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Alyousef B, Kazemi Z, Cicuttini FM, Heritier S, Wang Y, Urquhart DM. High levels of back disability, not back pain, are associated with reduced physical activity across key activity domains. Musculoskelet Sci Pract 2023; 65:102768. [PMID: 37126982 DOI: 10.1016/j.msksp.2023.102768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 03/20/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Although remaining physically active is the cornerstone of management for low back pain, our understanding of the physical activity performed by those with back pain is limited. OBJECTIVES To examine the physical activity reported by individuals with different levels of low back pain and disability across key activity domains. DESIGN Community-based, cross-sectional study. METHODS 542 women were recruited from a research database formed from an electoral roll and completed validated, self-report questionnaires. The amount and intensity of physical activity was reported using the International Physical Activity Questionnaire. Low back pain and disability were examined using the Graded Chronic Pain Scale. Participants were categorised into no, low or high pain and disability groups. RESULTS Individuals who reported high disability performed 55% of the physical activity of those without disability (MET(hours/week):median(95%CI) = 27.1(13.2-41.0); 48.8(37.8-59.9),p = 0.01), including less moderate (18.0(10.4-25.6); 31.0(24.0-38.1),p = 0.007), and domestic and gardening activity (14.7(7.2-22.3); 25.7(19.8-31.7),p = 0.001). Fewer women with high disability performed vigorous (OR(95%CI) = 0.29(0.13-0.65),p = 0.002) and leisure activities (0.17(0.04-0.75),p = 0.02) compared to those with no disability. Those with low disability reported less leisure activity ((0.55(0.35-0.88),p = 0.01), but more work-related activities and active transport than individuals without disability (1.65(1.01-2.7),p = 0.04; 1.6(1.04-2.6),p = 0.03). There were no differences in activity between pain groups, with the exception of those with low intensity pain performing less leisure activity (0.51(0.30-0.88),p = 0.01). CONCLUSIONS Individuals who reported high back disability, not back pain, were found to perform reduced physical activity, including less total, moderate, vigorous, and discretionary activity. These findings highlight the altered activity levels of people with back disability and the need to examine its impact on their health and wellbeing.
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Affiliation(s)
- Bothaina Alyousef
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Department of Rehabilitation Sciences, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Zeinab Kazemi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Donna M Urquhart
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Nim CG, Hansen A, Backmann T, Ziegler DS, O'Neill S. Multidisciplinary team-based management approach for secondary-care patients with severe and persistent low back pain: A mixed-method feasibility trial. J Back Musculoskelet Rehabil 2023:BMR220369. [PMID: 37092217 DOI: 10.3233/bmr-220369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Persistent and severe low back pain is challenging to treat. Multidisciplinary care with systematic follow-up may be more effective than usual care. However, such a model has yet to be developed and tested. OBJECTIVE Our objectives were to develop and test the feasibility of a three-month multidisciplinary intervention with systematic follow-up in a specialized hospital spine center for patients with severe and persistent low back pain. METHODS Using the Medical Research Council and National Institute for Health and Care Research framework for the development and testing of complex interventions, we developed a multidisciplinary intervention with systematic follow-up and tested its feasibility, using a-priori-determined outcomes during three months for 24 patients seen at a regional diagnostic spine center unit. As part of the evaluation, we conducted semi-structured interviews with participants and a focus-group interview with clinicians. RESULTS Of the 24 patients included, only 17 completed the course of care and provided complete data for feasibility assessment. We failed to reach our a-priori feasibility outcomes, had difficulty with inclusion, and participants did not find the intervention effective or satisfactory. CONCLUSIONS The intervention was not feasible as barriers existed on multiple levels (e.g., clinical, administrative, and patient). Excessive study moderations must be made before the intervention is feasible in a randomized trial.
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Affiliation(s)
- Casper Glissmann Nim
- Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Anders Hansen
- Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Tina Backmann
- Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
| | - Dorthe Schøler Ziegler
- Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Søren O'Neill
- Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Rambla C, Aragonès E, Pallejà-Millán M, Tomé-Pires C, López-Cortacans G, Sánchez-Rodríguez E, Miró J. Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression. BMC Musculoskelet Disord 2023; 24:270. [PMID: 37020278 PMCID: PMC10074832 DOI: 10.1186/s12891-023-06357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Chronic pain and depression are frequent comorbidities in primary care. Depression among other psychosocial factors play a role in the clinical course of chronic pain. OBJECTIVE To study the short and long-term predictive factors of severity and interference of chronic pain in primary care patients with chronic musculoskeletal pain and major depression. METHODS Longitudinal study of a cohort of 317 patients. The outcomes are severity and functional interference of pain (Brief Pain Inventory) measured at 3 and 12 months. We performed multivariate linear regression models to estimate the effects the explanatory baseline variables on the outcomes. RESULTS 83% participants were women; average age was 60.3 years (SD = 10.2). In multivariate models, baseline pain severity predicted pain severity at 3 months (β = 0.53; 95% CI = 0.37-0.68) and at 12 months (β = 0.48; 95% CI = 0.29-0.67). Also, pain > 2 years of evolution predicted long term pain severity (β = 0.91; CI95%=0.11-1.71). Baseline pain interference predicted interference at 3 and 12 months (β = 0.27; 95%CI = 0.11-0.43 and β = 0.21; 95%CI = 0.03-0.40, respectively). Baseline pain severity predicted interference at 3 and 12 months (β = 0.26; 95%CI = 0.10-0.42 and β = 0.20; 95%CI = 0.02-0.39, respectively). Pain > 2 years predicted greater severity and greater interference at 12 months (β = 0.91; CI95%=0.11-1.71, and β = 1.23; CI95%=0.41-2.04). Depression severity predicted more interference at 12 months (β = 0.58; CI95%=0.04-1.11). Occupational status as active worker predicted less interference throughout the follow-up (β=-0.74; CI95%=-1.36 to -0.13 and β=-0.96; CI95%=-1.71 to -0.21, at 3 and 12 months). Currently working also predicts less pain severity at 12 months (β=-0.77; CI95%=1.52 - 0.02). With regard to the psychological variables, pain catastrophizing predicted pain severity and interference at three months (β = 0.03; 95% CI = 0.00-0.05 and β = 0.03; 95% CI = 0.00-0.05), but not at long term. CONCLUSION In a sample of adults with chronic pain and depression, this primary care study has identified prognostic factors that independently predict the severity and functional interference of pain. If confirmed in new studies, these factors should be targeted for individualized interventions. TRIAL REGISTRATION ClinicalTrials.gov (NCT02605278), registered 16/11/2015.
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Affiliation(s)
- Concepció Rambla
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Enric Aragonès
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain.
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
- Centre d'Atenció Primària Constantí, Carrer dels Horts, 6, Constantí, 43120, Tarragona, Spain.
| | | | - Catarina Tomé-Pires
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain
- Psychology Research Center (CIP), Autonomous University of Lisbon, Lisboa, Portugal
| | - Germán López-Cortacans
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain
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Smalley H, Edwards K. Understanding the burden of chronic back pain: a spatial microsimulation of chronic back pain at small area level across England. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023:10.1007/s00586-023-07584-w. [PMID: 37005929 DOI: 10.1007/s00586-023-07584-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE Chronic back pain (CBP) carries a significant burden. Understanding how and why CBP prevalence varies spatially, as well as the potential impact of policies to decrease CBP would prove valuable for public health planning. This study aims to simulate and map the prevalence of CBP at ward-level across England, identify associations which may explain spatial variation, and explore 'what-if' scenarios for the impact of policies to increase physical activity (PA) on CBP. METHODS A two-stage static spatial microsimulation approach was used to simulate CBP prevalence in England, combining national-level CBP and PA data from the Health Survey for England with spatially disaggregated demographic data from the 2011 Census. The output was validated, mapped, and spatially analysed using geographically weighted regression. 'What-if' analysis assumed changes to individuals' moderate-to-vigorous physical activity (MVPA) levels. RESULTS Large significant clusters of high CBP prevalence were found predominantly in coastal areas and low prevalence in cities. Univariate analysis found a strong positive correlation between physical inactivity and CBP prevalence at ward-level (R2 = 0.735; Coefficient = 0.857). The local model showed the relationship to be stronger in/around cities (R2 = 0.815; Coefficient: Mean = 0.833, SD = 0.234, Range = 0.073-2.623). Multivariate modelling showed this relationship was largely explained by confounders (R2 = 0.924; Coefficient: Mean = 0.070, SD = 0.001, Range = 0.069-0.072). 'What-if' analysis showed a detectable reduction in CBP prevalence for increases in MVPA of 30 and 60 min (- 2.71%; 1, 164, 056 cases). CONCLUSION CBP prevalence varies at ward-level across England. At ward-level, physical inactivity is strongly positively correlated with CBP. This relationship is largely explained by geographic variation in confounders (the proportion of residents that are: over 60, in low-skilled jobs, female, pregnant, obese, smokers, white or black, disabled). Policies to increase PA by 30 min weekly MVPA will likely result in a significant reduction in CBP prevalence. To maximise their impact, policies could be tailored to areas of high prevalence, which are identified by this study.
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Affiliation(s)
- Harrison Smalley
- Queens Medical Centre, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Kimberley Edwards
- Queens Medical Centre, School of Medicine, University of Nottingham, Nottingham, UK
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Carrière JS, Donayre Pimentel S, Bou Saba S, Boehme B, Berbiche D, Coutu MF, Durand MJ. Recovery expectations can be assessed with single-item measures: findings of a systematic review and meta-analysis on the role of recovery expectations on return-to-work outcomes after musculoskeletal pain conditions. Pain 2023; 164:e190-e206. [PMID: 36155605 PMCID: PMC10026834 DOI: 10.1097/j.pain.0000000000002789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT The objective of this systematic review is to quantify the association between recovery expectations and return-to-work outcomes in adults with musculoskeletal pain conditions. In addition, this review has the second objective to compare the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Relevant articles were selected from Embase, PsycINFO, PubMed, Cochrane, and manual searches. Studies that assessed recovery expectations as predictors of return-to-work outcomes in adults with musculoskeletal pain conditions were eligible. Data were extracted on study characteristics, recovery expectations, return-to-work outcomes, and the quantitative association between recovery expectations and return-to-work outcomes. Risk of bias was assessed using the Effective Public Health Practice Project. Odds ratios were pooled to examine the effects of recovery expectations on return-to-work outcomes. Chi-square analyses compared the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Thirty studies on a total of 28,741 individuals with musculoskeletal pain conditions were included in this review. The odds of being work disabled at follow-up were twice as high in individuals with low recovery expectations (OR = 2.06 [95% CI 1.20-2.92] P < 0.001). Analyses also revealed no significant differences in the predictive value of validated and nonvalidated single-item measures of recovery expectations on work disability (χ 2 = 1.68, P = 0.19). There is strong evidence that recovery expectations are associated with return-to-work outcomes. The results suggest that single-item measures of recovery expectations can validly be used to predict return-to-work outcomes in individuals with musculoskeletal pain conditions.
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Affiliation(s)
- Junie S. Carrière
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | | | - Sabine Bou Saba
- School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
| | - Blake Boehme
- Department of Psychology, University of Regina, Regina, Saskatchewan
| | - Djamal Berbiche
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Coutu
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marie-José Durand
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
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Overstreet DS, Strath LJ, Jordan M, Jordan IA, Hobson JM, Owens MA, Williams AC, Edwards RR, Meints SM. A Brief Overview: Sex Differences in Prevalent Chronic Musculoskeletal Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4521. [PMID: 36901530 PMCID: PMC10001545 DOI: 10.3390/ijerph20054521] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/25/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Musculoskeletal (MSK) pain disorders are some of the most prevalent and disabling chronic pain conditions worldwide. These chronic conditions have a considerable impact on the quality of life of individuals, families, communities, and healthcare systems. Unfortunately, the burden of MSK pain disorders does not fall equally across the sexes. Females consistently demonstrate more prevalent and severe clinical presentations of MSK disorders, and this disparity increases in magnitude with age. The aim of the present article is to review recent studies that have examined sex differences between males and females in four of the most common MSK pain disorders: neck pain, low back pain, osteoarthritis, and rheumatoid arthritis.
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Affiliation(s)
- Demario S. Overstreet
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Woman’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Larissa J. Strath
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL 32603, USA
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL 32610, USA
| | | | - Indonesia A. Jordan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Joanna M. Hobson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Michael A. Owens
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Adrian C. Williams
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Woman’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Robert R. Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Woman’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Samantha M. Meints
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Woman’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
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Development and Validation of a Risk-Prediction Nomogram for Chronic Low Back Pain Using a National Health Examination Survey: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11040468. [PMID: 36833002 PMCID: PMC9957065 DOI: 10.3390/healthcare11040468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Several prognostic factors have been reported for chronic low back pain (CLBP). However, there are no studies on the prediction of CLBP development in the general population using a risk prediction model. This cross-sectional study aimed to develop and validate a risk prediction model for CLBP development in the general population, and to create a nomogram that can help a person at risk of developing CLBP to receive appropriate counseling on risk modification. METHODS Data on CLBP development, demographics, socioeconomic history, and comorbid health conditions of the participants were obtained through a nationally representative health examination and survey from 2007 to 2009. Prediction models for CLBP development were derived from a health survey on a random sample of 80% of the data and validated in the remaining 20%. After developing the risk prediction model for CLBP, the model was incorporated into a nomogram. RESULTS Data for 17,038 participants were analyzed, including 2693 with CLBP and 14,345 without CLBP. The selected risk factors included age, sex, occupation, education level, mid-intensity physical activity, depressive symptoms, and comorbidities. This model had good predictive performance in the validation dataset (concordance statistic = 0.7569, Hosmer-Lemeshow chi-square statistic = 12.10, p = 0.278). Based on our model, the findings indicated no significant differences between the observed and predicted probabilities. CONCLUSIONS The risk prediction model presented by a nomogram, which is a score-based prediction system, can be incorporated into the clinical setting. Thus, our prediction model can help individuals at risk of developing CLBP to receive appropriate counseling on risk modification from primary physicians.
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Morozova TE, Vorob'eva OV, Gertsog AA. Effect of obesity and sociodemographic factors on chronic pain: a cohort study in general practice. CONSILIUM MEDICUM 2023. [DOI: 10.26442/20751753.2022.12.201950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background. Obesity is a component of metabolic syndrome, a separate disease, and a predictor of most chronic diseases. In recent decades, increasing attention has been paid to the effect of obesity on chronic localized pain.
Aim. To determine the clinical characteristics of chronic localized pain depending on the body mass index and sociodemographic factors.
Materials and methods. The study enrolled 112 eligible patients, 37 (33%) males and 75 (67%) females aged 19 to 65 years, with a mean age of 40 [32; 40] years. Patients were divided into three groups depending on the body mass index. All patients underwent a comprehensive general clinical examination, including an assessment of the pain prevalence and duration, the number of exacerbations in the current year, the pain severity using the Numeric Pain Rating Scale (NPRS), and the number of pain descriptors.
Results. Obese patients experience more severe pain (p=0.004), are prone to prolonged (p=0.010) and frequent exacerbations (p=0.004), and use more lexical units to describe the pain (p=0.001). The main pain sites associated with obesity are the upper (p=0.023) and lower extremities (p=0.002). The overweight group falls between obese subjects and those with normal body weight and, by many parameters, is similar to the normal body weight group. It was noted that age worsens the pain; thus, with age, the number of exacerbations per year (p=0.006) and the duration of exacerbations (p=0.016) increase, and a direct correlation of age with the pain prevalence and the number of descriptors was revealed (r=0.271; p=0.004 and r=0.267; p=0.004, respectively). The most severe pain occurs in females. In contrast, physical activity reduces the number and duration of exacerbations and the prevalence of pain (p=0.004; p=0.048; p=0.015, respectively).
Conclusion. Obesity, older age, and female gender are associated with more severe chronic pain. Body weight loss in obese patients with pain, as well as lifestyle modification with increased physical activity, is an essential aspect of overall rehabilitation, although additional studies are needed to establish strategies for maintaining long-term effects.
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Yihunie M, Abich Y, Demissie SF, Kassa T, Ranganathan P, Janakiraman B. Fear-Avoidance Beliefs for Physical Activity Among Chronic Low Back Pain: A Multicenter Cross-Sectional Study. J Pain Res 2023; 16:233-243. [PMID: 36726857 PMCID: PMC9885961 DOI: 10.2147/jpr.s388002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Background Among different psychological predictors of outcome in low back pain (LBP) adults, the negative influence of fear-avoidance beliefs in physical activity is an area of research attention. However, there is a lack of evidence on the burden of fear avoidance about physical activity among chronic LBP adults in Ethiopia. Objective To describe fear-avoidance beliefs about physical activity and explore its association with socio-demographic and clinical factors among low back pain patients attending physiotherapy treatment in 3 Amhara regional comprehensive hospitals. Methods A multi-center cross-sectional study was conducted and adults with chronic LBP (n = 263) participated. Data were collected by face-to-face interview using the modified Fear-Avoidance Belief Questionnaire about Physical Activity (mFABQ-PA) tool. Multivariable logistic regression at a p-value <0.05 significance level was used to identify predictors of fear-avoidance beliefs about physical activity. Results Among the 263 participants, 113 subjects (43%, 95% CI (36.9-49.0)) reported a higher cut-off (>15) mFABQ-PA. The logistic regression model demonstrated that LBP adults with a higher mFABQ-PA score were more likely to be urban residents (AOR 2.75, 95% CI (1.32, 5.88)), and ADL-related LBP (AOR 1.97 95% CI (1.18, 3.29)). The clinical-specific factor indicative of a higher cut-off score of mFABQ-PA was using analgesic medications (AOR 2.00, 95% CI (1.19, 3.37)). The model fit was 0.21 and 0.11 (R2 = Nagelkerke's, Cox & snell respectively). Conclusion High fear avoidance beliefs about physical activity in adults with low back pain were found and associated with residence, work, and medication intake. These findings might urge the researchers to explore further associations and assist clinicians in choosing subgroups to use behavioral therapy and graded exposure to physical activity.
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Affiliation(s)
- Mulualem Yihunie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Yohannes Abich, Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, PO Box: 196, Gondar, Ethiopia, Email
| | - Solomon Fasika Demissie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Kassa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Parthasarathy Ranganathan
- Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India
| | - Balamurugan Janakiraman
- Department of Research and Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India
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Park HJ, Choi JY, Lee WM, Park SM. Prevalence of chronic low back pain and its associated factors in the general population of South Korea: a cross-sectional study using the National Health and Nutrition Examination Surveys. J Orthop Surg Res 2023; 18:29. [PMID: 36631903 PMCID: PMC9832776 DOI: 10.1186/s13018-023-03509-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Many factors associated with chronic low back pain (CLBP) have been proposed, including individual, psychosocial, and physical factors. However, these associated factors are still controversial. PURPOSE (1) To determine the prevalence of CLBP and (2) to analyze factors associated with CLBP in the general population using a nationally representative sample of South Koreans. STUDY DESIGN Cross-sectional study. PATIENT SAMPLE Data from versions IV-1, -2, and -3 of the Korea National Health and Nutrition Examination Survey (KNHANES), which were performed in 2007, 2008, and 2009, respectively (n = 24,871). OUTCOME MEASURES Multiple logistic regression analysis was performed to determine the association between several factors (age, gender, alcohol consumption, household income, education level, mid-intensity physical activity, depressive symptoms, vitamin D level, and comorbidities [stroke, ischemic heart disease, knee osteoarthritis, asthma, COPD, cancer history]) and CLBP. METHODS CLBP status was surveyed using a self-reported questionnaire. Demographic, socioeconomic status, comorbidities, and other factors were evaluated from health questionnaires, health and physical examinations, and laboratory tests. To analyze the association between these factors and CLBP, we used multiple logistic regression analysis. RESULTS Data from 17,038 participants were included in the final analysis, including 2,693 with CLBP and 14,345 without. The prevalence of CLBP was 15.8% in South Korean subjects, with a prevalence of 11.8% in men and 24.5% in women. After regression analysis, we found advanced age, female gender, mid-intensity physical activity, depressive symptoms, stroke, ischemic heart disease, knee arthritis, asthma, COPD, and cancer history were positively associated with CLBP. In contrast, alcohol consumption ≥ 1 drink per month, increased household income, higher education level, and vitamin D insufficiency were negatively associated with CLBP. CONCLUSIONS Our study showed that CLBP was most common in the elderly and women in the general South Korean population. Several individual, socioeconomic, lifestyle, and health-related factors were associated with CLBP. These results demonstrate the influence of these factors on CLBP in the general population and suggest that consideration of these factors may improve the management of CLBP.
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Affiliation(s)
- Hyun-Jin Park
- grid.464606.60000 0004 0647 432XDepartment of Orthopedic Surgery, Spine Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jun-Young Choi
- grid.31501.360000 0004 0470 5905Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 Republic of Korea
| | - Woo Myung Lee
- grid.464606.60000 0004 0647 432XDepartment of Orthopedic Surgery, Spine Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sang-Min Park
- grid.31501.360000 0004 0470 5905Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 Republic of Korea
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Scheer JK, Costa F, Janela D, Molinos M, Areias AC, Moulder RG, Lains J, Bento V, Yanamadala V, Correia FD. Sleep Disturbance in Musculoskeletal Conditions: Impact of a Digital Care Program. J Pain Res 2023; 16:33-46. [PMID: 36636267 PMCID: PMC9830709 DOI: 10.2147/jpr.s394421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Background Musculoskeletal (MSK) pain is highly prevalent worldwide, resulting in significant disability, and comorbid sleep disturbances. Digital therapy for MSK pain can provide significant improvements in care access, alongside pain and disability reductions. However, studies on the effect of such programs on sleep are lacking. Purpose To evaluate the impact on pain-related sleep impairment after a 12-week remote multimodal digital care program (DCP) for MSK conditions. Patients and Methods This is an ad-hoc analysis of a decentralized single-arm study into engagement and clinical outcomes after a DCP for MSK rehabilitation. Patients were stratified by baseline sleep disturbance, based on sleep questions in the questionnaires: Oswestry Disability Index, Neck Disability Index, and the Quick Disabilities of the Arm, Shoulder and Hand questionnaire. Additional outcomes were pain, Generalized Anxiety Disorder 7-item scale, Patient Health 9-item questionnaire, Work Productivity, and Activity Impairment, and program engagement. Results At baseline, 5749 patients reported sleep disturbance (78.0% of eligible patients). These reported significantly worse clinical outcomes at baseline than patients without sleep disturbance (all p<0.001). Patients with comorbid sleep disturbance showed improvements in sleep, with a significant proportion reporting full recovery at program completion: 56% of patients with upper limb conditions (including 10% of patients with severe sleep disturbance at baseline), and 24% with spine conditions. These patients also reported significant improvements in all clinical outcomes at program completion. Engagement and satisfaction were high, and also higher than in patients without sleep impairment. Conclusion This is the first study of its kind investigating the effect of a completely remote DCP for MSK pain on sleep. Patients reporting comorbid sleep disturbance had significant improvement in sleep, alongside pain, mental health and work productivity at program completion. The results suggest that a DCP for MSK pain can improve sleep disturbances in patients with upper limb and spine conditions.
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Affiliation(s)
- Justin K Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | | | | | | | | | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal,Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | | | - Vijay Yanamadala
- Sword Health, Inc, Draper, UT, USA,Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA,Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
| | - Fernando Dias Correia
- Sword Health, Inc, Draper, UT, USA,Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal,Correspondence: Fernando Dias Correia, Sword Health Inc, 13937 Sprague Lane Ste 100, Draper, UT, 84020, USA, Tel +1 385-308-8034, Fax +1 801-206-3433, Email
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Goudman L, Rigoard P, Billot M, De Smedt A, Roulaud M, Consortium D, Moens M, De Keersmaecker K, Gorissen M, De Clerck C, Donck AV, Braems H, Buyse K, Puylaert M, Duyvendak W, De Smet C, Vissers S, Debeuf J, De Beucker K, Ceuppens J, Germonpré PJ, Mortier S, Van Buyten JP, Smet I, Devos M, Vanhauwaert D, Billet B, Hanssens K, Demeyere A, Casier T, Bertrem B, Van Havenbergh T, Van Looy P, Heylen G, de Schryver C, Vangeneugden J, Louis F, Stalmans V, Remacle JM, Remacle T, Mauviel S, Abeloos L, Theys T, Van Hoylandt A, Bruyninckx D, Das J, Callebaut I, Rigoard P, Roulaud M, Lorgeoux B, De Jaeger M, Espinoza AV, Van Hooff RJ. Spinal Cord Stimulation-Naïve Patients vs Patients With Failed Previous Experiences With Standard Spinal Cord Stimulation: Two Distinct Entities or One Population? Neuromodulation 2023; 26:157-163. [PMID: 35551868 DOI: 10.1016/j.neurom.2022.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/25/2021] [Accepted: 01/26/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Nowadays, the success of spinal cord stimulation (SCS) is evaluated separately in patients who have previous experiences with standard SCS and in SCS-naïve patients. Nevertheless, it is yet to be evaluated whether both patient groups are effectively distinct patient groups. Therefore, the aims of this study are twofold: 1) Are there clusters in the data to distinguish between both patient groups? 2) Can we discriminate both patient groups based on routinely collected clinical parameters? MATERIALS AND METHODS Baseline data from the Discover study were used, in which 263 patients with persistent spinal pain syndrome type 2 were included (185 neurostimulation-naïve patients and 78 patients with previous SCS experience). Pain intensity scores for low back and leg pain, functional disability, medication use, and health-related quality of life utility scores were used in the analysis. Model-based clustering was performed on standardized data. Discriminant analysis was performed with linear and quadratic discriminant analysis, with leave-one-out cross-validation to evaluate model performance. RESULTS Model-based clustering revealed two different clusters in the data. None of the clusters clearly separated SCS-naïve patients from patients with previous SCS experience. Linear discriminant analysis resulted in a leave-one-out cross-validation error rate of 30.0% to discriminate between both patient groups, based on routinely collected clinical parameters. CONCLUSIONS Clustering analysis did not result in clusters that separate SCS-naïve patients from patients with previous SCS experience. This may suggest that both patient groups should not be considered as two different patient groups when comparing them on routine clinical parameters, with potentially profound implications for research and clinical settings. CLINICAL TRIAL REGISTRATION The Clinicaltrials.gov registration number for the Discover study is NCT02787265.
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Affiliation(s)
- Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; STIMULUS consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation-Flanders, Brussels, Belgium.
| | - Philippe Rigoard
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France; Department of Spine Surgery & Neuromodulation, Poitiers University Hospital, Poitiers, France; Pprime Institute UPR 3346, CNRS, ISAE-ENSMA, University of Poitiers, Chasseneuil-du-Poitou, France
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Ann De Smedt
- STIMULUS consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Manuel Roulaud
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | | | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; STIMULUS consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Morillon GF, Benkhalti M, Dagenais P, Poder TG. Preferences of patients with chronic low back pain about nonsurgical treatments: Results of a discrete choice experiment. Health Expect 2022; 26:510-530. [PMID: 36482802 PMCID: PMC9854323 DOI: 10.1111/hex.13685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION This study aimed to assess patients' preferences of nonsurgical treatments for chronic low back pain (CLBP). METHOD We conducted a discrete choice experiment (DCE) in Quebec, Canada, in 2018. Seven attributes were included: treatment modality, pain reduction, the onset of treatment efficacy, duration effectiveness, difficulties with daily activities, sleep problems, and knowledge of the patient's body and pain location. Treatment modalities were corticosteroid injections, supervised body-mind physical activities, supervised sports physical activities, physical manipulations, self-management courses, and psychotherapy. Utility levels were estimated using a logit model, a latent class model and a Bayesian hierarchical model. RESULTS Analyses were conducted on 424 $424$ individuals. According to the Bayesian hierarchical model, the conditional relative importance weights of attributes were as follows: (1) treatment modality (34.79%), (2) pain reduction (18.73%), (3) difficulties with daily activities (11.71%), (4) duration effectiveness (10.06%), (5) sleep problems (10.05%), (6) onset of treatment efficacy (8.60%) and (7) knowledge of the patient's body and pain location (6.06%). According to the latent class model that found six classes of respondents with different behaviours (using Akaike and Bayesian criteria), the treatment modality was the most important attribute for all classes, except for class 4 for which pain reduction was the most important. In addition, classes 2 and 5 refused corticosteroid injections, while psychotherapy was preferred only in class 3. CONCLUSION Given the preference heterogeneity found in the analysis, it is important that patient preferences are discussed and considered by the physicians. This will help to improve the patient care pathway in a context of a patient-centred model for a disease with growing prevalence. PATIENT OR PUBLIC CONTRIBUTION A small group of patients was involved in the conception, design and interpretation of data. Participants in the DCE were all CLBP patients.
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Affiliation(s)
- Gabin F. Morillon
- Montpellier Recherche en EconomieUniversity of MontpellierMontpellierFrance
| | | | - Pierre Dagenais
- CIUSSS de l'Estrie—CHUSSherbrookeQuebecCanada,Department of Medicine, Faculty of Medicine and Health ScienceUniversity of SherbrookeSherbrookeQuebecCanada
| | - Thomas G. Poder
- Department of Management, Evaluation and Health Policy, School of Public HealthUniversity of MontrealMontrealQuebecCanada,Centre de recherche de l'Institut Universitaire en Santé Mentale de MontréalCIUSSS de l'Est de l'île de MontréalMontrealQuebecCanada
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64
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Feldman DE, Nahin RL. Disability Among Persons With Chronic Severe Back Pain: Results From a Nationally Representative Population-based Sample. THE JOURNAL OF PAIN 2022; 23:2144-2154. [PMID: 36096352 DOI: 10.1016/j.jpain.2022.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 01/04/2023]
Abstract
We evaluated the association between the chronic severe back pain with disability and participation, in U.S. Adults using data from the US 2019 National Health Interview Survey. In our sample of 2,925 adults (weighted n: 20,468,134) who reported having chronic severe back pain, 60% reported mobility disability, 60% had work limitations, 34% were limited for social participation and 16% had self-care limitations. Older age (65+) was associated with mobility difficulties (OR 1.99, 95% CI 1.28,6.09) and work limitation (OR 2.21, 95% CI 1.61,3.05). Lower socioeconomic status was associated with increasing odds of disability across the 4 categories. Being obese was only associated with mobility difficulties (OR 1.95, 95% CI 1.41,2.71), while not working in the past week was associated with difficulties in mobility (OR 3.55, 95% CI 2.64,4.75), self-care (OR 3.34, 95% CI 2.20,5.08), and social participation (OR 3.20, 95% CI 2.13,4.80). Comorbidities were highly associated with limitations in all 4 categories. Those deeming their ability to manage their pain ineffective were twice as likely to have limitations in self-care, social and work participation but not mobility. Identifying factors associated with disability and limitation may help target appropriate management for persons with chronic pain at high risk for disability. PERSPECTIVE: We evaluated the association between the chronic severe back pain with disability and participation, in a representative sample of Americans. Identifying factors associated with a likelihood of disability may help target appropriate pain management for persons at high risk for disability due to chronic severe back pain.
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Affiliation(s)
- Debbie Ehrmann Feldman
- School of Rehabilitation, Faculty of Medicine, Physiotherapy Program and School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Centre for interdisciplinary research in rehabilitation, CReSP: Center for Research in Public Health, Université de Montréal, Montreal, Canada.
| | - Richard L Nahin
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
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Long-Term Clinical Outcomes of a Remote Digital Musculoskeletal Program: An Ad Hoc Analysis from a Longitudinal Study with a Non-Participant Comparison Group. Healthcare (Basel) 2022; 10:healthcare10122349. [PMID: 36553873 PMCID: PMC9778537 DOI: 10.3390/healthcare10122349] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Digital solutions have emerged as an alternative to conventional physiotherapy, particularly for chronic musculoskeletal pain (CMP) management; however, its long-term effects remain largely unexplored. This study focuses on patients reporting CMP, assessing 1-year clinical outcomes after a multimodal digital care program (DCP) versus non-participants, who enrolled in the program but never engaged in a single exercise session or partook of the educational content made available to them. In this longitudinal study ad-hoc analysis, pain and functionality outcomes at 1-year reassessment were studied, focusing on the odds of reaching minimal clinically important difference (MCID) and, overall average reduction in both outcomes. Healthcare utilization was additionally studied within the same period. From 867 individuals allocated to the study, 460 completed the 1-year reassessment (intervention group: 310; comparison group: 150). The intervention group presented sustained and greater pain reduction until 1-year reassessment than the comparison group, reflecting greater odds ratio of achieving the MCID both in pain and functionality (1.90 95% CI: 1.27-2.86, p = 0.002 and 2.02 95% CI: 1.31-3.12, p = 0.001, respectively). A lower healthcare utilization during the 1-year follow-up was observed in the intervention group than in the comparison group. This study suggests that a digital CMP program may have a lasting impact on improved pain and functionality in patients with CMP.
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Aljohani R, Barradah N, Kashkari A. Awareness and knowledge of the common features of inflammatory back pain among primary care physicians in the western region of Saudi Arabia. Medicine (Baltimore) 2022; 101:e31626. [PMID: 36316825 PMCID: PMC9622622 DOI: 10.1097/md.0000000000031626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Often, there is a delay in the diagnosis of inflammatory back pain (IBP) in the primary care setting. This may be attributed to the inability of healthcare providers to distinguish between inflammatory and mechanical back pain. This study aimed to evaluate primary care physicians' current practices for assessing patients with IBP using clinical, radiographic, and laboratory tests. A questionnaire-based survey was emailed to all primary care physicians in the western region of Saudi Arabia by the Saudi Commission of Health Specialists from February to May 2021. The questionnaire included data about axial spondyloarthropathy based on the Calin, Berlin, and European Spondyloarthropathy Study Group criteria. A total of 103 primary care physicians responded who represented around 24% of primary care physicians at primary healthcare. The most often perceived IBP symptoms include a response to NSAIDs, morning stiffness lasting >30 minutes, age of onset <45 years old, duration of back pain >3 months, and improvement with exercise. The most frequently questioned patient or family history conditions were peripheral arthritis (92.2%), family history of spondyloarthritis (83.5%), and inflammatory bowel disease (97.6%). The most-reported investigations were CRP/ESR (86.4%) and spinal radiography (66%). For treatment of IBP, NSAIDs were most prescribed (48.6%), followed by physiotherapy (45.6%) and disease-modifying anti-rheumatic drugs (41.7%). Primary care physicians were more confident in management of mechanical back pain than IBP (P < .001). Primary care physicians have good knowledge of IBP symptoms but not of disease-specific features and modest confidence in evaluating patients with IBP, indicating the need for educational programs and a more effective, feasible referral strategy.
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Affiliation(s)
- Roaa Aljohani
- Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
- *Correspondence: Roaa Aljohani, Department of Medicine, College of Medicine, Taibah University, Madinah 42312, Saudi Arabia (e-mail: )
| | - Noha Barradah
- Department of Medicine, Taibah University, Medina, Saudi Arabia
| | - Amnah Kashkari
- Department of Medicine, Taibah University, Medina, Saudi Arabia
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Chatprem T, Puntumetakul R, Siritaratiwat W, Hunsawong T, Boucaut R. Prevalence of Thai People with Lumbar Instability and Associated Factors: A Cross-Sectional Study. J Pain Res 2022; 15:3287-3297. [PMID: 36304488 PMCID: PMC9592730 DOI: 10.2147/jpr.s381270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Lumbar instability has been extensively reported; however, the risk factors for lumbar instability remain poorly defined, and understanding this condition better would help health professionals and their patients. Proposal To determine the prevalence of lumbar instability in Thai people with chronic low back pain (CLBP) and explore the factors associated with lumbar instability in these patients. Patients and Methods Using multistage random sampling methods, 1762 participants with CLBP were enrolled in the study from six regions of Thailand. Data were collected using a paper-based questionnaire. Participants were interviewed by physical therapists in the hospital they attended. They were classified as having lumbar instability when they attained ≥7/14 items on the lumbar instability screening tool. Univariate and multivariate regression analysese were used to determine the possible factors associated with lumbar instability. Results There were 961 (54.54%) participants with lumbar instability and 801 (45.46%) participants without. The eight factors associated with lumbar instability were: (i) age ≥40 years (AOR: 1.36; 95% CI: 1.09-1.69); (ii) body mass index ≥25 kg/m2 (AOR: 1.42; 95% CI: 1.16-1.74); (iii) having an underlying disease (AOR: 1.32; 95% CI: 1.06-1.65); (iv) frequent lifting ≥5 kg in occupational habits (AOR: 1.69; 95% CI: 1.36-2.09); (v) prolonged walking ≥4 hours per day (AOR: 1.31; 95% CI: 1.04-1.64); (vi) gardening in leisure time (AOR: 1.37; 95% CI: 1.10-1.71); (vii) other area of pain (AOR: 1.24; 95% CI: 1.01-2.52): and (viii) other area of numbness (AOR: 1.85; 95% CI: 1.50-2.27). When considering only women, prior pregnancy was associated with lumbar instability with OR of 1.76 (95% CI: 1.36-2.22), p-value <0.0001. Conclusion When treating patients with CLBP who are suspected to have lumbar instability, healthcare professionals should consider associated factors that might be modifiable targets for interventions to improve outcomes.
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Affiliation(s)
- Thiwaphon Chatprem
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Correspondence: Rungthip Puntumetakul, Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand, Tel +66 83 419 6186, Email
| | - Wantana Siritaratiwat
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Torkamol Hunsawong
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence; University of South Australia, Allied Health and Human Performance, Adelaide, Australia
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Ecija C, Catala P, Gutierrez L, Javier Arrayás-Grajera M, Peñacoba C. The Influence of the Fear of Negative Evaluation on Activity Avoidance in Fibromyalgia: Exploring Pain Acceptance and Positive Affect as Resilience Variables. Clin Nurs Res 2022; 32:902-913. [PMID: 36217962 DOI: 10.1177/10547738221122670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To examine the mediating role of pain acceptance (PAcc) between fear of negative evaluation (FNE) and activity avoidance (AV) at different levels of positive affect (PA) (moderator) among women diagnosed with fibromyalgia (FM) (moderate mediation model). This study was cross-sectional in design. A convenience sample of women with FM (n = 231) completed measures of pain severity, FNE, PAcc, AV, and PA. A simple mediation model and a moderate mediation model was constructed and analyzed using the SPSS macro-PROCESS. First, PAcc mediated the effect of FNE on AV (β = .02, SE = 0.008; [95% CI [0.0075, 0.0394]). Second, a mediated effect of PAcc between FNE and AV moderated by PA at medium and high levels of PA were found (m: 0.23; β = -.22, p = .0006; h: 9.59; β = -.34, p = .0002. Future work should seek to validate study findings in diverse samples of FM patients. Additionally, future work should explore how FM self-management interventions that include PAcc can promote increased activity among women suffering from FM with medium to high levels of PA.
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Bakhshaie J, Penn TM, Doorley J, Pham TV, Greenberg J, Bannon S, Saadi A, Vranceanu AM. Psychosocial Predictors of Chronic Musculoskeletal Pain Outcomes and their Contextual Determinants Among Black Individuals: A Narrative Review. THE JOURNAL OF PAIN 2022; 23:1697-1711. [PMID: 35644442 DOI: 10.1016/j.jpain.2022.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/14/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Black communities are disproportionally affected by Chronic Musculoskeletal Pain (CMP), but little is known about the psychological predictors of CMP outcomes and their contextual determinants among Black individuals. To address this gap, we conducted a narrative review of extant literature to (1) report the major conceptual models mentioned in prior work explaining the link between contextual determinants and psychological responses to pain among Black individuals with CMP; and (2) describe psychological factors related to CMP outcomes in this population that are highlighted in the literature. We searched 4 databases (APA PsycNet, PubMed/MEDLINE, Scopus, and Google Scholar) using the following search terms: musculoskeletal pain, chronic pain, mental health, psychological, coping, health disparities, contextual factors, conceptual models, psychosocial, Black, African American, pain, disability, and outcomes. We illustrate 3 relevant conceptual models - socioecological, cumulative stress, and biopsychosocial - related to contextual determinants and several psychological factors that influence CMP outcomes among Black individuals: (1) disproportionate burden of mental health and psychiatric diagnoses, (2) distinct coping strategies, (3) pain-related perceived injustice and perceived racial/ethnic discrimination, and (4) preferences and expectations related to seeking and receiving pain care. The detailed clinical and research implications could serve as a blueprint for the providers and clinical researchers to address health disparities and improve care for Black individuals with CMP. PERSPECTIVE: This narrative review illustrates conceptual models explaining the link between contextual determinants and psychological responses to pain among Black individuals with chronic musculoskeletal pain. We discuss 3 relevant conceptual models - socioecological, cumulative stress, biopsychosocial -, and 4 psychological factors: disproportionate burden of mental health, distinct coping strategies, perceived injustice/discrimination, preferences/expectations.
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Affiliation(s)
- Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Terence M Penn
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - James Doorley
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Tony V Pham
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Tulane Medical School, New Orleans, Louisiana; Duke University Global Health Master's Program, Durham, North Carolina
| | - Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Sarah Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Altaf Saadi
- Harvard Medical School, Boston, Massachusetts; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Hochheim M, Ramm P, Wunderlich M, Amelung V. Association between chronic low back pain and regular exercise, sedentary behaviour and mental health before and during COVID-19 pandemic: insights from a large-scale cross-sectional study in Germany. BMC Musculoskelet Disord 2022; 23:860. [PMID: 36104661 PMCID: PMC9474280 DOI: 10.1186/s12891-022-05806-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nonspecific chronic low back pain (CLBP) is a complex symptom with numerous possible causes and influencing factors. Understanding how modifiable factors affect the course of CLBP is important for preventing progression. As the COVID-19 pandemic has changed the lifestyle of many people, this study paper assessed whether it also changed the influence of modifiable lifestyle factors (regular exercise and sedentary behaviour) and mental health factors (anxiety and depression) on CLBP pain intensity and disability by comparing the strength of these associations before and during the pandemic. We hypothesised that the importance of regular physical activity and good mental health for CLBP patients would increase during the pandemic.
Methods
These questions were investigated in a cross-sectional study of insurance claims data and self-reported data from various questionnaires from 3,478 participants in a German CLBP health intervention (2014–2021) by calculating pre- and intra-pandemic odds ratios (OR) and 95% confidence intervals (CI) for each variable of interest and outcome. Potential confounders were also considered. Pandemic status was treated as an effect modifier. Based on the date of enrolment, participants were classified as “pre-pandemic” or “pandemic”.
Results
Regularly exercising ≥ 4 h/week significantly reduced the odds of high disability for men (OR 0.49, 95% CI 0.31 – 0.79, p = 0.003) and women (OR 0.30, 95% CI 0.14 – 0.563, p = 0.002) and reduced the probability of severe pain in women (OR 0.37, 95% CI 0.21 – 0.65, p < 0.001). Each one-point increase in PHQ-4 score for anxiety and depression increased the OR of high pain intensity by 1.25 points (95% CI 1.18 – 1.34, p < 0.001). A clear impact of COVID-19 lockdowns was observed. In individuals who exercised ≥ 4 h/week the OR of high disability was 0.57 (95% CI 0.36 – 0.92, p = 0.021) in the pre-pandemic group compared to 0.29 (95% CI 0.12 – 0.56, p = 0.002) in the pandemic group. The probability of high disability increased from an OR of 1.42 (95% CI 1.33 – 1.52, p < 0.001) per marginal increase in the PHQ-4 scale before the pandemic, to an OR of 1.73 (95% CI 1.58 – 1.89, p < 0.001) during the pandemic.
Conclusions
The magnitude of association of the factors that influenced high pain intensity and disability increased during the pandemic. On the one hand, the protective effect of regular exercising was greater in participants surveyed during lockdown. On the other hand, a higher risk through anxiety or depression during the lockdown was identified. An additional study with objective measures of sedentary behaviour and physical activity is needed to validate these results. More in-depth investigation of lockdown-induced associations between reduced daily physical activity, increased levels of anxiety and depression, and their effects on CLPB could also be worthwhile.
Trial registration
This study used routinely collected data from a CLBP intervention that was previously evaluated and registered in the German Registry of Clinical Trials under DRKS00015463 (04/09/2018). The original ethics approval, informed consent and self-reported questionnaire have remained unchanged and are still valid.
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71
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Virkkunen T, Husu P, Tokola K, Parkkari J, Kankaanpää M. Depressive Symptoms Are Associated With Decreased Quality of Life and Work Ability in Currently Working Health Care Workers With Recurrent Low Back Pain. J Occup Environ Med 2022; 64:782-787. [PMID: 35673261 PMCID: PMC9426739 DOI: 10.1097/jom.0000000000002586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study investigates the association between depressive symptoms and multisite pain and health-related quality of life and work ability in currently employed health care workers with recurrent low back pain (LBP). METHODS Multisite pain, depressive symptoms, quality of life, and work ability were assessed by validated questionnaires. A generalized linear model was used for statistical analysis. RESULTS Notably, 28% of female health care workers with LBP had at least moderate levels of depressive symptoms. Depressive symptoms were significantly associated with decreased health-related quality of life and work ability. Multisite pain was not significantly associated with work ability. CONCLUSIONS Depressive symptoms are relatively common in female health care workers with LBP, and treatment of these symptoms may be crucial to improve their work ability.
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72
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Inman JGK, Ellard DR. What influences graduate medical students' beliefs of lower back pain? A mixed methods cross sectional study. BMC MEDICAL EDUCATION 2022; 22:633. [PMID: 35987611 PMCID: PMC9392230 DOI: 10.1186/s12909-022-03692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Low back pain (LBP) is a common condition with substantial associated disability and costs, best understood using a biopsychosocial approach. Research demonstrates that beliefs about LBP are important, with biomedical beliefs influencing practitioner's management and patient recovery. Beliefs about LBP can be inconsistent amongst healthcare and medical students. The aim of this study was to investigate graduate medical student's beliefs of LBP and what influences them. METHOD A cross sectional mixed methods study of Phase 1 (first year) and Phase 3 (third and fourth year) current graduate medical students at the University of Warwick (MBChB) was conducted. Participants were recruited via voluntary response sampling. A survey investigated LBP beliefs, utilising the Back Beliefs Questionnaire (BBQ) and Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS). Qualitative data was collected on what influences beliefs about the causes and management of LBP, which was analysed descriptively using thematic analysis. RESULTS Fifty-seven students completed the questionnaire (61% female), with a mean age of 27.2 years. Eighty two percent of participants reported a history of LBP. Median BBQ scores were 31.5 for phase 1 and 31 for phase 3, with median HC-PAIRS scores of 57 and 60 for phase 1 and phase 3 students respectively. Three main themes emerged from the qualitative data: Sources of influence, influence of personal experience and influence of medical education. Participants discussed single or multiple sources influencing their beliefs about the causes and management of LBP. Another main theme was the influence of experiencing LBP personally or through discussions with family, friends and patients. The final main theme described the influence of medical education, including lectures, seminars and clinical placements. CONCLUSIONS The HC-PAIRS and BBQ scores suggest graduate medical students in this sample tended to have positive beliefs about the outcome of LBP and functional expectations of chronic LBP patients, consistent with other healthcare students. The findings from qualitative data suggest how medical students form beliefs about the causes and management of LBP is complex.
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Affiliation(s)
- John G. K. Inman
- Warwick Medical School, Medical School Building, University of Warwick, Coventry, CV4 7HL UK
| | - David R. Ellard
- Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7HL UK
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Costa F, Janela D, Molinos M, Moulder RG, Lains J, Bento V, Scheer J, Yanamadala V, Correia FD, Cohen SP. Digital Rehabilitation for Acute Low Back Pain: A Prospective Longitudinal Cohort Study. J Pain Res 2022; 15:1873-1887. [PMID: 35813029 PMCID: PMC9261956 DOI: 10.2147/jpr.s369926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Low back pain (LBP) has a lifetime prevalence of 70–80%. Access to timely and personalized, evidence-based care is key to prevent chronic progression. Digital solutions may ease accessibility to treatment while reducing healthcare-related costs. Purpose We aim to report the results of a fully remote digital care program (DCP) for acute LBP. Patients and Methods This was an interventional, single-arm, cohort study of patients with acute LBP who received a DCP. Primary outcome was the mean change in disability (Oswestry Disability Index – ODI) after 12 weeks. Secondary outcomes included change in pain (NPRS), analgesic consumption, surgery likelihood, depression (PHQ-9), anxiety (GAD-7), fear-avoidance beliefs (FABQ-PA), work productivity (WPAI) and engagement. Results A total of 406 patients were enrolled in the program and of those, 332 (81.8%) completed the intervention. A significant disability reduction of 55.1% (14.93, 95% CI 13.95; 15.91) was observed, corresponding to a 76.1% responder rate (30% cut-off). Disability reduction was accompanied by significant improvements in pain (61.0%), depression (55.4%), anxiety (59.5%), productivity (65.6%), fear-avoidance beliefs (46.3%), intent to pursue surgery (59.1%), and analgesic consumption (from 35.7% at baseline to 10.8% at program end). DCP-related patient satisfaction score was 8.7/10.0 (SD 1.4). Conclusion This study demonstrated the utility of a multimodal DCP for patients with acute LBP. Very high adherence rates and patient satisfaction were observed, alongside significant reductions in all assessed outcomes, consistent with the growing body of evidence supporting the management of acute LBP with DCPs.
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Affiliation(s)
- Fabíola Costa
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
| | - Dora Janela
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
| | - Maria Molinos
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
| | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal
- Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | | | - Justin Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Vijay Yanamadala
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
- Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA
- Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
| | - Fernando Dias Correia
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Correspondence: Fernando Dias Correia, 65 E Wadsworth Park Dr Ste 230, Draper, UT, 84020, USA, Tel +1 385-308-8034, Fax +1 801-206-3433, Email
| | - Steven P Cohen
- Departments of Anesthesiology & Critical Care Medicine, Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Departments of Anesthesiology and Physical Medicine and Rehabilitation and Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Causal effects of psychosocial factors on chronic back pain: a bidirectional Mendelian randomisation study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:1906-1915. [PMID: 35662366 PMCID: PMC9273132 DOI: 10.1007/s00586-022-07263-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/16/2022] [Accepted: 05/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Risk factors for chronic back pain (CBP) may share underlying genetic factors, making them difficult to study using conventional methods. We conducted a bi-directional Mendelian randomisation (MR) study to examine the causal effects of risk factors (education, smoking, alcohol consumption, physical activity, sleep and depression) on CBP and the causal effect of CBP on the same risk factors. METHODS Genetic instruments for risk factors and CBP were obtained from the largest published genome-wide association studies (GWAS) of risk factor traits conducted in individuals of European ancestry. We used inverse weighted variance meta-analysis (IVW), Causal Analysis Using Summary Effect (CAUSE) and sensitivity analyses to examine evidence for causal associations. We interpreted exposure-outcome associations as being consistent with a causal relationship if results with IVW or CAUSE were statistically significant after accounting for multiple statistical testing (p < 0.003), and the direction and magnitude of effect estimates were concordant between IVW, CAUSE, and sensitivity analyses. RESULTS We found evidence for statistically significant causal associations between greater education (OR per 4.2 years of schooling = 0.54), ever smoking (OR = 1.27), greater alcohol consumption (OR = 1.29 per consumption category increase) and major depressive disorder (OR = 1.41) and risk of CBP. Conversely, we found evidence for significant causal associations between CBP and greater alcohol consumption (OR = 1.19) and between CBP and smoking (OR = 1.21). Other relationships did not meet our pre-defined criteria for causal association. CONCLUSION Fewer years of schooling, smoking, greater alcohol consumption, and major depressive disorder increase the risk of CBP. CBP increases the risk of greater alcohol consumption and smoking.
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Costa F, Janela D, Molinos M, Moulder R, Bento V, Lains J, Scheer J, Yanamadala V, Cohen S, Dias Correia F. Depression and work productivity: insights from a longitudinal cohort study on digital care programs for Musculoskeletal conditions. J Med Internet Res 2022; 24:e38942. [PMID: 35714099 PMCID: PMC9361146 DOI: 10.2196/38942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Comorbidity between musculoskeletal (MSK) pain and depression is highly common and associated with greater symptom burden and greater loss of work productivity. Multimodal care programs tackling both physical and mental health components may maximize productivity recovery and return to work. Digital delivery of such programs can facilitate access, ensure continuity of care, and enhance patient engagement. OBJECTIVE Assess the impact of a completely remote multimodal digital care program (DCP) for MSK pain on mental health and work-related outcomes stratified by baseline depression levels. METHODS The present study is an ad-hoc analysis of an interventional, single-arm, cohort study of individuals with MSK pain undergoing a DCP. Three subgroups with different baseline depression severity levels were created based on the Patient Health Questionnaire (PHQ-9): cluster 1 (<5: minimal depression); cluster 2 (5-10: mild depression) and cluster 3 (≥10: moderate depression). The mean change between baseline and end-of-program (8-12 weeks) on depression, anxiety, fear-avoidance beliefs, work productivity and activity impairment and adherence was assessed across subgroups. Outcome changes were analyzed by latent growth curve analysis. RESULTS From a total of 7785 eligible participants, 6137 (78.8%) were included in Cluster 1, 1158 (14.9%) in cluster 2 and 490 (6.3%) in cluster 3. Significant improvements in depression and anxiety scores were observed in clusters 2 and 3 but not cluster 1, with average end-of-the program scores in clusters 2 and 3 below the initially defined cluster thresholds (5 and 10 for clusters 2 and 3, respectively). All clusters reported significant improvements in productivity impairment scores (mean changes from -16.82, 95%CI -20.32 to -13.42 in cluster 1 to -20.10, 95%CI -32.64 to -7.57 in cluster 3). Higher adherence was associated with higher improvements in depression in clusters 2 and 3, and with greater recovery in activities of daily living in cluster 3. Overall patient satisfaction was 8.59/10.0 (SD 1.74). CONCLUSIONS A multimodal DCP was able to promote improvements in productivity impairment scores comparable to those previously reported in the literature, even in participants with comorbid depression and anxiety. These results reinforce the need to follow a biopsychosocial framework to optimize outcomes in patients with MSK pain. CLINICALTRIAL ClinicalTrials.gov NCT04092946; https://clinicaltrials.gov/ct2/show/NCT04092946.
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Affiliation(s)
- Fabíola Costa
- SWORD Health Inc, 65 E Wadsworth Park Drive, Suite 230, Draper, US
| | - Dora Janela
- SWORD Health Inc, 65 E Wadsworth Park Drive, Suite 230, Draper, US
| | - Maria Molinos
- SWORD Health Inc, 65 E Wadsworth Park Drive, Suite 230, Draper, US
| | - Robert Moulder
- Institute for Cognitive Science, University of Colorado, Boulder, US
| | - Vírgilio Bento
- SWORD Health Inc, 65 E Wadsworth Park Drive, Suite 230, Draper, US
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, PT.,Faculty of Medicine, Coimbra University, Coimbra, PT
| | - Justin Scheer
- Department of Neurological Surgery, University of California, San Francisco, US
| | - Vijay Yanamadala
- Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, US.,Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, US.,SWORD Health Inc, 65 E Wadsworth Park Drive, Suite 230, Draper, US
| | - Steven Cohen
- Departments of Anesthesiology & Critical Care Medicine, Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, US.,Departments of Anesthesiology and Physical Medicine and Rehabilitation and Anesthesiology, Uniformed Services University of the Health Sciences, Maryland, USA, Bethesda, US
| | - Fernando Dias Correia
- SWORD Health Inc, 65 E Wadsworth Park Drive, Suite 230, Draper, US.,Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, PT
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Naliboff BD, Locke K, Schrepf AD, Griffith JW, Moldwin R, Krieger JN, Rodriguez LV, Stephens-Shields AJ, Clemens JQ, Lai HH, Sutcliffe S, Taple BJ, Williams D, Pontari MA, Mullins C, Landis JR. Reliability and Validity of Pain and Urinary Symptom Severity Assessment in Urological Chronic Pelvic Pain: A MAPP Network Analysis. J Urol 2022; 207:1246-1255. [PMID: 35060778 PMCID: PMC10494963 DOI: 10.1097/ju.0000000000002438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We assessed the reliability and validity of an efficient severity assessment for pelvic pain and urinary symptoms in urological chronic pelvic pain syndrome, which consists of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS A total of 578 patients were assessed using brief, empirically derived self-report scales for pelvic pain severity (PPS) and urinary symptom severity (USS) 4 times during a 1-month period and baseline clinic visit that included urological, pain and illness-impact measures. Mild, moderate and severe categories on each dimension were examined for measurement stability and construct validity. RESULTS PPS and USS severity categories had adequate reliability and both discriminant validity (differential relationships with specific clinical and self-report measures) and convergent validity (common association with nonurological somatic symptoms). For example, increasing PPS was associated with pelvic tenderness and widespread pelvic pain, whereas USS was associated with urgency during a bladder filling test and increased sensory sensitivity. PPS and USS categories were independently associated with nonurological pain and emotional distress. A descriptive analysis identified higher likelihood characteristics associated with having moderate to severe PPS or USS or both. Lack of sex interactions indicated that the measures are comparable in interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome. CONCLUSIONS Women and men with urological chronic pelvic pain syndrome can be reliably subgrouped using brief self-report measures of mild, moderate or severe pelvic pain and urinary symptoms. Comparisons with a broad range of clinical variables demonstrate the validity and potential clinical utility of these classifications, including use in clinical trials, health services and biological research.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chris Mullins
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - J. Richard Landis
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
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The Portuguese osteopaths attitudes towards a biomechanical or biopsychosocial model in the approach of chronic low back pain – A cross-sectional questionnaire-based survey. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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78
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de Luca K, Briggs AM, French SD, Ferreira ML, Cross M, Blyth F, March L. Disability burden due to musculoskeletal conditions and low back pain in Australia: findings from GBD 2019. Chiropr Man Therap 2022; 30:22. [PMID: 35505334 PMCID: PMC9063272 DOI: 10.1186/s12998-022-00434-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report the national prevalence, years lived with disability (YLDs) and attributable risk factors for all musculoskeletal conditions and separately for low back pain (LBP), as well as compare the disability burden related to musculoskeletal with other health conditions in Australia in 2019. METHODS Global Burden of Disease (GBD) 2019 study meta-data on all musculoskeletal conditions and LBP specifically were accessed and aggregated. Counts and age-standardised rates, for both sexes and across all ages, for prevalence, YLDs and attributable risk factors are reported. RESULTS In 2019, musculoskeletal conditions were estimated to be the leading cause of YLDs in Australia (20.1%). There were 7,219,894.5 (95% UI: 6,847,113-7,616,567) prevalent cases of musculoskeletal conditions and 685,363 (95% UI: 487,722-921,471) YLDs due to musculoskeletal conditions. There were 2,676,192 (95% UI: 2,339,327-3,061,066) prevalent cases of LBP and 298,624 (95% UI: 209,364-402,395) YLDs due to LBP. LBP was attributed to 44% of YLDs due to musculoskeletal conditions. In 2019, 22.3% and 39.8% of YLDs due to musculoskeletal conditions and LBP, respectively, were attributed to modifiable GBD risk factors. CONCLUSIONS The ongoing high burden due to musculoskeletal conditions impacts Australians across the life course, and in particular females and older Australians. Strategies for integrative and organisational interventions in the Australian healthcare system should support high-value care and address key modifiable risk factors for disability such as smoking, occupational ergonomic factors and obesity.
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Affiliation(s)
- Katie de Luca
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, Australia.
| | - Andrew M Briggs
- Curtin School of Allied Health and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.,Global Alliance for Musculoskeletal Health, Sydney, Australia
| | - Simon D French
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Marita Cross
- Global Alliance for Musculoskeletal Health, Sydney, Australia.,Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Fiona Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lyn March
- Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia
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d'Errico A, Falkstedt D, Almroth M, Badarin K, Hemmingsson T, Kjellberg K. Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers. Int Arch Occup Environ Health 2022; 95:1521-1535. [PMID: 35451628 PMCID: PMC9424129 DOI: 10.1007/s00420-022-01862-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
Purpose To assess the risk of disability and early-age retirement associated with previous long-term sickness absence for back pain (back-pain SA), exposure to high physical workload, low job control, high demands and high strain, and to evaluate effect modification by work factors on the relationship between back-pain SA and premature retirement. Methods All employed Swedish residents born 1946–1955 (n = 835,956) were followed up from 2010 to 2016 for disability (DP) and early-age pension (EAP). Associations of premature retirement with exposure to work factors and back-pain SA in the 3 years before follow-up were estimated through proportional hazards models. Retirement, back-pain SA and covariates were assessed through administrative sources, and exposure to work factors through a job-exposure matrix. Results In both genders, back-pain SA was associated with DP (> 1 episode: HR 3.23 among men; HR 3.12 among women) and EAP (> 1 episode: HR 1.24 among men; HR 1.18 among women). Higher physical workload and lower job control were also associated with an increased DP risk in both genders, whereas higher job demands showed a decreased risk. For EAP, associations with work factors were weak and inconsistent across genders. No effect modification by work factors was found, except for a negative effect modification by job strain on DP risk among women, i.e. a reduced effect of back-pain SA with increasing exposure. Conclusion Back-pain SA was a significant predictor of both DP and EAP, while work factors were consistently associated only with DP. Our results indicate that the joint effect of back-pain SA and work factors on DP is additive and does not support effect modification by work factors. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-022-01862-8.
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Affiliation(s)
- Angelo d'Errico
- Department of Epidemiology, Local Health Unit ASL TO 3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy.
| | - Daniel Falkstedt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Melody Almroth
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kathryn Badarin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hemmingsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Katarina Kjellberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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80
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Bernstein MJ. Outcomes of a digitally delivered exercise and education treatment program for low back pain after three months (Preprint). JMIR Rehabil Assist Technol 2022; 9:e38084. [PMID: 357276 PMCID: PMC9257621 DOI: 10.2196/38084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/13/2022] Open
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Kahere M, Hlongwa M, Ginindza TG. A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052964. [PMID: 35270657 PMCID: PMC8910337 DOI: 10.3390/ijerph19052964] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The global burden of chronic low back pain (CLBP) is a major concern in public health. Several CLBP epidemiological studies have been conducted in high-income-countries (HICs) with little known in low-and-middle-income-countries (LMICs) due to other competing priorities of communicable diseases. The extrapolation of results of studies from HICs for use in LMICs is difficult due to differences in social norms, healthcare systems, and legislations, yet there is urgent need to address this growing burden. It is against this backdrop that we conducted this review to map the current evidence on the distribution of CLBP in Sub-Saharan Africa (SSA). METHODS A comprehensive literature search was conducted from the following databases: PubMed, Google Scholar, Science Direct databases, World Health Organizations library databases, EMBASE, EBSCOhost by searching the following databases within the platform; academic search complete, CINAHL with full text, health sources: nursing/academic and MEDLINE. The title, abstract and the full text screening phases were performed by two independent reviewers with the third reviewer employed to adjudicate discrepancies. The reference list of all included articles was also searched for eligible articles. This scoping review was reported in accordance with the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation, as well as guided by Arksey and O'Malley's scoping review framework. A thematic content analysis was used to give a narrative account of the review. RESULTS The electronic search strategy retrieved 21,189 articles. Title/abstract and full text screening only identified 11 articles, which were included in this review. The prevalence of CLBP among the general population ranged from 18.1% to 28.2% and from 22.2% to 59.1% among LBP patients. The prevalence of occupation based CLBP ranged from 30.1% to 55.5%. Identified risk factors for CLBP are multifactorial and included biomechanical, psychological, socioeconomic and lifestyle factors, with psychosocial factors playing a significant role. Hypertension, diabetes mellitus, peptic ulcer disease were the most common comorbidities identified. CLBP disability was significantly associated with psychosocial factors. The management of CLBP in primary care follows the traditional biomedical paradigm and primarily involves pain medication and inconsistent with guidelines. CONCLUSIONS There are limited epidemiological data on CLBP in SSA, however, this study concluded that the prevalence and risk factors of CLBP in SSA are comparable to reports in HICs. Considering the projected increase in the burden of CLBP in LMICs extensive research effort is needed to close this knowledge gap.
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Affiliation(s)
- Morris Kahere
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa; (M.H.); (T.G.G.)
- Correspondence: ; Tel.: +27-836153446
| | - Mbuzeleni Hlongwa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa; (M.H.); (T.G.G.)
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa; (M.H.); (T.G.G.)
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Lin CH, Lin CH, Chen LC, Wei SH, Sung WH, Lu LH, Chang ST, Lin YH, Lee CY, Chiang SL. Chronic low back pain is associated with impaired bed turning ability: Evaluation by a mobility detection system. Clin Biomech (Bristol, Avon) 2022; 92:105572. [PMID: 35051838 DOI: 10.1016/j.clinbiomech.2022.105572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND We aimed to assess and compare kinetics and kinematic variables of bed turning ability using a mobility detection system in patients with and without chronic low back pain and to observe the impacts of the disease on bed turning kinetics and kinematics. METHODS Thirty-five patients with chronic low back pain were enrolled and compared to healthy controls (n = 34). Pain scores and disability level were assessed by Numeric Pain Rating Scale and the function questionnaires including Oswestry Disability Index and Roland Morris Disability Questionnaire. Bed turning ability was tested using the Mobile Detection System. Univariate and multivariate regression analysis were applied to compare the differences between groups. FINDINGS Patients with chronic low back pain had significantly lower turning over and back force/weight ratio (p < 0.001) than those healthy controls. Turning over time was significantly longer in patients with Numeric Rating Scale score 3 than in those with Numeric Rating Scale score 2 (p = 0.015). Turning over and back force were significantly higher in male patients and patients with higher BMI after adjusting BMI and sex, respectively (all p < 0.001). When turning back, chronic low back pain patients with Numeric Rating Scale scores of 3 had lower turning back force/weight ratio than those with Numeric Rating Scale scores of 2 (p = 0.014). Male patients had higher turning back force/weight ratio after adjusting pain score (p = 0.001). INTERPRETATION The novel Mobility Detection System can provide more objective assessments of bed turning kinetics and kinematics in patients with chronic low back pain.
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Affiliation(s)
- Chia-Huei Lin
- School of Nursing, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Chueh-Ho Lin
- Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Liang-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shun-Hwa Wei
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Hsu Sung
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Liang-Hsuan Lu
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shin-Tsu Chang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yi-Hui Lin
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chun-Yi Lee
- Department of Physical Medicine and Rehabilitation, Kaohsiung Armed Forces General Hospital Gangshan Branch, Kaohsiung, Taiwan
| | - Shang-Lin Chiang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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83
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Shu P, Ji L, Ping Z, Sun Z, Liu W. Association of insomnia and daytime sleepiness with low back pain: A bidirectional mendelian randomization analysis. Front Genet 2022; 13:938334. [PMID: 36267398 PMCID: PMC9577110 DOI: 10.3389/fgene.2022.938334] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: Observational research has indicated the presence of a causal relationship between sleep disturbances and low back pain (LBP). However, the link may have been biased by confounding factors. The purpose of this study was to examine the potential causal association of insomnia and daytime sleepiness with LBP by using mendelian randomization (MR). Methods: Genome-wide association study (GWAS) summary statistics of insomnia were obtained from a large-scale GWAS meta-analysis (n = 1,331,010; individuals from UK Biobank and 23andMe) or UK Biobank alone (n = 453,379). The summary statistics of daytime sleepiness were from UK Biobank (n = 452,071) and LBP were provided by the FinnGen Release 6 (210,645 individuals with 16,356 LBP cases and 194,289 controls) or UK Biobank (5,423 cases versus 355,771 controls). Linkage disequilibrium score (LDSC) regression and bidirectional MR analysis was employed to estimate genetic correlation and causal relationship. In the MR analysis, the inverse variance weighted method (IVW) was utilized as the main analysis procedure, while MR-Egger, Weighted median and Robust adjusted profile score (RAPS) were utilized for supplementary analyses. Results: LDSC analysis showed that LBP were significantly genetically correlated with insomnia (rg = 0.57, p = 2.26e-25) and daytime sleepiness (rg = 0.18, p = 0.001). The MR analysis revealed that genetically predicted insomnia was significantly associated with an increased risk of LBP (OR = 1.250, 95% CI: 1.186-1.318; p = 1.69e-16). However, the reverse causality was not confirmed. No evidence was identified supporting causality of daytime sleepiness and LBP. Conclusion: This study demonstrates a putative causal link of insomnia on LBP and a null causal effect of LBP on insomnia. Furthermore, a causal link between daytime sleepiness and LBP were not reported. This finding may stimulate new strategies for patient management in clinical practice, benefiting public health.
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Affiliation(s)
- Peng Shu
- Department of Orthopedic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Lixian Ji
- Department of Rheumatology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Zichuan Ping
- Department of Orthopedic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Zhibo Sun
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, China
| | - Wei Liu
- Department of Orthopedic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
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The influence of cognitive factors in relation to the patients' treatment adherence for non-specific chronic low-back pain. A case series. J Bodyw Mov Ther 2022; 29:271-278. [DOI: 10.1016/j.jbmt.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 10/17/2021] [Indexed: 11/20/2022]
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Maksimova M, Kotlyar Y, Shabalina A. Chronic musculoskeletal pain in degenerative changes of the spine in young and middle-aged patients. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:77-84. [DOI: 10.17116/jnevro202212206177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Perfectionism, maladaptive beliefs and anxiety in women with fibromyalgia. An explanatory model from the conflict of goals. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Sidiq M, Alenazi W, Kashoo FZ, Qasim M, Lopez MP, Ahmad M, Mani S, Shaphe MA, Khodairi O, Almutairi A, Mir SA. Prevalence of non-specific chronic low-back pain and risk factors among male soldiers in Saudi Arabia. PeerJ 2021; 9:e12249. [PMID: 34721972 PMCID: PMC8519176 DOI: 10.7717/peerj.12249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background Non-specific chronic low back pain (NSCLBP) is the most common musculoskeletal disorder affecting health and work among the military population. NSCLBP is a complex disorder with several risk factors contributing to its occurrence. Therefore, the objective of our study was to estimate the prevalence and contribution of risk factors towards NSCLBP among male soldiers in Saudi Arabia. Methods A cross-sectional study was conducted from March 2020 to January 2021 among the military personnel at Hafar Al-Batin military base, Saudi Arabia. The entire population (n = 62, 000) at the military base were invited to participate in the study. The participants were invited to participate in the study either through direct referral from in-patient and out-patient departments of the military hospital or by invitation through pamphlets, email, and advertisement across the offices and residential areas. Soldiers reporting lower back pain for at least 12 weeks were screened for inclusion criteria at the physical therapy department of the military hospital. Inclusion criteria included pain or discomfort originating from the lower back without any known spinal diseases. Participants with a systemic inflammatory disorder, trauma, neurological symptoms, and recent spinal surgery were excluded. All eligible participants were assessed for demographic variables and risk factors and complete the Rolland Morris Disability Questionnaire and WHO-Five Well-Being Index. Results This study identified a 46.3% prevalence of pain originating from the spine with a 2.7% prevalence of NSCLBP. Spearman's rho correlation between the severity of disability due to NSCLBP was strongly associated with age (rs = 0.834, p < 0.01), quality of sleep (rs = 0.790, p < 0.01), body mass index (BMI) (rs = 0.617, p < 0.01), smoking (rs = 0.520, p < 0.01), co-morbidity (rs = 0.357, p < 0.01), but not with the level of physical activity (rs = 0.044, p = 0.07). Conclusion There was a high prevalence of pain originating from the spine among male Saudi soldiers with a relatively low prevalence of NSCLBP. However, the prevalence of disability due to NSCLBP was strongly associated with age, sleep quality, BMI, smoking habit, and co-morbidity.
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Affiliation(s)
- Mohammad Sidiq
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia.,Faculty of Physiotherapy, Madhav University, Abu Road, Rajasthan, India
| | - Wadha Alenazi
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia
| | - Faizan Z Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Mjamaah University, Al Majmaah, Saudi Arabia
| | - Mohammad Qasim
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia
| | - Marisia Paz Lopez
- Department of Rehabilitation Medicine, Northern Area Armed Force Hospital, Hafer Al-Batin, Hafer, Saudi Arabia
| | - Mehrunnisha Ahmad
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Almajmaah, Saudi Arabia
| | - Suresh Mani
- Department of Physiotherapy, Lovely Professional University, Phagwara, Punjab, India
| | - Mohammad Abu Shaphe
- College of Applied Medical Sciences, Physical Therapy Department, Jazan University, Jazan, Saudi Arabia
| | - Omaymah Khodairi
- Department of Physical Therapy, College of Applied Medical science, Jazan University, Jazan, Saudi Arabia
| | - Abdulqader Almutairi
- Department of Physical Therapy, College of Applied Medical science, Jazan University, Jazan, Saudi Arabia
| | - Shabir Ahmad Mir
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, Riyadh, Saudi Arabia
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Ecija C, Catala P, Lopez-Gomez I, Bedmar D, Peñacoba C. What Does the Psychological Flexibility Model Contribute to the Relationship Between Depression and Disability in Chronic Pain? The Role of Cognitive Fusion and Pain Acceptance. Clin Nurs Res 2021; 31:217-229. [PMID: 34301154 DOI: 10.1177/10547738211034307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examines the mediator role of cognitive fusion between depressive symptoms, activity avoidance and excessive persistence at different levels of pain acceptance (moderator) among fibromyalgia patients (FM). Using a sample of 231 women, multiple and moderate mediation analyses were conducted with PROCESS. Results showed that depression was positively associated with activity avoidance and excessive persistence. Furthermore, cognitive fusion and pain acceptance were found to mediate the effect of depression in both patterns. Additionally, pain acceptance was found to play a contextual role in cognitive fusion, as a moderator, between depressive symptoms and maladaptive patterns. Specifically, FM patients with high acceptance levels and low levels of depression presented the strongest associations between depression and cognitive fusion. Techniques aimed at reducing cognitive fusion, could be especially beneficial to FM women with high pain acceptance.
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Affiliation(s)
- Carmen Ecija
- Rey Juan Carlos University, Alcorcón, Madrid, Spain
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