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Benebo FO, Lukic M, Jakobsen MD, Braaten TB. The role of lifestyle factors in the association between education and self-reported fibromyalgia: a mediation analysis. BMC Womens Health 2024; 24:244. [PMID: 38632566 PMCID: PMC11022321 DOI: 10.1186/s12905-024-03060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Socioeconomic status as measured by education, income, or occupation, has been associated with fibromyalgia but the underlying mechanism and the role of lifestyle factors are unclear. Thus, we examine the role of modifiable lifestyle factors (body mass index, physical activity, alcohol consumption and smoking) in the association between education and self-reported fibromyalgia. METHODS We used data from 74,157 participants in the population-based prospective Norwegian Women and Cancer (NOWAC) study. Socioeconomic position, operationalized as years of educational attainment, and lifestyle factors were assessed via self-reported questionnaires. Multiple mediation analysis was used to decompose total effects into direct and indirect effects. Estimates were reported as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS The cumulative incidence of fibromyalgia was 3.2% after a median follow up time of 13 years. Fibromyalgia was inversely associated with years of educational attainment for ≤ 9 years (HR = 2.56; 95% CI 2.32-2.91) and for 10-12 years (HR = 1.84; 95% CI 1.72-2.02), compared with ≥ 13 years of education. Overall, all lifestyle factors together jointly mediated 17.3% (95% CI 14.3-21.6) and 14.1% (95% CI 11.3-18.9) of the total effect for ≤ 9 years and 10-12 years of education, respectively. Smoking and alcohol consumption contributed the most to the proportion mediated, for ≤ 9 years (5.0% and 7.0%) and 10-12 years (5.6% and 4.5%) of education. CONCLUSION The association between education and self-reported fibromyalgia was partly explained through lifestyle factors, mainly smoking and alcohol consumption.
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Affiliation(s)
- Faith Owunari Benebo
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Marko Lukic
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Frasson VB, Vaz MA, Telöken MA, Gusmão PDF, Crestani MV, Baroni BM. Can a clinical assessment predict the functional status progression in patients with femoroacetabular impingement syndrome? Braz J Phys Ther 2024; 28:101050. [PMID: 38574558 PMCID: PMC10999820 DOI: 10.1016/j.bjpt.2024.101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/15/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Femoroacetabular impingement syndrome (FAIS) is a hip joint motion-related clinical disorder with a triad of symptoms, clinical signs, and imaging findings. However, scientific evidence is still unclear regarding the best treatment for FAIS. OBJECTIVES To assess the value of a physical therapy evaluation in predicting the progression of functional status over the subsequent years in patients with FAIS who are candidates for hip arthroscopy surgery. METHODS In this case-series study, patients with FAIS, candidates for hip arthroscopy surgery, underwent a standard physical therapy evaluation. Baseline data were collected between 2013 and 2019. In 2020/2021, the patients' functional status was assessed through the International Hip Outcome Tool (iHOT-33). Functional status progression was calculated as the difference between the follow-up and baseline iHOT-33 scores. A multivariate forward stepwise regression analysis was conducted to explore the relationship between baseline characteristics and the functional status progression. RESULTS From 353 patients who completed the baseline assessment, 145 completed the iHOT-33 follow-up. The mean (±SD) follow-up time was 58.7 (27.2) months (minimum 12 and maximum 103 months). The iHOT-33 scores increased 20.7 (21.8) points on average, ranging from -39.8 to 76.9 points. Among the 15 potential predictive factors assessed in this study, only baseline iHOT-33 score (β -0.44; -0.061, -0.27), femoral version (β 9.03; 1.36, 16.71), and body mass index (β -0.99; -1.98, -0.01) had the ability to predict the functional status progression. CONCLUSION Patients with a lower baseline iHOT-33 score, lower body mass index, and normal femoral version were more likely to increase their functional status after a minimum of one year of follow-up.
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Affiliation(s)
- Viviane Bortoluzzi Frasson
- Universidade Federal de Ciências da Saúde de Porto Alegre, Rehabilitation Sciences Program, Porto Alegre, RS, Brazil; Physique - Centro de Fisioterapia, Porto Alegre, RS, Brazil.
| | - Marco Aurélio Vaz
- Physique - Centro de Fisioterapia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, School of Physical Education, Physical Therapy and Dance, Porto Alegre, RS, Brazil
| | | | | | | | - Bruno Manfredini Baroni
- Universidade Federal de Ciências da Saúde de Porto Alegre, Rehabilitation Sciences Program, Porto Alegre, RS, Brazil
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Quadros Santos Rocha J, Pereira Vieira Y, Lucia Caputo E, Manjourany Silva Duro S, de Oliveira Saes M. Association between physical activity status and musculoskeletal pain in individuals infected with SARS-CoV-2: Sulcovid-19 survey. Musculoskelet Sci Pract 2024; 69:102878. [PMID: 38006659 DOI: 10.1016/j.msksp.2023.102878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND This study aimed to evaluate the association of physical activity (PA) before SARS-Cov-2 infection with Musculoskeletal (MSK) pain after infection. METHODS We used data from the Sulcovid-19, a longitudinal study. This study was carried out in the city of Rio Grande, in the extreme south of Brazil with individuals who were infected by SARS-Cov-2 between December/2020 and March/2021. Participants were asked on MSK pain in the cervical, thoracic, low back, upper and lower limbs. Three PA variables were built, as follows: 1) any PA (yes or no), 2) sufficient PA (based on WHO recommendations), and 3) PA status before and after COVID-19 (i.e., remained inactive, became inactive, and remained active). RESULTS Participants reporting sufficient PA levels were less likely to experience pain in the cervical (PR 0.70, 0.53-0.92 95% CI) after COVID-19. Those who remained active were less likely to experience pain in the cervical spine and in at least one body site. Becoming inactive increased the likelihood of experiencing pain in the lower limbs after infection by 30%. CONCLUSIONS Continuous PA practice regardless SARS-Cov-2 infection showed important protection effect for MSK as a consequence of infection.
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Affiliation(s)
| | | | - Eduardo Lucia Caputo
- Center for Evidence Synthesis in Health-School of Public Health- Brown University, RI, 02912, USA
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Png ME, Mason KJ, Marshall M, Jordan KP, Bailey J, Frisher M, Heron N, Huntley AL, Mallen CD, Mamas MA, Tatton S, White S, Edwards JJ, Achana F. Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study. Curr Med Res Opin 2023; 39:1473-1480. [PMID: 37853741 DOI: 10.1080/03007995.2023.2271862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To investigate the impact of pre-existing painful musculoskeletal conditions on healthcare utilization and costs among patients with five common conditions: acute coronary syndrome (ACS), stroke, cancer, dementia and pneumonia. METHODS Using primary and secondary care services data from electronic health records, a negative binomial regression model was used to compare resource use while a two-part model was used to compare costs across the five conditions, between those with and without a pre-existing musculoskeletal pain. RESULTS The study included 760,792 patients (144,870 with ACS, 121,208 with stroke, 231,702 with cancer, 134,638 with dementia, and 128,374 with pneumonia) in the complete case analysis. Pre-existing musculoskeletal pain had an incident rate ratio of above one for most healthcare resources over the follow-up period and an adjusted additional mean cumulative total healthcare costs per patient of £674.59 (95%CI 570.30 to 778.87) for ACS; £613.34 (95%CI 496.87 to 729.82) for stroke; £459.26 (95%CI 376.60 to 541.91) for cancer; and £766.23 (95%CI 655.06 to 877.39) for dementia over five years after diagnosis; and £200.85 (95%CI 104.16 to 297.55) for pneumonia over one year after diagnosis compared to those without musculoskeletal pain. CONCLUSION This study highlights that individuals with painful musculoskeletal conditions have higher healthcare utiliszation and costs than those without painful musculoskeletal conditions. Given the high occurrence of musculoskeletal pain in patients with other conditions, effective management strategies are needed to reduce the burden on healthcare resources.
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Affiliation(s)
- May Ee Png
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kayleigh J Mason
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - Michelle Marshall
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - Kelvin P Jordan
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - James Bailey
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - Martin Frisher
- School of Pharmacy and Bioengineering, Keele University, Keele, UK
| | - Neil Heron
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Alyson L Huntley
- Centre for Academic Primary Care, Bristol Medical School, Bristol University, Bristol, UK
| | - Christian D Mallen
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK
| | - Stephen Tatton
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - Simon White
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - John J Edwards
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele, UK
| | - Felix Achana
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Lohmander LS, Roemer FW, Frobell RB, Roos EM. Treatment for Acute Anterior Cruciate Ligament Tear in Young Active Adults. NEJM EVIDENCE 2023; 2:EVIDoa2200287. [PMID: 38320141 DOI: 10.1056/evidoa2200287] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND: Anterior cruciate ligament (ACL) injury of the knee is common in young active adults and often has severe and sometimes lifelong consequences. The clinical management of this injury remains debated. A prior trial of early versus delayed optional ACL repair showed no differences in outcomes at 2 years. METHODS: We present the 11-year follow-up of a randomized clinical trial involving 121 young active adults (mean age 26yo, 74% male) with an acute sports-related ACL tear. We compared patient-reported and radiographic outcomes between those randomized to receive early ACL reconstruction (ACLR) followed by exercise therapy (N=62) and those treated with early exercise therapy plus optional delayed ACLR (N=59). The primary end point at 11 years was change from baseline in the mean of four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS) — pain, symptoms, function in sports and recreation, and knee-related quality of life (KOOS4; range of scores, 0 [worst] to 100 [best]; minimal important change=9). RESULTS: In all, 88% of the cohort followed up at 11 years (53/62 in the early vs. 54/59 in the optional late ACL repair groups), and 52% of those assigned to optional delayed ACLR underwent ACLR. Mean improvement in KOOS4 from baseline to 11 years was 46 points for those assigned to early ACLR plus exercise therapy and 45 points for those assigned to exercise therapy plus optional delayed ACLR (between-group difference, 1.6 points; 95% confidence interval [CI], −8.8 to 5.6; P=0.67 after adjustment for baseline score, full analysis set). About two thirds of the full cohort reported meeting the case definition for a “patient-acceptable symptom state” (KOOS4 patient-acceptable symptom state threshold value=79), whereas 44% had developed radiographic osteoarthritis of their injured knee. Mean summed incident radiographic osteoarthritis feature scores, scores range from 0 to 30 where higher scores indicate more severe joint damage, were 2.4 for the group assigned to early ACLR and 1.0 for the group assigned to exercise therapy plus optional delayed ACLR (mean difference, 1.0; 95% CI, 0.1 to 1.9). CONCLUSIONS: At 11-year follow-up, among young active adults with acute ACL tears assigned to early ACLR plus exercise versus initial exercise therapy with the option of delayed ACLR, there were no differences in patient-reported outcomes. (Funded by the Swedish Research Council; ISRCTN number, ISRCTN84752559.)
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Affiliation(s)
- L Stefan Lohmander
- Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
| | - Frank W Roemer
- Department of Radiology, Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Radiology, Boston University School of Medicine, Boston
| | - Richard B Frobell
- Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
| | - Ewa M Roos
- Center for Muscle and Joint Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Årnes AP, Nielsen CS, Stubhaug A, Fjeld MK, Johansen A, Morseth B, Strand BH, Wilsgaard T, Steingrímsdóttir ÓA. Longitudinal relationships between habitual physical activity and pain tolerance in the general population. PLoS One 2023; 18:e0285041. [PMID: 37224163 DOI: 10.1371/journal.pone.0285041] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/13/2023] [Indexed: 05/26/2023] Open
Abstract
Physical activity (PA) might influence the risk or progression of chronic pain through pain tolerance. Hence, we aimed to assess whether habitual leisure-time PA level and PA change affects pain tolerance longitudinally in the population. Our sample (n = 10,732; 51% women) was gathered from the sixth (Tromsø6, 2007-08) and seventh (Tromsø7, 2015-16) waves of the prospective population-based Tromsø Study, Norway. Level of leisure-time PA (sedentary, light, moderate, or vigorous) was derived from questionnaires; experimental pain tolerance was measured by the cold-pressor test (CPT). We used ordinary, and multiple-adjusted mixed, Tobit regression to assess 1) the effect of longitudinal PA change on CPT tolerance at follow-up, and 2) whether a change in pain tolerance over time varied with level of LTPA. We found that participants with high consistent PA levels over the two surveys (Tromsø6 and Tromsø7) had significantly higher tolerance than those staying sedentary (20.4 s. (95% CI: 13.7, 27.1)). Repeated measurements show that light (6.7 s. (CI 3.4, 10.0)), moderate (CI 14.1 s. (9.9, 18.3)), and vigorous (16.3 s. (CI 6.0, 26.5)) PA groups had higher pain tolerance than sedentary, with non-significant interaction showed slightly falling effects of PA over time. In conclusion, being physically active at either of two time points measured 7-8 years apart was associated with higher pain tolerance compared to being sedentary at both time-points. Pain tolerance increased with higher total activity levels, and more for those who increased their activity level during follow-up. This indicates that not only total PA amount matters but also the direction of change. PA did not significantly moderate pain tolerance change over time, though estimates suggested a slightly falling effect possibly due to ageing. These results support increased PA levels as a possible non-pharmacological pathway towards reducing or preventing chronic pain.
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Affiliation(s)
| | - Christopher Sievert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Aslak Johansen
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Heine Strand
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust Norway, Tønsberg, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Coburn O. Social enterprise model for more equitable musculoskeletal care: introducing Freehab. Br J Sports Med 2022; 56:774. [DOI: 10.1136/bjsports-2022-105861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/04/2022]
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Braun A, Franczukowska AA, Teufl I, Krczal E. The economic impact of workplace physical activity interventions in Europe: a systematic review of available evidence. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-04-2021-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThere is growing interest in the economic impact of workplace physical activity interventions, but the evidence is still lacking — especially in Europe. Although, some evidence on the return on investment (ROI) is found in literature, the included studies may not be applicable to the Europe situation. Therefore, the objective of this study was to review current evidence on the economic impact of workplace physical activity interventions in European countries.Design/methodology/approachA systematic review on the economic impact of worksite health promotion programs aiming at increasing physical activity was conducted. Five electronic databases (MEDLINE (Ovid), MEDLINE (PubMed), EMBASE, NHS-EED and Emerald Insights) were searched for relevant studies published between 2000 and 2020.FindingsA total of 953 abstracts were screened, and 28 were reviewed, 11 of which met all inclusion criteria. The studies varied substantially in sample size, intervention type, duration and frequency of follow-up measurements, valuation methods and assessed economic outcomes. There is inconclusive evidence for decreasing absenteeism, positive net benefit (NB) and positive ROI. No evidence was found to indicate an effect on self-assessed productivity or job satisfaction.Originality/valueThis study is the first try to take the different working conditions from Europe into consideration. The authors found that working conditions could have some impact on the valuation of absenteeism costs and thereof on the ROI. Further, this study provides insight into how to deploy effective and efficient workplace physical activity interventions, based on a standardized and validated methodology and program scope.
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Argus M, Pääsuke M. Musculoskeletal disorders and associated factors among office workers in an activity-based work environment. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2419-2425. [PMID: 34714221 DOI: 10.1080/10803548.2021.1999616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the prevalence of musculoskeletal disorders (MSD) and associated factors among office workers working in the activity-based workplace (ABW). METHODS 42 office workers with ABW and 68 office workers as control participated. Nordic Musculoskeletal Questionnaire, Baecke Physical Activity Questionnaire, Copenhagen Psychosocial Questionnaire III, and Fear Avoidance Beliefs Questionnaire were used and Pain pressure threshold (PPT) was measured. RESULTS There were no significant differences in the prevalence of MSDs in most body areas between the ABW and control group. ABW group experienced significantly (p < 0.05) more right wrist, hand, and finger pain in the past 6 months when compared with the control group. ABW group demonstrated significantly (p < 0.05) more work-related physical activity and daily time spent standing. There were no significant differences in other pain-related factors measured. CONCLUSIONS Office workers with ABW had a similar prevalence of MSDs to office workers with a designated workplace and no differences in associated factors.
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Affiliation(s)
- Martin Argus
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia.
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Argus M, Pääsuke M. Effects of the COVID-19 lockdown on musculoskeletal pain, physical activity, and work environment in Estonian office workers transitioning to working from home. Work 2021; 69:741-749. [PMID: 34180447 DOI: 10.3233/wor-210033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND COVID-19 lockdown caused a sudden change in the work culture and environment. OBJECTIVE The aim of this study was to evaluate the impact of COVID-19 lockdown caused changes in musculoskeletal pain (MSP), physical activity (PA), workplace properties, and their in-between relationships among office workers. METHODS A total of 161 office workers (64.6%female) with a mean age of 38.2±9.5 years participated. The study was conducted as an online form. Baecke Physical Activity Questionnaire, NORDIC Questionnaire, and questions about the work environment were used. The participants were asked to describe the current situation and retrospectively the situation 3 months before. RESULTS We found no significant differences in the prevalence of MSP or between the mean number of body regions suffering from MSP before and during the lockdown. During the lockdown, a significant (p < 0.001) reduction in total PA and sport-related PA and a significant (p < 0.001) increase in work-related PA was noted. A significant drop in both workplace comfort rating (p < 0.05) and workplace ergonomics rating (p < 0.001) was suggested during the lockdown. Our data also suggested several individual factors influencing the MSP among office workers during the lockdown. CONCLUSIONS Maintaining habitual physical activity level and preparing a more comfortable and ergonomic workspace can play a role in a healthier transition to working from home.
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Affiliation(s)
- Martin Argus
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia
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Wilke J, Hollander K, Mohr L, Edouard P, Fossati C, González-Gross M, Sánchez Ramírez C, Laiño F, Tan B, Pillay JD, Pigozzi F, Jimenez-Pavon D, Sattler MC, Jaunig J, Zhang M, van Poppel M, Heidt C, Willwacher S, Vogt L, Verhagen E, Hespanhol L, Tenforde AS. Drastic Reductions in Mental Well-Being Observed Globally During the COVID-19 Pandemic: Results From the ASAP Survey. Front Med (Lausanne) 2021; 8:578959. [PMID: 33842492 PMCID: PMC8032868 DOI: 10.3389/fmed.2021.578959] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/17/2021] [Indexed: 12/15/2022] Open
Abstract
Most countries affected by the COVID-19 pandemic have repeatedly restricted public life to control the contagion. However, the health impact of confinement measures is hitherto unclear. We performed a multinational survey investigating changes in mental and physical well-being (MWB/PWB) during the first wave of the pandemic. A total of 14,975 individuals from 14 countries provided valid responses. Compared to pre-restrictions, MWB, as measured by the WHO-5 questionnaire, decreased considerably during restrictions (68.1 ± 16.9 to 51.9 ± 21.0 points). Whereas 14.2% of the participants met the cutoff for depression screening pre-restrictions, this share tripled to 45.2% during restrictions. Factors associated with clinically relevant decreases in MWB were female sex (odds ratio/OR = 1.20, 95% CI: 1.11-1.29), high physical activity levels pre-restrictions (OR = 1.29, 95% CI 1.16-1.42), decreased vigorous physical activity during restrictions (OR = 1.14, 95% CI: 1.05-1.23), and working (partially) outside the home vs. working remotely (OR = 1.29, 95% CI: 1.16-1.44/OR = 1.35, 95% CI: 1.23-1.47). Reductions, although smaller, were also seen for PWB. Scores in the SF-36 bodily pain subscale decreased from 85.8 ± 18.7% pre-restrictions to 81.3 ± 21.9% during restrictions. Clinically relevant decrements of PWB were associated with female sex (OR = 1.62, 95% CI: 1.50-1.75), high levels of public life restrictions (OR = 1.26, 95% CI: 1.18-1.36), and young age (OR = 1.10, 95% CI: 1.03-1.19). Study findings suggest lockdowns instituted during the COVID-19 pandemic may have had substantial adverse public health effects. The development of interventions mitigating losses in MWB and PWB is, thus, paramount when preparing for forthcoming waves of COVID-19 or future public life restrictions.
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Affiliation(s)
- Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Karsten Hollander
- Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Lisa Mohr
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Pascal Edouard
- Inter-University Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unity, Faculty of Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Marcela González-Gross
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Exercise is Medicine Spain, Madrid, Spain
| | - Celso Sánchez Ramírez
- School of Physical Activity Sciences, University of Santiago de Chile, Santiago, Chile
| | - Fernando Laiño
- Fundación Instituto Superior de Ciencias de la Salud, Buenos Aires, Argentina
| | - Benedict Tan
- Department of Sport and Exercise Medicine, Changi General Hospital, Singapore, Singapore
| | - Julian David Pillay
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - David Jimenez-Pavon
- Exercise is Medicine Spain, Madrid, Spain
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Matteo C. Sattler
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Johannes Jaunig
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Mandy Zhang
- Department of Sport and Exercise Medicine, Changi General Hospital, Singapore, Singapore
| | - Mireille van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Christoph Heidt
- Department of Orthopedics, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Steffen Willwacher
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers—Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Luiz Hespanhol
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers—Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, United States
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Lima TM, Coelho DA. Gender differences in associating musculoskeletal complaints, housework, electronic device usage and physical exercise for administrative workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1189-1197. [PMID: 33468020 DOI: 10.1080/10803548.2021.1878695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives. This study assessed musculoskeletal complaints (MSCs) in administrative workers, associating MSCs with non-paid housework, home use of electronic devices and physical exercise, while keeping a distinctive gender approach. This may promote the development of more effective preventive measures, by meeting the specific strengths and weaknesses of each gender. Methods. Ninety-six administrative workers (58 women and 38 men) who used computers more than 50% of their working time participated in a cross-sectional study. A questionnaire concerning individual socio-demographic data, habits and lifestyle, and including the Nordic musculoskeletal questionnaire (NMQ), was deployed. Gender-based odds ratios for MSCs in body areas over the previous 12 months and correlation coefficients between habits and lifestyle variables and NMQ variables were computed. Results. Women did not incur a higher risk of MSCs than men. Analysis of the association did not yield meaningful associations for either gender. Results suggest giving future consideration to development of gender-specific preventive measures. Conclusion. Computerized work performed concomitantly with physical exposures outside the workplace showed mixed associations with MSCs, according to gender and depending on the kind of exposure. Results are indicative of the need for development of gender-specific preventive measures.
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Affiliation(s)
- Tânia M Lima
- C-MAST - Centre for Mechanical and Aerospace Science and Technologies, Department of Electromechanical Engineering, University of Beira Interior, Covilhã, Portugal
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13
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Årnes AP, Nielsen CS, Stubhaug A, Fjeld MK, Hopstock LA, Horsch A, Johansen A, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Physical activity and cold pain tolerance in the general population. Eur J Pain 2020; 25:637-650. [PMID: 33165994 DOI: 10.1002/ejp.1699] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The relationship between habitual physical activity (PA) and experimental pain tolerance has been investigated in small samples of young, healthy and/or single-sex volunteers. We used a large, population-based sample to assess this relationship in men and women with and without chronic pain. METHODS We used data from the sixth and seventh Tromsø Study surveys (2007-2008; 2015-2016), with assessed pain tolerance of participants with the cold pressor test (CPT: dominant hand in circulating cold water at 3°C, maximum test time 106 s), and self-reported total amount of habitual PA in leisure time (n = 19,087), exercise frequency (n = 19,388), exercise intensity (n = 18,393) and exercise duration (n = 18,343). A sub-sample had PA measured by accelerometers (n = 4,922). We used Cox regression to compare CPT tolerance times between self-reported PA levels. For accelerometer-measured PA, we estimated hazard ratios for average daily activity counts, and for average daily minutes of moderate-to-vigorous PA done in bouts lasting 10 min or more. Models were tested for PA-sex, and PA-chronic pain and PA-moderate-to-severe chronic pain interactions. RESULTS Leisure-time PA, exercise intensity and exercise duration were positively associated with CPT tolerance (p < .001; p = .011; p < .001). More PA was associated with higher CPT tolerance. At high levels of leisure-time PA and exercise intensity, men had a significantly higher CPT tolerance than women. Accelerometer-measured PA was not associated with CPT tolerance. CONCLUSIONS This study is one of the first to show that higher self-reported habitual PA was connected to higher experimental pain tolerance in a population-based sample, especially for men. This was not found for accelerometer-measured PA. SIGNIFICANCE This study finds that higher level of self-reported leisure-time physical activity is associated with increased cold pressor pain tolerance in a large population-based sample. Though present in both sexes, the association is strongest among men. Despite the robust dose-response relationship between pain tolerance and self-reported activity level, no such relationship was found for accelerometer-measured activity, reflecting a possible discrepancy in the aspect of physical activity measured. Though the study design does not permit causal conclusions, the findings suggest that increasing physical activity may increase pain tolerance in the general population.
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Affiliation(s)
- Anders P Årnes
- Department of Pain, Department of Community Medicine, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christopher S Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mats K Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Alexander Horsch
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Aslak Johansen
- Department of Pain, Department of Community Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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14
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Schäfer A, Laekeman M, Egan Moog M, Dieterich AV. [On the move-Prevention of chronic pain with physical activity and movement]. Schmerz 2020; 35:14-20. [PMID: 33048190 DOI: 10.1007/s00482-020-00509-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/28/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Sufficient physical activity and exercise shows a variety of health-promoting positive effects. In the context of pain therapy, promotion of physical activity could be an important contribution to primary, secondary and tertiary prevention of chronic pain. OBJECTIVES The aim is to investigate the relationship between physical activity and chronic pain, the preventive effect of physical activity on pain and the factors to successfully promote physical activity in people with chronic pain. METHODS For this narrative review databases of the Cochrane Library, MEDLINE (via PubMed) and the Physiotherapy Evidence Database (PEDro) were searched for reviews and studies with the keywords chronic pain, physical activity, movement, exercise and prevention. RESULTS A total of 10 reviews, 10 clinical studies and 4 surveys were included and summarized. CONCLUSION Although the evidence base on this topic is still insufficient, positive effects of physical activity on the prevention of chronic pain could be demonstrated. Interventions for people with chronic pain that sustainably increase physical activity should take into account individual resources, address barriers such as maladaptive beliefs, and create positive movement experiences.
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Affiliation(s)
- Axel Schäfer
- Studiengänge Ergotherapie, Logopädie und Physiotherapie, Fakultät Soziale Arbeit und Gesundheit, Hochschule für Angewandte Wissenschaft und Kunst (HAWK) Hildesheim, Goschentor 1, 31134, Hildesheim, Deutschland.
| | - Marjan Laekeman
- Fakultät für Gesundheit, Department für Pflegewissenschaft, Ph.D.-Kolleg, Universität Witten/Herdecke, Witten, Deutschland.,Physiologische Psychologie, Otto-Friedrich-Universität Bamberg, Bamberg, Deutschland
| | - Martina Egan Moog
- Pain Management, Precision Ascend, Melbourne, Australien.,Neuro Orthopaedic Institute, Adelaide, Australien
| | - Angela V Dieterich
- Physiotherapie, Fakultät Gesundheit, Sicherheit, Gesellschaft, Hochschule Furtwangen, Furtwangen, Deutschland
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15
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Toprak Celenay S, Karaaslan Y, Mete O, Ozer Kaya D. Coronaphobia, musculoskeletal pain, and sleep quality in stay-at home and continued-working persons during the 3-month Covid-19 pandemic lockdown in Turkey. Chronobiol Int 2020; 37:1778-1785. [DOI: 10.1080/07420528.2020.1815759] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Seyda Toprak Celenay
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Yasemin Karaaslan
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Beykent University, Istanbul, Turkey
| | - Oguzhan Mete
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Derya Ozer Kaya
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
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16
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Al Gadeeb M, Hassan A, Al Dandan O, Al Shammari M, Kalalah M, Zabeeri N, Farea A, Gari D, Alsaif HS. Physical exercise among radiologists in Saudi Arabia: a cross-sectional study. ACTA ACUST UNITED AC 2020; 78:73. [PMID: 32793346 PMCID: PMC7418417 DOI: 10.1186/s13690-020-00450-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/17/2020] [Indexed: 11/10/2022]
Abstract
Background The practice of clinical radiology has become more sedentary in the era of the Picture Archiving and Communication System. Physical inactivity is a well-known risk factor for various chronic diseases. This study aimed to determine the frequency and pattern of physical exercises among radiologists in the Eastern Province of Saudi Arabia and the association between physical exercises and the prevalence of work-related musculoskeletal symptoms. Methods An online survey was sent to radiologists in all hospitals (academic, public, and private) in the major cities of the Eastern Province of Saudi Arabia. It covered information about demographic characteristics and the frequency and pattern of physical exercises. It also included an evaluation of work-related musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. This survey of 263 radiologists was conducted in April 2019. The study outcome was the presence of disabling musculoskeletal symptoms in any body region which restricted the performance of normal activities within the last 12 months. The study results were analyzed descriptively using the Chi-square test. Results The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were less than 40 years. Eighty-three men (74.8%) did a physical exercise at least weekly, compared to 45 (51.7%) women. Men were more likely to engage in various physical exercises than women. Overall, 60.9% of participants who did not do any physical exercise regularly (less than monthly) reported having disabling neck pain. This figure was found lower among participants who did physical exercises monthly (45.8%) or at least weekly (32.8%). A similar pattern was observed with shoulder pain, with 45.7% found in participants who did not exercise and only 25.8% in those engaging in physical activities at least weekly. Conclusions Physical inactivity is common among radiologists, especially female ones, in the Eastern Province of Saudi Arabia. The physical inactivity was significantly associated with work-related musculoskeletal symptoms. Gender-specific health promotion programs are needed to mitigate the negative health outcomes due to the sedentary nature of the radiology current practice.
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Affiliation(s)
- Mohammed Al Gadeeb
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Malak Al Shammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mawaheb Kalalah
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Najwa Zabeeri
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz Farea
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Danya Gari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hind S Alsaif
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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17
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Delacour C, Chambe J, Lefebvre F, Bodot C, Bigerel E, Epifani L, Granda C, Haller DM, Maisonneuve H. Association between physical activity and Nocturnal Leg Cramps in patients over 60 years old: a case-control study. Sci Rep 2020; 10:2638. [PMID: 32060316 PMCID: PMC7021766 DOI: 10.1038/s41598-020-59312-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 01/24/2020] [Indexed: 11/09/2022] Open
Abstract
Nocturnal Legs Cramps are a frequent disorder, which have a negative impact on quality of life, particularly among patients over 60 years old. Lifestyle factors such as alcohol consumption have been shown to be associated with Nocturnal Leg Cramps. This study aimed to explore the association between nocturnal leg cramps and a sedentary lifestyle among elderly patients. A case-control study was conducted with a Bayesian approach for sensitivity analysis. Patients over 60 years old consulting their family doctor were recruited in the Alsace region, France. Cases were matched with controls free from cramps for age, sex, medical history and medications known to trigger cramps. The level of physical activity was assessed using the Dijon Physical Activity Score (DPAS). We performed univariate and multivariate analyses adjusting for alcohol consumption. 272 participants were matched into 136 pairs. 11% of all were sedentary persons. Adjusting for alcohol consumption, we observed an association between Nocturnal Leg Cramps and a sedentary lifestyle OR = 9.84 (95% credibility interval [1.74; 101.9]; posterior probability 99.68%). Our findings represent an additional argument to promote physical activity to patients over 60 years old. They also highlight the need to develop and evaluate physical activity interventions in the treatment of Nocturnal Legs Cramps.
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Affiliation(s)
- Chloé Delacour
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France.
| | - Juliette Chambe
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - François Lefebvre
- Public Health Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Claire Bodot
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Elodie Bigerel
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Laetitia Epifani
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Céline Granda
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, 1211, Switzerland
| | - Hubert Maisonneuve
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France.,Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, 1211, Switzerland
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18
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Sliepen M, Lipperts M, Tjur M, Mechlenburg I. Use of accelerometer-based activity monitoring in orthopaedics: benefits, impact and practical considerations. EFORT Open Rev 2020; 4:678-685. [PMID: 32010456 PMCID: PMC6986392 DOI: 10.1302/2058-5241.4.180041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Studies of the effectiveness of orthopaedic interventions do not generally measure physical activity (PA). Applying accelerometer-based activity monitoring in orthopaedic studies will add relevant information to the generally examined physical function and pain assessment.Accelerometer-based activity monitoring is practically feasible in orthopaedic patient populations, since current day activity sensors have battery time and memory to measure continuously for several weeks without requiring technical expertise.The ongoing development in sensor technology has made it possible to combine functional tests with activity monitoring.For clinicians, the application of accelerometer-based activity monitoring can provide a measure of PA and can be used for clinical comparisons before and after interventions.In orthopaedic rehabilitation, accelerometer-based activity monitoring may be used to help patients reach their targets for PA and to coach patients towards a more active lifestyle through direct feedback. Cite this article: EFORT Open Rev 2019;4:678-685. DOI: 10.1302/2058-5241.4.180041.
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Affiliation(s)
- Maik Sliepen
- Institut für Experimentelle Muskuloskelettale Medizin (IEMM), Universitätsklinikum Münster (UKM), Westfälische Wilhelms-Universität Münster (WWU), Germany
| | - Matthijs Lipperts
- AHORSE, Department of Orthopaedics, Zuyderland Medical Centre, The Netherlands
| | - Marianne Tjur
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark.,Centre of Research in Rehabilitation (CORIR), Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
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19
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Zadro JR, Nilsen TIL, Shirley D, Amorim AB, Ferreira PH, Lier R, Mork PJ. Parental Multisite Chronic Pain and the Risk of Adult Offspring Developing Additional Chronic Pain Sites: Family-Linkage Data From the Norwegian HUNT Study. THE JOURNAL OF PAIN 2020; 21:968-978. [PMID: 31904500 DOI: 10.1016/j.jpain.2019.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/11/2019] [Accepted: 12/03/2019] [Indexed: 10/25/2022]
Abstract
We investigated if parental multisite chronic pain increases the risk of adult offspring developing additional chronic pain sites, and if offspring body mass index (BMI) and leisure time physical activity modify this association. We used longitudinal data on 7,654 offspring linked with their parents who participated in the population-based HUNT Study (Norway) in 1995 to 1997 and 2006 to 2008. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence interval (CI). One-third of offspring (n = 2,573) developed additional chronic pain sites. Having both parents with 1-2 chronic pain sites increased the risk of developing additional pain sites compared to having parents free of chronic pain (OR = 1.33; 95% CI 1.05-1.68), with larger effects observed when both parents had ≥3 chronic pain sites (OR = 1.46; 95% CI 1.17-1.82). These associations were largely driven by maternal pain, that is, there was no association between paternal chronic pain and risk of additional pain sites in offspring. The parent-offspring transfer of additional pain sites (when both parents had ≥3 pain sites) strengthened when offspring were obese (OR = 2.56; 95% CI 1.75-3.75) or physically inactive (OR = 1.73; 95% CI 1.33-2.27). In conclusion, parental multisite chronic pain increases the risk of offspring developing additional chronic pain sites, particularly those with obesity or inactivity. PERSPECTIVE: This longitudinal analysis investigated the parent-offspring transmission of multisite chronic pain, and whether lifestyle behaviors in offspring modify this association. The findings suggest that having parents with multisite chronic pain increases the risk of offspring developing additional chronic pain sites, particularly if offspring are obese or inactive.
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Affiliation(s)
- Joshua R Zadro
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Institute for Musculoskeletal Health, Sydney, New South Wales, Australia.
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Anesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Debra Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Anita B Amorim
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Paulo H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Ragnhild Lier
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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20
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Ho-A-Tham N, Vanlandewijck Y, de Donder L, Wittoek R, Ting-A-Kee B, Basantram R, Dankaerts W. Prevalence of musculoskeletal complaints in urban communities in multi-ethnic Suriname: a cross-sectional study with the COPCORD methodology (stage 1, phase 1 and 2). Clin Rheumatol 2019; 39:1065-1075. [PMID: 31802349 DOI: 10.1007/s10067-019-04842-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/19/2019] [Accepted: 11/01/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION/OBJECTIVES Musculoskeletal complaints (MSCs) are a major burden worldwide. In Suriname, a South American developing country, the epidemiology of MSCs and its related disorders is still unknown. Therefore, a cross-sectional survey was carried out to determine prevalence and risk factors of MSCs in urban areas of Suriname. METHODS This is the first Community Oriented Program for the Control of Rheumatic Diseases survey in a Caribbean Community. Trained interviewers collecting self-reported data conducted this house-to-house community-based survey. Data was analyzed using SPSS version 23 and Stata version 14.1. RESULTS The prevalence of MSCs was 62.1% with a higher prevalence rate among women compared with men (resp. 64.3% vs. 58.6%) (Odds ratio = 1.185; p ≤ 0.05). The most decisive self-reported variables associated with MSCs were older age (defined as ≥ 45 years) and moderate to heavy physical workload. The prevalence of MSCs was also associated with women, low educational level, smoking, alcohol use, high-intensity physical activity level, and body mass index (≥ 25 kg/m2). The highest prevalence of MSCs was found among African descendants (Maroons (68.8%) and Creoles (68.0%)), followed by the Indigenous (65.0%) and Asian descendants (Hindustani (64.3%) and Javanese (49.5%)). Most persons with MSCs (75.7%) reported multisite complaints with lower back, knee, and shoulder being the most frequently reported sites. In our study population, MSCs were not considered disabling (mean Health Assessment Questionnaire Disability Index score of 0.23). CONCLUSIONS The prevalence of MSCs in this urban multi-ethnic Surinamese community is high; therefore, future research is needed to further explore the burden of MSCs in Suriname.Key Points• Musculoskeletal complaints are highly prevalent in different ethnic groups in an urban Surinamese community; almost two-thirds of the population reported MSCs with the highest prevalence rate among women and African descendants.• The most decisive self-reported variables associated with MSCs were older age (defined as ≥ 45 years) and moderate to heavy physical workload. Gender, educational level, smoking, alcohol use, high-intensity physical activity, and body mass index were also significantly associated with musculoskeletal complaints.
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Affiliation(s)
- N Ho-A-Tham
- Department of Physiotherapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname. .,Department of Rehabilitation Sciences, Research Group for Musculoskeletal rehabilitation, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
| | - Y Vanlandewijck
- Department of Rehabilitation Sciences, Research Group of Adapted Physical Activity and Psychomotor Rehabilitation, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - L de Donder
- Department of Educational Sciences, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - R Wittoek
- Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - B Ting-A-Kee
- Department of Pathology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - R Basantram
- Department of Physiotherapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - W Dankaerts
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal rehabilitation, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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21
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Physical Fitness and the Level of Pain Intensity in Adolescents: A School-based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132410. [PMID: 31284625 PMCID: PMC6651017 DOI: 10.3390/ijerph16132410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/05/2019] [Accepted: 07/06/2019] [Indexed: 01/25/2023]
Abstract
Background: The main aim of the study was to explore the association between objectively measured physical fitness and the level of pain intensity. Methods: In this cross-sectional study, we included 1036 adolescents (mage ± SD = 16.3 ± 1.1 years; mheight ± SD = 1.74 ± 0.1 m; mweight ± SD = 64.7 ± 12.4 kg; mbody-mass index ± SD = 21.3 ± 3.0 kg/m2) from 11 secondary schools located in the city of Zagreb (Croatia). Physical fitness was determined by using waist circumference, sit-ups in 1 min, standing long jump and sit-and-reach tests. Overall physical fitness index was calculated by summing the z-score values of each physical fitness test. The level of pain intensity was assessed with the Numeric Pain Rating Scale, a one-dimensional measure of pain intensity. Associations were calculated with correlation analyses. Results: In boys, pain intensity was associated with sit-ups in 1 min (r = -0.16, p < 0.001), standing long jump (r = -0.14, p = 0.003) and overall physical fitness index (r = -0.13, p = 0.004), while no significant associations with waist circumference (r = 0.04, p = 0.438) and sit-and-reach test (r = -0.01, p = 0.822) were observed. In girls, pain intensity was associated with standing long jump (r = -0.17, p < 0.001) and overall physical fitness index (r = -0.10, p = 0.018), while no significant associations with waist circumference (r = 0.01, p = 0.735), sit-ups in 1 min (r = -0.06, p = 0.126) and sit-and-reach test (r = -0.05, p = 0.232) were observed. When we adjusted for self-rated health, sleep duration, smoking status, alcohol consumption, screen-time and psychological distress, similar associations remained. Conclusions: Our study shows a weak association between physical fitness and pain intensity in a large sample of adolescents. Although a cross-sectional design, health-professionals should use physical fitness as a screening tool to assess the level of pain intensity.
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22
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Gaskell L, Williams AE. A qualitative study of the experiences and perceptions of adults with chronic musculoskeletal conditions following a 12-week Pilates exercise programme. Musculoskeletal Care 2019; 17:54-62. [PMID: 30402992 DOI: 10.1002/msc.1365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 08/30/2018] [Accepted: 09/01/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The aim of the present study was to explore the experiences and perceptions of adult patients with chronic musculoskeletal conditions following a Pilates exercise programme. A qualitative approach was taken to both data collection and analysis, with alignment to the philosophy of interpretive phenomenology. Participants included 15 women and seven men with a range of chronic musculoskeletal conditions, including nonspecific low back pain, peripheral joint osteoarthritis and a range of postsurgical conditions. The age range was from 36 years to 83 years, and the mean age was 57 years (standard deviation 14.1 years). METHODS Data were collected via digital recordings of four focus groups in three North-West of England physiotherapy clinics. The data were transcribed verbatim and then analysed using a thematic framework. Data were verified by a researcher and randomly selected participants, and agreement was achieved between all parties. RESULTS The results were organized into five main themes: physical improvements; Pilates promotes an active lifestyle: improved performance at work and hobbies; psychosocial benefits and improved confidence; increased autonomy in managing their own condition; and motivation to continue with exercise. CONCLUSION The study was the first to investigate individual perceptions of the impact of Pilates on the daily lives of people with chronic conditions. The Pilates-based exercise programme enabled the participants to function better and manage their condition more effectively and independently. Further to previous work, the study revealed psychological and social benefits which increase motivation to adhere to the programme and promote a healthier lifestyle.
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Affiliation(s)
- Lynne Gaskell
- Allerton Building, University of Salford, Salford, UK
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Determination of musculoskeletal system pain, physical activity intensity, and prolonged sitting of university students using smartphone. BIOMEDICAL HUMAN KINETICS 2019. [DOI: 10.2478/bhk-2019-0004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Abstract
Study aim: The purpose of this study was to examine smartphone-using university students’ musculoskeletal system pain complaints, duration of smartphone and computer usage, participation in moderate-vigorous physical activities (MVPA), and prolonged sitting time.
Material and methods: This study was conducted on Hitit University students (n = 387; 206 female, 181 male) in the province of Çorum. The International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Physical Activity Assessment Questionnaire (PAAQ) (sports/exercise activities section), and a personal information form prepared by the researchers were used as data collection tools. Descriptive statistics and the t-test were used to determine differences between groups. The Pearson chi-square test was used to examine the relationship between categorical variables.
Results: It was observed that half of the participants with musculoskeletal system pain complaints (54.5%) feel the pain in all four areas (neck, shoulder, upper and lower back). There was no statistically significant relationship between physical activity intensity and pain complaint (p > 0.05). The students with musculoskeletal pain complaints spend more time on the smartphone and computer than students who do not have pain complaints (p < 0.05). During electronic device usage, the students who are in the low-intensity physical activity category spend more time sitting down than students in the moderate/vigorous intensity physical activity category (p < 0.05).
Conclusions: In consequence, information can be provided about the importance of reducing sitting time during smartphone use and increasing the duration of moderate/vigorous-intensity physical activity (PA) so awareness can be raised on the issue among university students.
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Chun MY, Cho BJ, Yoo SH, Oh B, Kang JS, Yeon C. Association between sleep duration and musculoskeletal pain: The Korea National Health and Nutrition Examination Survey 2010-2015. Medicine (Baltimore) 2018; 97:e13656. [PMID: 30558063 PMCID: PMC6320184 DOI: 10.1097/md.0000000000013656] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Both extremely long and short sleep durations have been associated with increased risk of numerous health problems. This study examined the association between self-reported sleep duration and reporting of musculoskeletal pain in the adult Korean population.This study included data from 17,108 adults aged ≥50 years, obtained from the Korea National Health and Nutrition Examination Survey 2010-2012 and 2013-2015. Self-reported daily hours slept and the presence of musculoskeletal pain in knee joint, hip joint, or low back were examined. Patients were stratified into 5 groups by their sleep duration: ≤5, 6, 7, 8, or ≥9 h. Multivariate logistic regression analysis was performed, adjusting for covariates including age, sex, marital status, smoking, alcohol use, family income level, education, physical exercise, body mass index (BMI), and stress level.A U-shaped relationship was observed between the length of sleep duration and the presence of musculoskeletal pain. After adjusting for covariates, sleep duration of ≤5 h or ≥9 h was significantly associated with musculoskeletal pain experienced for more than 30 days over a 3-month period. We also found that the presence of multi-site musculoskeletal pain was significantly higher among those who slept for ≤5 h or ≥9 h than in those who slept for 7 h.These findings suggest that either short or long sleep duration is associated with musculoskeletal pain among Korean adults.
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Affiliation(s)
- Min Young Chun
- Department of Global Medical Science, Sungshin Women's University
- Department of Pharmacology & Clinical Pharmacology Lab, College of Medicine, Hanyang University, Seoul
| | - Bum-Joo Cho
- Department of Ophthalmology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon
| | - Sang Ho Yoo
- Department of Medical Humanities and Ethics, Hanyang University College of Medicine
| | - Bumjo Oh
- Department of Family Medicine, SMG - SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Ju-Seop Kang
- Department of Pharmacology & Clinical Pharmacology Lab, College of Medicine, Hanyang University, Seoul
| | - Cholog Yeon
- College of Medicine, American University of Antigua, Antigua and Barbuda, USA
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Amorim AB, Ferreira PH, Ferreira ML, Lier R, Simic M, Pappas E, Zadro JR, Mork PJ, Nilsen TI. 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. BMJ Open 2018; 8:e022785. [PMID: 30341129 PMCID: PMC6196861 DOI: 10.1136/bmjopen-2018-022785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. DESIGN Prospective cohort study. SETTING We used family-linked longitudinal data from the Norwegian HUNT study collected in HUNT2 (1995-1997) and HUNT3 (2006-2008). PARTICIPANTS A total of 1529 offspring who reported spinal pain in HUNT2 were linked with parental data and followed up in HUNT3. OUTCOMES We estimated relative risk (RR) with 95% CI for recovery from chronic spinal pain, and also from activity limiting spinal pain, in offspring related to chronic spinal pain in parents. We also investigated whether offspring leisure time physical activity and BMI modified these intergenerational associations in spinal pain. RESULTS A total of 540 (35%) offspring were defined as recovered after approximately 11 years of follow-up. Offspring with both parents reporting chronic spinal pain were less likely to recover from chronic spinal pain (RR 0.83, 95% CI 0.69 to 0.99) and activity limiting spinal pain (RR 0.71, 95% CI 0.54 to 0.94), compared with offspring of parents without chronic spinal pain. Analyses stratified by BMI and physical activity showed no strong evidence of effect modification on these associations. However, offspring who were overweight/obese and with both parents reporting chronic spinal pain had particularly low probability of recovery from activity limiting spinal pain, compared with those who were normal weight and had parents without chronic spinal pain (RR 0.57, 95% CI 0.39 to 0.84). CONCLUSION Offspring with chronic spinal pain are less likely to recover if they have parents with chronic spinal pain, particularly if offspring are overweight/obese.
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Affiliation(s)
- Anita B Amorim
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Paulo H Ferreira
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, New South Wales, Australia
| | - Ragnhild Lier
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Milena Simic
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Joshua R Zadro
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tom Il Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Åsberg AN, Hagen K, Stovner LJ, Heuch I, Zwart JA, Winsvold BS. Do incident musculoskeletal complaints influence mortality? The Nord-Trøndelag Health study. PLoS One 2018; 13:e0203925. [PMID: 30265708 PMCID: PMC6161841 DOI: 10.1371/journal.pone.0203925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 08/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background Musculoskeletal complaints (MSC) are common in the general population, causing a major disease burden to the individual and society. The association between MSC and mortality is still unclear. To our knowledge, no study has hitherto evaluated the association between MSC onset within the last month (incident MSC) on the one hand, and all-cause and cause-specific mortality on the other. Methods This prospective population-based cohort study was done using data from the second Nord-Trøndelag Health Study (HUNT2) linked with data from a comprehensive national registry of cause of death. A total of 25,931 participants at risk for incident MSC were included. Hazard ratios (HR) of mortality were estimated for participants with incident MSC using Cox regression based on a mean of 14.1 years of follow-up. Results Participants who reported incident MSC did not have an excess mortality compared to those with no MSC in the analyses of all-cause mortality (HR 0.99, 95% CI 0.89–1.10) and cause specific mortality. This was true also after adjustment for several potential confounding factors. No clear association between the number of MSC body sites and mortality was found. Conclusion Incident MSC were not associated with an increased mortality, neither for all-cause mortality, nor cause-specific mortality.
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Affiliation(s)
- Anders Nikolai Åsberg
- Department of Neuroscience, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Knut Hagen
- Department of Neuroscience, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headache, St. Olavs University Hospital, Trondheim, Norway
| | - Lars Jacob Stovner
- Department of Neuroscience, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headache, St. Olavs University Hospital, Trondheim, Norway
| | - Ingrid Heuch
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - John-Anker Zwart
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bendik Slagsvold Winsvold
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology and FORMI; Oslo University Hospital, Oslo, Norway
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Dybowski C, Löwe B, Brünahl C. Predictors of pain, urinary symptoms and quality of life in patients with chronic pelvic pain syndrome (CPPS): A prospective 12-month follow-up study. J Psychosom Res 2018; 112:99-106. [PMID: 30097143 DOI: 10.1016/j.jpsychores.2018.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/18/2018] [Accepted: 06/29/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Chronic pelvic pain syndrome (CPPS) can affect both men and women and often causes substantial impairment to quality of life. Although cross-sectional studies have suggested that psychosocial aspects may constitute important factors in the etiology and maintenance of CPPS, longitudinal studies are rare. Therefore, the present study examines psychosocial factors as prospective predictors of pain intensity, urinary symptoms and impediments to quality of life in men and women with CPPS. METHODS Data were collected from patients during visits to a specialized, interdisciplinary outpatient clinic and after 12 months. Outcomes included pain intensity, urinary symptoms and impediments to quality of life, all of which were measured with the NIH-CPSI. Age, sex, depressive-anxious symptomatology (PHQ-ADS), pain catastrophizing (PCS), health anxiety (WI-7) and social support (FSozU) were examined as predictors in multivariate linear regressions. RESULTS Data from 109 patients (59.6% female; age M = 49.3, SD = 16.7) were analyzed. Pain severity (β = .30, p = .004), age (β = .22, p = .02), urinary symptoms (β = .24, p = .01) and depressive-anxious symptomatology (β = .29, p = .009) at baseline emerged as predictors of pain at follow-up. Urinary symptoms were predicted by urinary symptoms (β = .53, p < .001) and depressive-anxious symptomatology (β = .25, p = .01) at baseline; impediments to quality of life were predicted by depressive-anxious symptomatology (β = .27, p = .01). CONCLUSION Psychological factors, especially depressive-anxious symptomatology, predict CPPS-specific symptom severity and impediments to quality of life after 12 months and thus substantially contribute to the chronification of CPPS. It is recommended to address anxiety and depression in patients with CPPS as early as possible in biopsychosocially oriented treatment approaches.
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Affiliation(s)
- Christoph Dybowski
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - Christian Brünahl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany
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Aktürk S, Büyükavcı R, Aktürk Ü. Relationship between musculoskeletal disorders and physical inactivity in adolescents. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0923-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Zadro JR, Nilsen TIL, Shirley D, Amorim AB, Ferreira PH, Mork PJ. Parental chronic widespread pain and the association with chronic widespread pain in adult offspring: Family-linkage data from the Norwegian HUNT Study. Eur J Pain 2018; 22:1485-1493. [PMID: 29704885 DOI: 10.1002/ejp.1237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individuals experiencing chronic widespread pain (CWP) have greater disability and poorer quality of life compared to those with other chronic painful conditions; although research identifying risk factors for CWP is lacking. We aimed to investigate whether parental CWP increases the risk of offspring CWP, and if offspring body mass index (BMI) and leisure time physical activity modify this association. METHODS We included 6589 parent-offspring trios participating in the Norwegian HUNT Study in 1995-1997 and 2006-2008. Logistic regression was used to calculate adjusted odd ratios (ORs) (95% confidence intervals, CIs) as estimates of relative risk for offspring CWP. We analysed the joint effect of parental CWP and offspring BMI or leisure time physical activity on offspring risk of CWP and calculated the relative excess risk due to interaction (RERI). RESULTS In total, 886 (13.5%) offspring developed CWP during follow-up. Having one (OR = 1.23, 95% CI, 1.05-1.44) or both parents with CWP (OR = 1.89, 95% CI, 1.50-2.38) increased the risk of offspring CWP. In analyses of joint effects, ORs were 1.84 (95% CI, 1.31-2.56) and 3.35 (95% CI, 1.94-5.77) in normal weight and obese offspring, respectively, when both parents had CWP. The estimate of RERI suggested some synergistic effect (RERI = 1.19, 95% CI, -0.68 to 3.05), although precision was low. Risk of CWP was similar in active (OR = 2.05, 95% CI, 1.56-2.70) and inactive (OR = 1.96, 95% CI, 1.31-2.91) offspring when both parents had CWP. CONCLUSION Parental CWP increases the risk of CWP in adult offspring, particularly if both parents have CWP and offspring are obese. This highlights a familial predisposition for CWP and an important target group for preventive measures. SIGNIFICANCE The parent-offspring transmission of CWP is stronger in obese offspring (particularly when both parents have CWP). This study is the first to investigate the interaction between modifiable lifestyle factors, familial factors and CWP.
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Affiliation(s)
- J R Zadro
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - T I L Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Norway
| | - D Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - A B Amorim
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - P H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - P J Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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30
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Uhlig BL, Sand T, Nilsen TI, Mork PJ, Hagen K. Insomnia and risk of chronic musculoskeletal complaints: longitudinal data from the HUNT study, Norway. BMC Musculoskelet Disord 2018; 19:128. [PMID: 29699540 PMCID: PMC5921548 DOI: 10.1186/s12891-018-2035-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 04/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the prospective association between insomnia and risk of chronic musculoskeletal complaints (CMSC) and chronic widespread musculoskeletal complaints (CWMSC). A second aim was to evaluate the association between insomnia and number of body regions with CMSC at follow-up. METHODS We used data from the second (HUNT2, 1995-1997) and third (HUNT3, 2006-2008) wave of the Nord-Trøndelag Health Study (the HUNT Study). The population-at-risk included 13,429 people aged 20-70 years who reported no CMSC at baseline in HUNT2 and who answered the questionnaires on insomnia in HUNT2 and CMSC in HUNT3. Insomnia was defined according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with minor modification, whereas CMSC was assessed for nine different body regions. CWMSC was defined according to the 1990 criteria by the American College of Rheumatology. We used Poisson regression to estimate adjusted risk ratios (RRs) for CMSC and CWMSC at 11 years follow-up. Precision of the estimates was assessed by a 95% confidence interval (CIs). RESULTS Insomnia at baseline was associated with increased risk of any CMSC (RR 1.16, 95% CI 1.03-1.32) and CWMSC (RR 1.58, 95% CI 1.26-1.98) at follow-up. RR for CMSC for specific body regions ranged from 1.34 (95% CI 1.05-1.73) for the knees and 1.34 (1.10-1.63) for the neck to 1.60 (95% CI 1.19-2.14) for the ankles/ft. Further, insomnia was associated with increased risk of CMSC in 3-4 regions (RR 1.36, 95% CI 1.05-1.77), and 5 or more regions (RR 1.93, 95% CI 1.40-2.66), but not 1-2 regions (RR 0.99, 95% CI 0.80-1.24). CONCLUSIONS Insomnia is associated with increased risk of CMSC, CWMSC, and CMSC located in 3 or more body regions.
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Affiliation(s)
- B L Uhlig
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, N-7489, Trondheim, Norway.
| | - T Sand
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, N-7489, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, N-7006, Trondheim, Norway
| | - T I Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, N-7006, Trondheim, Norway
| | - P J Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
| | - K Hagen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), PB 8905, MTFS, N-7489, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, N-7006, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St. Olavs Hospital, N-7006, Trondheim, Norway
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Tittlbach SA, Jekauc D, Schmidt SCE, Woll A, Bös K. The relationship between physical activity, fitness, physical complaints and BMI in German adults - results of a longitudinal study. Eur J Sport Sci 2018; 17:1090-1099. [PMID: 28747143 DOI: 10.1080/17461391.2017.1347963] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study's aims were to describe the development of physical activity, physical fitness (PF), subjective (physical complaints (PC)) and objective (Body mass index (BMI)) health measures and to examine the relationship between the development trajectories. In addition, the study also aimed to assess the influence of sociodemographic determinants (age, sex, socioeconomic status (SES)) in German adults over a period of 18 years. METHODS The longitudinal study population comprises of 721 men and women, aged 33-76 years over the study period. There was self-report of physical activity and PC and testing of physical fitness and BMI in each study year (1992, 1997, 2002 and 2010). Latent growth curve models were used to analyse the development. RESULTS Physical activity slightly increased while fitness, PC and BMI worsened over the course of 18 years. Sex, age and SES play important roles concerning physical activity, fitness and health. Several integrative associations could be detected between physical activity, fitness, PC and BMI as well as their trajectories. In particular, high initial levels of physical activity and fitness protect from high PC and BMI.The slope of physical activity was not significantly associated with slopes of fitness, PC and BMI. However, increase of fitness resulted in decrease of PC. CONCLUSIONS A general positive development regarding the amount of physical activity could be detected. However, if it is only an unsystematic increase of physical activity, this is not in itself enough to achieve health benefits. The strengthening of fitness should be focused when increasing physical activity, since only then a health benefit is possible.
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Affiliation(s)
| | - Darko Jekauc
- b Institute of Sport Science , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Steffen C E Schmidt
- c Institute of Sport and Sport Science , Karlsruhe Institute of Technology (KIT) , Karlsruhe , Germany
| | - Alexander Woll
- c Institute of Sport and Sport Science , Karlsruhe Institute of Technology (KIT) , Karlsruhe , Germany
| | - Klaus Bös
- c Institute of Sport and Sport Science , Karlsruhe Institute of Technology (KIT) , Karlsruhe , Germany
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Zhang Y, Duffy JF, de Castillero ER, Wang K. Chronotype, Sleep Characteristics, and Musculoskeletal Disorders Among Hospital Nurses. Workplace Health Saf 2018; 66:8-15. [PMID: 28732185 PMCID: PMC8556702 DOI: 10.1177/2165079917704671] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Work-related musculoskeletal disorders (WMSDs) persist as the leading occupational injury, accounting for nearly half of nurses' total occupational injuries. Musculoskeletal pain is a known cause of sleep disruption, and individuals with WMSDs that interfere with sleep often report more pain. Evening chronotype has been associated with poor sleep among nurses. However, the associations among chronotype, sleep, and WMSDs are still unclear, and were explored in the present study. A cross-sectional survey was administered to 397 nurses, with 47.4% reporting WMSDs. Robust Poisson regression modeling suggested that evening type (PR = 1.32, p < .05), prolonged sleep onset latency (PR = 1.37, p < .05), and using sleep-promoting substances (PR = 1.35, p < .01) were associated with increased risk of WMSDs among nurses, after adjusting for shift work, regular exercise, body mass index, and other covariates. This study suggests that well-designed evidence-based nonpharmacological interventions to improve sleep may reduce the risk of WMSDs among nurses.
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Kim H, Min TJ, Kang SH, Kim DK, Seo KM, Lee SY. Association Between Walking and Low Back Pain in the Korean Population: A Cross-Sectional Study. Ann Rehabil Med 2017; 41:786-792. [PMID: 29201817 PMCID: PMC5698665 DOI: 10.5535/arm.2017.41.5.786] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/27/2017] [Indexed: 12/19/2022] Open
Abstract
Objective To investigate if walking is independently associated with low back pain (LBP) in the general population. Methods This cross-sectional study used public data from the Fourth and Fifth Korean National Health and Nutrition Examination Survey. Subjects included 5,982 community-dwelling adults aged ≥50 years. Presence of current LBP was defined as LBP for 1 month or more in the past 3 months. Walking was measured as total walking duration for the past week and subjects were divided into four quartiles. Independent effect of walking on LBP was determined using odds ratios (OR) adjusted for age, sex, osteoporosis, depression or anxiety, and radiographic lumbar spondylosis. Results Prevalence of LBP was 26.4% in this population. Older people and women had higher prevalence of current LBP. Prevalence of obesity and osteoporosis was higher in subjects with current LBP and quality of life was poorer in subjects with current LBP. Adjusted logistic regression model revealed that older age (OR, 1.655; p=0.018), female sex (OR, 2.578; p<0.001), radiographic lumbar spondylosis (OR, 2.728; p<0.001), depression or anxiety (OR, 5.409; p<0.001), and presence of osteoporosis (OR, 1.467; p=0.002) were positively associated with current LBP. Walking decreased prevalence of current LBP proportionally (2nd quartile OR, 0.795; 3rd quartile OR, 0.770; and 4th quartile OR, 0.686 compared with the 1st quartile of walking). Conclusion Walking was negatively associated with LBP. Further studies are needed to reveal causal relationship of this phenomenon.
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Affiliation(s)
- Heesang Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Korea
| | - Tae Jun Min
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Korea
| | - Si Hyun Kang
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Korea
| | - Don-Kyu Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Korea
| | - Kyung Mook Seo
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Korea
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
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Adapting to floor sitting and kneeling. J Bodyw Mov Ther 2017; 21:731-735. [PMID: 28750992 DOI: 10.1016/j.jbmt.2017.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This short practical article suggests that for those unused to ground living, increasing their time spent in sitting or kneeling postures may improve their adaptation of their passive and active joint structures by using low stools, mats, blocks, yoga bricks, bolsters/cushions, and rolled towels. A very slow approach to adaptation and a deliberate reduction of extremes of available lower limb joint range, in the beginning of the process, is likely to reduce possible tissue overload injury risk.
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Andorsen OF, Ahmed LA, Emaus N, Klouman E. A prospective cohort study on risk factors of musculoskeletal complaints (pain and/or stiffness) in a general population. The Tromsø study. PLoS One 2017; 12:e0181417. [PMID: 28727753 PMCID: PMC5519093 DOI: 10.1371/journal.pone.0181417] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 07/02/2017] [Indexed: 12/31/2022] Open
Abstract
Background Female gender has been associated with musculoskeletal complaints (MSCs), but there are limited studies on how other factors may influence women and men differently. The aim of this prospective cohort study was to explore possible predictors of MSCs in women and men free of MSCs at baseline. Methods The present study included participants from the population-based Tromsø study, with baseline data from 1994–1995 and follow-up data from 2007–2008. MSCs were defined as having pain and/or stiffness in muscles and joints for 3 consecutive months during the past year. Predictors of MSCs were examined through binary logistic regression analyses and presented as odds ratios with 95% confidence intervals. Results At baseline 4,496 participants reported no MSCs and among these 2,015 (44.8%) and 441 (9.8%) participants reported mild or severe MSCs, respectively, at follow-up. Female gender predicted MSCs in multivariable logistic regression analyses (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.29–1.66). Educational level of primary/secondary school (OR 1.73, 95% CI: 1.46–2.05) was the strongest predictor of MSCs, followed by poor self-perceived health (OR 1.62, 95% CI: 1.30–2.02). Other predictors were BMI ≥30 kg/m2 (OR 1.39, 95% CI: 1.10–1.77) and smoking (OR 1.33, 95% CI: 1.16–1.52). Age and physical activity level were not significantly associated with MSCs. Gender-stratified analyses revealed that mental health complaints (i.e., depression and/or anxiety) predicted MSCs in men (OR 2.03, 95% CI: 1.18–3.50), but not in women. Current smoking (OR 1.43, 95% CI: 1.16–1.76) and poor self-perceived health (OR 1.90, 95% CI: 1.34–2.71) showed slightly higher odds ratios among women than men, but the gender differences were not significant. Conclusion The present study demonstrates that several negative health determinants are predicting subsequent MSCs. However, the examined risk factors could not explain the higher prevalence of MSCs in women.
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Affiliation(s)
- Ole Fredrik Andorsen
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
| | - Elise Klouman
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
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Lunde LK, Skare Ø, Aass HCD, Mamen A, Einarsdóttir E, Ulvestad B, Skogstad M. Physical activity initiated by employer induces improvements in a novel set of biomarkers of inflammation: an 8-week follow-up study. Eur J Appl Physiol 2017; 117:521-532. [PMID: 28185008 PMCID: PMC5346428 DOI: 10.1007/s00421-016-3533-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/30/2016] [Indexed: 02/06/2023]
Abstract
Purpose We investigated the level of pro- and anti-inflammatory biomarkers before and after 8 weeks of unsupervised physical activity (PA) initiated by employer. Methods During autumn 2014, background data, blood samples and self-reported exercise level were collected from 76 men and 41 women in a Norwegian road maintenance company. Monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), leptin, adiponectin, p-selectin and CD40 ligand (CD40L) were analyzed. \documentclass[12pt]{minimal}
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\begin{document}$${\dot V}{{\rm{O}}_{{\rm{2max}}}}$$\end{document}V˙O2max was measured in a subgroup of 50 subjects. Results With reference point of exercise ≤1 time/week, we found that participants who exercised 2–3 times/week had higher \documentclass[12pt]{minimal}
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\begin{document}$${\dot V}{{\rm{O}}_{{\rm{2max}}}}$$\end{document}V˙O2max values (5.6 mL kg−1 min−1; 95% CI [1.3, 9.9]). MCP-1 was lower in those who exercised ≥ 4 times/week (−81.98 pg/ml [−142.9, −21.0]). IL-6 and p-selectin levels were lower in females who exercised ≥4 times/week (−1.04 pg/ml [−2.04, −0.03] and −13.75 ng/ml [−24.03, −3.48]). Leptin was lower in participants who exercised 2–3 times/week (−0.39 µg/ml ln [−0.68, −0.09]) and ≥4 times/week (−0.69 µg/ml ln [−1.10, −0.28]). During follow-up, \documentclass[12pt]{minimal}
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\begin{document}$${\dot V}{{\rm{O}}_{{\rm{2max}}}}$$\end{document}V˙O2max increased (2.9 mL kg−1 min−1 [1.5, 4.3]), while p-selectin and CD40L decreased (−2.33 ng/ml [−3.78, −0.87] and 718.14 ng/ml [−1368, −68]). MCP-1 levels decreased among men (−32.70 pg/ml [−51.21, −14.19]). A joint analysis of all biomarkers (inversed adiponectin) showed that those who exercised ≥4 times/week at baseline had lower total levels of biomarkers and that total biomarker levels decreased during follow-up. Conclusions Exercising several times a week was associated with less inflammation compared to exercising once a week or less. During the 8-week follow-up, total levels of biomarkers of inflammation improved. Electronic supplementary material The online version of this article (doi:10.1007/s00421-016-3533-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lars-Kristian Lunde
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Box 8149 Dep., 0033, Oslo, Norway
| | - Øivind Skare
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Box 8149 Dep., 0033, Oslo, Norway.
| | - Hans C D Aass
- The Blood Cell Research Group, Section of Research, Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Norway
| | - Asgeir Mamen
- Norwegian School of Health Sciences, Kristiania University College, Box 1190 Sentrum, 0107, Oslo, Norway
| | - Elín Einarsdóttir
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Box 8149 Dep., 0033, Oslo, Norway
| | - Bente Ulvestad
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Box 8149 Dep., 0033, Oslo, Norway
| | - Marit Skogstad
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Box 8149 Dep., 0033, Oslo, Norway
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Andorsen OF, Ahmed LA, Emaus N, Klouman E. Musculoskeletal Complaints (Pain and/or Stiffness) and Their Impact on Mortality in the General Population. The Tromsø Study. PLoS One 2016; 11:e0164341. [PMID: 27736952 PMCID: PMC5063314 DOI: 10.1371/journal.pone.0164341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/24/2016] [Indexed: 11/18/2022] Open
Abstract
Background The long-term consequences of chronic pain and/or stiffness from the musculoskeletal system (musculoskeletal complaints: MSCs) have not been well explored. The aims of this study were to investigate whether MSCs reported at baseline influence all-cause and cause-specific mortality during 21 years follow-up of a general Northern Norwegian adult population. Methods A total of 26,977 men and women aged 25–97 years who participated in the 1994–1995 survey of the Tromsø study (response rate 77%) were included in the present prospective cohort study. Baseline data were collected from the 1994–1995 survey and information on death and emigration was taken from the National Register of Norway. Cox regression analyses were performed to examine if MSCs predicted risk of mortality. Results 5693 (21.1%) participants died during follow-up. Mean time between entry into the survey and death or emigration was 18.6 years (standard deviation 4.87) for all-cause mortality. There was an increased risk of death among those with MSCs at baseline in the crude Cox regression model. However, the multivariable model revealed no significant association between MSCs at baseline and all-cause mortality by sex (women: hazard ratio [HR] = 0.93, 95% confidence interval [CI]: 0.85–1.01; men: HR = 0.93, 95%CI: 0.85–1.01). Furthermore, no significant associations were found between widespread MSCs at baseline and all-cause mortality in multivariable models (women: HR = 0.90, 95%CI: 0.80–1.01; men HR = 0.87, 95%CI: 0.76–1.00). Analyses on cause-specific mortality did not reveal any significant results. Conclusion MSCs are not independently associated with increased risk of death from cardiovascular disease, cancer, or death from all causes.
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Affiliation(s)
- Ole Fredrik Andorsen
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
| | - Elise Klouman
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
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Associations of Sedentary Behavior, Physical Activity, Cardiorespiratory Fitness, and Body Fat Content With Pain Conditions in Children: The Physical Activity and Nutrition in Children Study. THE JOURNAL OF PAIN 2016; 17:845-53. [PMID: 27126997 DOI: 10.1016/j.jpain.2016.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 03/22/2016] [Accepted: 03/28/2016] [Indexed: 11/20/2022]
Abstract
UNLABELLED We investigated the cross-sectional associations of sedentary behavior, physical activity, cardiorespiratory fitness, and body fat content with pain conditions in prepubertal children. The participants were a population sample of 439 children aged 6 to 8 years. Sedentary behavior, physical activity, and pain conditions were assessed using questionnaires, cardiorespiratory fitness using maximal cycle ergometer test, and body fat percentage using dual-energy X-ray absorptiometry. The associations of sedentary behavior, physical activity, cardiorespiratory fitness, and body fat percentage with the risk of pain conditions were analyzed using multivariate logistic regression. Children in the highest sex-specific third of sedentary behavior had 1.95 (95% confidence interval [CI], 1.20-3.17; P = .007 for trend across thirds) times higher odds of any pain than children in the lowest third. Children in the highest sex-specific third of cardiorespiratory fitness had 46% (odds ratio [OR] = .54; 95% CI, .32-.91; P = .019) lower odds of any pain and 50% (OR = .50; 95% CI, .28-.87; P = .015) lower odds of headache than children in the lowest third. Children in the highest sex-specific third of body fat percentage had 44% (OR = .56; 95% CI, .34-.93; P = .023) lower odds of any pain, 49% (OR = .51; 95% CI, .30-.86; P = .011) lower risk of multiple pain, and 48% (OR = .52; 95% CI, .31-.86; P = .010) lower odds of lower limb pain than children in the lowest third. Physical activity was not associated with pain conditions. These findings suggest that prepubertal children with high levels of sedentary behavior, low levels of cardiorespiratory fitness, and low body fat content have increased likelihood of various pain conditions. This information could be used to develop strategies to prevent chronic pain in childhood. PERSPECTIVE Our findings suggest that low cardiorespiratory fitness, high levels of sedentary behavior, and low body fat content are associated with increased likelihood of various pain conditions among prepubertal children. This information could be used to develop strategies to prevent chronic pain in childhood.
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Al-Khotani A, Naimi-Akbar A, Albadawi E, Ernberg M, Hedenberg-Magnusson B, Christidis N. Prevalence of diagnosed temporomandibular disorders among Saudi Arabian children and adolescents. J Headache Pain 2016; 17:41. [PMID: 27102118 PMCID: PMC4840132 DOI: 10.1186/s10194-016-0642-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/16/2016] [Indexed: 01/07/2023] Open
Abstract
Background Studies have indicated that the prevalence of symptoms and signs of temporomandibular disorders (TMD) are rare early in childhood, but become more prevalent in adolescents and adulthood. To our knowledge, no study has investigated the prevalence of TMD-diagnoses in children in the general population. The aim was thus to investigate the prevalence of TMD-diagnoses among children and adolescents in the general population using the Research Diagnostic Criteria for TMD (RDC/TMD). Methods The current cross-sectional study consisted of 456 children and adolescents, aged between 10 and 18, randomly enrolled from 10 boy’s- and 10 girl’s- schools in Jeddah. The participants first answered two validated questions about TMD-pain, followed by a clinical examination according to RDC/TMD. Results One hundred twenty-four participants (27.2 %) were diagnosed with at least one TMD-diagnosis. Myofascial pain was the most common diagnosis (15 %) followed by disc displacement with reduction, arthralgia, myofascial pain with limited mouth opening and osteoarthrosis. Children diagnosed with myofascial pain more often reported orofacial pain, headache and tooth clenching (p < 0.05), whereas children with arthralgia more often reported orofacial pain and tooth grinding than those without a TMD-diagnosis (p < 0.05). Only 18 % of the subjects in the TMD group had sought a dentist or physician for their pain. Conclusion TMD was common among children and adolescents in Saudi Arabia. Self-reported orofacial pain and headache as well as bruxism were associated with a TMD-pain diagnosis and disc displacement. A surprisingly low percentage of children and adolescents sought treatment by a dentist or physician for their pains.
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Affiliation(s)
- Amal Al-Khotani
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden. .,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
| | - Aron Naimi-Akbar
- Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden
| | - Emad Albadawi
- Jeddah Dental Speciality Center, Ministry of Health, Jeddah, Saudi Arabia
| | - Malin Ernberg
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Britt Hedenberg-Magnusson
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Department of Clinical Oral Physiology at the Eastman Institute, Stockholm Public Dental Health (Folktandvården SLL AB), SE-113 24, Stockholm, Sweden
| | - Nikolaos Christidis
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. PLoS One 2016; 11:e0153828. [PMID: 27082110 PMCID: PMC4833298 DOI: 10.1371/journal.pone.0153828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/03/2016] [Indexed: 02/02/2023] Open
Abstract
The main objectives of the current study was i) to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii) to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995–97 and in 2006–08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR) with 95% confidence interval (CI). In total, 1,674 offspring (35.3%) developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55) and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57) was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52) versus high (RR: 1.32, 95% CI: 0.95, 1.84) level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24) of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.
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Liu L, Skinner MA, McDonough SM, Taylor KGM, Baxter GD. Does the dose of Traditional Chinese Medicine acupuncture in addition to usual care affect outcomes for adults with chronic low back pain? Protocol for a randomized controlled feasibility study. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2015.1107365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jones MD, Booth J, Taylor JL, Barry BK. Limited Association Between Aerobic Fitness and Pain in Healthy Individuals: A Cross-Sectional Study. PAIN MEDICINE 2016; 17:1799-1808. [DOI: 10.1093/pm/pnv084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/01/2015] [Accepted: 11/08/2015] [Indexed: 11/13/2022]
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Kvalheim S, Sandvik L, Winsvold B, Hagen K, Zwart JA. Early menarche and chronic widespread musculoskeletal complaints--Results from the HUNT study. Eur J Pain 2015; 20:458-64. [PMID: 26132558 DOI: 10.1002/ejp.747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a predominance of chronic widespread musculoskeletal complaints (WMSC) among women. Previous studies suggest an association between hormonal factors and pain. However, it is not known whether earlier age at menarche is associated with higher prevalence of chronic WMSC. The aim of this study was to investigate the association between age at menarche and chronic WMSC. METHODS Data from a cross-sectional study of inhabitants ≥20 years in Nord-Trøndelag County (Helseundersøkelsen i Nord-Trøndelag -HUNT), conducted in 1995-1997 (HUNT 2) were used. The study population comprised 32,673 women with valid information of age at menarche (exposure) and chronic WMSC (outcome data). RESULTS In total, 8986 (27.5%) women reported WMSC. The overall prevalence of WMSC was 29.7% among those with menarche ≤12 years and 26.7% among those with menarche >12 years. The prevalence of chronic WMSC was consistently higher for those with early age at menarche in all age groups. The crude odds ratio for chronic WMSC, when comparing women with age at menarche ≤12 years to women with age at menarche >12 years, was 1.16 (95% CI: 1.10-1.22). The corresponding odds ratio was 1.26 (95% CI: 1.19-1.34) when adjusted for age, education, body mass index (BMI), smoking, alcohol consumption, depression, systolic blood pressure (SBP) and parity. CONCLUSION In this cross-sectional study, there was an association between early age at menarche and chronic WMSC later in life, but the difference in absolute risk was low (3%).
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Affiliation(s)
- S Kvalheim
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
| | - L Sandvik
- Department of Biostatistics, Oslo University Hospital, Oslo, Norway
| | - B Winsvold
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
| | - K Hagen
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian National Headache Centre, Section of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - J-A Zwart
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
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Puroila A, Paananen M, Taimela S, Järvelin MR, Karppinen J. Lifestyle-Factors in Adolescence as Predictors of Number of Musculoskeletal Pain Sites in Adulthood: A 17-Year Follow-Up Study of a Birth Cohort. PAIN MEDICINE 2015; 16:1177-85. [DOI: 10.1111/pme.12697] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Teichtahl AJ, Urquhart DM, Wang Y, Wluka AE, O'Sullivan R, Jones G, Cicuttini FM. Physical inactivity is associated with narrower lumbar intervertebral discs, high fat content of paraspinal muscles and low back pain and disability. Arthritis Res Ther 2015; 17:114. [PMID: 25947906 PMCID: PMC4422596 DOI: 10.1186/s13075-015-0629-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 04/17/2015] [Indexed: 11/24/2022] Open
Abstract
Introduction Although physical inactivity has been associated with numerous chronic musculoskeletal complaints, few studies have examined its associations with spinal structures. Moreover, previously reported associations between physical activity and low back pain are conflicting. This study examined the associations between physical inactivity and intervertebral disc height, paraspinal fat content and low back pain and disability. Methods Seventy-two community-based volunteers not selected for low back pain underwent magnetic resonance imaging (MRI) of their lumbosacral spine (L1 to S1) between 2011 and 2012. Physical activity was assessed between 2005 and 2008 by questionnaire, while low back pain and disability were assessed by the Chronic Pain Grade Scale at the time of MRI. Intervertebral disc height and cross-sectional area and fat content of multifidus and erector spinae were assessed from MRI. Results Lower physical activity levels were associated with a more narrow average intervertebral disc height (β −0.63 mm, 95% confidence interval (CI) −1.17 mm to −0.08 mm, P = 0.026) after adjusting for age, gender and body mass index (BMI). There were no significant associations between physical activity levels and the cross-sectional area of multifidus or erector spinae. Lower levels of physical activity were associated with an increased risk of high fat content in multifidus (odds ratio (OR) 2.7, 95% CI 1.1 to 6.7, P = 0.04) and high-intensity pain/disability (OR = 5.0, 95% CI 1.5 to 16.4, P = 0.008) after adjustment for age, gender and BMI. Conclusions Physical inactivity is associated with narrower intervertebral discs, high fat content of the multifidus and high-intensity low back pain and disability in a dose-dependent manner among community-based adults. Longitudinal studies will help to determine the cause and effect nature of these associations. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0629-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia. .,Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Richard O'Sullivan
- MRI Department, Healthcare Imaging Services, Epworth Hospital, 89 Bridge Road, Richmond, VIC, 3121, Australia. richard.o'.,Department of Medicine, Central Clinical School, Monash University, 89 Commercial Road, Melbourne, VIC, 3004, Australia. richard.o'
| | - Graeme Jones
- Menzies Research Institute, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
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Beasley M, Prescott GJ, Scotland G, McBeth J, Lovell K, Keeley P, Hannaford PC, Symmons DPM, MacDonald RIR, Woby S, Macfarlane GJ. Patient-reported improvements in health are maintained 2 years after completing a short course of cognitive behaviour therapy, exercise or both treatments for chronic widespread pain: long-term results from the MUSICIAN randomised controlled trial. RMD Open 2015; 1:e000026. [PMID: 26509056 PMCID: PMC4613171 DOI: 10.1136/rmdopen-2014-000026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 12/23/2014] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES The MUSICIAN study has previously shown short-term benefit but only marginal cost-effectiveness for two non-pharmacological interventions for chronic widespread pain (CWP). We wished to determine their long-term effectiveness and cost-effectiveness. METHODS A 2×2 factorial randomised controlled trial based in primary care in the UK. People were eligible if they were aged ≥25 years with CWP for which they had consulted their general practitioner. The interventions were a 6-month telephone cognitive behaviour therapy (tCBT) and/or a tailored exercise programme, in comparison to usual care. The primary outcome was patient-reported change in health. RESULTS 884 persons were eligible, 442 were randomised and 81.7% were followed up 24 months post-treatment. In comparison to usual care (positive outcome 12.8%), tCBT (35.4%; OR 3.7 95% CI (1.8 to 8.0)), exercise (29.3%; OR 2.8 95% CI (1.3 to 6.0)) and both interventions (31.2%; OR 3.1 95% CI (1.3 to 6.0)) were significantly more effective. There was only a small decrease in effectiveness over time for individual and combined treatments. Those with more intense/disabling pain, higher distress and those who exhibited passive coping at baseline were more likely to have a positive outcome with tCBT than persons without these characteristics. tCBT was associated with the greatest increase in quality of life and lowest costs. Cost per quality adjusted life year was £3957-£5917 depending on method of analysis. CONCLUSIONS A short course of tCBT for people with CWP was effective long-term and was highly cost-effective. Exercise was also effective but delivered positive outcome for fewer patients at greater cost, and there was no advantage for patients receiving both interventions. TRIAL REGISTRATION NUMBER ISRCTN67013851.
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Affiliation(s)
- Marcus Beasley
- Musculoskeletal Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry , Aberdeen , UK
| | - Gordon J Prescott
- Medical Statistics Team , Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry , Aberdeen , UK
| | - Graham Scotland
- Health Economic Research Unit , Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry , Aberdeen , UK
| | - John McBeth
- Arthritis Research UK Centre of Excellence in Primary Care, Keele University , Keele, Staffordshire , UK
| | - Karina Lovell
- School of Nursing, Midwifery and Social Work, The University of Manchester , Manchester , UK
| | - Phil Keeley
- School of Nursing, Midwifery and Social Work, The University of Manchester , Manchester , UK
| | - Philip C Hannaford
- Centre for Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry , Aberdeen , UK
| | - Deborah P M Symmons
- Arthritis Research UK Centre for Epidemiology, The University of Manchester , Manchester , UK
| | - Ross I R MacDonald
- Musculoskeletal Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry , Aberdeen , UK
| | - Steve Woby
- Research and Development Department , The Pennine Acute Hospitals NHS Trust, North Manchester General Hospital , Manchester , UK
| | - Gary J Macfarlane
- Musculoskeletal Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry , Aberdeen , UK
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48
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Supervised walking in comparison with fitness training for chronic back pain in physiotherapy. Pain 2015; 156:131-147. [DOI: 10.1016/j.pain.0000000000000013] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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49
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Viester L, Verhagen EALM, Bongers PM, van der Beek AJ. The effect of a health promotion intervention for construction workers on work-related outcomes: results from a randomized controlled trial. Int Arch Occup Environ Health 2014; 88:789-98. [DOI: 10.1007/s00420-014-1007-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 12/01/2014] [Indexed: 12/28/2022]
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50
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Abstract
An ageing, physically inactive and increasingly obese population, coupled with finite health and social care resources, requires a shift from treating musculoskeletal disease when it arises to a preventive approach promoting lifelong musculoskeletal health. A public health approach to musculoskeletal health ensures that people are able to live not only long, but also well. Supporting self-management, addressing common misconceptions about the inevitability of musculoskeletal conditions, and offering brief interventions to support necessary lifestyle changes are basic public health functions that all health professionals can deliver. More specialist public health skills including needs assessment, data interpretation and service planning are also needed to deliver high quality services. These will require improvements in the data collected about musculoskeletal health nationally. A public health approach would benefit individuals through reduced pain and improved function due to musculoskeletal conditions, and wider society by minimising lost economic productivity and lowering health and social care costs.
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Affiliation(s)
- P M Clark
- London and KSS School of Public Health, London, UK.
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