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Heidari Z, Feizi A, Roohafza H, Keshteli AH, Shiravi FZ, Adibi P. Demographic and Life Styles Determinants of Somatic Complaints' Structures: A Cross-sectional Study on a Large Sample of Iranian Adults Using Factor Mixture Model. Int J Prev Med 2017; 8:8. [PMID: 28299032 PMCID: PMC5343604 DOI: 10.4103/2008-7802.200526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 12/24/2016] [Indexed: 11/06/2022] Open
Abstract
Background: To identify somatic complaints dimensions, classify studied population and study the association of demographic and lifestyle factors with somatic complaints dimensions. Methods: In a cross-sectional study conducted on 4763 Iranian adults, somatic complaints were assessed using a comprehensive 30-item questionnaire. Self-administered standard questionnaires were used to assess demographic and lifestyle factors. Factor mixture modeling (FMM) was used to identify somatic complaints dimensions and classify studied population. Results: The mean age of participants was 36.58 ± 0.13 years, 55.8% were females, 81.2% were married, and 57.2% had college education. About 9.4% of individuals were obese, and 34.8% of participants had regular physical activity. Four domains of somatic complaints were extracted, including “psychological,” “gastrointestinal,” “neuro-skeletal,” and “pharyngeal-respiratory.” Females, obese and inactive participants, and those in low educations had significantly greater scores in terms of four domains than the others (P < 0.05). A two-class, four-factor structure fitted to the somatic complaints based on FMM. Two classes were labeled “high psychological complaints” (519 individuals (11%) and “low psychological complaints” (4243 individuals (89%). There were no significant differences between two classes in terms of demographic and lifestyle factors, except in educational level. Conclusions: This study suggested that somatic complaints had a dimensional-categorical structure within studied population so that it could be useful for dealing with diagnostic and therapeutic approaches. The results did not show any association between somatic complaints dimensions and demographic, lifestyle factors, except in educational level.
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Affiliation(s)
- Zahra Heidari
- Department of Biostatistics and Epidemiology, Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Zahra Shiravi
- Department of Biostatistics and Epidemiology, Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Department of Internal Medicine, Integrative Functional Gastroenterology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Self-Reported Childhood Maltreatment and Traumatic Events among Israeli Patients Suffering from Fibromyalgia and Rheumatoid Arthritis. Pain Res Manag 2017; 2017:3865249. [PMID: 28167861 PMCID: PMC5266864 DOI: 10.1155/2017/3865249] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/15/2016] [Indexed: 12/19/2022]
Abstract
Objective. The association between Fibromyalgia Syndrome (FMS) and childhood maltreatment and adversity has frequently been proposed but limited data exists regarding the transcultural nature of this association. Methods. 75 Israeli FMS patients and 23 Rheumatoid Arthritis (RA) patients were compared. Childhood maltreatment was assessed by the Childhood Trauma Questionnaire (CTQ) and potential depressive and anxiety disorders were assessed by the Patient Health Questionnaire-4. FMS severity was assessed by the Widespread Pain Index (WPI), the Symptom Severity Score (SSS), and the FIQ. PTSD was diagnosed according to the DSM IV. RA severity was assessed by the RA Disease Activity Index. Health status was assessed by the SF-36. Results. Similar to reports in other countries, high levels of self-reported childhood adversity were reported by Israeli FMS patients. PTSD was significantly more common among FMS patients compared with RA patients, as well as childhood emotional abuse and physical and emotional neglect. Levels of depression and anxiety were significantly higher among FMS patients. Conclusion. The study demonstrated the cross cultural association between FMS and childhood maltreatment, including neglect, emotional abuse, and PTSD. Significant differences were demonstrated between FMS patients and patients suffering from RA, a model of an inflammatory chronic rheumatic disease.
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103
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Physical Activity to Reduce Systemic Inflammation Associated With Chronic Pain and Obesity: A Narrative Review. Clin J Pain 2016; 32:365-70. [PMID: 25988939 DOI: 10.1097/ajp.0000000000000258] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The increasing prevalence of chronic pain and obesity has significant health and cost implications for economies in the developed and developing world. Evidence suggests that there is a positive correlation between obesity and chronic pain and the link between them is thought to be systemic inflammation. OBJECTIVES The aim of this narrative review was to explore the physiological links between chronic musculoskeletal pain and obesity and to consider the potential role of regular physical activity in providing a means of managing obesity-related chronic pain. DISCUSSION Systemic inflammation, mechanical overload, and autonomic dysfunction are associated with increased prevalence and severity of chronic pain in individuals with obesity. It has been proposed, therefore, that interventions that target systemic inflammation could help to reduce chronic pain in obese individuals. Reduction in abdominal fat has been shown to alleviate pain and reduce the systemic markers of inflammation that contribute to chronic pain. Interventions that include exercise prescription have been shown to reduce both abdominal fat and systemic inflammation. Furthermore, exercise is also known to reduce pain perception and improve mental health and quality of life that also improves pain outcomes. However, adherence to formal exercise prescription is poor and therefore exercise programmes should be tailored to the interests, needs, and abilities of individuals to reduce attrition.
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104
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Bezzoli E, Andreotti D, Pianta L, Mascheroni M, Piccinno L, Puricelli L, Cimolin V, Salvadori A, Codecasa F, Capodaglio P. Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study. Disabil Rehabil 2016; 40:152-158. [PMID: 27830949 DOI: 10.1080/09638288.2016.1244292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Obese subjects have decreased pulmonary function. The hypothesis of our study was that poor coordination of the lumbar-pelvic musculature secondary to obesity may hinder the synergic activation of the respiratory muscles. The aim of the paper was to evaluate whether specific motor control exercises of the lumbar-pelvic musculature were able to improve respiratory function. METHOD Twenty obese male patients underwent a rehabilitation program including adapted physical activity and respiratory physiotherapy. Patients were randomly assigned to a Specific Motor Control Exercise Group (SG) and a Control Group (CG). SG followed a protocol according to the SMARTERehab concept aimed at improving posture, intra-abdominal pressure, rib cage mobility, and perception of correct muscle activation. CG performed an exercise training protocol to improve aerobic capacity and muscle strength. RESULT After intervention, both groups showed similar changes in body weight, fat, and fat-free mass. Respiratory function indexes improved in SG due to improved proprioception and coordination of the deep lumbar-pelvic muscles. CONCLUSION Our study provides preliminary evidence that breathing, postural control, and spinal stability are intertwined. Positive respiratory effects in obese men can be obtained by prescribing specific motor control exercises of the lumbar-pelvic muscles. Implications for rehabilitation Obese subjects present with decreased pulmonary function and postural changes. Poor coordination of the lumbar-pelvic muscles affects posture and the synergic activation of the respiratory muscles. Specific motor control exercises of the lumbar-pelvic musculature can improve respiratory function. Breathing and postural control are intertwined: positive respiratory effects can be obtained by enhancing motor control of the lumbar-pelvic muscles.
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Affiliation(s)
| | | | - Lucia Pianta
- a Istituto Auxologico Italiano , Piancavallo (VB) , Italy
| | | | | | - Luca Puricelli
- c Università degli studi dell'Insubria, Medical school, Bachelor degree Physiotherapy , Varese , Italy
| | - Veronica Cimolin
- d Bioengineering Department , Politecnico di Milano , Milan , Italy
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105
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Itz C, Huygen F, Kleef MV. A proposal for the organization of the referral of patients with chronicnon-specific low back pain. Curr Med Res Opin 2016; 32:1903-1909. [PMID: 27499500 DOI: 10.1080/03007995.2016.1220933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Low back pain in general and specifically chronic low back pain forms a major burden for the patient and society. Recently studies demonstrated that up to 65% of patients evolve to chronic pain as opposed to the previously accepted 8%. As low back pain patients present first with their general practitioner, the latter should establish a treatment plan, including the appropriate referrals. There are, however, no clear guidelines as to how to refer low back pain patients. The process of trial and error of different specialties and treatment possibilities often results in a long and costly trajectory. A better understanding of the subtypes of chronic low back pain, the risks for chronification and fast adequate referral may result in higher patient satisfaction and cost reduction. Proposed solutions: We propose a classification system based on the clinical and anatomical characteristics of axial low back pain, separated from radicular pain. It is important to recognize the risks for chronification, such as degenerative and/or herniated disk, a smaller cross-sectional area of the multifidus, erector spinae, and psoas muscles and psychological and social factors, to be able to provide appropriate management. Also stratification of the patients according to the degree of disability may help in defining the correct treatment approach. A one-and-a-half line approach, where a spine physician assistant works under the supervision of the general practitioner to establish the sub-diagnosis, the risk factors for chronicity and to explain the proposed management plan to the patient, may be helpful for an early appropriate treatment selection for the patient with chronic low back pain.
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Affiliation(s)
- Coen Itz
- a Department of Anesthesiology and Pain Medicine , Maastricht University Medical Centre , Maastricht , The Netherlands
- b Health Insurance Company VGZ Eindhoven , Eindhoven , The Netherlands
| | - Frank Huygen
- c Department of Anesthesiology , Centre of Pain Medicine, Erasmus Medical Center , Rotterdam , the Netherlands
| | - Maarten van Kleef
- a Department of Anesthesiology and Pain Medicine , Maastricht University Medical Centre , Maastricht , The Netherlands
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106
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Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil 2016; 12:463-470. [PMID: 27807526 PMCID: PMC5091063 DOI: 10.12965/jer.1632650.325] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/24/2016] [Indexed: 11/26/2022] Open
Abstract
The beneficial effects of a strength exercise program and a combined exercise program of strength training plus walking were examined in overweight with chronic back pain patients. The participants were randomly placed in the strength exercise group (SEG, n=15), combined exercise group (CEG, n=15), and control group (CG, n=6). All subjects performed exercise twice per week, 50 min per session with a professional instructors for 12 weeks. In order to evaluate exercise intervention effects, lumbar function was measured by back strength and flexibility. Roland-Morris disability questionnaire (RMDQ) and visual analogue scale (VAS) were used to evaluate pain level. Fat and muscle mass were measured to compare body composition changes. All measurements were performed before and after 12 weeks of exercise program. Lumbar function: Back strength was significantly different over time, and significant time×group differences were found between SEG and CG and, CEG and CG. Pain disorder degree: VAS showed a significant group difference, and significant time×group differences were shown between SEG and CG, and CEG and CG. Also, RMDG showed a significant difference between CEG and CG. Body composition: Fat mass was significantly different over time×group between SEG and CG. In conclusion, participating in strength and walking exercises were beneficial to improve lumbar function. Also, the combined exercise program was more effective for reducing pain levels than the strength exercise. Finally, fat mass was reduced in this study and this may play a possible role in the improvement of lumbar function and reduction in low back pain.
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Affiliation(s)
- Jung-Seok Lee
- Department of Physical Education, Graduate School, Sangmyung University, Seoul, Korea
| | - Suh-Jung Kang
- Department of Sport & Health Science, College of Natural Science, Sangmyung University, Seoul, Korea
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Serra MVGB, Camargo PR, Zaia JE, Tonello MGM, Quemelo PRV. Effects of physical exercise on musculoskeletal disorders, stress and quality of life in workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2016; 24:62-67. [DOI: 10.1080/10803548.2016.1234132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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108
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Brooks C, Siegler JC, Marshall PWM. Relative abdominal adiposity is associated with chronic low back pain: a preliminary explorative study. BMC Public Health 2016; 16:700. [PMID: 27485214 PMCID: PMC4971654 DOI: 10.1186/s12889-016-3357-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/22/2016] [Indexed: 12/18/2022] Open
Abstract
Background Although previous research suggests a relationship between chronic low back pain (cLBP) and adiposity, this relationship is poorly understood. No research has explored the relationship between abdominal-specific subcutaneous and visceral adiposity with pain and disability in cLBP individuals. The aim of this study therefore was to examine the relationship of regional and total body adiposity to pain and disability in cLBP individuals. Methods A preliminary explorative study design of seventy (n = 70) adult men and women with cLBP was employed. Anthropometric and adiposity measures were collected, including body mass index, waist-to-hip ratio, total body adiposity and specific ultrasound-based abdominal adiposity measurements. Self-reported pain and disability were measured using a Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) questionnaires respectively. Relationships between anthropometric and adiposity measures with pain and disability were assessed using correlation and regression analyses. Results Significant correlations between abdominal to lumbar adiposity ratio (A-L) variables and the waist-to-hip ratio with self-reported pain were observed. A-L variables were found to predict pain, with 9.1–30.5 % of the variance in pain across the three analysis models explained by these variables. No relationships between anthropometric or adiposity variables to self-reported disability were identified. Conclusions The findings of this study indicated that regional distribution of adiposity via the A-L is associated with cLBP, providing a rationale for future research on adiposity and cLBP.
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Affiliation(s)
- Cristy Brooks
- School of Science and Health, Western Sydney University, Locked Bag 1797, Campbelltown Campus, Sydney, NSW, 2751, Australia.
| | - Jason C Siegler
- School of Science and Health, Western Sydney University, Campbelltown Campus, Sydney, Australia
| | - Paul W M Marshall
- School of Science and Health, Western Sydney University, Campbelltown Campus, Sydney, Australia
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Collins CK, Johnson VS, Godwin EM, Pappas E. The reliability and validity of the Saliba Postural Classification System. J Man Manip Ther 2016; 24:174-81. [PMID: 27559288 PMCID: PMC4984814 DOI: 10.1080/10669817.2016.1138599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To determine the reliability and validity of the Saliba Postural Classification System (SPCS). METHODS Two physical therapists classified pictures of 100 volunteer participants standing in their habitual posture for inter and intra-tester reliability. For validity, 54 participants stood on a force plate in a habitual and a corrected posture, while a vertical force was applied through the shoulders until the clinician felt a postural give. Data were extracted at the time the give was felt and at a time in the corrected posture that matched the peak vertical ground reaction force (VGRF) in the habitual posture. RESULTS Inter-tester reliability demonstrated 75% agreement with a Kappa = 0.64 (95% CI = 0.524-0.756, SE = 0.059). Intra-tester reliability demonstrated 87% agreement with a Kappa = 0.8, (95% CI = 0.702-0.898, SE = 0.05) and 80% agreement with a Kappa = 0.706, (95% CI = 0.594-0818, SE = 0.057). The examiner applied a significantly higher (p < 0.001) peak vertical force in the corrected posture prior to a postural give when compared to the habitual posture. Within the corrected posture, the %VGRF was higher when the test was ongoing vs. when a postural give was felt (p < 0.001). The %VGRF was not different between the two postures when comparing the peaks (p = 0.214). DISCUSSION The SPCS has substantial agreement for inter- and intra-tester reliability and is largely a valid postural classification system as determined by the larger vertical forces in the corrected postures. Further studies on the correlation between the SPCS and diagnostic classifications are indicated.
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Affiliation(s)
- Cristiana Kahl Collins
- Physical Therapy Department, Long Island University, 1 University Plaza, Brooklyn 11201, NY, USA
| | | | - Ellen M. Godwin
- Physical Therapy Department, Long Island University, 1 University Plaza, Brooklyn 11201, NY, USA
| | - Evangelos Pappas
- Faculty of Health Sciences, Discipline of Physiotherapy, University of Sydney, 75 East St, Lidcombe 2141, NSW, Australia
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110
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Hesselman Borg J, Westerståhl M, Lundell S, Madison G, Aasa U. Longitudinal study exploring factors associated with neck/shoulder pain at 52 years of age. J Pain Res 2016; 9:303-10. [PMID: 27307762 PMCID: PMC4889214 DOI: 10.2147/jpr.s93845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To investigate the ability of work-related measurements, body composition, physical activity, and fitness levels to predict neck/shoulder pain (upper body pain, UBP) at the age of 52 years. Another aim was to investigate the cross-sectional relationships between UBP, work-related factors, and individual factors at the age of 52 years. METHODS We followed a randomly selected cohort of 429 adolescents that was recruited in 1974 (baseline), when they were 16 years old. The participants completed physical fitness tests, questions about sociodemographic and lifestyle factors at 16, 34, and 52 years of age, and questions about work-related factors and pain in the follow-ups. Logistic regression analyses were used to examine the associations between UBP and the other variables. RESULTS Univariate logistic regression analyses showed that high body mass index and the work-related factors, low control, and low social support at the age of 34 years were related to UBP at the age of 52 years. For social support, there was an interaction between men and women where the relationship between low social support and the experience of pain was more evident for women. Among women, body mass index and social support remained significantly related in the multivariate analyses. For men, social support remained significantly related. Cross-sectional relationships at the age of 52 differed from the longitudinal in the sense that measures of joint flexibility and work posture were also significantly associated with UBP. CONCLUSION The fact that the cross-sectional differed from the longitudinal relationships strengthens the importance of performing longitudinal studies when studying factors that might influence the initiation of pain. UBP preventative measures might need to include both lifestyle (such as dietary habits and physical activity to ensure that the individuals are not becoming overweight) and work-related factors such as social support.
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Affiliation(s)
| | - Maria Westerståhl
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sara Lundell
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Guy Madison
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Ulrika Aasa
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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111
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Palmlöf L, Holm LW, Alfredsson L, Magnusson C, Vingård E, Skillgate E. The impact of work related physical activity and leisure physical activity on the risk and prognosis of neck pain - a population based cohort study on workers. BMC Musculoskelet Disord 2016; 17:219. [PMID: 27206535 PMCID: PMC4875718 DOI: 10.1186/s12891-016-1080-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/13/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The effect of physical activity on risk and prognosis for neck pain has been studied earlier with inconclusive results. There is a need for large prospective studies on the subject. The aim of this study was to investigate if work related physical activity and physical activity during leisure time are of importance for the risk and prognosis of neck pain in men and women. METHODS We used the Stockholm Public Health Cohort and formed two sub-cohorts of the working population based on data from 2002. Cohort I (risk cohort) included persons without neck pain (n = 4681), and cohort II (prognostic cohort) included persons with occasional neck pain (n = 6820) during the previous six months. Both cohorts were assessed for the outcome long duration troublesome neck pain (LDNP) in 2007. The exposures and potential confounders were assessed through a questionnaire in 2002. The question regarding work related physical activity over the past 12 months had five answering categories ranging from "sedentary" to"heavy". The question regarding leisure physical activity for the past 12 months had five answering categories ranging from "sedentary" to "regular physical activity". LDNP in 2007 was defined as having had troublesome neck pain lasting ≥ 3 consecutive months during the previous five years. Associations between work related physical activity and LDNP, as well as leisure physical activity and LDNP, were investigated by multivariable logistic regression, considering potential confounding factors. RESULTS In cohort I (risk cohort) we found an association between leisure physical activity and LDNP. In cohort II (prognostic cohort) we found no association between the exposures and the outcome. CONCLUSION The results suggest that leisure physical activity has a protective effect on the risk of developing LDNP in a population free from neck pain. It did not, however, affect the prognosis of occasional neck pain. Neither the risk nor the prognosis of neck pain was affected by work related physical activity in this study.
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Affiliation(s)
- Lina Palmlöf
- The Institute of Environmental Medicine, Musculoskeletal & Sports Injury Epidemiology Center, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Lena W Holm
- The Institute of Environmental Medicine, Musculoskeletal & Sports Injury Epidemiology Center, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Lars Alfredsson
- The Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Cecilia Magnusson
- The Institution of Public Health Sciences, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden
| | - Eva Vingård
- Department of Medical Science, Occupational and Environmental Medicine, Akademiska sjukhuset, Ulleråkersvägen 40, 751 85, Uppsala, Sweden
| | - Eva Skillgate
- The Institute of Environmental Medicine, Musculoskeletal & Sports Injury Epidemiology Center, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden. .,Naprapathögskolan - Scandinavian College of Naprapathic Manual Medicine, Kräftriket 23A, 11419, Stockholm, Sweden.
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112
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Brady SRE, Hussain SM, Brown WJ, Heritier S, Billah B, Wang Y, Teede H, Urquhart DM, Cicuttini FM. Relationships Between Weight, Physical Activity, and Back Pain in Young Adult Women. Medicine (Baltimore) 2016; 95:e3368. [PMID: 27175634 PMCID: PMC4902476 DOI: 10.1097/md.0000000000003368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Back pain causes enormous financial and disability burden worldwide, which could potentially be reduced by understanding its determinants to develop effective prevention strategies. Our aim was to identify whether modifiable risk factors, weight and physical activity, are predictive of back pain in young adult women.Women born between 1973 and 1978 were randomly selected from the national health insurance scheme database to participate in The Australian Longitudinal Study of Women's Health. Self-reported data on back pain in the last 12 months, weight, height, age, education status, physical activity, and depression were collected in 2000, 2003, 2006, 2009, and 2012. In 2000, 9688 women completed the questionnaire and 83% completed follow-up 12 years later.At baseline, median age was 24.6 years and 41% had self-reported back pain. For every 5 kg higher weight at baseline, there was a 5% (95% confidence interval [CI] 4%-6%) increased risk of back pain over the next 12 years. Higher weight at each survey also predicted back pain risk 3 years later (P < 0.001). The effects of weight on back pain were most significant in those with BMI ≥25 kg/m and were observed at all levels of physical activity. Inadequate physical activity and depression were independent predictors of back pain over the following 12 years (both P < 0.001), after adjusting for age, weight, height, and education status.Back pain is common in community-based young adult women. Higher weight, inadequate levels of physical activity, and depression were all independent predictors of back pain over the following decade. Furthermore, the adverse effects of weight on back pain were not mitigated by physical activity. Our findings highlight the role of both higher weight and physical inactivity in back pain among young women and suggest potential opportunities for future prevention.
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Affiliation(s)
- Sharmayne R E Brady
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria (SREB, SMH, SH, BB, YW, DMU, FMC); School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland (WJB); Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University (HT); and Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria, Australia (HT)
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Shemory ST, Pfefferle KJ, Gradisar IM. Modifiable Risk Factors in Patients With Low Back Pain. Orthopedics 2016; 39:e413-6. [PMID: 27064774 DOI: 10.3928/01477447-20160404-02] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/09/2015] [Indexed: 02/03/2023]
Abstract
Low back pain is one of the most common reasons for physician visits in the United States and is a chief complaint frequently seen by orthopedic surgeons. Patients with chronic low back pain can experience recurring debilitating pain and disability, decreasing their quality of life. A commercially available software platform, Explorys (Explorys, Inc, Cleveland, Ohio), was used to mine a pooled electronic health care database consisting of the medical records of more than 26 million patients. According to the available medical history data, 1.2 million patients had a diagnosis of low back pain (4.54%). The information was used to determine the incidence of low back pain in patients with a history of nicotine dependence, obesity (body mass index, >30 kg/m(2)), depressive disorders, and alcohol abuse. Relative risk was then calculated for the defined modifiable risk factors. Patients with nicotine dependence, obesity, depressive disorders, and alcohol abuse had a relative risk of 4.489, 6.007, 5.511, and 3.326 for low back pain, respectively, compared with patients without the defined risk factor. A statistically significant difference was found in the incidence of low back pain between all 4 groups with the risk factors evaluated and the general population (P<.05). By determining treatable patient risk factors for low back pain, physicians can monitor at-risk patients and focus on prevention and control of debilitating disease. These approaches can decrease the number of patients with isolated low back pain who are seen by orthopedic surgeons. [Orthopedics. 2016; 39(3):e413-e416.].
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Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. PLoS One 2016; 11:e0153828. [PMID: 27082110 PMCID: PMC4833298 DOI: 10.1371/journal.pone.0153828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/03/2016] [Indexed: 02/02/2023] Open
Abstract
The main objectives of the current study was i) to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii) to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995–97 and in 2006–08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR) with 95% confidence interval (CI). In total, 1,674 offspring (35.3%) developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55) and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57) was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52) versus high (RR: 1.32, 95% CI: 0.95, 1.84) level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24) of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.
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Heuch I, Heuch I, Hagen K, Zwart JA. Is there a U-shaped relationship between physical activity in leisure time and risk of chronic low back pain? A follow-up in the HUNT Study. BMC Public Health 2016; 16:306. [PMID: 27068452 PMCID: PMC4827170 DOI: 10.1186/s12889-016-2970-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/18/2016] [Indexed: 11/21/2022] Open
Abstract
Background Physical activity in leisure time is often considered to have favourable effects on the risk of low back pain (LBP), but demonstrating a definite association in epidemiological studies has proven difficult. The purpose of the present study was to explore associations between physical activity and risk of chronic LBP in an adult population and to investigate whether relationships are limited to certain age groups or to females or males. A particular objective was to determine whether support could be found for a U-shaped relationship, with both low and high activity levels carrying greater risk. Methods The relationship between physical activity and risk of chronic LBP was examined in a Norwegian prospective study using data from the community-based HUNT2 and HUNT3 surveys. Participants were 9616 women and 8452 men without LBP at baseline, who reported after 11 years whether they suffered from LBP. Associations between baseline physical activity in leisure time and risk of chronic LBP at end of follow-up were evaluated by generalized linear modelling with adjustment for potential confounders. Results Significant associations between leisure time physical activity and risk were observed in both sexes after age adjustment, mainly suggesting inverse relationships. Women participating in hard physical activity 1–2 h per week had a relative risk (RR) of chronic LBP of 0.81 (95 % CI 0.71–0.93) compared to those with only light physical activity less than 1 h per week. The corresponding RR in men was 0.71 (95 % CI 0.60–0.85). After adjustment for education, employment, occupational activity, body mass index (BMI) and smoking, significant relationships could only be demonstrated in those aged 50 years or more at baseline. The associations differed between female educational groups, with more U-shaped relationships being observed among women with basic education only. Conclusion No strong support was found overall for U-shaped relationships. However, no further general decrease in risk was seen among those with 3 h or more of hard physical activity per week. The contrasts observed between female educational groups may reflect different preferences regarding specific strenuous activities. Men aged 50 years or more seem in particular to benefit from hard physical activities.
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Affiliation(s)
- Ingrid Heuch
- Department of Neurology and FORMI, Oslo University Hospital, N-0407, Oslo, Norway.
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, Norwegian National Headache Centre, St. Olavs Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Department of Neurology and FORMI, Oslo University Hospital, N-0407, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Onyemaechi NOC, Anyanwu GE, Obikili EN, Onwuasoigwe O, Nwankwo OE. Impact of overweight and obesity on the musculoskeletal system using lumbosacral angles. Patient Prefer Adherence 2016; 10:291-6. [PMID: 27022251 PMCID: PMC4792212 DOI: 10.2147/ppa.s90967] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Overweight and obesity have been identified as independent risk factors for musculoskeletal disorders. However, the association between obesity and low back pain remains controversial. Little is known about the effects of overweight and obesity on the angles of the lumbosacral spine. The objective of this study was to evaluate the effects of body mass index (BMI) and waist-hip ratio (WHR) on lumbosacral angles. METHODS The effects of BMI and WHR on the lumbar lordosis angle (LLA), lumbosacral angle (LSA), sacral inclination angle (°°), and lumbosacral disc angle (LSDA) of 174 overweight and obese subjects (test group) and 126 underweight and normal-weight subjects (control group) were analyzed. RESULTS The test group had a significantly higher mean LSA, LLA, sacral inclination angle (SIA), and LSDA (P=0.001). A significant correlation was noted between BMI and LSA (P=0.001), LLA (P=0.001), SIA (P=0.001), and LSDA (P=0.03). There was also a positive relationship between WHR and LSA (P=0.012), LLA (P=0.009), SIA (P=0.02), and LSDA (P=0.01). CONCLUSION There was an increase in lumbosacral angles in individuals with raised BMI and WHR. This may result in biomechanical changes in the lumbosacral spine, which increase the incidence of low back pain.
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Affiliation(s)
- Ndubuisi OC Onyemaechi
- Department of Surgery, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- University of Nigeria Teaching Hospital, Enugu, Nigeria
- Correspondence: Ndubuisi OC Onyemaechi, Department of Surgery, College of Medicine, University of Nigeria Enugu Campus, PMB 01129, Enugu, Nigeria, Tel +234 80 3550 4767, Email
| | - Godson E Anyanwu
- Department of Anatomy, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Emmanuel N Obikili
- Department of Anatomy, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Okechukwu Onwuasoigwe
- Department of Surgery, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Okechukwu E Nwankwo
- Department of Surgery, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- University of Nigeria Teaching Hospital, Enugu, Nigeria
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Iguti AM, Bastos TF, Barros MBDA. Dor nas costas em população adulta: estudo de base populacional em Campinas, São Paulo, Brasil. CAD SAUDE PUBLICA 2015; 31:2546-58. [DOI: 10.1590/0102-311x00178114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 06/08/2015] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo teve por objetivos estimar a prevalência de dor nas costas na população urbana de Campinas, São Paulo, Brasil, e identificar os subgrupos populacionais mais afetados pelo problema. Os dados foram obtidos na pesquisa populacional realizada em 2008 e 2009, que envolveu 1.118 indivíduos com idades de 18 a 59 anos. A prevalência de dor nas costas foi de 30,6%, acometendo 34,4% das mulheres e 26,5% dos homens. Após ajustes, a prevalência se mostrou mais elevada nas mulheres, nos de menor escolaridade, nos que trabalhavam mais de 40 horas por semana, nos fumantes e ex-fumantes, nos que não faziam atividade física em contexto de lazer e nos ativos nas atividades domésticas e de trabalho. A prevalência revelou-se crescente com a idade e com o número de filhos, com o número de morbidades e problemas de saúde e com a piora da autoavaliação da saúde. Os resultados confirmam a elevada prevalência do problema e das limitações que provoca, indicando os segmentos sociodemográficos que merecem maior atenção em ações de prevenção e controle dos serviços de saúde.
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Heuch I, Heuch I, Hagen K, Zwart JA. A Comparison of Anthropometric Measures for Assessing the Association between Body Size and Risk of Chronic Low Back Pain: The HUNT Study. PLoS One 2015; 10:e0141268. [PMID: 26506618 PMCID: PMC4623972 DOI: 10.1371/journal.pone.0141268] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/05/2015] [Indexed: 12/16/2022] Open
Abstract
Background Previous work indicates that overweight and obese individuals carry an increased risk of experiencing chronic low back pain (LBP). It is not known, however, how the association with body size depends on the choice of anthropometric measure used. Objective This work compares relationships with LBP for several measures of body size. Different results may indicate underlying mechanisms for the association between body size and risk of LBP. Methods In a cohort study, baseline information was collected in the community-based HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys in Norway. Participants were 10,059 women and 8725 men aged 30–69 years without LBP, and 3883 women and 2662 men with LBP at baseline. Associations with LBP at end of follow-up were assessed by generalized linear modeling, with adjustment for potential confounders. Results Relationships between waist-hip-ratio and occurrence of LBP at end of follow-up were weak and non-significant after adjustment for age, education, work status, physical activity, smoking, lipid levels and blood pressure. Positive associations with LBP at end of follow-up were all significant for body weight, BMI, waist circumference and hip circumference after similar adjustment, both in women without and with LBP at baseline, and in men without LBP at baseline. After additional mutual adjustment for anthropometric measures, the magnitude of the association with body weight increased in women without LBP at baseline (RR: 1.130 per standard deviation, 95% CI: 0.995–1.284) and in men (RR: 1.124, 95% CI 0.976–1.294), with other measures showing weak associations only. Conclusion Central adiposity is unlikely to play a major role in the etiology of LBP. Total fat mass may be one common factor underlying the associations observed. The association with body weight remaining after mutual adjustment may reflect mechanical or structural components behind the relationship between overweight or obesity and LBP.
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Affiliation(s)
- Ingrid Heuch
- Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Norwegian National Headache Centre, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
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Anderson RJ, Hurley RW, Staud R, Robinson ME. Cognitive-Motivational Influences on Health Behavior Change in Adults with Chronic Pain. PAIN MEDICINE 2015; 17:1079-1093. [PMID: 26441145 DOI: 10.1111/pme.12929] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary aim was to assess the psychological factors that influence engagement in health behaviors in individuals with chronic pain using a new measure, the Behavioral Engagement Test for Chronic Pain (BET-CP). A secondary aim was to determine preliminary psychometric properties of the BET-CP. SUBJECTS Participants were 86 adults with chronic musculoskeletal pain recruited from University of Florida pain clinics and the community. METHODS Participants completed a battery of self-report instruments online, including the BET-CP and measures of related constructs. Items on the BET-CP assessed motivation, self-efficacy, outcome expectations, and the symptom benefit required to engage across four health behaviors: exercise, diet, sleep, and pain self-management (e.g., relaxation and activity pacing). RESULTS Participants reported modest expectations of pain-related symptom improvement if they practiced the health behaviors (22-26% improvement), but they required twice that (47-54% improvement) to make it worth their while to commit to practicing them. Participants expected to get the most symptom relief from relaxation and activity pacing, but they were most confident and motivated to eat a healthy diet. In a subsample of participants who provided data for psychometric analysis, the BET-CP demonstrated strong test-retest reliability across 7 days and adequate convergent validity. CONCLUSION While patients with musculoskeletal pain have outcome expectancies that are nearly in line with research on behavioral pain treatments, their stringent requirements for symptom benefit may impede engagement in the health behaviors recommended for their pain-related symptoms. Additional psychometric study with larger sample sizes is needed to further validate the BET-CP.
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Affiliation(s)
- Ryan J Anderson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Robert W Hurley
- Department of Anesthesiology, Pain Medicine, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael E Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
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Al-Marwani Al-Juhani M, Khandekar R, Al-Harby M, Al-Hassan A, Edward DP. Neck and upper back pain among eye care professionals. Occup Med (Lond) 2015; 65:753-7. [PMID: 26416844 DOI: 10.1093/occmed/kqv132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ophthalmologists and optometrists have reported a higher prevalence of neck, hand/wrist and lower back pain than family medicine physicians. Work-related musculoskeletal disorders have not previously been studied in Saudi eye care professionals. AIMS To determine the magnitude and determinants of neck and upper back pain among eye care professionals at a tertiary hospital in Saudi Arabia in 2013. METHODS A cross-sectional study using a close-ended questionnaire to determine the frequency of neck and back pain and its association with age, sex, weight, comorbidities, duration of professional work, history of injury and physician sub-speciality. RESULTS The response rate was 82% and 165 eye care professionals participated, 70% (113) of whom reported neck and back pain. The rate was similar in ophthalmologists and allied eye care professionals and among surgical and medical ophthalmologists. The prevalence rate of neck and upper back pain was not associated with number of years in the profession, comorbidities, self-reported weight or injury. Pain appeared to be associated with reported physical discomfort during professional activities (P < 0.01) but not with mental stress. Pain was thought to be work related by 50% of participants. A lower rate of neck and upper back pain was associated with regular exercise [odds ratio = 0.5 (95% confidence interval 0.2-0.9)]. CONCLUSIONS Neck and back pain was reported by 70% of eye care professionals. The pain was graded as mild to moderate and improved when on holidays. Regular physical exercise appeared to prevent or reduce neck and upper back pain.
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Affiliation(s)
| | - R Khandekar
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia,
| | - M Al-Harby
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia
| | - A Al-Hassan
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia
| | - D P Edward
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Großschädl F, Stolz E, Mayerl H, Rásky É, Freidl W, Stronegger WJ. Rising prevalence of back pain in Austria: considering regional disparities. Wien Klin Wochenschr 2015; 128:6-13. [PMID: 26373747 DOI: 10.1007/s00508-015-0857-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/19/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Back pain is the most common form of musculoskeletal conditions and leads to high health care costs. Information about geographic variations in highly prevalent diseases/disorders represents important implications for public health planning to face structural challenges. The present study aims to investigate regional trends in the prevalence of back pain and the role of obesity and social inequalities among Austrian adults. METHODS A secondary data analysis based on five nationally representative cross-sectional surveys (1973-2007) was carried out (N = 178,818). Back pain was measured as self-reported presence. Obesity (BMI ≥ 30 kg/m²) was adjusted for self-report bias. For the regional analyses, Austria was divided into Western, Central and Eastern Austria. A relative index of inequality (RII) was computed to quantify the extent of social inequality. RESULTS A continuous rise in back pain prevalence was observed in the three regions and among all investigated subgroups. In 2007 the age-standardised prevalence was similar in Central (36.9 %), Western (35.2 %) and Eastern Austria (34.3 %). The absolute change in back pain prevalence was highest among obese subjects in Central Austria (women: + 29.8 %, men: + 32.5 %). RIIs were unstable during the study period and in 2007 highest in Eastern Austria. CONCLUSION Variation and trends in back pain are not attributable to geographic variation in Austria: an assumed East-West gradient in Austria has not been confirmed. Nevertheless our study confirms that back pain dramatically increased in all Austrian regions and investigated subgroups. This worrying trend should be further monitored and public health interventions should be implemented increasingly, especially among obese women and men.
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Affiliation(s)
- Franziska Großschädl
- Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010, Graz, Austria.
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria
| | - Hannes Mayerl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria
| | - Éva Rásky
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria
| | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria
| | - Willibald J Stronegger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, 8010, Graz, Austria.
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Großschädl F, Stolz E, Mayerl H, Rásky É, Freidl W, Stronegger W. Educational inequality as a predictor of rising back pain prevalence in Austria—sex differences. Eur J Public Health 2015; 26:248-53. [DOI: 10.1093/eurpub/ckv163] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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123
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Frilander H, Solovieva S, Mutanen P, Pihlajamäki H, Heliövaara M, Viikari-Juntura E. Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach. BMJ Open 2015; 5:e007805. [PMID: 26297359 PMCID: PMC4550727 DOI: 10.1136/bmjopen-2015-007805] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course. DESIGN A longitudinal and cross-sectional study. SETTING A nationwide health survey supplemented with data from records of prior compulsory military service. PARTICIPANTS Premilitary health records (baseline) were searched for men aged 30-50 years (n=1385) who participated in a national health examination survey (follow-up). METHODS AND OUTCOME MEASURES Height and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica. RESULTS Baseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m(2)) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m(2)). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP. CONCLUSIONS Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.
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Affiliation(s)
- Heikki Frilander
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
- Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Svetlana Solovieva
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
- Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Pertti Mutanen
- Department of Statistics and Health Economics, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Harri Pihlajamäki
- Department of Orthopaedics and Trauma Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
- University of Tampere, Seinäjoki, Finland
| | - Markku Heliövaara
- Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Eira Viikari-Juntura
- Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
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Leung YY, Teo SL, Chua MB, Raman P, Liu C, Chan A. Living arrangements, social networks and onset or progression of pain among older adults in Singapore. Geriatr Gerontol Int 2015; 16:693-700. [PMID: 26081796 DOI: 10.1111/ggi.12539] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 11/28/2022]
Abstract
AIMS We aimed to evaluate the relationship between living arrangements, and strength of social network with onset and progression of chronic pain over 2 years in elderly Singaporeans. METHODS We used data from the Social Isolation Health and Lifestyles Survey, a nationally representative survey of community-dwelling older Singaporeans aged >60 years (n = 4990) in 2009 and follow up in 2011. We used binomial logistic regression models to examine factors associated with self-reported onset and progression of chronic pain over time. RESULTS A total of 3103 participants (53.8% women) completed both surveys (weighted response rate 63.7%). The mean age (SD) was 69.4 (0.5) years. The prevalence of mild and moderate-extreme chronic pain at baseline were 27.7% and 12.8%. A total of 20.1% and 3.9% of the participants reported having chronic pain onset and progression over 2 years, respectively. In the binomial regression models, lower education level, living alone and poorer self-rated health were predictors for onset of chronic pain in women. Weak social networks and disability were associated with progression of chronic pain in women. CONCLUSIONS Chronic pain is common in Singaporean older adults. Living alone and weak social network were sociopsychological factors associated with the onset or progression of chronic pain. Geriatr Gerontol Int 2015; ●●: ●●-●●.
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Affiliation(s)
- Ying-Ying Leung
- Clinical Sciences, Duke-NUS Graduate Medical School, Singapore.,Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
| | - Suat Lay Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ming Boon Chua
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
| | - Prassanna Raman
- Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - Chang Liu
- Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - Angelique Chan
- Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
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Zdziarski LA, Wasser JG, Vincent HK. Chronic pain management in the obese patient: a focused review of key challenges and potential exercise solutions. J Pain Res 2015; 8:63-77. [PMID: 25709495 PMCID: PMC4332294 DOI: 10.2147/jpr.s55360] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
In obese persons, general and specific musculoskeletal pain is common. Emerging evidence suggests that obesity modulates pain via several mechanisms such as mechanical loading, inflammation, and psychological status. Pain in obesity contributes to deterioration of physical ability, health-related quality of life, and functional dependence. We present the accumulating evidence showing the interrelationships of mechanical stress, inflammation, and psychological characteristics on pain. While acute exercise may transiently exacerbate pain symptoms, regular participation in exercise can lower pain severity or prevalence. Aerobic exercise, resistance exercise, or multimodal exercise programs (combination of the two types) can reduce joint pain in young and older obese adults in the range of 14%-71.4% depending on the study design and intervention used. While published attrition rates with regular exercise are high (∼50%), adherence to exercise may be enhanced with modification to exercise including the accumulation of several exercise bouts rather than one long session, reducing joint range of motion, and replacing impact with nonimpact activity. This field would benefit from rigorous comparative efficacy studies of exercise intensity, frequency, and mode on specific and general musculoskeletal pain in young and older obese persons.
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Affiliation(s)
- Laura Ann Zdziarski
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL, USA
| | - Joseph G Wasser
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL, USA
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL, USA
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Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc 2015; 90:284-99. [PMID: 25659245 DOI: 10.1016/j.mayocp.2014.09.008] [Citation(s) in RCA: 301] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/07/2014] [Accepted: 09/10/2014] [Indexed: 01/22/2023]
Abstract
Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. History and physical examination can provide important clues as to whether the pain is neuropathic or mechanical and can also be used to identify "red flags" that may signify serious pathology, such as myelopathy, atlantoaxial subluxation, and metastases. Magnetic resonance imaging is characterized by a high prevalence of abnormal findings in asymptomatic individuals but should be considered for cases involving focal neurologic symptoms, pain refractory to conventional treatment, and when referring a patient for interventional treatment. Few clinical trials have evaluated treatments for neck pain. Exercise treatment appears to be beneficial in patients with neck pain. There is some evidence to support muscle relaxants in acute neck pain associated with muscle spasm, conflicting evidence for epidural corticosteroid injections for radiculopathy, and weak positive evidence for cervical facet joint radiofrequency denervation. In patients with radiculopathy or myelopathy, surgery appears to be more effective than nonsurgical therapy in the short term but not in the long term for most people.
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Affiliation(s)
- Steven P Cohen
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD; Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD; Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, MD; Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD.
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128
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Haukenes I, Hensing G, Stålnacke BM, Hammarström A. Does pain severity guide selection to multimodal pain rehabilitation across gender? Eur J Pain 2014; 19:826-33. [PMID: 25366906 DOI: 10.1002/ejp.609] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Studies have addressed the effect of multimodal pain rehabilitation (MMR), whereas criteria for selection are sparse. This study examines whether higher scores on musculoskeletal pain measures are associated with selection to MMR, and whether this differs across gender. METHOD A clinical population of 262 male and 589 female patients was recruited consecutively during 3 years, 2007-2010. The patients were referred from primary care to a pain rehabilitation clinic in Northern Sweden for assessment and selection to MMR. Register-based data on self-reported pain were linked to patients' records where outcome (MMR or not) was stated. We modelled odds ratios for selection to MMR by higher scores on validated pain measures (pain severity, interference with daily life, pain sites and localized pain vs. varying pain location). Covariates were age, educational level and multiple pain measures. Anxiety and depression (Hospital, Anxiety and Depression Scale) and working status were used in sensitivity tests. RESULTS Higher scores of self-reported pain were not associated with selection to MMR in multivariate models. Among women, higher scores on pain severity, pain sites and varying pain location (localized pain = reference) were negatively associated with selection to MMR. After adjustment for multiple pain measures, the negative odds ratio for varying location persisted (OR = 0.59, 95% CI = 0.39-0.89). CONCLUSION Higher scores on self-reported pain did not guide selection to MMR and a negative trend was found among women. Studies of referral patterns and decision processes may contribute to a better understanding of the clinical practice that decides selection to MMR.
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Affiliation(s)
- I Haukenes
- Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway; Department of Public Health and Clinical Medicine, Umeå University, Sweden
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129
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Lunde LK, Koch M, Knardahl S, Wærsted M, Mathiassen SE, Forsman M, Holtermann A, Veiersted KB. Musculoskeletal health and work ability in physically demanding occupations: study protocol for a prospective field study on construction and health care workers. BMC Public Health 2014; 14:1075. [PMID: 25318646 PMCID: PMC4203897 DOI: 10.1186/1471-2458-14-1075] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/10/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders have a profound impact on individual health, sickness absence and early retirement, particularly in physically demanding occupations. Demographics are changing in the developed countries, towards increasing proportions of senior workers. These senior workers may have particular difficulties coping with physically demanding occupations while maintaining good health. Previous studies investigating the relationship between physical work demands and musculoskeletal disorders are mainly based on self-reported exposures and lack a prospective design. The aim of this paper is to describe the background and methods and discuss challenges for a field study examining physical demands in construction and health care work and their prospective associations with musculoskeletal disorders, work ability and sickness absence. METHODS AND DESIGN This protocol describes a prospective cohort study on 1200 construction and health care workers. Participants will answer a baseline questionnaire concerning musculoskeletal complaints, general health, psychosocial and organizational factors at work, work demands, work ability and physical activity during leisure. A shorter questionnaire will be answered every 6th months for a total of two years, together with continuous sickness absence monitoring during this period. Analysis will prospectively consider associations between self-reported physical demands and musculoskeletal disorders, work ability and sickness absence. To obtain objective data on physical exposures, technical measurements will be collected from two subgroups of N = 300 (Group A) and N = 160 (Group B) during work and leisure. Both group A and B will be given a physical health examination, be tested for physical capacity and physical activity will be measured for four days. Additionally, muscle activity, ground reaction force, body positions and physical activity will be examined during one workday for Group B. Analysis of associations between objectively measured exposure data and the outcomes described above will be done separately for these subpopulations. DISCUSSION The field study will at baseline produce objectively measured data on physical demands in the construction and health care occupations. In combination with clinical measurements and questionnaire data during follow-up, this will provide a solid foundation to prospectively investigate relationships between physical demands at work and development of musculoskeletal disorders, work ability and sickness absence.
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Affiliation(s)
| | | | | | | | | | | | | | - Kaj Bo Veiersted
- National Institute of Occupational Health, Gydas vei 8, 0336 Oslo, Norway.
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130
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Lier R, Nilsen TIL, Vasseljen O, Mork PJ. Neck/upper back and low back pain in parents and their adult offspring: Family linkage data from the Norwegian HUNT Study. Eur J Pain 2014; 19:762-71. [PMID: 25263611 DOI: 10.1002/ejp.599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic pain in the neck and low back is highly prevalent. Although heritable components have been identified, knowledge about generational transmission of spinal pain between parents and their adult offspring is sparse. METHODS This study examined the intergenerational association of spinal pain using data from 11,081 parent-offspring trios participating in the population-based HUNT Study in Norway. Logistic regression was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for offspring spinal pain associated with parental spinal pain. RESULTS In total, 3654 (33%) offspring reported spinal pain at participation. Maternal and paternal spinal pain was consistently associated with higher ORs for offspring spinal pain. The results suggest a slightly stronger association for parental multilevel spinal pain (i.e., both neck/upper back pain and low back pain) than for pain localized to the neck/upper back or low back. Multilevel spinal pain in both parents was associated with ORs of 2.6 (95% CI, 2.1-3.3), 2.4 (95% CI, 1.9-3.1) and 3.1 (95% CI, 2.2-4.4) for offspring neck/upper back, low back and multilevel spinal pain, respectively. CONCLUSION Parental chronic spinal pain was consistently associated with increased occurrence of chronic spinal pain in their adult offspring, and this association was particularly strong for multilevel spinal pain.
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Affiliation(s)
- R Lier
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Liaison Committee between the Central Norway Regional Health Authority, Stjørdal, Norway; the Norwegian University of Science and Technology, Trondheim, Norway
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Großschädl F, Freidl W, Rásky É, Burkert N, Muckenhuber J, Stronegger WJ. A 35-year trend analysis for back pain in Austria: the role of obesity. PLoS One 2014; 9:e107436. [PMID: 25207972 PMCID: PMC4160246 DOI: 10.1371/journal.pone.0107436] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/11/2014] [Indexed: 11/18/2022] Open
Abstract
Background The prevalence of back pain is constantly increasing and a public health problem of high priority. In Austria there is a lack of empirical evidence for the development of back pain and its related factors. The present study aims to investigate trends in the prevalence of back pain across different subpopulations (sex, age, obesity). Methods A secondary data analysis based on five nationally representative cross-sectional health surveys (1973–2007) was carried out. Face-to-face interviews were conducted in private homes in Austria. Subjects aged 20 years and older were included in the study sample (n = 178,818). Obesity was defined as BMI≥30 kg/m2 and adjusted for self-report bias. Back pain was measured as the self-reported presence of the disorder. Results The age-standardized prevalence of back pain was 32.9% in 2007; it was higher among women than men (p<0.001), higher in older than younger subjects (p<0.001) and higher in obese than non-obese individuals (p<0.001). During the investigation period the absolute change in the prevalence of back pain was +19.4%. Among all subpopulations the prevalence steadily increased. Obese men showed the highest increase of and the greatest risk for back pain. Conclusion These results help to understand the development of back pain in Austria and can be used to plan controlled promotion programs. Further monitoring is recommended in order to control risk groups and plan target group-specific prevention strategies. In Austria particular emphasis should be on obese individuals. We recommend conducting prospective studies to confirm our results and investigate causal relationships.
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Affiliation(s)
- Franziska Großschädl
- Medical University of Graz, Institute of Social Medicine and Epidemiology, Graz, Austria
- * E-mail:
| | - Wolfgang Freidl
- Medical University of Graz, Institute of Social Medicine and Epidemiology, Graz, Austria
| | - Éva Rásky
- Medical University of Graz, Institute of Social Medicine and Epidemiology, Graz, Austria
| | - Nathalie Burkert
- Medical University of Graz, Institute of Social Medicine and Epidemiology, Graz, Austria
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Predictors of Work-Related Musculoskeletal Disorders among Commercial Minibus Drivers in Accra Metropolis, Ghana. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/384279] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background. The objective of this study is to determine the prevalence and predictors of work-related musculoskeletal disorders (WMSDs) among a sample of commercial minibus drivers in the Accra Metropolis of Ghana. Methods. The participating drivers (n=148) were recruited from various lorry terminals and assessed by using a semistructured questionnaire that included the Nordic Musculoskeletal Questionnaire (NMQ). Results. Of the 148 drivers, 116 (78.4%) reported having WMSDs during the previous 12 months. The prevalence of the various WMSD domains was low back pain (58.8%), neck pain (25%), upper back pain (22.3%), shoulder pain (18.2%), knee pain (14.9%), ankle pain (9.5%), wrist pain (7.4%), elbow pain (4.7%), and hip/thigh pain (2.7%). Multiple logistic regression analysis adjusted for possible confounders showed that less physical activity (OR = 4.9; 95% CI = 1.5–16.5; P=0.010), driving more than 12 hours per day (OR = 2.9; 95% CI = 1.1–7.8; P=0.037), and driving at least 5 days per week (OR = 3.7; 95% CI = 1.4–9.4; P=0.007) were significantly associated with WMSDs among this cohort of drivers. Conclusion. These modifiable factors may be targets for preventive strategies to reduce the incidence of WMSDs among occupational minibus drivers in Ghana.
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Occupational and Personal Determinants of Musculoskeletal Disorders among Urban Taxi Drivers in Ghana. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:517259. [PMID: 27379297 PMCID: PMC4897274 DOI: 10.1155/2014/517259] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/17/2014] [Accepted: 06/09/2014] [Indexed: 01/29/2023]
Abstract
Background. There is a lack of epidemiological data on musculoskeletal disorders (MSDs) among occupational drivers in Ghana. The present study seeks to estimate the prevalence, body distribution, and occupational and personal determinants of MSDs in a sample of taxi drivers in the Accra Metropolis of Ghana. Methods. A total of 210 participants were enrolled in this cross-sectional study. All the participants were evaluated by using a semistructured questionnaire and the standardized Nordic Musculoskeletal Disorder Questionnaire. Results. The estimated prevalence of MSDs was 70.5%. The prevalence of the various MSD domains was as follows: lower back pain (34.3%), upper back pain (16.7%), neck pain (15.2%), shoulder pain (11.0%), knee pain (10.0%), hip/thigh pain (2.9%), elbow pain (4.8%), ankle/feet pain (2.4%), and wrist/hand pain (1.9%). Multiple logistic regression analysis of the data showed that participants who were employee drivers, drove taxi more than 12 hours per day or at least 5 days per week, perceived their job as stressful, and were dissatisfied with their job were at a greater risk of developing MSDs. Conclusions. These findings call for preventive strategies and safety guidelines in order to reduce the incidence of MSDs among urban taxi drivers in Ghana.
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Lier R, Nilsen TIL, Mork PJ. Parental chronic pain in relation to chronic pain in their adult offspring: family-linkage within the HUNT Study, Norway. BMC Public Health 2014; 14:797. [PMID: 25096408 PMCID: PMC4133600 DOI: 10.1186/1471-2458-14-797] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 07/24/2014] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about the association between parental chronic musculoskeletal pain (CMP) and occurrence of CMP in the adult offspring. The main objective of this study was to assess the parent-offspring association of CMP, and also to examine possible modifying effects of age and sex. Methods The study includes 11 248 parent-offspring trios from the Norwegian HUNT Study with information on parental CMP obtained in 1995–97 and offspring CMP obtained in 2006–08. Logistic regression was used to calculate adjusted odds ratios (ORs) for offspring CMP associated with parental CMP. Results Maternal and paternal CMP was associated with 20-40% increased odds of CMP in sons and daughters. Both sons and daughters had an OR of 1.6 (95% CI 1.4 to 1.9) when both parents reported CMP, compared to when none of the parents had CMP. Restricting the analyses to parental CMP that was associated with limited work ability and leisure time activity did not change the strength of the association. Further, analyses stratified by parental age ±65 years showed no clear difference in the estimated associations, and there was no evidence of interaction for parental sex (P ≥ 0.39) or offspring age ±40 years (P ≥ 0.26). Conclusions This large family-linkage study show that maternal and paternal CMP are positively associated with CMP in the adult offspring, irrespective of parental and offspring age, and that the associations are strongest when both parents have CMP. Although the high prevalence of CMP in both parents and offspring suggests that not all cases are clinically relevant, the results suggest that chronic pain has a heritable component.
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Affiliation(s)
- Ragnhild Lier
- Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), N-7491 Trondheim, Norway.
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135
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Has overweight any influence on the effectiveness of conservative treatment in patients with low back pain? 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 2014; 24:467-73. [PMID: 24935829 DOI: 10.1007/s00586-014-3425-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 12/17/2022]
Abstract
PURPOSE Low back pain and overweight are two relevant disabling health conditions. To date, there is a lack of information about the effectiveness of nonoperative therapy in persons with overweight and low back pain. The aim of our study was to evaluate if overweight has any influence on the effectivity of conservative treatment in patients with low back pain during a mid- to long-term time period. METHODS 128 patients with low back pain participated in this study. All of them got an inpatient conservative treatment program. The weight status was classified according to the body mass index (BMI) in three weight groups (normal, overweight, obesity). The patients were asked to fill out a standardized questionnaire regarding self-reported pain with the visual analog scale and their disability with the Oswestry Disability Index and the Roland-Morris Disability Questionnaire at four time points (beginning and end of hospital stay and after 5 and 17 months). RESULTS Concerning the short-term results of the three scores, we always observed an improvement of the patients' condition with statistically significant reduction of pain and disability at discharge. This was true for the total collective as well as for each of the three BMI-groups when considered separately. The pain intensity and disability were still and mostly statistically significantly decreased in the mid- to long-term follow-up. Regarding the three BMI-groups among themselves, the differences of the data in the pain and disability scores showed generally no statistical significance. CONCLUSIONS We conclude for the first time that a conservative treatment program in patients even with chronic low back pain is effective both in a short-term and a mid- to long-term time period respectively without any significant differences between patients with a normal BMI or with overweight or obesity.
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136
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Vas J, Modesto M, Aguilar I, Gonçalo CDS, Rivas-Ruiz F. Efficacy and Safety of Auriculopressure for Primary Care Patients with Chronic Non-Specific Spinal Pain: A Multicentre Randomised Controlled Trial. Acupunct Med 2014; 32:227-35. [DOI: 10.1136/acupmed-2013-010507] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Chronic uncomplicated musculoskeletal pain in the spine (cervical, thoracic or lumbar) is highly prevalent and may severely limit the daily activities of those affected by it. Objective To evaluate the efficacy and safety of treatment with auriculopressure applied to patients with non-specific spinal pain. Methods A multicentre randomised controlled trial with two parallel arms (true auriculopressure (TAP) and placebo auriculopressure (PAP)) was performed. The intervention phase lasted 8 weeks and outcomes were measured 1 week after the last intervention (T1) and 6 months after baseline (T2). The primary outcome measure was change in pain intensity according to a 100 mm visual analogue scale (pain VAS) at T1. Secondary outcome measures were the Lattinen index, the McGill Pain Questionnaire and the SF-12 health-related quality of life scale (Spanish version in every case). Results There were 265 participants (TAP group, n=130; PAP group, n=135). Pain was most frequently located in the upper back (55.1%, n=146), followed by the lower back (25.3%, n=67) and the dorsal area (12.5%, n=33). Nineteen patients (7.2%) reported pain affecting the entire spine. There were statistically significant differences between TAP and PAP in the change in the pain VAS at T1 of 10 mm (95% CI 2.8 to 17.3, p=0.007) and in the change in the pain VAS at T2 of 7.2 mm (95% CI 0.02 to 14.3, p=0.049) in favour of TAP. We also observed a statistically significant difference of 3.4 points in the physical component of the SF-12 in favour of TAP at T2 (95% CI 0.45 to 6.3, p=0.024). No severe adverse effects were detected or reported during treatment. Conclusions The application of auriculopressure in patients with non-specific spinal pain in primary healthcare is effective and safe, and therefore should be considered for inclusion in the portfolio of primary healthcare services. Trial Registration Number ISRCTN01897462.
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Affiliation(s)
- Jorge Vas
- Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain
- Carlos III Health Institute, Network of Research in Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | - Manuela Modesto
- Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain
| | - Inmaculada Aguilar
- Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain
| | | | - Francisco Rivas-Ruiz
- Carlos III Health Institute, Network of Research in Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
- Support Research Unit, Costa del Sol Hospital, Marbella, Spain
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137
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Yalcinkaya H, Ucok K, Ulasli AM, Coban NF, Aydin S, Kaya I, Akkan G, Tugrul Senay T. Do male and female patients with chronic neck pain really have different health-related physical fitness, depression, anxiety and quality of life parameters? Int J Rheum Dis 2014; 20:1079-1087. [PMID: 24810182 DOI: 10.1111/1756-185x.12389] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM The purpose of this study was to investigate whole body physical fitness parameters such as maximal aerobic capacity (VO2 max), muscle strength, trunk flexibility, daily physical activity, pulmonary function, body composition, anxiety and depression, as well as other disease-related changes in patients with chronic neck pain (CNP), and to compare them with healthy controls. METHOD Eighty patients (40 male, 40 female) with CNP and 80 (40 male, 40 female) controls were included in this study. VO2 max, handgrip and back-leg strengths, trunk flexibility, daily physical activity, pulmonary function test (PFT), body composition and pressure pain threshold (PPT) measurements were carried out. Neck disability index (NDI), Beck anxiety inventory (BAI), Beck depression inventory (BDI), Pittsburg sleep quality index (PSQI), and Short-Form health survey (SF-36) questionnaires were applied to all participants. RESULTS Handgrip and back-leg strengths and suboccipital and paraspinal-C7 PPTs and health-related quality of life (HRQoL) were lower, and PSQI, BAI and BDI were higher, in female patients with CNP, compared to healthy controls; whereas, VO2 max and HRQoL were lower, and body fat percantage and PSQI were higher, in male patients with CNP, compared to healthy controls. Trunk flexibility and PFT values were not significantly different between the patients and the controls in both genders. CONCLUSION We suggest that, on the basis of gender, consideration of not only the neck region but also whole body physical fitness, anxiety and depression parameters in patients with CNP might be helpful to the development of more benefical strategies for illness management.
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Affiliation(s)
- Hatice Yalcinkaya
- Department of Physiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Kagan Ucok
- Department of Physiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Alper M Ulasli
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Necip F Coban
- Department of Physiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Sedat Aydin
- Department of Physiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Idris Kaya
- Department of Physiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Gokhan Akkan
- Department of Physiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Tugba Tugrul Senay
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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138
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Bilberg R, Nørgaard B, Overgaard S, Roessler KK. Mental health and quality of life in shoulder pain patients and hip pain patients assessed by patient reported outcome. Int J Orthop Trauma Nurs 2014. [DOI: 10.1016/j.ijotn.2013.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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139
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Fujii T, Matsudaira K, Yoshimura N, Hirai M, Tanaka S. Associations between neck and shoulder discomfort (Katakori) and job demand, job control, and worksite support. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0824-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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140
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No relationship between body mass index and changes in pain and disability after exercise rehabilitation for patients with mild to moderate chronic low back pain. Spine (Phila Pa 1976) 2013; 38:2190-5. [PMID: 24296481 DOI: 10.1097/brs.0000000000000002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective multicenter study. OBJECTIVE To investigate the relationship between body mass index (BMI) and changes in pain and disability resulting from exercise-based chronic low back pain (cLBP) treatment. SUMMARY OF BACKGROUND DATA Past research has shown evidence of a relationship between BMI, a measurement of obesity, and cLBP. Exercise is a known beneficial treatment for cLBP. However, it is unclear if exercise-induced changes in pain and disability are related to baseline levels of, or changes in, BMI. METHODS One hundred and twenty-eight (n = 128) males and females with cLBP performed 8 weeks of exercise, consisting of 3 to 5 exercise sessions (minimum of 1 supervised session) per week. Outcome measures included BMI and self-reported pain and disability. BMI was calculated as weight divided by height squared (kg/m). Pain was measured using the visual analogue scale and disability was measured using the Oswestry Disability Index. Correlation, regression, covariance and likelihood ratios analyses were used to examine the relationship between BMI and self-reported pain and disability changes. RESULTS No baseline relationships between BMI and self-reported pain (r = -0.083, P = 0.349) and disability (r = 0.090, P = 0.314) were observed. There was no relationship observed between baseline BMI (P = 0.938, P = 0.873), or changes in BMI (P = 0.402, P = 0.854), with exercise-related changes in pain and disability, respectively. No relationships between baseline BMI or BMI changes with pain and disability at baseline or after exercise were observed on the basis of pain and disability subgroups. BMI was not a predictor of exercise-based pain and disability changes. CONCLUSION There was no significant relationship between BMI and self-reported pain and disability in cLBP participants. BMI was not a predictor of exercise-induced changes in pain and disability. The reliance on BMI as a sole measurement of obesity in cLBP research may be unwarranted.
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141
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Mork PJ, Vik KL, Moe B, Lier R, Bardal EM, Nilsen TIL. Sleep problems, exercise and obesity and risk of chronic musculoskeletal pain: the Norwegian HUNT study. Eur J Public Health 2013; 24:924-9. [PMID: 24293504 DOI: 10.1093/eurpub/ckt198] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The objective was to investigate the association between self-reported sleep problems and risk of chronic pain in the low back and neck/shoulders, and whether physical exercise and body mass index (BMI) alter this association. METHODS The study comprised data on 26 896 women and men in the Nord-Trøndelag Health Study (Norway) without chronic pain or physical impairment at baseline in 1984-86. Occurrence of chronic pain was assessed at follow-up in 1995-97. A generalized linear model was used to calculate adjusted risk ratios. RESULTS Sleep problems were dose-dependently associated with risk of pain in the low back and neck/shoulders in both women and men (P < 0.001 both genders). Women and men who reported sleep problems 'sometimes' and 'often/always' had a higher risk of chronic pain of 23-32% and 51-66%, respectively, than those who reported sleep problems 'never'. Combined analyses showed that persons with sleep problems 'sometimes' and who exercised ≥1 hour per week had lower risk of chronic pain in the low back (P < 0.04) and neck/shoulders (P < 0.001) than inactive persons with a similar level of sleep problems (P < 0.04). Likewise, persons with BMI <25 kg/cm(2) and sleep problems 'sometimes' had lower risk of chronic pain in the low back (P < 0.001) and neck/shoulders (P < 0.001) than persons with BMI ≥25 kg/cm(2) and a similar level of sleep problems. CONCLUSION Sleep problems are associated with an increased risk of chronic pain in the low back and neck/shoulders. Regular exercise and maintenance of normal body weight may reduce the adverse effect of mild sleep problems on risk of chronic pain.
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Affiliation(s)
- Paul Jarle Mork
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kirsti Lund Vik
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 2 Liaison Committee between the Central Norway Regional Health Authority (RHA), Stjørdal, Norway, and the Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Børge Moe
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ragnhild Lier
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 2 Liaison Committee between the Central Norway Regional Health Authority (RHA), Stjørdal, Norway, and the Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ellen Marie Bardal
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- 1 Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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142
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Bihari V, Kesavachandran CN, Mathur N, Pangtey BS, Kamal R, Pathak MK, Srivastava AK. Mathematically derived body volume and risk of musculoskeletal pain among housewives in North India. PLoS One 2013; 8:e80133. [PMID: 24223218 PMCID: PMC3819295 DOI: 10.1371/journal.pone.0080133] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/30/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Global Burden of Disease Study 2010 demonstrates the impact of musculoskeletal diseases as the second greatest cause of disability globally in all regions of the world. The study was conducted to determine the role of mathematically derived body volume (BV), body volume index (BVI), body mass index (BMI), body surface area (BSA) and body fat % (BF %) on musculoskeletal pain (MSP) among housewives in National Capital Region (NCR). METHODS A cross sectional study was undertaken among 495 housewives from Gurgaon and New Okhla Industrial Development Area (NOIDA) in National Capital Region (NCR), New Delhi, India. The study includes questionnaire survey, clinical examination and body composition monitoring among housewives. RESULTS A significantly higher BMI, BVI, BV and BSA were observed in subjects with MSP as compared to those who had no MSP. This was also true for subjects with pain in knee for BMI category for overweight. Subjects with pain in limbs had significantly high BMI and BVI as compared to subjects with no MSP. A significant positive correlation of age with BMI, BVI, BV and BSA was observed among subjects having no MSP denoting a direct relationship of age and these body factors. CONCLUSIONS The prevalence of MSP among housewives is associated with increasing age, BMI and BVI. This can possibly be used for formulating a strategy for prevention of MSP.
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Affiliation(s)
- Vipin Bihari
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | | | - Neeraj Mathur
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Balram Singh Pangtey
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Ritul Kamal
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar Pathak
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
| | - Anup Kumar Srivastava
- Epidemiology Division, CSIR-Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
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143
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Holtermann A, Clausen T, Jørgensen MB, Mork PJ, Andersen LL. Should physical activity recommendation depend on state of low back pain? Eur J Pain 2013; 18:575-81. [PMID: 24115569 DOI: 10.1002/j.1532-2149.2013.00403.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Leisure time physical activity is recommended for preventing long-term sickness absence (LTSA). Although low back pain (LBP) is a risk factor for sickness absence and physical activity is recommended for people with LBP, it is unknown if leisure time physical activity prevents LTSA among persons with different levels of LBP. METHODS Prospective cohort study among 8655 Danish female healthcare workers responding to a questionnaire in 2004-2005 on leisure time physical activity and LBP, and subsequently followed for 1 year on periods with LTSA ∼2 consecutive weeks or more of sickness absence in a national register of social transfer payments (DREAM). Multi-adjusted Cox regression analysis was used to model risk estimates for LTSA associated with low, moderate, high and very high leisure time physical activity at baseline among healthcare workers with no LBP (0 days past 12 months, n = 2761), non-chronic LBP (1-30 days the past 12 months, n = 3942) and persistent LBP (>30 days the past 12 months, n = 1952). RESULTS A strongly reduced risk for LTSA from high leisure time physical activity was found among healthcare workers with no LBP [hazard ratio (HR): 95% confidence interval (CI) 0.47:0.23-0.97 for low vs. very high activity] and non-chronic LBP (HR: 95%CI 0.43:0.23-0.84 of low vs. very high activity), but not among healthcare workers with persistent LBP (HR: 95%CI 1.15:0.55-2.44 of low vs. very high activity). CONCLUSIONS Leisure time physical activity is a strong predictive factor on LTSA among female healthcare workers with no and non-chronic LBP, but not among those with more persistent LBP.
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Affiliation(s)
- A Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
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144
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Nagashima M, Abe H, Amaya K, Matsumoto H, Yanaihara H, Nishiwaki Y, Toyama Y, Matsumoto M. Risk factors for lumbar disc degeneration in high school American football players: a prospective 2-year follow-up study. Am J Sports Med 2013; 41:2059-64. [PMID: 23841993 DOI: 10.1177/0363546513495173] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Several risk factors have been proposed for intervertebral disc degeneration (DD) among adolescent athletes. However, the causes of DD are not well understood, and there have been few prospective studies evaluating DD in adolescents. PURPOSE To identify risk factors for DD among adolescent American football (AF) players. STUDY DESIGN Cohort study (prevalence); Level of evidence, 2. METHODS This study investigated the relationships between the progression of DD and the following factors: lumbar spine abnormalities on baseline radiographs, body mass index, AF position played (lineman or other), and length of playing career (2 full competitive AF seasons or <2 seasons). Included were 192 students who joined a top-ranked high school AF team from 2004 to 2008. Of these, 160 played for 2 full competitive AF seasons. The remaining 32 players, who stopped before completing 2 seasons, were used as a control group. Baseline radiographs and lumbar magnetic resonance imaging (MRI) scans were obtained when the players enrolled in the AF team in May, and follow-up lumbar MRI scans were obtained 2 years later at the end of their second academic year in March. Disc degeneration was measured by the signal intensity of the nucleus pulposus, and its progression was evaluated by multiple regression analysis of decreases in signal intensity. Also analyzed was the relationship between DD and low back pain (LBP). RESULTS The mean decrease in signal intensity of the nucleus pulposus was 4.30% ± 11.63% in players who completed 2 AF seasons and 1.41% ± 10.03% in those who did not (P = .12). Mean visual analog scale scores for LBP at follow-up were significantly higher (P = .001) in players who had played for 2 full seasons (2.67 ± 2.81) than in those with a shorter career (0.99 ± 1.61). Decreases in signal intensity of the nucleus pulposus after 2 years of playing AF related significantly to playing a lineman position (partial regression coefficient, 3.47%), the presence of Schmorl nodes (partial regression coefficient, 3.58%), and disc herniation (partial regression coefficient, 4.09%). CONCLUSION Significant risk factors for DD progression in high school AF players included playing a lineman position, the presence of Schmorl nodes, and disc herniation. Continuing to play AF through 2 years of high school was a risk factor for the onset of LBP.
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Affiliation(s)
- Masaki Nagashima
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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145
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Viester L, Verhagen EALM, Oude Hengel KM, Koppes LLJ, van der Beek AJ, Bongers PM. The relation between body mass index and musculoskeletal symptoms in the working population. BMC Musculoskelet Disord 2013; 14:238. [PMID: 23937768 PMCID: PMC3751130 DOI: 10.1186/1471-2474-14-238] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 07/30/2013] [Indexed: 12/19/2022] Open
Abstract
Background The primary aim of this study was to investigate the association between BMI and musculoskeletal symptoms in interaction with physical workload. In addition, it was aimed to obtain insight into whether overweight and obesity are associated with an increase in occurrence of symptoms and/or decrease in recovery from symptoms. Methods Based on a large working population sample (n = 44,793), using the data from The Netherlands Working Conditions Survey (NWCS), logistic regression analyses were carried out to investigate the association between BMI and musculoskeletal symptoms, with adjustment for potential confounders. Longitudinal data from the Netherlands Working Conditions Cohort Study (NWCCS) of 7,909 respondents was used for the second research aim (i.e., to investigate the transition in musculoskeletal symptoms). Results For high BMI an increased 12-month prevalence of musculoskeletal symptoms was found (overweight: OR 1.13, 95% CI: 1.08-1.19 and obesity: OR 1.28, 95% CI: 1.19-1.39). The association was modified by physical workload, with a stronger association for employees with low physical workload than for those with high physical workload. Obesity was related to developing musculoskeletal symptoms (OR 1.37, 95% CI: 1.05-1.79) and inversely related to recovery from symptoms (OR 0.76, 95% CI: 0.59-0.97). Conclusion BMI was associated with musculoskeletal symptoms, in particular symptoms of the lower extremity. Furthermore, the association differed for employees with high or low physical workload. Compared to employees with normal weight, obese employees had higher risk for developing symptoms as well as less recovery from symptoms. This study supports the role of biomechanical factors for the relationship between BMI and symptoms in the lower extremity.
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Affiliation(s)
- Laura Viester
- Department of Public and Occupational Health, the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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Jørgensen MB, Korshøj M, Lagersted-Olsen J, Villumsen M, Mortensen OS, Skotte J, Søgaard K, Madeleine P, Thomsen BL, Holtermann A. Physical activities at work and risk of musculoskeletal pain and its consequences: protocol for a study with objective field measures among blue-collar workers. BMC Musculoskelet Disord 2013; 14:213. [PMID: 23870666 PMCID: PMC3724749 DOI: 10.1186/1471-2474-14-213] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 07/17/2013] [Indexed: 11/10/2022] Open
Abstract
Background Among blue-collar workers, high physical work demands are generally considered to be the main cause of musculoskeletal pain and work disability. However, current available research on this topic has been criticised for using self-reported data, cross-sectional design, insufficient adjustment for potential confounders, and inadequate follow-up on the recurrent and fluctuating pattern of musculoskeletal pain. Recent technological advances have provided possibilities for objective diurnal field measurements of physical activities and frequent follow-up on musculoskeletal pain. The main aim of this paper is to describe the background, design, methods, limitations and perspectives of the Danish Physical Activity cohort with Objective measurements (DPhacto) investigating the association between objectively measured physical activities capturing work and leisure time and frequent measurements of musculoskeletal pain among blue-collar workers. Methods/design Approximately 2000 blue-collar workers are invited for the study and asked to respond to a baseline questionnaire, participate in physical tests (i.e. muscle strength, aerobic fitness, back muscle endurance and flexibility), to wear accelerometers and a heart rate monitor for four consecutive days, and finally respond to monthly text messages regarding musculoskeletal pain and quarterly questionnaires regarding the consequences of musculoskeletal pain on work activities, social activities and work ability for a one-year follow-up period. Discussion This study will provide novel information on the association between physical activities at work and musculoskeletal pain. The study will provide valid and precise documentation about the relation between physical work activities and musculoskeletal pain and its consequences among blue-collar workers.
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Affiliation(s)
- Marie Birk Jørgensen
- National Research Centre for the Working Environment, Copenhagen, Lersø Parkallé 105, 2100, Copenhagen, DK, Denmark.
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Sembajwe G, Tveito TH, Hopcia K, Kenwood C, O'Day ET, Stoddard AM, Dennerlein JT, Hashimoto D, Sorensen G. Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers. Workplace Health Saf 2013; 61:117-25. [PMID: 23452130 DOI: 10.1177/216507991306100304] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 10/15/2012] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess the relationship between psychosocial factors at work and multi-site musculoskeletal pain among patient care workers. In a survey of 1,572 workers from two hospitals, occupational psychosocial factors and health outcomes of workers with single and multi-site pain were evaluated using items from the Job Content Questionnaire that was designed to measure psychological demands, decision latitude, and social support. An adapted Nordic Questionnaire provided data on the musculoskeletal pain outcome. Covariates included body mass index, age, gender, and occupation. The analyses revealed statistically significant associations between psychosocial demands and multi-site musculoskeletal pain among patient care associates, nurses, and administrative personnel, both men and women. Supervisor support played a significant role for nurses and women. These results remained statistically significant after adjusting for covariates. These results highlight the associations between workplace psychosocial strain and multi-site musculoskeletal pain, setting the stage for future longitudinal explorations.
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Affiliation(s)
- Grace Sembajwe
- City University New York School of Public Health at Hunter College, New York, NY 10035, USA.
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Smoking as a risk factor for chronic musculoskeletal complaints is influenced by age. The HUNT Study. Pain 2013; 154:1073-9. [DOI: 10.1016/j.pain.2013.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/01/2013] [Accepted: 03/11/2013] [Indexed: 11/17/2022]
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Development of a screening instrument for risk factors of persistent pain after breast cancer surgery. Br J Cancer 2013; 107:1459-66. [PMID: 23093294 PMCID: PMC3493779 DOI: 10.1038/bjc.2012.445] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Persistent postsurgical pain can have a significant effect on the quality of life of women being treated for breast cancer. The aim of this prospective study was to develop a screening tool to identify presurgical demographic, psychological and treatment-related factors that predict persistence of significant pain in the operated area after 6 months from surgery. Methods: Background and self-reported questionnaire data were collected the day before surgery and combined with treatment-related data. Pain in the operated area was assessed 6 months after surgery with a questionnaire. The Bayesian model was used for the development of a screening tool. Results: Report of preoperative chronic pain, more than four or more previous operations, preoperative pain in the area to be operated, high body mass index, previous smoking and older age were included in the six-factor model that best predicted significant pain at the follow-up in the 489 women studied. Conclusion: A six-factor risk index was developed to estimate the risk of developing significant pain after breast cancer surgery. Neither treatment- nor mood-related variables were included in the model. Identification of risk factors may lead to prevention of persistent postsurgery pain. This tool could be used for target prevention to those who are at the highest risk of developing persistent postsurgery pain.
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