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Background Lumbar disc herniation is a prevalent condition that leads to pain, disability, and a reduction in quality of life. While conventional treatments are widely utilized, virtual reality-based exercise programs present a promising alternative. However, the effectiveness of these exercises in the rehabilitation of lumbar disc herniation remains unclear. The aim of this study was to evaluate the effects of virtual reality-based exercises on pain, daily activities, quality of life, and fall risk in individuals with lumbar disc herniation. Materials and methods This randomized controlled trial included 68 patients meeting the study criteria. Inclusion criteria: No other physical disabilities, no surgery in the last 6 months, no uncontrolled diseases, no vertigo, knee or joint issues, moderate/low balance impairment, and body mass ındex below 40. Exclusion criteria: Uncontrolled diseases, vertigo, knee/joint issues, cognitive impairments, pregnancy, inability to complete fall risk measurement, or attend follow-ups . Participants were divided into a virtual reality group ( n  = 34, Mean age ± Standard Deviation = 51.05 ± 13.39, 41.2% male, 58.8% female) and a control group ( n  = 34, Mean age ± Standard Deviation = 53.55 ± 12.25, 29.4% male, 70.6% female). The virtual reality group performed 28 sessions of virtual reality -based exercises, while the control group received routine hospital treatment. The study was conducted in a single hospital due to equipment limitations in the region. Data were collected using the Patient Information Form, Visual Analog Scale, Oswestry Disability Index, Short Form-36 Quality of Life Scale, and Fall Risk Device. Statistical analyses were performed using Statistical Package for the Social Sciences 20, including t-tests, chi-square tests, effect size analysis, and skewness/kurtosis assessments for homogeneity. Results The virtual reality group showed a significant reduction in pain (Visual Analog Scale: 3.38 ± 1.48, Cl: -2.49, -0.86, p  < 0.05) and disability (Oswestry Disability Index: 21.59 ± 6.00, Cl: -19.92, -7.38, p  < 0.05), along with significant improvements in all Short Form-36 Quality Of Life sub-dimensions ( p  < 0.05).Fall risk scores also decreased significantly in the virtual reality group (Cl: -26.57, -7.26, p  < 0.05). There were no significant baseline differences between the groups, confirming their comparability before the intervention. Conclusion Virtual reality -based exercises effectively reduced pain, improved daily activities and quality of life, and decreased fall risk in lumbar disc herniation patients, suggesting their potential as a complementary rehabilitation approach. Blinding was not applied due to the nature of the interventions, which may introduce a potential risk of bias. Trial registration This study was registered at ClinicalTrials.gov (Clinical trial number: NCT05463588; Registration date: 08/07/2022). The study was retrospectively registered.

Background: This study aimed to investigate the effect of manual therapy on pain, kinesiophobia, pain catastrophizing, anxiety, depression, and quality of life in patients with lumbar disc herniation (LDH). Methods: The study included 32 LDH patients. Patients were divided into the Manual therapy group (MTG—age 39.81 ± 9.45 years) and the Exercise group (EG—age 38.31 ± 9.21 years) by sealed envelope randomization. Patients were evaluated pre-study, post-study, and after a 3-month period using the McGill–Melzack Pain Questionnaire (MMPQ), Hospital Anxiety and Depression Scale (HADS), Tampa Kinesiophobia Scale (TKS), Pain Catastrophizing Scale (PCS) and Nottingham Health Profile (NSP). The exercise group received a total of ten sessions of stabilization exercises and sham spinal mobilization in five weeks, two sessions per week. In addition to the stabilization exercises, mobilization applications including Anterior-Posterior Lumbar Spinal Mobilization, Lumbar Spinal Rotational Mobilization, and Joint Mobilization in Lumbar Flexion Position, were applied to the manual therapy group. Results: It was found that the HADS and TKS values decreased in the MTG group compared to the pre-treatment period (p < 0.05), while there was no difference between these values in the EG group (p > 0.05). There was a statistically significant difference in the MMPQ, PCS, and NHP values after treatment in both the MTG and EG groups (p < 0.05). Conclusions: It was found that manual therapy had positive effects on psychological factors such as pain, kinesiophobia, pain catastrophizing, anxiety, depression, and quality of life in patients with LDH. Trial registration: NCT05804357 (27 March 2023) (retrospectively registered).

From the Man Booker Prize-shortlisted author of Swimming Home, a single volume comprising her first two novels: Beautiful Mutants, long out of print, and Swallowing Geography, never before published in the United States.

Despite the continuous development of surgical techniques and implants, a substantial number of patients still undergo surgery for chronic low back pain (CLBP) without any benefit, or even become worse. With the aim of finding predictors of functional and work status outcome, 264 patients with severe CLBP of long duration, randomised to surgical or non-surgical treatment, were characterized by socio-demographic, clinical, radiological and psychological variables. The variables were estimated as predictors of outcome at the 2-year follow-up. Univariate and multiple logistic regression analyses were used in both treatment groups. We found that a personality characterized by low neuroticism and low disc height were significant predictors of functional improvement after surgical treatment. Depressive symptoms predicted functional improvement after non-surgical treatment. Work resumption was predicted by low age and short sick leave in the surgical group, and by short sick leave in the non-surgical group. We conclude that improved selection of successful surgical candidates with CLBP seems to be promoted by attention to severe disc degeneration, evaluation of personality traits and shortening of preoperative sick leave.

This article introduces a time perspective on 'protracted displacement' and seeks to theorize 'agency-in-waiting' through a focus on the ways in which people simultaneously carry on during displacement, feel trapped in the present, and actively relate to alternative notions of the future. The article analyzes the protracted case of internally displaced Georgians from Abkhazia and the dominant discourse of return that characterizes their lives in displacement. Changing notions of hope are analyzed in order to understand the role that an uncertain future plays and the potential for agency that people develop during displacement. Agency-in-waiting and future perspectives, it is suggested, contribute valuable conceptual and political dimensions to the ways in which protracted displacement can be understood and addressed.

\"Displacement and the Somatics of Postcolonial Culture is Douglas Robinson's study of postcolonial affect--specifically, of the breakdown of the normative (regulatory) circulation of affect in the refugee experience and the colonial encounter, the restructuring of that regulatory circulation in colonization, and the persistence of that restructuring in decolonization and intergenerational trauma. Robinson defines \"somatics\" as a cultural construction of \"reality\" and \"identity\" through the regulatory circulation of evaluative affect. This book is divided into three essays covering the refugee experience, colonization and decolonization, and intergenerational trauma. Each essay contains a review of empirical studies of its main topic, a study of literary representations of that topic, and a study of postcolonial theoretical spins. The literary representations in the refugee essay are a novel and short story by the Haitian writer Edwidge Danticat; in the colonization essay a short film by Javier Fesser and a novella by Mahasweta Devi (translated by Gayatri Chakravorty Spivak); and in the intergenerational trauma essay novels by James Welch and Toni Morrison and a short story by Percival Everett. The first essay's theoretical spins include Deleuze and Guattari on nomad thought and Iain Chambers on migrancy; the second's, Nietzsche's Genealogy of Morals and theories of postcolonial affect in Bhabha and Spivak; the third's, work on historical trauma by Cathy Caruth and Dominic LaCapra\"--Page 4 of cover.

Whether one thinks of the modern world or of more remote times, both seem to have been affected - if not moulded - by the interaction between the concepts of authority and displacement. Indeed, political and social sources of authority have often been the causes of major geographical displacements, as can be illustrated by the numerous waves of migration which have been observed in the past and which are still present today, such as the transportation of slaves from African to American coasts in colonial times.If displacement can often be understood as spatial displacement, it can also be synonymous with psychological, social, and even aesthetic displacement, for instance through different artistic means or through the use of stylistic discursive devices. Displacement also entails dis-placement, dis-location, as well as dislocation, or chaos. This suggests that the etymological meaning of the term authority, auctoritas, has to be highlighted, thus referring to the author of a particular work and to the different manifestations of the authorial persona in a work of art.This collection of essays in two volumes examines the relationships between the concepts of authority and displacement in the English-speaking world, without restricting the analysis to a particular area, or to the field of literature. Some essays do, indeed, deal with literature, from different spatial areas and temporal eras, while others look into these concepts from a more cultural or aesthetic point of view.Volume Two, Exploring American Shores, includes essays on the place of famous fugitives in American culture (notably through the story of Bonnie and Clyde) as well as on the links between displacement, authority and sculpture on the one hand (Placing and Replacing the Capitol Sculptures), and on the links between displacement and photography on the other, through a study of Joel Sternfeld's Walking the High Line. In addition to investigations of Louise Erdrich's novel Books and Islands in Ojibwe Country, Canadian \"landscapes in transit\" will be studied to highlight the displacement of the Western landscape tradition in English Canada. The volume concludes with a study of some literary works by several writers of Guyanese origin - first with an essay comparing Martin Carter's and Leon-Gontran Damas's literary productions, and then with an essay devoted to Fred D'Aguiar's novel, The Longest Memory (1994).