Search

Background C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are the main inflammatory biomarkers used in assessment of disease activity in numerous inflammatory diseases such as ankylosing spondylitis (SA). In recent years, it has been shown that Platelet count (PC) provided additional information on inflammatory status. Objectives The present study aimed to investigate the correlation between PC and clinical activity indices assessed by Bath ankylosing spondylitis disease activity index (BASDAI) Methods The study included 68 patients who fulfilled Assessment of Spondyloarthritis International Society Criteria. A cell blood count, including platelet count, ESR (mm/h), CRP (mg/L) and albumin (g/L), was obtained for each patient. Disease activity measures at the time of blood sampling were obtained using the BASDAI. Statistical Package for Social Sciences (SPSS) was used for analysis. Results Of the 68 patients, 73.5% were male (Sex Ratio: 2.7). The mean age was 36±12.9 years. The mean disease duration was 40 months [0–192]. The average age of the onset of the disease was 36.6±11.9 years. No patient had ongoing infection at time of study. The mean BASDAI score was 5.1 [1.55–9.2]. Forty-one% of our patients (n=28) had active AS (BASDAI >4) The mean ESR, CRP, albumin and PC were 39.4 (mm/h), 34.1(mg/dL), 39,32 g/L and 311 (103/mL), respectively. There was a positive correlation between platelet count and following biomarkers: ESR (r: −0.481; p: 0.000), CRP (r: 0.417; p: 0.000) and albumin levels (r: −0.556; p:0.000). A negative correlation between and Haemoglobin (Hg) was noted (r: −0.643; p: 0.000). There was no significant difference in laboratory parameters (ESR, CRP, albumin, PC, Hg) between patients with active AS (BASDAI >4) and those with inactive AS (BASDI Conclusions Although acute phase reactant such as ESR, CRP and PC mirror disease activity in AS,1 their values were not associated with disease activity assessed by BASDAI in our study. However, new prospective studies including larger study groups are required to verify the findings of the present study. Reference [1] Ruof J, Stucki G. Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review. J Rheumatol1999;26:966e70. Disclosure of Interest None declared

Background The notions of apprehension-avoidance and beliefs are among the psychosocial factors associated with the occurrence, maintenance and strengthening of the chronic painful process. Therapeutic education is increasingly described in the literature as a means to manage these factors in order to limit the transition to a chronic stage. Objectives The aim of this study is to examine the effect of therapeutic education on fears and beliefs in chronic low back pain. Methods A prospective, comparative study was conducted with two groups of 50 patients each one having chronic low back pain. Both groups had benefited from the same physical rehabilitation program. The second group concurrently attended therapeutic education sessions. Fears and beliefs of patients and their kinesiophobia were evaluated with the FABQ: Fear-Avoidance beliefs questionnaire and the TSK: Tampa scale of kinesiophobia for the evaluation of kinesiophobia index. Results The initial evaluation of apprehension-avoidance showed a high FABQ score in two groups. Management that was limited to physical rehabilitation demonstrated no effect on the apprehension-avoidance indices evaluated by the FABQ scale. However, there was a clear improvement in apprehension and avoidance in the G2 and with a statically significant difference (P=0.03). An initial and high kinesiophobic score (≥48) was noted in two groups. G1 patients showed no significant improvement in their TSK scores after the end of the program. G2 patients who benefited from a therapeutic education workshop improved their TSK scores significantly after the program completion compared to G2. Conclusions The integration of the patient into the therapeutic education workshops improved the behavior of apprehension and kinesiophobia. This further supports the usefulness of applying cognitive therapy to our patients when restructuring of preconceived ideas about movement and physical activities. References Nguyen C, Poiraudeau S, Revel M. Lombalgie chronique: facteurs de passage a la chronicite. Rev rhum.2009;76:537–42. Butron AK, Waddel G, Tilloston KM, Sumerton N. Information and advice to patients with back pain can have positive effects. A randomized controlled trial of a novel educational book in primary care. Spine. 1999;24:2481–91. Fritz JM, George SZ, Delitto A.The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status.Pain. 2000;94:7–15 Disclosure of Interest None declared

Background The occupational impact of low back pain is generally assessed in terms of absenteeism and duration of sick leave. A non-return to work greater than eight days has been considered a poor prognosis factor. Several psychosocial factors have been identified as the original cause. Objectives Studying the impact of erroneous beliefs, avoidance behaviors, apprehension and fear of movement on sick leave in patients with chronic low back pain. Methods A prospective study was conducted in patients with chronic low back pain patients. The notion of apprehension-avoidance was evaluated by the Fear Avoidance Beliefs questionnaire (FABQ), fear of movement by the Tampa scale of kinesiophobia (TSK) and functional disability by the Functional Disability Scale Of low back pain: EIFFEL (French version of Roland Disability Questionnaire). A study of the correlations between these different parameters and the duration of sick leave was carried out subsequently. Results Our study included 100 patients. The findings revealed a 95% absenteeism rate including 67% with a sick leave of more than one month. The FABQ, TSK and EIFFEIL scores were high. The statistical study concluded that there was a positive and significant correlation between sick leave time, fears and erroneous beliefs (r =0.147, P=0.033). We also found a positive and significant correlation between the duration of sick leave and kinesiophobia. There were no statistically significant correlations between sick leave and functional disability. Conclusions The high scores of FABQ and TSK confirm the important role of false beliefs and fear of movement in the genesis of chronicity in chronic low back pain as reported in the literature. The positive correlations found in our study reinforce the theory of the deconditioning of these patients following their beliefs. Management of these factors would be an important contribution to limit sick leave times in chronic low back pain. References Williams RA, Pruitt SD, Doctor JN, Epping-Jordan JE, Wahlgren DR, Grant I et al.The contribution of job satisfaction to the transition from acute to chronic low back pain. Arch Phys Med Rehab.1998;79:366–74. Ratinaud MC,Chamoux A,Glace B,Coudeyre E. Job satisfaction evaluation in low back pain: a literature review and tools appraisal. Ann Phys Rehabil Med. 2013;56(6):465–81. Fayad F, Lefevre-Colau MM, Poiraudeau S,Fermanian J, Rannou F, Wlodyka Demaille S et al. Chronicite, recidive et reprise du travail dans la lombalgie: facteurs communs de pronostic. Ann Readap Med Phy.2004; 47:179–88. Gronblad M, Jarvinen E, Airaksinen O, Ruuskanen M, Hamalainen H, Kouri JP. Relationship of subjective disability with pain intensity, pain duration, pain location and work –related factors in non operated patients with chronic low back pain. Clin J Pain. 1996;12:194–200. Disclosure of Interest None declared