lobes, and pons. A lumbar puncture revealed normal findings. Continuous electroencephalography monitoring showed continued right temporal seizure activity. A paraneoplastic panel was positive for N-type voltage-gated calcium channels. Subsequent bronchial biopsy revealed small cell carcinoma of the lung. A right temporal lobectomy was performed due to refractory status, resulting in resolution of seizure activity and recovery of good neurological function. The authors describe their case and review the literature on surgical therapy for refractory status epilepticus and limbic encephalitis.
    MeSH term(s) Carcinoma, Small Cell/secondary ; Electroencephalography ; Female ; Humans ; Limbic Encephalitis/complications ; Limbic Encephalitis/pathology ; Limbic Encephalitis/surgery ; Lung Neoplasms/pathology ; Magnetic Resonance Imaging ; Middle Aged ; Status Epilepticus/etiology ; Status Epilepticus/pathology ; Status Epilepticus/surgery ; Temporal Lobe/pathology ; Temporal Lobe/surgery
    Language English
    Publishing date 2008-10
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/JNS/2008/109/10/0742
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Glomeruloid hemangiomas: a marker for POEMS.

    Weimer, Tracy / Norton, Amy / Gutmann, Ludwig

    Neurology

    2006  Volume 66, Issue 3, Page(s) 453–454

    MeSH term(s) Diagnosis, Differential ; Female ; Hemangioma/etiology ; Hemangioma/pathology ; Humans ; Middle Aged ; POEMS Syndrome/complications ; POEMS Syndrome/diagnosis ; Skin Neoplasms/etiology ; Skin Neoplasms/pathology
    Language English
    Publishing date 2006-02-14
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/01.wnl.0000196487.33341.03
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Biofeedback-Assisted Resilience Training for Traumatic and Operational Stress: Preliminary Analysis of a Self-Delivered Digital Health Methodology.

    Kizakevich, Paul N / Eckhoff, Randall P / Lewis, Gregory F / Davila, Maria I / Hourani, Laurel L / Watkins, Rebecca / Weimer, Belinda / Wills, Tracy / Morgan, Jessica K / Morgan, Tim / Meleth, Sreelatha / Lewis, Amanda / Krzyzanowski, Michelle C / Ramirez, Derek / Boyce, Matthew / Litavecz, Stephen D / Lane, Marian E / Strange, Laura B

    JMIR mHealth and uHealth

    2019  Volume 7, Issue 9, Page(s) e12590

    Abstract: Background: Psychological resilience is critical to minimize the health effects of traumatic events. Trauma may induce a chronic state of hyperarousal, resulting in problems such as anxiety, insomnia, or posttraumatic stress disorder. Mind-body ... ...

    Abstract Background: Psychological resilience is critical to minimize the health effects of traumatic events. Trauma may induce a chronic state of hyperarousal, resulting in problems such as anxiety, insomnia, or posttraumatic stress disorder. Mind-body practices, such as relaxation breathing and mindfulness meditation, help to reduce arousal and may reduce the likelihood of such psychological distress. To better understand resilience-building practices, we are conducting the Biofeedback-Assisted Resilience Training (BART) study to evaluate whether the practice of slow, paced breathing with or without heart rate variability biofeedback can be effectively learned via a smartphone app to enhance psychological resilience.
    Objective: Our objective was to conduct a limited, interim review of user interactions and study data on use of the BART resilience training app and demonstrate analyses of real-time sensor-streaming data.
    Methods: We developed the BART app to provide paced breathing resilience training, with or without heart rate variability biofeedback, via a self-managed 6-week protocol. The app receives streaming data from a Bluetooth-linked heart rate sensor and displays heart rate variability biofeedback to indicate movement between calmer and stressful states. To evaluate the app, a population of military personnel, veterans, and civilian first responders used the app for 6 weeks of resilience training. We analyzed app usage and heart rate variability measures during rest, cognitive stress, and paced breathing. Currently released for the BART research study, the BART app is being used to collect self-reported survey and heart rate sensor data for comparative evaluation of paced breathing relaxation training with and without heart rate variability biofeedback.
    Results: To date, we have analyzed the results of 328 participants who began using the BART app for 6 weeks of stress relaxation training via a self-managed protocol. Of these, 207 (63.1%) followed the app-directed procedures and completed the training regimen. Our review of adherence to protocol and app-calculated heart rate variability measures indicated that the BART app acquired high-quality data for evaluating self-managed stress relaxation training programs.
    Conclusions: The BART app acquired high-quality data for studying changes in psychophysiological stress according to mind-body activity states, including conditions of rest, cognitive stress, and slow, paced breathing.
    MeSH term(s) Biofeedback, Psychology/methods ; Breathing Exercises/methods ; Breathing Exercises/psychology ; Breathing Exercises/standards ; Female ; Heart Rate/physiology ; Humans ; Male ; Monitoring, Physiologic/instrumentation ; Monitoring, Physiologic/methods ; Relaxation Therapy/methods ; Relaxation Therapy/psychology ; Relaxation Therapy/standards ; Resilience, Psychological ; Self Care/instrumentation ; Self Care/methods ; Self Care/standards ; Stress, Psychological/psychology ; Stress, Psychological/therapy ; Surveys and Questionnaires ; Teaching/psychology ; Teaching/standards ; Young Adult
    Language English
    Publishing date 2019-09-06
    Publishing country Canada
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2719220-9
    ISSN 2291-5222 ; 2291-5222
    ISSN (online) 2291-5222
    ISSN 2291-5222
    DOI 10.2196/12590
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline.

    Chou, Roger / Deyo, Richard / Friedly, Janna / Skelly, Andrea / Hashimoto, Robin / Weimer, Melissa / Fu, Rochelle / Dana, Tracy / Kraegel, Paul / Griffin, Jessica / Grusing, Sara / Brodt, Erika D

    Annals of internal medicine

    2017  Volume 166, Issue 7, Page(s) 493–505

    Abstract: Background: A 2007 American College of Physicians guideline addressed nonpharmacologic treatment options for low back pain. New evidence is now available.: Purpose: To systematically review the current evidence on nonpharmacologic therapies for acute ...

    Abstract Background: A 2007 American College of Physicians guideline addressed nonpharmacologic treatment options for low back pain. New evidence is now available.
    Purpose: To systematically review the current evidence on nonpharmacologic therapies for acute or chronic nonradicular or radicular low back pain.
    Data sources: Ovid MEDLINE (January 2008 through February 2016), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and reference lists.
    Study selection: Randomized trials of 9 nonpharmacologic options versus sham treatment, wait list, or usual care, or of 1 nonpharmacologic option versus another.
    Data extraction: One investigator abstracted data, and a second checked abstractions for accuracy; 2 investigators independently assessed study quality.
    Data synthesis: The number of trials evaluating nonpharmacologic therapies ranged from 2 (tai chi) to 121 (exercise). New evidence indicates that tai chi (strength of evidence [SOE], low) and mindfulness-based stress reduction (SOE, moderate) are effective for chronic low back pain and strengthens previous findings regarding the effectiveness of yoga (SOE, moderate). Evidence continues to support the effectiveness of exercise, psychological therapies, multidisciplinary rehabilitation, spinal manipulation, massage, and acupuncture for chronic low back pain (SOE, low to moderate). Limited evidence shows that acupuncture is modestly effective for acute low back pain (SOE, low). The magnitude of pain benefits was small to moderate and generally short term; effects on function generally were smaller than effects on pain.
    Limitation: Qualitatively synthesized new trials with prior meta-analyses, restricted to English-language studies; heterogeneity in treatment techniques; and inability to exclude placebo effects.
    Conclusion: Several nonpharmacologic therapies for primarily chronic low back pain are associated with small to moderate, usually short-term effects on pain; findings include new evidence on mind-body interventions.
    Primary funding source: Agency for Healthcare Research and Quality. (PROSPERO: CRD42014014735).
    MeSH term(s) Acupuncture Therapy ; Acute Pain/etiology ; Acute Pain/therapy ; Chronic Pain/etiology ; Chronic Pain/therapy ; Humans ; Low Back Pain/etiology ; Low Back Pain/therapy ; Mind-Body Therapies ; Physical Therapy Modalities ; Psychotherapy ; Radiculopathy/complications
    Language English
    Publishing date 2017-02-14
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M16-2459
    Database MEDical Literature Analysis and Retrieval System OnLINE

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