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aimel,1 Mohammed M Alshehri,4 Bader A Alqahtani,1 Faris A Alodaibi51Department of Health and Rehabilitation Sciences, College of Applied Medical Science, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; 2Department of Physical Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 3Joint Clinic, Riyadh, Saudi Arabia; 4Physical Therapy Department, Jazan University, Jazan, Saudi Arabia; 5Department of Rehabilitation Science, King Saud University, Riyadh, Saudi Arabia Correspondence: Ahmed S Alhowimel, Department of Health and Rehabilitation Sciences, College of Applied Medical Science, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia, Tel +96611558888, Email a.a; [email protected] Purpose: This cross-sectional study aimed to validate the Arabic version of the Attitude toward Education and Advice for Low Back Pain (AxEL) Questionnaire. Patients and Methods: This study was conducted in two phases. First, the AxEL questionnaire was translated into Arabic and cross-culturally adapted. Second, the psychometric properties (such as validity) of the translated AxEL were evaluated. Results: The results showed that back translators and language specialists had no trouble translating the AxEL. The translators' agreement was very high (88.2%), and the questionnaire items were logically and clearly translated from English into Arabic. Conclusion: The Arabic version of AxEL is a valid tool that can assess individuals' beliefs and attitudes towards low back pain (LBP). It fills a significant void in cross-cultural research and can help healthcare providers understand the attitudes and beliefs influencing individuals' management of LBP within the Arabic context. [ABSTRACT FROM AUTHOR]

Background: Research evidence suggests that a stratified care management approach is better at improving clinical and economic outcomes for low back pain (LBP) patients compared with usual care in the short‐term. However, it is uncertain if these health and economic benefits are sustainable in the longer term. Objective: To determine the effectiveness of stratified care compared with standard physiotherapy for LBP treatment. Methods: A comprehensive search was undertaken of seven electronic databases (CINAHL, MEDLINE, Pedro, EMBASE, PsycINFO, Cochrane Register for Controlled Trials and Web of Science with full text. No time limits were applied, but studies were limited to English language publications and those involving human participants. Two independent reviewers undertook study selection, data extraction and appraisal of study Results: In total, 6,842 patients (18 years and above) were included in the 8 trials reviewed – 4 were randomised controlled trials (RCTs) and the other 4 were non‐RCTs. The pooled analysis of 3 studies (n = 2,460) demonstrated a strong evidence in favour of stratified care over standard care at improving overall pain (WMD [random] 0.46 [95% CI 0.21, 0.71]; P < 0.0003), with overall effect (Z = 3.6) and (RMDQ) scores (WMD [random] 0.71 [95% CI 0.05, 1.37]; P < 0.03), with overall effect (Z = 2.11) at 3, 4‐ and 6‐months follow‐up periods. Conclusion: This current review demonstrated that a stratified care approach provides substantial clinical, economic and health related cost benefits in the medium and high‐risk subgroups compared with usual care. Further research is needed for longer‐term benefits. Highlights: Stratified care approach demonstrated better improvement in back pain, function and disability in patients with LBP at 3, 4 and 6 months over current standard practice. Further research is needed to establish longer term benefits.A stratified care approach provides substantial clinical, economic and health related cost benefits in the medium and high‐risk subgroups compared with usual care.Stratified care approach had significant improvements for treatment satisfaction, quality of life, general health (physical and emotional component), global change and SBST risk reduction. [ABSTRACT FROM AUTHOR]

Background: Recent studies have shown that physical exercise significantly modulates immunocyte dynamics and possibly plays a significant role on immune function. This study examined the responses of some selected immune system parameters to isometric handgrip exercise and identified possible effects of intensity and duration of the exercise protocols., Methods: One hundred and ninety-two (N=192) sedentary pre-hypertensive subjects, aged between 30-50 years were recruited into the study. They were randomly distributed into three groups of 64 subjects each. A detailed explanation and a demonstration of the exercise protocol were given to the subjects and they were asked to report at the Exercise Physiology unit of the Physiotherapy department, Federal Medical Centre, Asaba, Delta State at 4.00 pm daily for the exercise practice. The training session for each day took place between the hours of 4.00 pm and 8.00 pm daily (FMC/ASB/A81.VOL.XII/101). The subjects performed a 24 consecutive day's isometric handgrip exercise at 30% Maximum Voluntary Contraction (MVC). At the end of the 24 days, group one (GP1) discontinued with the exercise protocol, while group two (GP2) and group three (GP3) continued with the exercise protocol for another 24 consecutive days nevertheless GP3 performed at an increased intensity of 50% MVC. The clinical trial was registered with Nigeria Clinical Trial Registry, Federal Ministry of Health, Abuja Nigeriawith Trial No: 1216582 (https://www.nctr.nhrec.net/viewTrials.php?TID=1216582)., Results: At the end of the study, the result shows thatthe number of CD4 cells and CD4/CD8 ratio significantly (P<0.05) increased while the CD8 cell decreased in GP2 and GP3. It was further shown that increase in duration produced a more significant change compared to an increase in intensity of the isometric effort., Conclusion: The study established that isometric handgrip exercise alters the circulating levels of the immune system parameters which could have positive beneficial effects on the prehypertensive individuals as the number of CD4 cells and CD4/CD8 ratio increased especially when practiced over a longer duration., Competing Interests: None., (IJPPP Copyright © 2022.)