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Xu T, Chen G, Li J, Zhang Y. Exploring causal correlations between inflammatory cytokines and intervertebral disc degeneration: A Mendelian randomization. JOR Spine 2024; 7:e1349. [PMID: 38993524 PMCID: PMC11237178 DOI: 10.1002/jsp2.1349] [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: 03/07/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/13/2024] Open
Abstract
Background Inflammatory cytokines have been reported to be related to intervertebral disc degeneration (IVDD) in several previous studies. However, it remains unclear about the causal relationship between inflammatory cytokines and IVDD. This study employs Mendelian randomization (MR) to analyze the causal link between inflammatory cytokines and the risk of IVDD. Method We used genetic variants associated with inflammatory cytokines from a meta-analysis of genome-wide association study (GWAS) in 8293 Finns as instrumental variables and IVDD data were sourced from the FinnGen consortium. The main analytical approach utilized Inverse-Variance Weighting (IVW) with random effects to assess the causal relationship. Additionally, complementary methods such as MR-Egger, weighted median, simple mode, weighted mode, and MR pleiotropy residual sum and outlier were employed to enhance the robustness of the final results. Result We found interferon-gamma (IFN-γ, p = 2.14 × 10-6, OR = 0.870, 95% CI = 0.821-0.921), interleukin-1 beta (IL-1b, p = 0.012, OR = 0.951, 95% CI = 0.914-0.989), interleukin-4 (IL-4, p = 0.034, OR = 0.946, 95% CI = 0.899-0.996), interleukin-18 (IL-18, p = 0.028, OR = 0.964, 95% CI = 0.934-0.996), granulocyte colony-stimulating factor (GCSF, p = 0.010, OR = 0.919, 95% CI = 0.861-0.980), and Stromal cell-derived factor 1a (SDF1a, p = 0.014, OR = 1.072, 95% CI = 1.014-1.134) were causally associated with risk of IVDD. Conclusion Our MR analyses found a potential causal relationship between six inflammation cytokines (IFN-γ, IL-1b, IL-4, IL-18, SDF1a, and GCSF) and altered IVDD risk.
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Affiliation(s)
- Tao Xu
- Department of Orthopedics, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople's Republic of China
| | - Guangzi Chen
- Department of Orthopedics, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople's Republic of China
| | - Jian Li
- Department of OrthopaedicsThird Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi HospitalTaiyuanPeople's Republic of China
| | - Yingchi Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople's Republic of China
- Department of Traumatology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople's Republic of China
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García-Dopico N, Terrasa JL, González-Roldán AM, Velasco-Roldán O, Sitges C. Unraveling the Left-Right Judgment Task in Chronic Low Back Pain: Insights Through Behavioral, Electrophysiological, Motor Imagery, and Bodily Disruption Perspectives. THE JOURNAL OF PAIN 2024; 25:104484. [PMID: 38307439 DOI: 10.1016/j.jpain.2024.01.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
Bodily disruptions have been consistently demonstrated in individuals with chronic low back pain. The performance on the left-right judgment task has been purposed as an indirect measure of the cortical proprioceptive representation of the body. It has been suggested to be dependent on implicit motor imagery, although the available evidence is conflicting. Hence, the aim of this case-control observational study was to examine the performance (accuracy and reaction times) and event-related potentials while performing the left-right judgment task for back and hand images in individuals with chronic low back pain versus healthy controls, along with its relationship with self-reported measurements and quantitative sensory testing. While self-reported data suggested bodily disruptions in the chronic low back pain sample, this was not supported by quantitative sensory testing. Although both groups displayed the same performance, our results suggested an increased attentional load on participants with chronic low back pain to achieve equal performance, measured by a higher N1 peak amplitude in occipital electrodes, especially when the effect of contextual images arises. The absence of differences in the reaction times for the left-right judgment task between both groups, along with inconsistencies in self-reported and quantitative sensory testing data, could question the involvement of implicit motor imagery in solving the task. In conclusion, our results suggest disrupted attentional processing in participants with chronic low back pain to solve the left-right judgment task. PERSPECTIVE: Although there are no differences in the performance of the left-right judgment task (hits, reaction times) between chronic low back pain patients and controls, the analysis of event-related potentials revealed that patients require a higher cognitive load, measured by N1 peak amplitude.
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Affiliation(s)
- Nuria García-Dopico
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain; Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Juan L Terrasa
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Ana M González-Roldán
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain; Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Carolina Sitges
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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Sanabria-Mazo JP, D'Amico F, Cardeñosa E, Ferrer M, Edo S, Borràs X, McCracken LM, Feliu-Soler A, Sanz A, Luciano JV. Economic Evaluation of Videoconference Group Acceptance and Commitment Therapy and Behavioral Activation Therapy for Depression Versus Usual Care Among Adults With Chronic Low Back Pain Plus Comorbid Depressive Symptoms. THE JOURNAL OF PAIN 2024; 25:104472. [PMID: 38242333 DOI: 10.1016/j.jpain.2024.01.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
Chronic pain and depression are frequently comorbid conditions associated with significant health care and social costs. This study examined the cost-utility and cost-effectiveness of videoconference-based group forms of Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD), as a complement to treatment-as-usual (TAU), for patients with chronic low back pain (CLBP) plus depressive symptoms, compared to TAU alone. A trial-based economic evaluation (n = 234) was conducted from a governmental and health care perspective with a time horizon of 12 months. Primary outcomes were the Brief Pain Inventory-Interference Scale (BPI-IS) and Quality Adjusted Life Year. Compared to TAU, ACT achieved a significant reduction in total costs (d = .47), and BATD achieved significant reductions in indirect (d = .61) and total costs (d = .63). Significant improvements in BPI-IS (d = .73 and d = .66, respectively) and Quality Adjusted Life Year scores (d = .46 and d = .28, respectively) were found in ACT and BATD compared to TAU. No significant differences in costs and outcomes were found between ACT and BATD. In the intention-to-treat analyses, from the governmental and health care perspective, no significant differences in cost reduction and incremental effects were identified in the comparison between ACT, BATD, and TAU. However, in the complete case analysis, significant incremental effects of ACT (∆BPI-IS = -1.57 and -1.39, respectively) and BATD (∆BPI-IS = -1.08 and -1.04, respectively) compared with TAU were observed. In the per-protocol analysis, only the significant incremental effects of ACT (∆BPI-IS = -1.68 and -1.43, respectively) compared to TAU were detected. In conclusion, ACT and BATD might be efficient options in the management of CLBP plus comorbid depression symptoms as compared to usual care. However, no clear difference was found in the comparison between the 2 active therapies regarding cost-effectiveness or cost-utility. PERSPECTIVE: The economic evaluation of psychological therapies for the management of complex conditions can be used in decision-making and resource allocation. This study provides evidence that ACT and BATD are more effective and involve a greater reduction in costs than usual care in the management of CLBP plus comorbid depressive symptoms. TRIAL NUMBER: NCT04140838.
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Affiliation(s)
- Juan P Sanabria-Mazo
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Francesco D'Amico
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Eugenia Cardeñosa
- Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Basic Health Area (ABS) Maria Bernades, Direcció d'Atenció Primària Metropolitana Sud, Institut Català de la Salut, Viladecans, Spain
| | - Montse Ferrer
- Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Sílvia Edo
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Xavier Borràs
- Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | | | - Albert Feliu-Soler
- Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Antoni Sanz
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Juan V Luciano
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
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Franco-López F, Durkalec-Michalski K, Díaz-Morón J, Higueras-Liébana E, Hernández-Belmonte A, Courel-Ibáñez J. Using Resistance-Band Tests to Evaluate Trunk Muscle Strength in Chronic Low Back Pain: A Test-Retest Reliability Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4131. [PMID: 39000910 PMCID: PMC11244540 DOI: 10.3390/s24134131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024]
Abstract
Exercise is a front-line intervention to increase functional capacity and reduce pain and disability in people with low strength levels or disorders. However, there is a lack of validated field-based tests to check the initial status and, more importantly, to control the process and make tailored adjustments in load, intensity, and recovery. We aimed to determine the test-retest reliability of a submaximal, resistance-band test to evaluate the strength of the trunk stability muscles using a portable force sensor in middle-aged adults (48 ± 13 years) with medically diagnosed chronic low back pain and healthy peers (n = 35). Participants completed two submaximal progressive tests of two resistance-band exercises (unilateral row and Pallof press), consisting of 5 s maintained contraction, progressively increasing the load. The test stopped when deviation from the initial position by compensation movements occurred. Trunk muscle strength (CORE muscles) was monitored in real time using a portable force sensor (strain gauge). Results revealed that both tests were highly reliable (intra-class correlation [ICC] > 0.901) and presented low errors and coefficients of variation (CV) in both groups. In particular, people with low back pain had errors of 14-19 N (CV = 9-12%) in the unilateral row test and 13-19 N (CV = 8-12%) in the Pallof press. No discomfort or pain was reported during or after the tests. These two easy-to-use and technology-based tests result in a reliable and objective screening tool to evaluate the strength and trunk stability in middle-aged adults with chronic low back pain, considering an error of measurement < 20 N. This contribution may have an impact on improving the individualization and control of rehabilitation or physical training in people with lumbar injuries or disorders.
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Affiliation(s)
- Francisco Franco-López
- Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, 30720 Murcia, Spain
| | | | | | - Enrique Higueras-Liébana
- Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, 30720 Murcia, Spain
| | | | - Javier Courel-Ibáñez
- Department of Physical Education and Sports, Faculty of Education and Sport Sciences, University of Granada, 52005 Melilla, Spain
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Jiang TE, Edwards KA, Dildine TC, You DS, Nguyen T, Pascual AP, Falasinnu T. Trends in Patient Representation in Low Back Pain Pharmacological Randomized Clinical Trials, 2011 to 2020: A Systematic Review. THE JOURNAL OF PAIN 2024; 25:104456. [PMID: 38185211 PMCID: PMC11128353 DOI: 10.1016/j.jpain.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
Low back pain (LBP) significantly affects global health, with associated detrimental outcomes such as physical impairment, emotional distress, and exacerbated mental health symptoms. This study evaluated the representation of marginalized groups, including racialized, gender minority, pregnant/lactating, and elderly individuals in randomized controlled trials for pharmacological interventions treating LBP from 2011 to 2020. We searched Embase, MEDLINE, and CINAHL in December 2021, and 139 studies were eligible. Most trials (n = 113, 81%) reported participant sex; however, no study collected data on sexual and gender minorities, and the majority (n = 99, 71%) excluded pregnant/lactating individuals. Most trials (n = 105, 76%) reported no data on participant race or ethnicity. We limited within-country analyses of race and ethnicity to US-based trials because US-based trials were more likely to report race and/or ethnicity (48%) compared to non-US-based trials (8%). Black participants were the only racialized group whose composition was comparable to US Census estimates. About half (n = 73, 53%) of all trials had an upper age limit for eligibility (range: 40-85 years old) and 24% (n = 33) excluded adults aged >65 years. Our findings confirm that trials for pharmacological LBP interventions underreport demographic data, and the trials that include this data have unrepresentative samples. There is an urgent need for more inclusive and representative patient samples to ensure generalizability and equitable benefits. Standardizing demographic data reporting and integrating community-based participatory research methods can help foster inclusive research practices. This review was registered with prospective register of systematic reviews (PROSPERO), ID 296017. PERSPECTIVE: This systematic review investigates patient representation in pharmacological-based clinical trials for low back pain, LBP, the most prevalent pain condition worldwide. Improvements in reporting demographic data and recruiting diverse participant populations-across different racialized, gender and sexual minority, and age groups-will help clinical research generalizability and provide equitable benefits.
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Affiliation(s)
- Tiffany E Jiang
- Department of Epidemiology and Population Sciences, Stanford University School of Medicine, Stanford, California; Yale School of Medicine, New Haven, Connecticut
| | - Karlyn A Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California; The Center for Research on Health Care, University of Pittsburgh Division of General Internal Medicine, Pittsburgh, Pennsylvania
| | - Troy C Dildine
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Dokyoung S You
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Thy Nguyen
- Department of Epidemiology and Population Sciences, Stanford University School of Medicine, Stanford, California
| | - Alissa P Pascual
- Department of Human Biology, Stanford University, Stanford, California
| | - Titilola Falasinnu
- Department of Epidemiology and Population Sciences, Stanford University School of Medicine, Stanford, California; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
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Silişteanu SC, Antonescu E, Duică L, Totan M, Cucu AI, Costea AI. Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities. Healthcare (Basel) 2024; 12:853. [PMID: 38667615 PMCID: PMC11050304 DOI: 10.3390/healthcare12080853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.
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Affiliation(s)
- Sînziana Călina Silişteanu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Elisabeta Antonescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Lavinia Duică
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Andrei Ionuţ Cucu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Andrei Ioan Costea
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
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Oertel J, Sharif S, Zygourakis C, Sippl C. Acute low back pain: Epidemiology, etiology, and prevention: WFNS spine committee recommendations. World Neurosurg X 2024; 22:100313. [PMID: 38510335 PMCID: PMC10951075 DOI: 10.1016/j.wnsx.2024.100313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Objective Acute low back pain is a highly prevalent condition that poses significant challenges to healthcare systems worldwide. In this manuscript, we present the most current, evidence-based guidelines from the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the epidemiology, etiology, and prevention of acute low back pain (LBP) lasting ≤ 4 weeks. Methods We performed a literature review 2012-2022 using the PubMed, Medline, and CENTRAL databases with the keywords "acute low back pain", "acute back pain", "low back pain", "epidemiology", "etiology", "costs", "risk factor", "cultural", "developed", "developing" and "prevention". Systematic screening criteria were applied, resulting in 13 final articles on epidemiology and etiology of LBP, 2 manuscripts on costs, 5 articles on risk factors, and 23 articles on prevention strategies for acute LBP. These were presented at two separate international meetings, where members of the WFNS Spine Committee voted on five final consensus statements presented here. Results and Conclusions: There is a high incidence and prevalence of acute LBP, particularly in high-income countries, which is felt to be at least partially due to demographic shifts with an aging population and lifestyle changes including higher rates of obesity and physical inactivity. Acute LBP has a significant impact on quality of life and ability to work, resulting in high direct and indirect costs worldwide. Early diagnosis and appropriate management of acute LBP is recommended to prevent this pain from turning into chronic LBP. The WFNS Spine Committee's recommendations respresent the latest guidelies to help improve patient care for acute LBP worldwide.
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Affiliation(s)
- Joachim Oertel
- Department of Neurosurgery, Saarland University Medical Centre, Kirrbergerstrasse 100, Gebaeude 90.5, 66421 Homburg Saar, Germany
| | - Salman Sharif
- Department of Neurosurgery, Liaqat National Hospital and Medical School, Stadium Road, Karachi 74800, Pakistan
| | - Corinna Zygourakis
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Christoph Sippl
- Department of Neurosurgery, Saarland University Medical Centre, Kirrbergerstrasse 100, Gebaeude 90.5, 66421 Homburg Saar, Germany
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Chen N, Fong DYT, Wong JYH. Health and economic burden of low back pain and rheumatoid arthritis attributable to smoking in 192 countries and territories in 2019. Addiction 2024; 119:677-685. [PMID: 38105035 DOI: 10.1111/add.16404] [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: 12/24/2022] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND AND AIMS Smoking is a risk factor for low back pain (LBP) and rheumatoid arthritis (RA). We aimed to estimate the global health and economic burden of LBP and RA attributable to smoking. DESIGN This was a cross-sectional study. SETTING The study was conducted in 192 countries and territories. CASES Prevalent cases of LBP and RA were used, extracted from the Global Burden of Diseases, Injuries and Risk Factors Study 2019 data repositories. MEASUREMENTS Smoking-attributable health and economic burden was estimated with the population-attributable fraction method. Smoking-attributable prevalence of LBP and RA and health-care costs were estimated for patients of all ages, whereas years lived with disability (YLDs) and productivity losses due to morbidity were estimated for patients aged 15-84 years. Uncertainty intervals (UIs) of the results were obtained by repeating the analysis with the lower and upper bounds of all input variables. FINDINGS Globally, smoking accounted for 84.5 million (UI = 56.7-120.2 million) prevalent cases of LBP, 1.8 million (UI = 0.5-3.4 million) prevalent cases of RA and 11.3 million (UI = 6.2-18.5 million) YLDs, which represented 1.5% of all-cause YLDs in the working-age population aged 15-84 years in 2019. Health-care costs and productivity losses of smoking-attributable LBP and RA cost the global economy purchasing-power parity $326.0 billion (UI = $184.0-521.4 billion), representing 0.2% of the global gross domestic product. Specifically, smoking accounted for $65.8 billion (UI = $38.0-101.2 billion) in health-care costs world-wide, with more than half [$39.8 billion (UI = $23.1-61.3 billion), 60.6%] borne by the public sector. Smoking also contributed to $260.3 billion (UI = $146.0-420.3 billion) in productivity losses globally. Approximately 60.0% of the global YLDs were observed in middle-income countries, whereas 84.4% of health-care costs and 72.7% of productivity losses were borne by high-income countries. CONCLUSIONS Globally, in 2019, smoking accounted for more than 11.0 million years lived with disability and purchasing-power parity $326.0 billion in economic losses due to low back pain and rheumatoid arthritis. Middle-income countries suffered more morbidity, whereas high-income countries experienced larger economic losses.
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Affiliation(s)
- Ningjing Chen
- School of Nursing, Putian University, Putian, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
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Soreau A, Ferey C, Hardouin JB, Draper-Rodi J, Sarzeaud R, Benoist H, Ostelo RW, Merdy O. Translation, validity and reliability of the pain attitudes and beliefs scale for physiotherapists in French. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2078. [PMID: 38430539 DOI: 10.1002/pri.2078] [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: 02/09/2023] [Revised: 06/29/2023] [Accepted: 02/13/2024] [Indexed: 03/04/2024]
Abstract
BACKGROUND The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) questionnaire evaluates manual therapists' biomedical and biopsychosocial beliefs regarding the management of chronic low back pain. Its usage in clinical settings is an important step in the implementation of national guidelines and policies to improve patient management. OBJECTIVES The objective of this study was to translate the PABS-PT questionnaire into French, to adapt it culturally, and to conduct a psychometric analysis. DESIGN Qualitative and cross-sectional study. METHOD The translation process followed published guidelines with cross-cultural validation by an expert committee. We followed a forward and backward translation procedure and an expert committee, including the original author of the questionnaire and a linguistics expert ensuring good cultural adaptation, issued a finalised version. Psychometric analysis of the French version of the questionnaire was conducted among 390 French manual therapists in two phases. The first phase evaluated structural validity as well as external validity compared with the TSK and BBQ questionnaires. Then, reliability and scalability were analysed. The second phase evaluated test-retest reproducibility by sending the same questionnaire 3 months later. RESULTS The validity study revealed three subscales: the classic biomedical subscale and two subscales for biopsychosocial beliefs (aetiology of pain and physical activity). With 21 items in total for the PABS-PT-FR, the structural validity scores were good (BM: alpha = 0.82, H = 0.38; Physical Activity: alpha = 0.62, H = 0.32; Aetiology of Pain: alpha = 0.55, H = 0.29). CONCLUSIONS This study provides a validated tool to assess French physiotherapists' and, more generally, healthcare providers' beliefs about chronic low back pain, with a new insight into the BPS subscale internal construct.
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Affiliation(s)
- Alexis Soreau
- Institut des Hautes Études Ostéopathiques (IdHEO), St-Herblain, France
| | - Cassandre Ferey
- Institut des Hautes Études Ostéopathiques (IdHEO), St-Herblain, France
- UMR INSERM 1246 - SPHERE, Nantes Université, Université de Tours, Tours, France
| | - Jean-Benoit Hardouin
- UMR INSERM 1246 - SPHERE, Nantes Université, Université de Tours, Tours, France
- Service de santé publique - Plateforme de Méthodologie et de Biostatistique - CHU de Nantes, Nantes, France
| | - Jerry Draper-Rodi
- Research Centre, University College of Osteopathy, London, UK
- National Council for Osteopathic Research, London, UK
| | - Robert Sarzeaud
- Institut des Hautes Études Ostéopathiques (IdHEO), St-Herblain, France
| | - Hélène Benoist
- Freelance Translator (English and Spanish into French), Finistère, France
| | - Raymond W Ostelo
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit & Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Olivier Merdy
- Institut des Hautes Études Ostéopathiques (IdHEO), St-Herblain, France
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Ma J, Tian Z, Chai P, Wan Q, Zhai T, Guo F, Li Y. Estimating the economic burden of stroke in China: a cost-of-illness study. BMJ Open 2024; 14:e080634. [PMID: 38485178 PMCID: PMC10941115 DOI: 10.1136/bmjopen-2023-080634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES Stroke imposes a heavy economic burden and loss of productivity on individuals and society. This study assessed a range of crucial factors, including direct costs and indirect costs, to gauge the economic implications of stroke in China. These outcomes were evaluated with specific reference to the year 2018, using the Chinese yuan (¥) as the unit of measurement and providing the corresponding purchasing power parity dollar ($PPP) currency value. METHODS A cost-of-illness methodology was used to ascertain the economic implications of stroke in 2018. Within the constraints of this approach, economic costs were defined as 'direct costs' or 'indirect costs'. We estimated direct costs from sample data, the National Health Service Survey and the National Health Account and Health Statistical Yearbook. A human capital method was used to conservatively estimate indirect costs. RESULTS In 2018, of the economic burden of stroke in China, the direct costs were ¥247.8 billion ($PPP 58.6 billion) and indirect costs were ¥704.4 billion ($PPP 166.5 billion). The curative care expenditure for stroke was ¥193.1 billion ($PPP 45.7 billion), consuming nearly 5.5% of curative expenditure. The cost of stroke treatment relied heavily on public financing, with 58% from social health insurance and 14% from government sources. CONCLUSIONS A significant economic burden is imposed by stroke on China's economy, and there is a risk of underestimating this burden if indirect costs are not comprehensively considered. The importance of implementing effective preventive measures and screening strategies for stroke, with a particular focus on high-risk populations, is underscored by this study's findings. Such investments in public health have the potential to yield substantial benefits.
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Affiliation(s)
- Jingdong Ma
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Zeshi Tian
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Peipei Chai
- Department of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China
| | - Quan Wan
- Department of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China
| | - Tiemin Zhai
- Department of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China
| | - Feng Guo
- Department of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China
| | - Yan Li
- Department of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China
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11
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Van Bogaert W, Liew BXW, Fernández-de-Las-Peñas C, Valera-Calero JA, Varol U, Coppieters I, Kregel J, Nijs J, Meeus M, Cagnie B, Danneels L, Malfliet A. Exploring Interactions Between Sex, Pain Characteristics, Disability, and Quality of Life in People With Chronic Spinal Pain: A Structural Equation Model. THE JOURNAL OF PAIN 2024; 25:791-804. [PMID: 37871684 DOI: 10.1016/j.jpain.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023]
Abstract
In people with nonspecific chronic spinal pain (nCSP), disability and quality of life are associated with clinical, cognitive, psychophysical, and demographic variables. However, evidence regarding the interactions between these variables is only limited to this population. Therefore, this study aims to explore path models explaining the multivariate contributions of such variables to disability and quality of life in people with nCSP. This secondary analysis uses baseline data from a randomized controlled trial including 120 participants with nCSP. Structural equation modeling was used to explore path models for the Pain Disability Index (PDI), the Short Form 36-item physical (SF-36 PC), and mental (SF-36 MC) component scores. All models included sex, pain catastrophizing, kinesiophobia, hypervigilance, and pain intensity. Additionally, the PDI and SF-36 PC models included pressure pain thresholds (PPTs) at the dominant pain site (ie, neck or low back). Significant associations were found between sex, pain cognitions, pain intensity, and PPTs. Only pain catastrophizing significantly directly influenced the PDI (P ≤ .001) and SF-36 MC (P = .014), while the direct effects on the SF-36 PC from kinesiophobia (P = .008) and pain intensity (P = .006) were also significant. However, only the combined effect of all pain cognitions on the SF-36 PC was mediated by pain intensity (P = .019). Our findings indicate that patients' pain-related cognitions have an adverse effect on their physical health-related quality of life via a negative influence on their pain intensity in people with nCSP. PERSPECTIVE: This secondary analysis details a network analysis confirming significant interactions between sex, pain cognitions, pain intensity, and PPTs in relation to disability and health-related quality of life in people with chronic spinal pain. Moreover, its findings establish the importance of pain cognitions and pain intensity for these outcomes. TRIALS REGISTRATION: Clinicaltrials.gov (NCT02098005).
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Affiliation(s)
- Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Juan A Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain; InPhysio Group, Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Umut Varol
- International Doctoral School, Rey Juan Carlos University, Alcorcón, Spain
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; The Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
| | - Jeroen Kregel
- Breederode Hogeschool, Rotterdam, The Netherlands; Pain in Motion International Research Group
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mira Meeus
- Pain in Motion International Research Group; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium; Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
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12
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Sanchis-Soler G, Tortosa-Martinez J, Sebastia-Amat S, Chulvi-Medrano I, Cortell-Tormo JM. Is Acute Lower Back Pain Associated with Heart Rate Variability Changes? A Protocol for Systematic Reviews. Healthcare (Basel) 2024; 12:397. [PMID: 38338282 PMCID: PMC10855181 DOI: 10.3390/healthcare12030397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Acute lower back pain (ALBP) is an extremely common musculoskeletal problem. ALBP consists of a sudden onset of short-duration pain in the lower back. However, repeated attacks can make the pain chronic. It can be measured through a self-report scale as well as through physical and physiological evaluations. Heart Rate Variability (HRV) has been used to evaluate the body's response to pain. However, to the best of our knowledge, no clear consensus has been reached regarding the relationship between both variables and on an optimal protocol for ALBP evaluation based on HRV. The objective of this review is to analyze the relationship and effectiveness of HRV as an instrument for measuring ALBP. Furthermore, we consider the influence of different types of interventions in this relationship. The protocol of this review was previously recorded in the International Prospective Register of Systematic Reviews (number CRD42023437160). The PRISMA guidelines for systematic reviews and PubMed, WOS and Scopus databases are employed. Studies with samples of adults with ALBP are included. This study sets out a systematic review protocol to help identify the relationship between HRV and ALBP. Understanding this relationship could help in designing early detection or action protocols that alleviate ALBP.
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Affiliation(s)
- Gema Sanchis-Soler
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (G.S.-S.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Juan Tortosa-Martinez
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (G.S.-S.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Sergio Sebastia-Amat
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (G.S.-S.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Ivan Chulvi-Medrano
- Department of Physical and Sports Education, University of Valencia, 46010 Valencia, Spain;
| | - Juan Manuel Cortell-Tormo
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (G.S.-S.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
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13
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Ceulemans D, Moens M, Reneman M, Callens J, De Smedt A, Godderis L, Goudman L, Lavreysen O, Putman K, Van de Velde D. Biopsychosocial rehabilitation in the working population with chronic low back pain: a concept analysis. J Rehabil Med 2024; 56:jrm13454. [PMID: 38226563 PMCID: PMC10802789 DOI: 10.2340/jrm.v56.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/29/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE To identify the essential attributes of biopsychosocial rehabilitation for chronic low back pain in the working population. DESIGN A concept analysis was conducted according to the 8-step method of Walker and Avant. This framework provides a clear concept and theoretical and operational definitions. METHODS Five databases were searched, followed by a systematic screening. Subsequently, attributes, illustrative cases, antecedents, consequences and empirical referents were formulated. RESULTS Of the 3793 studies identified, 42 unique references were included. Eleven attributes were identified: therapeutic exercise, psychological support, education, personalization, self-management, participation, follow-up, practice standard, goal-setting, social support, and dietary advice. Subsequently, illustrative cases were described. Antecedents, such as motivation, preparedness and a multidisciplinary team, were found, together with consequences such as decreased pain, less sick-leave and increased function and work status. Finally, examples of empirical referents were given. CONCLUSION This study identified the attributes that are necessary to develop biopsychosocial rehabilitation intervention programmes for chronic low back pain. The defined concept of biopsychosocial rehabilitation for chronic low back pain may serve as a solid base to further develop and apply interventions. Future research should focus on the objectification of biopsychosocial rehabilitation and conceptualization regarding how personalization is done.
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Affiliation(s)
- Dries Ceulemans
- Faculty of Medicine and Healthcare Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium; STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium.
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Michiel Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Jonas Callens
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium
| | - Ann De Smedt
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Olivia Lavreysen
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Healthcare Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium
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14
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Leão Monteiro R. Future of low back pain: unravelling IVD components and MSCs' potential. CELL REGENERATION (LONDON, ENGLAND) 2024; 13:1. [PMID: 38227139 DOI: 10.1186/s13619-023-00184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Abstract
Low back pain (LBP) mainly emerges from intervertebral disc (IVD) degeneration. However, the failing mechanism of IVD ́s components, like the annulus fibrosus (AF) and nucleus pulposus (NP), leading to IVD degeneration/herniation is still poorly understood. Moreover, the specific role of cellular populations and molecular pathways involved in the inflammatory process associated with IVD herniation remains to be highlighted. The limited knowledge of inflammation associated with the initial steps of herniation and the lack of suitable models to mimic human IVD ́s complexity are some of the reasons for that. It has become essential to enhance the knowledge of cellular and molecular key players for AF and NP cells during inflammatory-driven degeneration. Due to unique properties of immunomodulation and pluripotency, mesenchymal stem cells (MSCs) have attained diverse recognition in this field of bone and cartilage regeneration. MSCs therapy has been particularly valuable in facilitating repair of damaged tissues and may benefit in mitigating inflammation' degenerative events. Therefore, this review article conducts comprehensive research to further understand the intertwine between the mechanisms of action of IVD components and therapeutic potential of MSCs, exploring their characteristics, how to optimize their use and establish them safely in distinct settings for LPB treatment.
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15
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Park H, Lee J, Choi Y, Kim JH, Kim S, Kim YR, Lee CH, Park SB, Kim KT, Rhee JM, Kim CH. Screening patients requiring secondary lumbar surgery for degenerative lumbar spine diseases: a nationwide sample cohort study. Sci Rep 2024; 14:1295. [PMID: 38221532 PMCID: PMC10788335 DOI: 10.1038/s41598-024-51861-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/10/2024] [Indexed: 01/16/2024] Open
Abstract
This study aims to identify healthcare costs indicators predicting secondary surgery for degenerative lumbar spine disease (DLSD), which significantly impacts healthcare budgets. Analyzing data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database of Republic of Korea (ROK), the study included 3881 patients who had surgery for lumbar disc herniation (LDH), lumbar spinal stenosis without spondylolisthesis (LSS without SPL), lumbar spinal stenosis with spondylolisthesis (LSS with SPL), and spondylolysis (SP) from 2006 to 2008. Patients were categorized into two groups: those undergoing secondary surgery (S-group) and those not (NS-group). Surgical and interim costs were compared, with S-group having higher secondary surgery costs ($1829.59 vs $1618.40 in NS-group, P = 0.002) and higher interim costs ($30.03; 1.86% of initial surgery costs vs $16.09; 0.99% of initial surgery costs in NS-group, P < 0.0001). The same trend was observed in LDH, LSS without SPL, and LSS with SPL (P < 0.0001). Monitoring interim costs trends post-initial surgery can effectively identify patients requiring secondary surgery.
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Affiliation(s)
- Hangeul Park
- Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Juhee Lee
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yunhee Choi
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jun-Hoe Kim
- Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sum Kim
- Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young-Rak Kim
- Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Neurosurgery, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sung Bae Park
- Department of Neurosurgery, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Neurosurgery, Seoul National University Boramae Hospital, Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - John M Rhee
- Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Neurosurgery, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Medical Device Development, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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16
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Upadhyay R, Kumar A, Bhattacherjee A, Patra AK, Chau N. Reducing musculoskeletal disorders in iron ore mine operators: A fuzzy-based intervention approach. Work 2024; 78:131-152. [PMID: 38517835 DOI: 10.3233/wor-230489] [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] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND This study focuses on evaluating the exposure to whole-body vibration (WBV) and association of musculoskeletal disorders (MSDs) with various risk factors among dumper operators in the mining industry. Despite the issue's significance, prior research has been limited. OBJECTIVE The study introduces a novel fuzzy-based approach for identifying, selecting, and prioritizing safety measures to mitigate MSD risks. METHODS Data collection comprised face-to-face interviews, anthropometric measurements, Rapid Upper Limb Assessment (RULA) scoring for posture assessment, and the Nordic Musculoskeletal questionnaire for assessment of MSD prevalence. Multiple linear and logistic regression models were used to analyse the contributing risk factors to MSDs and WBV exposure. These risk factors formed the basis for a practical approach to select appropriate safety measures based on fuzzy based aggregation method of expert's judgment aimed at mitigating the risk of MSDs. RESULTS The results revealed that the risk factors such as poor work posture, WBV exposure and poor seat design were significantly associated with neck (adjusted odds ratio aOR = 4.81), upper limb and shoulder (aOR = 3.28), upper back (aOR = 5.09), and lower back pain (aOR = 3.67) at p < 0.05. Using these factors to formulate safety measures to reduce MSD risk, the minimization of sharp turns and abrupt changes in elevation in designing the haul roads, scheduled maintenance practices, and ergonomic seat design were found as important safety measures in this study. CONCLUSION Our unique methodological approach in occupational health research could be highly beneficial for tailoring safety measures at the unit level with minimal effort.
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Affiliation(s)
- Rahul Upadhyay
- Department of Mining Engineering, Indian Institute of Technology, Kharagpur, India
| | - Ashish Kumar
- Department of Mining Engineering, Indian Institute of Technology, Kharagpur, India
| | - Ashis Bhattacherjee
- Department of Mining Engineering, Indian Institute of Technology, Kharagpur, India
| | - Aditya Kumar Patra
- Department of Mining Engineering, Indian Institute of Technology, Kharagpur, India
| | - Nearkasen Chau
- National Institute for Health and Medical Research (Inserm), Paris, France
- University Paris-Sud and University Paris Descartes, UMR, Paris, France
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17
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Hansen A, Mortensen OS, Escorpizo R, Søgaard K, Søndergaard J, Schiøttz-Christensen B, Lauridsen HH. Assessing Work Functioning in Patients with Persistent Low Back Pain: Exploring the Structural Validity of the Work Rehabilitation Questionnaire. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10157-9. [PMID: 38102368 DOI: 10.1007/s10926-023-10157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/05/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Assessing work functioning in patients with persistent low back pain (LBP) is important for understanding their ability to engage in work-related activities. This study aims to evaluate the item characteristics, factor structure, and internal consistency of the Work Rehabilitation Questionnaire (WORQ) in patients with persistent LBP. METHODS Four hundred and twenty-five individuals with LBP completed the WORQ. Item characteristics, exploratory factor analysis (EFA), and consistency were performed to identify the underlying factors. RESULTS Missing responses were < 2% for each item. The analysis revealed three factors: psychological wellbeing, physical functioning, and cognitive ability. The factors demonstrated strong internal consistency, with Cronbach's alpha values ranging from 0.88 to 0.93 and McDonald's Omega from 0.92 to 0.96. Fifteen items did not fit into any identified factors, suggesting their potential value in screening functioning levels beyond the factors. CONCLUSIONS The WORQ is a valid instrument for evaluating work limitations in individuals with persistent LBP. Further research should assess its responsiveness to changes from interventions that target workability. Advancing this knowledge has the potential to promote work rehabilitation and improve the quality of life for patients with persistent LBP.
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Affiliation(s)
- Anders Hansen
- Medical Research, Spine Centre of Southern Denmark, Lillebaelt Hospital, University Hospital of Southern Denmark, Østre Houghvej 55, 5500, Middelfart, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbæk Hospital, Part of Copenhagen University Hospital, Holbæk, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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18
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Fuming Z, Zhicheng L, Huanjie H, Xinna Z, Rong C, Jiahui P, Liming Y, Xi C, Chuhuai W. Home-based rehabilitation training with human key point detection for chronic low back pain patients: a randomized controlled trial protocol. Trials 2023; 24:760. [PMID: 38012740 PMCID: PMC10680338 DOI: 10.1186/s13063-023-07805-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Core stability exercise (CSE) is a globally acknowledged intervention for managing chronic low back pain. However, the sustained adherence of patients with chronic low back pain to CSE can be challenging, mainly due to the absence of supervision and guidance from physical therapists during home-based exercise sessions. Consequently, exercise compliance tends to decline, resulting in suboptimal long-term effectiveness of the intervention. In this trial, our primary aim is to evaluate the potential therapeutic equivalence between home-based rehabilitation training employing key point identification technology and exercise guidance administered in a hospital setting. METHODS In this trial, we will randomly assign 104 adults with chronic low back pain (CLBP) to either an intervention or control group, with 52 participants in each group. Both interventions will consist of three weekly 0.5-h sessions of core stability exercise (CSE). The intervention group will engage in home rehabilitation training utilizing key identification technology for movement, while the control group will perform supervised exercises in a hospital setting. Outcome assessments will be conducted at 4 weeks and 16 weeks after randomization. The primary outcome measure will be the change in pain intensity based on numeric rating scale (NRS scores) from baseline to 4 weeks. Secondary outcomes will include changes in physical function (measured by the Oswestry Disability Index (ODI)) and lumbar spine mobility as well as activity participation and treatment satisfaction. DISCUSSION If home-based rehabilitation method is demonstrated to be non-inferior or even superior to traditional face-to-face exercise guidance, it could significantly advance the adoption of digital medical care and contribute to improving the overall health of the population. TRIAL REGISTRATION NCT05998434 . Registered on 16 August 2023.
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Affiliation(s)
- Zheng Fuming
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Li Zhicheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Huang Huanjie
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Zhang Xinna
- Yinshan Future Health Technology Co., Ltd, Beijing, 100080, China
| | - Chen Rong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Peng Jiahui
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yang Liming
- Yinshan Future Health Technology Co., Ltd, Beijing, 100080, China
| | - Chen Xi
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Wang Chuhuai
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
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19
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Capel-Alcaraz AM, Castro-Sánchez AM, Matarán-Peñarrocha GA, Antequera-Soler E, Lara-Palomo IC. Effects of Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis. Clin J Sport Med 2023; 33:579-597. [PMID: 37432388 DOI: 10.1097/jsm.0000000000001175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The primary objective of this systematic review is to assess whether motor control exercises consisting of the methodology described by Richardson and Hodges improve the pain and disability of patients with nonspecific low back pain. DESIGN Systematic review and a meta-analysis. SETTING A literature review was conducted using PubMed, PEDro, Scielo, CINAHL, Web of Science, Dialnet, Scopus, and MEDLINE from inception to November 2021. PATIENTS Patients with chronic nonspecific low back pain. INTERVENTIONS Randomized controlled trials assessing motor control exercises versus inactive control, placebo or minimal intervention, and other exercises. MAIN OUTCOME MEASURES Pain intensity, disability, and physical activity were considered as primary outcomes. RESULTS Eighteen studies with 1356 patients were finally included in the systematic review, of which only 13 randomized clinical trials could be meta-analyzed. Statistically significant results were found in favor of the motor control group for the comparison with other exercises in disability at postintervention term (Mean Difference, 95% Confidence Interval [CI], -3.13 [-5.87 to -0.38], P = 0.03); for the comparison with inactive control, placebo, or minimal intervention in pain at postintervention term (MD, 95% CI, -18.10 [-30.79 to -5.41], P = 0.008); and for comparison with general exercises (MD, 95% CI, -12.70 [-20.80 to -4.60], P = 0.002). CONCLUSIONS Moderate-quality evidence regarding the effectiveness of motor control exercises to reduce pain intensity and disability exists, but the reduction should be interpreted with caution.
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Affiliation(s)
- Ana M Capel-Alcaraz
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain; and
| | | | | | - Eduardo Antequera-Soler
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain; and
| | - Inmaculada C Lara-Palomo
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain; and
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20
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Rubí-Carnacea F, Masbernat-Almenara M, Climent-Sanz C, Soler-González J, García-Escudero M, Martínez-Navarro O, Valenzuela-Pascual F. Effectiveness of an exercise intervention based on preactivation of the abdominal transverse muscle in patients with chronic nonspecific low back pain in primary care: a randomized control trial. BMC PRIMARY CARE 2023; 24:180. [PMID: 37674205 PMCID: PMC10483714 DOI: 10.1186/s12875-023-02140-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain. METHODS A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group. RESULTS For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle. CONCLUSION A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.
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Affiliation(s)
- Francesc Rubí-Carnacea
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Maria Masbernat-Almenara
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España.
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España.
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España.
| | - Carolina Climent-Sanz
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Jorge Soler-González
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
- Catalan Institute of Health, Rambla de Ferran 44, 25007, Lleida, España
| | - María García-Escudero
- Faculty of Medicine and Health Sciences, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - Oriol Martínez-Navarro
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Fran Valenzuela-Pascual
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
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21
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Geng Z, Wang J, Chen G, Liu J, Lan J, Zhang Z, Miao J. Gut microbiota and intervertebral disc degeneration: a bidirectional two-sample Mendelian randomization study. J Orthop Surg Res 2023; 18:601. [PMID: 37580794 PMCID: PMC10424333 DOI: 10.1186/s13018-023-04081-0] [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: 06/20/2023] [Accepted: 08/06/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Although previous studies have suggested a close association between gut microbiota (GM) and intervertebral disc degeneration (IVDD), the causal relationship between them remains unclear. Hence, we thoroughly investigate their causal relationship by means of a two-sample Mendelian randomization (MR) study, aiming to determine the impact of gut microbiota on the risk of developing intervertebral disc degeneration. METHODS Summary data from genome-wide association studies of GM (the MiBioGen) and IVDD (the FinnGen biobank) have been acquired. The inverse variance weighted (IVW) method was utilized as the primary MR analysis approach. Weighted median, MR-Egger regression, weighted mode, and simple mode were used as supplements. The Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) and MR-Egger regression were performed to assess horizontal pleiotropy. Cochran's Q test evaluated heterogeneity. Leave-one-out sensitivity analysis was further conducted to determine the reliability of the causal relationship. A reverse MR analysis was conducted to assess potential reverse causation. RESULTS We identified nine gut microbial taxa that were causally associated with IVDD (P < 0.05). Following the Benjamini-Hochberg corrected test, the association between the phylum Bacteroidetes and a higher risk of IVDD remained significant (IVW FDR-corrected P = 0.0365). The results of the Cochrane Q test did not indicate heterogeneity (P > 0.05). Additionally, both the MR-Egger intercept test and the MR-PRESSO global test revealed that our results were not influenced by horizontal pleiotropy (P > 0.05). Furthermore, the leave-one-out analysis substantiated the reliability of the causal relationship. In the reverse analysis, no evidence was found to suggest that IVDD has an impact on the gut microbiota. CONCLUSION Our results validate the potential causal impact of particular GM taxa on IVDD, thus providing fresh insights into the gut microbiota-mediated mechanism of IVDD and laying the groundwork for further research into targeted preventive measures.
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Affiliation(s)
- Ziming Geng
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China
| | - Jian Wang
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China
| | - Guangdong Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China
| | - Jianchao Liu
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China
| | - Jie Lan
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China
| | - Zepei Zhang
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China
| | - Jun Miao
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China.
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22
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Fatoye F, Gebrye T, Ryan CG, Useh U, Mbada C. Global and regional estimates of clinical and economic burden of low back pain in high-income countries: a systematic review and meta-analysis. Front Public Health 2023; 11:1098100. [PMID: 37383269 PMCID: PMC10298167 DOI: 10.3389/fpubh.2023.1098100] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/25/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Low back pain (LBP) is a common health problem, and the leading cause of activity limitation and work absence among people of all ages and socioeconomic strata. This study aimed to analyse the clinical and economic burden of LBP in high income countries (HICs) via systematic review and meta-analysis. Methods A literature search was carried out on PubMed, Medline, CINAHL, PsycINFO, AMED, and Scopus databases was from inception to March 15th, 2023. Studies that assessed the clinical and economic burden of LBP in HICs and published in English language were reviewed. The methodological quality of the included studies was assessed using the Newcastle-Ottawa quality assessment scale (NOS) for cohort studies. Two reviewers, using a predefined data extraction form, independently extracted data. Meta-analyses were conducted for clinical and economic outcomes. Results The search identified 4,081 potentially relevant articles. Twenty-one studies that met the eligibility criteria were included and reviewed in this systematic review and meta-analysis. The included studies were from the regions of America (n = 5); Europe (n = 12), and the Western Pacific (n = 4). The average annual direct and indirect costs estimate per population for LBP ranged from € 2.3 billion to € 2.6 billion; and € 0.24 billion to $8.15 billion, respectively. In the random effects meta-analysis, the pooled annual rate of hospitalization for LBP was 3.2% (95% confidence interval 0.6%-5.7%). The pooled direct costs and total costs of LBP per patients were USD 9,231 (95% confidence interval -7,126.71-25,588.9) and USD 10,143.1 (95% confidence interval 6,083.59-14,202.6), respectively. Discussion Low back pain led to high clinical and economic burden in HICs that varied significantly across the geographical contexts. The results of our analysis can be used by clinicians, and policymakers to better allocate resources for prevention and management strategies for LBP to improve health outcomes and reduce the substantial burden associated with the condition. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails?, PROSPERO [CRD42020196335].
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
- Lifestyle Diseases, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Tadesse Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Cormac G. Ryan
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middleborough, United Kingdom
| | - Ushotanefe Useh
- Lifestyle Diseases, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Chidozie Mbada
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
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Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The objectives of this systematic review, conducted using a collaborative review model, are to: Assess the effectiveness of exercise treatment (overall) in adults with chronic non‐specific low back pain on important individual health outcomes: pain, functional limitations, health‐related quality of life, depression, and adverse effects versus comparison treatments: (a) placebo, sham, or attention control, (b) no trial treatment (including waiting lists, control groups described as having no treatment provided, usual/normal care not controlled by the trial available to all treatment groups, or when the exercise and comparison groups receive the same co‐interventions, allowing the effect of exercise treatment to be isolated), and (c) other conservative treatments (eight categories). Estimate the treatment effects and associated uncertainty for comparisons of different specific types of exercise treatment in adults with chronic non‐specific low back pain to each other, and to each comparison treatment, using direct and indirect evidence with network meta‐analysis. Estimate the treatment effects and associated uncertainty for comparisons of treatments composed of different exercise type categories, design, delivery, dose, and additional treatment components, and their combinations, using direct and indirect evidence with component network meta‐analysis.
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24
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Otero-Ketterer E, Peñacoba-Puente C, Ortega-Santiago R, Galán-Del-Río F, Valera-Calero JA. Consideration of Psychosocial Factors in Acute Low Back Pain by Physical Therapists. J Clin Med 2023; 12:jcm12113865. [PMID: 37298060 DOI: 10.3390/jcm12113865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Clinical guidelines consistently recommend screening psychosocial (PS) factors in patients with low back pain (LBP), regardless of its mechanical nature, as recognized contributors to pain chronicity. However, the ability of physiotherapists (PTs) in identifying these factors remains controversial. This study aimed to assess the current identification of psychosocial risk factors by physical therapists (PTs) and which characteristics of PTs are associated with the identification of the main risk for chronicity (physical or psychosocial). A cross-sectional descriptive study surveying Spanish PTs in public and private health services was conducted, including questions on PT characteristics and three low back pain (LBP) patient vignettes with different biopsychosocial (BPS) clinical presentations. From 484 respondents, the majority of PTs agreed regarding the main risk for chronicity for each vignette (PS 95.7% for vignette A, PS and physical 83.5% for vignette B and PS 66% for vignette C). Female PTs were more likely to rate psychosocial compared with males (p < 0.05). PTs with higher levels of social and emotional intelligence (both, p < 0.05) were more likely to identify the main risk for chronicity. However, only gender and social information processing for vignette A (p = 0.024) and emotional clarity for vignette B (p = 0.006) were able to predict the identification of psychosocial and physical risk, respectively. The main risk for chronicity was correctly identified by a large majority of PTs through patient vignettes. Gender, social and emotional intelligence played a relevant role in the recognition of psychosocial risk and biopsychosocial factors.
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Affiliation(s)
- Emilia Otero-Ketterer
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Physiotherapy Department, Mutua Universal Mugenat, 28801 Alcalá de Henares, Spain
| | | | - Ricardo Ortega-Santiago
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Fernando Galán-Del-Río
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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25
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Villatoro-Luque FJ, Rodríguez-Almagro D, Aibar-Almazán A, Fernández-Carnero S, Pecos-Martín D, Ibáñez-Vera AJ, Achalandabaso-Ochoa A. In non-specific low back pain, is an exercise program carried out through telerehabilitation as effective as one carried out in a physiotherapy center? A controlled randomized trial. Musculoskelet Sci Pract 2023; 65:102765. [PMID: 37141771 DOI: 10.1016/j.msksp.2023.102765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND s:The effectiveness of telerehabilitation (TLRH) in patients with non-specific low back pain (NLBP) remains unknown. No study till date has investigated the efficacy of a mobile-based TLRH in patients with NLBP. OBJECTIVES To investigate if a TLRH program is as effective as a clinical exercise programme in improving disability, pain intensity, pain catastrophizing, and hip pain and strength in patients with NLBP. DESIGN Single-blind, two-armed, randomized controlled study. METHOD A total of 71 individuals with NLBP were randomly allocated to either the TLRH home group (TLRH) or clinic group (CG). The TLRH followed exercise videos and read information on pain neurophysiology. The CG performed the same exercises and received on-site pain education. Both groups performed the exercises twice weekly for 8 weeks. Disability, pain intensity, pain catastrophizing, and hip pain and strength were assessed at baseline, at post-treatment, and at three months. RESULTS Statistically significant differences for time-by-group interaction were detected in the strength of left hip flexors (supine [F = 8.356; p = .005]; sitting [F = 9.828; p = .003]), right hip extensors with extended knee [F = 7.461; p = .008], left hip extensors (extended knee [F = 13.175; p = .001]; flexed knee [F = 13.505; p < .001]), pain during flexion of the right [F = 5.133; p = .027] and left [F = 4.731; p = .033] hips in the supine position, disability [F = 4.557; p = .014], and pain catastrophizing [F = 14.132; p < .001]. CONCLUSION A TLRH mobile-based is as effective as clinical treatment in improving disability, pain catastrophizing, and pain and strength of the hip structures in patients with NLBP.
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Affiliation(s)
| | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
| | - Samuel Fernández-Carnero
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
| | - Daniel Pecos-Martín
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
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26
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Rambla C, Aragonès E, Pallejà-Millán M, Tomé-Pires C, López-Cortacans G, Sánchez-Rodríguez E, Miró J. Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression. BMC Musculoskelet Disord 2023; 24:270. [PMID: 37020278 PMCID: PMC10074832 DOI: 10.1186/s12891-023-06357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Chronic pain and depression are frequent comorbidities in primary care. Depression among other psychosocial factors play a role in the clinical course of chronic pain. OBJECTIVE To study the short and long-term predictive factors of severity and interference of chronic pain in primary care patients with chronic musculoskeletal pain and major depression. METHODS Longitudinal study of a cohort of 317 patients. The outcomes are severity and functional interference of pain (Brief Pain Inventory) measured at 3 and 12 months. We performed multivariate linear regression models to estimate the effects the explanatory baseline variables on the outcomes. RESULTS 83% participants were women; average age was 60.3 years (SD = 10.2). In multivariate models, baseline pain severity predicted pain severity at 3 months (β = 0.53; 95% CI = 0.37-0.68) and at 12 months (β = 0.48; 95% CI = 0.29-0.67). Also, pain > 2 years of evolution predicted long term pain severity (β = 0.91; CI95%=0.11-1.71). Baseline pain interference predicted interference at 3 and 12 months (β = 0.27; 95%CI = 0.11-0.43 and β = 0.21; 95%CI = 0.03-0.40, respectively). Baseline pain severity predicted interference at 3 and 12 months (β = 0.26; 95%CI = 0.10-0.42 and β = 0.20; 95%CI = 0.02-0.39, respectively). Pain > 2 years predicted greater severity and greater interference at 12 months (β = 0.91; CI95%=0.11-1.71, and β = 1.23; CI95%=0.41-2.04). Depression severity predicted more interference at 12 months (β = 0.58; CI95%=0.04-1.11). Occupational status as active worker predicted less interference throughout the follow-up (β=-0.74; CI95%=-1.36 to -0.13 and β=-0.96; CI95%=-1.71 to -0.21, at 3 and 12 months). Currently working also predicts less pain severity at 12 months (β=-0.77; CI95%=1.52 - 0.02). With regard to the psychological variables, pain catastrophizing predicted pain severity and interference at three months (β = 0.03; 95% CI = 0.00-0.05 and β = 0.03; 95% CI = 0.00-0.05), but not at long term. CONCLUSION In a sample of adults with chronic pain and depression, this primary care study has identified prognostic factors that independently predict the severity and functional interference of pain. If confirmed in new studies, these factors should be targeted for individualized interventions. TRIAL REGISTRATION ClinicalTrials.gov (NCT02605278), registered 16/11/2015.
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Affiliation(s)
- Concepció Rambla
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Enric Aragonès
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain.
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
- Centre d'Atenció Primària Constantí, Carrer dels Horts, 6, Constantí, 43120, Tarragona, Spain.
| | | | - Catarina Tomé-Pires
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain
- Psychology Research Center (CIP), Autonomous University of Lisbon, Lisboa, Portugal
| | - Germán López-Cortacans
- Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain
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27
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Lavín-Pérez AM, León-Llamas JL, Salas Costilla FJ, Collado-Mateo D, López de las Heras R, Gasque Celma P, Villafaina S. Validity of On-Line Supervised Fitness Tests in People with Low Back Pain. Healthcare (Basel) 2023; 11:healthcare11071019. [PMID: 37046945 PMCID: PMC10094436 DOI: 10.3390/healthcare11071019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
This study aimed to investigate the concurrent validity between online evaluations (OEs) and face-to-face evaluations (IPEs) of a Senior Fitness Test and two balance tests in people with low back pain (LBP). Forty participants of 58.48 (9.87) years were included. The 30 s chair stand-up, arm curl, 2 min step, chair-sit and reach, back scratch, 8 foot up-and-go, sharpened Romberg, and one-legged stance tests were administrated using both OE and IPE methods. The results indicated no significant differences (p > 0.05) between the two methods except in the 8-foot up-and-go test (p = 0.007). Considering the ICC values and Bland-Altman plots, excellent agreement was found for the chair-sit and reach test, moderate agreement for the arm-curl and 8-foot up-and-go tests, and good agreement for the other tests. Strong correlations (p < 0.001) were observed in all variables except for the arm-curl and 8-foot up-and-go tests, where moderate correlations were found (p < 0.05). These results support the validity of OEs and IPEs in all tests, except for the arm-curl and 8-foot up-and-go tests, where lower ICC values and moderate correlations were found. However, it is important to consider the range of fluctuation of the ICC and the significant values obtained through correlations.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- Centre for Sport Studies, Rey Juan Carlos University, 28943 Fuenlabrada, Spain
- GO fitLAB, Ingesport, 28003 Madrid, Spain
| | - Juan Luis León-Llamas
- Physical Activity and Quality of Life Research Group (AFYCAV), Facultad de Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain
| | | | | | | | - Pablo Gasque Celma
- Sports Medicine Service, Alcobendas City Council, 28100 Alcobendas, Spain
- Department of Physical Education, Sport and Human Motricity, Autónoma Univesity, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Facultad de Ciencias del Deporte, Universidad de Extremadura, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
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Chen N, Fong DYT, Wong JYH. Health and Economic Outcomes Associated With Musculoskeletal Disorders Attributable to High Body Mass Index in 192 Countries and Territories in 2019. JAMA Netw Open 2023; 6:e2250674. [PMID: 36662529 PMCID: PMC9860530 DOI: 10.1001/jamanetworkopen.2022.50674] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/20/2022] [Indexed: 01/21/2023] Open
Abstract
Importance The degree to which health and economic outcomes of musculoskeletal disorders are attributable to high body mass index (BMI) has not been quantified on a global scale. Objective To estimate global health and economic outcomes associated with musculoskeletal disorders-low back pain (LBP), gout, and osteoarthritis attributable to high BMI in 2019. Design, Setting, and Participants This cross-sectional study used data of 192 countries and territories from the Global Burden of Diseases, Injuries, and Risk Factors Study, World Health Organization Global Health Expenditure, World Bank, and International Labour Organization databases. Data analyses were conducted from February 24 to June 16, 2022. Main Outcomes and Measures Prevalence, years lived with disability (YLDs), health care costs, and productivity losses due to morbidity from LBP, gout, and osteoarthritis attributable to high BMI by region and country. Prevalence and YLDs were calculated with the population attributable fraction approach. The economic burden, including health care costs and productivity losses due to morbidity, was also quantified. Health care costs borne by the public, private, and out-of-pocket sectors were estimated based on their corresponding payment shares. Productivity losses were estimated based on the output per worker. A sensitivity analysis was conducted to arrive at the base, minimum, and maximum estimates (ie, uncertainty interval [UI]) by using the mean, lower, and upper bounds of all input variables. Results High BMI was estimated to be responsible for 36.3 million (UI, 18.4-61.0 million), 16.9 million (UI, 7.5-32.5 million), and 73.0 million (UI, 32.4-131.1 million) prevalent cases of LBP, gout, and osteoarthritis, respectively, which accounted for 7.3 million (UI, 3.0-15.0 million) YLDs across 192 countries and territories in 2019. Globally, the YLDs of musculoskeletal disorders attributable to high BMI accounted for 1.0% of all-cause YLDs in the working-age population aged 15 to 84 years. The global total costs of musculoskeletal disorders attributable to high BMI reached $180.7 billion (UI, $83.8-$333.1 billion), including $60.5 billion (UI, $30.7-$100.5 billion) in health care costs and $120.2 billion (UI, $53.1-$232.7 billion) in productivity losses. In terms of the global health care costs, 58.9% ($35.6 billion; UI, $17.8-$59.6 billion) was borne by the public sector, 24.0% ($14.5 billion; UI, $7.8-$23.2 billion) by the private sector, and 17.1% ($10.3 billion; UI, $5.1-$17.6 billion) by the out-of-pocket sector. On average, the total costs accounted for 0.2% of global gross domestic product. Great inequalities in the disease and economic burden existed across regions and countries. Nearly 80% of global health care (82.4%) and morbidity-related costs (82.9%) were paid by high-income countries, whereas more than 60% (61.4%) of global YLDs occurred in middle-income countries. Conclusions and Relevance In this cross-sectional study of 192 countries and territories, a substantial amount of the health and economic impact of musculoskeletal disorders was attributable to high BMI. Developing effective policies and active participation from health professionals to prevent excessive weight gain are needed. More available estimates are also needed to facilitate a global analysis.
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Affiliation(s)
- Ningjing Chen
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
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García-Dopico N, De La Torre-Luque A, Wand BM, Velasco-Roldán O, Sitges C. The cross-cultural adaptation, validity, and reliability of the Spanish version of the Fremantle Back Awareness Questionnaire. Front Psychol 2023; 14:1070411. [PMID: 36935999 PMCID: PMC10017493 DOI: 10.3389/fpsyg.2023.1070411] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction In chronic low back pain (CLBP), disturbed body image has been highlighted as a contributor to the condition and a potential target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) allows its assessment. Following international guidelines for the cross-cultural translation of questionnaires, we aimed to translate the FreBAQ into Spanish (FreBAQ-S) and validate the new questionnaire in a sample of Spanish-speaking people with CLBP. Methods Two hundred and sixty-four adults with CLBP (91 males) and 128 healthy controls (34 males) completed an online form including the FreBAQ-S and questionnaires related to the pain experience. All participants were Spanish and no gender identities differing from biological sex were reported. A week later, 113 CLBP participants and 45 healthy controls (41 and 13 males, respectively), re-answered the FreBAQ-S to evaluate test-retest reliability. Confirmatory factor and multigroup analysis assessed the scale consistency on the patient sample. Discriminant and convergent validity were explored by between-group differences and the relationship with clinical characteristics. Reliability relied on Cronbach's alpha estimates and test-retest (intraclass correlation coefficient, standard error of measurement, minimal detectable change). Results and discussion Confirmatory factor analysis showed a one-factor structure of the questionnaire, without supporting evidence for item deletion (CFI = 0.97; TLI = 0.96; RMSEA = 0.06; SRMR = 0.07; SRMRu = 0.064). Multigroup analyses do not support mean invariance between groups regarding health condition or sex. The FreBAQ-S demonstrated good discriminant and convergent validity, internal consistency (α = 0.82), and test-retest reliability (ICC = 0.78; SE = 3.41; MDC = 5.12). The FreBAQ-S is a valid and reliable tool to assess back awareness in clinical and non-clinical samples.
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Affiliation(s)
- Nuria García-Dopico
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
- *Correspondence: Nuria García-Dopico,
| | - Alejandro De La Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Benedict Martin Wand
- Faculty of Medicine, Nursing and Midwifery and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Olga Velasco-Roldán
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Carolina Sitges
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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Huang J, Xie ZF. Dried fruit intake causally protects against low back pain: A Mendelian randomization study. Front Nutr 2023; 10:1027481. [PMID: 37032770 PMCID: PMC10076586 DOI: 10.3389/fnut.2023.1027481] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
Background Low back pain is the leading cause of years lived with disability worldwide. The aim of this study was to evaluate whether dried fruit intake causally protects against low back pain using two-sample Mendelian randomization (MR). Methods We obtained summary-level data for dried fruit intake (N = 421,764) from the IEU Open GWAS Project. Forty-one independent genetic variants proxied dried fruit intake. The corresponding data for low back pain were derived from the FinnGen project (13,178 cases and 164,682 controls; discovery data) and the Neale lab (5,423 cases and 355,771 controls; replication data). We conducted univariable and multivariable MR analyses. Results In the univariable MR analysis, the inverse variance weighted estimate showed that greater dried fruit intake was associated with decreased risk of low back pain [odds ratio (OR) = 0.435, 95% confidence interval (CI): 0.287-0.659, P = 8.657 × 10-5]. Sensitivity analyses using the MR-Egger (OR = 0.078, 95% CI: 0.013-0.479, P = 0.009), maximum likelihood (OR = 0.433, 95% CI: 0.295-0.635, P = 1.801 × 10-5), weighted median (OR = 0.561, 95% CI: 0.325-0.967, P = 0.038) and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) (OR = 0.454, 95% CI: 0.302-0.683, P = 4.535 × 10-4) methods showed consistent results. No evidence of directional pleiotropy was identified according to the Egger intercept (intercept P-value = 0.065) or applying the MR-PRESSO method (global test P-value = 0.164). The replication analysis yielded similar results. The multivariable MR revealed that the inverse association between dried fruit intake and low back pain was consistent after adjustment for fresh fruit intake, body mass index, current tobacco smoking, alcohol intake frequency, total body bone mineral density, serum 25-hydroxyvitamin D levels, and vigorous physical activity. Conclusion This MR study provides evidence to support that dried fruit intake causally protects against low back pain.
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Affiliation(s)
- Jian Huang
- Clinical Laboratory Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zheng-Fu Xie
- Geriatrics Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Zheng-Fu Xie
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Lazarus JV, Ortiz A, Tyrovolas S, Fernández E, Guy D, White TM, Ma R, Hay SI, Naghavi M, Soriano JB. A GBD 2019 study of health and Sustainable Development Goal gains and forecasts to 2030 in Spain. Sci Rep 2022; 12:21154. [PMID: 36477107 PMCID: PMC9729199 DOI: 10.1038/s41598-022-24719-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
This study aimed to report mortality, risk factors, and burden of diseases in Spain. The Global Burden of Disease, Injuries, and Risk Factors 2019 estimates the burden due to 369 diseases, injuries, and impairments and 87 risk factors and risk factor combinations. Here, we detail the updated Spain 1990-2019 burden of disease estimates and project certain metrics up to 2030. In 2019, leading causes of death were ischaemic heart disease, stroke, chronic obstructive pulmonary disease, Alzheimer's disease, and lung cancer. Main causes of disability adjusted life years (DALYs) were ischaemic heart disease, diabetes, lung cancer, low back pain, and stroke. Leading DALYs risk factors included smoking, high body mass index, and high fasting plasma glucose. Spain scored 74/100 among all health-related Sustainable Development Goals (SDGs) indicators, ranking 20 of 195 countries and territories. We forecasted that by 2030, Spain would outpace Japan, the United States, and the European Union. Behavioural risk factors, such as smoking and poor diet, and environmental factors added a significant burden to the Spanish population's health in 2019. Monitoring these trends, particularly in light of COVID-19, is essential to prioritise interventions that will reduce the future burden of disease to meet population health and SDG commitments.
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Affiliation(s)
- Jeffrey V. Lazarus
- grid.5841.80000 0004 1937 0247Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 08036 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Alberto Ortiz
- grid.5515.40000000119578126Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain ,grid.411171.30000 0004 0425 3881Department of Nephrology and Hypertension, The Institute for Health Research Foundation Jiménez Díaz University Hospital, Madrid, Spain
| | - Stefanos Tyrovolas
- St. John of God Health Park, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain ,Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Esteve Fernández
- grid.417656.7Tobacco Control Unit, Catalan Institute of Oncology- ICO, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Tobacco Control Research Group, Bellvitge Biomedical Research Institute -IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Danielle Guy
- grid.5841.80000 0004 1937 0247Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 08036 Barcelona, Spain
| | - Trenton M. White
- grid.5841.80000 0004 1937 0247Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 08036 Barcelona, Spain
| | - Rui Ma
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA USA
| | - Simon I. Hay
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA USA
| | - Mohsen Naghavi
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA USA
| | - Joan B. Soriano
- grid.413448.e0000 0000 9314 1427Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ,grid.411251.20000 0004 1767 647XHospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
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Association Between Low Back Pain, Workaholism, and Work Engagement in Japanese Hospital Workers: A Quantitative Cross-sectional Study. J Occup Environ Med 2022; 64:994-1000. [PMID: 35941743 PMCID: PMC9722383 DOI: 10.1097/jom.0000000000002654] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aimed to examine the association between two types of heavy work investment, workaholism and work engagement, and low back pain prevalence. METHODS We conducted a paper-based survey of Japanese hospital workers. The Dutch Workaholism Scale (DUWAS) and the Utrecht Work Engagement Scale (UWES) were used to classify the participants into four groups and perform multiple logistic regression analyses. RESULTS Among 699 participants, the group with low DUWAS and high UWES at 37.1% had the lowest low back pain prevalence. In order, the groups with low DUWAS and UWES were at 51.7%; those with high DUWAS and UWES, 58.5%; and those with high DUWAS and low UWES, 62.4%, with multivariate-adjusted odds ratios of 1.77, 2.01, and 2.33, respectively. CONCLUSIONS Low back pain prevalence among Japanese hospital workers was reduced by high levels of work engagement, even at high levels of workaholism.
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Ge L, Pereira MJ, Yap CW, Heng BH. Chronic low back pain and its impact on physical function, mental health, and health-related quality of life: a cross-sectional study in Singapore. Sci Rep 2022; 12:20040. [PMID: 36414674 PMCID: PMC9681885 DOI: 10.1038/s41598-022-24703-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic low back pain, defined as low back pain lasting more than 3 months, is a globally prevalent health problem with significantly high medical and economic burden on individuals and the society. This study aimed to estimate the prevalence of chronic low back pain and examine its association with health outcomes including physical function, mental health, and quality of life among adult population in Singapore. Cross-sectional secondary data analysis was performed using baseline data of the 1941 adults (mean age: 52.6 years, range: 21-97 years) from a representative population health survey conducted in the Central region of Singapore. Those with self-reported chronic low back pain in past six months were identified. The Late-Life Function and Disability Instrument, Patient Health Questionnaire-9, and EQ-5D-5L were used to measure physical function and limitation, mental health, and health-related quality of life, respectively. Generalized Linear Regressions were used to examine the association of chronic low back pain with physical function, limitation, depressive symptoms, and health-related quality of life. There were 8.1% (n = 180) participants reporting having chronic low back pain in past six months, among whom 80.5% sought treatments at either primary care, specialist outpatient, or Traditional Chinese Medicine clinics. Individuals with chronic low back pain reported poorer physical function, more limitations in performing major life tasks and social activities, more depressive symptoms, and lower health-related quality of life (all p < 0.01), even after adjusting for socio-demographics, lifestyle factors, and number of morbidities. The prevalence of chronic low back pain was 8.1% among the study population. Chronic low back pain was associated with poorer physical function, more limitations and depressive symptoms, and lower health-related quality of life. The findings highlight the significant impact of chronic low back pain on physical function and limitation, mental health, and health-related quality of life in a general population. Increased awareness on prevention, early and proper management of low back pain, and rehabilitation policies are required to better tackle the burden of low back pain at the population level.
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Affiliation(s)
- Lixia Ge
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
| | - Michelle Jessica Pereira
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
| | - Chun Wei Yap
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
| | - Bee Hoon Heng
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
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Giménez-Costa M, Schomacher J, Murillo C, Blanco-Hernández T, Falla D, Lluch E. Specific versus non-specific exercises for the neck extensor muscles in women with chronic idiopathic neck pain: A randomized controlled trial. Musculoskelet Sci Pract 2022; 60:102561. [PMID: 35421696 DOI: 10.1016/j.msksp.2022.102561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Structural and functional impairments of the cervical extensor muscles have been demonstrated in people with neck pain. A global exercise approach targeting all neck extensor muscles has shown positive effects in this population. However, to date, the efficacy of exercises specifically targeting the deep neck extensors has neither been tested nor compared to global exercises for the neck extensors. OBJECTIVES To compare the effects on pain and disability of a specific lower deep neck extensors (SLDNE) versus a general neck extensor (GNE) exercise program in women with chronic idiopathic neck pain. METHODS Fourty-three women with chronic idiopathic neck pain were randomly allocated to either a six-week SLDNE or a GNE exercise program. As primary outcome, neck disability was measured with the Neck Disability Index (NDI). Secondarily, pain intensity (VAS), cervical ROM, pressure pain thresholds (PPTs), cervical and thoracic posture and self-perceived benefit of treatment (GROC) were also measured. Every outcome was measured at baseline and immediately after treatment, except NDI, which was also measured at 6-months follow-up. The GROC was only assessed post-intervention. RESULTS Both exercise programs lead to reduced neck disability immediately post-intervention (within-group mean difference [MD] = -6.09; 95% Confidence Interval [CI]: 7.75, -4.42 and -4.73; 95%CI: 6.57, -2.91 respectively) and at the 6-months follow-up (-4.47; 95%CI: 6.41, -2.53 and -4.74; 95%CI: 6.50, -2.97), but with no between group differences. Similar results were found for pain intensity post-intervention, with no between group interaction (within-group MD = -20.87 mm; 95% CI: 28.55, -13.19 and -18.00 mm; 95%CI: (-26.24, -9.76) for SLDNE and GNE groups, respectively). GROC improved after both interventions without any between-group difference. CONCLUSIONS A six-week exercise program specifically targeting the lower deep neck extensors lead to comparable outcomes as a general neck extensor exercise program in women with chronic idiopathic neck pain.
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Affiliation(s)
- M Giménez-Costa
- Diputació de València, Valencia, Spain; University of Alcalá, Alcalá de Henares, Spain
| | | | - C Murillo
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium; Pain in Motion International Research Group, Belgium(1)
| | | | - D Falla
- Center of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - E Lluch
- Pain in Motion International Research Group, Belgium(1); Department of Physical Therapy, University of Valencia, Spain.
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Xiong GX, Goh BC, Agaronnik N, Crawford AM, Smith JT, Hershman SH, Schoenfeld AJ, Simpson AK. Impact of insurance type on patient-reported outcome measures in patients with lumbar disc herniation. Spine J 2022; 22:1309-1317. [PMID: 35351668 DOI: 10.1016/j.spinee.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/22/2022] [Accepted: 03/22/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Lumbar disc herniations (LDH) are among the most common spinal conditions. Despite increased appreciation for the importance of social determinants of health, the role that these factors play in patients with lumbar disc herniations is poorly defined. PURPOSE To elucidate the association between insurance status and baseline patient reported outcome measures (PROMs) in the setting of lumbar disc herniations. STUDY DESIGN/SETTING Retrospective cohort study PATIENT SAMPLE: Baseline patient-reported outcome measures (PROMS) were reviewed from 924 adult patients presenting for treatment of lumbar disc herniation within our institutional healthcare system (2015-2020). OUTCOME MEASURES The Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10a (PF10a), PROMIS Global-Mental, PROMIS Global-Physical, and visual analogue scale (VAS) for back and leg pain were assessed. METHODS PROMIS scores at presentation were defined at the primary outcome and insurance status as the primary predictor. Differences in clinical and sociodemographic characteristics between our cohorts, stratified by insurance status, were evaluated using Wilcoxon rank-sum or chi-squared testing. We used multivariable negative binomial regression modeling to adjust for potential confounders including age, gender, race, language, ethnicity, comorbidity index, and median geospatial household income. RESULTS We included 924 patients, with mean age of 58.4 +/- 15.2 years and 52.6% male prevalence. Patients insured through Medicaid were more likely to be Black, Hispanic, and non-English speaking patients compared with the commercially insured. The Charlson Comorbidity index was significantly higher in the Medicare group. Following adjusted analysis, patients with Medicaid insurance had significantly worse PF10a (IRR, 0.90, 95% CI 0.85-0.96), as well as PROMIS Global-Physical score (IRR 0.88, 95% CI 0.82-0.94), and VAS low back pain (IRR 1.20, 95% CI 1.04-1.40) when compared to the commercially insured. CONCLUSIONS We encountered worse physical function, mental, and pain-related patient-reported outcomes for those with Medicaid insurance in a population of patients presenting for evaluation of lumbar disc herniation. These findings, including worse depression, anxiety, and higher axial back pain scores, merit further investigation into potential health system asymmetries, and should be accounted for by treating providers.
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Affiliation(s)
- Grace X Xiong
- Harvard Combined Orthopaedic Residency Program, Harvard Medical School, Boston, MA, USA
| | - Brian C Goh
- Harvard Combined Orthopaedic Residency Program, Harvard Medical School, Boston, MA, USA
| | | | - Alexander M Crawford
- Harvard Combined Orthopaedic Residency Program, Harvard Medical School, Boston, MA, USA
| | - Jeremy T Smith
- Department of Orthopaedic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Stuart H Hershman
- Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew J Schoenfeld
- Department of Orthopaedic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew K Simpson
- Department of Orthopaedic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
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Proprioceptive manipulations in orthograde posture modulate postural control in low back pain patients: a pilot study. Sci Rep 2022; 12:6860. [PMID: 35478206 PMCID: PMC9046231 DOI: 10.1038/s41598-022-10701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
As we stand upright, perceptual afferences are crucial to successfully help generating postural motor commands. Non-Specific Low Back Pain patients frequently demonstrate a lack of proprioceptive acuity, often translating into postural control deficiencies. For the first time, to our knowledge, we studied the postural effects of proprioceptive manipulations in orthograde posture on Non-Specific Low Back Pain patients. Using static posturography recordings, we computed sway speed, speed variance, and the main direction of sway. We also addressed the patient’s subjective feedbacks after being manipulated. Five minutes after the proprioceptive manipulations, our results revealed decreased speed and speed variance outcomes, but the main direction of sway was not modulated. Furthermore, after the proprioceptive manipulations, the patients also self-reported improved clinical outcomes. These findings provide new knowledge opening new fields of research as well as potential treatment strategies in Low Back Pain patients.
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Sarria-Santamera A, Alexeyeva Z, Yen Chan M, Ortega MA, Asunsolo-del-Barco A, Navarro-García C. Direct and Indirect Costs Related to Physical Activity Levels in Patients with Diabetes Mellitus in Spain: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10040752. [PMID: 35455929 PMCID: PMC9027157 DOI: 10.3390/healthcare10040752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 02/01/2023] Open
Abstract
Diabetes mellitus (DM) is a global public health concern. DM is importantly linked to the modern lifestyle. Lifestyle-based interventions currently represent a critical preventive and therapeutic approach for patients with DM. Increasing physical activity has proven multiple benefits to prevent this condition; however, there is still room for further progress in this field, especially in terms of the effect of exercise in patients with already established DM. This study intends to examine the economic relationship between physical activity and direct/indirect costs in patients with DM. We analyze a national representative sample (n = 1496) of the general population of Spain, using available data from the National Health Survey of 2017 (NHS 2017). Our results show that 63.7% of the sample engaged in some degree of physical activity, being more frequent in men (67.5%), younger individuals (80.0%), and those with higher educational levels (69.7%). Conversely, lower levels of physical activity were associated with female sex, older subjects, and various comorbidities. Our study estimates that 2151 € per (51% in direct costs) patient may be saved if a minimum level of physical activity is implemented, primarily, due to a decrease in indirect costs (absenteeism and presenteeism). This study shows that physical activity will bring notable savings in terms of direct and indirect costs in patients with DM, particularly in some vulnerable groups.
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Affiliation(s)
- Antonio Sarria-Santamera
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan; (Z.A.); (M.Y.C.)
- Correspondence:
| | - Zhanna Alexeyeva
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan; (Z.A.); (M.Y.C.)
| | - Mei Yen Chan
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan; (Z.A.); (M.Y.C.)
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - Angel Asunsolo-del-Barco
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain
| | - Carlos Navarro-García
- Faculty of Health and Sports Sciences, Universidad Alfonso X, Villanueva de la Cañada, 28691 Madrid, Spain;
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Effectiveness of Negative Pulsed-Pressure Myofascial Vacuum Therapy and Therapeutic Exercise in Chronic Non-Specific Low Back Pain: A Single-Blind Randomized Controlled Trial. J Clin Med 2022; 11:jcm11071984. [PMID: 35407595 PMCID: PMC8999761 DOI: 10.3390/jcm11071984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Non-specific low back pain is defined as pain located in the lumbar region; this condition is the most frequent musculoskeletal disorder. Negative pulsed-pressure myofascial vacuum therapy (vacuum treatment (VT)) devices mobilize tissue according to previously programmed parameters of force, time and frequency. The purpose of this study was to compare the effects of VT combined with core therapeutic exercise versus a physical therapy program (PTP) based only on core therapeutic exercise. Fifty participants with chronic non-specific low back pain were randomly assigned to two treatment groups, the VT group (n = 25) or the PTP group (n = 25). Pain, pressure-pain threshold, range of motion, functionality and quality of life were measured before treatment, at the end of treatment, and at one-month and three-month follow-ups. Both groups received 15 therapy sessions over 5 weeks. Statistically significant differences in favor of the VT group were shown in the results. In conclusion, the intervention based on myofascial vacuum therapy improved pain, mobility, pressure pain threshold, functionality and quality of life.
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Sarria-Santamera A, Kuntuganova A, Alonso M. Economic Costs of Pain in the Spanish Working Population. J Occup Environ Med 2022; 64:e261-e266. [DOI: 10.1097/jom.0000000000002497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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40
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Zozaya N, Abdalla F, Casado Moreno I, Crespo-Diz C, Ramírez Gallardo AM, Rueda Soriano J, Alcalá Galán M, Hidalgo-Vega Á. The economic burden of pulmonary arterial hypertension in Spain. BMC Pulm Med 2022; 22:105. [PMID: 35346140 PMCID: PMC8962538 DOI: 10.1186/s12890-022-01906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Pulmonary Arterial Hypertension (PAH) is a rare, debilitating, and potentially fatal disease. This study aims to quantify the economic burden of PAH in Spain.
Methods The study was conducted from a societal perspective, including direct and indirect costs associated with incident and prevalent patients. Average annual costs per patient were estimated by multiplying the number of resources consumed by their unit cost, differentiating the functional class (FC) of the patient. Total annual costs per FC were also calculated, taking the 2020 prevalence and incidence ranges into account. An expert committee validated the information on resource consumption and provided primary information on pharmacological consumption. Unit costs were estimated using official tariffs and salaries in Spain. A deterministic sensitivity analysis was conducted to test the uncertainty of the model. Results The average annual total cost was estimated at €98,839 per prevalent patient (FC I-II: €65,233; FC III: €103,736; FC IV: €208,821), being €42,110 for incident patients (FC I-II: €25,666; FC III: €44,667; FC IV: €95,188). The total annual cost of PAH in Spain, taking into account a prevalence between 16.0 and 25.9 cases per million adult inhabitants (FC I-II 31.8%; FC III 61.3%; FC IV 6.9%) and an incidence of 3.7, was estimated at €67,891,405 to €106,131,626, depending on the prevalence considered. Direct healthcare costs accounted for 64% of the total cost, followed by indirect costs (24%), and direct non-healthcare costs (12%). The total costs associated with patients in FC I-II ranged between €14,161,651 and €22,193,954, while for patients in FC III costs ranged between €43,763,019 and €68,391,651, and for patients in FC IV between €9,966,735 and €15,546,021. In global terms, patients with the worst functional status (FC IV) account for only 6.9% of the adults suffering from PAH in Spain, but are responsible for 14.7% of the total costs. Conclusions PAH places a considerable economic burden on patients and their families, the healthcare system, and society as a whole. Efforts must be made to improve the health and management of these patients since the early stages of the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01906-2.
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Affiliation(s)
- Néboa Zozaya
- Department of Health Economics, Weber, Calle Moreto, 17, 5º Dcha., 28014, Madrid, Spain. .,Department of Quantitative Methods in Economics and Management, University Las Palmas de Gran Canaria, Las Palmas, Spain.
| | - Fernando Abdalla
- Department of Health Economics, Weber, Calle Moreto, 17, 5º Dcha., 28014, Madrid, Spain
| | | | - Carlos Crespo-Diz
- Pharmacy Department, Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Pontevedra, Spain
| | | | - Joaquín Rueda Soriano
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, CIBERCV, Valencia, Spain
| | | | - Álvaro Hidalgo-Vega
- Weber Foundation, Madrid, Spain.,Department of Economic Analysis and Finances, University of Castilla-La Mancha, Toledo, Spain
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Masuy R, Bamelis L, Bogaerts K, Depreitere B, De Smedt K, Ceuppens J, Lenaert B, Lonneville S, Peuskens D, Van Lerbeirghe J, Van Schaeybroeck P, Vorlat P, Zijlstra S, Meulders A, Vlaeyen JWS. Generalization of fear of movement-related pain and avoidance behavior as predictors of work resumption after back surgery: a study protocol for a prospective study (WABS). BMC Psychol 2022; 10:39. [PMID: 35193697 PMCID: PMC8862001 DOI: 10.1186/s40359-022-00736-5] [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: 06/03/2021] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies indicated that about 20% of the individuals undergoing back surgery are unable to return to work 3 months to 1 year after surgery. The specific factors that predict individual trajectories in postoperative pain, recovery, and work resumption are largely unknown. The aim of this study is to identify modifiable predictors of work resumption after back surgery. Methods In this multisite, prospective, longitudinal study, 300 individuals with radicular pain undergoing a lumbar decompression will be followed until 1-year post-surgery. Prior to surgery, participants will perform a computer task to assess fear of movement-related pain, avoidance behavior, and their generalization to novel situations. Before and immediately after surgery, participants will additionally complete questionnaires to assess fear of movement-related pain, avoidance behavior, optimism, expectancies towards recovery and work resumption, and the duration and severity of the pain. Six weeks, 3 months, 6 months, and 12 months after surgery, they will again complete questionnaires to assess sustainable work resumption, pain severity, disability, and quality of life. The primary hypothesis is that (generalization of) fear of movement-related pain and avoidance behavior will negatively affect sustainable work resumption after back surgery. Second, we hypothesize that (generalization of) fear of movement-related pain and avoidance behavior, negative expectancies towards recovery and work resumption, longer pain duration, and more severe pain before the surgery will negatively affect work resumption, pain severity, disability, and quality of life after back surgery. In contrast, optimism and positive expectancies towards recovery and work resumption are expected to predict more favorable work resumption, better quality of life, and lower levels of pain severity and disability after back surgery. Discussion With the results of this research, we hope to contribute to the development of strategies for early identification of risk factors and appropriate guidance and interventions before and after back surgery. Trial registration The study was preregistered on ClinicalTrials.gov: NCT04747860 on February 9, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00736-5.
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Affiliation(s)
- Rini Masuy
- Research Group Health Psychology, KU Leuven, Leuven, Belgium.
| | - Lotte Bamelis
- Research Group Health Psychology, KU Leuven, Leuven, Belgium.,Centre for Translational Psychological Research TRACE, Genk, Belgium.,Department of Psychology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Katleen Bogaerts
- Research Group Health Psychology, KU Leuven, Leuven, Belgium.,REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Bart Depreitere
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Kris De Smedt
- Department of Neurosurgery, GasthuisZusters Antwerpen, Wilrijk, Belgium
| | | | - Bert Lenaert
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Limburg Brain Injury Centre, Maastricht, The Netherlands
| | - Sarah Lonneville
- Department of Neurosurgery, Centre Hospitalier de Wallonie picarde, Tournai, Belgium
| | - Dieter Peuskens
- Department of Neurosurgery, Ziekenhuis Oost-Limburg, Genk, Belgium.,Department of Neurosurgery, Noorderhart Mariaziekenhuis, Pelt, Belgium
| | | | - Patrick Van Schaeybroeck
- Department of Neurosurgery, Imeldaziekenhuis, Bonheiden, Belgium.,Department of Neurosurgery, Regional Hospital Sacred Heart Tienen, Tienen, Belgium
| | - Peter Vorlat
- Department of Orthopedics, Noorderhart Mariaziekenhuis, Pelt, Belgium
| | | | - Ann Meulders
- Research Group Health Psychology, KU Leuven, Leuven, Belgium.,Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands
| | - Johan W S Vlaeyen
- Research Group Health Psychology, KU Leuven, Leuven, Belgium.,Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands
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42
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Al Sad S, Start AR. Primary care providers' experiences treating low back pain. J Osteopath Med 2022; 122:263-269. [PMID: 35128904 DOI: 10.1515/jom-2021-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT Our original work addresses the biological sex impact on low back pain (LBP) management and prognosis in primary care settings. To our knowledge, our study is the first in the United States to evaluate the differences in clinicians' approaches to LBP in the ambulatory setting specifically based on patient gender. Our findings suggest that there is a knowledge gap among primary care providers (PCPs) toward the potential impact of biological sex on LBP and a bias toward gender roles when counseling patients for home chores or occupational tasks. Further evaluation of this knowledge gap and its impact on LBP management and prognosis is recommended in US healthcare settings. OBJECTIVES This study aims to explore PCP experiences and practice patterns regarding LBP in females compared to males in US healthcare settings. METHODS We utilized a cross-sectional study design and convenience sampling. Data were collected anonymously utilizing a 27-item online survey sent periodically via email to PCPs working in Ohio. We had 58 responses for analysis; data were analyzed utilizing bivariate and multivariate analyses. RESULTS On average, approximately 9 out of 10 responding clinicians reported experiencing LBP. PCPs were not in agreement that LBP is different in women than men. Clinicians with a women's health, osteopathic, or sport's medicine background were more likely to agree that LBP is different in women than in men. PCPs were more likely to counsel female patients about pelvic floor exercises; however, their intake of present pelvic symptoms in LBP female patients is suboptimal. PCPs were more likely to counsel females for home chores than males, which is aligned with the perceived traditional gender roles among PCPs. CONCLUSIONS There may be a knowledge gap among PCPs toward the potential impact of biological sex on LBP and a bias toward gender roles when counseling patients for home chores or occupational tasks. Further investigation of this knowledge gap and counseling approaches is recommended to better bridge the gender disparity.
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Affiliation(s)
- Sondos Al Sad
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Amanda R Start
- The Ohio State University College of Medicine Office of Curriculum and Scholarship, Columbus, OH, USA
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Schitter AM, Frei P, Elfering A, Kurpiers N, Radlinger L. Evaluation of short-term effects of three passive aquatic interventions on chronic non-specific low back pain: Study protocol for a randomized cross-over clinical trial. Contemp Clin Trials Commun 2022; 26:100904. [PMID: 35243125 PMCID: PMC8886016 DOI: 10.1016/j.conctc.2022.100904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Low back pain (LBP) is among the most common physical ailments and its chronic manifestation is a leading cause for disability worldwide. LBP is not attributable to a known diagnosis in 85% of the cases and therefore called chronic non-specific LBP (cnLBP). Passive immersion in warm water is commonly claimed to reduce muscular tension and pain, but not yet sufficiently investigated with regard to cnLBP. The current study compares three passive aquatic interventions regarding their effects on cnLBP: floating (resting in a supine immersed position on flotation devices), WATSU (a passive hands-on treatment, in which a practitioner stands in warm water, gently moving and massaging the client), and a Spa session. Methods In this randomized cross-over clinical trial, all 24 adult participants with cnLBP will undergo the three interventions in balanced order with a washout-period of at least two weeks in between. Assessments will take place at baseline and follow-up of study and immediately before and after each intervention. Assessments cover the primary outcome self-reported current pain (Visual Analog Scale, range: 0–100 mm), other self-report questionnaires (addressing, e.g., personality traits or -states), and physiological parameters (e.g., measurement of spinal range of motion). Discussion The study adds estimates of intervention-specific effect-sizes of widespread passive aquatic interventions to cnLBP. The study also points to potential underlying pain-reducing mechanisms. Trial registration The protocol was approved by the Ethics Committee of the Canton Bern (ProjectID: 2018–00461). Trial registration is intended at ClinicalTrials.gov.
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da Rosa BN, Candotti CT, Pivotto LR, Noll M, Silva MG, Vieira A, Loss JF. Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA): Expansion, Content Validation, and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031398. [PMID: 35162421 PMCID: PMC8835607 DOI: 10.3390/ijerph19031398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 12/04/2022]
Abstract
The Back Pain and Body Posture Evaluation Instrument (BackPEI) was created in 2013 to assess back pain and its risk factors in school children. However, it does not assess neck pain or the habits of mobile device usage, which are aspects that are often part of school children’s lives. Therefore, we aimed to update the BackPEI questionnaire to include new questions assessing aspects related to neck pain and the use of mobile devices and to test the content validity and reliability of the new questions. The updated questionnaire was named Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA). The content was validated by eight experts using the content validity index (CVI). To assess reliability, the BackPEI-CA questionnaire was applied at two different times in 105 school children, and Cohen’s kappa (k) and intraclass correlation coefficient (ICC) were calculated. All aspects assessed regarding content validity had a CVI higher than 0.8. The new questions presented moderate and good kappa values and excellent ICC values. The updated version of BackPEI-CA can be used as a clinic tool for assessing the presence, frequency, and intensity of back and neck pain and their risk factors.
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Affiliation(s)
- Bruna Nichele da Rosa
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil; (C.T.C.); (L.R.P.); (M.G.S.); (A.V.); (J.F.L.)
- Correspondence:
| | - Cláudia Tarragô Candotti
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil; (C.T.C.); (L.R.P.); (M.G.S.); (A.V.); (J.F.L.)
| | - Luiza Rampi Pivotto
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil; (C.T.C.); (L.R.P.); (M.G.S.); (A.V.); (J.F.L.)
| | - Matias Noll
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74605-050, Brazil;
- Campus Ceres, Instituto Federal Goiano, Ceres 76300-000, Brazil
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Marcelle Guimarães Silva
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil; (C.T.C.); (L.R.P.); (M.G.S.); (A.V.); (J.F.L.)
| | - Adriane Vieira
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil; (C.T.C.); (L.R.P.); (M.G.S.); (A.V.); (J.F.L.)
| | - Jefferson Fagundes Loss
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre 90690-200, Brazil; (C.T.C.); (L.R.P.); (M.G.S.); (A.V.); (J.F.L.)
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Chen S, Chen M, Wu X, Lin S, Tao C, Cao H, Shao Z, Xiao G. Global, regional and national burden of low back pain 1990-2019: A systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat 2022; 32:49-58. [PMID: 34934626 PMCID: PMC8639804 DOI: 10.1016/j.jot.2021.07.005] [Citation(s) in RCA: 121] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To comprehensively analyze the global level and trends of prevalence, incidence and years lived with disability (YLDs) for low back pain (LBP) from 1990 to 2019 by age, sex and sociodemographic index (SDI). METHODS Publicly available modelled data and methods were obtained from the Global Burden of Diseases (GBD) study 2019, and used to evaluate the global burden of LBP through a systematic analysis. RESULTS Globally, the age-standardized prevalence, incidence and YLDs rate of LBP were slightly decreased from 1990 to 2019, but the number of the prevalent cases, incident cases and YLDs had substantially increased, and LBP remains the leading cause of YLDs in 2019 worldwide. The number of prevalent cases was increased with age and peaked at the age of 45-54 years for both sexes, and the global prevalence rate was higher in females than in males and increased with age, peaking at the 80-84 age group in both sexes in 2019. Overall, a positive association between the age-standardized YLD rate and SDI was observed over the past thirty years. At the national revel, the United States, Denmark and Switzerland had the three highest levels of age-standardized prevalence, while Zambia, Zimbabwe and Canada showed the highest increase in the age-standardized prevalence during 1990-2019. CONCLUSIONS LBP is a major public health issue globally, and its burden remains high. Increasing population awareness about its risk factors and preventive measures for LBP are needed to reduce the future burden of this condition. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE Due to the high prevalence and heavy burden of LBP globally, it is important to update its epidemiological data. This systematic analysis provides researchers and healthcare policy makers with up-to-date, comprehensive and comparable information on global LBP burden, which is of clinical translational significance.
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Affiliation(s)
- Sheng Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Mingjue Chen
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Xiaohao Wu
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Sixiong Lin
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Chu Tao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Huiling Cao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Guozhi Xiao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
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García-Dopico N, de la Torre-Luque A, Sitges C, Velasco-Roldán O. Proprioceptive acuity is core for back awareness in chronic low back pain: Further analysis of the content validity of the Spanish version of the Fremantle Back Awareness Questionnaire. Front Hum Neurosci 2022; 16:1070402. [PMID: 36875741 PMCID: PMC9983349 DOI: 10.3389/fnhum.2022.1070402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/28/2022] [Indexed: 02/19/2023] Open
Abstract
Treatments aimed at increasing self-perception may improve chronic low back pain (CLBP) symptomatology and present novel management approaches. Consequently, it is important to have valid, complete, and reliable tools for its assessment, and to understand which variables influence altered back awareness. We aimed to evaluate the face/content validity of the Spanish version of the Fremantle Back Awareness Questionnaire (FreBAQ-S) among people with and without CLBP, and to explore additional variables suggested to be involved in back awareness. A total of 264 individuals with CLBP and 128 healthy controls (HC) answered an online survey, including the FreBAQ-S, and questions regarding the completeness, comprehensibility, time-to-complete adequacy, and time spent completing it. If participants declared a lack of completeness, they had to report which aspects would be incorporated into the questionnaire to explore additional back-awareness-related variables. A statistically significant difference in completeness emerged between groups (p < 0.01). The questionnaire was comprehensible for more than 85% of participants, regardless of the group (p = 0.45). CLBP participants spent significantly more time in completing the questionnaire than controls (p < 0.01), but no differences were found between groups regarding the time-to-complete adequacy (p = 0.49). Regarding the back-awareness-related variables, 77 suggestions from CLBP group and seven from the HC were received. Most of them were related to proprioceptive acuity such as posture, weight, or movement patterns, among others. The FreBAQ-S demonstrated adequate face/content validity, completeness, comprehensibility, and adequate time of response. The feedback provided will help improve currently available assessment tools.
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Affiliation(s)
- Nuria García-Dopico
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, CIBERSAM ISCIII, Complutense University of Madrid (UCM), Madrid, Spain
| | - Carolina Sitges
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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Zhang SK, Yang Y, Gu ML, Mao SJ, Zhou WS. Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis. Percept Mot Skills 2021; 129:63-89. [PMID: 34911404 DOI: 10.1177/00315125211059407] [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: 11/16/2022]
Abstract
Our objective in this paper was to systematically review evaluations of the effects of exercises on pain symptoms and activities of daily living (ADL) in middle-aged and elderly patients with low back pain (LBP). We searched Web of Science, PubMed, EBSCO, and China National Knowledge Internet (CNKI) databases for randomized controlled trials (RCTs) on this topic. We evaluated the methodological quality of included articles using the Physiotherapy Evidence Database (PEDro) scale, and we statistically analyzed these studies using RevMan software. We reviewed 18 RCTs (23 comparison groups) with a total of 910 participants, and our meta-analysis confirmed that exercises significantly improved both pain and ADLs measured on visual analog scales (VAS) (SMD = -0.91, 95% CI: [-1.3, -0.52], p < 0.00001) and on the Oswestry Disability Index (ODI) (SMD = -2.07, 95% CI: [-3.19, -0.96], p < 0.00001). We conclude that exercises can reduce pain severity and improve ADL capacity in middle-aged and elderly persons with LBP, confirming that exercise can serve as a medical intervention for these indivdiuals. However, given the high heterogeneity of responses among individual participants, there remains a need for further study.
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Affiliation(s)
- Shi-Kun Zhang
- Department of Police Physical Education, 164369Jiangsu Police Institute, Nanjing, China
| | - Yong Yang
- Institute of Sport, Henan University, Kai Feng, China
| | - Mei-Ling Gu
- Nanjing Tian-zheng Primary School, Nanjing, China
| | - Su-Jie Mao
- 71198Graduate School of Nanjing University of Physical Education, Nanjing, China
| | - Wen-Sheng Zhou
- Department of Physical Education, 74587Nanjing Xiao-Zhuang University, Nanjing, China
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Kim BY, Concannon TA, Barboza LC, Khan TW. The Role of Diagnostic Injections in Spinal Disorders: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11122311. [PMID: 34943548 PMCID: PMC8700513 DOI: 10.3390/diagnostics11122311] [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: 10/19/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
Neck and back pain is increasingly prevalent, and has increased exponentially in recent years. As more resources are dedicated to the diagnosis of pain conditions, it is increasingly important that the diagnostic techniques used are as precise and accurate as possible. Traditional diagnostic methods rely heavily upon patient history and physical examination to determine the most appropriate treatments and/or imaging studies. Though traditional means of diagnosis remain a necessity, in many cases, correlation with positive or negative responses to injections may further enhance diagnostic specificity, and improve outcomes by preventing unnecessary treatments or surgeries. This narrative review aims to present the most recent literature describing the diagnostic validity of precision injections, as well as their impact on surgical planning and outcomes. Diagnostic injections are discussed in terms of facet arthropathy, lumbar radiculopathy, discogenic pain and discography, and sacroiliac joint dysfunction. There is a growing body of evidence supporting the use of diagnostic local anesthetic injections or nerve blocks to aid in diagnosis. Spinal injections add valuable objective information that can potentially improve diagnostic precision, guide treatment strategies, and aid in patient selection for invasive surgical interventions.
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Affiliation(s)
- Brian Y. Kim
- Correspondence: ; Tel.: +1-913-588-6670; Fax: +1-913-588-5311
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Direct medical costs after surgical or nonsurgical treatment for degenerative lumbar spinal disease: A nationwide matched cohort study with a 10-year follow-up. PLoS One 2021; 16:e0260460. [PMID: 34852015 PMCID: PMC8635587 DOI: 10.1371/journal.pone.0260460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/09/2021] [Indexed: 11/19/2022] Open
Abstract
Objective The demand for treating degenerative lumbar spinal disease has been increasing, leading to increased utilization of medical resources. Thus, we need to understand how the budget of insurance is currently used. The objective of the present study is to overview the utilization of the National Health Insurance Service (NHIS) by providing the direct insured cost between patients receiving surgery and patients receiving nonsurgical treatment for degenerative lumbar disease. Methods The NHIS-National Sample Cohort was utilized to select patients with lumbar disc herniation, spinal stenosis, spondylolisthesis or spondylolysis. A matched cohort study design was used to show direct medical costs of surgery (n = 2,698) and nonsurgical (n = 2,698) cohorts. Non-surgical treatment included medication, physiotherapy, injection, and chiropractic. The monthly costs of the surgery cohort and nonsurgical cohort were presented at initial treatment, posttreatment 1, 3, 6, 9, and 12 months and yearly thereafter for 10 years. Results The characteristics and matching factors were well-balanced between the matched cohorts. Overall, surgery cohort spent $50.84/patient/month, while the nonsurgical cohort spent $29.34/patient/month (p<0.01). Initially, surgery treatment led to more charge to NHIS ($2,762) than nonsurgical treatment ($180.4) (p<0.01). Compared with the non-surgical cohort, the surgery cohort charged $33/month more for the first 3 months, charged less at 12 months, and charged approximately the same over the course of 10 years. Conclusion Surgical treatment initially led to more government reimbursement than nonsurgical treatment, but the charges during follow-up period were not different. The results of the present study should be interpreted in light of the costs of medical services, indirect costs, societal cost, quality of life and societal willingness to pay in each country. The monetary figures are implied to be actual economic costs but those in the reimbursement system instead reflect reimbursement charges from the government.
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Erezuma UL, Espin A, Torres-Unda J, Esain I, Irazusta J, Rodriguez-Larrad A. Use of a passive lumbar back exoskeleton during a repetitive lifting task: effects on physiologic parameters and intersubject variability. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2377-2384. [PMID: 34608854 DOI: 10.1080/10803548.2021.1989179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives. This study evaluated the effects of wearing the Laevo v2.56 exoskeleton (Laevo, The Netherlands) on physiological parameters related to working load and metabolic cost (MC) during a lifting task, explored the variability in exoskeleton performance among users and determined whether perceived discomfort negatively correlates with a reduction in MC. Methods. Twenty participants completed a 4-min repetitive lifting task with/without the exoskeleton. Respiratory gases, heart rate, blood lactate and ratings of perceived exertion and experienced discomfort were collected, and MC was calculated. Results. Wearing the exoskeleton significantly reduced MC and oxygen uptake during the lifting task by 4.8 and 3.8%, respectively. Workload reduction occurred in 65% of the participants. Conclusion. The Laevo v2.56 exoskeleton reduced MC and workload in a repetitive lifting task in a subject-dependent manner. Future studies should focus on identifying factors that could cause performance variability such as user-robot interaction forces.
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Affiliation(s)
- Unai Latorre Erezuma
- Department of Physiology, University of the Basque Country (UPV/EHU), Spain.,Biocruces Bizkaia Health Research Institute, Spain
| | - Ander Espin
- Department of Physiology, University of the Basque Country (UPV/EHU), Spain.,Biocruces Bizkaia Health Research Institute, Spain
| | - Jon Torres-Unda
- Department of Physiology, University of the Basque Country (UPV/EHU), Spain
| | - Izaro Esain
- Department of Physiology, University of the Basque Country (UPV/EHU), Spain
| | - Jon Irazusta
- Department of Physiology, University of the Basque Country (UPV/EHU), Spain.,Biocruces Bizkaia Health Research Institute, Spain
| | - Ana Rodriguez-Larrad
- Department of Physiology, University of the Basque Country (UPV/EHU), Spain.,Biocruces Bizkaia Health Research Institute, Spain
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