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Khadour FA, Khadour YA, Alhatem W, Albarroush D, Dao X. Risk factors Associated with Pain Severity in Syrian patients with non-specific low back Pain. BMC Musculoskelet Disord 2024; 25:687. [PMID: 39217298 PMCID: PMC11365148 DOI: 10.1186/s12891-024-07828-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Low back pain (LBP) majorly contributes to activity limitations and work absences worldwide. Therefore, a comprehensive knowledge of the risk factors linked to non-specific low back pain (NSLBP) can enable early and timely interventions to achieve long-term improvements. Current study aimed to assess the risk factors associated with the severity of NSLBP patients in Syria. METHODS This study used a cross-sectional design and a self-assessment questionnaire to collect data on NSLBP, as well as personal and physical factors, across four provinces in Syria (Damascus, Aleppo, Homs, and Latakia) from November 2021 to September 2022. The assessments incorporated the Short Form 36-Item Health Survey (SF-36), the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). Then we examined the relationship between the severity of NSLBP and these potential risk factors. Descriptive statistics were employed to summarize the demographic characteristics of the participants. Additionally, multiple logistic regression analysis was performed to evaluate the risk factors for non-specific low back pain. RESULTS The study included a total of 875 patients with NSLBP. The results indicated that patients with primary school education, a high body mass index (BMI), prolonged driving and sitting durations, smoking habits, and recurrent low back pain had higher VAS and ODI scores, as well as lower SF-36 scores (p < 0.01). Additionally, workers and drivers had higher VAS and ODI scores and lower SF-36 scores compared to waiters and patients who lifted objects heavier than 10 kg for more than a quarter of their work time for over 10 years (p < 0.01). The multiple logistic regression analysis revealed that lower education levels, low back pain lasting 1-7 days, chronic low back pain in the past year, smoking, driving for prolonged time, and higher BMI were associated with more severe VAS scores. CONCLUSION The severity of NSLBP is related to lower education levels, poor living conditions, strenuous physical labor, inactive lifestyle, and driving for a long time. Additionally, patients with recurrent NSLBP experience more intense pain. To manage these issues, potential interventions could include reducing obesity rates, limiting the duration of hard physical work, limiting driving duration and reducing sedentary behaviors and smoking. These measures may help alleviate the overall burden of NSLBP.
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Affiliation(s)
- Fater A Khadour
- Department of Rehabilitation, Faculty of Medicine, Al Baath University, Homs, Syria.
- Department of Physical Therapy, Health Science Faculty, Al-Baath University, Homs, Syria.
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China.
| | - Younes A Khadour
- Department of Rehabilitation, Faculty of Medicine, Al Baath University, Homs, Syria
- Department of Physical Therapy, Health Science Faculty, Al-Baath University, Homs, Syria
- Department of Physical Therapy, Cairo University, Cairo, 11835, Egypt
| | - Weaam Alhatem
- Department of Rehabilitation, Faculty of Medicine, Al Baath University, Homs, Syria
| | - Deema Albarroush
- Department of Rehabilitation, Faculty of Medicine, Al Baath University, Homs, Syria
| | - Xiuli Dao
- Department of Sport Education, Neijiang Normal University, Sichuan, 641004, China
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García-Moreno JM, Calvo-Muñoz I, Gómez-Conesa A, López-López JA. Obesity and overweight as risk factors for low back pain in children and adolescents: a meta-analysis. Int J Obes (Lond) 2024; 48:612-625. [PMID: 38273033 DOI: 10.1038/s41366-024-01475-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Childhood obesity and overweight are associated with musculoskeletal pain, but the association between low back pain (LBP) and overweight/obesity in this population needs clarification. The objective of this meta-analysis is to ascertain the relationship between LBP and obesity/overweight in children and adolescents. METHODS Various databases and specialized journals were queried from inception to October 2022. Encompassed were all studies examining the association between overweight or obesity and LBP among participants aged 6 to 18 years. The ROBINS-E tool was employed to assess bias. Random-effects models were used to pool results across studies, with location-scale models used to search for moderator variables where evidence of heterogeneity was found. RESULTS In total, 34 studies were incorporated. Four studies had a low risk of bias, while the remaining studies had some concerns. Nine studies evinced an association between overweight and LBP, in contrast to normal weight, yielding an OR of 1.13 (95% CI 1.10-1.16) and no heterogeneity. Eight studies demonstrated a similar association between obesity and LBP compared to normal weight, with an OR of 1.27 (95% CI 1.20-1.34) and no heterogeneity. Ten studies established an association between overweight/obesity and LBP compared to normal weight, yielding an OR of 1.18 (95% CI 1.14-1.23) and no heterogeneity. Finally, nineteen studies showcased an association between body mass index (BMI) and LBP, with an OR of 1.19 (95% CI 1.03-1.39) with evidence of heterogeneity. For this last analysis, we compared the mean BMI in groups and transformed results to log OR, and then retransformed to OR. CONCLUSION Overweight and obesity may be risk factors for LBP in children and adolescents. The association between LBP and obesity appears to be stronger than with overweight. However, the analysis revealed considerable heterogeneity and risk of bias across studies.
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Affiliation(s)
| | | | - Antonia Gómez-Conesa
- Research Group Research Methods and Evaluation in Social Sciences. Mare Nostrum Campus of International Excellence, University of Murcia, Murcia, Spain
| | - José Antonio López-López
- Research Group Research Methods and Evaluation in Social Sciences. Mare Nostrum Campus of International Excellence, University of Murcia, Murcia, Spain
- Dept. of Basic Psychology and Methodology, University of Murcia, Murcia, Spain
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Neves AB, Martins R, Matela N, Atalaia T. PosturAll: A Posture Assessment Software for Children. Bioengineering (Basel) 2023; 10:1171. [PMID: 37892901 PMCID: PMC10603916 DOI: 10.3390/bioengineering10101171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/21/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023] Open
Abstract
From an early age, people are exposed to risk factors that can lead to musculoskeletal disorders like low back pain, neck pain and scoliosis. Medical screenings at an early age might minimize their incidence. The study intends to improve a software that processes images of patients, using specific anatomical sites to obtain risk indicators for possible musculoskeletal problems. This project was divided into four phases. First, markers and body metrics were selected for the postural assessment. Second, the software's capacity to detect the markers and run optimization tests was evaluated. Third, data were acquired from a population to validate the results using clinical software. Fourth, the classifiers' performance with the acquired data was analyzed. Green markers with diameters of 20 mm were used to optimize the software. The postural assessment using different types of cameras was conducted via the blob detection method. In the optimization tests, the angle parameters were the most influenced parameters. The data acquired showed that the postural analysis results were statistically equivalent. For the classifiers, the study population had 16 subjects with no evidence of postural problems, 25 with mild evidence and 16 with moderate-to-severe evidence. In general, using a binary classification with the train/test split validation method provided better results.
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Affiliation(s)
- Ana Beatriz Neves
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal;
| | - Rodrigo Martins
- Escola Superior De Saúde Da Cruz Vermelha Portuguesa, 1300-125 Lisboa, Portugal; (R.M.); (T.A.)
| | - Nuno Matela
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal;
| | - Tiago Atalaia
- Escola Superior De Saúde Da Cruz Vermelha Portuguesa, 1300-125 Lisboa, Portugal; (R.M.); (T.A.)
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Gaydarski L, Sirakov I, Uzunov K, Chervenkov M, Ivanova T, Gergova R, Angushev I, Mirazchiyski G, Landzhov B. A Case-Control Study of the Fokl Polymorphism of the Vitamin D Receptor Gene in Bulgarians With Lumbar Disc Herniation. Cureus 2023; 15:e45628. [PMID: 37868452 PMCID: PMC10588962 DOI: 10.7759/cureus.45628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND The present study investigates whether vitamin D receptor (VDR) gene polymorphisms play a role in intervertebral disc degeneration (IDD), a common cause of low back pain (LBP) and reduced quality of life. Specifically, we examined the FokI VDR polymorphism and its potential association with lumbar disc herniation (LDH) in patients from Bulgaria. Previous studies have suggested a link between mutations in the VDR gene and IDD. METHODS We investigated whether a potential connection between VDR polymorphisms and LDH was present by comparing the FokI polymorphism of 60 selected patients (25 to 60) with LDH and 60 healthy volunteers within the same age range. We used polymerase chain reaction to assess the phenotype of the examined subjects and statistical tests to evaluate whether the obtained results were statistically significant. RESULTS The performed genetic and statistical analyses reviewed significant differences in genotypic frequencies between the patient group and healthy volunteers. The frequency of the F allele is notably higher in patients with LDH (80%) compared to volunteers (52%), while the f allele is more common among patients (86.6%) than volunteers (100%). CONCLUSION This study strongly suggests that expression of the F allele of the VDR gene may increase the susceptibility of developing LDH, while having the f allele could potentially have a protective effect. Our results shed light on the underlying complex mechanisms contributing to the development of LDH.
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Affiliation(s)
- Lyubomir Gaydarski
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, BGR
| | - Ivo Sirakov
- Department of Medical Microbiology, Medical University of Sofia, Sofia, BGR
| | | | - Mihail Chervenkov
- Department of Cytology and Histology, University of Forestry, Sofia, BGR
- Department of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, Sofia, BGR
| | - Teodora Ivanova
- Department of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, Sofia, BGR
| | - Raina Gergova
- Department of Medical Microbiology, Medical University of Sofia, Sofia, BGR
| | - Ivan Angushev
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, BGR
| | - Georgi Mirazchiyski
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, BGR
| | - Boycho Landzhov
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, BGR
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Azevedo N, Ribeiro JC, Machado L. Back pain in children and adolescents: a cross-sectional study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:3280-3289. [PMID: 37156852 DOI: 10.1007/s00586-023-07751-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/27/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Back pain is a growing problem worldwide, not only in adults but also in children. Therefore, it is becoming increasingly important to investigate and understand the factors that influence the early onset of back pain. The aim of this study was to determine the prevalence of back pain in children and adolescents and to identify predisposing risk factors and protective factors. METHODS A cross-sectional study was conducted between October and December 2019 in schools from northern Portugal, evaluating 1463 students aged 9 to 19 years, of both genders. The instruments used were the Spinal Mouse® to assess posture, the Inbody 230® to assess body composition, an online questionnaire to characterize the sample and back pain, and the FITescola® battery test to access physical fitness. RESULTS Half of the subjects experienced back pain at least once in their lifetime. The most frequently mentioned were lumbar spine and thoracic spine, mostly with mild or moderate pain intensities. Age, female gender, percent body fat, prolonged smartphone and computer use, hyperkyphosis, and the lateral global spine tilt to the left side are all factors with higher relative risk of back pain. Practicing physical activity or sports regularly and video games have a protective effect. CONCLUSION The prevalence of back pain in children and adolescents is very high: The study enhances the case for protective factors such as physical activity habits or video games while reinforcing risk factors such as percent body fat, prolonged smartphone or computer use, and posture.
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Affiliation(s)
- Nelson Azevedo
- CICS, ISAVE, Faculdade de Desporto da Universidade do Porto, 4200-450, Porto, Portugal.
| | - José Carlos Ribeiro
- CIAFEL, ITR, Faculdade de Desporto da Universidade do Porto, 4200-450, Porto, Portugal
| | - Leandro Machado
- CIFI2D, LABIOMEP, Faculdade de Desporto da Universidade do Porto, 4200-450, Porto, Portugal
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Shinde N, Kanabar DJ, Miles LJ. Narrative review of the prevalence and distribution of acute pain in children in the self-care setting. PAEDIATRIC & NEONATAL PAIN 2022; 4:169-191. [PMID: 36618510 PMCID: PMC9798044 DOI: 10.1002/pne2.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
Acute pain among children is common, yet it may be underestimated and undertreated if the pain is not recognized. Assessing and managing pediatric pain can be complicated, and as such, measuring the prevalence of acute pain in children can be challenging. We sought to provide a consolidated review of the available data on the prevalence of commonly occurring acute pain in children in the self-care setting. An extensive literature search was performed to determine the prevalence of acute pain at multiple bodily locations in children aged between 3 months and 18 years. We considered the influence of age, sex, and sociodemographic factors on prevalence estimates. We also sought to identify some of the challenges involved in assessing and managing pediatric pain, thus shedding light on areas where there may be clinical and medical unmet needs. In general, a high prevalence of acute pain in children was detected, particularly headache, menstruation-related pain, and dental and back pain. Older age, female sex, and lower socioeconomic status were associated with increased pain prevalence. Risk factors were identified for all pain types and included psychological issues, stress, and unhealthy lifestyle habits. Owing to the heterogeneity in study populations, the prevalence estimates varied widely; there was also heterogeneity in the pain assessment tools utilized. The paucity of information regarding pain prevalence appears to be out of proportion with the burden of acute pain in children. This could indicate that clinicians may not be equipped with an optimal pain management strategy to guide their practice, especially regarding the use of developmentally appropriate pain assessment tools, without which prevalence data may not be captured. If acute pain is not accurately identified, it cannot be optimally treated. Further investigation is required to determine how the information from prevalence studies translates to the real-world setting.
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Affiliation(s)
- Nutan Shinde
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
| | | | - Lisa J. Miles
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
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Podrekar Loredan N, Kastelic K, Burnard MD, Šarabon N. Ergonomic evaluation of school furniture in Slovenia: From primary school to university. Work 2022; 73:229-245. [PMID: 35912766 PMCID: PMC9535564 DOI: 10.3233/wor-210487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Adequate school furniture is important to prevent musculoskeletal discomfort among students. OBJECTIVE: The aim of the study was to assess the suitability of school furniture compared to body dimensions of students. METHODS: A cross-sectional study included a total of 442 students from primary school, secondary school, and university. Nine body dimensions along with five furniture dimensions were measured and equations for mismatch criteria were applied. RESULTS: In primary school, differences in body dimensions were more evident among students of different age, while in secondary school and university, differences between male and female students became more apparent. The mismatch for desk height ranged from 100.0% at primary school to 48.0% at university. Similarly, the seat height mismatch was the most evident in primary school (89.7% –94.6%), lower at university (52.0%) and the lowest in secondary school (18.0%). The seat depth mismatch was present among all groups, ranging from 23.1% to 40.4%, and was in general more pronounced in males. Seat to desk clearance mismatch was the most evident among secondary school students. In primary school, seat and desk height were generally too high for most of students. CONCLUSIONS: Specific differences in body dimensions among groups of students of different age and gender were observed and a high student-furniture mismatch was identified in all educational institutions. Implementation of adjustable school furniture, covering at least two size marks, is needed to provide ergonomic and healthy learning conditions and to further enhance the comfort and well-being of students in the classroom.
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Affiliation(s)
- Nastja Podrekar Loredan
- Human Health in the Built Environment, Inno Renew CoE, Izola, Slovenia
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Kaja Kastelic
- Human Health in the Built Environment, Inno Renew CoE, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Michael David Burnard
- Human Health in the Built Environment, Inno Renew CoE, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Nejc Šarabon
- Human Health in the Built Environment, Inno Renew CoE, Izola, Slovenia
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
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Azevedo N, Ribeiro JC, Machado L. Balance and Posture in Children and Adolescents: A Cross-Sectional Study. SENSORS 2022; 22:s22134973. [PMID: 35808468 PMCID: PMC9269686 DOI: 10.3390/s22134973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
Balance and posture are two topics that have been extensively studied, although with some conflicting findings. Therefore, the aim of this work is to analyze the relationship between the postural angles of the spine in the sagittal plane and the stable static balance. A cross-sectional study was conducted with children and adolescents from schools in northern Portugal in 2019. An online questionnaire was used to characterize the sample and analyze back pain. Spinal postural angle assessment (pelvic, lumbar, and thoracic) was performed using the Spinal Mouse®, while stabilometry assessment was performed using Namrol® Podoprint®. Statistical significance was set as α = 0.05. The results showed that girls have better balance variables. There is a weak correlation between the anthropometric variables with stabilometry variables and the postural angles. This correlation is mostly negative, except for the thoracic spine with anthropometric variables and the lumbar spine with BMI. The results showed that postural angles of the spine are poor predictors of the stabilometric variables. Concerning back pain, increasing the postural angle of the thoracic spine increases the odds ratio of manifestation of back pain by 3%.
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Affiliation(s)
- Nelson Azevedo
- CICS, ISAVE, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - José Carlos Ribeiro
- CIAFEL, ITR, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - Leandro Machado
- CIFI2D, LABIOMEP, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal
- Correspondence:
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Treatment of Unspecific Back Pain in Children and Adolescents: Results of an Evidence-Based Interdisciplinary Guideline. CHILDREN 2022; 9:children9030417. [PMID: 35327789 PMCID: PMC8947172 DOI: 10.3390/children9030417] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/17/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
Using a structured approach and expert consensus, we developed an evidence-based guideline on the treatment and prevention of non-specific back pain in children and adolescents. A comprehensive and systematic literature search identified relevant guidelines and studies. Based on the findings of this literature search, recommendations on treatment and prevention were formulated and voted on by experts in a structured consensus-building process. Physical therapy (particularly physical activity) and psychotherapy (particularly cognitive behavioral therapy) are recommended for treating pediatric non-specific back pain. Intensive interdisciplinary treatment programs should be provided for chronic and severe pain. Drug therapy should not be applied in children and adolescents. Further research on non-specific back pain in childhood and adolescence is strongly needed to reduce the imbalance between the high burden of non-specific back pain in childhood and adolescence and the low research activity in this field.
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Prevalence and Characteristics of Back Pain in Children and Adolescents from the Region of Murcia (Spain): ISQUIOS Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020946. [PMID: 35055768 PMCID: PMC8775889 DOI: 10.3390/ijerph19020946] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
Puberty is a vulnerable period for musculoskeletal disorders due to the existence of a wide inter-individual variation in growth and development. The main objective of the present study was to describe the prevalence of back pain (BP) in the past year and month in school-aged children according to sex, age, maturity status, body mass index (BMI) and pain characteristics. This study involved 513 students aged between 9 and 16 years. Anthropometric measures were recorded to calculate the maturity stage of the students using a regression equation comprising measures for age, body mass, body height, sitting height and leg length. An ad hoc questionnaire composed of eight questions was used to describe BP prevalence in school-aged children. The results showed that the prevalence of BP in school-aged children was observed in 35.1% over the last year (45% boys and 55% girls), and 17.3% (40.4% boys and 59.6% girls, with an association found between female sex and BP) in the last month. The prevalence of back pain in the past year and month was higher the older the students were, or the more pubertal development they had experienced. The prevalence of BP in the last year was also higher in those with overweight or obesity. After adjustment for sex, there was an association between BP and older age and higher BMI in boys and an association between BP and higher pubertal development in girls. In summary, the present study showed that the prevalence of BP was related to the maturity stage and weight of the participants, with different prevalence patterns found according to sex.
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Vitta AD, Bento TPF, Cornelio GP, Perrucini PDDO, Felippe LA, Conti MHSD. Incidence and factors associated with low back pain in adolescents: A prospective study. Braz J Phys Ther 2021; 25:864-873. [PMID: 34872870 DOI: 10.1016/j.bjpt.2021.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/27/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Low back pain (LBP) is a common complaint among children and adolescents and can negatively impact their physical and mental health. Although previous studies investigating the incidence of low back pain (LBP) in children and adolescents have been performed in high income countries, it is unclear whether countries such as Brazil would show similar incidence rates. OBJECTIVE To determine the incidence and to identify predictors of new episodes of LBP in high school students. METHODS This is a 1-year longitudinal study of high school students from public schools in the city of Bauru, Sao Paulo. Collected clinical data were: demographic and socioeconomic factors, information on the use of electronic devices, mental health status (the Strengths and Difficulties Questionnaires), level of habitual physical activity (Baecke Physical Activity Questionnaire), and incidence of LBP (measured with question about LBP in the past 12 months and the Nordic Musculoskeletal Questionnaire). Descriptive analysis and bivariate and multivariate logistic regressions were performed. RESULTS The cumulative incidence of new LBP episodes for the total cohort of 757 high school students was 18.9% (95% CI: 16.2, 21.8). The cumulative incidence was 14.8% (95% CI: 11.7, 18.5) for male students and 24.1% (95% CI: 19.8, 29.9) for female students. Being a female student (OR = 1.78; 95% CI: 1.23, 2.59), sitting posture while using tablet (OR = 4.34; 95% CI: 1.19, 16.60), daily time spent on tablet (OR = 3.21; 95% CI: 1.41, 7.30), daily time spent on mobile phone (OR =1.49; 95% CI: 1.11, 2.00), lying posture while using mobile phone (OR = 1.49; 95% CI: 1.05, 2.12), and mental health status (OR = 2.81; 95% CI: 1.76, 4.48) were identified as predictor variables. CONCLUSION Our findings showed that one in five high school students reported having a LBP episode over the last year. The predictors found to be associated with low back pain include those related to sex, time and posture while using electronic devices, and mental health status.
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Affiliation(s)
- Alberto de Vitta
- Physical Therapy Course, Centro Universitário de Ourinhos, Ourinhos, SP, Brazil.
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Masiero S, Sarto F, Cattelan M, Sarto D, Del Felice A, Agostini F, Scanu A. Lifetime Prevalence of Nonspecific Low Back Pain in Adolescents: A Cross-sectional Epidemiologic Survey. Am J Phys Med Rehabil 2021; 100:1170-1175. [PMID: 33605577 PMCID: PMC9988216 DOI: 10.1097/phm.0000000000001720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Many nonconclusive studies have been conducted on low back pain (LBP) in adolescents and associated factors. OBJECTIVE The aim was to assess the lifetime prevalence and associated factors of LBP in adolescents. MATERIALS AND METHODS A questionnaire was administered in high school students (14-19-yr-old participants) in Veneto region (Italy). The self-administered, structured questionnaire included anthropometric data; psychologic factors and lifestyle; presence, intensity, and family history of LBP; referral to professional health care for LBP; and a short version of the International Physical Activity Questionnaire. RESULTS A total of 6281 adolescents were recruited; 5204 questionnaires were included in the final analysis. A total of 2549 (48.98%) students reported one or more LBP episodes and 723 (13.89%) reported nonspecific disabling lumbar pain (i.e., no underlying pathology); 1040 (41.11%) subjects with LBP consulted a healthcare professional. A significant association emerged for LBP with sex (female), positive family history, time spent sitting or using electronic devices, sleep deprivation (<5 hrs/night), and low level of physical activity. CONCLUSION In a large sample of adolescents, LBP lifetime prevalence is high and often associated with disabling pain and sedentary lifestyle, requiring professional care. These findings may support the development of prevention and treatment strategies of LBP in adolescents, reducing the risk of developing chronic pain.
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Yabe Y, Hagiwara Y, Sekiguchi T, Momma H, Tsuchiya M, Kanazawa K, Yoshida S, Sogi Y, Onoki T, Suzuki K, Takahashi T, Itoi E, Nagatomi R. Low Back Pain in Young Sports Players: A Cross-sectional Study in Japan. Spine (Phila Pa 1976) 2021; 46:1154-1159. [PMID: 34384092 DOI: 10.1097/brs.0000000000003978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A cross-sectional study. OBJECTIVE The purpose of this large cohort study was to assess the prevalence of low back pain (LBP) among young players participating in several types of sports. SUMMARY OF BACKGROUND DATA LBP is a significant problem among young sports players. Sport discipline among young players is thought to be associated with LBP. However, similar previous studies did not specifically analyze LBP by age and sex. METHODS A cross-sectional study was conducted with young sports players (ages 6-15 years, n = 7277) using a self-reported questionnaire. The prevalence of LBP was assessed using the variables of age, sex, and sport discipline. RESULTS The point prevalence of LBP among young sports players was 5.0%. The participants between 6 and 8 years' old had the lowest prevalence of LBP (0.4%-1.3%), which increased with aging and reached the highest proportion of 13.5% to 14.8% at 13 to 14 years. Furthermore, female players had significantly higher proportions of LBP than male players (8.1% vs. 3.7%). Regarding sport discipline, the prevalence of LBP was higher in basketball, handball, and volleyball. CONCLUSION The prevalence of LBP among young sports players was different for age, sex, and sport discipline. Further studies are needed to clarify the association of sport-specific movements to LBP in each sport discipline. This may assist in developing programs or strategies for preventing LBP among young sports players.Level of Evidence: 3.
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Affiliation(s)
- Yutaka Yabe
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Yoshihiro Hagiwara
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Takuya Sekiguchi
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, Aoba-ku, Sendai, Japan
| | - Kenji Kanazawa
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Shinichirou Yoshida
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Yasuhito Sogi
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Takahiro Onoki
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Kazuaki Suzuki
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Tadahisa Takahashi
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Eiji Itoi
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Aoba-ku, Sendai, Japan
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Innes S, Jacques A, Scott K, Walker B. Early age at menarche is associated with post-menarche back pain: An analysis of the Raine Study. Eur J Pain 2021; 25:2155-2165. [PMID: 34219328 DOI: 10.1002/ejp.1828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Back pain (BP) experienced by females during adolescent years appears to predispose them to an increased likelihood of its presence in adulthood. Understanding this phenomenon by identifying risk factors of those at risk potentially fosters preventative strategies and effective treatments. OBJECTIVES To investigate for associations between post-menarche BP and low back pain (LBP) and age at menarche (AAM) in Australian adolescents using the Western Australian pregnancy cohort (The Raine Study). METHODS This study used data from a longitudinal cohort study. BP data were collected retrospectively using a questionnaire. Menarche data was split into three established age classifications early (<12-years), normal (≥12 to >14-years) and late (≥14-years). Logistic regression models examined the effect of AAM on BP. RESULTS 666 female participants provided valid menarche data with 183 (27.5%) early AAM, 429 (64.4%) normal AAM and 54 (8.1%) with late AAM. The mean AAM was 12.59 years. BP was disclosed by 27.5% in the 14-year follow-up and 31.5% in the 17-year follow-up. Participants who had early AAM had 79% higher odds of experiencing BP compared to participants who had normal AAM, after adjusting for confounders at the 14-year follow-up (adjOR 1.79, 95% CI 1.18-2.64). CONCLUSION There is evidence of an association, in this cohort, of early AAM with post-menarche BP. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures. SIGNIFICANCE Age at menarche is related to a range of health issues. This study sought to investigate if it was a risk factor for spinal pain. We used an existing Australian data base to explore this possibility and found an association with early age onset and post-menarche back pain. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures.
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Affiliation(s)
- Stanley Innes
- Murdoch University, College of Science, Health, Education & Engineering, Perth, Western Australia, Australia
| | | | - Karin Scott
- Murdoch University, College of Science, Health, Education & Engineering, Perth, Western Australia, Australia
| | - Bruce Walker
- Murdoch University, College of Science, Health, Education & Engineering, Perth, Western Australia, Australia
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Effectiveness of a Back School and Postural Education Program on the improvement of literacy about postures and low back pain in adolescents: A 1-year follow-up study. J Orthop Sci 2021; 26:543-547. [PMID: 32703627 DOI: 10.1016/j.jos.2020.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/21/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Some health problems can be associated with the school environment and lifestyles, so it is necessary to carry out intervention actions that promote health and problem prevention. This study evaluates the effects of a Back School and Postural Education on improving short-term and long-term ergonomic knowledge of postures adopted at school and home, as well as reducing low back pain (LBP) in adolescents. METHODS The sample comprises 98 students, aged 10-16 years (11.61 ± 1.28 years), with 63 (64.3%) girls. The measuring instruments included a theoretical and a practical test, a low back pain (LBP) questionnaire and a scale. The tests and the scale have been applied 1 week before the intervention, 1 week following the Back School and Postural Education Program, and a 1 year later. The questionnaire was applied 1 week before of intervention and after 1 year. The intervention included three sessions of a theoretical and practical nature, each lasting 45 min, with intervals of 1 week. RESULTS The values of the theoretical test before the intervention, 1 week, and 1 year after the intervention were, respectively, 8.67 ± 2.64, 11.37 ± 1.93, and 11.11 ± 1.92 (p ≤ 0.001), and the practical test were 6.42 ± 2.47, 12.48 ± 2.25, and 12.83 ± 1.78 (p ≤ 0.001). The presence of LBP fell by 42.9%-25.5% after the 1-year period. CONCLUSIONS Our data show an improvement of ergonomic knowledge of postures adopted at school and home as a result of the education program and a decrease of self-reported LBP.
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16
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Minghelli B. School physiotherapy programme: Improving literacy regarding postures adopted at home and in school in adolescents living in the south of Portugal. Work 2021; 67:95-102. [PMID: 32955476 DOI: 10.3233/wor-203255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Health literacy consists of an individual's ability to make informed decisions in various sectors, including school. Most of the health problems and risky behaviours associated with the environment and lifestyle can be minimised or even prevented by increasing health literacy. OBJECTIVES This study aimed to evaluate the effectiveness of a school physiotherapy programme in improving literacy regarding postures adopted at home and in school in adolescents living in the south of Portugal. METHODS The sample was comprised of 84 students in the 5th grade, 42 (50%) were boys, aged to 10 and 13 years old (10.35±0.61). The measurement instruments included a theoretical and practical test applied one week before and one week after the school physiotherapy programme. RESULTS The values obtained on the theoretical test before and after the intervention ranged from 1-13 (7.70±2.47) and 5-13 (10.83±2.27), respectively (p≤0.001) and, on the practical test, before and after ranged from 0-10 (4.14±2.21) and 6-15 (11.8±2.28), respectively (p≤0.001). CONCLUSION This study found significant improvements in both theoretical and practical knowledge acquisition after participants attended a school physiotherapy programme. Thus, a school physiotherapy programme could be a useful tool to prevent and/or minimise musculoskeletal disorders in adolescents.
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Affiliation(s)
- Beatriz Minghelli
- School of Health Jean Piaget Algarve, Piaget Institute, Portugal.,Research in Education and Community Intervention (RECI), Portugal
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17
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Kędra A, Plandowska M, Kędra P, Czaprowski D. Non-specific low back pain: cross-sectional study of 11,423 children and youth and the association with the perception of heaviness in carrying of schoolbags. PeerJ 2021; 9:e11220. [PMID: 33986989 PMCID: PMC8103923 DOI: 10.7717/peerj.11220] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Background Carrying a schoolbag is a daily activity for most children and adolescents.The perception of a schoolbag’s weight depends upon the individual and is a relevant theme in schoolchildren. Describing the association between the perception of heaviness in carrying a schoolbag and NLBP can facilitate the planning of preventive programs, quite different from those based on specific weight limits for schoolbags in children and youth. Objective To determine the prevalence of non-specific low back pain (NLBP) and to analyse the association between the perception of heaviness in carrying of schoolbags and NLBP in Polish children and youth aged 10–19. Methods This study included 11,423 children and youth (6,252 girls and 5,171 boys) from Poland. An original questionnaire was used to assess NLBP prevalence. Results Among 11,423 of the respondents, 41.5% of the respondents admitted that they had experienced NLBP in the period of the last 12 months. The percentage of individuals reporting NLBP increased with age of participants, p < 0.001. Girls reported NLBP more often than boys (p < 0.001). Students with NLBP declared that their school backpack was heavy more often than students without LBP. Students who thought that their backpacks weighed too much manifested a 1.44 (95% Cl [1.33–1.55]) times higher probability to experience NLBP. Conclusion In the examined group of schoolchildren a frequent occurrence of NLBP (41.5%) was noted. Its occurrence was related to female sex and age. Students who thought that their backpacks weighed too much manifested higher probability to develop NLBP.
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Affiliation(s)
- Agnieszka Kędra
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Magdalena Plandowska
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Przemysław Kędra
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Dariusz Czaprowski
- Physiotherapy Unit, Department of Health Sciences, Poznan University of Medical Sciences, Poznan, Poland.,Department of Health Sciences, Olsztyn University, Olsztyn, Poland
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Back School Postural Education Program: Comparison of Two Types of Interventions in Improving Ergonomic Knowledge about Postures and Reducing Low Back Pain in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094434. [PMID: 33921952 PMCID: PMC8122336 DOI: 10.3390/ijerph18094434] [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: 04/12/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 12/19/2022]
Abstract
This study aimed to compare the impact of two Back School Postural Education Programs on improving ergonomic knowledge of postures adopted at school and home, as well as on reducing low back pain (LPB) in adolescents. The sample was constituted by 153 students, aged 10–16 years, with 96 (62.7%) girls, divided into 2 intervention groups (GA, GB). Two tests (theoretical and practical) and LBP questionnaire were applied 1 week before and 1 year after the end of the program. In GA, three sessions were performed for each class separately, on theoretical and practical issues, lasting 45 min and at intervals of 1 week, and in GB, only one theoretical session (90 min) was given to all students. Statistically differences on GA were obtained between the values 1 week before and after 1 year of evaluation in both theoretical and practical tests (p ≤ 0.001). In GB, only the values of the practical test present a statistical difference (p ≤ 0.001). GA obtained higher values on both tests after 1 year of follow-up compared with GB (p ≤ 0.001). The number of students with LBP decreased on GA (p ≤ 0.001). The program with longer duration, higher weekly frequency, and more practical and individualized character promotes better effects.
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Schwertner DS, Oliveira RANS, Koerich MHAL, Motta AF, Pimenta AL, Gioda FR. Prevalence of low back pain in young Brazilians and associated factors: Sex, physical activity, sedentary behavior, sleep and body mass index. J Back Musculoskelet Rehabil 2020; 33:233-244. [PMID: 31356188 DOI: 10.3233/bmr-170821] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain (LBP) has become increasingly common, but the prevalence of this complaint and associated factors in young people remains controversial. OBJECTIVE This study aimed to identify the prevalence of LBP and to explore the existence of associated factors (sex, physical activity, sedentary lifestyle, sleep, body mass index and waist circumference). METHODS This study considered all complaints of the lumbar region (acute or chronic) as LBP, which can irradiate to the backside and legs, lasting a minimum of 24 hours. Youngsters aged 15 to 18 years from a school in the south of Brazil were evaluated. Descriptive statistics was used, in particular Chi-square, Mann-Whitney U tests and binary logistic regression. A significance level of p< 0.05 was adopted. RESULTS A total of 330 youngsters answered a questionnaire and had their anthropometric measurements measured (response rate 84%). The prevalence of LBP in the present was 30%, quarterly 63% and throughout life 77%. There was a significant association between LBP and sex: girls have an increased risk of LBP in the last three-month period (PR = 1.3, 95% CI 1.06-1.56) and throughout life (PR = 1.2, 95% CI 1.04-1.43). The practice of physical activities was also associated with LBP, but as a protection factor in the present and in the last three-month period (PR = 0.7, 95% CI 0.47-0.90). Physical education at school has demonstrated a protective factor regarding LBP throughout life (PR = 0.9, 95% CI 0.77-0.97). Most of the students did not comply with recommendations related to sleep and time spent doing activities in front of a screen, and no association of these factors with LBP was detected. This exposure (physical activity, sleep time, sedentarism) did not present significant association with LBP when adjusted by the confusion factors (sex, age, BMI). CONCLUSIONS Youngsters reported a high prevalence of LBP. Girls were at greater risk of LBP than boys. It is recommended that prevention strategies focus on the practices of physical activities and scholar physical education. No association of LBP with sedentary lifestyle (TV and computer use time, sleep time), anthropometric measures and sleeping duration was observed.
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Affiliation(s)
- Debora Soccal Schwertner
- Universidade do Estado de Santa Catarina - UDESC, Santa Catarina State University, Florianópolis, Brazil.,Laboratory of Motor Behaviour, Postgraduate Program of Human Kinetics Faculty, University of Lisbon, UL, Lisbon, Portugal
| | - Raul A N S Oliveira
- Laboratory of Motor Behaviour, Postgraduate Program of Human Kinetics Faculty, University of Lisbon, UL, Lisbon, Portugal
| | - Micheline H A L Koerich
- Universidade do Estado de Santa Catarina - UDESC, Santa Catarina State University, Florianópolis, Brazil
| | - Andréa Fontoura Motta
- Universidade do Estado de Santa Catarina - UDESC, Santa Catarina State University, Florianópolis, Brazil
| | | | - Fabiane Rosa Gioda
- Universidade Regional de Blumenau - FURB, Regional University of Blumenau, Blumenau, Brazil
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20
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The short-term effects of balneotherapy on pain, disability and fatigue in patients with chronic low back pain treated with physical therapy: A randomized controlled trial. Complement Ther Med 2020; 54:102550. [PMID: 33183668 DOI: 10.1016/j.ctim.2020.102550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/09/2020] [Accepted: 08/24/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study aimed to compare whether there are positive effects of balneotherapy(BT) on pain, quality of life and disability of individuals receiving physical therapy(PT) for chronic low back pain and to examine the effect of body mass index(BMI) on treatment. MATERIALS AND METHOD This prospective, controlled, single blind study was conducted. Patients were randomized into two groups through a simple randomization in a 1:1 ratio. The clinician and biostatistics expert were blinded. PT group was applied PT, BT + PT group was applied PT + BT. All patients were included in the study for 3 weeks (total of 15 sessions, 5 days per week). All patients applied hot pack, transcutaneous electrical nerve stimulation and ultrasound. Patients in the BT + PT group applied BT in thermo mineralized water pool (20 min at 38-40 °C). Assessments were made using Pain-Visual Analog Scale(VAS), EQ-5D-3 L Scale(EQ5), EQ-VAS, Functional Assessment of Chronic Illness Therapy-Fatigue(FACIT-F), Roland-Morris Disability Questionnaire(RMDQ) and Quebec Back Pain Disability Scale(QBPDS) at the beginning (W0) and end (W3) of treatment. While performing statistical analysis, patients were divided into 3 categories of BMI1(18.5-24.9 kg/m2), BMI2 (25.0-29.9 kg/m2) and BMI3(≥30.0 kg/m2). RESULTS 270 patients were randomized. 129 patients in PT group and 133 patients in PT + BT group completed the study. In the BT + PT group, there were increases in the EQ5 and EQ-VAS variables and decreases in all other variables compared to the PT group which were found to be statistically significant (for QBPDS p < 0.05, the others p < 0.01). The differences in all variables W0 and W3 were at least half reductions and increases which were found to be statistically significant (p < 0.01). In terms of BMI, there were significant differences for all groups, especially BMI3 had higher means for all variables apart from EQ5 and EQ-VAS than the other two categories. BMI1 was the BMI category with highest means for EQ5 and EQ-VAS. The Group × Time interaction was found to be statistically significant for Pain-VAS, EQ5, EQ-VAS, FACIT-F, QBPDS and RMDQ(p < 0.01). For Pain-VAS, the effect of the Group × Time × BMI interaction was found to be statistically significant(p < 0.05). CONCLUSION BT plus PT was more effective than PT. BT may have positive contributions to reducing pain, functionality of patients, quality of life, fatigue and disability status.
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Muscular fitness is associated with spinal pain among young people: A cross-sectional exploratory study. J Bodyw Mov Ther 2020; 26:174-179. [PMID: 33992240 DOI: 10.1016/j.jbmt.2020.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 08/03/2020] [Accepted: 08/28/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE the aim of this study was to analyze the association between upper limb muscular fitness and spinal pain in the cervical, thoracic, and lumbar regions among young people. METHODS Cross-sectional study involving a probabilistic sample of 1054 participants (547 female) with ages ranging from 10 to 17 years, from Brazil. The dependent variable was pain in the cervical, thoracic, and lumbar regions of the spine, assessed by a self-report instrument. The independent variable was muscular fitness, verified using the 90° push-up test with the cut-offs proposed by FITNESSGRAM. The covariates were age, sex, socioeconomic status, physical activity, and body mass index. Ordinal logistic regression was adopted to conduct the multivariate association and estimate the Odds Ratios (OR). Two separate analyses were conducted: one with the whole sample and the other with only participants who reported pain. RESULTS The prevalences of spine pain in the cervical, thoracic, and lumbar regions were 24.4, 28.3, and 31.0%. In the whole sample, young people who achieved the criterion-referenced standard for muscular fitness were less likely to present high intensity pain in the thoracic region (OR = 0.67, 0.50-0.90). The same occurred when analyzing only those who reported pain for cervical region (OR = 0.48, 0.29-0.79). No association was found between muscular fitness and lumbar pain. CONCLUSIONS Upper limb muscular fitness can be used as an additional tool to prevent high levels of spine pain in the thoracic region among young people as well as the severity of cervical pain in those who report pain.
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Minghelli B. Musculoskeletal spine pain in adolescents: Epidemiology of non-specific neck and low back pain and risk factors. J Orthop Sci 2020; 25:776-780. [PMID: 31708228 DOI: 10.1016/j.jos.2019.10.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/05/2019] [Accepted: 10/15/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Neck pain (NP) and low back pain (LBP) have become a growing public health problem in adolescents that involve multiple factors, including modifiable factors, such as behavioral factors that include sedentary activities and adoption of inadequate postures. This study aimed to determine the prevalence of NP and LBP in adolescents and to investigate its association with sedentary activities and postures. METHODS The sample was comprised of 304 students, being 144 (47.4%) boys, aged between 10 and 17 years old (13.68 ± 2.02). The measurement instruments included a questionnaire, postural evaluation of some task and the transportation and weighing of the backpack. RESULTS The prevalence of NP and LBP were, respectively: in the lifetime: 51% and 65.1%; at the moment: 5.9% and 8.6%; and in a 12-month period: 39.8% and 47%. The older students (15-17 years old) had 3.03 times higher probability of developing LBP (95% CI (1.82-5.03; p ≤ 0.001) than the younger one (10-14 years), adolescents who used a mobile phone more than 10 h per week had 2.48 times higher probability of developing NP (95% CI: 1.29-4.75; p = 0.006) than those who had used for a shorter period (until 10 h) and 2.39 more probability to developed the LBP (95% CI: 1.41-4.08; p = 0.001). The students who sit with a spine in a wrong position had 3.24 more chances to have LBP (95% CI: 1.33-7.89; p = 0.010). CONCLUSIONS Data of this study showed a higher prevalence of NP and LBP in this sample and revealed that adolescents who used a mobile phone more than 10 h per week had more probability to develop both NP and LBP and older students and who sit with a spine in a wrong position had more chances to have LBP.
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Affiliation(s)
- Beatriz Minghelli
- School of Health Jean Piaget Algarve, Piaget Institute Research in Education and Community Intervention (RECI), Portugal.
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Beynon AM, Hebert JJ, Lebouef-Yde C, Walker BF. Potential risk factors and triggers for back pain in children and young adults. A scoping review, part II: unclear or mixed types of back pain. Chiropr Man Therap 2019; 27:61. [PMID: 31827768 PMCID: PMC6862810 DOI: 10.1186/s12998-019-0281-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Back pain is a global problem in terms of disability and financially, with a large burden both to the individual and to society. Back pain was previously believed to be uncommon in children. However, there is a growing body of evidence that this is not the case. Objective Part I of this scoping review studied risk factors of incident and episodic back pain. In this part II we aimed to identify all risk factors and triggers with unclear or mixed type back pain in young people and to identify any gaps in the literature. Methods A scoping review design was selected to summarise the evidence, as there are many studies on "risk factors" for back pain. The scoping review followed the PRISMSA-ScR guidelines. We considered all studies that tested potential risk factors and triggers for thoracic and/or lumbar spine pain, in children, adolescents, and young adults (≤ 24 years). PubMed and Cochrane databases were searched from inception to September 2018, to identify relevant English language articles. The results regarding potential risk factors were separated into temporal precursors and bidirectional risk factors and the studies were classified by study design. Results Our comprehensive search strategy identified 7356 articles, of which 83 articles were considered eligible for this review (part II). There were 53 cross-sectional studies and 30 cohort studies. Potential risk factors for back pain were: female sex, older age, later pubertal status, positive family history of back pain, increased growth, and a history of back pain, most of which are temporal precursor variables. There was limited research for the illness factors, spinal posture, and muscle endurance in the development of back pain. Conclusion Many of the included studies approached risk factors in similar ways and found factors that were associated with back pain but were not obvious risk factors as causality was uncertain. Future research should be more rigorous and innovative in the way that risk factors are considered. This could be through statistical approaches including cumulative exposures, or longitudinal approaches including multi-trajectory methods. Additionally, data on proposed risk factors should be collected before the onset of back pain.
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Affiliation(s)
- Amber M Beynon
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
- Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, Fredericton, New Brunswick E3B 5A3 Canada
| | - Charlotte Lebouef-Yde
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
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Bai R, Li C, Xiao Y, Sharma M, Zhang F, Zhao Y. Effectiveness of spa therapy for patients with chronic low back pain: An updated systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17092. [PMID: 31517832 PMCID: PMC6750337 DOI: 10.1097/md.0000000000017092] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a major health problem around the world. Two previous meta-analyses showed that the spa therapy has a positive effect on reducing pain among patients with LBP based on studies published before 2006 and studies published between 2006 and 2013. In recent years, more studies reported the effect of spa therapy on treating chronic low back pain (CLBP). Our study aimed to update the meta-analysis of randomized controlled trials (RCTs) about the effect of spa therapy on treating CLBP and to examine the effect of spa therapy based on different interventions. METHODS PubMed, Embase, Web of Science, and Cochrane Library were searched until May 2018 to identify RCTs about spa therapy among patients with CLBP. Summary effect estimates were calculated by using a random-effects model. The quality of each eligible study was evaluated by Jadad checklist. RESULTS Twelve studies met the inclusion criteria for the systematic review and were included in meta-analysis. There was a significant decrease in pain based on visual analogue scale (VAS) (mean difference [MD] 16.07, 95% confidence interval [CI] [9.57, 22.57], P < .00001, I = 88%, n = 966), and lumbar spine function in Oswestry disability index (ODI) (MD 7.12, 95% CI [3.77, 10.47], P < .00001, I = 87%, n = 468) comparing spa therapy group to control group. Methodological assessment for included studies showed that the study's quality is associated with lacking blinding. CONCLUSION This updated meta-analysis confirmed that spa therapy can benefit pain reliving and improve lumbar spine function among patients with CLBP. Physiotherapy of subgroup analysis indicated that it can improve lumbar spine function. However, these conclusions should be treated with caution due to limited studies. More high-quality RCTs with double-blind design, larger sample size, and longer follow-up should be employed to improve the validity of study results.
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Affiliation(s)
- Ruixue Bai
- School of Public Health and Management
- Research Center for Medicine and Social Development
- Innovation Center for Social Risk Governance in Health
- Health Management (Physical Examination) Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing
| | - Chihua Li
- Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan, China
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Yangxue Xiao
- School of Public Health and Management
- Research Center for Medicine and Social Development
- Innovation Center for Social Risk Governance in Health
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS
| | - Fan Zhang
- School of Public Health and Management
- Research Center for Medicine and Social Development
- Innovation Center for Social Risk Governance in Health
| | - Yong Zhao
- School of Public Health and Management
- Research Center for Medicine and Social Development
- Innovation Center for Social Risk Governance in Health
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Noll M, Candotti CT, da Rosa BN, Vieira A, Loss JF. Back pain and its risk factors in Brazilian adolescents: a longitudinal study. Br J Pain 2019; 15:16-25. [PMID: 33633850 DOI: 10.1177/2049463719871751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Owing to the lack of longitudinal studies in Latin American countries, we aimed to evaluate back pain and its risk factors in a 3-year longitudinal study of Brazilian adolescents. We analysed data of 525 adolescents (aged 11-16 years) attending primary school (fifth to eighth grade) in Brazil. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument (BackPEI) questionnaire in 2011 and at a follow-up evaluation that was conducted 3 years later (2014). Back pain was the outcome variable; the exposure variables included exercise, behavioural, hereditary and postural factors. Generalized estimating equations were used to perform a Poisson regression model with robust variance to evaluate the risk factors for back pain. The prevalence of back pain at baseline was 56% (n = 294); this increased significantly at the 3-year follow-up evaluation to 65.9% (n = 346). The frequency of experiencing back pain also significantly increased after 3 years in both boys (p = 0.002) and girls (p = 0.001). The prevalence of back pain increased significantly in adolescents up to the age of 13 years, stabilized in those aged 14 years and older and was higher among girls. A family history of back pain (in the parents), watching television for lengthy periods and carrying a backpack asymmetrically were predictors for back pain.
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Affiliation(s)
| | | | | | - Adriane Vieira
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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26
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Sribastav SS, Long J, He P, He W, Ye F, Li Z, Wang J, Liu H, Wang H, Zheng Z. Risk Factors Associated with Pain Severity in Patients with Non-specific Low Back Pain in Southern China. Asian Spine J 2018; 12:533-543. [PMID: 29879782 PMCID: PMC6002175 DOI: 10.4184/asj.2018.12.3.533] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/16/2017] [Accepted: 10/26/2017] [Indexed: 12/19/2022] Open
Abstract
STUDY DESIGN A prospective cross-sectional study. PURPOSE To evaluate the risk factors associated with the severity of pain intensity in patients with non-specific low back pain (NSLBP) in Southern China. OVERVIEW OF LITERATURE Low back pain (LBP) is the leading cause of activity limitation and work absence throughout the world, so a firm understanding of the risk factor associated with NSLBP can provide early and prompt interventions that are aimed at attaining long-term results. METHODS Participants were recruited from January 2014 to January 2016 and were surveyed using a self-designed questionnaire. Anonymous assessments included Short Form 36-Item Health Survey (SF-36) and Visual Analogue Scale (VAS). The association between the severity of NSLBP and these potential risk factors were evaluated. RESULTS A total of 1,046 NSLBP patients were enrolled. The patients with primary school education, high body mass index (BMI), those exposed to sustained durations of driving and sitting, smoking, recurrent LBP had increased VAS and Oswestry Disability Index (ODI) scores with lower SF-36 scores (p <0.01). Workers and drivers compared with waiters and patients who lifted >10 kg objects in a quarter of their work time for >10 years had higher VAS and ODI scores with lower SF-36 scores (p <0.01). Multiple logistic regression showed lower levels of education, LBP for 1-7 days, long-lasting LBP in last year, smoking, long duration driving, and higher BMI were associated with more severe VAS score. CONCLUSIONS The severity of NSLBP is associated with lower levels of education, poor standards of living, heavy physical labor, long duration driving, and sedentary lifestyle. Patients with recurrent NSLBP have more severe pain. Reducing rates of obesity, the duration of heavy physical work, driving or riding, and attenuating the prevalence of sedentary lifestyles and smoking may reduce the prevalence of NSLBP.
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Affiliation(s)
- Shilabant Sen Sribastav
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jun Long
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Peiheng He
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei He
- Department of Orthopaedics, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fubiao Ye
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zemin Li
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianru Wang
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hui Liu
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hua Wang
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhaomin Zheng
- Department of Orthopaedics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Pain Research Center and Department of Physiology, Zhongshan Medical School of Sun Yat-sen University, Guangzhou, China
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Yamato TP, Maher CG, Traeger AC, Wiliams CM, Kamper SJ. Do schoolbags cause back pain in children and adolescents? A systematic review. Br J Sports Med 2018; 52:1241-1245. [PMID: 29720469 DOI: 10.1136/bjsports-2017-098927] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate whether characteristics of schoolbag use are risk factors for back pain in children and adolescents. DATA SOURCES Electronic searches of MEDLINE, EMBASE and CINAHL databases up to April 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies, cross-sectional and randomised controlled trials conducted with children or adolescents. The primary outcome was an episode of back pain and the secondary outcomes were an episode of care seeking and school absence due to back pain. We weighted evidence from longitudinal studies above that from cross-sectional. The risk of bias of the longitudinal studies was assessed by a modified version of the Quality in Prognosis Studies tool. RESULTS We included 69 studies (n=72 627), of which five were prospective longitudinal and 64 cross-sectional or retrospective. We found evidence from five prospective studies that schoolbag characteristics such as weight, design and carriage method do not increase the risk of developing back pain in children and adolescents. The included studies were at moderate to high risk of bias. Evidence from cross-sectional studies aligned with that from longitudinal studies (ie, there was no consistent pattern of association between schoolbag use or type and back pain). We were unable to pool results due to different variables and inconsistent results. SUMMARY/CONCLUSION There is no convincing evidence that aspects of schoolbag use increase the risk of back pain in children and adolescents.
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Affiliation(s)
- Tiê Parma Yamato
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Australia
| | - Chris G Maher
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian C Traeger
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia
| | - Christopher M Wiliams
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Steve J Kamper
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Australia
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Feng Q, Jiang C, Zhou Y, Huang Y, Zhang M. Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study. J Back Musculoskelet Rehabil 2017; 30:625-633. [PMID: 28234252 DOI: 10.3233/bmr-160544] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Non-specific back pain has become a public health problem affecting adolescent health. OBJECTIVE To examine the relationships between abnormalities in spinal morphology and non-specific back pain among adolescents. DESIGN Cross-sectional study. SETTING Junior and senior high schools. PATIENTS Participants were screened using a questionnaire regarding back pain. Students in the pain group (n= 273, 121 boys and 152 girls) reported experiencing upper and/or lower back pain within the previous month, and those who did not report pain were assigned to the group without pain (n= 127, 63 boys and 64 girls). Participants who had experienced acute upper and/or lower back injuries within the previous month or received a definitive diagnose of disease were excluded. METHODS The SpinalMouse® was used to measure the thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacrum/hip angle (SA), and incline angle (INA) in both the standing position and sitting position. The SpinalMouse® also was used to measure the sacral, thoracic, and lumbar range of motion (ROM) in the fully flexed position and fully extended position in the sagittal plane. The thoracic and lumbar ROM in left/right lateral flexion was recorded. The Matthiass test was used to assess changes in the measured angles upon loading. RESULTS Among junior high school students, 47.0% of boys and 53% of girls had an abnormal TKA. Among senior high school students, 52.6% of boys and 46.99% of girls had an abnormal TKA. The incidence of LLA abnormality was significantly higher among junior high boys than girls (p< 0.05), as was the incidence of hypolordosis (p< 0.05). Significantly fewer senior high boys than girls had a normal LLA value (p< 0.05). An excessive TKA (p< 0.05, odds ratio = 1.236) and limited lumbar ROM (p< 0.01, odds ratio = 0.975) were correlated with back pain in adolescents. CONCLUSIONS The incidences of TKA and LLA abnormality are high among Chinese adolescents, and an excessive TKA and insufficient total lumbar ROM may be risk factors for non-specific back pain in adolescents.
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Affiliation(s)
- Qiang Feng
- China Institute of Sport Science, Beijing, China
| | | | - Yu Zhou
- National Institute of Education Sciences, Beijing, China
| | - Yun Huang
- Guangxi College of Sports and Physical Education, Guangxi, China
| | - Ming Zhang
- China Institute of Sport Science, Beijing, China
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Toye F, Williamson E, Williams MA, Fairbank J, Lamb SE. What Value Can Qualitative Research Add to Quantitative Research Design? An Example From an Adolescent Idiopathic Scoliosis Trial Feasibility Study. QUALITATIVE HEALTH RESEARCH 2016; 26:1838-1850. [PMID: 27509903 DOI: 10.1177/1049732316662446] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Using an example of qualitative research embedded in a non-surgical feasibility trial, we explore the benefits of including qualitative research in trial design and reflect on epistemological challenges. We interviewed 18 trial participants and used methods of Interpretive Phenomenological Analysis. Our findings demonstrate that qualitative research can make a valuable contribution by allowing trial stakeholders to see things from alternative perspectives. Specifically, it can help to make specific recommendations for improved trial design, generate questions which contextualize findings, and also explore disease experience beyond the trial. To make the most out of qualitative research embedded in quantitative design it would be useful to (a) agree specific qualitative study aims that underpin research design, (b) understand the impact of differences in epistemological truth claims, (c) provide clear thematic interpretations for trial researchers to utilize, and (d) include qualitative findings that explore experience beyond the trial setting within the impact plan.
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Affiliation(s)
- Francine Toye
- 1 Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Esther Williamson
- 2 The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7HE, UK
| | - Mark A Williams
- 2 The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7HE, UK
| | - Jeremy Fairbank
- 2 The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7HE, UK
| | - Sarah E Lamb
- 2 The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7HE, UK
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Li SSW, Chow DHK. Multi-objective analysis for assessing simultaneous changes in regional spinal curvatures under backpack carriage in young adults. ERGONOMICS 2016; 59:1494-1504. [PMID: 26885751 DOI: 10.1080/00140139.2016.1151947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Change in sagittal spinal curvature from the neutral upright stance is an important measure of the heaviness and correctness of backpack use. As current recommendations, with respect to spinal profile, of backpack load thresholds were based on the significant curvature change in individual spinal region only, this study investigated the most critical backpack load by assessing simultaneously the spinal curvature changes along the whole spine. A motion analysis system was used to measure the curvature changes in cervical, upper thoracic, lower thoracic and lumbar regions with backpack load at 0, 5, 10, 15 and 20% of body weight. A multi-objective goal programming model was adopted to determine the global critical load of maximum curvature change of the whole spine in accordance with the maximum curvature changes of the four spinal regions. Results suggested that the most critical backpack load was 13% of body weight for healthy male college students. Practitioner Summary: As current recommendations of backpack load thresholds were based on the significant curvature change in individual spinal region only, this study investigated the backpack load by considering simultaneously the spinal curvature changes along the whole spine. The recommendation, in terms of the global critical load, was 13% of body weight for healthy male college students.
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Affiliation(s)
- Simon S W Li
- a Interdisciplinary Division of Biomedical Engineering , The Hong Kong Polytechnic University , Hong Kong , China
- b Department of Health and Physical Education , The Hong Kong Institute of Education , Hong Kong , China
| | - Daniel H K Chow
- b Department of Health and Physical Education , The Hong Kong Institute of Education , Hong Kong , China
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31
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Wáng YXJ, Wáng JQ, Káplár Z. Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg 2016; 6:199-206. [PMID: 27190772 DOI: 10.21037/qims.2016.04.06] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Female sex hormones play an important role in the etiology and pathophysiology of a variety of musculoskeletal degenerative diseases. Postmenopausal women show accelerated disc degeneration due to relative estrogen deficiency. This literature review aims to validate or falsify this hypothesis, i.e., while overall females have higher prevalence of low back pain (LBP) across all age groups, this male vs. female difference in LBP prevalence further increases after female menopause age. The literature search was performed on PubMed on January 2, 2016. The search word combination was (low back pain) AND prevalence AND [(males OR men) AND (females OR women)]. The following criteria were taken to include the papers for synthetic analysis: (I) only English primary literatures on nonspecific pain; (II) only prospective studies on general population, but not population with occupational LBP causes, of both males and female subjects studied using the same LBP criterion, ages-specific information available, and males and female subjects were age-matched; (III) studies without major quality flaws. In total 98 studies with 772,927 subjects were analyzed. According to the information in the literature, participant subjects were divided into four age groups: (I) school age children group: 6-19 years; (II) young and middle aged group: 20-50 years; (III) mixed age group: data from studies did not differentiate age groups; (IV) elderly group: ≥50 years old. When individual studies were not weighted by participant number and each individual study is represented as one entry regardless of their sample size, the median LBP prevalence ratio of female vs. males was 1.310, 1.140, 1.220, and 1.270 respectively for the four age groups. When individual studies were weighted by participant number, the LBP prevalence ratio of female vs. males was 1.360, 1.127, 1.185, and 1.280 respectively for the four groups. The higher LBP prevalence in school age girls than in school age boys is likely due to psychological factors, female hormone fluctuation, and menstruation. Compared with young and middle aged subjects, a further increased LBP prevalence in females than in males was noted after menopause age.
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Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Jùn-Qīng Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Zoltán Káplár
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Association Between VDR FokI Polymorphism and Intervertebral Disk Degeneration. GENOMICS PROTEOMICS & BIOINFORMATICS 2016; 13:371-6. [PMID: 26772150 PMCID: PMC4747649 DOI: 10.1016/j.gpb.2015.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 11/22/2015] [Accepted: 11/23/2015] [Indexed: 11/22/2022]
Abstract
Intervertebral disk degeneration (IDD) is strongly associated with genetic predisposition and environmental susceptibility. Several studies been conducted to investigate the potential association between IDD and FokI polymorphism located in the gene encoding the vitamin D receptor (VDR), and inconsistent conclusions had been reached among different ethnic populations. In order to assess the association between the FokI polymorphism and the risk of IDD, we performed a comprehensive and systematic meta-analysis. Candidate articles were retrieved from PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and China Biology Medical (CBM) with strict inclusion criteria in January 2015. Among the 54 articles that were retrieved, only eight studies met the inclusion criteria. The pooled data analysis based on allele contrast, homozygote, heterozygote, dominant, and recessive models revealed no significant correlation between the FokI polymorphism and the risk of IDD. However, when stratified by ethnicity, significant associations were detected for Hispanics based on allele contrast (OR=1.395, 95% CI=1.059-1.836, P=0.018), homozygote (OR=1.849, 95% CI=1.001-3.416, P=0.049), heterozygote (OR=1.254, 95% CI=1.049-1.498, P=0.013), and dominant (OR=1.742, 95% CI=1.174-2.583, P=0.006) models, and for Asians using the dominant model (OR=1.293, 95% CI=1.025-1.632, P=0.030), whereas there is no significant association detected for Caucasians. In conclusion, FokI polymorphism is not generally associated with IDD, but there is increased risk for IDD in Hispanics and Asians carrying FokI allele T.
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