The U.S. Preventive Services Task Force did not find sufficiently strong evidence to make a recommendation for or against screening people with no thyroid symptoms for thyroid disease (Clinical Guidelines, p. 125; Background Evidence Summary, p. 128). The USPSTF evaluates published research and makes recommendations about preventive health care. The Task Force says that physicians should test for thyroid disease in people with symptoms of thyroid dysfunction and look for signs of thyroid dysfunction among those at relative risk for thyroid disease, such as the elderly, post-partum women, people with high levels of radiation exposure, and those with Down syndrome.
2. Graded Activity for Low Back Pain Reduced Lost Work Days
Researchers in the Netherlands found that a program of graded exercises for low back pain reduced the number of days lost from work more than "usual care" for work-related low back pain (Article, p. 77). Participants randomized to the graded activity program missed 58 days of work during the six-month follow-up period compared to 87 days in the usual-care group. Participants in the activity group exercised under the supervision of physical therapists who insisted that they complete exercises despite pain, graphed progress to provide positive reinforcement and set their own return-to-work dates. An editorial writer commends the program, particularly for its philosophy that patients should function despite pain, but says "we need to know much more about back pain if we are to devise more powerful treatments." (Editorial, p. 142.)
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