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Lemmers GPG, Melis RJF, Hak R, de Snoo EK, Pagen S, Westert GP, Staal JB, van der Wees PJ. The association of physical activity and sedentary behaviour with low back pain disability trajectories: A prospective cohort study. Musculoskelet Sci Pract 2024; 72:102954. [PMID: 38691981 DOI: 10.1016/j.msksp.2024.102954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/22/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Multiple factors influence the recovery process of low back pain (LBP). The identification and increased knowledge of risk factors might contribute to a better understanding of the course of LBP. OBJECTIVES To investigate the association of habitual physical activity (PA) and sedentary behaviour (SB), measured at baseline, with disability trajectories in adults with LBP. METHODS A prospective cohort study where habitual PA levels were measured using the Short QUestionnaire to ASsess Health enhancing physical activity (SQUASH), SB was calculated as average sedentary hours per day, and LBP disability using the Oswestry Disability Index (ODI). Participants completed the questionnaires at one and a half, three, six, and twelve months. Linear mixed models were estimated to describe the association of habitual PA levels SB measured at baseline with disability trajectories. Other predictors were gender, education level, age, pain, number of previous episodes of LBP, and duration of LBP. RESULTS Habitual SB measured at baseline in adults (n = 347) with LBP were not associated with disability trajectories. For PA, participants with one metabolic equivalent of task (MET) hour per day above average recovered 0.04 [95% CI 0.004 to 0.076] points on the ODI per month faster than participants with an average amount of MET hours per day. CONCLUSIONS Habitual SB was not associated with LBP disability trajectories over a one-year follow-up. High levels of habitual PA at baseline were associated with improved recovery in LBP disability trajectory, but the finding is not clinically relevant.
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Affiliation(s)
- Gijs Petrus Gerardus Lemmers
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands; Dutch Healthcare Authority, Newtonlaan 1-41, 3584 BX, Utrecht, the Netherlands.
| | - René Johannes Fransiscus Melis
- Radboud University Medical Center, Department of Geriatric Medicine, Reinier Postlaan 4, 6525 EX, Nijmegen, the Netherlands.
| | - Robin Hak
- Fysius Back Experts, Bedrijvenweg 7, 7442 CX, Nijverdal, the Netherlands.
| | | | - Sophie Pagen
- TheFysioclub, Vicaris van der Asdonckstraat 55, 5421 VB, Gemert, the Netherlands.
| | - Gerard Pieter Westert
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands.
| | - Jacobus Bart Staal
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands; Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN, Nijmegen, the Netherlands.
| | - Philip Jan van der Wees
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands.
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Montgomery G, Tobias JH, Paskins Z, Khera TK, Huggins CJ, Allison SJ, Abasolo D, Clark EM, Ireland A. Daily Pain Severity but Not Vertebral Fractures Is Associated With Lower Physical Activity in Postmenopausal Women With Back Pain. J Aging Phys Act 2024; 32:428-437. [PMID: 38527456 DOI: 10.1123/japa.2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/24/2023] [Accepted: 12/13/2023] [Indexed: 03/27/2024]
Abstract
Back pain lifetime incidence is 60%-70%, while 12%-20% of older women have vertebral fractures (VFs), often with back pain. We aimed to provide objective evidence, currently lacking, regarding whether back pain and VFs affect physical activity (PA). We recruited 69 women with recent back pain (age 74.5 ± 5.4 years). Low- (0.5 < g < 1.0), medium- (1.0 ≤ g < 1.5), and high-impact (g ≥ 1.5) PA and walking time were measured (100 Hz for 7 days, hip-worn accelerometer). Linear mixed-effects models assessed associations between self-reported pain and PA, and group differences (VFs from spine radiographs/no-VF) in PA. Higher daily pain was associated with reduced low (β = -0.12, 95% confidence interval, [-0.22, -0.03], p = .013) and medium-impact PA (β = -0.11, 95% confidence interval, [-0.21, -0.01], p = .041), but not high-impact PA or walking time (p > .11). VFs were not associated with PA (all p > .2). Higher daily pain levels but not VFs were associated with reduced low- and medium-impact PA, which could increase sarcopenia and falls risk in older women with back pain.
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Affiliation(s)
- Gallin Montgomery
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jon H Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Zoe Paskins
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Tarnjit K Khera
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Cameron J Huggins
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sarah J Allison
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
- Department of Nutrition, Food & Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Daniel Abasolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Emma M Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alex Ireland
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
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Apeldoorn AT, Swart NM, Conijn D, Meerhoff GA, Ostelo RW. Management of low back pain and lumbosacral radicular syndrome: the Guideline of the Royal Dutch Society for Physical Therapy (KNGF). Eur J Phys Rehabil Med 2024; 60:292-318. [PMID: 38407016 PMCID: PMC11112513 DOI: 10.23736/s1973-9087.24.08352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/08/2024] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Significant progress and new insights have been gained since the Dutch Physical Therapy guideline on low back pain (LBP) in 2013 and the Cesar en Mensendieck guideline in 2009, necessitating an update of these guidelines. AIM To update and develop an evidence-based guideline for the comprehensive management of LBP and lumbosacral radicular syndrome (LRS) without serious specific conditions (red flags) for Dutch physical therapists and Cesar and Mensendieck Therapists. DESIGN Clinical practice guideline. SETTING Inpatient and outpatient. POPULATION Adults with LBP and/or LRS. METHODS Clinically relevant questions were identified based on perceived barriers in current practice of physical therapy. All clinical questions were answered using published guidelines, systematic reviews, narrative reviews or systematic reviews performed by the project group. Recommendations were formulated based on evidence and additional considerations, as described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework. Patients participated in every phase. RESULTS The guideline describes a comprehensive assessment based on the International Classification of Functioning, Disability and Health (ICF) Core Set for LBP and LRS, including the identification of alarm symptoms and red flags. Patients are assigned to three treatment profiles (low, moderate and high risk of persistent symptoms) based on prognostic factors for persistent LBP. The guideline recommends offering simple and less intensive support to people who are likely to recover quickly (low-risk profile) and more complex and intensive support to people with a moderate or high risk of persistent complaints. Criteria for initiating and discontinuing physical therapy, and referral to a general practitioner are specified. Recommendations are formulated for information and advice, measurement instruments, active and passive interventions and behavior-oriented treatment. CONCLUSIONS An evidence based physical therapy guideline for the management of patients with LBP and LRS without red flags for physical therapists and Cesar and Mensendieck therapists was developed. Cornerstones of physical therapy assessment and treatment are risk stratification, shared decision-making, information and advice, and exercises. CLINICAL REHABILITATION IMPACT This guideline provides guidance for clinicians and patients to optimize treatment outcomes in patients with LBP and LRS and offers transparency for other healthcare providers and stakeholders.
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Affiliation(s)
- Adri T Apeldoorn
- Department of Rehabilitation, Noordwest Ziekenhuisgroep Alkmaar, Alkmaar, the Netherlands -
| | - Nynke M Swart
- Royal Dutch Society of Physical Therapy, Amersfoort, the Netherlands
| | - Daniëlle Conijn
- Royal Dutch Society of Physical Therapy, Amersfoort, the Netherlands
| | - Guus A Meerhoff
- Royal Dutch Society of Physical Therapy, Amersfoort, the Netherlands
| | - Raymond W Ostelo
- Department of Health Sciences, Faculty of Science, VU University Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Free University, Amsterdam, the Netherlands
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Comachio J, Ferreira ML, Mork PJ, Holtermann A, Ho EKY, Wang DXM, Lan Q, Stamatakis E, Beckenkamp PR, Ferreira PH. Clinical guidelines are silent on the recommendation of physical activity and exercise therapy for low back pain: A systematic review. J Sci Med Sport 2024; 27:257-265. [PMID: 38267294 DOI: 10.1016/j.jsams.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To synthesise and evaluate the quality of the recommendations for exercise therapy and physical activity from guidelines for the prevention and/or management of low back pain. DESIGN Systematic review. METHODS Included clinical practice guidelines for the management of low back pain published between 2014 and 2022 and searched in 9 databases until September 2022. The quality of evidence was evaluated with the Appraisal of Guidelines, Research and Evaluation tool (AGREE-II instrument). RESULTS After screening 3448 studies, 18 clinical practice guidelines were included in this review. Only five (27 %) guidelines were judged as having a satisfactory quality of evidence (i.e., rigour of development and applicability), and 13 (72 %) of guidelines are discussed and rated as critical. Regarding physical activity, no guidelines provided recommendations for the primary prevention of low back pain or incorporated adequate physical activity aspects considering type, dosage, frequency, and intensity. For exercises, all (100 %) guidelines recommended at least one type of supervised exercise in the management of low back pain, and 16 (88 %) provided an overall recommendation for people to stay active. CONCLUSIONS Guidelines offer minimal or, sometimes, no detail regarding physical activity or specific exercise regimens for the management and prevention of low back pain. When some guidance is provided, the recommendations typically lack specificity concerning the type, intensity, duration, and frequency of exercise and, in many cases, they represent a combination of scarce available evidence and stakeholder perspectives.
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Affiliation(s)
- Josielli Comachio
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia.
| | - Manuela Loureiro Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
| | | | - Emma Kwan-Yee Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Daniel Xin Mo Wang
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Qianwen Lan
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Emmanuel Stamatakis
- School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Paula R Beckenkamp
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Paulo Henrique Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
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Saltychev M, Hellgren H, Juhola J. Factors affecting association between pain severity and physical activity among people with low back pain. Int J Rehabil Res 2023; 46:293-296. [PMID: 37421303 PMCID: PMC10653291 DOI: 10.1097/mrr.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/03/2023] [Indexed: 07/10/2023]
Abstract
The aim was to identify factors, which may affect the relationship between physical activity and pain severity among patients with low back pain (LBP). It was a cross-sectional survey-based study among 1332 consecutive patients with LBP. Linear regression models were employed. Patients were 47.6 years old and 64% were women. For the entire sample, pain severity and the intensity of physical activity were negatively associated. Higher physical activity was associated with younger age, higher educational level, normal weight and optimal perceived general health. Sex, smoking, marital status and occupation did not demonstrate significant interactions on the association. The severity of disability showed paradoxical effect on the relationship between pain and physical activity - severe disability was associated with increase in physical activity.
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Affiliation(s)
- Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku
| | - Henri Hellgren
- Clinical Division, Faculty of Medicine, University of Turku, Turku, Finland
| | - Juhani Juhola
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku
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Alyousef B, Kazemi Z, Cicuttini FM, Heritier S, Wang Y, Urquhart DM. High levels of back disability, not back pain, are associated with reduced physical activity across key activity domains. Musculoskelet Sci Pract 2023; 65:102768. [PMID: 37126982 DOI: 10.1016/j.msksp.2023.102768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 03/20/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Although remaining physically active is the cornerstone of management for low back pain, our understanding of the physical activity performed by those with back pain is limited. OBJECTIVES To examine the physical activity reported by individuals with different levels of low back pain and disability across key activity domains. DESIGN Community-based, cross-sectional study. METHODS 542 women were recruited from a research database formed from an electoral roll and completed validated, self-report questionnaires. The amount and intensity of physical activity was reported using the International Physical Activity Questionnaire. Low back pain and disability were examined using the Graded Chronic Pain Scale. Participants were categorised into no, low or high pain and disability groups. RESULTS Individuals who reported high disability performed 55% of the physical activity of those without disability (MET(hours/week):median(95%CI) = 27.1(13.2-41.0); 48.8(37.8-59.9),p = 0.01), including less moderate (18.0(10.4-25.6); 31.0(24.0-38.1),p = 0.007), and domestic and gardening activity (14.7(7.2-22.3); 25.7(19.8-31.7),p = 0.001). Fewer women with high disability performed vigorous (OR(95%CI) = 0.29(0.13-0.65),p = 0.002) and leisure activities (0.17(0.04-0.75),p = 0.02) compared to those with no disability. Those with low disability reported less leisure activity ((0.55(0.35-0.88),p = 0.01), but more work-related activities and active transport than individuals without disability (1.65(1.01-2.7),p = 0.04; 1.6(1.04-2.6),p = 0.03). There were no differences in activity between pain groups, with the exception of those with low intensity pain performing less leisure activity (0.51(0.30-0.88),p = 0.01). CONCLUSIONS Individuals who reported high back disability, not back pain, were found to perform reduced physical activity, including less total, moderate, vigorous, and discretionary activity. These findings highlight the altered activity levels of people with back disability and the need to examine its impact on their health and wellbeing.
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Affiliation(s)
- Bothaina Alyousef
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Department of Rehabilitation Sciences, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Zeinab Kazemi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Donna M Urquhart
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Short-term impact of COVID-19 pandemic on low back pain: data from the PAMPA Cohort, Brazil. BMC Public Health 2023; 23:44. [PMID: 36609256 PMCID: PMC9817356 DOI: 10.1186/s12889-022-14932-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To evaluate the short-term impact of COVID-19 pandemic on low back pain (LBP) outcomes in southern Brazil. METHODS Data from the PAMPA Cohort were analyzed. Adults were recruited between June and July 2020 in the Rio Grande do Sul state using online-based strategies. Participants responded a self-reported, online questionnaire on LBP with two timepoints: before (retrospectively) and during COVID-19 pandemic. We assessed LBP experience, LBP-related activity limitation (no/yes), and LBP intensity (0 to 10 [strongest pain]). RESULTS From a total sample of 2,321 respondents (mean age: 37.6 ± 13.5; 75.4% women), the prevalence of LBP did not change significantly from before (74.7% [95%CI 72.3; 76.9]) to the first months of pandemic (74.2% [95%CI 71.9; 76.3]). However, an increased pain levels (β: 0.40; 95%CI 0.22; 0.58) and a higher likelihood for activity limitation due to LBP was observed (PR 1.14; 95%CI 1.01; 1.29). Longitudinal analyzes showed that age, gender, BMI, chronic diseases, physical activity, and anxiety and depression symptoms, were associated with LBP in the first pandemic months. CONCLUSION Although the prevalence of LBP did not change at the first months of COVID-19 pandemic, LBP-induced impairment in daily activities and pain intensity was higher when compared to before the pandemic.
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Gomes LA, Rodrigues AM, Branco JC, Canhão H, Cruz EB. Clinical courses, impact and prognostic indicators for a persistent course of low back pain: Results from a population-based cohort study. PLoS One 2023; 18:e0265104. [PMID: 36930625 PMCID: PMC10022778 DOI: 10.1371/journal.pone.0265104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a long-term health condition with distinct clinical courses. Its characterization together with the identification of prognostic factors for a persistent LBP course may trigger the development of personalized interventions. This study aimed to investigate the courses of chronic LBP (CLBP), its cumulative impact, and the indicators for the persistence of pain. MATERIAL AND METHODS Patients with active CLBP from the EpiDoC, a population-based cohort study of a randomly recruited sample of 10.661 adults with prolonged follow-up, were considered. Pain, disability, and health-related quality of life (HRQoL) were assessed at three time-points over five years. According to their pain symptoms over time, participants were classified as having a persistent (pain at the baseline and at all the subsequent time-points) or a relapsing pain course (pain at the baseline and no pain at least in one of the subsequent time-points). A mixed ANOVA was used to compare mean differences within and between patients of distinct courses. Prognostic indicators for the persistent LBP course were modulated through logistic regression. RESULTS Among the 1.201 adults with active CLBP at baseline, 634 (52.8%) completed the three time-points of data collection: 400 (63.1%) had a persistent and 234 (36.9%) a relapsing course. Statistically significant interactions were found between the group and time on disability (F (2,1258) = 23.779, p<0.001) and HRQoL (F (2,1252) = 82.779, p<0.001). In the adjusted model, the persistent course was associated with the disability level (OR 1.86, CI95% 1.40-2.40, p<0.001), depressive symptoms (OR 1.96, CI95% 1.21-3.18, p = 0.007), female gender (OR 1.90, CI95% 1.26-2.87, p = 0.002) and having a manual job (OR 1.46, CI95% 1.02-2.10, p = 0.040). CONCLUSION In the long-term, patients with CLBP may follow a persistent or relapsing course of pain. Being female, presenting depressive symptoms, having a manual job and higher disability at baseline predicts a persistent course of LBP.
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Affiliation(s)
- Luís Antunes Gomes
- CHRC, Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- EpiDoC Unit, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setubal, Portugal
- * E-mail:
| | - Ana Maria Rodrigues
- CHRC, Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- EpiDoC Unit, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- Unidade de Reumatologia, Hospital dos Lusíadas, Lisbon, Portugal
| | - Jaime C. Branco
- CHRC, Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- EpiDoC Unit, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- Serviço de Reumatologia do Hospital Egas Moniz—Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Lisbon, Portugal
| | - Helena Canhão
- CHRC, Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- EpiDoC Unit, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- Unidade de Reumatologia, Centro Hospitalar Universitário Lisboa Central–Hospital Santo António dos Capuchos (CHULC-EPE), Lisbon, Portugal
| | - Eduardo Brazete Cruz
- CHRC, Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setubal, Portugal
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Reneman MF, Ansuategui Echeita J, van Kammen K, Schiphorst Preuper HR, Dekker R, Lamoth CJC. Do rehabilitation patients with chronic low back pain meet World Health Organisation's recommended physical activity levels? Musculoskelet Sci Pract 2022; 62:102618. [PMID: 35809379 DOI: 10.1016/j.msksp.2022.102618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Primary: to analyse the time that patients with chronic low back pain (CLBP) admitted to pain rehabilitation spent on moderate to vigorous physical activity (MVPA) and compare this to the WHO recommendations. Secondary: to explore factors that might differentiate between those who do and do not meet the recommendations. MATERIALS AND METHODS A Cross-sectional study embedded in secondary interdisciplinary rehabilitation of adults with CLBP. PA was measured with a tri-axial accelerometer for 1 week during admission phase. Time spent in each PA level was calculated. MVPA was also analysed in ≥10 min bouts. RESULTS Complete datasets of 4-6 days recorded accelerometery of n = 46 patients were analysed. Time spent in MVPA was on average 6.0% per day. MVPA per day in ≥10-min bouts occurred on average 0.8 times per day (sd = 0.9; min-max 0-4). Percentage of patients meeting the recommended level of MVPA was 21.7% (10/46) and 84.8% (39/46) for the 2010 and 2020 recommendations, respectively. Most demographic and clinical variables did not seem to differentiate between those who met the WHO recommendations, and those who did not. CONCLUSION The minority of the patients (22%) met the WHO recommended MVPA level of 2010. The more lenient recommendation of 2020 was met by 85%.
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Affiliation(s)
- Michiel F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.
| | - Jone Ansuategui Echeita
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Klaske van Kammen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Henrika R Schiphorst Preuper
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Claudine J C Lamoth
- University of Groningen, University Medical Center Groningen, Department of Human Movement Sciences Groningen, the Netherlands
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Rhim HC, Tenforde A, Mohr L, Hollander K, Vogt L, Groneberg DA, Wilke J. Association between physical activity and musculoskeletal pain: an analysis of international data from the ASAP survey. BMJ Open 2022; 12:e059525. [PMID: 36123076 PMCID: PMC9486184 DOI: 10.1136/bmjopen-2021-059525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore the association of physical activity (PA) with musculoskeletal pain (MSK pain). DESIGN Cross-sectional study SETTING: 14 countries (Argentina, Australia, Austria, Brazil, Chile, France, Germany, Italy, the Netherlands, Singapore, South Africa, Spain, Switzerland and the USA). PARTICIPANTS Individuals aged 18 or older. PRIMARY AND SECONDARY OUTCOME MEASURES PA volumes were assessed with an adapted version of the Nordic Physical Activity Questionnaire-short. Prevalence of MSK pain was captured by means of a 20-item checklist of body locations. Based on the WHO recommendation on PA, participants were classified as non-compliers (0-150 min/week), compliers (150-300 min/week), double compliers (300-450 min/week), triple compliers (450-600 min/week), quadruple compliers (600-750 min/week), quintuple compliers (750-900 min/week) and top compliers (more than 900 min/week). Multivariate logistic regression was used to obtain adjusted ORs of the association between PA and MSK pain for each body location, correcting for age, sex, employment status and depression risk. RESULTS A total of 13 741 participants completed the survey. Compared with non-compliers, compliers had smaller odds of MSK pain in one location (thoracic pain, OR 0.77, 95% CI 0.64 to 0.93). Double compliance was associated with reduced pain occurrence in six locations (elbow, OR 0.70, 95% CI 0.50 to 0.98; forearm, OR 0.63, 95% CI 0.40 to 0.99; wrist, OR 0.74, 95% CI 0.57 to 0.98; hand, OR 0.57, 95% CI 0.40 to 0.79; fingers, OR 0.72, 95% CI 0.52 to 0.99; abdomen, OR 0.61, 95% CI 0.41 to 0.91). Triple to top compliance was also linked with lower odds of MSK pain (five locations in triple compliance, three in quadruple compliance, two in quintuple compliance, three in top compliance), but, at the same time, presented increased odds of MSK pain in some of the other locations. CONCLUSION A dose of 300-450 min WHO-equivalent PA/week was associated with lower odds of MSK pain in six body locations. On the other hand, excessive doses of PA were associated with higher odds of pain in certain body locations.
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Adam Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Lisa Mohr
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Wilke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
- Department of Movement Sciences, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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11
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Otero-Ketterer E, Peñacoba-Puente C, Ferreira Pinheiro-Araujo C, Valera-Calero JA, Ortega-Santiago R. Biopsychosocial Factors for Chronicity in Individuals with Non-Specific Low Back Pain: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610145. [PMID: 36011780 PMCID: PMC9408093 DOI: 10.3390/ijerph191610145] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 06/12/2023]
Abstract
Low back pain (LBP) is a global and disabling problem. A considerable number of systematic reviews published over the past decade have reported a range of factors that increase the risk of chronicity due to LBP. This study summarizes up-to-date and high-level research evidence on the biopsychosocial prognostic factors of outcomes in adults with non-specific low back pain at follow-up. An umbrella review was carried out. PubMed, the Cochrane Database of Systematic Reviews, Web of Science, PsycINFO, CINAHL Plus and PEDro were searched for studies published between 1 January 2008 and 20 March 2020. Two reviewers independently screened abstracts and full texts, extracted data and assessed review quality. Fifteen systematic reviews met the eligibility criteria; all were deemed reliable according to our criteria. There were five prognostic factors with consistent evidence of association with poor acute-subacute LBP outcomes in the long term (high levels of pain intensity and disability, high emotional distress, negative recovery expectations and high physical demands at work), as well as one factor with consistent evidence of no association (low education levels). For mixed-duration LBP, there was one predictor consistently associated with poor outcomes in the long term (high pain catastrophism). We observed insufficient evidence to synthesize social factors as well as to fully assess predictors in the chronic phase of LBP. This study provides consistent evidence of the predictive value of biological and psychological factors for LBP outcomes in the long term. The identified prognostic factors should be considered for inclusion into low back pain explanatory models.
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Affiliation(s)
- Emilia Otero-Ketterer
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Physiotherapy Department, Mutua Universal Mugenat, 28001 Alcalá de Henares, Spain
| | | | | | - Juan Antonio Valera-Calero
- Valtradofi Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
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12
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Papalia GF, Petrucci G, Russo F, Ambrosio L, Vadalà G, Iavicoli S, Papalia R, Denaro V. COVID-19 Pandemic Increases the Impact of Low Back Pain: A Systematic Review and Metanalysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084599. [PMID: 35457462 PMCID: PMC9027663 DOI: 10.3390/ijerph19084599] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/31/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022]
Abstract
In March 2019, the World Health Organization (WHO) recognized the COVID-19 pandemic as a global issue. To reduce the spread of this disease, health safety pathways were implemented worldwide. These extraordinary measures changed people's lifestyles, e.g., by being forced to isolate, and in many cases, to work remotely from home. Low back pain (LBP), the most common cause of disability worldwide, is often a symptom of COVID-19. Moreover, it is often associated with different lifestyle features (type of job, physical activity, body weight). Therefore, the purpose of this systematic review and meta-analysis was to estimate the effect of the COVID-19 lockdown on LBP intensity and prevalence compared with LBP rates before the pandemic. A systematic search was performed on Scopus, PubMed, and Cochrane Central. Overall, eight studies with 2365 patients were included in the analysis. We used the Joanna Briggs Institute (JBI) critical appraisal tool to evaluate the risk of bias: six studies (75%) were at moderate risk of bias and two studies (25%) were at low risk of bias. These studies showed an increase in both the prevalence and intensity of LBP during the COVID-19 lockdown.
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Affiliation(s)
- Giuseppe Francesco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
- Correspondence: (G.F.P.); (F.R.)
| | - Giorgia Petrucci
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
| | - Fabrizio Russo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
- Correspondence: (G.F.P.); (F.R.)
| | - Luca Ambrosio
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
| | - Gianluca Vadalà
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
| | - Sergio Iavicoli
- Directorate of Communication and International Affairs, Ministry of Health, 00144 Rome, Italy;
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (G.P.); (L.A.); (G.V.); (R.P.); (V.D.)
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13
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Hamdalla G, Jabbari GM, Abushegarh MY, Abulnaja YH, Dallak EE, AlHammali KA, Almomin IA, AlHuwaymili AS, AlTwalah SF, Hassan AE, AlRuwaili OM. Review on Lower Back Pain Management in Primary Health Care. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/pefqvhsg8e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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14
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Holm LW, Onell C, Carlseus M, Ekwurtzel R, Holmertz O, Bohman T, Skillgate E. Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain - a secondary analysis of randomized controlled trials. BMC Musculoskelet Disord 2021; 22:857. [PMID: 34625083 PMCID: PMC8501526 DOI: 10.1186/s12891-021-04727-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs). Methods Analyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location. Results Participants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49). Conclusions Persons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain. Trial registration Registration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776
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Affiliation(s)
- Lena W Holm
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Clara Onell
- Department of Health Promotion Sciences, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.
| | | | - Robin Ekwurtzel
- Department of Health Promotion Sciences, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden
| | - Olle Holmertz
- Department of Health Promotion Sciences, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden
| | - Tony Bohman
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Eva Skillgate
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.,Department of Health Promotion Sciences, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden
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15
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Illario M, De Luca V, Cano A, Tramontano D. Go for it! Exercising makes you happy and strong. TRANSLATIONAL MEDICINE AT UNISA 2021; 23:92-105. [PMID: 34447722 PMCID: PMC8370514 DOI: 10.37825/2239-9747.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite it is generally recognized the beneficial role of physical activity, large portion of the population is physically inactive. Very alarmingly, the well-known gender gap in physical activity is constantly increasing. Several barriers obstacle women to perform physical activity although exercising would be of paramount importance for their health in particular during pregnancy and menopause. In addition to physical health benefits, physical activity may influence well-being and resilience, greatly impacting on quality of life. Here we explore the relationship between physical activity resilience and well-being in a group of 1107 female residents in the Metropolitan area of Naples.
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Affiliation(s)
- M Illario
- Department of Public Health; Research & Development Unit, Federico II University & Hospital, Naples, Italy
| | - V De Luca
- Department of Public Health; Research & Development Unit, Federico II University & Hospital, Naples, Italy
| | - A Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain
| | - D Tramontano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy; Fondazione GENS, Naples Italy
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16
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Ahmed S, Akter R, Islam MJ, Muthalib AA, Sadia AA. Impact of lockdown on musculoskeletal health due to COVID-19 outbreak in Bangladesh: A cross sectional survey study. Heliyon 2021; 7:e07335. [PMID: 34179540 PMCID: PMC8217068 DOI: 10.1016/j.heliyon.2021.e07335] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/17/2021] [Accepted: 06/14/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND During the nationwide lockdown implemented by the government of Bangladesh due to the coronavirus, has led to the various changes in the overall activities and lifestyle. Most of the people began living a sedentary lifestyle, spending more time on their phone, watching television and excessive sleeping. Reduction of physical activity level had profoundly negative impact on musculoskeletal health. AIM This study aims to investigate the impact of lockdown on musculoskeletal health, association between leisure and musculoskeletal pain during this period. METHODS A cross sectional study was conducted among general populations living in a specific area of Bangladesh by simple random sampling methods. A total of 230 participants both male (182) and female (48) age group between 18-60 years have participated. The study was carried out by sending the Google Form link containing demographic questionnaire, numeric pain rating scale and Nordic musculoskeletal Questionnaire. Wilcoxon sign rank t and Chi squire test was used to analyze the data. RESULTS The mean height, weight and BMI of the participants were 164.17 ± 8.40 cm, 63.82 ± 10.70 kg and 23.74 ± 3.97 kg/m2 respectively. There was significant increase in time spent in watching television (p= < 0.0001), using smartphone (p= < 0.0001) and sleeping (p= < 0.0001) during the lockdown period. 33.9% participants had pain before the lockdown which increased by 57% during the lockdown periods. There was a significant association between pain intensity and sleeping time (X2 = 54.84; p= < 0.0001), time spent watching television (X2 = 83.70; <0.0001), time spent on smartphone (X2 = 58.39; <0.0001) during the lockdown period. CONCLUSION The result of this study concluded that the lockdown has negatively impacted the musculoskeletal health of the participants. The musculoskeletal pain might be short term initially, but can develop to be a long-term problem and burden if proper measures are not taken.
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Affiliation(s)
- Sohel Ahmed
- Mount Adora Physiotherapy & Neuro-rehabilitation Center, Mount Adora Hospital, Akhalia 3100, Sylhet, Bangladesh
| | - Rahemun Akter
- Mount Adora Physiotherapy & Neuro-rehabilitation Center, Mount Adora Hospital, Akhalia 3100, Sylhet, Bangladesh
| | - Mohammad Jahirul Islam
- Department of Physical Medicine and Rehabilitation, M A G Osmani Medical College Hospital, Sylhet 3100, Bangladesh
| | - Amena Abdul Muthalib
- Mount Adora Physiotherapy & Neuro-rehabilitation Center, Mount Adora Hospital, Akhalia 3100, Sylhet, Bangladesh
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17
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Mansell G, Corp N, Wynne-Jones G, Hill J, Stynes S, van der Windt D. Self-reported prognostic factors in adults reporting neck or low back pain: An umbrella review. Eur J Pain 2021; 25:1627-1643. [PMID: 33864327 DOI: 10.1002/ejp.1782] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/09/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Numerous systematic reviews have attempted to synthesize evidence on prognostic factors for predicting future outcomes such as pain, disability and return-to-work/work absence in neck and low back pain populations. DATABASES AND DATATREATMENT An umbrella review of systematic reviews was conducted to summarize the magnitude and quality of the evidence for each prognostic factor investigated. Searches were limited to the last 10 years (2008-11th April 2018, updated 28th September 2020). A two-stage approach was undertaken: in stage one, data on prognostic factors was extracted from systematic reviews identified from the systematic search that met the inclusion criteria. Where a prognostic factor was investigated in ≥1 systematic review and where 50% or more of those reviews found an association between the prognostic factor and one of the outcomes of interest, it was taken forward to stage two. In stage two, additional information extracted included the strength of association found, consistency of effects and risk of bias. The GRADE approach was used to grade confidence in the evidence. RESULTS Stage one identified 41 reviews (90 prognostic factors), with 35 reviews (25 prognostic factors) taken forward to stage two. Seven prognostic factors (disability/activity limitation, mental health; pain intensity; pain severity; coping; expectation of outcome/recovery and fear-avoidance) were judged as having moderate confidence for robust findings. CONCLUSIONS Although there was conflicting evidence for the strength of association with outcome, these factors may be used for identifying vulnerable subgroups or people able to self-manage. Further research can investigate the impact of using such prognostic information on treatment/referral decisions and patient outcomes.
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Affiliation(s)
- Gemma Mansell
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Nadia Corp
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Gwenllian Wynne-Jones
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Jonathan Hill
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Siobhán Stynes
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
| | - Daniëlle van der Windt
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK
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18
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Osinuga A, Hicks C, Ibitoye SE, Schweizer M, Fethke NB, Baker KK. A meta-analysis of the association between physical demands of domestic labor and back pain among women. BMC WOMENS HEALTH 2021; 21:150. [PMID: 33849504 PMCID: PMC8045256 DOI: 10.1186/s12905-021-01294-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
Background Back pain (BP) is among the most common musculoskeletal problems globally and is a leading contributor to disability among adults. Millions of women especially those in low-income settings, engage in strenuous domestic activities that may increase their risk of BP. The purpose of this meta-analysis was to estimate the association between physically demanding domestic labor (PDDL) which is characterized as intensity, frequency, duration of work and biomechanical risk factors of work and BP among women. Methods Five databases were searched for records published from January 1991 to March 2020; and results from 11studies were included in the meta-analysis. A random effects model and the generic inverse-variance method was used to estimate the pooled odds ratio (OR), 95% confidence interval (CI), and the degree of heterogeneity among studies (I2). Stratified and sensitivity analyses were conducted to identify the influence of outliers and identify the sources of heterogeneity. Results Exposure to high PDDL was significantly associated with BP (OR = 1.63; 95% CI 1.30, 2.04; I2 = 70%). The odds of back pain were highest among the following groups: women performing domestic labor in non-neutral postures (OR = 2.30; 95% CI = 1.75–3.04; I2 = 0%; N = 4 studies) and among women from low- and middle-income countries (OR = 1.98; 95% CI = 1.58–2.49; I2 = 29%; N = 5 studies). We found no evidence of publication bias (Egger’s test p-value = 0.15). Conclusions PDDL may significantly increase a woman’s risk of experiencing BP, but larger prospective studies are needed to further investigate the association. Presenting data on how domestic work affects the musculoskeletal health of women will be important in designing future interventions (behavioral, infrastructural, and ergonomic) that can reduce the burdens from domestic labor. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01294-5.
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Affiliation(s)
- Abisola Osinuga
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA.
| | - Chelsea Hicks
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| | - Segun E Ibitoye
- Department of Health Promotion and Education, University of Ibadan, Ibadan, 200212, Nigeria
| | - Marin Schweizer
- Department of Epidemiology, University of Iowa, Iowa City, 52242, USA
| | - Nathan B Fethke
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| | - Kelly K Baker
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
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19
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Xu C, Fu Z, Wang X. Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain. BMC Sports Sci Med Rehabil 2021; 13:35. [PMID: 33794983 PMCID: PMC8017650 DOI: 10.1186/s13102-021-00262-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/23/2021] [Indexed: 12/29/2022]
Abstract
Background Therapeutic training is the most commonly used treatment methods for chronic low back pain (CLBP), and the use of a pressure biofeedback unit for transversus abdominis muscle (TrA) training is one of the core muscle training methods. The study aim of this research is to explore the effects of different intensities (sham training, low-intensity and high-intensity) of TrA muscle training on people with CLBP in pressure-pain threshold (PPT). Methods A total of 45 patients with CLBP were recruited, of whom 44 were included in the analysis. Fifteen, 14, and 15 were included in the sham training group, the low-intensity group, and the high-intensity group, respectively. A pressure biofeedback unit was used in performing a one-time TrA training intervention involving 30 times of 180 mmHg TrA contraction training at high intensity for 10 min and 15 times of 100 mmHg TrA contraction training at low intensity for 5 min. The sham training group completed comfort exercises and did not undergo training. The evaluation indicators were as follows: PPT, short-form McGill pain questionnaire, and body surface pain radiation. Results High-intensity training could activate more waist core muscles than low-intensity training. Significant changes on PPT (units: kgf) were observed in the following four muscles immediately after high-intensity training: iliopsoas [0.69 (0.13–1.25) 95% CI, p = 0.020]; quadratus lumborum [0.84 (0.23–1.45) 95% CI, p = 0.012]; erector spinae [0.66 (0.18–1.15) 95% CI, p = 0.011]; transversus abdominis [0.70 (0.26–1.14) 95% CI, p = 0.004], and in three muscles after low-intensity training: quadratus lumborum [0.61 (0.17–1.05) 95% CI, p = 0.009]; transversus abdominis [0.14 (from − 0.15 to 0.43) 95% CI, p = 0.022]; piriformis [0.55 (0.13–0.98) 95% CI, p = 0.014]. The change in body surface pain radiation immediately after exercise was [− 10.87 (from − 17.51 to − 4.22) 95% CI, p = 0.003] for high-intensity training and [− 5.21 (from − 9.40 to − 1.03) 95% CI, p = 0.019] for low-intensity training. Conclusions TrA training could increase the PPT of the waist core muscles and reduce the radiation range of waist pain. The benefits of high-intensity training are higher than those of low-intensity training. Trial registration ChiCTR-TRC-13003701. Registered 18 October 2013. Code of ethical approval: 2018069.
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Affiliation(s)
- Changming Xu
- Department of Rehabilitation, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zhiwei Fu
- Department of Bone and Joint Surgery, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China. .,Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospitai, Shanghai, China.
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20
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Almeida SD, Eapen C, Krishnan S. Association of thoraco-lumbar fascia length in individuals with non-specific low back pain - an observational study. J Bodyw Mov Ther 2020; 24:581-587. [PMID: 33218565 DOI: 10.1016/j.jbmt.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 07/03/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of the study was to assess the length of TLF and to evaluate the strength of muscles attached to it in subjects with and without nonspecific low back pain (NSLBP). METHODS 31 patients with NSLBP and 31 healthy individuals were included in the study. In each subject the TLF length was assessed by quantifying lumbar rotation using Back range of motion (BROM-II) instrument. The endurance of transverses abdominis was assessed using the pressure biofeedback unit while the strength of Latissimus dorsi, internal and external oblique's were assessed using MMT. Outcome measure such as Range of Motion (ROM) was compared across the group using independent sample T-test. While the muscle strength of Latissimus dorsi and oblique's were compared across the group using Man-whitney U- test. Transverse abdominis endurance was tested using chi-square test. RESULTS There was statistically significant difference in the length of TLF of subjects with NSLBP when compared with subjects without NSLBP. When the strength of Latissimus dorsi muscle, transverses abdominis muscle and internal and external oblique's muscle was assessed no significant (p value > 0.05) difference was found in either group. CONCLUSIONS There was statistically significant reduction in length of TLF but there was no difference in the strength of Latissimus dorsi, internal and external oblique's or endurance of transverses abdominus attached to the TLF in individuals with NSLBP and without low back pain. This study will help in determining the inclusion of TLF and the associated structures in evaluation and management of subjects with NSLBP.
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Affiliation(s)
- Shellette D' Almeida
- Katurba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Charu Eapen
- Katurba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Shyam Krishnan
- Katurba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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21
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Carvalho-E-Silva AP, Pinheiro MB, Ferreira ML, Hübscher M, Calais-Ferreira L, Ferreira PH. Cohort profile: the AUstralian Twin BACK pain and physical activity study (AUTBACK study). BMJ Open 2020; 10:e036301. [PMID: 32723740 PMCID: PMC7389487 DOI: 10.1136/bmjopen-2019-036301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/17/2020] [Accepted: 05/28/2020] [Indexed: 11/03/2022] Open
Abstract
PURPOSE Despite the growing evidence that physical activity and familial factors play a role in low back pain (LBP), there is a lack of robust longitudinal studies that (1) investigate the types and dosages of physical activity that are protective or harmful for LBP, (2) employ objective measures of physical activity and (3) conduct appropriate adjustment for confounders. The AUstralian Twin BACK (AUTBACK) study was established to elucidate the longitudinal LBP-physical activity relationship with the benefits of controlling for familial (both genetic/nongenetic) factors that may influence physical activity engagement and LBP. PARTICIPANTS Participants are twins registered at Twins Research Australia (TRA), older than 18 years, with access to internet. We collected data on LBP status (weekly) and physical activity levels (monthly) for 12 months as well as a wide range of health, lifestyle and physical activity (objective, self-reported, including different types and dosages) data. FINDINGS TO DATE We included 401 twins, 157 being complete twin pairs (n=314). Lifetime prevalence of LBP was 85%. Participants spent 61% of their week in sedentary time and only 4% in moderate/vigorous intensity physical activity (accelerometer). So far, 168 participants (40% of the sample) have completed the 12-month follow-up. A total of 7150 weekly (LBP status) and 1763 monthly questionnaires (physical activity status) have been answered (92% response rate). FUTURE PLANS The 12-month follow-up will be completed by June 2020. This cohort represents a novel and comprehensive resource for researchers in the field, and includes high-quality, and frequent data on LBP and physical activity. It allows the investigation of genetic and shared environmental factors on the LBP-physical activity relationship. The AUTBACK group has planned a number of projects, with the main one being the investigation of the influence of physical activity on recurrence of LBP. Data linkage opportunities are available, including with other studies conducted by TRA.
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Affiliation(s)
- Ana Paula Carvalho-E-Silva
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Marina B Pinheiro
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Markus Hübscher
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Lucas Calais-Ferreira
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paulo H Ferreira
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Sousa Filho LF, Barbosa Santos MM, Teles CV, da Silva Lima H, De Farias Neto JP, Da Silva Júnior WM. The Influence of Clinical, Functional, and Psychosocial Factors on Walking Time in Individuals With Chronic Low Back Pain. J Manipulative Physiol Ther 2020; 43:331-338. [PMID: 32703612 DOI: 10.1016/j.jmpt.2019.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether clinical, functional, and psychosocial factors are associated with walking time in patients with chronic low back pain. METHODS This study included patients aged ≥18 years with low back pain for at least 3 months who visited our outpatient clinic between October 2017 and February 2018. We used the following scales/questionnaires: International Physical Activity Questionnaire for self-reported walking time, Numerical Pain Rating Scale for pain intensity, self-report assessing symptom duration, Roland Morris Disability Questionnaire for disability, Patient-Specific Functional Scale for function, Pain Catastrophizing Scale for pain catastrophizing, and screening questions to assess depression and anxiety. Odds ratios (ORs) with their respective 95% CIs were obtained using logistic regression analysis. RESULTS Neither clinical nor functional factors were associated with the total walking time. Among psychosocial factors, only anxiety showed a negative association with the total walking time (OR 0.23, 95% CI 0.06-0.82)-an association that persisted even after adjusting for confounders (OR 0.15, 95% CI 0.03-0.77). CONCLUSION Anxiety was shown to be associated with the total walking time in patients with CLBP. No clinical or functional factors seem to be associated with walking in this study sample.
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Affiliation(s)
- Luis Fernando Sousa Filho
- Graduate Program in Physical Education, Universidade Federal de Sergipe, São Cristovão, Sergipe, Brazil.
| | | | - Calistene Vieira Teles
- Department of Physiotherapy, Universidade Federal de Sergipe, São Cristovão, Sergipe, Brazil
| | - Heliadja da Silva Lima
- Department of Physiotherapy, Universidade Federal de Sergipe, São Cristovão, Sergipe, Brazil
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Zanoni CT, Galvão F, Maria RM, Zulli R, Ricciardi JB, Cliquet A, Saad STO. Effectiveness of a home-based therapeutic exercise program on lower back pain and functionality in Sickle Cell Disease (SCD) patients. Hematol Transfus Cell Ther 2020; 43:268-279. [PMID: 32680757 PMCID: PMC8446254 DOI: 10.1016/j.htct.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/09/2020] [Indexed: 11/04/2022] Open
Abstract
Objective To investigate the effectiveness of a home-based therapeutic exercise program on lower back pain and functionality of SCD patients. Setting A Hematology and Transfusion Medicine Center, University of Campinas (HEMOCENTRO-UNICAMP). Methods This was a prospective study, with a three-month follow-up of SCD patients with lower back pain. The lumbar spine functionality was evaluated by questionnaires, trunk flexion and extension analyses by fiber-optic-electrogoniometry and measurements of muscle strength of trunk flexor and extensors. The Intervention Group (IG) comprised 18 volunteers, median age 44y (28–58) and the control group (CG) comprised 15 volunteers, median age 42y (19–58), who did not perform exercises. The protocol consisted of daily home-based exercises with two evaluations: at the beginning and end of a three-month program. In order to compare the groups at baseline, the Fisher´s exact test and Mann–Whitney test were used for categorical and numeric variables, respectively. The Wilcoxon test was used for related samples comparing numeric measures of each group over time with a 5% (p < 0.05) significance level. Results After the intervention, patients demonstrated a significant improvement, according to the Visual-Analog-Scale (VAS; p = 0.01), Rolland Morris Disability questionnaire (RMDQ; p < 0.01) and trunk flexion and extension muscle strength (p < 0.01). No significant differences were found for the Start-Back-Screening-Tool-Brazil (SBST) and in measures of trunk flexion and extension range-of-motion (RoM). Conclusion Results suggest that daily home-based exercises for a three-month period ameliorate pain and improve disability related to lower back pain and muscle strength.
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Affiliation(s)
| | - Fábio Galvão
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Roberto Zulli
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Alberto Cliquet
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
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Zadro JR, Cheng S, O'Keeffe M, Maher CG. What Interventions Do Physical Therapists Provide for Patients With Cardiorespiratory Conditions, Neurological Conditions, and Conditions Requiring Acute Hospital Care? A Systematic Review. Phys Ther 2020; 100:1180-1205. [PMID: 32285118 DOI: 10.1093/ptj/pzaa064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this systematic review was to determine what percentages of physical therapists provide interventions that are of high value, low value, or unknown value for cardiorespiratory conditions, neurological conditions, or conditions requiring acute hospital care. Whether an intervention was considered high or low value was determined by reference to guidelines or systematic reviews. METHODS Searches of numerous databases were performed by combining terms synonymous with "practice patterns" and "physical therapy" until April 2018. Studies that investigated what interventions physical therapists provide for any cardiorespiratory condition, neurological condition, or condition requiring acute hospital care through surveys and audits of clinical notes were included. Through the use of medians and interquartile ranges, the percentages of physical therapists who provided interventions that were of high value, low value, or unknown value were summarized. RESULTS Twenty-six studies were included. The median percentages of physical therapists who provided interventions of high, low, and unknown value for chronic obstructive pulmonary disease ranged from 78% to 96%, 67% to 100%, and 56% to 91%, respectively. These percentages ranged from 61% to 97%, 87% to 98%, and 83% to 98% for adults who were critically ill in intensive care units; 70% to 93%, 38% to 50%, and 8% to 95% before or after cardiac/thoracic surgery; 25% to 96%, 23% to 84%, and 96% for acute stroke; and 11% (high value) and 13% (unknown value) for Parkinson disease, respectively. CONCLUSIONS This review found patterns of physical therapist practice for cardiorespiratory conditions, neurological conditions, and conditions requiring acute hospital care that were both evidence based and not evidence based. A concern is that a substantial percentage of physical therapists provided interventions that were of low or unknown value despite the availability of high-value interventions. IMPACT This systematic review is the first, to our knowledge, to summarize the percentage of physical therapist treatment choices that were high versus low value for cardiorespiratory conditions, neurological conditions, and conditions requiring acute hospital care. The findings highlight areas of practice where low-value care could be replaced with high-value care-such as in the management of patients who have chronic obstructive pulmonary disease or who are in intensive care-and identify an urgent need to develop and test strategies to ensure that patients with these conditions receive the interventions most likely to improve their outcomes.
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Affiliation(s)
- Joshua R Zadro
- Sydney School of Public Health, Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Level 10 N, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Australia
| | - Sonia Cheng
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Mary O'Keeffe
- Sydney School of Public Health, Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney
| | - Christopher G Maher
- Sydney School of Public Health, Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney
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Øverås CK, Villumsen M, Axén I, Cabrita M, Leboeuf-Yde C, Hartvigsen J, Mork PJ. Association between objectively measured physical behaviour and neck- and/or low back pain: A systematic review. Eur J Pain 2020; 24:1007-1022. [PMID: 32096285 DOI: 10.1002/ejp.1551] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/07/2020] [Accepted: 02/23/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Clinical guidelines recommend physical activity to manage neck pain (NP) and low back pain (LBP). However, studies used to support these guidelines are based on self-reports of physical behaviour, which are prone to bias and misclassification. This systematic review aimed to investigate associations between objectively measured physical behaviour and the risk or prognosis of NP and/or LBP. DATABASES AND DATA TREATMENT Literature searches were performed in MEDLINE, Embase and Scopus from their inception until 18 January 2019. We considered prospective cohort studies for eligibility. Article selection, data extraction and critical appraisal were carried out by independent reviewers. Results were stratified on activity/sedentariness. RESULTS Ten articles out of 897 unique records identified met the inclusion criteria, of which eight studied working populations with mainly blue-collar workers. The overall results indicate that increased sitting time at work reduces the risk of NP and LBP while increased physical activity during work and/or leisure increases the risk of these conditions among blue-collar workers; however, associations were weak. Physical activity was not associated with prognosis of LBP (no studies investigated prognosis of NP). Most of the included articles have methodological shortcomings. CONCLUSIONS This review indicates that, among blue-collar workers, increased sitting at work may protect against NP and LBP while increased physical activity during work and/or leisure may increase this risk. There was no evidence supporting physical activity as a prognostic factor for LBP. Findings should be interpreted with caution due to the weak associations and few available studies with methodological shortcomings. SIGNIFICANCE Based on prospective cohort studies with objectively measured physical behaviour, this review questions the common notion that increased physical activity is associated with reduced risk or better prognosis of NP and/or LBP. We found that, among blue-collar workers, increased sitting time at work reduces the risk of NP and LBP, whereas physical activity somewhat increases the risk. Despite methodological shortcomings, there was consistency in the direction of the results, although high-quality articles reported the weakest associations. Systematic review registration: PROSPERO CRD42018100765.
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Affiliation(s)
- Cecilie K Øverås
- Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Morten Villumsen
- Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Iben Axén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Miriam Cabrita
- Roessingh Research and Development, eHealth Group, Enschede, The Netherlands.,Biomedical Signals and Systems group, University of Twente, Enschede, The Netherlands
| | - Charlotte Leboeuf-Yde
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Paul J Mork
- Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
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26
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Grande-Alonso M, Muñoz-García D, Cuenca-Martínez F, Delgado-Sanz L, Prieto-Aldana M, La Touche R, Gil-Martínez A. Relationship between healthcare seeking and pain expansion in patients with nonspecific chronic low back pain. PeerJ 2020; 8:e8756. [PMID: 32195061 PMCID: PMC7067182 DOI: 10.7717/peerj.8756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/16/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives Low back pain (LBP) is the most prevalent musculoskeletal problem, which implies a high rate of chronicity. The chronicity of symptoms can lead to pain expansion. The main objective of this study was to assess whether there were differences between patients with nonspecific chronic LBP (CLBP) who sought healthcare compared to those who did not in terms of pain expansion. Methods Ninety individuals participated in the study and were divided into three groups: 30 patients who sought care; 30 patients who did not seek care; and 30 asymptomatic individuals. The primary variable analyzed was pain expansion. Secondary physical and psychological variables were assessed later, and a regression analysis was performed. Results Patients who sought help showed significant differences in pain expansion and pain intensity compared with the group who did not seek help, with a medium effect size (0.50–0.79). The regression model for the care-seeking group showed that dynamic balance with the left leg and depression were predictors of percentage pain surface area (34.6%). The combination of dynamic balance, range of movement in flexoextension and depression were predictors of widespread pain (48.5%). Conclusion Patients who soughtcare presented greater pain expansion than patients whodidnot. A combination of functional and psychological variables can significantly predict pain expansion in patients with nonspecific CLBP who seek help.
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Affiliation(s)
- Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Muñoz-García
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Delgado-Sanz
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Prieto-Aldana
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.,CranioSPain Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Physical Activity and Health-Related Quality of Life in People With Back Pain: A Population-Based Pooled Study of 27,273 Adults. J Phys Act Health 2020; 17:177-188. [PMID: 31869821 DOI: 10.1123/jpah.2019-0429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND To investigate the association between moderate- to vigorous-intensity physical activity (MVPA) and health-related quality of life (HRQoL) in people with back pain. METHODS The sample comprised adults aged 16 years and older who participated in the Welsh Health Survey (2011-2015). The HRQoL was evaluated using the 36-item short form. Participants were categorized into 4 groups based on minutes per week of MVPA: inactive (no MVPA), insufficiently active (<150 min/wk), sufficiently active (≥150 and <300 min/wk), and very active (≥300 min/wk). The authors investigated the association between MVPA and HRQoL using generalized linear models and multiple linear regression. RESULTS Of the 74,578 adults in the survey cohorts, 27,273 participants diagnosed with back pain were included in the analyses. Consistent direct curvilinear associations between MVPA and HRQoL were demonstrated for all 36-item short form domains (P < .001), in both the minimally and fully adjusted models, with the highest scores observed for sufficiently active and very active participants. Compared with the inactive group, those who were insufficiently active; sufficiently active; and very active had an average difference of 6.31 (95% confidence interval, 5.70-6.92), 7.72 (95% confidence interval, 7.04-8.41), and 8.00 (95% confidence interval, 7.12-8.89) points in the overall HRQoL, respectively. CONCLUSION The authors found a consistent direct curvilinear association between MVPA and HRQoL.
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Hayden JA, Wilson MN, Riley RD, Iles R, Pincus T, Ogilvie R. Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review. Cochrane Database Syst Rev 2019; 2019:CD011284. [PMID: 31765487 PMCID: PMC6877336 DOI: 10.1002/14651858.cd011284.pub2] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low back pain is costly and disabling. Prognostic factor evidence can help healthcare providers and patients understand likely prognosis, inform the development of prediction models to identify subgroups, and may inform new treatment strategies. Recent studies have suggested that people who have poor expectations for recovery experience more back pain disability, but study results have differed. OBJECTIVES To synthesise evidence on the association between recovery expectations and disability outcomes in adults with low back pain, and explore sources of heterogeneity. SEARCH METHODS The search strategy included broad and focused electronic searches of MEDLINE, Embase, CINAHL, and PsycINFO to 12 March 2019, reference list searches of relevant reviews and included studies, and citation searches of relevant expectation measurement tools. SELECTION CRITERIA We included low back pain prognosis studies from any setting assessing general, self-efficacy, and treatment expectations (measured dichotomously and continuously on a 0 - 10 scale), and their association with work participation, clinically important recovery, functional limitations, or pain intensity outcomes at short (3 months), medium (6 months), long (12 months), and very long (> 16 months) follow-up. DATA COLLECTION AND ANALYSIS We extracted study characteristics and all reported estimates of unadjusted and adjusted associations between expectations and related outcomes. Two review authors independently assessed risks of bias using the Quality in Prognosis Studies (QUIPS) tool. We conducted narrative syntheses and meta-analyses when appropriate unadjusted or adjusted estimates were available. Two review authors independently graded and reported the overall quality of evidence. MAIN RESULTS We screened 4635 unique citations to include 60 studies (30,530 participants). Thirty-five studies were conducted in Europe, 21 in North America, and four in Australia. Study populations were mostly chronic (37%), from healthcare (62%) or occupational settings (26%). General expectation was the most common type of recovery expectation measured (70%); 16 studies measured more than one type of expectation. Usable data for syntheses were available for 52 studies (87% of studies; 28,885 participants). We found moderate-quality evidence that positive recovery expectations are strongly associated with better work participation (narrative synthesis: 21 studies; meta-analysis: 12 studies, 4777 participants: odds ratio (OR) 2.43, 95% confidence interval (CI) 1.64 to 3.62), and low-quality evidence for clinically important recovery outcomes (narrative synthesis: 12 studies; meta-analysis: 5 studies, 1820 participants: OR 1.89, 95% CI 1.49 to 2.41), both at follow-up times closest to 12 months, using adjusted data. The association of recovery expectations with other outcomes of interest, including functional limitations (narrative synthesis: 10 studies; meta-analysis: 3 studies, 1435 participants: OR 1.40, 95% CI 0.85 to 2.31) and pain intensity (narrative synthesis: 9 studies; meta-analysis: 3 studies, 1555 participants: OR 1.15, 95% CI 1.08 to 1.23) outcomes at follow-up times closest to 12 months using adjusted data, is less certain, achieving very low- and low-quality evidence, respectively. No studies reported statistically significant or clinically important negative associations between recovery expectations and any low back pain outcome. AUTHORS' CONCLUSIONS We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain.
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Affiliation(s)
- Jill A Hayden
- Dalhousie UniversityDepartment of Community Health & Epidemiology5790 University AvenueRoom 403HalifaxNSCanadaB3H 1V7
| | - Maria N Wilson
- Dalhousie UniversityDepartment of Community Health and EpidemiologyHalifaxNova ScotiaCanada
| | - Richard D Riley
- Keele UniversitySchool of Primary, Community and Social CareDavid Weatherall Building, Keele University CampusKeeleStaffordshireUKST5 5BG
| | - Ross Iles
- Monash UniversityDepartment of Physiotherapy, Faculty of Medicine, Nursing and Health SciencesPeninsula CampusFrankstonVictoriaAustralia3199
| | - Tamar Pincus
- Royal Holloway University of LondonDepartment of PsychologyEghamSurreyUKTW20 0EX
| | - Rachel Ogilvie
- Dalhousie UniversityCommunity Health & Epidemiology5760 University AvenueHalifaxCanadaB3H 1V7
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Early Return to Work Has Benefits for Relief of Back Pain and Functional Recovery After Controlling for Multiple Confounds. J Occup Environ Med 2019; 60:901-910. [PMID: 29933319 PMCID: PMC6200378 DOI: 10.1097/jom.0000000000001380] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the effect on health outcomes of an early or immediate return-to-work (RTW) after acute low back pain (LBP). METHODS A longitudinal cohort of workers (N = 557) consulting for uncomplicated LBP were assessed on demographic, pain, occupational, and psychosocial variables. Pain and function were assessed at 3-month postpain onset. We tested the longitudinal effects of an early RTW on 3-month outcomes. RESULTS Pain and function improved more rapidly for workers with an immediate (30.7%) or early (1 to 7 days) RTW (36.8%). Eleven demographic, health, or workplace variables were identified as potential confounds, but controlling for these factors only partially attenuated the benefits of an early RTW. CONCLUSIONS An early RTW improves acute LBP and functional recovery, and alternate confounding explanations only partially eclipse this therapeutic effect.
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The Evolving Case Supporting Individualised Physiotherapy for Low Back Pain. J Clin Med 2019; 8:jcm8091334. [PMID: 31466408 PMCID: PMC6780711 DOI: 10.3390/jcm8091334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023] Open
Abstract
Low-back pain (LBP) is one of the most burdensome health problems in the world. Guidelines recommend simple treatments such as advice that may result in suboptimal outcomes, particularly when applied to people with complex biopsychosocial barriers to recovery. Individualised physiotherapy has the potential of being more effective for people with LBP; however, there is limited evidence supporting this approach. A series of studies supporting the mechanisms underpinning and effectiveness of the Specific Treatment of Problems of the Spine (STOPS) approach to individualised physiotherapy have been published. The clinical and research implications of these findings are presented and discussed. Treatment based on the STOPS approach should also be considered as an approach to individualised physiotherapy in people with LBP.
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Nieto-García J, Suso-Martí L, La Touche R, Grande-Alonso M. Somatosensory and Motor Differences between Physically Active Patients with Chronic Low Back Pain and Asymptomatic Individuals. ACTA ACUST UNITED AC 2019; 55:medicina55090524. [PMID: 31450752 PMCID: PMC6780835 DOI: 10.3390/medicina55090524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 12/22/2022]
Abstract
Background and Objectives: Chronic low back pain (CLBP) is the most common occupational disorder due to its associated disability and high risk of recurrence and chronicity. However, the mechanisms underlying physical and psychological variables in patients with CLBP remain unclear. The main objective of this study was to assess whether there were differences between physically active patients with nonspecific CLBP compared with asymptomatic individuals in sensorimotor and psychological variables. Materials and Methods: This was an observational cross-sectional design with a nonprobabilistic sample. The sample was divided into two groups: individuals with nonspecific CLBP (n = 30) and asymptomatic individuals as a control (n = 30). The psychological variables assessed were low back disability, fear of movement, pain catastrophizing, and self-efficacy. The sensorimotor variables assessed were two-point discrimination, pressure pain threshold, lumbopelvic stability, lumbar flexion active range of motion, and isometric leg and back strength. Results: Statistically significant differences between the groups in terms of catastrophizing levels (p = 0.026) and fear of movement (p = 0.001) were found, but no statistically significant differences between groups were found in self-efficacy (p > 0.05). No statistically significant differences between the groups in any of the sensorimotor variables were found (p > 0.05). Conclusion: No sensorimotor differences were found between patients with asymptomatic and chronic low back pain, but differences were found in the psychological variables of catastrophizing and fear of movement.
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Affiliation(s)
- Juan Nieto-García
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain.
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain.
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28023 Madrid, Spain.
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain.
| | - Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
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Pain Intensity and Fear Avoidance Explain Disability Related to Chronic Low Back Pain in a Saudi Arabian Population. Spine (Phila Pa 1976) 2019; 44:E889-E898. [PMID: 30817741 DOI: 10.1097/brs.0000000000003002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A cross-sectional study. OBJECTIVE The aim of this study was to describe multi-dimensional profiles for people with chronic low back pain (CLBP) and to examine the associations between CLBP-related disability and individual, psychosocial and physical factors in a Saudi population. SUMMARY OF BACKGROUND DATA CLBP-related disability is a multidimensional phenomenon. There is growing interest in exploring factors associated with CLBP-related disability in Saudi Arabia but research is limited in comparison to other countries. METHODS Participants completed questionnaires covering demographics, pain intensity, back beliefs, fear avoidance, psychological distress, and physical activity. Oswestry Disability Index (ODI) was used to measure disability. Participants also performed a standardized sequence of physical performance tests and a Pain Behavior Scale was used to evaluate pain behaviors during performance of these tests. The relationships between disability and all variables were explored using univariate and multivariate regression analyses. RESULTS One hundred and fifteen participants were included, 63% of whom were female. Participants demonstrated moderate disability (mean [SD]: 26.6 [13.5]). The mean (SD) back beliefs score was 28.6 (7.3). Mean depression, anxiety, and stress (DASS 21) scores indicated mild distress; however, 26% to 39% scored in the moderate to severe range for at least one subscale. In univariate analyses, pain intensity and fear avoidance beliefs (physical activity and work) were moderately associated with disability (r = 0.56, 0.49, 0.52, respectively, P < 0.001), with all other factors demonstrating weak association. Multivariate regression revealed that pain intensity, fear avoidance beliefs, psychological distress, and participants' age were all found to be associated with disability, accounting for 52.9% (adjusted R = 0.529) of variability. CONCLUSION This study provides a unique insight into the clinical profile of people with CLBP in a Saudi Arabian population. Pain and psychosocial factors were significantly associated with disability. This study supports the contention that CLBP-related disability is a multifactorial biopsychosocial condition across different cultures. LEVEL OF EVIDENCE 3.
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Pozzobon D, Nogueira LAC, Ferreira PH, Steffens D, Beckenkamp PR, Blyth FM, Ferreira ML. Return to self-reported physical activity level after an event of acute low back pain. PLoS One 2019; 14:e0219556. [PMID: 31291377 PMCID: PMC6619819 DOI: 10.1371/journal.pone.0219556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 06/26/2019] [Indexed: 01/22/2023] Open
Abstract
Background Regular physical activity participation is known to promote better mobility and coordination. Although previous research has established that lack of physical activity participation may increase the risk of developing low back pain, the role of physical activity as a predictor of recovery among symptomatic individuals remains unclear. Objective To evaluate whether: (i) the level of physical activity participation before an acute episode of low back pain predicts recovery within 12 months following the acute pain episode (i.e. index episode); and (ii) participants return to their pre-pain level of physical activity participation 12 months from the index episode. Design This study used longitudinal data from the TRIGGERS case-crossover study. Setting This study was conducted through over-the-phone interviews to participants that presented to 300 primary care clinics with a new episode of acute low back pain. Participants This study included 999 consecutive patients, aged 18 years or older. Follow-up assessment was completed at 12 months following the index episode. Methods This is a cohort study where consecutive patients, aged 18 years or older, that presented with a new episode of acute low back pain were recruited between October 2011 and November 2012. Main outcome measurements Self-reported level of physical activity participation. Results A total of 830 participants completed the study. When comparing participants who reported pain at 12 months follow-up with those without pain, all participants reported similar levels of physical activity participation one week before (p = 0.449), one week after (p = 0.812) and 12 months after the index episode (p = 0.233). The level of physical activity participation before the index episode was not a reliable predictor of presence of pain at either 3 or 12 months follow-up (OR 0.99; 95% CI 0.993 to 1.003; p = 0.523 and OR 1; 95% CI 0.992 to 1.008; p = 0.923, respectively). Conclusion Physical activity participation did not predict recovery from the pain episode. Also all participants returned to their pre-pain level of physical activity participation after 12 months.
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Affiliation(s)
- Daniel Pozzobon
- Institute of Bone and Joint Research, the Kolling Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Leandro A. Calazans Nogueira
- Rehabilitation Science Post-graduate Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, RJ, Brazil
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), RJ, Brazil
| | - Paulo H. Ferreira
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Discipline of Physiotherapy, Sydney, NSW, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia
| | - Paula R. Beckenkamp
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Discipline of Physiotherapy, Sydney, NSW, Australia
| | - Fiona M. Blyth
- Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Manuela L. Ferreira
- Institute of Bone and Joint Research, the Kolling Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Alzahrani H, Mackey M, Stamatakis E, Zadro JR, Shirley D. The association between physical activity and low back pain: a systematic review and meta-analysis of observational studies. Sci Rep 2019; 9:8244. [PMID: 31160632 PMCID: PMC6547713 DOI: 10.1038/s41598-019-44664-8] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/17/2019] [Indexed: 12/21/2022] Open
Abstract
The aim of this review was to investigate the association between total and domain-specific physical activity (PA) and non-specific low back pain (LBP) in adults. Seven databases were searched for cohort and cross-sectional studies. Pooled estimates of the association of medium and high levels PA and LBP, using the generic inverse-variance method with fixed- and random-effects models were calculated. Twenty-four studies (15 cohort and nine cross-sectional; 95,796 participants) were included. The pooled fully adjusted risk ratios (RR) from cohort studies comparing medium with lowest activity levels were 0.90 (95%CI 0.85 to 0.96) for total PA, and 0.90 (95%CI 0.85 to 0.96) for leisure-time PA (LTPA). The pooled RR comparing highest with lowest activity levels were 1.00 (95%CI 0.92 to 1.08) for total PA, and 1.01 (95%CI 0.93 to 1.10) for LTPA. The pooled fully adjusted odds ratios (OR) from cross-sectional studies comparing medium with lowest activity levels were 0.93 (95%CI 0.65 to 1.32) for total PA, and 0.77 (95%CI 0.62 to 0.96) for LTPA. The pooled OR comparing highest with lowest activity levels were 1.05 (95%CI 0.89 to 1.23) for total PA, and 0.85 (95%CI 0.79 to 0.93) for LTPA. PA seems to be associated with lower prevalence of LBP.
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Affiliation(s)
- Hosam Alzahrani
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, 2141, Australia.
- Department of Physiotherapy, College of Applied Medical Sciences, Taif University, Taif, 21974, Saudi Arabia.
| | - Martin Mackey
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, 2141, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, 2006, Australia
| | - Joshua Robert Zadro
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, 2050, Australia
| | - Debra Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, 2141, Australia
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Oliveira CB, Pinheiro MB, Teixeira RJ, Franco MR, Silva FG, Hisamatsu TM, Ferreira PH, Pinto RZ. Physical activity as a prognostic factor of pain intensity and disability in patients with low back pain: A systematic review. Eur J Pain 2019; 23:1251-1263. [DOI: 10.1002/ejp.1395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/16/2019] [Accepted: 03/20/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Crystian B. Oliveira
- Department of Physical Therapy, School of Science and Technology Sao Paulo State University (UNESP) Presidente Prudente Brazil
| | - Marina B. Pinheiro
- Discipline of Physiotherapy, Faculty of Health Sciences The University of Sydney Sydney Australia
| | - Renan J. Teixeira
- Department of Physical Therapy, School of Science and Technology Sao Paulo State University (UNESP) Presidente Prudente Brazil
| | - Márcia R. Franco
- Departament of Physical Therapy, Centro Universitário UNA Contagem Brazil
| | - Fernanda G. Silva
- Department of Physical Therapy, School of Science and Technology Sao Paulo State University (UNESP) Presidente Prudente Brazil
| | - Thalysi M. Hisamatsu
- Department of Physical Therapy, School of Science and Technology Sao Paulo State University (UNESP) Presidente Prudente Brazil
| | - Paulo H. Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences The University of Sydney Sydney Australia
| | - Rafael Z. Pinto
- Departament of Physical Therapy Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
- Sydney School of Public Health, Faculty of Medicine and Health The University of Sydney Sydney Australia
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Fett D, Trompeter K, Platen P. Prevalence of back pain in a group of elite athletes exposed to repetitive overhead activity. PLoS One 2019; 14:e0210429. [PMID: 30677044 PMCID: PMC6345455 DOI: 10.1371/journal.pone.0210429] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/21/2018] [Indexed: 11/18/2022] Open
Abstract
Background The prevalence of back pain in athletes has been investigated in several studies, but there are still under- or uninvestigated sports discipline like sports exposed to repetitive overhead activity. Elite athletes spend much time in training and competition and, because of the nature of their disciplines, subject their bodies to a great deal of mechanical strain, which puts a high level of stress on their musculoskeletal systems. From this it is hypothesized that elite athletes who engage in repetitive overhead motions experience a higher strain on their spine and thus possibly a higher prevalence of back pain compared with an active control group. Objectives To examine the prevalence of back pain and the exact location of pain in a cohort of elite athletes with repetitive overhead activity and in a control group of physically active sport students. Additionally, to examine different characteristics of pain, and to evaluate the influence of confounders on back pain. Methods A standardized and validated online back pain questionnaire was sent by the German Olympic Sports Confederation to German national and international elite athletes, and a control group of physically active but non-elite sports students. Results The final sample comprised 181 elite athletes of the sports disciplines badminton, beach volleyball, handball, tennis and volleyball and 166 physically active controls. In elite athletes, lifetime prevalence of back pain was 85%, 12-month prevalence was 75%, 3-month prevalence was 58% and point prevalence was 38%; for the physically active control group, these prevalences were 81%, 70%, 59% and 43%, respectively. There was no significant group difference in prevalence over all time periods. The lower back was the main location of back pain in elite athletes across all disciplines and in controls; additionally a distinct problem of upper back pain was found among volleyball players. Conclusion Despite the high mechanical load inherent in the sport disciplines included in this study, the elite athletes who engaged in repetitive overhead activities did not suffer more from back pain than the physically active controls. This suggests that other mechanisms may be influencing back pain prevalences in a positive way in these athletes. Furthermore, these disciplines may practice preventive factors for back pain that outweigh their detrimental factors. Therefore, we posit that extensive prevention work is already being implemented in these sports and that there are additional individual protection factors in play. More research is required to explore these suppositions, and should include investigations into which preventive training programs are being used. Nevertheless, in volleyball particularly, a focus on stabilization/preventive training should be applied to the upper back and neck.
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Affiliation(s)
- Daniela Fett
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
- * E-mail:
| | - Katharina Trompeter
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
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Heidari J, Özen E, Kellmann M. Evaluation of the effect of psychological recovery tools on back pain in an out-patient prevention program. Work 2018; 60:555-566. [DOI: 10.3233/wor-182763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jahan Heidari
- Unit of Sport Psychology, Faculty of Sport Science, Ruhr University Bochum, Germany
| | - Ersan Özen
- medicos.AufSchalke, Unit of Training and Health Management, Gelsenkirchen, Germany
| | - Michael Kellmann
- Unit of Sport Psychology, Faculty of Sport Science, Ruhr University Bochum, Germany
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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Zadro JR, Shirley D, Duncan GE, Ferreira PH. Familial factors predicting recovery and maintenance of physical activity in people with low back pain: Insights from a population-based twin study. Eur J Pain 2018; 23:367-377. [PMID: 30176096 DOI: 10.1002/ejp.1311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/21/2018] [Accepted: 08/29/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND It is unknown how familial factors influence the recovery from low back pain (LBP) and the maintenance activity behaviours. We aimed to investigate whether individual and within-family physical activity (PA) and sedentary behaviour influenced recovery from LBP, and maintenance of PA and sedentary behaviour in people with and without LBP. METHODS Longitudinal logistic regression analyses were performed on adult twins from the Washington State Twin Registry. First, individual and within-family (based on co-twin data) sufficient PA (at least 75 min of vigorous-intensity PA, or 150 min of moderate-intensity PA per week) and high leisure sitting time (≥3 hr/day) were our exposure variables (baseline). LBP within the past 3 months at follow-up defined non-recovery (outcome). Second, within-family sufficient PA and high leisure sitting time were our exposure variables(baseline) and our outcomes were individual PA and sitting time at follow-up. All analyses were adjusted for follow-up length (range: 1-7 years) and confounding variables. RESULTS Individual and within-family PA and sitting time were not associated with recovery. Within-family PA and sitting time predicted individual maintenance of PA (OR = 1.47, 95% CI: 1.17-1.84, n = 1,388 twins) and sitting time (OR = 1.41, 95% CI: 1.10-1.82, n = 1,534). Within-family PA and sitting time had the strongest effects on those without (OR = 1.79, 95% CI: 1.33-2.41, n = 788) and with LBP (OR = 1.90, 95% CI: 1.32-2.76, n = 698), respectively. CONCLUSION Having active family members increased the likelihood of continuing to be active (particularly for those without LBP), while having sedentary family members increased the likelihood of maintaining sedentary behaviours (particularly for those with LBP). SIGNIFICANCE This study was the first to investigate how familial activity behaviours influence recovery from LBP and ongoing activity behaviours. People with LBP living within a sedentary family likely require specific interventions to reduce their sedentary behaviours.
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Affiliation(s)
- Joshua Robert Zadro
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Debra Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Glen E Duncan
- Elson S. Floyd College of Medicine, Department of Nutrition and Exercise Physiology, Washington State University, Spokane, Washington
| | - Paulo H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
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Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, Smeets RJ, Underwood M. What low back pain is and why we need to pay attention. Lancet 2018; 391:2356-2367. [PMID: 29573870 DOI: 10.1016/s0140-6736(18)30480-x] [Citation(s) in RCA: 2237] [Impact Index Per Article: 372.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/08/2017] [Accepted: 12/13/2017] [Indexed: 02/08/2023]
Abstract
Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.
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Affiliation(s)
- Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Mark J Hancock
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Quinette Louw
- Faculty of Medicine and Health Sciences, Physiotherapy Division and Department of Health and Rehabilitation Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Stéphane Genevay
- Division of Rheumatology, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Jaro Karppinen
- Medical Research Centre Oulu, University of Oulu and University Hospital, Oulu, Finland
| | - Glenn Pransky
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA USA
| | - Joachim Sieper
- Department of Rheumatology, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - Rob J Smeets
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, Netherlands; Libra Rehabilitation and Audiology, Eindhoven, Netherlands
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
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Ford JJ, Richards MC, Surkitt LD, Chan AYP, Slater SL, Taylor NF, Hahne AJ. Development of a Multivariate Prognostic Model for Pain and Activity Limitation in People With Low Back Disorders Receiving Physiotherapy. Arch Phys Med Rehabil 2018; 99:2504-2512.e12. [PMID: 29852152 DOI: 10.1016/j.apmr.2018.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/19/2018] [Accepted: 04/21/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs). DESIGN Prospective inception cohort study. SETTING Primary care private physiotherapy clinics in Melbourne, Australia. PARTICIPANTS Individuals (N=300) aged 18-65 years with low back and/or referred leg pain of ≥6 weeks and ≤6 months duration. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Numeric rating scales for back pain and leg pain as well as the Oswestry Disability Scale. RESULTS Prognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors, and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain, and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (P<.05) associations with at least 1 of the 3 outcomes. There were 5 indicators of positive outcome (2 types of LBD subgroups, paresthesia below waist, walking as an easing factor, and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity, and higher pain drawing percentage coverage). The preliminary model identifying predictors of LBDs explained up to 37% of the variance in outcome. CONCLUSIONS This study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of LBDs. The preliminary multivariate model requires further validation before being considered for clinical use.
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Affiliation(s)
- Jon J Ford
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia.
| | - Matt C Richards
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Luke D Surkitt
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Alexander Y P Chan
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Sarah L Slater
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Nicholas F Taylor
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Andrew J Hahne
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
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Shiri R, Falah-Hassani K. Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies. Br J Sports Med 2017; 51:1410-1418. [DOI: 10.1136/bjsports-2016-097352] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 11/03/2022]
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Evaluation of the Effects of Physical Activity, Cardiorespiratory Condition, and Neuromuscular Fitness on Direct Healthcare Costs and Sickness-Related Absence Among Nursing Personnel With Recurrent Nonspecific Low Back Pain. Spine (Phila Pa 1976) 2017; 42:854-862. [PMID: 27753785 DOI: 10.1097/brs.0000000000001922] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A cross-sectional study, part of a randomized controlled trial. OBJECTIVE To evaluate the association of physical activity, cardiorespiratory fitness, and neuromuscular fitness with direct healthcare costs and sickness-related absence among nursing personnel with nonspecific low back pain. SUMMARY OF BACKGROUND DATA Low back pain creates a huge economic burden due to increased sick leave and use of healthcare services. METHODS Female nursing personnel with nonspecific low back pain were included (n = 219). Physical activity was assessed with accelerometry and a questionnaire. In addition, measurements of cardiorespiratory and muscular fitness were conducted. Direct costs and sickness-related absence for a 6-month period were collected retrospectively by questionnaire. Health care utilization and absence from work were analyzed with a general linear model. RESULTS The mean total costs were 80.5% lower among women who met physical activity recommendations than inactive women. Those with a higher mean daily intensity level of 10-minute activity sessions showed lower total costs than women in the lowest tertile (middle: 64.0% of the lowest; highest: 54.3% of the lowest). Women with good cardiorespiratory fitness (the highest tertile) as measured with the 6-minute-walk test (based on walking distance) had 77.0% lower total costs when compared with the lowest tertile. Women in the highest third for the modified push-up test had 84.0% lower total costs than those with the poorest results (the bottom tertile). CONCLUSION High cardiorespiratory and muscular fitness and meeting physical activity recommendations for aerobic and muscular fitness were strongly associated with lower total costs among nursing personnel with pain-related disorders of recurrent nonspecific low back pain. Actions to increase physical activity and muscle conditioning may significantly save on healthcare costs and decrease sick-leave costs due to low back pain.
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Marini M, Bendinelli B, Assedi M, Occhini D, Castaldo M, Fabiano J, Petranelli M, Migliolo M, Monaci M, Masala G. Low back pain in healthy postmenopausal women and the effect of physical activity: A secondary analysis in a randomized trial. PLoS One 2017; 12:e0177370. [PMID: 28489877 PMCID: PMC5425229 DOI: 10.1371/journal.pone.0177370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 04/26/2017] [Indexed: 12/19/2022] Open
Abstract
Epidemiological studies on the prevalence of musculoskeletal pain have consistently shown that this is a relevant health problem, with non-specific low back pain (LBP) being the most commonly reported in adult females. Conflicting data on the association between LBP symptoms and physical activity (PA) have been reported. Here, we investigated the prevalence of LBP and the effect of a 24-month non-specific PA intervention on changes in LBP prevalence in a series of Italian healthy postmenopausal women. We performed a secondary analysis in the frame of the DAMA trial, a factorial randomized intervention trial aimed to evaluate the ability of a 24-month intervention, based on moderate-intensity PA, and/or dietary modification, in reducing mammographic breast density in healthy postmenopausal women. The PA intervention included at least 1 hour/day of moderate PA and a more strenuous weekly activity, collective walks and theoretical group sessions. A self-administered pain questionnaire was administered at baseline and at the end of the intervention. The questionnaire was specifically structured to investigate the occurrence of musculoskeletal pain, the body localization, intensity and duration of the pain. Two hundred and ten women (102 randomized to PA intervention, 108 not receiving the PA intervention) filled out the questionnaires. At baseline LBP was present in 32.9% of the participants. Among women randomized to the PA intervention, LBP prevalence at follow up (21.6%) was lower than at baseline (33.3%) (p = 0.02), while in women who did not receive the PA intervention the LBP prevalence at baseline and follow up were 32.4% and 25.9%, respectively (p = 0.30). Overall, there was no significant between-group effect of PA intervention on LBP. Further studies are needed to understand the role of non-specific PA intervention, aimed to improve overall fitness, on LBP prevalence.
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Affiliation(s)
- Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
- * E-mail:
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Melania Assedi
- Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Daniela Occhini
- Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Maria Castaldo
- Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Jacopo Fabiano
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
| | - Marco Petranelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mario Migliolo
- President of the Florentine Sports Medicine Association (FMSI – CONI), Florence, Italy
| | - Marco Monaci
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy
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Low back pain during military service predicts low back pain later in life. PLoS One 2017; 12:e0173568. [PMID: 28282419 PMCID: PMC5345828 DOI: 10.1371/journal.pone.0173568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/23/2017] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life.
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Mansfield M, Thacker M, Spahr N, Smith T. Factors associated with physical activity participation in adults with chronic cervical spine pain: a systematic review. Physiotherapy 2017; 104:54-60. [PMID: 28822600 DOI: 10.1016/j.physio.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 01/12/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the factors associated with physical activity participation in adults with chronic cervical spine pain. METHODS A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE and CINAHL from inception to June 12th, 2016. Grey literature and reference checking was also undertaken. Quantitative studies including factors related to physical activity participation in adults with chronic cervical spine pain were included. Two independent authors conducted the searches, extracted data and completed methodological quality assessment. RESULTS A total of seven studies met the selection criteria, however, four papers were finally included in the final review. A modified Downs and Black criteria was used to assess methodological quality, each study included was classed as moderate quality. A total of six factors were assessed against physical activity participation for people with chronic neck pain. These included: pain, fear of movement, smoking habits, socioeconomic status, gender, leisure and work time habits. A significant relationship was demonstrated between pain, leisure and work time habits and physical activity. Subjects were less likely to participate in physical activity if they were in pain. Subjects with neck pain were less likely to participate in physical activity in their leisure and work time. CONCLUSION This review, based on a small number of heterogeneous studies demonstrated key factors that are likely to affect physical activity in people with chronic neck pain, most notably, pain levels, leisure and work habits. This review suggests that more in-depth, high quality studies are required to fully understand the impact of chronic pain on physical activity. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42015027970.
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Affiliation(s)
- Michael Mansfield
- Guy's and St Thomas Hospital NHS Foundation Trust, Physiotherapy Department, St Thomas Hospital, Westminster Bridge Road, London, United Kingdom.
| | - Michael Thacker
- Guy's and St Thomas Hospital NHS Foundation Trust, Physiotherapy Department, St Thomas Hospital, Westminster Bridge Road, London, United Kingdom; Centre for Human and Aerospace Physiological Sciences, King's College London, United Kingdom; Pain Section, Neuroimaging, Institute of Psychiatry, Kings College London, United Kingdom; School of Health Sciences, University of South Australia, Australia.
| | - Nicolas Spahr
- Guy's and St Thomas Hospital NHS Foundation Trust, Physiotherapy Department, St Thomas Hospital, Westminster Bridge Road, London, United Kingdom; Pain Section, Neuroimaging, Institute of Psychiatry, Kings College London, United Kingdom.
| | - Toby Smith
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, United Kingdom.
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Reliability and validity of two multidimensional self-reported physical activity questionnaires in people with chronic low back pain. Musculoskelet Sci Pract 2017. [PMID: 28637603 DOI: 10.1016/j.msksp.2016.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although there is some evidence for reliability and validity of self-report physical activity (PA) questionnaires in the general adult population, it is unclear whether we can assume similar measurement properties in people with chronic low back pain (LBP). OBJECTIVE To determine the test-retest reliability of the International Physical Activity Questionnaire (IPAQ) long-version and the Baecke Physical Activity Questionnaire (BPAQ) and their criterion-related validity against data derived from accelerometers in patients with chronic LBP. DESIGN Cross-sectional study. METHODS Patients with non-specific chronic LBP were recruited. Each participant attended the clinic twice (one week interval) and completed self-report PA. Accelerometer measures >7 days included time spent in moderate-and-vigorous physical activity, steps/day, counts/minute, and vector magnitude counts/minute. Intraclass Correlation Coefficients (ICC) and Bland and Altman method were used to determine reliability and spearman rho correlation were used for criterion-related validity. RESULTS A total of 73 patients were included in our analyses. The reliability analyses revealed that the BPAQ and its subscales have moderate to excellent reliability (ICC2,1: 0.61 to 0.81), whereas IPAQ and most IPAQ domains (except walking) showed poor reliability (ICC2,1: 0.20 to 0.40). The Bland and Altman method revealed larger discrepancies for the IPAQ. For the validity analysis, questionnaire and accelerometer measures showed at best fair correlation (rho < 0.37). CONCLUSIONS Although the BPAQ showed better reliability than the IPAQ long-version, both questionnaires did not demonstrate acceptable validity against accelerometer data. These findings suggest that questionnaire and accelerometer PA measures should not be used interchangeably in this population.
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Sousa CDDD, Nunes ACL, Jesus-Moraleida FRD. Association between Physical Activity and Disability in patients with low back pain. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700020015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Salah El-din Mahmoud W, Yousef A, Manssor E, Ahmed S. The relationship between pain and functional disability with morphological changes of psoas major in discogenic low back pain patients. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.8.363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Ahmed Yousef
- Chief, Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Al-Kharj, KSA, Physics Department, Faculty of Science, South Valley University, Qena, Egypt
| | - E Manssor
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Al-Kharj, KSA
| | - Sameh Ahmed
- Lecturer Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Egypt
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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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