Low back pain prevalence and associated factors in Iranian population: findings from the national health survey

Global prevalence of musculoskeletal pain in rural and urban populations. A systematic review with meta-analysis. Musculoskeletal pain in rural and urban populations

INTRODUCTION

To systematically compare the global prevalence of musculoskeletal pain and care-seeking in rural and urban populations.

METHODS

A systematic review with meta-analysis of observational studies reporting a direct comparison of rural and urban populations was conducted worldwide and included back, knee, hip, shoulder, neck pain and a broad diagnosis of 'musculoskeletal pain'. A search strategy combining terms related to 'prevalence', 'musculoskeletal pain' and 'rural' was used on the following databases: MEDLINE, Embase, CINAHL, Scopus, and rural and remote health from their inception to 1 June 2022. Random-effects meta-analysis was used to pool the data. Results were presented as odds ratios (OR) along with 95% confidence intervals (95% CI).

RESULTS

A total of 42 studies from 24 countries were included with a total population of 489 439 participants. The quality scores for the included studies, using the modified Newcastle Ottawa Scale tool, showed an average score of 0.78/1, which represents an overall good quality. The pooled analysis showed statistically greater odds of hip (OR = 1.62, 95% CI = 1.23-2.15), shoulder (OR = 1.42, 95% CI = 1.06-1.90) and overall musculoskeletal pain (OR = 1.26, 95% CI = 1.08-1.47) in rural populations compared to urban populations. Although the odds of seeking treatment were higher in rural populations this relationship was not statistically significant (OR = 0.76, 95% CI = 0.55-1.03).

CONCLUSION

Very low-certainty evidence suggests that musculoskeletal, hip and shoulder pain are more prevalent in rural than urban areas, although neck, back and knee pain, along with care-seeking, showed no significant difference between these populations. Strategies aimed to reduce the burden of musculoskeletal pain should consider the specific needs and limited access to quality evidence-based care for musculoskeletal pain of rural populations.

Spinopelvic Parameters as Risk Factors of Nonspecific Low Back Pain: A Case-Control Study

Background

The effect of spinopelvic alignment on low back pain (LBP) incidence has been studied in many investigations. However, the interrelation between spinopelvic parameters and LBP is poorly understood. In particular, it is unknown whether particular patterns of spinopelvic parameters render nonspecific LBP. In this study, we aimed to evaluate the role of spinopelvic parameters as risk factors of nonspecific LBP.

Methods

In this case-control study, spinopelvic parameters, including lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI), were compared between 148 patients with nonspecific LBP and 148 healthy controls. Demographic characteristics of the patients, such as age, gender, occupation, smoking, diabetes mellitus, and body mass index (BMI), were recorded as confounders. Spinopelvic parameters were assessed using radiographic findings in 2 groups. The analysis was done once as univariate (Kolmogorov-Smirnov test) and once as multivariate (multivariate logistic regression) analysis.

Results

Univariate analysis showed that female gender, higher BMI, smoking, and blue-collar jobs were associated with a higher risk of nonspecific LBP. LL, SS, and PI, but not PT, were all greater in LPB patients in the univariate analysis regarding the spinopelvic parameters. Multivariate analysis showed female gender (odds ratio adjusted (ORAdj) = 4.26 [95% CI, 2.11-9.58]; P = 0.001) and LL (ORAdj = 1.58; [95% CI, 1.18-3.22]; P = 0.026) were predictable risk factors for Nonspecific LBP.

Conclusion

Spinopelvic parameters, particularly LL, could be considered as risk factors of nonspecific LBP so that a more significant LL might indicate a greater risk of LBP. However, the role of other parameters in this association could not be neglected.

Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study

Background and objectives

Low back pain (LBP) is a common health condition in populations. Limited large-scale population-based studies evaluated the prevalence and predictors of LBP in developing countries. This study aimed to evaluate the prevalence and factors associated with LBP among the Iranian population.

Methods

We used baseline information from the Prospective Epidemiological Research Studies in Iran (PERSIAN), including individuals from 16 provinces of Iran. LBP was defined as the history of back pain interfering with daily activities for more than one week during an individual's lifetime. Various factors hypothesized to affect LBP, such as age, sex, marital status, educational status, ethnicity, living area, employment status, history of smoking, body mass index (BMI), physical activity, sleep duration, wealth score, history of joint pain, and history of morning stiffness in the joints were evaluated.

Results

In total, 163770 Iranians with a mean age of 49.37 (SD = 9.15) were included in this study, 44.8% of whom were male. The prevalence of LBP was 25.2% among participants. After adjusting for confounders, the female gender [OR:1.244(1.02–1.50)], middle and older ages [OR:1.23(1.10–1.33) and OR:1.13(1.07–1.42), respectively], being overweight or obese [OR:1.13(1.07–1.19) and OR:1.21(1.16–1.27), respectively], former and current smokers (OR:1.25(1.16–1.36) and OR:1.28(1.17–1.39), respectively], low physical activity [OR:1.07(1.01–1.14)], and short sleep duration [OR: 1.09(1.02–1.17)] were significantly associated with LBP.

Conclusion

In this large-scale study, we found the lifetime prevalence of LBP to be lower among the Iranian population in comparison to the global prevalence of LBP; further studies are warranted to evaluate the causality of risk factors on LBP.

•

The lifetime prevalence of low back pain in the Iranian population is 25.2%.

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Our survey includes 163770 people from 16 Iranian provinces.

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We used PERSIAN Cohort data which is the largest study conducted in Iran population.

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For analysis, we used both unadjusted and adjusted logistic regression models.

Assessment of health-related quality of life and patient's knowledge in chronic non-specific low back pain

BACKGROUND

Chronic non-specific low back pain syndrome (cnsLBP) is a severe health problem in developed countries, which has an important effect on patients' quality of life and is highly determined by socio-demographic factors and low back pain specific knowledge. We examined patients' health-related quality of life according to the results of the Short Form Health Survey (SF-36), low back pain knowledge (LBPKQ) and the social determinants of the participants.

METHODS

We carried out our research in the first half of 2015 in Southern Transdanubia, Hungary. The examination included 1155 respondents living with chronic non-specific low back pain. The confidence interval of 95% was used, and the level of. significance was p < 0.05 using SPSS 22.0 software.

RESULTS

The SF-36 questionnaire is suitable for the examination of patients' health-related quality of life (Cronbach's Alpha> 0.76), as the LBPKQ's Cronbach's Alpha was 0.726 also, which showed good validity. Longer-term disease meant a lower health-related quality of life (p < 0.05). A greater decrease of function (Roland Morris scores (RM)) accounts for a lower HRQoL and higher knowledge level. We found significant differences in LBPKQ scores according to sociodemographic parameters. The general health status was positively correlated with LBPKQ (p = 0.024) adjusted for demographic and pain and functional status.

CONCLUSION

The negative effect of the symptoms on patients' quality of life is proved, which is determined by different socio-demographic parameters furthermore by knowledge. Above all could be useful information for professionals to adopt the right interventions.

Prevalence and associated occupational factors of low back pain among the bank employees in Dhaka City

OBJECTIVE

Low back pain (LBP) is one of the common health problems among full-time office employees that causes absenteeism from work. The aim of the study is to identify the association between occupational factors and LBP among full-time bank employees in Dhaka City.

MATERIALS AND METHODS

We conducted a cross-sectional study involving 593 full-time bank employees who were engaged in sedentary works. The 1-month complaint of LBP was measured using a subscale of subjective health complaints inventory. Multivariable logistic models were performed to identify variables related to LBP, and a random forest technique was performed to determine the top five important variables.

RESULTS

The 1-month prevalence for LBP was found to be 36.6% among the bank employees, and the prevalence was the highest (64.3%) for the 51- to 59-year-old age group. The regression analysis indicates that respondents from both agegroups, 41-50 years (OR = 2.00, 95% confidence interval [CI] = 1.10-3.69) and 51-59 years age groups (OR = 5.14, 95% CI = 2.05-13.64), are significantly associated with LBP. Furthermore, obesity (OR = 2.06, 95% CI = 1.01-4.21), and prolong working hours (>9 hours) (OR = 1.42, 95% CI = 1.01-2.0) are positively associated with LBP. The top five important variables for LBP identified by random forest technique are: age, length of employment, prolong office hours, presence of chronic illness, and physical activity.

CONCLUSION

LBP is highly prevalent in full-time bank employees. The occupational factors, including the length of employment (>10 years) and long working hours, play a significant role in developing LBP among bank employees. Moreover, several factors, including age, chronic illness, obesity, and physical activity, should be taken into account in the prevention of LBP in bank employees.

Unilateral discectomy: outcomes, postoperative pain, complications

In low back pain management surgery is currently commonly used with a new technique called minimally invasive discectomy, while open discectomy is still preferable in many cases. In this regard, the efficacy of tubular discectomy (TD) were compared with conventional standard lumbar disc procedure (conventional microdiscectomy). This study was performed as a clinical trial conducted on patients who were under TD and conventional microdiscectomy using unilateral retractor at Bou Ali, Mehrad, Laleh Hospitals during the years 2001 to 2017. The pain score was determined based on the use of Visual Analogue Scale (VAS). The Roland Morris Disability Questionnaires (RMQ) and mean Oswestry disability index (ODI) were also calculated. Our findings revealed that the two groups were similar in terms of demographic characteristics (age, sex, body mass index, etc.) (p> 0.05). The findings indicated the superiority of TD over the classic approach. The mean scores of ODI in conventional microdiscectomy and TD groups were reported as 12.53 ± 7.09 and 9.51 ± 7.83, respectively. ODI revealed that patients with TD surgery had less disability in lifting objects, sitting, standing, and traveling. In the conventional microdiscectomy group, 12 (20%) patients were affected by complications of surgery, but no complication was reported in any patient with TD (p = 0.000). The mean index of Roland Morris disability in the conventional microdiscectomy and TD groups were estimated to be 6.033 ± 2.98 and 3.73 ± 3.25 (p = 0.000). However, both groups did not differ in terms of visual scores for pain and relapse (p > 0.05). Our study demonstrates that disease relapse within 6 months after the surgery, the RMQ and the ODI values were significantly better in TD than the other group.

Comparative effect of driving side on low back pain due to Repetitive Ipsilateral Rotation

Objective:

To determine the effects of repetitive ipsilateral rotation on low back pain among the taxi drivers of right and left hand drive.

Methods:

A total of 1200 (600 Iran+600 Pakistan) male taxi drivers, aged between 20-60 years with work experience of more than one year were randomly selected and interviewed in Tehran (Iran) & Lahore (Pakistan) to fill self-administered questionnaires in Persian and Urdu languages which contained socio-demographic, work related and LBP characteristics. Chi-square test and multiple logistic regression models were employed for statistical analyses.

Results:

Point, one week, one year and lifetime prevalence of LBP among right hand drive taxi drivers was 26.7%, 35.5%, 49.8% and 77.7% respectively. Point, one week, one year and lifetime prevalence of LBP among left hand drive taxi drivers was 37%, 42.7%, 53.5% and 72.3% respectively. Mean Numeric Pain rating scale (NPRS) score was 4.15 (SD=1.42) in Pakistan, while in Iran it was 4(SD=1.57). There was no significant difference regarding pain intensity (p=0.123) between drivers from both countries. Mean Roland-Morris Questionnaire (RMQ) score among drivers in Pakistan with LBP was 7.76(SD= 2.50), while in Iranian drivers who had LBP, mean RMQ score was 7.71(SD=2.99).

Conclusion:

Static or less dynamic muscles are more prone to LBP due to lower endurance. Lack of exercising habit, work as a driver for more number of years, driving within city, more driving hours in a day, forward bending, lifting, no seat comfort, lack of awareness regarding ergonomics and lower satisfaction level of job were the main reasons of LBP.

Development and validation of a new scale for prediction of low back pain occurrence among nurses

There are several scales for prediction of low back pain (LBP) occurrence, but most of them only consider occupational aspect. This study aimed to develop and validate a new biopsychosocial scale for the LBP prediction among nurses. In this mixed-method study, a scale was developed by integrating the findings from the literature review and the semi-structured interviews. The qualitative and quantitative face and content validation were then performed. The construct validation was performed based on the hypothesis testing by independent-samples t-test using the SPSS in a case study with 241 nurses. The reliability of the scale was also tested through 15-day interval test-retest reliability by Intra Class Correlation Coefficient (ICC). Then the Minimum Detectable Changes (MDC) and MDC % was calculated. The results showed that the three dimensions (occupational, psychosocial and individual), consisted of 40 items, predict LBP occurrence. Both the scale and the three sub-scales could differentiate known groups of nurses in terms of LBP. These groups were nurses: with/without LBP during the past 12 years, with a high/low occurrence of LBP, with/without co-morbidity, being female/male, with/without night shift, and with high/low repetition of loads/patients handling. The average measure ICC of the scale was 0.866 (P <0.001). The MDC95 (MDC %) was 14.86 (15.65 %). We concluded that the proposed scale is a simple and trustworthy tool which supports the multidimensional nature of LBP.

Low back pain and some associated factors: is there any difference between genders?

OBJECTIVE

To compare men and women with low back pain and identify the prevalence and some of its associated factors in a population-based sample of adults aged 20 and over a seven day period.

METHODS

Cross-sectional study based on a population survey. 600 individuals were interviewed on the following: (1) characteristics of the participants (i.e. demographic, socioeconomic, and labor aspects); (2) physical activity level (IPAQ); (3) musculoskeletal symptoms (Nordic Questionnaire). Descriptive, bivariate, and Poisson regression analyses were performed.

RESULTS

Overall prevalence of LBP was 28.8%, being 39.0% in men and 60.9% in women. The measured associated factors in men were age between 36 and 59 years (PR=3.00 [1.31-6.88]) and over 60 (PR=4.52 [2.02-10.12]), smoking (PR=2.47 [1.20-5.11]), fewer years of formal education (0-4 years) (PR=6.37 [2.15-18.62]), and hypertension (PR=2.27 [1.15-4.50]). For women, the associated factors were occupational activities that involved heavy lifting (PR=1.80 [1.03-3.16]), standing posture leaning forward (PR=2.04 [1.20-3.44]), sitting posture leaning forward (PR=2.17 [1.24-3.82]), and sitting at the computer three or more days per week (PR=4.00 [1.44-11.11]). Widowed or divorced participants were more likely to report LBP, in both men (PR=3.06 [1.40-6.66]) and women (PR=2.11 [1.15-3.88]).

CONCLUSION

This study reveals high prevalence of low back pain in a seven day period. Older age, low education, hypertension, and smoking were associated with LBP in men. Occupational and ergonomic factors were associated with LBP in women. Marital status was associated with LBP in both genders.

Prevalence of low back pain among athletes: A systematic review

BACKGROUND

The prevalence of low back pain (LBP) in athletes across a variety of time frames and sports is not known.

OBJECTIVES

To systematically collate and appraise studies on the prevalence of LBP in athletes and stratify by point, one year and life-time prevalence.

METHODS

A comprehensive search was conducted in February 2016. The following sources were individually searched: PubMed (1950 to present), Ovid SP Medline (1950 to present), ISI (1982 to present) and Google Scholar; Surveys were included if they aimed to report the prevalence of LBP amongst the athletes. Two reviewers independently evaluated the methodological quality of the studies.

RESULTS

The literature search generated 4379 records. Title and/or abstracts were reviewed by two investigators and full-texts of 201 relevant articles were selected for further evaluation. Studies were included if they reported the prevalence of LBP in an athletic population (any level of participation in sports and any age range) and were written in English. Furthermore, to adequately assess the prevalence rate, studies had to report the number of athletes with LBP as a percentage of the total number of athletes. Studies that did not contain necessary data to calculate prevalence rate including case reports and non-original studies were excluded and 41 studies entered the bias assessment step. A bias assessment was applied to the methodology of 41 studies, and 36 with low to moderate risk for bias were included in this review. LBP in athletes was shown to have a point prevalence ranging from 10% to 67%, a one-year prevalence ranging from 17% to 94%, and a life-time prevalence ranging from 33% to 84%. The highest prevalence of LBP was found among skiers, floorball players and rowers and the lowest were found in shooters, golfers and triathletes.

CONCLUSION

Like general population, LBP is quite prevalent among athletes. There is a lack of sound data on the prevalence and mechanism of LBP in some popular sports such as volleyball, swimming and track and field. The lack of standardization of research methods and outcome measurement tools are significant problems in literature. Researchers need to use standard and internationally acceptable definitions for LBP and related functional disability. Investigators are encouraged to conduct epidemiologic studies, along with search for possible mechanism of LBP, by recruitment of large sample population of the athletes who are selected through randomization of the national population and adopt recent recommendations for a standard definition of LBP.

Vitamin D (FokI) Receptor Gene Polymorphism is associated with Vitamin D Deficiency and Chronic Musculoskeletal Pain. A meta-analysis

Background: Musculoskeletal pain is the most common chronic pain experienced by older adults. The aim of this study is to explore the associations between vitamin D (FOKI) receptor gene polymorphism (VDR) and vitamin D deficiency (VDD) and chronic musculoskeletal pain. Methods: Cross-sectional studies published in English from January 2000 to January 2015which reported prevalence of chronic pain (CP) and chronic musculoskeletal pain (CMP) were included in this systematic review and meta-analysis. A heat map was used to visualize and observe the correlation between VDR and CMP, CP and VDD. Results: 20 studies (N = 216,365) were included in the analysis, which showed an overall pooled prevalence estimate of CMP and CP as 30.6 per 100 (95 % CI: 30.59, 30.69) and 27.9 per 100 (95 % CI: 27.68, 28.24) respectively. The heat map clustering analysis visualizes the similarity between CP and CMP. Moreover, a direct correlation was observed between the three disease conditions (namely CMP, CP, and VDD) and FokI VDR polymorphism (FF). Spearman's correlation analyses with adjusted r² revealed that there is a statistically significant interaction effect of the FF genotype and VDD on CMP (r² = 0.19, p = 0.03), a marginally significant interaction effect of the ff genotype and VDD on CMP (r² = 0.11, p = 0.08). VDD was also associated with increased CMP (r² = 0.19, p = 0.028). The pooled estimates of the prevalence of CMP in this review were found to be high. Conclusion: FokI VDR gene polymorphism (FF) plays an important role in the relationship between VDD and CMP.

The Persian Version of Örebro Musculoskeletal Pain Screening Questionnaire: Translation and Evaluation of its Psychometric Properties

Background:

Screening of psychosocial risk factors for chronic low back pain (LBP) is essential. The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) is one of the most recognized and widely used instruments for this purpose. This study aimed to translate the ÖMPSQ into Persian, to adapt it for Iranian culture, and to investigate its psychometric properties.

Methods:

Using a linguistic methodology, the ÖMPSQ was translated into Persian according to the World Health Organization guideline. A total of 106 patients with LBP participated in the study. Internal consistency and test-retest reliability were evaluated. Concurrent validity was estimated with Pearson's correlation between the ÖMPSQ and short form health survey (SF-12), Hospital Anxiety and Depression Scale (HADS), and visual analog scale (VAS). Factor analysis was used to evaluate dimensionality.

Results:

The content validity index was 0.80. The instrument had a good test-retest reliability (intraclass correlation coefficient = 0.82) and internal consistency (Cronbach's α =0.82). Factor analysis indicates that factorial structure of Persian version was similar to original questionnaire. There was a significant correlation (r = 0.252–0.639, P < 0.01) between VAS score and all the ÖMPSQ domains. Physical component summary of SF-12 was positively correlated with miscellaneous domain (r = 384, P < 0.05) and negatively correlated with psychology domain of ÖMPSQ (r = −0.364, P < 0.05). A significant correlation between total score and anxiety component of HADS and psychology domain of ÖMPSQ was found (r = 0.49, P < 0.01 and r = 0.442, P < 0.05, respectively). Correlations between the ÖMPSQ and SF-12 and HADS and VAS indicate acceptable concurrent validity.

Conclusions:

The Persian version of ÖMPSQ was as a valid and reliable instrument and also a good cross-cultural equivalent for original English version.

Risk Factors for Low Back Pain and Spine Surgery: A Retrospective Cohort Study in Soldiers

INTRODUCTION

Musculoskeletal low back pain (LBP) is commonly treated symptomatically, with practice guidelines advocating reserving surgery for cases that fail conservative care. This study examined medical comorbidities and demographic variables as risk factors for chronic/recurrent LBP, spinal surgery, and time to surgery.

METHODS

A 2015 retrospective cohort study was conducted in U.S. Army soldiers (N=1,092,420) from 2002 to 2011. Soldiers with medical encounters for LBP were identified using ICD-9 codes. Surgical treatment for LBP was identified according to Current Procedural Terminology codes. Comorbid medical conditions (psychological disorders, sleep disorders, tobacco use, alcohol use, obesity) and demographic variables were examined as risk factors for chronic/recurrent LBP within 1 year of the incident encounter, surgery for LBP, and time to surgery.

RESULTS

Of 383,586 patients with incident LBP, 104,169 (27%) were treated for chronic/recurrent LBP and 7,446 (1.9%) had surgery. Comorbid variables showed increased risk of chronic/recurrent LBP ranging from 26% to 52%. Tobacco use increased risk for surgery by 33% (risk ratio, 1.33; 95% CI=1.24, 1.44). Comorbid variables showed 10%-42% shorter time to surgery (psychological disorders, time ratio [TR]=0.90, 95% CI=0.83, 0.98; sleep disorders, TR=0.68, 95% CI=0.60, 0.78; obesity, TR=0.88, 95% CI=0.79, 0.98; tobacco use, TR=0.58, 95% CI=0.54, 0.63; alcohol use, TR=0.85, 95% CI=0.70, 1.05). Women showed 20% increased risk of chronic/recurrent LBP than men but 42% less risk of surgery.

CONCLUSIONS

In the presence of comorbidities associated with mental health, sleep, obesity, tobacco use, and alcohol use, LBP shows increased risk of becoming chronic/recurrent and faster time to surgery.

Changes in Obesity Odds Ratio among Iranian Adults, since 2000: Quadratic Inference Functions Method

Background. Monitoring changes in obesity prevalence by risk factors is relevant to public health programs that focus on reducing or preventing obesity. The purpose of this paper was to study trends in obesity odds ratios (ORs) for individuals aged 20 years and older in Iran by using a new statistical methodology. Methods. Data collected by the National Surveys in Iran, from 2000 through 2011. Since responses of the member of each cluster are correlated, the quadratic inference functions (QIF) method was used to model the relationship between the odds of obesity and risk factors. Results. During the study period, the prevalence rate of obesity increased from 12% to 22%. By using QIF method and a model selection criterion for performing stepwise regression analysis, we found that while obesity prevalence generally increased in both sexes, all ages, all employment, residence, and smoking levels, it seems to have changes in obesity ORs since 2000. Conclusions. Because obesity is one of the main risk factors for many diseases, awareness of the differences by factors allows development of targets for prevention and early intervention.

Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study

OBJECTIVES

Studies have shown that dentists have a higher incidence of work-related musculoskeletal (MSK) pain than those in other occupations. The risk factors contributing to MSK pain among Saudi dentists has not been fully studied so this study aims to estimate the prevalence of MSK pain and investigate its associated risk factors among dentists in Saudi Arabia.

SETTING AND PARTICIPANTS

A cross-sectional survey was carried out in the capital city Riyadh, Saudi Arabia, using random cluster sampling. 224 surveys were distributed among dentists with a 91.1% response rate (101 women and 103 men).

OUTCOMES

The prevalence of MSK pain and its associated risk factors were investigated.

RESULTS

184 (90.2%) respondents reported having MSK pain. Lower back pain was the most commonly reported MSK pain (68.1%). Gender and age were reported to be predictors for at least one type of MSK pain. Older age was associated with lower back pain (OR 1.23; 95% CI 1.00 to 1.50) and women had double the risk of shoulder pain (OR 2.52; 95% CI 1.12 to 5.68). In addition, lower back pain was related to the time the dentist spent with patients (OR 0.28; 95% CI 0.14 to 0.54), while shoulder pain (OR 1.03; 95% CI 1.00 to 1.06) and lower back pain (OR 1.06; 95% CI 1.03 to 1.10) were significantly related to years of experience.

CONCLUSIONS

MSK pain is common among older and female Saudi dentists. Research on the impact of exercise and the ergonomics of the workplace on the intensity of MSK pain and the timing of its onset is required.

Association Between Farm Machinery Operation and Low Back Disorder in Farmers: A Retrospective Cohort Study

OBJECTIVE

The association between whole body vibration (WBV) as measured by annual accumulated use of all-terrain vehicles (ATV)/combine/tractor operation and low back disorders (LBDs) among farmers was investigated.

METHODS

Saskatchewan Farm Injury Cohort Study data was used. Baseline data were collected in 2007 on the three vehicle types and other factors. Follow-up data on LBD symptoms were collected during 2013 resulting in 1149 samples.

RESULTS

Adjusted for age, education, and gender, LBDs were associated with tractor operation for 1 to 150 hours/year (Relative Risk [RR] = 1.23, 95%CI 1.05 to 1.44), 151 to 400 hours/year (RR = 1.32, 95%CI 114 to 1.54) and 401+ hours/year (RR = 1.34, 95%CI 1.15 to 1.56). Additionally, hip symptoms were associated with tractor operation. Only unadjusted associations were found in combine and ATV operation.

CONCLUSIONS

Duration of tractor operation and older age are important predictors of both low back and hip symptoms in farmers.

Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey

To determine the prevalence of active chronic low back pain (CLBP) in the adult Portuguese population; to compare the active CLBP population with the population without CLBP; and to explore factors associated with active CLBP. The present study was conducted under the scope of EpiReumaPt a population-based study. Active CLBP was self-reported and considered if present on the day of the interview and for ≥90 days. Prevalence estimates were calculated. Association of active CLBP with quality of life, functional ability and healthcare consumption were evaluated. Factors associated with active CLBP were identified through logistic regression. Among 10.661 EpiReumaPt subjects, 1487 self-reported active CLBP. The prevalence of active CLBP was 10.4 % (95 % CI 9.6; 11.9 %). After adjustment, active CLBP subjects had a higher likelihood for anxiety symptoms (OR 2.77), early retirement due to disease (OR 1.88) and more physician visits (β = 2.65). Factors significantly and independently associated with the presence of active CLBP were: female gender (OR 1.34), overweight/obesity (OR 1.27), presence of self-reported rheumatic musculoskeletal disease (RMD) (OR 2.93), anxiety symptoms (OR 2.67), age (OR 1.02) and higher number of self-reported comorbidities (OR 1.12). Active CLBP is highly prevalent in the Portuguese population and is associated with disability and with a high consumption of healthcare resources. Female gender, older age, anxiety symptoms, overweight/obesity, the presence of other RMD and the number of comorbidities were independently associated with the presence of active CLBP. These factors should be taken into account when new cohort prospective studies will be developed.

Prevalence of obesity and overweight in adults and children in Iran; a systematic review

BACKGROUND

Obesity is one of the most important underlying risk factors for chronic disease. Dramatically increasing and following complication of obesity should be alerted to health politicians and practitioners to prevent associated health risks. This review aimed to give a better insight into the prevalence of obesity and overweight in different areas of Iran.

METHOD

All published internal (SID, Irandoc, Iranmedex), and international (Web of Knowledge, Pubmed, Scopus) source studies, reported the prevalence of overweight/obesity among normal population samples, during Jan 2005 through Jan 2014, were assessed in this review. Paper selection processes were done by two researchers separately. Studies which met the eligible criteria were included in this review.

RESULT

One hundred ninety three eligible studies enter into our review. Of 193 final selected studies, 86 (15 national, 71 sub national) of them were reported the prevalence of obesity/overweight in adult, and 107 studies (11 national, 96 sub national) in under-18 by individual. The range of overweight and obesity prevalence in national studies in adult, was 27.0-38.5 (95% CI: 26.8-27.1, 37.2-39.8), and 12.6-25.9 (95% CI: 12.2-13.0, 24.9-26.8), separately. In under-18 the range of overweight and obesity prevalence in national studies were 5.0-13.5 (95% CI: 4.5-5.5, 13.4-13.6), and 3.2-11.9 (95% CI: 3.0-3.4, 11.3-12.4).

CONCLUSION

Obesity as an important public health problem has been discussed in recent few decades worldwide. Although the national reported prevalence of obesity in Iran was not considerably diverse, but remarkable differences were seen in the sub national prevalence which must be noticed more in political health programs especially among women and children.

Demographic and health characteristics of rural- and urban-dwelling canadians with chronic back disorders: a population-based comparison

STUDY DESIGN

This is a cross-sectional design based on analysis of a national survey.

OBJECTIVE

To compare rural- and urban-dwelling adults with self-reported chronic back disorders (CBDs) with respect to their demographic, socioeconomic, comorbidity, and other health status indicators.

SUMMARY OF BACKGROUND DATA

People living in more rural and geographically remote areas have a greater risk of reporting CBD. Very little is known about whether the characteristics among people with CBD are different between rural and urban dwellers.

METHODS

We performed a secondary analysis of the 2009 and 2010 Canadian Community Health Surveys to develop a profile of adults with CBD, comparing populations defined by relative rurality of residence. In addition to descriptive analysis using proportions and bivariate logistic regression, multiple logistic regression was used to control for possible confounding and to better understand the differences between rural- and urban-dwelling Canadians with CBD.

RESULTS

With few exceptions, the descriptive bivariate analysis showed significant differences in demographic, socioeconomic, and health status indicators between rural and urban dwellers with CBD. We found no significant differences with respect to self-reported physical and sedentary activity levels, presence of asthma, presence of mood disorders, probability of depression, and self-rated mental health and pain and self-reported pain and function. The multivariate analysis showed that among adults with CBD, rural residence was significantly associated with lower levels of education (odds ratio [OR], 1.39-1.85), Aboriginal ethnicity (OR, 1.72), being married or in a common-law relationship (OR 1.44), being a former smoker (OR, 1.17) or current smoker (OR, 1.31), and being obese (OR, 1.24), regardless of the presence or number of comorbidities.

CONCLUSION

There are significant sociodemographic and lifestyle differences between rural and urban Canadians with CBD. These differences may have implications for the design and delivery of more equitable and appropriate health services as well as health promotion and prevention efforts.

LEVEL OF EVIDENCE

2.

Prevalence and correlates of low back pain in primary care: what are the contributing factors in a rapidly developing country

STUDY DESIGN

Cross-sectional.

PURPOSE

The purpose of the study was to determine the prevalence of low back pain (LBP) in the primary care setting with emphasis on the socio-demographic contributing factors and impact of LBP on lifestyle habits.

OVERVIEW OF LITERATURE

LBP is one of the most common medical conditions seen in the Primary Health Care Clinic.

METHODS

A representative sample of 2,600 patients were approached and 1,829 subjects agreed to participate in this study (70.0%). Data on socio-demographic characteristics, life style habits and type of treatment were collected through a questionnaire.

RESULTS

The prevalence of LBP in the study sample was 56.5% (95% confidence interval, 54.2-58.8). LBP was more prevalent among women (53.9%) compared to men (46.1%). There was significant difference between male and female patients of LBP in terms of ethnicity (p<0.001), marital status (p=0.010), occupation (p<0.001), monthly household income (p=0.004), and cigarette/sheesha smokers (p<0.001). The percentages of different aspects of functional disabilities were statistically significantly higher among females compared to male patients with LBP. Almost a quarter of female patients with LBP (26%) and 18% male patients with LBP reported pain in the arms and legs (p=0.002). In addition, gastrointestinal complaints such as abdominal pain and food intolerance were significantly higher among female patients with LBP as compared to males (31% vs. 24.6%, p=0.018; and 25% vs. 18%, p=0.008, respectively). Complaints about headache and fainting were also significantly higher among female patients as compared to male LBP patients (43% vs. 36%, p=0.029; and 26% vs. 20%, p=0.016, respectively). The multivariate logistic regression revealed that being female, prolonged standing, prolonged sitting, heavy weight lifting, weakness in the legs, regular exercise, and cigarette/sheesh a smoking had a significant effect on the presence of LBP.

CONCLUSIONS

LBP is highly prevalent among both genders and in older age. Also, weakness in the legs, smoking, prolonged standing and sitting had a significant effect on LBP. Furthermore, the current study findings support the fact that LBP continues to be an important clinical, social and economic, burden and a public health problem affecting the population of the entire world.