<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE Articles SYSTEM "HBI_DTD">
<Articles><Article><Journal><PublisherName></PublisherName><JournalTitle>International Journal of Preventive Medicine (Int J Prev Med)</JournalTitle><Issn>2008-7802</Issn><Volume>4</Volume><Issue>3</Issue><PubDate PubStatus="epublish"><Year>2012</Year><Month>09</Month><Day>18</Day></PubDate></Journal><title locale="en_US">Skew‑symmetric Random Effect Models with Application to a Preventive Cohort Study: Improving Outcomes in Low Back Pain Patients</title><FirstPage>279</FirstPage><LastPage>285</LastPage><Language>EN</Language><AuthorList><Author><affiliation locale="en_US">Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran</affiliation></Author><Author><affiliation locale="en_US">Department of Statistics, University of Isfahan, Isfahan, Iran</affiliation></Author><Author><affiliation locale="en_US">Department of Physical Medicine and Rehabilitation, Asian Medicine and Acupuncture Research, School of Medicine, University of North Carolina, USA</affiliation></Author><Author><affiliation locale="en_US">Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</affiliation></Author></AuthorList><History><PubDate PubStatus="received"><Year>2012</Year><Month>09</Month><Day>13</Day></PubDate><PubDate PubStatus="accepted"><Year>2012</Year><Month>09</Month><Day>17</Day></PubDate></History><abstract locale="en_US">&lt;p&gt;&amp;nbsp;&lt;strong&gt;Background: &lt;/strong&gt;To investigate the respective contribution of various biologic and psychosocial factors, especially Health Related Quality of Life (HRQOL) as a main outcome, in the natural history of acute low back pain (LBP) and to evaluate the impact of this condition on HRQOL.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a prospective cohort study For 24 weeks, 150 patients were assessed at an outpatient clinic in Korea consulting for low back and confirmed disc herniation duration at inclusion and treated with treatment package comprised of herbal medicines, acupuncture, bee venom acupuncture, and a Korean version of spinal manipulation (Chuna). Study participants were evaluated at baseline and every 4 weeks for 24 weeks. Low back intensity levels were measured on a visual analog scale (0‑10), back function was evaluated with the Oswestry Disability Index (0‑100), disability assessed by HRQOL assessed by the short form 36 health survey (0‑100 in 8 different sub‑categories).&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 150 patients, 128 completed the 24 weeks of traditional therapy. Patients reported improvements SF‑36 outcome measures. At the completion of the study, low back pain scores improved by a mean of 3.3 (95% CI = 2.8 to 3.8). According to the results of our modeling, low back intensity level, back function and BMI measures had significant effects on quality of life during study. Interpreting the coefficients of modeling, the impact of the decreasing acute LBP episode on HRQOL by VAS and ODI outcomes, was high and important.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study highlights the large contribution of integrative package therapy as an effective preventive method for improving LBP patient&amp;rsquo;s HRQOL.&lt;/p&gt; &lt;strong&gt;Keywords: &lt;/strong&gt;Low back pain, health related quality of life, oswestry disability index</abstract><web_url>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/907</web_url><pdf_url>http://ijpm.mui.ac.ir/index.php/ijpm/article/download/907/832</pdf_url></Article></Articles>
