1
|
Stott B, Driscoll M. Development and evaluation of sex-specific thoracolumbar spine finite element models to study spine biomechanics. Med Biol Eng Comput 2024; 62:1191-1199. [PMID: 38157201 DOI: 10.1007/s11517-023-03003-w] [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: 07/12/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
Musculoskeletal disorders and low back pain (LBP) are common global afflictions, with a higher prevalence observed in females. However, the cause of many LBP cases continues to elude researchers. Current approaches seldom consider differences in male and female spines. Thus, this study aimed to compare the load distribution between male and female spines through finite element modeling. Two finite element models of the spine, one male and one female, were developed, inclusive of sex-specific geometry and material properties. The models consisted of the vertebrae, intervertebral discs (IVD), tendons, surrounding spinal muscles, and thoracolumbar fascia and were subjected to loading conditions simulating flexion and extension. Following extensive validation against published literature, intersegmental rotation, IVD stress, and vertebral body stress were evaluated. The female model demonstrated increased magnitudes for rotation and stresses when compared to the male model. Results suggest that the augmented stresses in the female model indicate an increased load distribution throughout the spine compared to the male model. These findings may corroborate the higher prevalence of LBP in females. This study highlights the importance of using patient- and sex-specific models for patient analyses and care.
Collapse
Affiliation(s)
- Brittany Stott
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W Qc, H3A 0C3, Macdonald Engineering Building, Office #153, Montreal, QC, Canada
- Orthopaedic Research Laboratory, Research Institute MUHC, Montreal General Hospital, Montreal, QC, Canada
| | - Mark Driscoll
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W Qc, H3A 0C3, Macdonald Engineering Building, Office #153, Montreal, QC, Canada.
- Orthopaedic Research Laboratory, Research Institute MUHC, Montreal General Hospital, Montreal, QC, Canada.
| |
Collapse
|
2
|
Hashem M, AlMohaini RA, Alharbi TM, Aljurfi MM, Alzmamy SA, Alhussainan FS. Impact of Musculoskeletal Pain on Health-Related Quality of Life Among Adults in Saudi Arabia. Cureus 2024; 16:e57053. [PMID: 38681335 PMCID: PMC11051673 DOI: 10.7759/cureus.57053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 05/01/2024] Open
Abstract
Background Musculoskeletal pain (MSP) is widely recognized as a prevalent public health issue that affects individuals of various genders and age groups. The aim of this study is to assess the influence of musculoskeletal pain on the quality of life (QoL) of adult individuals living in Saudi Arabia. Method This is a cross-sectional study using an online-administered questionnaire that was distributed via online platforms in Saudi Arabia for the duration between January and August 2023. Three questionnaire instruments were used in this study. The 36-item Short Form Health Survey questionnaire (SF-36), The 5-level EQ-5D version (EQ-5D-5L), and Roland-Morris Disability Questionnaire. Binary logistic regression analysis was used to identify predictors of better QoL and having mild to moderate disability. Results A total of 8359 participants were involved in this study. The most commonly reported sites of musculoskeletal pain were the lower back, neck, and shoulder, accounting for 36.8% (n= 3072), 30.5% (n= 2549), and 30.1% (n= 2514), respectively. The mean pain score for the study participants was 4.3 (SD: 2.3), which indicates mild degree of pain. The median EQ-5D-5L index value for the study participants was 0.827 (0.756-1.00), which demonstrates a high quality of life. The mean SF-36 score for the study participants was 63.11 (17.4), which demonstrates moderate quality of life. The median Roland-Morris Disability score for the study participants was 1.00 (0.00-7.00), which demonstrates a low level of pain-related disability. Male gender, younger age (30-39 years), having higher education attainment, having higher monthly income (more than SAR 20000), and having lower BMI (less than 25.8 kg/cm2) were predictors of better QoL (p<0.05). Conclusion Musculoskeletal pain is a multifactorial condition influenced by structural, physical, psychological, social, lifestyle, and comorbid health elements. It ranges from acute to chronic pain and, despite rarely being fatal, has a significant impact on QoL. Musculoskeletal discomfort varies in terms of intensity, affected regions, and demographic and lifestyle factors. This study sheds light on the multifaceted nature of MSP, its impact on QoL, and the significance of early intervention and individualized management strategies to improve the QoL of those affected.
Collapse
Affiliation(s)
- Majdi Hashem
- Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Turki Melfi Alharbi
- Internal Medicine, College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU
| | - Muhamad Muslim Aljurfi
- Orthopedics, College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU
| | - Saad Abdullah Alzmamy
- Internal Medicine, College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU
| | | |
Collapse
|
3
|
Unver T, Unver B, Kacmaz KS. The test-retest reliability and minimal clinically important difference of the Dubousset Functional Test and its correlation with Rolland Morris disability questionnaire in chronic non-specific low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:2086-2092. [PMID: 37119310 DOI: 10.1007/s00586-023-07720-6] [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: 12/14/2022] [Revised: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE This study examines the test-retest reliability, the minimal clinically important difference (MCID), and its correlation with the Rolland Morris Disability Questionnaire (RMDQ) of the Dubousset Functional Test (DFT) in evaluating the functional capacity and dynamic balance of patients with chronic non-specific low back pain (cnsLBP). METHODS Seventy-five patients with cnsLBP aged 18 years and over were included. The Five-Repetition Sit-To-Stand Test (5R-STS), the subcomponents of the DFT (the Up and Walk Test, the Steps Test, the Down and Sitting Test, and the Dual-Tasking Test) were administered to the patients. Patients were rested for 1 h, and the DFT was applied again. Pain level was evaluated with the Visual Analogue Scale before the tests started and after the tests were completed. Self-report function assessment was made using the RMDQ. RESULTS The test-retest reliability of the subcomponents of the DFT was excellent. The ICCs were: 0.91, 0.86, 0.89, and 0.89, respectively. The standard measurement errors of the subcomponents of the DFT were 0.32, 0.12, 0.14, and 0.25, respectively. The subcomponents of the DFT were highly correlated with the RMDQ and 5R-STS with the correlation coefficients of 0,83, 0,83, 0,79, 0,83 and 0,81, 0,75, 0,73, and 0,82, respectively (p < 0.01). The MCIDs of the subcomponents were 0,60, 0,23, 0,27, and 0,48, respectively. CONCLUSION The DFT is reliable in evaluating patients' functional capacity and dynamic balance with cnsLBP without causing discomfort. It is simple, quick, and simultaneously assesses multiple areas contributing to spinal alignment, muscle integrity, and balance.
Collapse
Affiliation(s)
- Tuba Unver
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, TR-35340, Balçova, Izmir, Turkey
| | - Bayram Unver
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, TR-35340, Balçova, Izmir, Turkey
| | - Kevser Sevik Kacmaz
- Department of Physical Therapy and Rehabilitation, Izmir Katip Celebi University, TR-35340, Cigli, Izmir, Turkey.
| |
Collapse
|
4
|
Assessment of Qatar community pharmacists’ competence and practices related to renal and gastrointestinal adverse effects of nonprescription NSAIDs. Saudi Pharm J 2022; 30:1396-1404. [PMID: 36387344 PMCID: PMC9649341 DOI: 10.1016/j.jsps.2022.06.011] [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: 06/02/2021] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently dispensed nonprescription drugs in community pharmacies. However, inappropriate use of NSAIDs by consumers has been associated with development of gastrointestinal (GI) injuries and renal injuries. Community pharmacists’ education of consumers on proper use of NSAIDs and their associated adverse effects has been shown to reduce the GI and renal injuries. In Qatar, no studies have been done to assess the community pharmacists’ knowledge, attitude, and practices related to renal and GI adverse effects of NSAIDs. Therefore, this study aimed to assess Qatar community pharmacists’ knowledge, attitude, and practices on the safe use of nonprescription NSAIDs to reduce the risk of kidney and GI injuries. Methods A cross-sectional web-based survey was conducted among community pharmacists in Qatar. A pre-tested 28-item questionnaire that was developed through a multi-phase iterative process was administered to a convenient sample of community pharmacists in Qatar. Data were analyzed using descriptive and inferential statistics with statistical significance set at p < 0.05. Results Overall, 114 community pharmacists responded to the online questionnaire (response rate 15.2%). Approximately 90% of the community pharmacists demonstrated from good to excellent knowledge on the renal and GI adverse effects of NSAIDs, with none of their sociodemographic and professional characteristics having a significant effect on their knowledge scores. More than half of the pharmacists reported that they always or usually educated patients on the dosage (98.6%), administration (95.8%), side effects and precautions (78%), and contraindications (71.2%) of NSAIDs during their routine practices. The majority of the pharmacists had positive attitude towards educating patients about adverse effects of NSAIDs, as well as identifying high-risk patients who should avoid nonprescription NSAIDs. However, 45.7% of the pharmacists strongly agreed or agreed that educating patients about NSAIDs can be time consuming. Conclusion Community pharmacists in Qatar demonstrated good knowledge of the renal and GI adverse effects of NSAIDs with some obvious areas of improvement, and this can be reinforced through continuing professional development. They also showed positive attitudes towards protecting patients against the renal and GI adverse effects of NSAID. However, a significant proportion of the pharmacists admitted that educating patients on NSAIDs was time consuming, which is a cause of concern warranting further investigation. Community pharmacy managers should provide community pharmacists adequate time and support to educate individuals at risk of renal and GI injuries who obtain NSAIDs from their pharmacies. Also, the Ministry of Public Health of Qatar should consider making counseling on high-risk medications (e.g., NSAIDs and insulin) by community pharmacists mandatory so that measures can be put in place in the pharmacies to free the pharmacist for education and counseling.
Collapse
|
5
|
Elmoheen A, Nazal AF, Zubaidi O, Siddiqui UA, Alhatou M. Expert review and recommendations for the management of acute, chronic, and neuropathic pain in Qatar. Qatar Med J 2021; 2021:19. [PMID: 34285886 DOI: 10.5339/qmj.2021.19] [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: 11/18/2020] [Accepted: 02/24/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Pain management is an evolving area of expertise in Qatar. Gaps in knowledge, inadequate training for physicians and nurses, and the absence of policies/guidelines are the main barriers to effective pain management in Qatar. In addition, the use of certain pain medication, especially opioids, is highly regulated, limiting their availability in outpatient pain management. These factors are responsible for the undertreatment of pain in Qatar. This study aimed to standardize evidence-based local recommendations for pharmacological treatment of pain in Qatar. METHODS An expert panel of physicians from different disciplines, with experience in diagnosis and treatment of the three pain types (i.e., acute, chronic, and neuropathic), was convened for two face-to-face meetings in Doha, Qatar, on November 29, 2019, and on February 22, 2020, with subsequent virtual meetings. A literature search was performed on Medline and Google Scholar databases from inception till December 2019, and all relevant articles were selected. Based on these articles and repeated feedback from the authors, the final pain treatment protocols were developed. RESULTS Recommendations for the treatment of acute pain, based on pain severity, followed three approaches: acetaminophen/paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) for mild pain and moderate pain and referral to a pain specialist for severe pain. Acetaminophen/paracetamol or NSAIDs is recommended for chronic pain, and the use of opioids was strongly discouraged because of its long-term side effects. For neuropathic pain, tricyclic antidepressants or gabapentin or pregabalin or serotonin-norepinephrine reuptake inhibitors were recommended first-line agents. Non-responders must be referred to neurologists or a pain specialist. CONCLUSION The expert panel provides recommendations for the management of acute, chronic, and neuropathic pain based on international guidelines adapted to local practice and treatment availability in Qatar. More importantly, the panel has recommended taking extreme caution in the use of opioids for long-term management of chronic pain and to refer the patient to a pain specialist clinician as required.
Collapse
Affiliation(s)
- Amr Elmoheen
- Emergency Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdullah F Nazal
- Pain Management Section, Department of Anesthesiology, ICU and Perioperative Medicine, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Osman Zubaidi
- Research, Development and Medical, Upjohn-A Division of Pfizer, Doha, Qatar
| | - Urooj A Siddiqui
- Research, Development and Medical, Upjohn-A Division of Pfizer, Dubai, UAE
| | - Mohammed Alhatou
- Neuromuscular Division, Hamad Medical Corporation, Doha, Qatar; Neurology Division, Department of Medicine, Al Khor Hospital, Doha, Qatar
| |
Collapse
|
6
|
Osinuga A, Hicks C, Ibitoye SE, Schweizer M, Fethke NB, Baker KK. A meta-analysis of the association between physical demands of domestic labor and back pain among women. BMC WOMENS HEALTH 2021; 21:150. [PMID: 33849504 PMCID: PMC8045256 DOI: 10.1186/s12905-021-01294-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
Background Back pain (BP) is among the most common musculoskeletal problems globally and is a leading contributor to disability among adults. Millions of women especially those in low-income settings, engage in strenuous domestic activities that may increase their risk of BP. The purpose of this meta-analysis was to estimate the association between physically demanding domestic labor (PDDL) which is characterized as intensity, frequency, duration of work and biomechanical risk factors of work and BP among women. Methods Five databases were searched for records published from January 1991 to March 2020; and results from 11studies were included in the meta-analysis. A random effects model and the generic inverse-variance method was used to estimate the pooled odds ratio (OR), 95% confidence interval (CI), and the degree of heterogeneity among studies (I2). Stratified and sensitivity analyses were conducted to identify the influence of outliers and identify the sources of heterogeneity. Results Exposure to high PDDL was significantly associated with BP (OR = 1.63; 95% CI 1.30, 2.04; I2 = 70%). The odds of back pain were highest among the following groups: women performing domestic labor in non-neutral postures (OR = 2.30; 95% CI = 1.75–3.04; I2 = 0%; N = 4 studies) and among women from low- and middle-income countries (OR = 1.98; 95% CI = 1.58–2.49; I2 = 29%; N = 5 studies). We found no evidence of publication bias (Egger’s test p-value = 0.15). Conclusions PDDL may significantly increase a woman’s risk of experiencing BP, but larger prospective studies are needed to further investigate the association. Presenting data on how domestic work affects the musculoskeletal health of women will be important in designing future interventions (behavioral, infrastructural, and ergonomic) that can reduce the burdens from domestic labor. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01294-5.
Collapse
Affiliation(s)
- Abisola Osinuga
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA.
| | - Chelsea Hicks
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| | - Segun E Ibitoye
- Department of Health Promotion and Education, University of Ibadan, Ibadan, 200212, Nigeria
| | - Marin Schweizer
- Department of Epidemiology, University of Iowa, Iowa City, 52242, USA
| | - Nathan B Fethke
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| | - Kelly K Baker
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| |
Collapse
|
7
|
Yunus SZSA, Puteh SEW, Ali AM, Daud F. The Covid Impact to Public Healthcare Utilization Among Urban Low-Income Subsidized Community in Klang Valley Malaysia. Health Serv Res Manag Epidemiol 2021; 8:23333928211002407. [PMID: 33796627 PMCID: PMC7975447 DOI: 10.1177/23333928211002407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Appropriate level of healthcare utilization is one of the aims in translating health system inputs into improving the outcome of population health. Healthcare utilization services in Malaysia remains relatively low as compared to the rate in most high-income countries and some gaps exist across socioeconomic status. After the financial handouts deemed Household Living Aid (HLA) to low-income earners, Malaysia has recently implemented a financial health protection scheme toward for low-income group known as PeKa B40 to improve their access for healthcare services. This study aims to determine the healthcare utilization among the low-income population living in urban Klang Valley, and to explore the relationship between healthcare utilization with the demographic characteristics of this population. MATERIAL AND METHODS A cross-sectional study using face to face structured questionnaire. All 447 respondents included were low-income earners enrolled in the HLA. Chi-square analysis and multiple logistic regression were used to examine association between the risk factors and healthcare utilization. RESULTS The response rate was 93.5%. The healthcare utilization among the respondents during the partial lockdown period was 19.5% and 33.1% during the recovery lockdown period. Enrollment in the PeKa B40 scheme among the 7.6% respondents was not associated with healthcare utilization. After controlling for the variables, those aged 60 years and above [AOR: 1.87; 95% (CI): (1.07; 3.27)], self-rated poor health status [AOR: 2.16; 95% (CI): (1.07; 4.34)], having NCDs [AOR: 4.21; 95% (CI): (2.23; 7.94)], and being hospitalized in the past 12 months [AOR: 3.54; 95% (CI): (1.46; 8.62)], were more likely to utilize healthcare services as compared to their counterparts. CONCLUSION The results from this study is valuable for policy recommendations to improve on the coverage of the PeKa B40 scheme and healthcare access for the low-income population especially during the pandemic.
Collapse
Affiliation(s)
| | - Sharifa Ezat Wan Puteh
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia
(UKM), Kuala Lumpur, Malaysia
| | - Adliah Mhd Ali
- Center of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia
(UKM), Kuala Lumpur, Malaysia
| | - Faiz Daud
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia
(UKM), Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr (Rio J) 2020; 96:717-724. [PMID: 31580844 PMCID: PMC9432172 DOI: 10.1016/j.jped.2019.07.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/17/2019] [Accepted: 07/31/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems. METHODS Cross-sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used. RESULTS The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR=1.70), daily TV use for more than 3hours (PR=1.17), use of laptop computer (PR=1.40), use of the cell phone in the supine position (PR=1.23), use of the cell phone in semi-supine position (PR=1.49), daily cell phone use for more than 3hours (PR=1.36), use of tablet (PR=1.67), daily tablet use for more than above 3hours (PR=1.46), and clinically important mental health problems (PR=2.62). CONCLUSION There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.
Collapse
|
9
|
Chaiklieng S, Suggaravetsiri P, Stewart J. Incidence and risk factors associated with lower back pain among university office workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 27:1215-1221. [DOI: 10.1080/10803548.2019.1706827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - Jenny Stewart
- Faculty of Health and Environmental Science, Auckland University of Technology, New Zealand
| |
Collapse
|
10
|
How to care for adults with low back pain in the primary care setting. Nursing 2020; 50:48-55. [PMID: 31977806 DOI: 10.1097/01.nurse.0000651624.64152.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Low back pain (LBP) is one of the most frequent patient complaints in primary care. This article discusses the assessment and treatment of patients with LBP, including nonpharmacologic and pharmacologic approaches.
Collapse
|
11
|
Abitteboul Y, Lassoued S, Michot J, Depiesse F, Oustric S. [Back pain and non-professional running: From common beliefs to practice]. Presse Med 2019; 48:1573-1574. [PMID: 31757733 DOI: 10.1016/j.lpm.2019.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Yves Abitteboul
- Faculté de médecine de Toulouse-Purpan, 31000 Toulouse, France; Centre hospitalier Cahors, unité de médecine de l'exercice et du sport, 335, rue Wilson, 46005 Cahors, France.
| | - Slim Lassoued
- Centre hospitalier Cahors, rhumatologie et rééducation fonctionnelle, 335, rue Wilson, 46005 Cahors, France
| | | | | | | |
Collapse
|
12
|
Pfieffer ML. Evaluating and managing low back pain in primary care. Nurse Pract 2019; 44:40-47. [PMID: 31335502 DOI: 10.1097/01.npr.0000574664.42110.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Low back pain (LBP) is one of the most frequent patient complaints in primary care. Common LBP diagnoses include nonspecific LBP, radicular pain, lumbar-disk herniation, spinal infection, and ankylosing spondylitis. A thorough history and physical exam are imperative. LBP treatment is multifactorial and blends pharmacologic and nonpharmacologic approaches.
Collapse
Affiliation(s)
- Mary Lauren Pfieffer
- Mary Lauren Pfieffer is an instructor at the Vanderbilt University School of Nursing in Nashville, Tenn
| |
Collapse
|
13
|
Low back pain and some associated factors: is there any difference between genders? Braz J Phys Ther 2019; 24:79-87. [PMID: 30782429 DOI: 10.1016/j.bjpt.2019.01.012] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/04/2019] [Accepted: 01/30/2019] [Indexed: 11/22/2022] Open
Abstract
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.
Collapse
|
14
|
Uchmanowicz I, Kołtuniuk A, Stępień A, Uchmanowicz B, Rosińczuk J. The influence of sleep disorders on the quality of life in patients with chronic low back pain. Scand J Caring Sci 2018; 33:119-127. [PMID: 30113084 DOI: 10.1111/scs.12610] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 07/07/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Low back pain (LBP) is one of the most common pain syndromes, and its prevalence has increased significantly in the past three decades. OBJECTIVES The aim of this study was to evaluate the effects of insomnia and daytime sleepiness on the quality of life (QOL) of patients suffering from chronic back pain. MATERIAL AND METHODS It is a cross-sectional study conducted among 100 people (aged 25-75 years - mean age 49.53 ± 10.92) treated in a neurological clinic for chronic back pain lasting longer than 3 months. The diagnostic survey method was applied for the purposes of this study with the use of: the author's questionnaire and standardised questionnaires that is Visual Analogue Scale (VAS), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS) and Polish version of WHO Quality of Life-BREF questionnaire (WHOQOL-BREF). The results were statistically analysed. RESULTS Analysis of the study material showed that 83% of patients suffered from insomnia (scored 6 or more points on the AIS) and 29% experienced mild daytime sleepiness. People who were more sleepy during the day were characterised by lower perception of the QOL (r = -0.034, p = 0.029) and lower perception of general health (r = -0.035, p = 0.04). Analysis of multiple variables (using linear regression) showed that independent predictor of the QOL in all domains is the result of the AIS questionnaire (p < 0.05). CONCLUSIONS Sleep disorders - both insomnia and daytime sleepiness - are a common health problem experienced by people with LBP. Insomnia is an important predictor affecting the QOL in people with LBP.
Collapse
Affiliation(s)
- Izabella Uchmanowicz
- Faculty of Health Sciences, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Kołtuniuk
- Faculty of Health Sciences, Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Aneta Stępień
- Faculty of Health Sciences, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Uchmanowicz
- Faculty of Health Sciences, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Joanna Rosińczuk
- Faculty of Health Sciences, Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
15
|
Coenen P, Willenberg L, Parry S, Shi JW, Romero L, Blackwood DM, Maher CG, Healy GN, Dunstan DW, Straker LM. Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis. Br J Sports Med 2016; 52:176-183. [PMID: 27884862 DOI: 10.1136/bjsports-2016-096795] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Given the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms. DESIGN A systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous. DATA SOURCES Electronic databases were systematically searched. ELIGIBILITY CRITERIA Peer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified. RESULTS Of the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, 'substantial' (>4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms. CONCLUSIONS The evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing.
Collapse
Affiliation(s)
- Pieter Coenen
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Lisa Willenberg
- Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia
| | - Sharon Parry
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Joyce W Shi
- Monash Health, Melbourne, Victoria, Australia
| | | | - Diana M Blackwood
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Christopher G Maher
- Musculoskeletal Division, Sydney Medical School, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Genevieve N Healy
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - David W Dunstan
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia.,School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
16
|
Abolfotouh SM, Mahmoud K, Faraj K, Moammer G, ElSayed A, Abolfotouh MA. Prevalence, consequences and predictors of low back pain among nurses in a tertiary care setting. INTERNATIONAL ORTHOPAEDICS 2015; 39:2439-49. [PMID: 26189128 DOI: 10.1007/s00264-015-2900-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Nursing is a profession with high incidence and prevalence of low back pain (LBP), with its medical and professional consequences. These prevalence rates vary among countries, and with various measurements have been used to determine LBP. Individual and work-related factors are regarded as causal factors for many back injuries. The aims of study this were: (1) to estimate the prevalence of LBP using different measures, (2) to determine medical and professional consequences of LBP, and (3) to determine the associated factors and significant predictors of LBP. METHODS A cross-sectional study was conducted among 254 nurses from different departments/wards at Hamad General Hospital (HGH), Doha, Qatar over two months (February and March, 2015). A self-administered modified Nordic questionnaire was used to collect data regarding five different measures of LBP, its medical and occupational consequences and individual/lifestyle and work-related risk factors of LBP. Descriptive and analytic statistical analyses were done using chi-square and multivariate logistic regression techniques. Significance was considered at p ≤ 0.05. RESULTS The findings of this study broadly confirm the high levels of back pain in nursing, with a one-year prevalence of LBP of 54.3 % for LBP of at least one day, 26.8 % for chronic LBP, 18.1 % for sick leave seeking LBP, and 34.3 % for medical treatment seeking LBP. Difficult or impossible activities of daily living were reported due to LBP in climbing stairs (50.7 %), walking (42.8 %), standing up (39.9 %), sleeping (33.3 %), getting out of bed (30.4 %) and wearing clothes (20.3 %). Work stop due to LBP was reported by 76.8 % of nurses, with 2.03 ± 3.09 days within the last year. Treatment was sought in 58.7 % by medical care, and 15.9 % by physiotherapy, while seeking rest days and/or sick leave was sought in 50.8 % of nurses with LBP. Sports practice (p = 0.003), office work (p < 0.001) and exposure to physical stress (p = 0.002) were the only significant predictors of LBP among nurses, when logistic regression analysis was conducted. CONCLUSION The prevalence of LBP among nurses at HGH is high and should be actively addressed, however, it was not a major cause of sick leave. Preventive measures should be taken to reduce the risk of lower back pain, such as arranging proper rest periods, educational programs to teach the proper use of body mechanics and sports activity programs.
Collapse
Affiliation(s)
| | - Karim Mahmoud
- Orthopaedics Department, Hamad Medical Corporation, Doha, Qatar
| | - Khaled Faraj
- Orthopaedics Department, Hamad Medical Corporation, Doha, Qatar
| | - Gemeh Moammer
- Orthopaedics Department, Hamad Medical Corporation, Doha, Qatar
| | - Abir ElSayed
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | |
Collapse
|
17
|
Chiou SY, Shih YF, Chou LW, McGregor AH, Strutton PH. Impaired neural drive in patients with low back pain. Eur J Pain 2013; 18:794-802. [PMID: 24895331 DOI: 10.1002/j.1532-2149.2013.00428.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Control of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients. METHODS Seventeen patients with LBP and 11 healthy controls were recruited. Bilateral electromyographic (EMG) recordings were obtained from the erector spinae (ES) muscles at two vertebral levels (T12 and L4). Participants performed a series of brief isometric back extensions (50-100% maximum voluntary contraction - MVC), during which transcranial magnetic stimulation was delivered. The size of the evoked (superimposed) twitch was measured using dynamometry. RESULTS The size of the superimposed twitch decreased linearly with increasing contraction strength in the controls; however, this linear relationship was not observed in the patients. Additionally, patients had larger superimposed twitches and longer time-to-peak amplitudes during MVCs than those observed in controls. Furthermore, patients had lower MVC and root-mean-square EMG activity of ES muscles during MVCs. CONCLUSIONS A decline of central neural drive to the back muscles at high level of voluntary contraction was observed in patients with LBP. These results suggest that it might be pertinent to include neuromuscular facilitation programmes and therapeutic exercise utilizing high voluntary contractions for patients with LBP.
Collapse
Affiliation(s)
- S Y Chiou
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taiwan; The Nick Davey Laboratory, Human Performance Group, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | | | | | | | | |
Collapse
|