SUNDAY, Oct. 5 (HealthDay News) -- Doctors may soon be able to use a simple questionnaire to predict which spine surgery patients will engage in their own physical therapy, say Johns Hopkins researchers.
The 13-item questionnaire, known as the Patient Activation Measure (PAM), was developed in 2004 to assess patients' abilities to play active roles in their health care. The PAM has been used previously with chronic diseases such as HIV, type 2 diabetes and hypertension.
"It has long been known that physical therapy after spine surgery greatly improves outcomes, but to date, there has been no easy-to-administer, standardized method for assessing a patient's willingness to adhere to therapy," study author Richard L. Skolasky, of the Department of Orthopaedic Surgery at Johns Hopkins University School of Medicine, said in a university news release.
In this study, which is published in the Oct. 1 online edition of Spine, 65 Johns Hopkins patients who were to undergo their first surgical treatment for a degenerative spine disease completed the PAM before surgery.
For six weeks, the patients kept track of their attendance in physical therapy sessions. After the last session, the physical therapists rated the patients' attitude, need for prompts, understanding of the importance of therapy, and activity during sessions.
The researchers found that the patients who scored high on the PAM were 38 percent more likely to attend physical therapy and were rated as significantly more engaged in rehabilitation by their therapists, compared with the patients who had low PAM scores.
Specifically, patients with the lowest PAM scores attended 55.6 percent of their therapy sessions, compared with a 94.1 percent attendance rate in those with the highest scores.
"These results were very encouraging, and since the PAM is easy to administer, it may provide a practical component to a patient's preoperative treatment," said Skolasky.
Skolasky noted that before spine surgeons begin using the questionnaire, methods for improving PAM scores must be developed. He and his colleagues are planning a study to test methods for improving low PAM scorers' involvement in their own health care.
More information
The North American Spine Society has more about spine surgery 
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MONDAY, Sept. 29 (HealthDay News) -- The pain caused by osteoarthritis may be as damaging as the disease itself, according to a new study.
According to a University of Rochester study published Monday in the journal Arthritis & Rheumatism, the nerve pathways carrying pain signals between the arthritic joints and the spinal cord transfer inflammation to the spine and surrounding cells and back again.
"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, and inevitable part of aging," Stephanos Kyrkanides, associate professor of dentistry at the school's Medical Center, said in a university news release. "Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing and suggests the mechanisms behind the effect."
The study gives strong evidence that this two-way "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, eventually leading to it spreading through the central nervous system.
The researchers genetically engineered mice to study levels of a pro-inflammatory signaling chemical called interleukin 1-beta. Their experiments showed that higher levels of the chemical in a peripheral joint caused higher levels to be produced in the dorsal horns of the spinal cord and in spinal cord cells called astrocytes, which cause more osteoarthritic symptoms in joints.
In the mouse experiments, shutting down the signaling reversed the crosstalk effects. Some existing arthritis drugs, such as Kineret (anakinra), block the ability of interleukin 1-beta to send a pain signal through its specific nerve cell receptor, and Kyrkanides' group is experimenting with them as in osteoarthritis treatment.
More information
The Arthritis Foundation has more about osteoarthritis .