Influence of family history on prognosis of spinal pain and the role of leisure time physical activity and body mass index: a prospective study using family-linkage data from the Norwegian HUNT study

Investigation of Vitamin D Levels and the Effects of Being an Agricultural Worker on Etiology and Night Pain in Children and Adolescents With Chronic Low Back Pain

Objective: Chronic low back pain in children is a condition that should be investigated. In this study, we examined the effects of agricultural work on imaging results, risk factors, night pain, and vitamin D levels in children and adolescents with chronic low back pain.

Material and methods: The study included 133 patients who presented to the Physical Medicine and Rehabilitation and Neurosurgery outpatient clinics with low back pain that had lasted more than three months. The patients were evaluated based on the duration of their low back pain, the presence of night pain, a family history of low back pain, their employment status, local or radicular pain, and their body mass index (BMI). A physical examination was carried out to look into the etiologies of low back pain. Appropriate imaging, such as x-ray radiography, magnetic resonance imaging (MRI), and computed tomography (CT), was performed for the patients. Blood samples were collected from patients to assess inflammatory pathologies and vitamin D levels.

Results: The 133 patients in the study ranged in age from seven to 16 years, with a mean age of 14.3 + 1.9 years. Further, 60.2% (n = 80) of the cases were male, while 39.8% (n = 53) were female. Imaging revealed findings in 59.4% of the patients. In 97.7% of the participants, D hypovitaminosis was detected. There was no significant relationship between the patients’ imaging findings and vitamin D deficiency, family history, BMI, and employment status (p = 0.441, 0.147, 0.082, 0.605). The relationship between family history, employment status, and night pain was statistically significant (p < 0.001). There was no statistically significant relationship between night pain and vitamin D deficiency (p = 0.667).

Conclusion: Mechanical strain due to agricultural work and family history was found to be associated with night pain in patients with chronic low back pain in our study. The most important finding of this study is that night pain, which is considered a red flag, can occur in both inflammatory pathologies and situations causing mechanical low back pain, and risk factors should be thoroughly investigated. Studies with patients who have sufficient vitamin D will help to clarify the relationship between chronic low back pain and vitamin D.

Association Between Family History of Surgically Treated Low Back Pain and Adolescent Low Back Pain

STUDY DESIGN

Cross-sectional.

OBJECTIVE

To study the associations between a family history of surgically treated low back pain (LBP) and adolescent LBP.

SUMMARY OF BACKGROUND DATA

A family history of LBP is related to adolescent LBP, but whether a family history of back surgery is relevant to adolescent LBP is not known.

METHODS

A subpopulation of the Northern Finland Birth Cohort 1986 was contacted when they were aged between 18 and 19years. The postal questionnaire asked the participants to report their LBP and a relative's (mother, father, sibling) LBP and back surgery, and to provide data on potential covariates. The association between a family history of LBP ("no family history of LBP," "family history of LBP but no surgery," and "family history of LBP and surgery") and adolescent LBP (no LBP, occasional LBP, and frequent LBP) were evaluated using logistic regression analysis with odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for sex, smoking, and psychological distress.

RESULTS

Of the 1374 adolescents in the study, 33% reported occasional LBP and 9% frequent LBP. Both the "family history of LBP but no surgery" and "family history of LBP and surgery" categories were associated with frequent LBP (adjusted OR [aOR] 2.09, 95% CI 1.38-3.16; aOR 2.23, 95% CI 1.02-4.90, respectively). Occasional LBP was associated with the "family history of LBP and surgery" category. A subgroup analysis of adolescents with a family history of LBP found no statistically significant associations between family history of back surgery and adolescent LBP.

CONCLUSION

Our findings suggest that adolescents who report a family history of LBP have higher odds of frequent LBP irrespectively of a family history of back surgery.Level of evidence: 4.

Effectiveness of Baduanjin Exercise on Quality of Life and Psychological Health in Postoperative Patients With Breast Cancer: A Systematic Review and Meta-analysis

Background:

Baduanjin exercise is a traditional Chinese Qigong exercise. This study aimed to investigate the effects of Baduanjin exercise on the quality of life and psychological status of postoperative patients with breast cancer.

Methods:

A systematic review and meta-analysis were conducted. Eight databases were searched from inception to December 15, 2021, restricting the language to English and Chinese. RevMan5.3 software was employed for data analysis. This study was registered in PROSPERO, number CRD 42020222132.

Results:

A total of 7 randomized controlled trials (RCTs) with 450 postoperative breast cancer patients with or without Baduanjin exercise were collected. Compared with the group without Baduanjin, those who practiced Baduanjin showed significant improvement in quality of life (WMD = 5.70, 95% CI 3.11-8.29, P < .0001). Subgroup analysis showed significant improvement in physical (WMD = 1.83, 95% CI 1.13-2.53, P < .00001) and functional well-being (WMD = 1.58, 95% CI 0.77-2.39, P = .0001), which were measured by the functional assessment of cancer therapy-breast (FACT-B). Subgroup analysis also showed that role-physical (WMD = 11.49, 95% CI 8.86-14.13, P < .00001) and vitality (WMD = 8.58, 95% CI 5.60-11.56, P < .00001) were significantly increased, as measured by a 36-item Short Form survey (SF-36). In terms of psychological health, Baduanjin exercise reduced patients’ anxiety (WMD = −8.02, 95% CI −9.27 to −6.78, P < .00001) and depression (WMD = −4.45, 95% CI −5.62 to −3.28, P < .00001).

Conclusions:

Baduanjin is an effective exercise, which can significantly improve the quality of life and psychological health of breast cancer patients after operation.

Prognostic factors for pain chronicity in low back pain: a systematic review

Supplemental Digital Content is Available in the Text.

Several prognostic factors are related to low back pain chronicity, and these should be taken into account when planning more comprehensive models in its prevention.

Low back pain is the leading cause for years lived in disability. Most people with acute low back pain improve rapidly, but 4% to 25% of patients become chronic. Since the previous systematic reviews on the subject, a large number of new studies have been conducted. The objective of this article was to review the evidence of the prognostic factors behind nonspecific chronic low back pain. A systematic literature search was performed without date limitation from the MEDLINE, Cochrane library, and Medic databases. Specific inclusion criteria were used, and risk factors before the onset of chronic symptoms were searched. Study quality was assessed by 2 independent reviewers. One hundred eleven full articles were read for potential inclusion, and 25 articles met all the inclusion criteria. One study was rated as good quality, 19 studies were rated as fair quality, and 5 articles were rated as poor quality. Higher pain intensity, higher body weight, carrying heavy loads at work, difficult working positions, and depression were the most frequently observed risk factors for chronic low back pain. Maladaptive behavior strategies, general anxiety, functional limitation during the episode, smoking, and particularly physical work were also explicitly predictive of chronicity. According to this systematic review, several prognostic factors from the biomechanical, psychological and psychosocial point of view are significant for chronicity in low back pain.

The Association between Increased Body Mass Index and Overuse Injuries in Israel Defense Forces Conscripts

OBJECTIVES

To examine the association between body mass index (BMI) and overuse injuries (OI) among Israel Defense Forces soldiers, in different corps.

METHODS

Conscripts between 2003 and 2012, infantry, armored corps and intelligence corps (controls) were studied. OI data were taken from computerized patient records. The BMI was classified as underweight, low-normal (18.5-21.9), high-normal (22-24.9), overweight and obese. Multivariate analysis was performed using logistic regression.

RESULTS

There were 73,640 soldiers: 42,506 infantry, 20,781 armor and 10,353 intelligence. OI rates were 52.2, 51.6 and 27%, respectively. OI rate was directly proportional to BMI in all groups (relative risk compared to low-normal, underweight: 0.97, high-normal: 1.05, overweight: 1.11, obese: 1.19, p < 0.05 for all), increased height and younger age. By logistic regression, OI were significantly associated with training group, higher BMI, increased height, younger age, lower education, lower socioeconomic status and lower psychotechnical grading. Throughout the BMI range, each additional unit of BMI was associated with a 2% OI increase.

CONCLUSIONS

Higher BMI was associated with a higher rate of OI in all groups. Therefore there is no point in differentially assigning recruits based on BMI.