Impact of Work-Related Chronic Low Back Pain on Functional Performance and Physical Capabilities in Women and Men: A Sex-Wise Comparative Study

Movement-evoked pain is not associated with pain at rest or physical function in knee osteoarthritis

INTRODUCTION

Knee Osteoarthritis (KOA) is mainly characterized by pain. The assessment of KOA-related pain frequently focuses on different constructs subject to sources of bias or drawbacks, as the classical Pain at Rest (PAR). Movement-evoked pain (MEP), recently defined as 'pain during walking', emerges as a differential concept, since PAR and MEP are driven by different underlying mechanisms. Given the novelty of the MEP approach, its association with PAR or with different performance-based tests has not been studied in KOA yet.

MATERIALS AND METHODS

A cross sectional study was conducted. PAR was measured, alongside the performance of four mobility tests and their corresponding MEP: Timed Up and Go Test, 10-metre Walk Test, 2-Minute Walk Test, and 6-Minute Walk Test. Association and agreement were explored for MEP versus PAR, while the correlation of the tests versus each corresponding MEP-measure was assessed.

RESULTS

Neither association nor agreement were found in the duality MEP versus PAR. Also, the lack of association between the performance of a mobility test and the perceived level of pain during the development of the test was stated.

CONCLUSION

Movement-evoked pain is neither related to pain at rest nor to functional performance in subjects affected by knee osteoarthritis. The results from our study suggest that MEP and pain at rest measure and refer to different constructs in knee osteoarthritis. The implementation of MEP as an outcome in exercise-therapy could enhance the tracking of results, as well as the development of tailored interventions under different conditions.

SIGNIFICANCE

This research elucidates the relevance of MEP, recently defined as 'pain during walking', through the analysis of its association with PAR and with functional performance (measured through four mobility tests) in knee osteoarthritis. The results from our study highlight the absence of either association or agreement between MEP and PAR, fact that supports and endorses the idea that both concepts measure and refer to different constructs in knee osteoarthritis.

The Association of Psychological Variants with Back Pain, Muscle Endurance, and Functional Limitations in an Individual with Chronic Back Pain

Chronic low back pain (CLBP) substantially impacts quality of life through a multifarious interplay of physical and psychological elements. A comprehensive understanding of this relationship is imperative for developing effective treatment strategies. This study recruited 64 participants (35 males and 29 females) experiencing chronic low back pain to explore the associations between psychological factors, muscle endurance, and functional impairments. The study was conducted over six months in an outpatient department and a rehabilitation unit. The study utilized established outcome measures, such as the Biering-Sorensen Test and the Roland Morris Disability Questionnaire, and psychological variants as the core dependent variables, including the Beck Depression Inventory (BDI), STAI questionnaire, the FABQ-PA, and the Pain Catastrophizing Scale (PCS). The findings uncovered pronounced gender disparities, with females exhibiting elevated levels of depression (BDI: 27.68 ± 9.43, p < 0.001) and anxiety (STAI: 42.34 ± 8.94, p < 0.001) and diminished muscle endurance (130.47 ± 30.56 sec, p = 0.001). These revelations are congruent with the prevailing literature, emphasizing the need for gender-sensitive and personalized interventions. Bivariate correlations presented robust associations between psychological distress and decreased muscle endurance (r values ranging from -0.82 to -0.88, p < 0.001) alongside elevated functional impairments (r values from 0.89 to 0.94, p < 0.001) for both genders. Additionally, linear regression analyses illuminated the consequential impact of specific psychological variables such as the BDI, FABQ-PA, and PCS on muscle endurance and functional impairments (all p < 0.001). This study reveals gender-specific variations in chronic back pain, highlighting the influence of psychological factors on pain perception. It underscores the necessity for gender-sensitive treatment strategies. Future research is needed to explore these differences further and assess treatment efficacy to improve care and quality of life for chronic low back pain sufferers through personalized treatment plans.

Sensory Symptoms and effects on Health-related Quality of Life of Patients Undergoing Lumbar Spine Surgery

BACKGROUND

Patients with lumbar degenerative spine diseases (LDSDs) commonly report sensory symptoms before and after lumbar spine surgery.

AIM

To explore the changing patterns of sensory symptoms-namely pain, numbness, stinging, itching, and burning-and investigate the influences of sensory symptom changes on the health-related quality of life (HRQoL) of patients who experienced lumbar spine surgery.

METHODS

All sensory symptoms (i.e., pain, numbness, paresthesia) were measured using a visual analog scale. The Chinese versions of the Oswestry Disability Index, Pittsburgh Sleep Quality Index, Clinically Useful Depression Outcome Scale, and EuroQol-five dimensions (EQ-5D) Scale were used to assess patients 1 week prior to surgery and 6 weeks and 6 months after surgery. A generalized estimating equation was used for data analysis.

RESULTS

A total of 101 patients with mean age of 58.38 years were included. All sensory symptoms declined significantly over time (all p < .05) with the exception of itching (feeling on toes and thighs). Patients experiencing moderate-to-severe pain had poorer QoL over time, even after controlling for other sensory symptoms and potential confounders.

CONCLUSIONS

Sensory symptoms gradually declined after surgery, but itching symptom did not. Moderate-to-severe pain was the only sensory symptom that influenced HRQoL over time in patients with LDSDs.