Christopher Maher

It has been proposed that depression plays an important role in the course of low back pain, however there is considerable uncertainty regarding its predictive value. To investigate the effect of depression on the course of acute and sub-acute low back pain. Systematic review. We searched the following database using optimized search strategies: AMED, CINAHL, EMBASE, Health and Society Database (H&S), LILACS, MEDLINE, PsycINFO, Scopus, Web of Science. We only included prospective studies that investigated a cohort of participants with acute or sub-acute nonspecific low back pain (pain of less than 12 weeks duration). The prognostic factor of interest was depression or symptoms of depression assessed at baseline. The outcome of interest included: pain intensity, chronicity (non-recovery from low back pain), disability, return to work, health related quality of life, and overall patient satisfaction. Two independent reviewers selected studies, extracted data and assessed methodologica...

This prospective cohort study aimed to investigate whether there are differences in health outcomes among persons with mild or moderate injuries who were hospitalised compared with those not hospitalised following a road traffic crash. Sydney Metropolitan, New South Wales, Australia. Persons aged ≥18 years involved in a motor vehicle crash were surveyed at baseline (n=364), and at 12 (n=284) and 24 months (n=252). A telephone-administered questionnaire obtained information on a range of socioeconomic, and preinjury and postinjury psychological and heath characteristics of all participants. Participants who reported admission to hospital for 24 h or more (but less than 7 days) after the crash were classified as being hospitalised; those admitted for less than 24 h were classified as non-hospitalised. Around 1 in 5 participants (19.0%) were hospitalised for ≥24 h after the crash. After adjusting for age and sex, hospitalised participants compared with those not hospitalised had approx...

To evaluate whether individual types of pain (headache, stomach-ache, and backache) or multiple pains affect the odds of young people achieving the recommended 60 minutes of moderate to vigorous physical activity (MVPA) per day in a large representative sample. Multicenter cross-sectional survey. Twenty-eight countries across Europe and North America. Adolescents (N = 242,103). An analysis of data collected in two waves (2001/02 and 2005/06) of the health behavior in school-aged children (HBSC) study was performed. Survey questions included the HBSC symptoms checklist and the amount of regular physical activity. Multilevel logistic regression was used to account for clustering effect of MVPA within countries. Models investigated the relationship between pain and physical activity, adjusted for the HBSC study year. Six models were conducted separately for gender and age-group (11, 13, and 15 years) strata. In general, the presence of pain was associated with reduced physical activity. Headache alone was associated with reduced physical activity in all six strata (odd ratios 0.77-0.84), stomach-ache alone in five strata (0.77-0.92), and backache alone in four strata (0.86-0.96). In 11- and 13-year-old girls, headache, stomach-ache, and backache, individually and in combination, were associated with decreased odds of being physically active (odds ratios ranging from 0.73 to 0.91). Within the other four age and gender strata, the relationship was less consistent. Pain is associated with reduced physical activity in adolescents but this association varies according to gender, age, and the type of pain experienced.

To investigate a range of transient risk factors for an episode of sudden-onset, acute low back pain (LBP). This case-crossover study recruited 999 subjects with a new episode of acute LBP between October 2011 and November 2012 from 300 primary care clinics in Sydney, Australia. Each participant was asked to report exposure to 12 putative triggers over the 96 hours preceding the onset of back pain. Conditional logistic regression was used to estimate odds ratios (ORs) expressing the magnitude of increased risk with exposure to each trigger. Exposure to a range of physical and psychosocial triggers significantly increased the risk of a new onset of LBP; ORs ranged from 2.7 (moderate or vigorous physical activity) to 25.0 (distracted during an activity or task). Age moderated the effect of exposure to heavy loads and sexual activity. The ORs for heavy loads for people ages 20, 40, or 60 years were 13.6, 6.0, and 2.7, respectively. The risk of developing back pain was greatest between ...