1
|
Hassan HI, Kaka B, Bello F, Fatoye F, Ibrahim AA. Comparative effectiveness of low-level laser therapy versus muscle energy technique among diabetic patients with frozen shoulder: a study protocol for a parallel group randomised controlled trial. J Orthop Surg Res 2024; 19:272. [PMID: 38689290 PMCID: PMC11061961 DOI: 10.1186/s13018-024-04735-7] [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: 02/07/2024] [Accepted: 04/13/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Diabetes mellitus is one of the fastest-growing health challenges of the twenty-first century with multifactorial impact including high rates of morbidity and mortality as well as increased healthcare costs. It is associated with musculoskeletal complications, with frozen shoulder being commonly reported. While low-level laser therapy (LLLT) and muscle energy technique (MET) are commonly used to manage this condition, there remains a lack of agreement on the most effective approach, with limited research available on their comparative efficacy. OBJECTIVES To evaluate the comparative effectiveness of LLLT versus MET among diabetic patients with frozen shoulder. METHODS This is a single-centre, prospective, single-blind, randomised controlled trial with three parallel groups to be conducted at Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria. Sixty diabetic patients with frozen shoulder will be randomly assigned into LLLT group, MET group, or control group in a 1:1:1 ratio. All the groups will receive treatment three times weekly for 8 weeks. The primary outcome will be shoulder function and the secondary outcomes will include pain intensity, shoulder ROM, interleukin-6 (IL-6), depression, anxiety, and quality of life (QoL). All outcomes will be assessed at baseline, at post 8-week intervention, and at 3 months follow-up. DISCUSSION This will be the first randomised controlled trial to evaluate the comparative effectiveness of LLLT versus MET on both clinical and psychological parameters among diabetic patients with frozen shoulder. The findings of the study may provide evidence on the efficacy of these interventions and most likely, the optimal treatment approach for frozen shoulder related to diabetes, which may guide clinical practice. TRIAL REGISTRATION Pan African Clinical Trials Registry (PACTR202208562111554). Registered on August 10, 2022.
Collapse
Affiliation(s)
- Halima I Hassan
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Kano State, Nigeria
- Department of Physiotherapy, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Bashir Kaka
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Kano State, Nigeria
- Division of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Nata, Westville, Durban, South Africa
| | - Fatima Bello
- Endocrinology Unit, Department of Internal Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Francis Fatoye
- Department of Health Professions, Faculty of Health, Psychology and Care, Manchester Metropolitan University, Manchester, UK
| | - Aminu A Ibrahim
- Department of Physiotherapy, School of Basic Medical Sciences, Skyline University Nigeria, Kano, Kano State, Nigeria.
| |
Collapse
|
2
|
Csonka V, Varjú C, Lendvay M. Diabetes mellitus-related musculoskeletal disorders: Unveiling the cluster of diseases. Prim Care Diabetes 2023; 17:548-553. [PMID: 37643934 DOI: 10.1016/j.pcd.2023.08.003] [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: 02/24/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
The current study ushers in a comprehensive review in clinical research to demonstrate the prevalence of musculoskeletal (MSK) complications in diabetes mellitus and the most relevant clinical aspects. In particular, revealing the early symptoms of the disorders, the pathology lurking behind the complications and their optimal management. In diabetes mellitus, MSK complications are common and are largely due to similar pathogenetic factors responsible for the internal organ complications associated with diabetes leading to chronic low-intensity inflammatory processes. MSK disorders develop by vasculopathy, neuropathy, arthropathy or combinations of the above, which are not specific to diabetes. However, their prevalence is significantly increased in diabetes and contributes to the disability impairing patients' quality of life. Locomotor disease affects approximately 34.4-83.5 % of patients suffering from type-2 diabetes mellitus. Several musculoskeletal abnormalities (cheiroarthropathy, Dupuytren's contracture, trigger finger, ect.) can be diagnosed upon physical examination, although certain symptoms (frozen shoulder, neurogenic arthropathy, septic arthritis, etc.) require differential diagnostic considerations. Early identification regarding characteristic symptoms in the treatment reducing inflammation and pain, followed with increasingly strenuous exercise therapy, aligned with optimal management of carbohydrate metabolism, proves essential in alleviating MSK complications.
Collapse
Affiliation(s)
- Viktória Csonka
- Department of Rheumatology, Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Cecília Varjú
- Department of Rheumatology and Immunology, Medical School, University of Pécs, Pécs, Hungary
| | - Marcell Lendvay
- Department of Rheumatology and Immunology, Medical School, University of Pécs, Pécs, Hungary.
| |
Collapse
|
3
|
Liaghat B, Folkestad L, Skou ST, Koes B, Stammerjohan AF, Hartvigsen J. Prevalence and consequences of spinal pain among people with type 1 and type 2 diabetes mellitus in Denmark. 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; 32:3744-3752. [PMID: 37659046 DOI: 10.1007/s00586-023-07911-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/30/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE To describe 1-week and 1-year prevalence of spinal pain and its consequences in relation to leisure activity, work-life, and care-seeking in people with type 1 and 2 diabetes mellitus (DM). METHODS A cross-sectional survey including adults diagnosed with DM from two Danish secondary care centres. Using the Standardised Nordic Questionnaire, spinal pain prevalence (cervical, thoracic, lumbar) and its consequences were evaluated (proportions, 95% confidence intervals) and compared to the general population. RESULTS Among 3767 people, 1-week and 1-year spinal pain prevalence were 11.6-32.4 and 18.5-49.6%, respectively, highest for lumbar pain (24.6-49.6%). The prevalence was similar between DM types for cervical and thoracic pain, but higher in type 2 for lumbar spine. Women had higher pain prevalence across spinal regions and DM types, while cervical and thoracic pain estimates were higher for age < 60 vs. ≥ 60. Within the past year, > 50% reported pain > 30 days, high proportions had reduced their activities (leisure time, 43.7-63.9%; work, 20.7-33.3%), 13.3-28.1% reported sick-leave > 30 days, and 44.3-48.5% had sought care due to spinal pain. CONCLUSION Spinal pain is common in people with type 1 and 2 DM, resulting in considerable consequences for work/leisure activities, sick-leave, and healthcare utilisation as compared to the general population.
Collapse
Affiliation(s)
- Behnam Liaghat
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
- Centre for Evidence-Based Orthopaedics, Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark.
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Exploratory Network, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Bart Koes
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
- Department of General Practice, Erasmus MC, Rotterdam, The Netherlands
| | - Amalie Frost Stammerjohan
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
| |
Collapse
|
4
|
Li S, Brimmers A, van Boekel RL, Vissers KC, Coenen MJ. A systematic review of genome-wide association studies for pain, nociception, neuropathy, and pain treatment responses. Pain 2023; 164:1891-1911. [PMID: 37144689 PMCID: PMC10436363 DOI: 10.1097/j.pain.0000000000002910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 05/06/2023]
Abstract
ABSTRACT Pain is the leading cause of disability worldwide, imposing an enormous burden on personal health and society. Pain is a multifactorial and multidimensional problem. Currently, there is (some) evidence that genetic factors could partially explain individual susceptibility to pain and interpersonal differences in pain treatment response. To better understand the underlying genetic mechanisms of pain, we systematically reviewed and summarized genome-wide association studies (GWASes) investigating the associations between genetic variants and pain/pain-related phenotypes in humans. We reviewed 57 full-text articles and identified 30 loci reported in more than 1 study. To check whether genes described in this review are associated with (other) pain phenotypes, we searched 2 pain genetic databases, Human Pain Genetics Database and Mouse Pain Genetics Database. Six GWAS-identified genes/loci were also reported in those databases, mainly involved in neurological functions and inflammation. These findings demonstrate an important contribution of genetic factors to the risk of pain and pain-related phenotypes. However, replication studies with consistent phenotype definitions and sufficient statistical power are required to validate these pain-associated genes further. Our review also highlights the need for bioinformatic tools to elucidate the function of identified genes/loci. We believe that a better understanding of the genetic background of pain will shed light on the underlying biological mechanisms of pain and benefit patients by improving the clinical management of pain.
Collapse
Affiliation(s)
- Song Li
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Coenen is now with the Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Annika Brimmers
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Coenen is now with the Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Regina L.M. van Boekel
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kris C.P. Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marieke J.H. Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Coenen is now with the Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
5
|
Yagci G, Benli AC, Erel S, Fenkci SM. Investigation of body awareness and body image perception in patients with type 2 diabetes mellitus. J Bodyw Mov Ther 2023; 35:108-113. [PMID: 37330754 DOI: 10.1016/j.jbmt.2023.04.051] [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: 01/05/2022] [Revised: 02/26/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES The purpose of the study is to investigate body awareness and body image perception of patients with type 2 diabetes mellitus (T2DM) and to explore the association between clinical parameters and body awareness. METHODS A total of 92 participants with T2DM (38 women and 54 men) aged 36-76 years were recruited. Biochemical measurements, including fasting blood glucose, postprandial blood glucose and hemoglobin A1c (HbA1c), were obtained from the patients' blood sample records. The Body Awareness Questionnaire (BAQ), Body Cathexis Scale (BCS) and Awareness Body Chart (ABC) were filled in by all subjects. RESULTS Most participants had an above-average BAQ (81.5%) and BCS (87%) score. There was a significant correlation between body mass index and ABC pain subscale. HbA1c was significantly associated with the duration of diabetes and sleep-wake cycle, process domains and total BAQ score. The body awareness score for the lower leg and foot regions (ABC parts) was negatively correlated with fasting blood glucose and HbA1c levels, while body awareness in the foot region was negatively correlated with the duration of diabetes. There was no association between BCS and any clinical parameters. CONCLUSION This study showed that body awareness is associated with diabetes-related clinical parameters, such as fasting blood glucose and HbA1c levels, and duration of diabetes in patients with T2DM. Following diabetes progression and an increase in blood glucose levels, body awareness tended to decrease, particularly in the lower leg and foot regions. These findings highlighted the importance of evaluating body awareness in patients with T2DM.
Collapse
Affiliation(s)
- Gozde Yagci
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Aysenur Canan Benli
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Suat Erel
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Semin Melahat Fenkci
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey; Division of Endocrinology and Metabolism, Department of Internal Medicine, Pamukkale University, School of Medicine, Denizli, Turkey
| |
Collapse
|
6
|
Mehta D, Sihota P, Tikoo K, Kumar S, Kumar N. Type 2 diabetes alters the viscoelastic behavior and macromolecular composition of vertebra. Bone Rep 2023; 18:101680. [PMID: 37187573 PMCID: PMC10176031 DOI: 10.1016/j.bonr.2023.101680] [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: 01/07/2023] [Revised: 04/01/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Type 2 diabetes (T2D) affects the functional behavior of vertebra bone by altering its structural and mechanical properties. The vertebral bones are responsible to carry the body weight and it remains under prolonged constant load which results to viscoelastic deformation. The effect of T2D on the viscoelastic behavior of vertebral bone is not well explored yet. In this study, the effects of T2D on the creep and stress relaxation behavior of vertebral bone are investigated. Also, this study established a correlation between T2D associated alteration in macromolecular structure and viscoelastic behavior of vertebra. In this study T2D female rat SD model was used. The obtained results demonstrated a significant reduction in the amount of creep strain (p ≤ 0.05) and stress relaxation (p ≤ 0.01) in T2D specimens than the control. Also, the creep rate was found significantly lower in T2D specimens. On the other hand, molecular structural parameters such as mineral-to-matrix ratio (control vs T2D: 2.93 ± 0.78 vs 3.72 ± 0.53; p = 0.02), and non-enzymatic cross link ratio (NE-xL) (control vs T2D: 1.53 ± 0.07 vs 3.84 ± 0.20; p = 0.01) were found significantly altered in T2D specimens. Pearson linear correlation tests show a significant correlation; between creep rate and NE-xL (r = -0.94, p < 0.01), and between stress relaxation and NE-xL (r = -0.946, p < 0.01). Overall this study explored the understanding about the disease associated alteration in viscoelastic response of vertebra and its correlation with macromolecular composition which can help to understand the disease related impaired functioning of the vertebrae body.
Collapse
Affiliation(s)
- Deepak Mehta
- Department of Mechanical Engineering Indian Institute of Technology Ropar, India
| | - Praveer Sihota
- Department of Mechanical Engineering Indian Institute of Technology Ropar, India
| | - Kulbhushan Tikoo
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research Mohali, India
| | - Sachin Kumar
- Department of Mechanical Engineering Indian Institute of Technology Ropar, India
- Corresponding authors.
| | - Navin Kumar
- Department of Mechanical Engineering Indian Institute of Technology Ropar, India
- Corresponding authors.
| |
Collapse
|
7
|
Liaghat B, Folkestad L, Skou ST, Koes B, Hartvigsen J. Prevalence and consequences of musculoskeletal pain in the upper and lower extremities: A cross-sectional analysis of patients with type 1 and type 2 diabetes in Denmark. Prim Care Diabetes 2023; 17:267-272. [PMID: 36890059 DOI: 10.1016/j.pcd.2023.02.003] [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: 11/05/2022] [Revised: 01/18/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
AIMS To describe the one-week and 12-month prevalence of musculoskeletal pain in the upper and lower extremities and consequences in relation to care seeking, leisure time activity, and work life in patients with type 1 and 2 diabetes. METHODS A cross-sectional survey including adults diagnosed with type 1 and 2 diabetes from two Danish secondary care databases. Questions covered pain prevalence (shoulder, elbow, hand, hip, knee, ankle) and its consequences based on the Standardised Nordic Questionnaire. Data was presented using proportions (95 % confidence intervals). RESULTS The analysis included 3767 patients. The one-week prevalence was 9.3-30.8 % and 12-month prevalence 13.9-41.8 %, highest for shoulder pain (30.8-41.8 %). The prevalence was similar between type 1 and 2 diabetes for the upper extremity, but higher in type 2 for the lower extremity. Women had a higher pain prevalence for any joint for both diabetes types, while estimates did not vary between age groups (<60 or ≥60 years). More than half of the patients had reduced their activities at work or leisure time, and more than one-third had sought care during the past year because of pain. CONCLUSIONS Musculoskeletal pain in the upper and lower extremities is common in patients with type 1 and 2 diabetes from Denmark, with considerable consequences for work and leisure activities.
Collapse
Affiliation(s)
- Behnam Liaghat
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Centre for Evidence-Based Orthopaedics, Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark.
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient Exploratory Network, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Bart Koes
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of General Practice, Erasmus MC, Rotterdam, the Netherlands
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Chiropractic Knowledge Hub, Odense, Denmark
| |
Collapse
|
8
|
Oyewole OO, Ale AO, Ogunlana MO, Gurayah T. Burden of disability in type 2 diabetes mellitus and the moderating effects of physical activity. World J Clin Cases 2023; 11:3128-3139. [PMID: 37274052 PMCID: PMC10237122 DOI: 10.12998/wjcc.v11.i14.3128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/02/2023] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
The growing diabetic epidemic has created a substantial burden, not only on the people with diabetes but also on society at large. This mini-review discussed the limitations and patterns of disability in type 2 diabetes mellitus and put forward a case for the moderating effects of physical activity (PA) in the management of diabetes. The limitations and impairments associated with diabetes include vascular, neurological, cardiac, and renal impairments. Moreover, individuals participate less in their daily lives and in their instrumental activities of daily living, which negatively impacts the quality of life of individuals with diabetes. This often leads to a loss of quality of life due to disabilities, resulting in an increased rate of disability-adjusted life years among people with type 2 diabetes mellitus. Moreover, there are psychosocial sequelae of diabetes mellitus. This necessitates looking for moderating factors that may reduce the burden of the disease. PA has been shown to be one of the factors that can mitigate these burdens. PA does this in several ways, including through the benefits it confers, such as a reduction of hemoglobin A1c, a reduction of excess fat in the liver and pancreas, and the reduction of cardiovascular risk factors, all of which favorably affect glycemic parameters. Specifically, PA regulates or moderates diabetes disability through two mechanisms: The regulation of glucolipid metabolism disorders and the optimization of body mass index and systemic conditions. Therefore, efforts should be directed at PA uptake through identified strategies. This will not only prevent diabetes or diabetes complications but will reduce its burden.
Collapse
Affiliation(s)
- Olufemi O Oyewole
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu 201101, Ogun, Nigeria
- College of Health Sciences, University of KwaZulu-Natal, Durban 3629, South Africa
| | - Ayotunde O Ale
- Department of Medicine, Olabisi Onabanjo University, Sagamu 121101, Ogun, Nigeria
- Department of Endocrinology, Diabetes and Metabolism Unit, Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu 121101, Ogun, Nigeria
| | - Michael O Ogunlana
- College of Health Sciences, University of KwaZulu-Natal, Durban 3629, South Africa
- Department of Physiotherapy, Federal Medical Centre, Abeokuta 110101, Ogun, Nigeria
| | - Thavanesi Gurayah
- Occupational Therapy, School of Health Sciences, University of Kwazulu Natal, Private Bag X54001, Durban, 4000
| |
Collapse
|
9
|
Pinhal KC, Figueiredo PS, De Oliveira VC, Gomes WF, Pernambuco AP, Alcantara MA. Functional decline in people with diabetes: Bidirectional relationships between body function and activity-participation components in a two-wave longitudinal structural equation modeling. Physiother Theory Pract 2023; 39:598-606. [PMID: 35057703 DOI: 10.1080/09593985.2021.2023923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the impact of diabetes over time. The sample included 68 people with diabetes used a three-year longitudinal design to test a model of functional decline. Indicators of the body function and activity and participation components of the International Classification of Functioning, Disability and Health (ICF) were derived from the Nordic Musculoskeletal Questionnaire, World Health Organization Quality of Life-Brief version (WHOQOL-BREF), and Participation Scale. On the basis of the ICF framework, it is hypothesized and found that there is an interaction between the body function and the activity and participation components, which, in turn, are predictors of future functional capability. The structural equation analyses confirmed that at both T1 and T2 pain measures are associated with physical, psychological, and social functioning; environmental factors mediate the relationship between these two constructs. Moreover, the activity and participation component at T1 predicted the body function component at T2. The main finding suggests that functional consequences of diabetes are complex and multifactorial. The significant functional decline in people with diabetes in just three years is worrying. The theoretical and practical implications of these findings are discussed.
Collapse
Affiliation(s)
- Kaio C Pinhal
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Pedro S Figueiredo
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil.,Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Vinícius C De Oliveira
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil.,Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Wellington F Gomes
- Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Andrei P Pernambuco
- Department of Physiotherapy, Centro Universitário de Formiga (Unifor-mg), Formiga, Minas Gerais, Brazil
| | - Marcus A Alcantara
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil.,Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| |
Collapse
|
10
|
Dzakpasu FQS, Koster A, Owen N, Galan BED, Carver A, Brakenridge CJ, Boonen A, Bosma H, Dagnelie PC, Eussen SJPM, Sethi P, Stehouwer CDA, Schaper NC, Dunstan DW. Device-measured sitting time and musculoskeletal pain in adults with normal glucose metabolism, prediabetes and type 2 diabetes-The Maastricht Study. PLoS One 2023; 18:e0285276. [PMID: 37141228 PMCID: PMC10159126 DOI: 10.1371/journal.pone.0285276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/18/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Detrimental associations of sedentary behaviour (time spent sitting) with musculoskeletal pain (MSP) conditions have been observed. However, findings on those with, or at risk of, type 2 diabetes (T2D) have not been reported. We examined the linear and non-linear associations of device-measured daily sitting time with MSP outcomes according to glucose metabolism status (GMS). METHODS Cross-sectional data from 2827 participants aged 40-75 years in the Maastricht Study (1728 with normal glucose metabolism (NGM); 441 with prediabetes; 658 with T2D), for whom valid data were available on activPAL-derived daily sitting time, MSP [neck, shoulder, low back, and knee pain], and GMS. Associations were examined by logistic regression analyses, adjusted serially for relevant confounders, including moderate-to-vigorous intensity physical activity (MVPA) and body mass index (BMI). Restricted cubic splines were used to further examine non-linear relationships. RESULTS The fully adjusted model (including BMI, MVPA, and history of cardiovascular disease) showed daily sitting time to be significantly associated with knee pain in the overall sample (OR = 1.07, 95%CI: 1.01-1.12) and in those with T2D (OR = 1.11, 95%CI: 1.00-1.22); this was not statistically significant in those with prediabetes (OR = 1.04, 95%CI: 0.91-1.18) or NGM (OR = 1.05, 95%CI: 0.98-1.13). There were no statistically significant associations between daily sitting time and neck, shoulder, or low back pain in any of the models. Furthermore, the non-linear relationships were statistically non-significant. CONCLUSION Among middle-aged and older adults with T2D, daily sitting time was significantly associated with higher odds of knee pain, but not with neck, shoulder, or low back pain. No significant association was observed in those without T2D for neck, shoulder, low back, or knee pain. Future studies, preferably those utilising prospective designs, could examine additional attributes of daily sitting (e.g., sitting bouts and domain-specific sitting time) and the potential relationships of knee pain with mobility limitations.
Collapse
Affiliation(s)
- Francis Q S Dzakpasu
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Neville Owen
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Alison Carver
- National Centre for Healthy Ageing, Peninsula Clinical School, Monash University, Frankston, Victoria, Australia
| | - Christian J Brakenridge
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Annelies Boonen
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Parneet Sethi
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - David W Dunstan
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
11
|
Prather H, Fogarty AE, Cheng AL, Wahl G, Hong B, Hunt D. Feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions in the setting of lifestyle-related chronic disease. PM R 2023; 15:41-50. [PMID: 34713577 PMCID: PMC9046467 DOI: 10.1002/pmrj.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lifestyle factors are associated with musculoskeletal pain and metabolic chronic diseases. To date, intensive lifestyle medicine programs have predominantly targeted metabolic rather than musculoskeletal conditions. OBJECTIVE To assess the feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions. DESIGN Prospective observational feasibility study. SETTING Tertiary academic medical center. PATIENTS Adults diagnosed with musculoskeletal condition(s) and lifestyle-related chronic disease(s) who previously completed standard-of-care musculoskeletal treatments, enrolled from 2018 to 2020. INTERVENTIONS Patients enrolled in an intensive interprofessional lifestyle medicine program led by a physiatrist, with options to interface with an acupuncturist, dietician, massage therapist, psychologist, physical therapist, and smoking cessation specialist. The physiatrist engaged in shared decision making with patients to establish program goals related to function, overall health, and required lifestyle changes. Bimonthly interprofessional team conferences facilitated communication between treatment team and patients. MAIN OUTCOME MEASURES Feasibility was measured by patient participation and goal attainment. Secondary outcomes included changes from program enrollment to discharge in patient anthropometric, metabolic lab, sleep apnea risk, and Patient-Reported Outcomes Measurement Information System (PROMIS) function, pain, and behavioral health measures. RESULTS Twenty-six patients enrolled in the program (18 [69%] female, mean age 59 [SD 14.5] years, baseline hemoglobin A1c 6.0% [0.8%], high-sensitivity C-reactive protein 7.7 [12.1] mg/dL, 25-hydroxy vitamin D 32.0 [14.2] ng/mL). Of 21 (81%) patients who completed the program, 13/21 (62%) met their goal. On average, program completers presented for 26.2 (10.6) total visits over 191 (88) days. By discharge, program completers achieved clinically meaningful improvement in PROMIS Anxiety (mean difference -3.5 points, 95% confidence interval [-6.5 to 0.5], p = .035), whereas noncompleters did not (p > .05). CONCLUSIONS An intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions is feasible. With training in lifestyle intervention, physiatrists are well suited to lead interprofessional teams aimed at assisting patients in making lifestyle changes to achieve personalized function- and health-related goals.
Collapse
Affiliation(s)
- Heidi Prather
- Department of Physiatry, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - Alexandra E Fogarty
- Department of Neurology, Division of Physical Medicine & Rehabilitation, St. Louis, Missouri, USA
| | - Abby L Cheng
- Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation; Department of Surgery, Division of Public Health Sciences, Chesterfield, Missouri, USA
| | - Garett Wahl
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Barry Hong
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Devyani Hunt
- Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
12
|
Jiménez-García R, López-de-Andrés A, de Miguel-Diez J, Zamorano-León JJ, Carabantes-Alarcón D, Noriega C, Cuadrado-Corrales N, Pérez-Farinos N. Time Trends and Sex Differences in the Association between Diabetes and Chronic Neck Pain, Chronic Low Back Pain, and Migraine. Analysis of Population-Based National Surveys in Spain (2014-2020). J Clin Med 2022; 11:jcm11236953. [PMID: 36498528 PMCID: PMC9739053 DOI: 10.3390/jcm11236953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: To assess the time trend in the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine or frequent headache (MFH) among people with diabetes in Spain from 2014 to 2020, this study identified sex differences and compared the prevalence of these pain sites between people with diabetes and age−sex-matched non-diabetic subjects. (2) Methods: The study design included a cross-sectional and a case−control study. The data were obtained from the European Health Interview Surveys for Spain conducted in 2014 and 2020. The presence of diabetes, CNP, CLBP, and MFH was self-reported. Study covariates included sociodemographic characteristics, comorbidities, lifestyles, and pain-related variables. (3) Results: Among people with diabetes, the prevalence of CNP, CLBP, and MFH did not improve from 2014 to 2020. Women with diabetes had a significantly higher prevalence of all the pain sites analyzed than men with diabetes. After matching by sex and age, the prevalence of CNP (26.0% vs. 21.1%; p < 0.001), CLBP (31.2% vs. 25.0%; p < 0.001), and MFH (7.7% vs. 6.5%; p = 0.028) was higher for people with diabetes than for those without diabetes. Self-reported mental disease was independently associated with reporting the three pain sites analyzed in people with diabetes. (4) Conclusions: The prevalence of CNP, CLBP, and MFH has remained stable over time. Remarkable sex differences were found, with a higher prevalence among women than men with diabetes. Diabetes was associated with reporting in all the pain sites analyzed. Self-reported mental disease was associated with reporting CNP, CLBP, and MFH.
Collapse
Affiliation(s)
- Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913-941-520
| | - Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain
| | - José J. Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Concepción Noriega
- Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Napoleón Pérez-Farinos
- Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Málaga, 29016 Málaga, Spain
| |
Collapse
|
13
|
Habechian FAP, Flores Quezada ME, Cools AM, Kjaer BH, Cuevas Cid RI, Zanca GG. Shoulder-specific rehabilitation combined with aerobic exercises versus solely shoulder-specific rehabilitation in patients with type 2 diabetes mellitus: study protocol for a randomized controlled superiority trial. Trials 2022; 23:678. [PMID: 35978380 PMCID: PMC9387007 DOI: 10.1186/s13063-022-06647-5] [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: 11/22/2021] [Accepted: 08/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Musculoskeletal disorders are very common in patients with diabetes mellitus (DM). The upper limb is one of the regions that is most frequently affected generally presenting limited joint mobility, pain, and a decreased muscle strength. Most clinical trials with a focus on shoulder musculoskeletal rehabilitation are carried out in patients who do not present DM. Thus, the purpose of the present study is to compare the effects of two distinct treatment protocols (conventional shoulder musculoskeletal rehabilitation combined with aerobic exercises versus solely conventional shoulder musculoskeletal rehabilitation) on shoulder pain, function, strength, kinematics, and supraspinatus tendon thickness in patients with type 2 DM after 12 weeks of intervention and a subsequent follow-up at week 20. Methods A randomized controlled superiority trial will be conducted. Participants with a clinical diagnosis of type 2 DM of both sexes, age between 40 and 70 years, presenting shoulder pain will be randomly assigned to one of the following groups: (1) conventional shoulder musculoskeletal rehabilitation combined with aerobic exercises; (2) solely conventional shoulder musculoskeletal rehabilitation. All individuals will be evaluated before starting the treatment protocol (baseline) and at the end of treatment (post 12 weeks) and as a follow-up at 20 weeks. The shoulder function assessed by the SPADI (Shoulder Pain and Disability Index) questionnaire will be considered as primary outcome; the secondary outcome will be shoulder pain, measured with NPRS scales. Other outcomes will include range of motion, measured using a digital inclinometer; isometric shoulder muscle strength, measured using a manual muscle dynamometer; shoulder kinematics, measured using three-dimensional inertial units measurement; supraspinatus tendon thickness, measured using an ultrasound; AGE accumulation, using a skin autofluorescence measurement; and HbA1c (hemoglobin a1c), fasting glucose and lipid profile measured by a simple blood test. Discussion DM is a highly prevalent disease and a public health problem worldwide, and the upper extremity musculoskeletal disorders in DM are barely recognized and largely underestimated. In this way, it would be interesting to analyze if the combination of aerobic exercises with conventional musculoskeletal rehabilitation protocols could generate better results in the functionality, pain, mobility and an improvement in the biochemical aspects related to the hyperglycemia of these patients compared to solely the conventional musculoskeletal rehabilitation. Trial registration ClinicalTrials.gov NCT04817514. Registered on March 26, 2021.
Collapse
Affiliation(s)
- Fernanda A P Habechian
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Casa Central: Avda. San Miguel, 3605, Talca, Chile.
| | - Mauricio E Flores Quezada
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Casa Central: Avda. San Miguel, 3605, Talca, Chile
| | - Ann M Cools
- Faculty Medicine and Health Sciences, Department of Rehabilitation Science and Physiotherapy, Ghent University, Campus Heymans (UZ Ghent), Building B3 - Second floor, De Pintelaan 185, 9000, Ghent, Belgium
| | - Birgitte Hougs Kjaer
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospitals, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark
| | - Rodrigo I Cuevas Cid
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Casa Central: Avda. San Miguel, 3605, Talca, Chile
| | - Gisele G Zanca
- Postgraduate Program in Aging Sciences and Postgraduate Program in Physical Education, São Judas Tadeu University, Rua Taquari, 546. Mooca, São Paulo, 03166-000, Brazil
| |
Collapse
|
14
|
Heikkala E, Hagnäs M, Jokelainen J, Karppinen J, Ferreira P, Ferreira ML, Mikkola I. Association of musculoskeletal pain with the achievement of treatment targets for type 2 diabetes among primary care patients. Prim Care Diabetes 2022; 16:531-536. [PMID: 35523651 DOI: 10.1016/j.pcd.2022.04.006] [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: 11/18/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
AIMS To assess the association of diagnosed musculoskeletal (MS) pain (low back, neck, shoulder, and knee pain; and the number of pain sites) with the achievement of targets for glycosylated haemoglobin A1c (HbA1c), low-density-lipoprotein cholesterol (LDL), and systolic blood pressure (SBP) among primary care patients with type 2 diabetes (T2D). METHODS The cross-sectional study population consisted of 3478 patients with a registry-based T2D diagnosis and available registry-based data on MS pain diagnoses, covariates, and outcomes between 2016 and 2019. Logistic regression analysis was used to evaluate the study aims. RESULTS Overall, 22% had at least one of the four types of MS pain, and 73%, 57%, and 51% achieved the treatment targets of HbA1c, LDL, and SBP, respectively. T2D patients with or without MS pain did not differ in their achievement of T2D treatment goals. Of pain locations, low back pain was associated with higher rates of achievement of the LDL target (OR 1.29, 95% CI 1.01-1.65), but the association was attenuated in the adjusted model. CONCLUSIONS MS pain was relatively prevalent among primary care patients with T2D, but did not influence the achievement of T2D treatment goals.
Collapse
Affiliation(s)
- Eveliina Heikkala
- Rovaniemi Health Center, Rovaniemi, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Maria Hagnäs
- Rovaniemi Health Center, Rovaniemi, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland; Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Paulo Ferreira
- School of Health Sciences, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- Faculty of Medicine and Health, Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia
| | | |
Collapse
|
15
|
Causes of Shoulder Dysfunction in Diabetic Patients: A Review of Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106228. [PMID: 35627764 PMCID: PMC9140829 DOI: 10.3390/ijerph19106228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 12/15/2022]
Abstract
Objective: Understanding the underlying mechanisms behind shoulder dysfunctions in patients with diabetes mellitus. Study Design: Systematic qualitative literature review. Participants: Patients with shoulder dysfunctions and diagnosed with impaired glucose tolerance or diabetes mellitus. Intervention: Published scientific literature containing evidence about the mechanisms of shoulder dysfunctions in the diabetic population. Articles were selected based on criteria containing diabetic population, shoulder dysfunction, methodological quality ≥ 6/9 and >20 subjects. Main Outcome measures: range of motion; questionnaires (QoL, UCLA-m, SPADI, DASH); blood glucose, blood HbA1C; calculated capsular stiffness (Kcap); calcification shoulder joint; shoulder dysfunction in patients with glucose metabolism disorders and diabetes mellitus. Results: We found 17 published articles with level 2 and 3 evidence. Multiple factors such as age, duration of diabetes mellitus (DM), glycated hemoglobin (HbA1c), advanced glycation end products (AGE), vascular endothelial growth factor (VEGF), interleukin-1ß (IL-1ß) were shown to be associated with tendon changes and increased capsular stiffness (Kcap) conceivably leading to limited range of motion (ROM) or frozen shoulder. Decreased ROM and frozen shoulder have a significantly higher prevalence in DM than in non-DM. Conclusions: Based on the current literature we confirm a high prevalence of shoulder dysfunctions in patients with diabetes mellitus. The cause of the shoulder complications is unknown, and more research is mandatory to shed more light on the complex interplay between the multifactorial causes of shoulder dysfunction in diabetes mellitus.
Collapse
|
16
|
Wooldridge JS, Soriano EC, Harris DE, Afari N. Feasibility and Acceptability of Ecological Momentary Assessment of Psychosocial Factors and Self-Management Behaviors Among Veterans With Type 2 Diabetes. Diabetes Spectr 2022; 35:76-85. [PMID: 35308149 PMCID: PMC8914587 DOI: 10.2337/ds21-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Comorbid symptoms such as post-traumatic stress and pain are common barriers to optimal self-management among veterans with type 2 diabetes. Additionally, self-management behaviors occur in the context of veterans' daily routines and social environments. This study evaluated the feasibility and acceptability of ecological momentary assessment (EMA) among veterans with type 2 diabetes. Ten veterans with type 2 diabetes were asked to respond to random EMA surveys during preprogrammed intervals five times per day for 14 days. EMA surveys were delivered via a mobile application and assessed momentary physical location, activities, social interactions, mood, stress, and pain. The last survey of each day included additional items about daily post-traumatic stress symptoms, diabetes distress, social support, physical activity, self-management behaviors, and functioning. Participants completed interviews assessing their experience in the study and barriers to responding and indicated their likelihood of participating in similar studies. The mean survey response rate was 96%, providing 675 observations. The majority of participants completed the five momentary surveys in <1 minute and the daily EMA surveys in <5 minutes. Results revealed substantial individual day-to-day variability across symptoms and self-management behaviors that is not captured by aggregated means across all participants. Participants generally reported enjoying responding to surveys and experiencing few barriers. Nine of 10 participants reported being "extremely likely" to participate in a similar study. These pilot data suggest that intensive EMA designs are feasible and acceptable for veterans with type 2 diabetes and can inform the design of future larger studies.
Collapse
Affiliation(s)
- Jennalee S. Wooldridge
- VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Center of Excellence for Stress and Mental Health, San Diego, CA
- Corresponding author: Jennalee S. Wooldridge,
| | - Emily C. Soriano
- VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE
| | | | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Center of Excellence for Stress and Mental Health, San Diego, CA
| |
Collapse
|
17
|
Motives and Barriers to Exercise Training during Hospitalization in Patients with Type 2 Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031035. [PMID: 35162066 PMCID: PMC8834091 DOI: 10.3390/ijerph19031035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022]
Abstract
Background: Exercise training during hospitalization may prevent loss of physical function and hyperglycemia in patients with type 2 diabetes. The aim of this study was to assess motives and barriers to exercise training in hospitalized patients with type 2 diabetes. Methods: Data were collected using a questionnaire about motives and barriers to exercise training during hospitalization. Additional data for clinical characteristics of the participants were collected from patient records. Results: 79 patients participated (mean ± SD age 72 ± 12 years; 42% women), of whom 25% had a low level of education and 46% lived alone. The median (IQR) length of the stay was 6 (4–10) days. A total of 67% of the participants wished to be more physically active. Walking as exercise was preferred by 51%. The most frequently reported barriers to exercise training were bodily pain (48%) and dizziness (42%). Low vs. high level of education, and living alone vs. being married/living with a partner were associated with reduced odds of a wish to be more physically active, odds ratio (OR) 0.15 [95% CI 0.03; 0.76], p = 0.022, and 0.21 [0.05; 0.82], p = 0.025, respectively. Conclusion: Two out of three hospitalized patients with type 2 diabetes wished to be more physically active during admission. Bodily pain was a barrier to exercise training and needs attention in training programs. As a low level of education was associated with reduced odds of a wish to be more active, a strategy to include all patients in training programs which considers social inequality is needed.
Collapse
|
18
|
Kumar R, Laisram N, Jain N. A prospective study to determine the effect of Vitamin D levels on musculoskeletal pain, anxiety, and depressions in patients with type II diabetes. INDIAN JOURNAL OF PAIN 2022. [DOI: 10.4103/ijpn.ijpn_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
19
|
Molsted S, Jensen TM, Larsen JS, Olesen LB, Eriksen SBM, Rehling T, Rasmussen SS, Aadahl M. Changes of Physical Function and Quality of Life in Patients with Type 2 Diabetes after Exercise Training in a Municipality or a Hospital Setting. J Diabetes Res 2022; 2022:5751891. [PMID: 35083337 PMCID: PMC8786509 DOI: 10.1155/2022/5751891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim was to compare changes in physical function and quality of life (QOL) after an exercise training programme to patients with type 2 diabetes mellitus (T2DM) in a municipality and a hospital setting and to compare the patients' physical function and QOL with an age- and sex-matched general population. METHODS Patients with T2DM were stratified to exercise training in a municipality (n = 26) or a hospital (n = 46), respectively. The training was one hour twice weekly for 12 weeks. The outcomes were physical function (30 sec chair stand test (CST)) and QOL (using the SF-36). The data for the general population were collected from previous reference studies. RESULTS Fifty-one (71%) participants completed the intervention. The CST results improved in both groups with no difference between the municipality and hospital groups (1.6 [0.1; 3.1] vs. 3.5 [2.3; 4.8] no., respectively, p = 0.062). The QOL scales physical function and general health increased more in the municipality group than in the hospital group (10.5 [2.8; 18.2] vs. -1.2 [-7.9; 5.5], respectively, p = 0.031, and 8.3 [2.3; 14.4] vs. -0.2 [-5.6; 5.1], respectively, p = 0.042). Dropout (n = 21) during the intervention was associated with reduced QOL at baseline. The patients' CST results at baseline were reduced compared to the general population (11.8 ± 3.5vs.18.9 ± 3.3, respectively, p < 0.001). All QOL scales apart from social function were reduced in the patients compared to the general population. CONCLUSION Patients in a 12-week exercise training programme in a hospital or a municipality setting had significantly lower QOL compared to an age- and sex-matched population sample. Similar improvements in physical function were observed in patients after completion of the exercise programme irrespective of exercise setting, whereas patient exercising in a municipality setting had higher positive changes in QOL than patients undergoing the same exercise programme in a hospital setting.
Collapse
Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Trine Munk Jensen
- Department of Clinical Research, Nordsjællands Hospital, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | | | | | - Thomas Rehling
- Department of Physiotherapy, Nordsjællands Hospital, Denmark
| | | | - Mette Aadahl
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Centre for Clinical Research and Prevention, Frederiksberg-Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
20
|
Real-Time Tracking of Human Neck Postures and Movements. Healthcare (Basel) 2021; 9:healthcare9121755. [PMID: 34946481 PMCID: PMC8702106 DOI: 10.3390/healthcare9121755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/11/2021] [Accepted: 12/16/2021] [Indexed: 11/25/2022] Open
Abstract
Improper neck postures and movements are the major causes of human neck-related musculoskeletal disorders. To monitor, quantify, analyze, and detect the movements, remote and non-invasive based methods are being developed for prevention and rehabilitation. The purpose of this research is to provide a digital platform for analyzing the impact of human neck movements on the neck musculoskeletal system. The secondary objective is to design a rehabilitation monitoring system that brings accountability in the treatment prescribed, which is shown in the use-case model. To record neck movements effectively, a Smart Neckband integrated with the Inertial Measurement Unit (IMU) was designed. The initial task was to find a suitable position to locate the sensors embedded in the Smart Neckband. IMU-based real-world kinematic data were captured from eight research subjects and were used to extract kinetic data from the OpenSim simulation platform. A Random Forest algorithm was trained using the kinetic data to predict the neck movements. The results obtained correlated with the novel idea proposed in this paper of using the hyoid muscles to accurately detect neck postures and movements. The innovative approach of integrating kinematic data and kinetic data for analyzing neck postures and movements has been successfully demonstrated through the efficient application in a rehabilitation use case with about 95% accuracy. This research study presents a robust digital platform for the integration of kinematic and kinetic data that has enabled the design of a context-aware neckband for the support in the treatment of neck musculoskeletal disorders.
Collapse
|
21
|
Kamiab Z, Shafaee N, Askar PS, Abbasifard M. Prevalence and Prevention of Rheumatologic Manifestations and their Relationship with Blood Glucose Control in Patients with Type II Diabetes. Int J Prev Med 2021; 12:142. [PMID: 34912518 PMCID: PMC8631128 DOI: 10.4103/ijpvm.ijpvm_369_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Musculoskeletal disorders in diabetic patients are associated with pain and disability, and thus, a significant reduction in quality of life. The current study was conducted with the aim of evaluating the frequency and prevention of rheumatologic manifestations and their association with blood glucose levels in diabetic patients. Methods: In this cross-sectional study, a total of 273 patients with type II diabetes, referred to the diabetes clinic, were selected by using the census method. Using a checklist, demographic, and clinical data, including duration of diabetes, blood glucose level, HbA1c, type of diabetes, BMI, history of smoking, blood pressure, serum cholesterol level, triglyceride, HDL, LDL, and musculoskeletal disorder type were analyzed using SPSS20 software application using independent t-test. Modeling was performed to obtain the best fit using logistic regression. The significance level was considered less than 0.05. Results: 62.6% of patients had at least one of the rheumatologic complications. The most common complication was related to carpal tunnel syndrome (26.4%), followed by muscle contraction (23.8%). By moderating the effects of other variables, the odds ratio for rheumatoid complications was obtained as 1.74 with one unit of increase in HbA1c, which was statistically significant. In examining the influential variables, high age, gender, smoking, and BMI showed statistically significant effects (). Conclusions: Given the high prevalence of musculoskeletal disorders in diabetic patients, early diagnosis and timely treatment of the complications are crucial. It is recommended that musculoskeletal examinations be included as an important part of regular care for these patients.
Collapse
Affiliation(s)
- Zahra Kamiab
- Department of Family Medicine, School of Medicine, Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Negar Shafaee
- General Physician, Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Poya Saied Askar
- Medical Student, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mitra Abbasifard
- Department of Internal Medicine, School of Medicine; Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| |
Collapse
|
22
|
Dzakpasu FQS, Carver A, Brakenridge CJ, Cicuttini F, Urquhart DM, Owen N, Dunstan DW. Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis. Int J Behav Nutr Phys Act 2021; 18:159. [PMID: 34895248 PMCID: PMC8666269 DOI: 10.1186/s12966-021-01191-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/23/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions. METHODS Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies' risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review. RESULTS Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP - OR = 1.19(1.03 - 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 - 1.92)] and neck/shoulder pain [OR = 1.73(1.46 - 2.03)], but not with extremities pain [OR = 1.17(0.65 - 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting. CONCLUSIONS We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases. PROTOCOL REGISTRATION PROSPERO ID # CRD42020166412 (Amended to limit the scope).
Collapse
Affiliation(s)
- Francis Q S Dzakpasu
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia.
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
| | - Alison Carver
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Christian J Brakenridge
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Flavia Cicuttini
- Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Donna M Urquhart
- Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Neville Owen
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David W Dunstan
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| |
Collapse
|
23
|
Broz K, Walk RE, Tang SY. Complications in the spine associated with type 2 diabetes: The role of advanced glycation end-products. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021; 11. [PMID: 35992525 PMCID: PMC9390092 DOI: 10.1016/j.medntd.2021.100065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes mellitus (T2D) is an increasingly prevalent disease with numerous comorbidities including many in the spine. T2D is strongly linked with vertebral fractures, intervertebral disc (IVD) degeneration, and severe chronic spinal pain. Yet the causative mechanism for these musculoskeletal impairments remains unclear. The chronic hyperglycemic state in T2D promotes the formation of advanced glycation end-products (AGEs) in tissues, and the accumulation of AGEs may play a role in musculoskeletal complications by modifying the extracellular matrix, impairing cellular homeostasis, and perpetuating an inflammatory cascade via its receptor (RAGE). The AGE and RAGE associated alterations in extracellular matrix composition and morphological features of the vertebral bodies and IVDs are likely contributors to the incidence and severity of spinal pathologies in T2D. This review will broadly examine the effects of AGEs on tissues in the spine in the context of T2D, with an emphasis on the changes in the vertebrae and the IVD. Along with the clinical and epidemiological findings, we will provide an overview of preclinical rodent models of T2D that exhibit deficits in the IVD and vertebral bone. Elucidating the role of AGEs and RAGE will be crucial for understanding the disease mechanisms and translation therapies of musculoskeletal pathologies in T2D.
Collapse
Affiliation(s)
- Kaitlyn Broz
- Institute of Material Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Remy E. Walk
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Simon Y. Tang
- Institute of Material Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA
- Corresponding author. Department of Orthopaedic Surgery, Washington University in St. Louis, School of Medicine, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO, 63110, USA. (S.Y. Tang)
| |
Collapse
|
24
|
Meng W, Chan BW, Harris C, Freidin MB, Hebert HL, Adams MJ, Campbell A, Hayward C, Zheng H, Zhang X, Colvin LA, Hales TG, Palmer CNA, Williams FMK, McIntosh A, Smith BH. A genome-wide association study finds genetic variants associated with neck or shoulder pain in UK Biobank. Hum Mol Genet 2021; 29:1396-1404. [PMID: 32246137 PMCID: PMC7254846 DOI: 10.1093/hmg/ddaa058] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/19/2022] Open
Abstract
Background Common types of musculoskeletal conditions include pain in the neck and shoulder areas. This study seeks to identify the genetic variants associated with neck or shoulder pain based on a genome-wide association approach using 203 309 subjects from the UK Biobank cohort and look for replication evidence from the Generation Scotland: Scottish Family Health Study (GS:SFHS) and TwinsUK. Methods A genome-wide association study was performed adjusting for age, sex, BMI and nine population principal components. Significant and independent genetic variants were then sent to GS:SFHS and TwinsUK for replication. Results We identified three genetic loci that were associated with neck or shoulder pain in the UK Biobank samples. The most significant locus was in an intergenic region in chromosome 17, rs12453010, having P = 1.66 × 10−11. The second most significant locus was located in the FOXP2 gene in chromosome 7 with P = 2.38 × 10−10 for rs34291892. The third locus was located in the LINC01572 gene in chromosome 16 with P = 4.50 × 10−8 for rs62053992. In the replication stage, among four significant and independent genetic variants, rs2049604 in the FOXP2 gene and rs62053992 in the LINC01572 gene were weakly replicated in GS:SFHS (P = 0.0240 and P = 0.0202, respectively). Conclusions We have identified three loci associated with neck or shoulder pain in the UK Biobank cohort, two of which were weakly supported in a replication cohort. Further evidence is needed to confirm their roles in neck or shoulder pain.
Collapse
Affiliation(s)
- Weihua Meng
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Brian W Chan
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Cameron Harris
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, SE1 7EH, UK
| | - Harry L Hebert
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Mark J Adams
- Division of Psychiatry, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Hua Zheng
- Department of Anaesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xianwei Zhang
- Department of Anaesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lesley A Colvin
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Tim G Hales
- Institute for Academic Anaesthesia, Division of Systems Medicine, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, UK
| | - Colin N A Palmer
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, SE1 7EH, UK
| | - Andrew McIntosh
- Division of Psychiatry, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Blair H Smith
- Division of Population Health and Genomics, Medical Research Institute, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| |
Collapse
|
25
|
Shahid S, Akhter Z, Sukaina M, Sohail F, Nasir F. Association of Diabetes With Lower Back Pain: A Narrative Review. Cureus 2021; 13:e15776. [PMID: 34295586 PMCID: PMC8291343 DOI: 10.7759/cureus.15776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus with its increasing prevalence is one of the four major non-communicable diseases. It is characterized by hyperglycemia, which may progress to chronic complications such as peripheral vascular disease and neuropathy. This paper highlights the pathophysiology associated with diabetes, which is restricted to not only hyperglycemia but also other comorbidities including chronic lower back pain. Diabetes is a metabolic disorder associated with hypercholesteremia, hypertriglyceridemia, and hypertension. This chain of events leads to free plasma fatty acids and a pro-inflammatory state, therefore promoting calcification of blood vessels, which may block the blood supply to vertebral discs and thereby increase vulnerability in the patients with ongoing inflammatory disease such as osteoarthritis and also causing costochondritis. Functional limitation due to increased load on the weight-bearing joints is a common mechanical complication of diabetes. Obesity in diabetes is more prevalent due to a disturbed metabolism, which is aggravated with a persistent inflammatory state. Moreover, the aim of this review is to encourage further conduction of clinical studies to explore the definite cause and potential therapy for chronic lower back pain in diabetes, thereby investigating the association of lipid metabolism and skeletal muscle atrophy leading to chronic back pain, the role of diabetic medications, and vulnerability in the female gender. Diminished physical activity and depression in diabetic patients disrupt the hypothalamic-pituitary-adrenal axis (HPA), which further contributes to lower back pain. Further clinical investigation and research in this regard will establish substantial data for the linkage between depression in diabetes and back pain. However, despite all the advancements of medical literature, the exact cause of lower back pain in diabetes is arguable. Pain impedes the health status and life quality; therefore, it is essential to maintain the quality of health in patients with diabetes by treating not only hyperglycemia but also other multifactorial causes leading to lower back pain.
Collapse
Affiliation(s)
- Shehroz Shahid
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Zohaib Akhter
- Department of Clinical Trials Unit, University of York, York, GBR
| | - Mahnoor Sukaina
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Fatima Sohail
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Faseeha Nasir
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| |
Collapse
|
26
|
Boyle E, Folkestad L, Frafjord E, Koes BW, Skou ST, Hartvigsen J. The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data. Clin Epidemiol 2021; 13:397-405. [PMID: 34103998 PMCID: PMC8180289 DOI: 10.2147/clep.s293186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/29/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose To conduct a non-responder analysis on a musculoskeletal (MSK) electronic questionnaire. Methods Individuals aged 18 years and older, diagnosed with diabetes mellitus (DM), and attended an ambulatory DM clinic formed the sample frame. They were invited to complete an electronic musculoskeletal (MSK) conditions and symptoms questionnaire booklet using a secured electronic email system. Individuals whose secured email box was not active at the time were discarded. Using the Central Person Registry number, a unique number assigned to all Danish residents, we linked the sample frame to different registries to learn more about non-responders. Non-responders were either individuals who did not respond to a single question and those who responded “No” to the first question about willing to participate. We calculated descriptive statistics for each characteristic. Univariate logistic regression models were conducted to determine the relationship between each characteristic and non-responder status. Results The response rate was 36% (n = 3812). Individuals with type 2 DM (OR 2.0 (95% CI 1.8–2.2)), secondary DM (1.9 (1.3–2.8)) or unspecified DM (2.1 (1.8–2.4)) were more likely to be non-responders than individuals with Type 1 DM. Also, individuals aged 70–79 (1.3 (1.1–1.6)) and 80 years and older (5.9 (4.5–7.7)) were more likely to be non-responders than 18–29 years old individuals. However, individuals aged 40–49 (1.5 (1.2–1.8)), 50–59 (1.5 (1.3–1.8)) or 60–69 (1.4 (1.1–1.6)) were more likely to be responders than 18–29 years old individuals. Individuals with Charlson Comorbidity Index (CCI) of 1 (2.0 (1.3.2.9) or CCI of 2 (1.7 (1.1–2.5) were more likely to be responders than individuals with a CCI of 0. Lastly, individuals who were currently outside of the workforce (1.6 (2.4–2.9) or had unknown/missing socioeconomic status (3.9 (2.8–5.3) were more likely to be non-responders than individuals who were working. Conclusion Although we did find a non-response bias, this cohort will be an important source to determine the prevalence and consequences of MSK conditions in a secondary care DM population.
Collapse
Affiliation(s)
- Eleanor Boyle
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Folkestad
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.,Department of Internal Medicine, Hospital of South West Denmark, Esbjerg, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient Exploratory Network, University of Southern Denmark, Odense, Denmark
| | | | - Bart W Koes
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of General Practice, Erasmus MC, Rotterdam, the Netherlands
| | - Soren Thorgaard Skou
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
| |
Collapse
|
27
|
Carvalho-E-Silva AP, Harmer AR, Ferreira ML, Ferreira PH. The effect of the anti-diabetic drug metformin on musculoskeletal pain: A cross-sectional study with 21,889 individuals from the UK biobank. Eur J Pain 2021; 25:1264-1273. [PMID: 33561890 DOI: 10.1002/ejp.1747] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although there is growing evidence of metformin's pleiotropic effects, including possible effects on pain, there is a lack of studies investigating the association of metformin with the prevalence of musculoskeletal pain among a large cohort with type 2 diabetes cohort. METHODS Cross-sectional analyses were conducted with UK Biobank data from 21,889 participants with type 2 diabetes. Type 2 diabetes, metformin use and musculoskeletal (back, knee, hip and neck/shoulder) pain were self-reported. Participants reported musculoskeletal pain that had interfered with their usual activities in the last month (recent pain), and for more than 3 months (chronic pain). We performed logistic regression analyses for recent and chronic pain for each site and for multisite pain among participants with diabetes who did or did not take metformin. RESULTS Participants using metformin had lower odds of musculoskeletal pain for back [recent OR 0.91, 95%CI 0.85 to 0.97; chronic OR 0.87, 95%CI 0.81 to 0.93], knee [recent OR 0.91, 95%CI 0.85 to 0.97; chronic OR 0.87, 95%CI 0.81 to 0.94] and neck/shoulder regions [chronic OR 0.92, 95%CI 0.85 to 0.99] but not hip pain. Participants using metformin also had lower odds of reporting chronic multisite musculoskeletal pain. The associations were generally stronger among women. CONCLUSIONS People with diabetes taking metformin were less likely to report back, knee, neck/shoulder and multisite musculoskeletal pain than those not taking metformin. Therefore, when treating these patients, clinicians should be aware that metformin may contribute to fewer reports of musculoskeletal pain. These effects should be investigated in future studies. SIGNIFICANCE People with type 2 diabetes taking metformin are less likely to present with musculoskeletal pain than those not taking metformin. Metformin may have a protective effect for musculoskeletal pain, which appears to be stronger among women than men.
Collapse
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, NSW, Australia.,Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Paulo H Ferreira
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
28
|
Prevalence of Upper Extremity Musculoskeletal Disorders in Patients with Type 2 Diabetes in General Practice. MEDICINES 2021; 8:medicines8020008. [PMID: 33535409 PMCID: PMC7912777 DOI: 10.3390/medicines8020008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 11/17/2022]
Abstract
Background: One of the lesser recognized complications of diabetes mellitus are musculoskeletal (MSK) complications of the upper and lower extremity. No prevalence studies have been conducted in general practice. Thus, the aim of this study was to investigate the prevalence of upper extremity MSK disorders in patients with type 2 diabetes (T2DM) in the Netherlands. Methods: We conducted a cross-sectional study with two different approaches, namely a representative Dutch primary care medical database study and a questionnaire study among patients with T2DM. Results: In the database study, 2669 patients with T2DM and 2669 non-diabetes patients were included. MSK disorders were observed in 16.3% of patients with T2DM compared to 11.2% of non-diabetes patients (p < 0.001, OR 1.53, 95% CI 1.31, 1.80). In the questionnaire study, 200 patients with T2DM were included who reported a lifetime prevalence of painful upper extremity body sites for at least four weeks of 67.3%. Conclusion: We found that upper extremity MSK disorders have a high prevalence in Dutch patients with T2DM presenting in general practice. The prevalence ranges from 16% based on GP registered disorders and complaints to 67% based on self-reported diagnosis and pain. Early detection and treatment of these disorders may play a role in preventing the development of chronic MSK disorders.
Collapse
|
29
|
Alabdali LAS, Jaeken J, van Alfen N, Dinant GJ, Borghans RAP, Ottenheijm RPG. What Is the Diagnosis in Patients with Type 2 Diabetes Who Have a Painful Shoulder? Results from a Prospective Cross-Sectional Study. J Clin Med 2020; 9:jcm9124097. [PMID: 33353121 PMCID: PMC7767012 DOI: 10.3390/jcm9124097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Patients with diabetes mellitus have higher risk of developing shoulder pathology. However, only adhesive capsulitis is addressed in shoulder pain guidelines as a disorder associated with diabetes. Yet, patients with diabetes are at risk of having several other shoulder disorders, including focal neuropathy. Our aim was to quantify the presence of shoulder disorders using physical examination and ultrasound imaging in patients with type 2 diabetes (T2DM) suffering from shoulder pain in general practice. Methods: In this prospective cross-sectional study, patients with T2DM who had had a painful shoulder for at least four weeks were included. Patients filled out a questionnaire and underwent a physical examination of the shoulders and feet and ultrasound imaging of the shoulder. Results: A total of 66 patients were included, of whom 40.9% (n = 27) had bilateral complaints resulting in 93 symptomatic shoulders. Subacromial pain syndrome was most frequently diagnosed by physical examination (66.6%, 95% CI 51.6–72.0%; p < 0.0001), while ultrasound imaging showed that subacromial disorders were statistically significantly the most prevalent (90.3%, 95% CI 81.9–95.2%). Only two patients (3%) were diagnosed with neuropathic shoulder pain. Conclusion: When choosing treatment, general practitioners should be aware that in patients with T2DM the subacromial region is most frequently affected.
Collapse
Affiliation(s)
- Login Ahmed S. Alabdali
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (G.-J.D.); (R.P.G.O.)
- Ministry of Education, Riyadh 12435, Saudi Arabia
- Correspondence:
| | - Jasmien Jaeken
- Department of Public Health and Primary Care, Catholic University of Leuven, Kapucijnenvoer 33, B-3000 Leuven, Belgium;
| | - Nens van Alfen
- Department of Neurology and Clinical Neurophysiology, Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, 6500 HB Nijmegen, The Netherlands;
| | - Geert-Jan Dinant
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (G.-J.D.); (R.P.G.O.)
| | - Rob A. P. Borghans
- Department of Radiology, Zuyderland Medical Centre, 6162 BG Sittard-Geleen, The Netherlands;
| | - Ramon P. G. Ottenheijm
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (G.-J.D.); (R.P.G.O.)
| |
Collapse
|
30
|
Awotidebe AW, Shehu A. Prevalence and Correlates of Musculoskeletal Pain in Adults with Type 2 Diabetes in Populations with Low-Risk of Obesity: A Cross-Sectional Study. Ethiop J Health Sci 2020; 30:951-960. [PMID: 33883840 PMCID: PMC8047250 DOI: 10.4314/ejhs.v30i6.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/09/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There are few data concerning the prevalence and predictors of musculoskeletal pain among adults with type 2 diabetes in population with low-risk of obesity. Our objective was to describe the point prevalence and factors associated with increased risk of musculoskeletal pain in this population. METHODS A cross-sectional data of 200 adults with type 2 diabetes, aged ≥ 18 years who were attending two tertiary hospitals were examined. Musculoskeletal pain and physical activity were collected with Nordic Musculoskeletal Questionnaire (NMQ) and International Physical Activity Questionnaire (IPAQ-SF) respectively. We used logistic regression to examine the risks associated with musculoskeletal pain. RESULTS The point prevalence of musculoskeletal pain was 72.7% and similar between men (72.3%) and women (73.1%). In the last 7days, advancing age (odds ratio=1.09;95%CI:1.02-1.16) and comorbidity (odds ratio=3.0;95%CI:1.07-8.39) were risk factors associated with musculoskeletal pain. In the last 12 months, only comorbidity (odds ratio=5.57;95%CI:1.62-19.17) was a risk factor for increasing musculoskeletal pain. However, a unit increase in physical activity level (odds ratio=0.06;95%CI:0.008-0.51) was associated with decreased odds of musculoskeletal pain. CONCLUSIONS The prevalence of musculoskeletal pain was high and physical activity was associated with a decreased risk thereof. A further research should be evaluated on the influence of physical activity on musculoskeletal pain.
Collapse
Affiliation(s)
- Adedapo W Awotidebe
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, P.M.B. 3011, Kano State, Nigeria
| | - Auwalu Shehu
- Department of Physiotherapy, Aminu Kano Teaching Hospital, P.M.B. 3452, Kano State, Nigeria
| |
Collapse
|
31
|
Gill TK, Shanahan EM, Tucker GR, Buchbinder R, Hill CL. Shoulder range of movement in the general population: age and gender stratified normative data using a community-based cohort. BMC Musculoskelet Disord 2020; 21:676. [PMID: 33046038 PMCID: PMC7549223 DOI: 10.1186/s12891-020-03665-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022] Open
Abstract
Background An understanding of the average range of movement of the shoulder that is normally achievable is an important part of treatment for shoulder disorders. The average range of active shoulder flexion, abduction and external rotation was measured in a population cohort aged 20 years and over without shoulder pain and/or stiffness in order to provide normative shoulder range data. Methods Cross-sectional analysis using participants in a community-based longitudinal cohort study. There have been three stages of data collection – Stage 1 (1999–2003), Stage 2 (2004–2006) and Stage 3 (2008–2010). Each stage has consisted a of broad ranging computer assisted telephone interview, a self-complete questionnaire and a clinic assessment. Participants in this study are those who undertook assessments in Stage 2. The main outcome measures were active shoulder range of movement (flexion, abduction and external rotation) measured as part of the clinic assessment using a Plurimeter V inclinometer. Mean values were determined and analyses to examine differences between groups (sex and age) were undertaken using non-parametric tests. Results There were 2404 participants (51.5% male), mean age 45.8 years (SD 17.3, range 20–91). The average range of active right shoulder flexion was 161.5° for males and 158.5° for females, and active right shoulder abduction was 151.5° and 149.7° for males and females respectively. Shoulder range of movement declined with age, with mean right active shoulder flexion decreasing by 43° in males and 40.6° in females and right active shoulder abduction by 39.5° and 36.9° respectively. External rotation range also declined, particularly among females. Conclusion To our knowledge this is the largest community-based study providing normative data for active shoulder range of movement. This information can be used to set realistic goals for both clinical practice and clinical trials.
Collapse
Affiliation(s)
- Tiffany K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Level 7, SAHMRI, North Tce, Adelaide, SA, 5000, Australia.
| | - E Michael Shanahan
- Rheumatology Unit, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA, 5042, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, SA, 5042, Australia
| | - Graeme R Tucker
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Level 7, SAHMRI, North Tce, Adelaide, SA, 5000, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Vic, 3144, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic, 3004, Australia
| | - Catherine L Hill
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Level 7, SAHMRI, North Tce, Adelaide, SA, 5000, Australia.,Rheumatology Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville, SA, 5011, Australia
| |
Collapse
|
32
|
Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study. J Clin Med 2020; 9:jcm9092867. [PMID: 32899769 PMCID: PMC7563531 DOI: 10.3390/jcm9092867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 01/02/2023] Open
Abstract
We aimed to assess if subjects with diabetes exhibit higher prevalence of chronic back pain than age-sex-province of residence-matched non-diabetic controls. We also aimed to identify predictors for chronic neck pain (CNP) or chronic low back pain (CLBP) among subjects with diabetes. A case control study was conducted using data obtained from the Spanish National Health Survey 2017. Multivariable conditional and unconditional logistic regression models were constructed. A total of 2095 diabetes sufferers and 2095 non-diabetic matched controls were analyzed. The prevalence of CNP and CLBP was 27.3% and 34.8%, respectively, in diabetes sufferers and 22.1% and 29.0% in non-diabetes controls (both, p < 0.001). After multivariable analysis, the ORs showed significantly higher adjusted risk of CNP (OR 1.34; 95% CI 1.19–1.51) and CLBP (OR 1.19, 95% CI 1.09–1.31) in diabetes cases. Diabetes sufferers with CNP or CLBP showed higher use of pain medication and higher prevalence of migraine/frequent headache than controls. Female sex, worse self-rated health and use of pain medication were predictors for CNP and CLBP in subjects with diabetes. CNP and CLBP are significantly more prevalent in diabetes sufferers than in controls. Current results can help to design better preventive and educational strategies for these highly prevalent and burdensome pains among diabetic patients.
Collapse
|
33
|
Wackström N, Koponen AM, Suominen S, Tarkka IM, Simonsen N. Does chronic pain hinder physical activity among older adults with type 2 diabetes? Health Psychol Behav Med 2020; 8:362-382. [PMID: 34040877 PMCID: PMC8114375 DOI: 10.1080/21642850.2020.1807350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 08/01/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Physical activity (PA) is a key component in management of type 2 diabetes (T2D). Pain might be a barrier to PA especially among older adults with T2D, but surprisingly few studies have investigated the association between chronic pain and PA. Our aim was to evaluate the prevalence of chronic pain among older adults with T2D and to examine the association between chronic pain and PA while taking important life-contextual factors into account. Methods: Data of this register-based, cross-sectional study were collected in a survey among adults with T2D (n=2866). In the current study, only respondents aged 65-75 years were included (response rate 63%, n=1386). Data were analysed by means of descriptive statistics and multivariate logistic regression analysis. Results: In total, 64% reported chronic pain. In specific groups, e.g. women and those who were obese, the prevalence was even higher. Among respondents experiencing chronic pain, frequent pain among women and severe pain among both genders were independently associated with decreased likelihood of being physically active. Moreover, the likelihood of being physically active decreased with higher age and BMI, whereas it increased with higher autonomous motivation and feelings of energy. Among physically active respondents suffering from chronic pain, neither intensity nor frequency of pain explained engagement in exercise (as compared with incidental PA). Instead, men were more likely to exercise regularly as were those with good perceived health and higher autonomous motivation. Conclusions: The prevalence of chronic pain is high among older adults with T2D. This study shows that among those suffering from chronic pain, severe pain is independently and inversely associated with being physically active, as is frequent pain, but only among women. Moreover, the findings show the importance of autonomous motivation and health variables for both incidental PA and exercise among older adults with T2D experiencing chronic pain.
Collapse
Affiliation(s)
- Nanna Wackström
- Folkhälsan Research Center, Public Health Research Program, Helsinki, Finland
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anne M. Koponen
- Folkhälsan Research Center, Public Health Research Program, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku, Turku, Finland
- School of Health and Education, University of Skövde, Skövde, Sweden
| | - Ina M. Tarkka
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Nina Simonsen
- Folkhälsan Research Center, Public Health Research Program, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| |
Collapse
|
34
|
Kalam MN, Shah SNH, Rasool MF, Majeed A, Ahmed N, Saqlain M. Prevalence of musculoskeletal complications of type-2 diabetes mellitus in population of southern Punjab, Pakistan. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00854-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
35
|
Aldossari KK, Shubair MM, Al-Zahrani J, Alduraywish AA, AlAhmary K, Bahkali S, Aloudah SM, Almustanyir S, Al-Rizqi L, El-Zahaby SA, Toivola P, El-Metwally A. Association between Chronic Pain and Diabetes/Prediabetes: A Population-Based Cross-Sectional Survey in Saudi Arabia. Pain Res Manag 2020. [DOI: https://doi.org/10.1155/2020/8239474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. Diabetes is a debilitating chronic health condition that is associated with certain pain syndromes. The present study sought to evaluate chronic pain and its association with diabetes mellitus at a population level. Methods. A population-based cross-sectional questionnaire survey study was conducted in Al-Kharj, Saudi Arabia, from January 2016 to June 2016. Participants from both private and governmental institutions were selected following a multistage sampling technique and using a cluster sampling method. Anthropometric measurements were taken, including body weight, height, body mass index (BMI) and waist circumference. A blood sample was also drawn from each respondent for fasting blood sugar, HbA1c, and fasting lipid profile. A P value of less than 0.05 indicated statistical significance. Results. A total of 1003 subjects were included for final analysis. Compared to prediabetic and nondiabetic individuals, diabetic subjects had a higher prevalence of lower limb pain (11.1%), back pain (8.9%), abdominal pain (6.7%), and neck pain (4.4%) (X2 = 27.792, P=0.015). In a multiple logistic regression model, after adjusting for age, gender, education level, cholesterol, and smoking status, diabetic/prediabetic patients had a significantly higher prevalence of chronic pain ((OR) = 1.931 (95% CI = 1.536–2.362), P=0.037). Increased age was also significantly associated with chronic pain ((OR) = 1.032 (95% CI = 1.010–1.054, P=0.004). Conclusion. Results of this study found a significant association between diabetes and prediabetes and chronic pain symptoms. Prospective studies are needed to explore temporality of such association.
Collapse
Affiliation(s)
- Khaled K. Aldossari
- Family& Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mamdouh M. Shubair
- School of Health Sciences, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | - Jamaan Al-Zahrani
- Family& Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | - Khalid AlAhmary
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salwa Bahkali
- Princess Nourah Bint Abdulrahman University, King Abdullah Bin AbdulAziz University Hospital, Riyadh, Saudi Arabia
| | - Sara M. Aloudah
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 29391, Saudi Arabia
| | | | - Laila Al-Rizqi
- Internal Medicine, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Sally A. El-Zahaby
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy and Drug Manufacturing, Pharos University in Alexandria, Alexandria, Egypt
| | - Paivi Toivola
- King Abdullah Specialist Children’s Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ashraf El-Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| |
Collapse
|
36
|
Aldossari KK, Shubair MM, Al-Zahrani J, Alduraywish AA, AlAhmary K, Bahkali S, Aloudah SM, Almustanyir S, Al-Rizqi L, El-Zahaby SA, Toivola P, El-Metwally A. Association between Chronic Pain and Diabetes/Prediabetes: A Population-Based Cross-Sectional Survey in Saudi Arabia. Pain Res Manag 2020; 2020:8239474. [PMID: 32676137 PMCID: PMC7333061 DOI: 10.1155/2020/8239474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023]
Abstract
Background Diabetes is a debilitating chronic health condition that is associated with certain pain syndromes. The present study sought to evaluate chronic pain and its association with diabetes mellitus at a population level. Methods A population-based cross-sectional questionnaire survey study was conducted in Al-Kharj, Saudi Arabia, from January 2016 to June 2016. Participants from both private and governmental institutions were selected following a multistage sampling technique and using a cluster sampling method. Anthropometric measurements were taken, including body weight, height, body mass index (BMI) and waist circumference. A blood sample was also drawn from each respondent for fasting blood sugar, HbA1c, and fasting lipid profile. A P value of less than 0.05 indicated statistical significance. Results A total of 1003 subjects were included for final analysis. Compared to prediabetic and nondiabetic individuals, diabetic subjects had a higher prevalence of lower limb pain (11.1%), back pain (8.9%), abdominal pain (6.7%), and neck pain (4.4%) (X 2 = 27.792, P = 0.015). In a multiple logistic regression model, after adjusting for age, gender, education level, cholesterol, and smoking status, diabetic/prediabetic patients had a significantly higher prevalence of chronic pain ((OR) = 1.931 (95% CI = 1.536-2.362), P = 0.037). Increased age was also significantly associated with chronic pain ((OR) = 1.032 (95% CI = 1.010-1.054, P = 0.004). Conclusion Results of this study found a significant association between diabetes and prediabetes and chronic pain symptoms. Prospective studies are needed to explore temporality of such association.
Collapse
Affiliation(s)
- Khaled K. Aldossari
- Family& Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mamdouh M. Shubair
- School of Health Sciences, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | - Jamaan Al-Zahrani
- Family& Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | - Khalid AlAhmary
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salwa Bahkali
- Princess Nourah Bint Abdulrahman University, King Abdullah Bin AbdulAziz University Hospital, Riyadh, Saudi Arabia
| | - Sara M. Aloudah
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 29391, Saudi Arabia
| | | | - Laila Al-Rizqi
- Internal Medicine, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Sally A. El-Zahaby
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy and Drug Manufacturing, Pharos University in Alexandria, Alexandria, Egypt
| | - Paivi Toivola
- King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ashraf El-Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| |
Collapse
|
37
|
Cox ER, Gajanand T, Burton NW, Coombes JS, Coombes BK. Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes - Preliminary randomised controlled trial. Diabetes Res Clin Pract 2020; 164:108168. [PMID: 32360399 DOI: 10.1016/j.diabres.2020.108168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/21/2020] [Indexed: 12/16/2022]
Abstract
AIMS People with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. METHODS Thirty-two inactive adults with T2D (59% male, mean age 58.7 ± 9.1yrs, median HbA1c 7.8%) were randomised to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined high-intensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention. RESULTS Compared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT (MD -5.4, 95% CI [-10.6 to -0.2], p = 0.04) and non-significantly greater for C-MICT (MD -5.9 [-12.4 to 0.7], p = 0.08). Changes in neuropathy symptoms were not different between C-HIIT and CON (MD 1.0 [-0.9 to 2.8], p = 0.31), or C-MICT and CON (MD 0.2 [-3.1 to 3.6], p = 0.89). No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions (19 C-HIIT; 17 C-MICT), all but one of which were mild. CONCLUSIONS Preliminary data suggests 8-weeks of high-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with T2D and may reduce musculoskeletal pain but not neuropathic symptoms. TRIAL REGISTRATION ACTRN12615000475549.
Collapse
Affiliation(s)
- Emily R Cox
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Trishan Gajanand
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Brooke K Coombes
- School of Allied Health Sciences, Griffith University, Nathan, Queensland, Australia.
| |
Collapse
|
38
|
Carvalho-E-Silva AP, Ferreira ML, Ferreira PH, Harmer AR. Does type 2 diabetes increase the risk of musculoskeletal pain? Cross-sectional and longitudinal analyses of UK biobank data. Semin Arthritis Rheum 2020; 50:728-734. [PMID: 32521327 DOI: 10.1016/j.semarthrit.2020.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/22/2020] [Accepted: 05/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE We investigated cross-sectional associations and whether type 2 diabetes increases the risk of musculoskeletal pain after adjusting for the presence of important comorbidities. METHODS The study employed data from the UK Biobank participants: 495,327 in cross-sectional (2006-2010) and 16,875 in longitudinal (2014-2016) analyses. Type 2 diabetes was self-reported and subsequently confirmed during an interview. Musculoskeletal pain was diagnosed by the participants' reports of back, knee, hip, or neck/shoulder pain that interfered with usual activities in the last month (recent pain), and for more than 3 months (chronic pain). RESULTS In cross-sectional adjusted logistic regression analyses, type 2 diabetes was associated with recent and chronic neck/shoulder pain [OR 1.14, 95%CI 1.10-1.18; OR 1.15, 95%CI 1.10-1.19] and hip pain [OR 1.13, 95%CI 1.08-1.17; OR 1.14 95%CI 1.09-1.19]; and with chronic knee pain [OR 1.01, 95%CI 1.01-1.01]. In longitudinal adjusted analyses, type 2 diabetes increased the risk of recent and chronic neck/shoulder pain [OR 1.39, 95%CI 1.01-1.91; OR 1.56; 95%CI 1.14-2.19]. CONCLUSION People with type 2 diabetes are more likely to report musculoskeletal pain in shoulder/neck, knee or hip. In addition, people with type 2 diabetes, particularly women, are more likely to present with a future episode of neck/shoulder pain. This study highlights the need to consider musculoskeletal screening among patients with diabetes and also serves as a stimulus for investigation of the mechanisms that explain the relationship between musculoskeletal pain and type 2 diabetes; with a view to prevention or improving future treatment.
Collapse
Affiliation(s)
- Ana Paula Carvalho-E-Silva
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, 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
| | - Paulo H Ferreira
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
39
|
Khodneva Y, Richman J, Andreae S, Cherrington A, Safford MM. Peer Support Intervention Improves Pain‐Related Outcomes Among Rural Adults With Diabetes and Chronic Pain at 12‐Month Follow‐Up. J Rural Health 2020; 37:394-405. [DOI: 10.1111/jrh.12422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Yulia Khodneva
- Department of Medicine School of Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Joshua Richman
- Department of Surgery School of Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Susan Andreae
- Department of Kinesiology University of Wisconsin ‐ Madison School of Education Madison Wisconsin
| | - Andrea Cherrington
- Department of Medicine School of Medicine University of Alabama at Birmingham Birmingham Alabama
| | - Monika M. Safford
- Department of Internal Medicine Weill Cornell Medical College New York New York
| |
Collapse
|
40
|
Cox ER, Coombes JS, Keating SE, Burton NW, Coombes BK. Not a Painless Condition: Rheumatological and Musculoskeletal Symptoms in Type 2 Diabetes, and the Implications for Exercise Participation. Curr Diabetes Rev 2020; 16:211-219. [PMID: 31146662 DOI: 10.2174/1573399815666190531083504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/15/2019] [Accepted: 05/03/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES People with type 2 diabetes (T2D) are more likely to develop a range of rheumatological and musculoskeletal symptoms (RMS), and experience both chronic and widespread pain, compared with the general population. However, these symptoms are not commonly acknowledged by researchers, which hampers our understanding of the impact on this population. Since exercise is a key lifestyle management strategy for T2D and participation levels are typically low, understanding the potential impact of RMS on exercise participation is critical. The aim of this review is to summarise the literature regarding the prevalence and pathophysiology of RMS in T2D, the evidence for the benefits and risks associated with exercise on RMS, and the currently available tools for the reporting of RMS in both research studies and community settings. METHODS A narrative review. RESULTS There are numerous exercise trials in T2D, but few have sufficiently reported pain-related adverse events and even fewer have investigated the effects of exercise on RMS and chronic pain. DISCUSSION Recommendations for future research are provided.
Collapse
Affiliation(s)
- Emily R Cox
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland, Australia
| | - Brooke K Coombes
- School of Allied Health Sciences, Griffith University, Nathan, Queensland, Australia
| |
Collapse
|
41
|
Rehling T, Bjørkman ASD, Andersen MB, Ekholm O, Molsted S. Diabetes Is Associated with Musculoskeletal Pain, Osteoarthritis, Osteoporosis, and Rheumatoid Arthritis. J Diabetes Res 2019; 2019:6324348. [PMID: 31886282 PMCID: PMC6925775 DOI: 10.1155/2019/6324348] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/04/2019] [Accepted: 11/19/2019] [Indexed: 12/14/2022] Open
Abstract
AIM To investigate the associations between diabetes and musculoskeletal pain, osteoarthritis, osteoporosis, and rheumatoid arthritis. METHODS Self-reported data were provided by the nationwide Danish National Health Survey 2013. Inclusion criteria were age ≥ 40 years and known diabetes status. The exposure variable was diabetes, and the outcome variables included musculoskeletal pain during the last 14 days in three body sites (back/lower back, limbs, and shoulder/neck), osteoarthritis, osteoporosis, and rheumatoid arthritis. Logistic regression analyses adjusted for age, gender, BMI, education, marital status, and physical activity were performed. RESULTS 9,238 participants with diabetes were 65.6 ± 11.0 (mean ± SD) years old; 55.6% were males. 99,980 participants without diabetes were 59.2 ± 11.8 years old; 46.7% were males. Diabetes was associated with back/lower back pain (OR 1.2 (CI 95% 1.1-1.2), p < 0.001), pain in the limbs (1.4 (1.3-1.4), p < 0.001), shoulder/neck pain (1.2 (1.1-1.3), p < 0.001), osteoarthritis (1.3 (1.2-1.4), p < 0.001), osteoporosis (1.2 (1.1-1.4), p = 0.010), and rheumatoid arthritis (1.6 (1.4-1.7), p < 0.001). In participants with diabetes, physical activity was associated with reduced pain (e.g., back/lower back pain (0.7 (0.6-0.7), p < 0.001)). CONCLUSION Diabetes was associated with elevated odds of having musculoskeletal pain. Diabetes was also associated with elevated odds of having osteoarthritis, osteoporosis, and rheumatoid arthritis. The most frequent disease in individuals with diabetes was osteoarthritis. The reported pain may have negative impacts on the level of physical activity. Health-care professionals should remember to inform patients with diabetes that musculoskeletal pain, osteoarthritis, osteoporosis, and rheumatoid arthritis are not contraindications to exercise training.
Collapse
Affiliation(s)
- Thomas Rehling
- Department of Clinical Research, Nordsjællands Hospital, Denmark
| | | | | | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Denmark
| |
Collapse
|
42
|
Heuch I, Heuch I, Hagen K, Sørgjerd EP, Åsvold BO, Zwart JA. Does diabetes influence the probability of experiencing chronic low back pain? A population-based cohort study: the Nord-Trøndelag Health Study. BMJ Open 2019; 9:e031692. [PMID: 31515434 PMCID: PMC6747649 DOI: 10.1136/bmjopen-2019-031692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is a major problem in modern society and it is important to study possible risk factors for this disorder. People with diabetes are often affected by LBP, but whether diabetes represents a risk factor for LBP has not been studied in detail. The aim of this study was to explore the association between diabetes and subsequent risk of chronic LBP. DESIGN An 11-year follow-up study. SETTING The Nord-Trøndelag Health Study (HUNT2; 1995-1997) and HUNT3 (2006-2008) surveys of Nord-Trøndelag County in Norway. MAIN OUTCOME MEASURE Chronic LBP, defined as LBP persisting at least 3 months continuously during the last year. PARTICIPANTS A total of 18 972 persons without chronic LBP at baseline in HUNT2, and 6802 persons who reported chronic LBP at baseline in HUNT2. METHODS Associations between diabetes and risk of chronic LBP among individuals aged 30-69 years were examined by generalised linear modelling. RESULTS Men without chronic LBP at baseline showed a significant association between diabetes and risk of chronic LBP (relative risk (RR) 1.43, 95% CI 1.04 to 1.96, p=0.043). In women, no association was found (RR 1.01, 95% CI 0.69 to 1.48, p=0.98). No association could be established between diabetes and recurrence or persistence of chronic LBP after 11 years in either sex. CONCLUSIONS Men with a diagnosis of diabetes may have a higher risk of subsequently experiencing chronic LBP.
Collapse
Affiliation(s)
- Ingrid Heuch
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St Olavs University Hospital, Trondheim, Norway
| | - Elin Pettersen Sørgjerd
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Endocrinology, St Olavs University Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
43
|
Yang YL, Chee W, Im EO. Type 2 Diabetes and Musculoskeletal Symptoms Among Midlife Women. DIABETES EDUCATOR 2019; 45:520-528. [PMID: 31486342 DOI: 10.1177/0145721719872558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE The purpose of this study was to describe the association between type 2 diabetes and musculoskeletal symptoms among midlife women from 4 major racial/ethnic groups in the United States. METHODS This is a secondary data analysis using the data from 164 participants aged 40 to 60 years of 2 larger survey studies (62 with type 2 diabetes and 102 without type 2 diabetes). In the original studies, the participants completed multiple questionnaires on background characteristics, health status, menopausal status, and musculoskeletal symptoms. The Musculoskeletal Symptom Index for Midlife Women was used to determine the number and severity of musculoskeletal symptoms. For data analysis, independent t tests, Mann-Whitney U tests, and multiple regression analyses were used. RESULTS The mean number of musculoskeletal symptoms was significantly higher in women with vs without type 2 diabetes as was the mean severity score. In subgroup analyses, among each menopausal stage and non-Hispanic white women, there were significant differences in the numbers and total severity scores between those with type 2 diabetes and without type 2 diabetes. When background characteristics, health status, and menopausal status were controlled, having diagnosis of type 2 diabetes was positively associated with the numbers and total severity scores of musculoskeletal symptoms. CONCLUSION Study findings supported significant associations of type 2 diabetes with musculoskeletal symptoms among midlife women. Further studies are recommended to confirm relationships in larger populations.
Collapse
Affiliation(s)
- You Lee Yang
- School of Nursing, Duke University, Durham, North Carolina
| | - Wonshik Chee
- School of Nursing, Duke University, Durham, North Carolina
| | - Eun-Ok Im
- School of Nursing, Duke University, Durham, North Carolina
| |
Collapse
|
44
|
Jensen TM, Eriksen SBM, Larsen JS, Aadahl M, Rasmussen SS, Olesen LB, Rehling T, Molsted S. Exercise training is associated with reduced pains from the musculoskeletal system in patients with type 2 diabetes. Diabetes Res Clin Pract 2019; 154:124-129. [PMID: 31299196 DOI: 10.1016/j.diabres.2019.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/29/2019] [Accepted: 07/01/2019] [Indexed: 02/02/2023]
Abstract
AIMS To investigate the effect of exercise training on musculoskeletal pain in patients with type 2 diabetes. METHODS The intervention was exercise twice weekly for 12 weeks. The primary outcome was musculoskeletal pain assessed using a 0-10 Numeric Rating Scale (NRS) in 11 body sites. Secondary outcomes were use of analgesics, glycaemic control and body weight. RESULTS The participants (n = 69) were 66 ± 10 years old, 38 were men and 50 completed the intervention. Pain in the limbs was more frequently reported by the participants compared to a matched general population (80.9% vs 65.3%, p = 0.007). The participants who had any pain at baseline (NRS > 0) and severe pain (NRS > 3) reported significantly decreased pain in the feet, calf muscles, knees, thighs, hips, lower back and arms after the training period. Use of analgesics was unchanged, HbA1c (mmol/mol) decreased from 60 ± 15 to 54 ± 11, p < 0.001 and body weight (kg) decreased from 100.5 ± 19.1 to 98.6 ± 17.7, p = 0.005. CONCLUSIONS The participants with type 2 diabetes reported more frequent pain than a matched general population. The training intervention was associated with reduced musculoskeletal pain. Reduced pain may together with a positive impact on glycaemic control be an important motivational factor in patients with type 2 diabetes to perform exercise training.
Collapse
Affiliation(s)
- Trine Munk Jensen
- Department of Clinical Research, Nordsjællands Hospital, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | | | - Mette Aadahl
- Centre for Clinical Research and Prevention, Frederiksberg-Bispebjerg Hospital, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | | | - Thomas Rehling
- Department of Physiotherapy, Nordsjællands Hospital, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Denmark.
| |
Collapse
|
45
|
Barnes R, Jelsma J, Parker R. Joint pain within adult middle-aged women, attending a community clinic in a peri-urban area in South Africa: a cross-sectional survey. Disabil Rehabil 2019; 41:1343-1350. [PMID: 29347849 DOI: 10.1080/09638288.2018.1428368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 12/06/2017] [Accepted: 01/11/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study aimed to investigate the prevalence of joint pain in women between the ages of 40 and 64 years who attended a community clinic in the Free State to provide micro-information for health care planners. METHODS A sample of convenience was utilized in the cross-sectional survey. Health care workers were recruited to conduct the survey. Outcome measures included the Community-Oriented-Programme-For-The-Control-Of-Rheumatic-Disease questionnaire and European Quality of Life - 5 Dimensions health related quality of life measure. Descriptive statistics were calculated for categorical data and non-parametric tests for ordinal data. Quality Adjusted Life Years lost were based on the preference weights generated by the European Quality of Life - 5 Dimensions. RESULTS One thousand three hundred seventy-six participants were enrolled. The prevalence of joint pain experienced in either the short or the long term was 62.1% (CI 59.5-64.6%). The total number of Quality Adjusted Life Years lost in this sample was 41.4, that is a rate of 3008.7 (CI 2740-3310) per 100,000. CONCLUSION Epidemiological transition seems to be rapidly taking place in South Africa and the prevalence of joint pain is considerable. Primary health care systems should develop a cost-effective approach to manage and identify joint pain and improve the health-related quality of life of those living with this. Implications for Rehabilitation Prevalence of joint pain is considerable. Consume large amounts of health and social resources. A protocol for routine screening should be developed in community clinics. Cost-effective approach to manage joint pain should be identified to improve healthrelated quality of life of individuals living with joint pain.
Collapse
Affiliation(s)
- Roline Barnes
- a Department of Physiotherapy , University of the Free State , Bloemfontein , South Africa
| | - Jennifer Jelsma
- b Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences , University of Cape Town , Cape Town , South Africa
| | - Romy Parker
- c Division of Physiotherapy, Department of Health and Rehabilitation Sciences and Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences , University of Cape Town , Cape Town , South Africa
| |
Collapse
|
46
|
Pozzobon D, Ferreira PH, Dario AB, Almeida L, Vesentini G, Harmer AR, Ferreira ML. Is there an association between diabetes and neck and back pain? A systematic review with meta-analyses. PLoS One 2019; 14:e0212030. [PMID: 30789940 PMCID: PMC6383876 DOI: 10.1371/journal.pone.0212030] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/26/2019] [Indexed: 01/04/2023] Open
Abstract
Background and objective Approximately half of the population will experience either low back pain or neck pain, at some point in their lives. Previous studies suggest that people with diabetes are more likely to present with chronic somatic pain, including shoulder, knee and spinal pain. This study aimed to systematically review and appraise the literature to explore the magnitude as well as the nature of the association between diabetes and back, neck, or spinal (back and neck) pain. Databases and data treatment A systematic search was performed using the Medline, CINAHL, EMBASE, and Web of Science electronic databases. Studies which assessed the association between diabetes and back or neck pain outcomes, in participants older than 18 years of age were included. Two independent reviewers extracted data on the incidence of pain and reported associations. Results Eight studies were included in the meta-analyses. Meta-analyses showed that people with diabetes are more likely to report low back pain [5 studies; n: 131,431; odds ratio (OR): 1.35; 95% Confidence Interval (CI): 1.20 to 1.52; p<0.001] and neck pain (2 studies; n: 6,560; OR: 1.24; 95% CI: 1.05 to 1.47; p = 0.01) compared to those without diabetes. Results from one longitudinal cohort study suggested that diabetes is not associated with the risk of developing future neck, low back or spinal pain. Conclusions Diabetes is associated with low back and neck individually, and spinal pain. The longitudinal analysis showed no association between the conditions. Our results suggest that diabetes co-exists with back pain; however, a direct causal link between diabetes and back pain was not established. Systematic review registration PROSPERO registration CRD42016050738.
Collapse
Affiliation(s)
- Daniel Pozzobon
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Paulo H. Ferreira
- Musculoskeletal Health Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Amabile B. Dario
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Lisandra Almeida
- Discipline of Physiotherapy, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Giovana Vesentini
- Department of Gynaecology and Obstetrics, Botucatu Medical School, UNESP–Paulista State University, Botucatu, São Paulo, Brazil
| | - Alison R. Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, 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
| |
Collapse
|
47
|
Siqueira FCM, Ferreira PH, Dario AB, Harmer A, Oliveira VC, Leite HR. Are perinatal factors associated with musculoskeletal pain across the lifespan? A systematic review with meta-analysis. Musculoskelet Sci Pract 2019; 39:170-177. [PMID: 30360956 DOI: 10.1016/j.msksp.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/25/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Musculoskeletal conditions are common health issues with great impact on individuals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood. OBJECTIVE To systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan. METHODS MEDLINE, CINAHL, Scopus, Web of Science and EMBASE databases were searched from their inception to December 2017. Descriptors used in our search strategy were related to "perinatal factors" and "musculoskeletal pain". There were no language, age, sex or date restrictions. Meta-analysis was used to pool the estimates of association between perinatal factors and musculoskeletal pain. RESULTS Among the six articles included in this systematic review, three were extracted for the meta-analysis. The pooled of three and two studies showed no association between chronic musculoskeletal pain and low birth weight (OR 1.8, 95% CI 0.9-3.8, I2 = 0; n = 157) or pre-term birth (OR 0.5, 95% CI 0.0-4.5; I2 = 78%; n = 374) in adults, respectively. Overall, the quality of evidence after applying the GRADE approach was very low across all the studies. CONCLUSION In adults, our meta-analysis showed no association between birth weight or pre-term birth and musculoskeletal pain, and the quality of the evidence was very low. Thus, the very low quality of evidence and limited number of studies do not suggest a direct clear association. Further high-quality longitudinal studies accounting for more relevant confounders are needed to better understand the complex mechanism that may operate between perinatal factors and musculoskeletal pain.
Collapse
Affiliation(s)
- Fernando C M Siqueira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Amabile B Dario
- Faculty of Health Sciences, The University of Sydney, Australia
| | - Alison Harmer
- Faculty of Health Sciences, The University of Sydney, Australia
| | - Vinicius Cunha Oliveira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Hercules Ribeiro Leite
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Faculty of Health Sciences, The University of Sydney, Australia.
| |
Collapse
|
48
|
Cox ER, Keating SE, Coombes JS, Burton NW. Potential Utility of Self-Report Measures of Affect to Optimise Exercise Adherence in People with Type 2 Diabetes. Curr Diabetes Rev 2019; 15:302-308. [PMID: 30117398 DOI: 10.2174/1573399814666180816165351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 07/20/2018] [Accepted: 08/10/2018] [Indexed: 11/22/2022]
Abstract
Exercise is essential for managing type 2 diabetes, however approximately only 40% of people with the condition meet guidelines. The aim of this review is to examine the evidence regarding the use self-report measures of affect to understand and predict exercise adherence. Self-reported affect has been successfully used to regulate exercise intensity, monitor training load, prevent injury, and predict future physical activity participation in otherwise healthy and some clinical populations. Specific recommendations are provided for research to explore the utility of self-report measures of affect to promote exercise adherence in people with type 2 diabetes.
Collapse
Affiliation(s)
- Emily R Cox
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Australia
| | | | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Australia
| | - Nicola W Burton
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Australia
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia
| |
Collapse
|
49
|
Iskra DA. [Comorbidity of type 2 diabetes mellitus and low back pain]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:126-130. [PMID: 30251990 DOI: 10.17116/jnevro2018118081126] [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: 11/17/2022]
Abstract
Diabetes mellitus (DM) and back pain are widespread and often develop simultaneously. In patients with DM 2 type, the incidence of back pain is increased. The association of DM with the severity of pain and the frequency of its chronization and recurrence has been revealed. The most likely mechanism of such an association is the lesion of intervertebral discs mediated by the accumulation of advanced glycation end-products (EGP). In DM the concentration of EGP increases significantly; they initiate ectopic calcification, a decrease in cell density in the end plates, and changes in vertebras. Cells of the pulpous nuclei begin to produce pro-inflammatory cytokines and chemokines that trigger the processes of angio- and neurogenesis. Dorsopathies develop due to other etiological factors, but the mechanisms of systemic inflammation are similar. Thus, DM and back pain are comorbid pathologies with common elements in pathogenesis. To prevent the development of dorsopathy in DM 2 type it is considered promising to use drugs that reduce the intensity of accumulation of AGP and inhibitors of pro-inflammatory cytokines, for example, symptomatic slow acting drugs.
Collapse
Affiliation(s)
- D A Iskra
- Kirov Military Medical Academy, St-Petersburg, Russia
| |
Collapse
|
50
|
Mueller MJ, Sorensen CJ, McGill JB, Clark BR, Lang CE, Chen L, Bohnert KL, Hastings MK. Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial. Phys Ther 2018; 98:745-753. [PMID: 29893977 PMCID: PMC6692706 DOI: 10.1093/ptj/pzy070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 06/06/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND People with diabetes are at high risk for shoulder pain, limited joint mobility, and adhesive capsulitis. OBJECTIVE The objective of this study was to evaluate the effects of a shoulder movement intervention (ShoMo) compared to a wellness intervention on the primary outcomes of active shoulder flexion and reported Shoulder Pain and Disability Index (SPADI) measured after intervention and 9 months later. DESIGN The design was a prospective, randomized, controlled clinical trial. SETTING The setting was a research center at an academic medical center. PARTICIPANTS Fifty-two participants with type 2 diabetes and shoulder pain or limited motion were randomized to a group receiving ShoMo (N = 27; mean age = 59.3; SD = 7.0) or a group receiving wellness activities (N = 25; mean age = 57.9; SD = 7.7). INTERVENTION The ShoMo group received instruction in a progressive, active shoulder movement program. The wellness group received instruction in diabetes management. MEASUREMENTS Measurements were made at baseline, after 3 months of intervention, and at 6, 9, and 12 months after baseline. RESULTS After intervention, the ShoMo group had a 7.2-degree increase in active shoulder flexion compared with the wellness group (95% CI = 0.9-13.5°), but there was no difference at subsequent follow-ups. The ShoMo group showed a 12.7-point improvement in the SPADI score compared to the wellness group after intervention (95% CI = 1.1-24.3), which remained better than the wellness group 9 months later. LIMITATIONS The number of participants and duration of follow-up were inadequate to determine if intervention can help to prevent future severe shoulder problems. CONCLUSIONS A progressive shoulder movement program can have meaningful effects on active motion and symptoms in people with type 2 diabetes and mild-to-moderate shoulder symptoms, with symptom improvement lasting at least 9 months.
Collapse
Affiliation(s)
- Michael J Mueller
- Program in Physical Therapy and Department of Radiology, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Blvd, St Louis, MO 63108 (USA),Address all correspondence to Dr Mueller at:
| | | | - Janet B McGill
- Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine
| | - B Ruth Clark
- Program in Physical Therapy and Department of Neurology, Washington University School of Medicine
| | - Catherine E Lang
- Program in Physical Therapy, Program in Occupational Therapy, and Department of Neurology, Washington University School of Medicine
| | - Ling Chen
- Division of Biostatistics, Washington University School of Medicine
| | - Kathryn L Bohnert
- Program in Physical Therapy, Washington University School of Medicine
| | - Mary K Hastings
- Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine
| |
Collapse
|