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Ao X, Parisien M, Zidan M, Grant AV, Martinsen AE, Winsvold BS, Diatchenko L. Rare variant analyses in large-scale cohorts identified SLC13A1 associated with chronic pain. Pain 2023:00006396-990000000-00273. [PMID: 36943258 DOI: 10.1097/j.pain.0000000000002882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/16/2022] [Indexed: 03/23/2023]
Abstract
ABSTRACT Chronic pain is a prevalent disease with increasing clinical challenges. Genome-wide association studies in chronic pain patients have identified hundreds of common pathogenic variants, yet they only explained a portion of individual variance of chronic pain. With the advances in next-generation sequencing technologies, it is now feasible to conduct rarer variants studies in large-scale databases. Here, we performed gene-based rare variant analyses in 200,000 human subjects in the UK biobank whole-exome sequencing database for investigating 9 different chronic pain states and validated our findings in 3 other large-scale databases. Our analyses identified the SLC13A1 gene coding for sodium/sulfate symporter associated with chronic back pain and multisite pain at the genome-wide level and with chronic headache, knee, and neck and shoulder pain at the nominal level. Seven loss-of-function rare variants were identified within the gene locus potentially contributing to the development of chronic pain, with 2 of them individually associated with back pain and multisite pain. These 2 rare variants were then tested for replication in 3 other biobanks, and the strongest evidence was found for rs28364172 as an individual contributor. Transcriptional analyses of Slc13a1 in rodents showed substantial regulation of its expression in the dorsal root ganglia and the sciatic nerve in neuropathic pain assays. Our results stress the importance of the SLC13A1 gene in sulfate homeostasis in the nervous system and its critical role in preventing pain states, thus suggesting new therapeutic approaches for treating chronic pain in a personalized manner, especially in people with mutations in the SLC13A1 gene.
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Affiliation(s)
- Xiang Ao
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Marc Parisien
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Maha Zidan
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Audrey V Grant
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Amy E Martinsen
- Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bendik S Winsvold
- Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurology and Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
| | - Luda Diatchenko
- Faculty of Dental Medicine and Oral Health Sciences, Department of Anesthesia, Faculty of Medicine and Health Sciences, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
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Santos H, Henriques AR, Branco J, Machado PM, Canhão H, Pimentel-Santos FM, Rodrigues AM. Health-related quality of life among spondyloarthritis and chronic low back pain patients: results from a nationwide population-based survey. Qual Life Res 2023; 32:383-399. [PMID: 36308590 DOI: 10.1007/s11136-022-03274-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Both spondyloarthritis and chronic low back pain (CLBP) significantly impact health-related quality of life (HRQoL). It is important to clarify whether these disorders have different impacts on the several domains of HRQoL as different mechanisms may necessitate different treatment interventions. Moreover, the factors associated with HRQoL can inform more targeted group interventions to promote HRQoL. METHODS We used data from EpiReumaPt, a population-based survey conducted from September 2011 to December 2013. HRQoL was assessed with EuroQoL-5-Dimensions (EQ-5D). Spondyloarthritis was diagnosed by expert opinion (rheumatologist) and predefined criteria. CLBP was diagnosed if low back pain was present on the day of the interview and persisted for > 90 days. Univariable and multivariable linear regression analyses compared HRQoL among subjects with spondyloarthritis, CLBP, and no rheumatic diseases. Multivariable linear regression analyses evaluated HRQoL factors in spondyloarthritis and CLBP subjects. RESULTS We included 92 spondyloarthritis patients, 1376 CLBP patients, and 679 subjects without rheumatic diseases. HRQoL was similarly affected in spondyloarthritis and CLBP (ß = - 0.03, 95% CI [- 0.08; 0.03]) in all EQ5D dimensions. A much lower HRQoL was found in spondyloarthritis and CLBP patients compared with subjects without rheumatic diseases (ß = - 0.14, 95% CI [- 0.19; - 0.10]; ß = - 0.12, 95% CI [- 0.14; - 0.09], respectively). In spondyloarthritis subjects, multimorbidity and active disease were associated with worse HRQoL (ß = - 0.18; 95% CI [- 0.24; 0.03]; ß = - 0.13; 95% CI [- 0.29; - 0.05], respectively), and regular physical exercise was associated with better HRQoL (ß = 0.18; 95% CI [0.10; 0.30]). In CLBP subjects, multimorbidity (β = - 0.11; 95% CI [- 0.14; - 0.08]), obesity (β = - 0.04; 95% CI [- 0.08; - 0.01]), and low back pain intensity (β = - 0.02; 95% CI [- 0.03; - 0.02]) were associated with worse HRQoL, and regular physical exercise (β = 0.08; 95% CI [0.05; 0.11]) was significantly associated with better HRQoL. CONCLUSION Spondyloarthritis and CLBP subjects reported similar levels of impairment in the mental, physical, and social domains of HRQoL. Future health plans should address modifiable factors associated with HRQoL in these conditions to achieve better outcomes.
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Affiliation(s)
- Helena Santos
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Instituto Português de Reumatologia, Rua da Beneficência, n 7, 1050-034, Lisbon, Portugal.
| | - Ana Rita Henriques
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
| | - Jaime Branco
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
| | - Pedro M Machado
- Centre for Rheumatology and Department of Neuromuscular Diseases, University College of London, London, UK
| | - Helena Canhão
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
| | | | - Ana Maria Rodrigues
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
- Hospital Dos Lusíadas, Lisbon, Portugal
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Jackson JA, Liv P, Sayed-Noor AS, Punnett L, Wahlström J. Risk factors for surgically treated cervical spondylosis in male construction workers: a 20-year prospective study. Spine J 2023; 23:136-145. [PMID: 36028215 DOI: 10.1016/j.spinee.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT Degenerative changes due to cervical spondylosis (CS) can detrimentally affect work ability and quality of life yet understanding of how physical exposure affects disease progression is limited. PURPOSE To assess the associations between occupational physical exposures and occurrence of surgically treated cervical spondylosis (ST-CS) and early exit from the labor market via disability pension. STUDY DESIGN/SETTING Prospective register study with 20 years follow-up period. PATIENT SAMPLE Swedish construction workers participating in a national health surveillance project conducted between 1971 and 1993. OUTCOME MEASURES Surgically treated cervical spondylosis (ST-CS) and early labor market exit at a minimum rate of 25% time on disability pension. METHODS Associations between occupational physical exposures (job exposure matrix) and subsequent ST-CS (National Hospital in-patient register) and early labor market exit via disability pension (Swedish Social Insurance Agency register) were assessed in a cohort of male construction workers (n=237,699). RESULTS A total of 1381 ST-CS cases were present and a 20 years incidence rate of 35.1 cases per 100,000 person years (95% confidence interval (CI) 33.2-36.9). Increased relative risk (RR) for ST-CS was found for workers exposed to non-neutral (RR 1.40, 95% CI 1.15-1.69), and awkward neck postures (1.52, 1.19-1.95), working with the hands above shoulder height (1.30, 1.06-1.60), and high upper extremity loading (1.35, 1.15-1.59). Increased risk was also present for workers who reported frequent neck (3.06, 2.18-4.30) and upper back (3.84, 2.57-5.73) pain in the 12 months prior to survey. Among workers with elevated arm exposure, higher risk was seen in those who also had more frequent neck pain. ST-CS cases took early retirement more often (41.3%) and at a younger age (53 years) than the total study cohort (14.8% and 56 years of age, respectively). CONCLUSIONS Occupational exposure to non-neutral neck postures, work with hands above shoulders and high loads born through the upper extremities increased the risk for ST-CS and early retirement due to disability. Decreasing postural and load exposure is salient for primary, secondary, and tertiary prevention of CS. Neck pain was shown to be a prognostic factor for ST-CS, which stresses the importance of acting early and taking preventative action to reduce workplace exposure, and the need for systematic medical check-ups within primary or occupational care to mitigate disease progression and early labour market exit due to disability.
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Affiliation(s)
- Jennie A Jackson
- Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
| | - Per Liv
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Arkan S Sayed-Noor
- Deparment of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Laura Punnett
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jens Wahlström
- Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
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Leow SN, Tay CL, Ng WW, Mior Mohammad Jafri MN. Effectiveness of Fit and Trimmed Staffs (FATS) program on weight management among the healthcare providers at Simpang Health Clinic, Perak: A pre-post interventional study. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:89-96. [PMID: 36606163 PMCID: PMC9809445 DOI: 10.51866/oa.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Obesity is associated with an increased risk for non-communicable diseases. Local studies have shown that 33.1% of healthcare providers (HCPs) are overweight, while 21.1% are obese. Interventions that consist of diet, physical exercise and cognitive behavioural training have been shown to be successful in reducing weight. METHOD We designed a weight loss programme for our HCPs named the 'Fit and Trimmed Staff programme, which consisted of 3 months of group education on obesity-related health problems led by a doctor, a pharmacist, a nutritionist and an occupational therapist among HCPs. Monthly individual dietary counselling by a nutritionist was also provided for 6 months. We measured the body weight, body mass index, percentage of body fat, visceral fat and percentage of skeletal muscle of the HCPs before and after the intervention. RESULTS Forty-five (56.25%) HCPs at Simpang Health Clinic were either overweight or obese; the majority of them were drivers and administrative clerks (100%), followed by health attendants (69.2%) and medical assistants (63.6%). At 6 months post-intervention, there was a trend towards a non-significant reduction in the fat percentage (median=-0.8%, P=0.423). Approximately 42% (n=19) of the HCPs lost weight, while 58% gained weight. Weight loss was observed more commonly in the male HCPs (>50%) than in the female HCPs. CONCLUSION A weight loss programme solely consisting of health discussion and nutritional advice is inadequate to induce weight reductions. A multimodal approach may be considered in managing weight among HCPs.
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Affiliation(s)
- Shing Ni Leow
- MD (MMA, Russia) , Doctor of Family Medicine (UKM), Klinik Kesihatan Changkat Jering, Changkat Jering, Taiping, Perak, Malaysia.
| | - Chai Li Tay
- MD (UKM), MFamMed (UM), Klinik Kesihatan Simpang, Jalan, Kuala Kangsar, Simpang, Taiping, Perak, Malaysia
| | - Wei Wei Ng
- BSc (Hon) Nutrition (UKM), Klinik Kesihatan Simpang, Jalan, Kuala Kangsar, Simpang 34700, Taiping, Perak, Malaysia
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Manderlier A, de Fooz M, Patris S, Berquin A. Modifiable lifestyle-related prognostic factors for the onset of chronic spinal pain: A systematic review of longitudinal studies. Ann Phys Rehabil Med 2022; 65:101660. [PMID: 35351652 DOI: 10.1016/j.rehab.2022.101660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Stratified approaches to spinal pain that address psychosocial risk factors reduce long-term disability to a moderate extent. Identifying and managing other risk factors might help improve outcomes. OBJECTIVE This systematic review of longitudinal studies aimed to evaluate possible associations between the onset of chronic spinal pain (including low back, back and neck pain) and putative modifiable lifestyle-related risk or protective factors. METHODS This systematic review of longitudinal studies published during the last 2 decades followed PRISMA guidelines. Two reviewers screened Medline, Scopus, Pedro, Cochrane Library, Psycinfo, Science Direct, PTSDpubs and Google Scholar for relevant studies. The QUIPS tool was used to assess the risk of bias. A qualitative meta-synthesis of relevant factors was performed. RESULTS Of 3716 unique records, 14 studies met the inclusion criteria (10 with low risk of bias and 4 moderate risk of bias). The highest bias observed was attrition. For chronic low back pain, we found moderate evidence for the involvement of high body weight, waist circumference, and hip circumference and conflicting evidence for high body mass index (BMI), smoking, and physical activity. For chronic neck pain, we found strong evidence for high BMI in women, moderate evidence for sleep disorders in women and conflicting evidence for high BMI in men and physical activity. For chronic back pain, we found limited evidence for gardening/yard work in men and more than one adult at home. Effect sizes were small. CONCLUSIONS Several modifiable lifestyle-related factors were identified. Evidence is still sparse and there is a need for more studies. PROSPERO database registration: Ref 172,112 CRD42020172112.
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Affiliation(s)
- Adrien Manderlier
- Saint-Luc University Hospital, Av. Hippocrate 10/1650, 1200 Brussels, Belgium
| | - Maxime de Fooz
- Saint-Luc University Hospital, Av. Hippocrate 10/1650, 1200 Brussels, Belgium
| | - Sophie Patris
- Psychology, Education and Motor Sciences Library, Université catholique de Louvain, Brussels, Place Cardinal Mercier, 10/L3.05.01, 1348 Louvain-la-Neuve, Belgium
| | - Anne Berquin
- Saint-Luc University Hospital, Av. Hippocrate 10/1650, 1200 Brussels, Belgium; Institute of Neuroscience, Université catholique de Louvain, Avenue E. Mounier 53, 1200 Brussels, Belgium.
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Perera RS, Chen L, Ferreira ML, Arden NK, Radojčić MR, Kluzek S. Age- and sex-specific effects of obesity, metabolic syndrome and its components on back pain: The English Longitudinal Study of Ageing. Joint Bone Spine 2022; 89:105366. [DOI: 10.1016/j.jbspin.2022.105366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
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Waist circumference, waist-hip ratio, body fat rate, total body fat mass and risk of low back pain: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 31:123-135. [PMID: 34561729 DOI: 10.1007/s00586-021-06994-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/08/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify the associations between waist circumference (WC), waist-hip ratio (WHR), body fat rate (BFR), total body fat mass (BFM), and the risk of low back pain (LBP). METHODS We have searched PubMed through October 2020 for observational studies investigating the associations between WC, WHR, BFR, or total BFM and the risk of LBP. Random-effect models were used to calculate the summary risk estimates and corresponding 95% confidence intervals (95% CIs). RESULTS A total of fifteen studies with 92,936 participants were included, of which ten were related to WC, five were related to WHR, four were related to BFR, and four were related to total BFM. Pooled results indicated that high WC (odds ratio (OR) = 1.30, 95% CI 1.10-1.54) and WHR (OR = 1.33, 95% CI 1.00-1.76) were associated with an increased risk of chronic low back pain (c-LBP). High WC (OR = 1.18, 95% CI 1.03-1.34) was also associated with an increased risk of non-c-LBP. The risk of non-c-LBP increased by 23% (OR = 1.23, 95% CI 1.01-1.50) for every 10% increase in BFR, and for every 10 kg increase in total BFM, the risk of non-c-LBP increased by 24% (OR = 1.24, 95% CI 1.10-1.39). CONCLUSION Observational epidemiological evidence suggested that individuals with increased WC, WHR, BFR, or total BFM tended to have an increased risk of LBP, regardless of whether their body mass indexes were normal. Excessive fat mass was the essence of the process.
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Peiris WL, Cicuttini FM, Hussain SM, Estee MM, Romero L, Ranger TA, Fairley JL, McLean EC, Urquhart DM. Is adiposity associated with back and lower limb pain? A systematic review. PLoS One 2021; 16:e0256720. [PMID: 34520462 PMCID: PMC8439494 DOI: 10.1371/journal.pone.0256720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/27/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Back and lower limb pain have a major impact on physical function and quality of life. While obesity is a modifiable risk factor for musculoskeletal pain, the role of adiposity is less clear. This systematic review aimed to examine the relationship between both adiposity and its distribution and back and lower limb pain. METHODS A systematic search of electronic databases was conducted to identify studies that examined the association between anthropometric and/or direct measures of adiposity and site specific musculoskeletal pain. Risk of bias was assessed and a best evidence synthesis was performed. RESULTS A total of 56 studies were identified which examined 4 pain regions, including the lower back (36 studies), hip (two studies), knee (13 studies) and foot (eight studies). 31(55%) studies were assessed as having low to moderate risk of bias. 17(30%) studies were cohort in design. The best evidence synthesis provided evidence of a relationship between central adiposity and low back and knee pain, but not hip or foot pain. There was also evidence of a longitudinal relationship between adiposity and the presence of back, knee and foot pain, as well as incident and increasing foot pain. CONCLUSIONS This systematic review provides evidence of an association between both body fat and its central distribution and low back and knee pain, and a longitudinal relationship between adiposity and back, knee and foot pain. These results highlight the potential for targeting adiposity in the development of novel treatments at these sites.
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Affiliation(s)
- Waruna L. Peiris
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia M. Cicuttini
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sultana Monira Hussain
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mahnuma M. Estee
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Tom A. Ranger
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica L. Fairley
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Emily C. McLean
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Donna M. Urquhart
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Varallo G, Scarpina F, Giusti EM, Cattivelli R, Guerrini Usubini A, Capodaglio P, Castelnuovo G. Does Kinesiophobia Mediate the Relationship between Pain Intensity and Disability in Individuals with Chronic Low-Back Pain and Obesity? Brain Sci 2021; 11:brainsci11060684. [PMID: 34067433 PMCID: PMC8224628 DOI: 10.3390/brainsci11060684] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/28/2023] Open
Abstract
Individuals suffering from chronic low-back pain and obesity face severe physical and functional limitations. According to the fear-avoidance model, kinesiophobia might play a crucial role in the relationship between pain intensity and disability. Thus, the purpose of this study was to verify the role of kinesiophobia as a mediator in the association between pain intensity and disability in individuals with both chronic low-back pain and obesity. A total of 213 individuals with chronic low-back pain and obesity were included in the study. The level of kinesiophobia, pain intensity and disability were all assessed using self-reported questionnaires. We verified through a simple mediation analysis that kinesiophobia partially mediated the association between pain intensity and disability in our sample. According to our findings, we emphasize the crucial role of kinesiophobia as a psychological factor that should be addressed in chronic low-back pain rehabilitative protocols to reduce disability in individuals with obesity.
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Affiliation(s)
- Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, 28824 Verbania, Italy; (G.V.); (R.C.); (A.G.U.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
| | - Federica Scarpina
- Rita Levi Montalcini Department of Neurosciences, University of Turin, 10124 Turin, Italy;
- Istituto Auxologico Italiano IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital, 28824 Verbania, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, 28824 Verbania, Italy; (G.V.); (R.C.); (A.G.U.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
- Correspondence: ; Tel.: +39-0323-4338
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, 28824 Verbania, Italy; (G.V.); (R.C.); (A.G.U.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
| | - Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, 28824 Verbania, Italy; (G.V.); (R.C.); (A.G.U.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
| | - Paolo Capodaglio
- Istituto Auxologico Italiano IRCCS, Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, San Giuseppe Hospital, 28824 Verbania, Italy;
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Turin, 10121 Turin, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, San Giuseppe Hospital, 28824 Verbania, Italy; (G.V.); (R.C.); (A.G.U.); (G.C.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
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Sagittal Integral Morphotype of Female Classical Ballet Dancers and Predictors of Sciatica and Low Back Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095039. [PMID: 34068738 PMCID: PMC8126247 DOI: 10.3390/ijerph18095039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/24/2021] [Accepted: 05/06/2021] [Indexed: 02/01/2023]
Abstract
The aims of this study were to describe the sagittal integral morphotype (SIM) of classical ballet (CB) dancers, and to establish predictor factors and their cut off values for high risk of experiencing sciatica or low back pain (LBP). This retrospective cohort study was performed in 33 female professional CB dancers. Data related to anthropometric parameters, CB dance experience, sciatica or LBP history, and sagittal spine curvatures were collected. A binary logistic regression and receiver-operating characteristic analysis were performed. The main spine misalignments observed in the SIM of CB dancers were thoracic functional hyperkyphosis, hypomobile kyphosis, and hypokyphosis, and those for the lumbar curvature were hyperlordotic attitude and functional hyperkyphosis. The lumbar curvature in slump sitting and trunk forward bending positions, together with the stature, were significant predictor factors of sciatica history, while the years of dance experience was a significant predictor factor of LBP history. The cut off values analysis revealed that dancers with a stature of 161 cm or less, and those with 14 years of experience or more, have a greater probability of experiencing sciatica or LBP history, respectively.
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Prognostic factors for pain chronicity in low back pain: a systematic review. Pain Rep 2021; 6:e919. [PMID: 33981936 PMCID: PMC8108595 DOI: 10.1097/pr9.0000000000000919] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/21/2021] [Accepted: 02/12/2021] [Indexed: 12/19/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Several prognostic factors are related to low back pain chronicity, and these should be taken into account when planning more comprehensive models in its prevention. Low back pain is the leading cause for years lived in disability. Most people with acute low back pain improve rapidly, but 4% to 25% of patients become chronic. Since the previous systematic reviews on the subject, a large number of new studies have been conducted. The objective of this article was to review the evidence of the prognostic factors behind nonspecific chronic low back pain. A systematic literature search was performed without date limitation from the MEDLINE, Cochrane library, and Medic databases. Specific inclusion criteria were used, and risk factors before the onset of chronic symptoms were searched. Study quality was assessed by 2 independent reviewers. One hundred eleven full articles were read for potential inclusion, and 25 articles met all the inclusion criteria. One study was rated as good quality, 19 studies were rated as fair quality, and 5 articles were rated as poor quality. Higher pain intensity, higher body weight, carrying heavy loads at work, difficult working positions, and depression were the most frequently observed risk factors for chronic low back pain. Maladaptive behavior strategies, general anxiety, functional limitation during the episode, smoking, and particularly physical work were also explicitly predictive of chronicity. According to this systematic review, several prognostic factors from the biomechanical, psychological and psychosocial point of view are significant for chronicity in low back pain.
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Muthuri S, Cooper R, Kuh D, Hardy R. Do the associations of body mass index and waist circumference with back pain change as people age? 32 years of follow-up in a British birth cohort. BMJ Open 2020; 10:e039197. [PMID: 33310796 PMCID: PMC7735102 DOI: 10.1136/bmjopen-2020-039197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To investigate whether cross-sectional and longitudinal associations of body mass index (BMI) and waist circumference (WC) with back pain change with age and extend into later life. DESIGN British birth cohort study. SETTING England, Scotland and Wales. PARTICIPANTS Up to 3426 men and women from the MRC National Survey of Health and Development. PRIMARY OUTCOME MEASURES Back pain (sciatica, lumbago or recurring/severe backache all or most of the time) was self-reported during nurse interviews at ages 36, 43, 53 and 60-64 years and in a postal questionnaire using a body manikin at age 68. RESULTS Findings from mixed-effects logistic regression models indicated that higher BMI was consistently associated with increased odds of back pain across adulthood. Sex-adjusted ORs of back pain per 1 SD increase in BMI were: 1.13 (95% CI: 1.01 to 1.26), 1.11 (95% CI: 1.00 to 1.23), 1.17 (95% CI: 1.05 to 1.30), 1.31 (95% CI: 1.15 to 1.48) and 1.08 (95% CI: 0.95 to 1.24) at ages 36, 43, 53, 60-64 and 68-69, respectively. Similar patterns of associations were observed for WC. These associations were maintained when potential confounders, including education, occupational class, height, cigarette smoking status, physical activity and symptoms of anxiety and depression were accounted for. BMI showed stronger associations than WC in models including both measures. CONCLUSIONS These findings demonstrate that higher BMI is a persistent risk factor for back pain across adulthood. This highlights the potential lifelong consequences on back pain of the rising prevalence of obesity within the population.
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Affiliation(s)
- Stella Muthuri
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
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13
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Between-day reliability of IMU-derived spine control metrics in patients with low back pain. J Biomech 2020; 113:110080. [DOI: 10.1016/j.jbiomech.2020.110080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/09/2020] [Accepted: 10/12/2020] [Indexed: 12/29/2022]
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14
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Heuch I, Heuch I, Hagen K, Storheim K, Zwart JA. Associations between the number of children, age at childbirths and prevalence of chronic low back pain: the Nord-Trøndelag Health Study. BMC Public Health 2020; 20:1556. [PMID: 33059635 PMCID: PMC7565361 DOI: 10.1186/s12889-020-09480-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/31/2020] [Indexed: 12/02/2022] Open
Abstract
Background Associations between childbirths and subsequent risk of low back pain (LBP) have not been clarified. Changes in sex hormone levels or lumbar posture during pregnancy may have an impact on LBP later in life. The purpose of this study was to explore associations between the number of childbirths, age at childbirths and prevalence of chronic LBP in a general population of women. Methods Data were obtained from the Norwegian community-based Nord-Trøndelag Health Study, HUNT2 (1995–1997). Women aged 20–69 years indicated whether they suffered from chronic LBP, defined as LBP persisting at least 3 months continuously during last year. Information about LBP was collected from 3936 women who had experienced no childbirths, 3143 women who had delivered one child only and 20,584 women who had delivered 2 or more children. Of these, 7339 women reported chronic LBP. The 595 women who were pregnant when information was collected were considered separately, regardless of previous births, with 80 women reporting chronic LBP. Associations with prevalence of chronic LBP were examined by generalised linear modelling with adjustment for potential confounders in a cross-sectional design. Results Women who had delivered one child only showed a higher prevalence of chronic LBP than women with no childbirths (prevalence ratio (PR) 1.11; 95% CI: 1.01–1.22). Among women with one or more childbirths, no overall change in prevalence could be demonstrated with an increasing number of children in analyses adjusted for age at first delivery. In women with at least two childbirths, an age less than 20 years at first childbirth was associated with an increased prevalence of chronic LBP (PR 1.36; 95% CI: 1.25–1.49; compared with age 25–29 years). No association was observed between age at last delivery and chronic LBP. The lowest prevalence of chronic LBP was found among women who were currently pregnant (PR 0.80; 95% CI: 0.63–1.00; compared with women with no childbirths). Conclusions Having experienced at least one childbirth seems to be associated with a higher prevalence of chronic LBP later in life. A young age at first childbirth is also associated with a long-lasting increased prevalence.
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Affiliation(s)
- Ingrid Heuch
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway.
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Clinical Research Unit Central Norway, St. Olavs Hospital, Trondheim, Norway
| | - Kjersti Storheim
- Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Ullevål, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - John-Anker Zwart
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Circulating Levels of Visceral Adipose Tissue-Derived Serine Protease Inhibitor (Vaspin) Appear as a Marker of Musculoskeletal Pain Disability. Diagnostics (Basel) 2020; 10:diagnostics10100797. [PMID: 33049941 PMCID: PMC7599595 DOI: 10.3390/diagnostics10100797] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/16/2020] [Accepted: 10/06/2020] [Indexed: 12/19/2022] Open
Abstract
Musculoskeletal pain (MSP), specifically low back pain (LBP), is often associated with several adipose tissue-derived cytokines (adipokines) and body composition, but their correlations with the LBP-related disability/severity phenotypes remain poorly understood. In this cross-sectional study, two self-reported validated questionnaires were used to collect back pain and disability data in an ethnically homogeneous family-based population sample (N = 1078). Plasma levels of relatively new adipokines, vaspin and adipsin, were detected by ELISA. Body composition parameters, including fat, skeletal muscle mass, extracellular water (ECW), and others were assessed through bioelectrical impedance analysis (BIA) technology. Statistical analysis was conducted, accounting for the familial composition of the sample. The multiple regression analyses with four LBP-related phenotypes as dependent variables consistently showed, for the first time, the significant associations with vaspin levels, regardless of other covariates. The odds ratios (OR)/SD ranged between 1.24 (95%CI = 1.03-1.50) and 1.33 (95%CI = 1.07-1.64), depending on the LBP phenotype. Among the tested body composition covariates, only ECW levels displayed consistent and highly significant associations with all tested LBP phenotypes (OR from 1.43, 95%CI = 1.14-1.79 to 1.68, 95%CI = 1.26-2.24). The results clearly suggest that circulating concentrations of vaspin and ECW levels could serve as biomarkers of MSP/LBP severity and complications.
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16
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BMI influences relationships among health factors for adults with persistent pain who use prescription opioids. Nurs Outlook 2020; 68:440-448. [PMID: 32402394 DOI: 10.1016/j.outlook.2020.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/13/2020] [Accepted: 03/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Long-term use of prescription opioids for pain results in negative health outcomes. Overweight and pain are related, and adults with either condition commonly report poor sleep quality, high levels of depression, low levels of self-efficacy, and high pain interference and intensity. Insufficient research exists regarding how weight may influence pain outcomes in the context of common symptoms. PURPOSE To investigate how body mass index (BMI) influences relationships between health factors and pain outcomes among adults with pain prescribed opioids. METHODS The sample included 226 adults. Linear regression models tested relationships among variables and outcomes of pain intensity and pain interference. FINDINGS BMI significantly strengthened relationships between health factors and pain interference but not pain intensity. DISCUSSION Adults with persistent pain suffer worsened pain interference in the context of increased weight status. Nurses should consider addressing BMI as part of a holistic pain management care plan.
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Dose-response associations of clinical markers of obesity and duration of exposure to excess weight with chronic musculoskeletal pain: cross-sectional analysis at baseline of ELSA-Brasil Musculoskeletal cohort. Rheumatol Int 2020; 40:881-891. [PMID: 32236646 DOI: 10.1007/s00296-020-04557-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/14/2020] [Indexed: 02/03/2023]
Abstract
The objective of this study is to investigate the association of clinical markers of obesity and weight trajectories with chronic musculoskeletal pain (CMP). This is a cross-sectional study using baseline data from ELSA-Brasil MSK cohort. CMP was evaluated at nine body sites (neck, shoulders, upper back, elbows, lower back, wrists/hands, hips/thighs, knees, ankles/feet), and defined as pain lasting > 6 months in the past year. General and abdominal obesity levels were classified according to accepted cut-offs for body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR). Binomial and multinomial logistic regressions tested for associations with CMP at any site, at ≥ 3 sites (multisite) and in upper + lower limbs + axial skeleton (generalized). A total of 2899 participants (mean age 56.0 ± 8.93) were included, 55.0% reported CMP, 19.1% had multisite, and 10.3% had generalized CMP. After adjustments for sex, age, education, physical activity and depressive symptoms, nearly all the investigated markers of obesity were associated with any CMP, multisite and generalized CMP, with strongest associations being observed for general obesity level II/III: OR 2.08 (95% CI 1.45-2.99), OR 3.19 (95% CI 2.06-4.94) and OR 3.65 (2.18-6.11), respectively. Having excess weight currently or both at age 20 and currently was also associated with all CMP presentations. Associations of greater magnitude were consistently observed at higher obesity levels and longer exposures to excess weight (dose-response). These results may support the contribution of obesity-derived mechanical and inflammatory mechanisms of CMP, and indicate a role for the accumulation of exposure to excess weight across the adult life course.
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18
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Tumin D, Frech A, Lynch JL, Raman VT, Bhalla T, Tobias JD. Weight Gain Trajectory and Pain Interference in Young Adulthood: Evidence from a Longitudinal Birth Cohort Study. PAIN MEDICINE 2020; 21:439-447. [PMID: 31386156 DOI: 10.1093/pm/pnz184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Obesity is associated with chronic pain, but the contribution of body mass index (BMI) trajectories over the life course to the onset of pain problems remains unclear. We retrospectively analyzed how BMI trajectories during the transition to adulthood were associated with a measure of pain interference obtained at age 29 in a longitudinal birth cohort study. METHODS Data from the National Longitudinal Survey of Youth, 1997 Cohort (follow-up from 1997 to 2015), were used to determine BMI trajectories from age 14 to 29 via group trajectory modeling. At age 29, respondents described whether pain interfered with their work inside and outside the home over the past four weeks (not at all, a little, or a lot). Multivariable ordinal logistic regression was used to evaluate pain interference according to BMI trajectory and study covariates. RESULTS Among 7,875 respondents, 11% reported "a little" and 4% reported "a lot" of pain interference at age 29. Four BMI trajectory groups were identified, varying in starting BMI and rate of weight gain. The "obese" group (8% of respondents) had a starting BMI of 30 kg/m2 and gained an average of 0.7 kg/m2/y. On multivariable analysis, this group was the most likely to have greater pain interference, compared with "high normal weight" (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.14-1.88), "low normal weight" (OR = 1.45, 95% CI = 1.13-1.87), and "overweight" trajectories (OR = 1.33, 95% CI = 1.02-1.73). CONCLUSIONS Obesity and rapid weight gain during the transition to adulthood were associated with higher risk of pain interference among young adults.
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Affiliation(s)
- Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina
| | - Adrianne Frech
- Department of Health Sciences, University of Missouri, Columbia, Missouri
| | - Jamie L Lynch
- Department of Sociology, St. Norbert College, De Pere, Wisconsin
| | - Vidya T Raman
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| | - Tarun Bhalla
- Department of Anesthesia & Pain Medicine, Akron Children's Hospital, Akron, Ohio, USA
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
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19
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Heuch I, Heuch I, Hagen K, Sørgjerd EP, Åsvold BO, Zwart JA. Does diabetes influence the probability of experiencing chronic low back pain? A population-based cohort study: the Nord-Trøndelag Health Study. BMJ Open 2019; 9:e031692. [PMID: 31515434 PMCID: PMC6747649 DOI: 10.1136/bmjopen-2019-031692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is a major problem in modern society and it is important to study possible risk factors for this disorder. People with diabetes are often affected by LBP, but whether diabetes represents a risk factor for LBP has not been studied in detail. The aim of this study was to explore the association between diabetes and subsequent risk of chronic LBP. DESIGN An 11-year follow-up study. SETTING The Nord-Trøndelag Health Study (HUNT2; 1995-1997) and HUNT3 (2006-2008) surveys of Nord-Trøndelag County in Norway. MAIN OUTCOME MEASURE Chronic LBP, defined as LBP persisting at least 3 months continuously during the last year. PARTICIPANTS A total of 18 972 persons without chronic LBP at baseline in HUNT2, and 6802 persons who reported chronic LBP at baseline in HUNT2. METHODS Associations between diabetes and risk of chronic LBP among individuals aged 30-69 years were examined by generalised linear modelling. RESULTS Men without chronic LBP at baseline showed a significant association between diabetes and risk of chronic LBP (relative risk (RR) 1.43, 95% CI 1.04 to 1.96, p=0.043). In women, no association was found (RR 1.01, 95% CI 0.69 to 1.48, p=0.98). No association could be established between diabetes and recurrence or persistence of chronic LBP after 11 years in either sex. CONCLUSIONS Men with a diagnosis of diabetes may have a higher risk of subsequently experiencing chronic LBP.
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Affiliation(s)
- Ingrid Heuch
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St Olavs University Hospital, Trondheim, Norway
| | - Elin Pettersen Sørgjerd
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Endocrinology, St Olavs University Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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20
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Brady SRE, Urquhart DM, Hussain SM, Teichtahl A, Wang Y, Wluka AE, Cicuttini F. High baseline fat mass, but not lean tissue mass, is associated with high intensity low back pain and disability in community-based adults. Arthritis Res Ther 2019; 21:165. [PMID: 31277706 PMCID: PMC6612201 DOI: 10.1186/s13075-019-1953-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives Low back pain is the largest contributor to disability worldwide. The role of body composition as a risk factor for back pain remains unclear. Our aim was to examine the relationship between fat mass and fat distribution on back pain intensity and disability using validated tools over 3 years. Methods Participants (aged 25–60 years) were assessed at baseline using dual-energy X-ray absorptiometry (DXA) to measure body composition. All participants completed the Chronic Pain Grade Scale at baseline and 3-year follow-up. Of the 150 participants, 123 (82%) completed the follow-up. Results Higher baseline body mass index (BMI) and fat mass (total, trunk, upper limb, lower limb, android, and gynoid) were all associated with high intensity back pain at either baseline and/or follow-up (total fat mass: multivariable OR 1.05, 95% CI 1.01–1.09, p < 0.001). There were similar findings for all fat mass measures and high levels of back disability. A higher android to gynoid ratio was associated with high intensity back pain (multivariable OR 1.04, 95% CI 1.01–1.08, p = 0.009). There were no associations between lean mass and back pain. Conclusions This cohort study provides evidence for the important role of fat mass, specifically android fat relative to gynoid fat, on back pain and disability.
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Affiliation(s)
- Sharmayne R E Brady
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia.
| | - Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Andrew Teichtahl
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
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21
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Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:967-975. [PMID: 30877387 DOI: 10.1007/s00586-019-05935-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/14/2019] [Accepted: 02/26/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this research was to evaluate the prevalence of cervical and lumbar pain in obese patients eligible for bariatric surgery and to investigate possible changes in sagittal spine alignment in these patients. METHODS The following parameters were compared in 30 obese patients and a control group of 25 non-obese volunteers: body mass index, prevalence of cervical and lumbar pain assessed by visual analog scale (VAS), Neck Disability Index [NDI] and Oswestry Disability Index [ODI], as well as radiographic parameters of the spine and pelvis measured with Surgimap software. RESULTS The cervical and lumbar VAS and the NDI and ODI were significantly worse in obese patients. Compared with the control group, the cervical sagittal vertical axis (cSVA) of the obese group had higher variance (p value = 0.0025) and the cervical lordosis was diminished (p value = 0.0023). Thoracic kyphosis, lumbar lordosis, and the pelvic parameters were not significantly different between the groups. CONCLUSIONS Obese patients demonstrated lower functional performance compared with their non-obese counterparts, while cervical lordosis was diminished and the cSVA was increased in obese patients. These slides can be retrieved under Electronic Supplementary Material.
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Bigand T, Wilson M, Bindler R, Daratha K. Examining Risk for Persistent Pain among Adults with Overweight Status. Pain Manag Nurs 2019; 19:549-556. [PMID: 29776874 DOI: 10.1016/j.pmn.2018.02.066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 01/10/2018] [Accepted: 02/17/2018] [Indexed: 12/19/2022]
Abstract
Aims of Investigation: Obesity and persistent pain are public health concerns with associated high costs. Evidence supports an increased risk for reports of persistent pain among adults who are above the recommended body mass index level. However, data have not been clearly synthesized to report the risk for the two co-occurring conditions. Even less is known about how overweight status that does not reach the level of obesity is related to pain. Thus, the aim driving this review was to calculate the risk and odds ratios of chronic pain among adults with an overweight body mass index. METHODS A literature review was completed using CINAHL and PubMed databases. Key words were entered using combinations of several MeSH headers. RESULTS Risk and odds ratios were calculated to determine overweight status among adults with chronic pain. Risk and odds ratios were calculated from nine studies. Overweight adults were between 14% and 71% more likely to report chronic pain than normal-weight adults. IMPLICATIONS FOR PRACTICE Pain management nurses should educate adults about the importance of weight management to reduce risk for persistent pain. Nurses need to be informed about current national physical activity and diet recommendations to ensure proper health information is relayed to patients. CONCLUSIONS There is an elevated risk for persistent pain among adults who are overweight compared with those who are recommended weight status. Future longitudinal research focused on causality can help determine which condition contributes to the other. Weight management may be implied for clinical risk reduction of pain conditions among adults who are above recommended body mass index levels.
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Affiliation(s)
| | | | - Ruth Bindler
- Washington State University, Spokane, Washington
| | - Kenn Daratha
- Washington State University, Spokane, Washington
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23
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Ranson WA, Cheung ZB, Di Capua J, Lee NJ, Ukogu C, Jacobs S, Vig KS, Kim JS, White SJW, Cho SK. Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion. Global Spine J 2018; 8:795-802. [PMID: 30560030 PMCID: PMC6293430 DOI: 10.1177/2192568218771363] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES The prevalence of obesity-related low back pain and degenerative disc disease is on the rise. Past studies have demonstrated that obesity is associated with higher perioperative complication rates, but there remains a gap in the literature regarding additional risk factors that further predispose this already high-risk patient population to poor surgical outcomes following elective posterior lumbar fusion (PLF). The aim of the study is to identify independent risk factors for poor 30-day perioperative outcomes in morbidly obese patients undergoing elective PLF. METHODS We identified 22 909 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent elective PLF. There were 1861 morbidly obese patients. Baseline patient demographics and medical comorbidities were collected. Univariate analysis was performed to compare perioperative complication rates between non-morbidly obese and morbidly obese patients. The 5 most common complications in the morbidly obese group were then selected for multivariate regression analysis to identify independent risk factors for poor 30-day outcomes. RESULTS Morbidly obese patients had a higher perioperative complication rate. The 5 most common complications were prolonged hospitalization, blood transfusion, readmission, wound complications, and reoperation. Independent risk factors for these complications were age ≥65 years, super obesity (ie, BMI > 48.6), chronic steroid use, American Society of Anesthesiology classification ≥3, poor functional status, long length of fusion ≥4 levels, and extended operative time (ie, operative time ≥318 minutes). CONCLUSIONS Morbidly obese patients are at higher risk of perioperative complications following elective PLF. Modifiable risk factors for the most common complications are obesity and preoperative steroid use.
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Affiliation(s)
| | - Zoe B. Cheung
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Di Capua
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nathan J. Lee
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chierika Ukogu
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Khushdeep S. Vig
- Icahn School of Medicine at Mount Sinai, New York, NY, USA,The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jun S. Kim
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Samuel K. Cho
- Icahn School of Medicine at Mount Sinai, New York, NY, USA,Samuel K. Cho, Department of Orthopaedic Surgery,
Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 4th Floor, New York, NY
10029, USA.
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24
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Oliveira IS, Costa LOP, Garcia AN, Miyamoto GC, Cabral CMN, Costa LDCM. Can demographic and anthropometric characteristics predict clinical improvement in patients with chronic non-specific low back pain? Braz J Phys Ther 2018; 22:328-335. [PMID: 30017258 DOI: 10.1016/j.bjpt.2018.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/03/2018] [Accepted: 06/07/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify potential prognostic factors that may predict clinical improvement of patients treated with different physical therapy interventions in the short-term. METHODS This is a prospective cohort study. A total of 616 patients with chronic non-specific low back pain treated with interventions commonly used by physical therapists were included. These patients were selected from five randomized controlled trials. Multivariate linear regression models were used to verify if sociodemographic characteristics (age, gender, and marital status), anthropometric variables (height, body mass, and body mass index), or duration of low back pain, pain intensity at baseline, and disability at baseline could be associated with clinical outcomes of pain intensity and disability four weeks after baseline. RESULTS The predictive variables for pain intensity were age (β=0.01 points, 95% CI=0.00 to 0.03, p=0.03) and pain intensity at baseline (β=0.23 points, 95% CI=0.13 to 0.33, p=0.00), with an explained variability of 4.6%. Similarly, the predictive variables for disability after four weeks were age (β=0.03 points, 95% CI=0.00 to 0.06, p=0.01) and disability at baseline (β=0.71 points, 95% CI=0.65 to 0.78, p=0.00), with an explained variability of 42.1%. CONCLUSION Only age, pain at baseline and disability at baseline influenced the pain intensity and disability after four weeks of treatment. The beta coefficient for age was statistically significant, but the magnitude of this association was very small and not clinically important.
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Affiliation(s)
- Indiara Soares Oliveira
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.
| | - Leonardo Oliveira Pena Costa
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Alessandra Narciso Garcia
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Gisela Cristiane Miyamoto
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Cristina Maria Nunes Cabral
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
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Childhood adiposity, adult adiposity, and the ACE gene insertion/deletion polymorphism: evidence of gene-environment interaction effects on adult blood pressure and hypertension status in adulthood. J Hypertens 2018; 36:2168-2176. [PMID: 29939946 DOI: 10.1097/hjh.0000000000001816] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Genetic variants may modify the associations of adiposity measures with blood pressure (BP) and hypertension. The insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene is an attractive candidate. AIMS To examine interaction effects between I/D polymorphism and adiposity measures (BMI, waist circumference, waist-to-hip ratio, and skinfold thickness) during childhood and adulthood in relation to adult BP and hypertension. METHODS Data were available for 4835 participants from three prospective cohort studies. Multivariable linear regression models for adult SBP and DBP, and multivariable logistic regression models for hypertension were fit that included interaction effects between child or adult adiposity and I/D polymorphism. RESULTS Evidence for interaction effects on BP/hypertension were found across the three studies. Compared with childhood measures, the effect modification appeared to be more consistent when using adult adiposity. In particular, the adverse effects of greater adult waist circumference on increasing adult SBP and DBP appeared to be larger among carriers of ACE DD (or GG) [adjusted linear regression coefficients 0.26, 95% CI (0.21-0.31) and 0.28 (0.24-0.32) for SBP and DBP, respectively] and ID (or AG) genotypes [0.25 (0.21-0.29) and 0.25 (0.21-0.28), respectively], whereas those with II (or AA) genotypes had smaller effects [0.15 (0.09-0.21) and 0.19 (0.13-0.23)]. CONCLUSION ACE genetic variation may modify the effect of adult adiposity on increasing BP and risk of hypertension in adulthood. Individuals with ACE DD (or GG) and/or ID (or AG) genotypes, compared with those with II (or AA) genotype, appear more vulnerable to the impact of excess adiposity.
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Peng T, Pérez A, Pettee Gabriel K. The Association Among Overweight, Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey. J Manipulative Physiol Ther 2018; 41:294-303. [PMID: 29459122 DOI: 10.1016/j.jmpt.2017.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the association between obesity (via body mass index [BMI]) and presence of low back pain (LBP) in a representative sample of US adults, aged ≥18 years. METHODS This cross-sectional study used data from 32 060 respondents to the 2015 National Health Interview Survey. Body mass index (kg/m2) was calculated using reported height and weight and expressed as normal weight (<25 kg/m2), overweight (25 to <30 kg/m2), or obese (≥30 kg/m2); 3-month prevalence of reported LBP was the targeted outcome. Weighted univariate and multivariable logistic regression (adjusting for age, sex, race/ethnicity, education, and leisure-time physical activity) were performed. Interaction by sex and race/ethnicity was also explored. RESULTS Findings suggest a statistically significant association between BMI categories and LBP. The adjusted odds ratios (95% confidence interval) of LBP in overweight and obese participants were higher than those in normal weight participants: 1.21 (1.11-1.32) and 1.55 (1.44-1.67), respectively. Both sex and race/ethnicity statistically significantly modified the association between BMI and LBP. Compared with normal weight white men (reference), odds ratios (95% confidence interval) of LBP were higher among obese white men, obese white women, and obese nonwhite women (1.28 [1.10, 1.48], 1.58 [1.36, 1.84], and 1.36 [1.16, 1.60], respectively), and lower in overweight, nonwhite men, and normal weight nonwhite men and women (0.80 [0.68, 0.94], 0.62 [0.51, 0.76], and 0.73 [0.61, 0.87], respectively). CONCLUSION Overweight and obesity were associated with increased odds of LBP. However, the measures of associations varied in magnitude and direction by race and sex groups.
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Affiliation(s)
- Trent Peng
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Austin Regional Campus, Austin, Texas.
| | - Adriana Pérez
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center, Austin Regional Campus, Austin, Texas
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Austin Regional Campus, Austin, Texas; Department of Women's Health, The University of Texas at Austin, Dell Medical School, Austin, Texas
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Heuch I, Heuch I, Hagen K, Zwart JA. Physical activity level at work and risk of chronic low back pain: A follow-up in the Nord-Trøndelag Health Study. PLoS One 2017; 12:e0175086. [PMID: 28394896 PMCID: PMC5386240 DOI: 10.1371/journal.pone.0175086] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/20/2017] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity in leisure time seems to reduce the risk of low back pain, but it is not known whether occupational activity, as recorded in a representative working population, produces a higher or lower risk. Objective To study associations between physical activity level at work and risk of chronic low back pain. Methods Associations were examined in a Norwegian prospective study using data from the HUNT2 and HUNT3 surveys carried out in the whole county of Nord-Trøndelag. Participants were 7580 women and 7335 men who supplied information about physical activity level at work. Levels considered were sedentary work, work involving walking but no heavy lifting, work involving walking and heavy lifting, and particularly strenuous physical work. Nobody in the cohort was affected by chronic low back pain at baseline. After 11 years, participants reported whether they suffered from chronic low back pain. Generalized linear modelling with adjustment for potential confounders was applied to assess associations with risk factors. Results In age-adjusted analyses both women and men showed statistically significant associations between physical activity at work and risk of chronic low back pain, suggesting positive relationships. For particularly strenuous physical work the relative risk of chronic low back pain was 1.30 (95% CI: 1.00–1.71) in women and 1.36 (95% CI 1.17–1.59) in men, compared to sedentary work. Women still showed a general association with activity level after adjustment for education, leisure time physical activity, BMI, smoking and occupational category. In men, the higher risk was only maintained for particularly strenuous work. Conclusion In this cohort, women had a higher risk of chronic low back pain with work involving walking and heavy lifting or particularly strenuous work, compared to sedentary work. Men participating in particularly strenuous work also experienced a higher risk of chronic low back pain.
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Affiliation(s)
- Ingrid Heuch
- Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
- * E-mail:
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian National Headache Centre, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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Bauer C, Rast F, Ernst M, Meichtry A, Kool J, Rissanen S, Suni J, Kankaanpää M. The effect of muscle fatigue and low back pain on lumbar movement variability and complexity. J Electromyogr Kinesiol 2017; 33:94-102. [DOI: 10.1016/j.jelekin.2017.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 01/20/2017] [Accepted: 02/09/2017] [Indexed: 11/17/2022] Open
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Sheng B, Feng C, Zhang D, Spitler H, Shi L. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E183. [PMID: 28208824 PMCID: PMC5334737 DOI: 10.3390/ijerph14020183] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/03/2017] [Accepted: 01/19/2017] [Indexed: 01/02/2023]
Abstract
Background: The link between body weight status and spinal diseases has been suggested by a number of cross-sectional and cohort studies with a limited range of patient populations. No population-representative samples have been used to examine the link between obesity and spinal diseases. The present study is based on a nationally representative sample drawn from the Medical Expenditure Panel Survey. Methods: Using the cross-sectional sample of the 2014 Medical Expenditure Panel Study, we built four weighted logistic regression analyses of the associations between body weight status and the following four spinal diseases: low back pain, spondylosis, other cervical disorders and intervertebral disc disorder (IDD). Each respondent's body weight status was used as the key independent variable with three categories: normal/underweight, overweight, and obese. We controlled for marital status, gender, age, smoking status, household income, health insurance coverage, educational attainment and the use of health services for other major categories of diseases. Results: A total sample of 23,048 respondents was used in our analysis. Overweight and obese respondents, as compared to normal/underweight respondents, were more likely to develop lower back problems (Overweight: logged odds = 0.218, p < 0.01; Obese: logged odds = 0.395, p < 0.001) and IDD (Overweight: logged odds = 0.441, p < 0.05; Obese: logged odds = 0.528, p < 0.001). The associations between bodyweight status and spondylitis were statistically insignificant (Overweight: logged odds = 0.281, p = 0.442; Obese: logged odds = 0.680, p = 0.104). The associations between body weight status and other cervical disorders (Overweight: logged odds = -0.116, p = 0.304; Obese: logged odds = -0.160, p = 0.865) were statistically insignificant. Conclusions: As the first study using a national sample to study bodyweight and spinal diseases, our paper supports the hypothesis that obesity adds to the burden of low back pain and IDD. Longitudinal and interventional studies are needed to understand the specific mechanisms behind these positive associations.
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Affiliation(s)
- Binwu Sheng
- First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
| | - Chaoling Feng
- Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, NY 14853, USA.
| | - Donglan Zhang
- Department of Health Policy and Management, University of Georgia, Athens, GA 30609, USA.
| | - Hugh Spitler
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
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Zarghami A, Nazari P. Obesity: An inevitable risk factor in evaluation of Low Back Pain. J Back Musculoskelet Rehabil 2016; 30:393-394. [PMID: 27858691 DOI: 10.3233/bmr-160523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Amin Zarghami
- Department of Neurology, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Pouya Nazari
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA
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Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil 2016; 12:463-470. [PMID: 27807526 PMCID: PMC5091063 DOI: 10.12965/jer.1632650.325] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/24/2016] [Indexed: 11/26/2022] Open
Abstract
The beneficial effects of a strength exercise program and a combined exercise program of strength training plus walking were examined in overweight with chronic back pain patients. The participants were randomly placed in the strength exercise group (SEG, n=15), combined exercise group (CEG, n=15), and control group (CG, n=6). All subjects performed exercise twice per week, 50 min per session with a professional instructors for 12 weeks. In order to evaluate exercise intervention effects, lumbar function was measured by back strength and flexibility. Roland-Morris disability questionnaire (RMDQ) and visual analogue scale (VAS) were used to evaluate pain level. Fat and muscle mass were measured to compare body composition changes. All measurements were performed before and after 12 weeks of exercise program. Lumbar function: Back strength was significantly different over time, and significant time×group differences were found between SEG and CG and, CEG and CG. Pain disorder degree: VAS showed a significant group difference, and significant time×group differences were shown between SEG and CG, and CEG and CG. Also, RMDG showed a significant difference between CEG and CG. Body composition: Fat mass was significantly different over time×group between SEG and CG. In conclusion, participating in strength and walking exercises were beneficial to improve lumbar function. Also, the combined exercise program was more effective for reducing pain levels than the strength exercise. Finally, fat mass was reduced in this study and this may play a possible role in the improvement of lumbar function and reduction in low back pain.
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Affiliation(s)
- Jung-Seok Lee
- Department of Physical Education, Graduate School, Sangmyung University, Seoul, Korea
| | - Suh-Jung Kang
- Department of Sport & Health Science, College of Natural Science, Sangmyung University, Seoul, Korea
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Ghezelbash F, Shirazi-Adl A, Arjmand N, El-Ouaaid Z, Plamondon A, Meakin J. Effects of sex, age, body height and body weight on spinal loads: Sensitivity analyses in a subject-specific trunk musculoskeletal model. J Biomech 2016; 49:3492-3501. [DOI: 10.1016/j.jbiomech.2016.09.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 02/02/2023]
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Wasser JG, Vasilopoulos T, Zdziarski LA, Vincent HK. Exercise Benefits for Chronic Low Back Pain in Overweight and Obese Individuals. PM R 2016; 9:181-192. [PMID: 27346092 DOI: 10.1016/j.pmrj.2016.06.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 06/09/2016] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
Abstract
Overweight and obese individuals with chronic low back pain (LBP) struggle with the combined physical challenges of physical activity and pain interference during daily life; perceived disability increases, pain symptoms worsen, and performance of functional tasks and quality of life (QOL) decline. Consistent participation in exercise programs positively affects several factors including musculoskeletal pain, perceptions of disability due to pain, functional ability, QOL, and body composition. It is not yet clear, however, what differential effects occur among different easily accessible exercise modalities in the overweight-obese population with chronic LBP. This narrative review synopsizes available randomized and controlled, or controlled and comparative, studies of easily accessible exercise programs on pain severity, QOL, and other outcomes, such as physical function or body composition change, in overweight-obese persons with chronic LBP. We identified 16 studies (N = 1,351) of various exercise programs (aerobic exercise [AX], resistance exercise [RX], aquatic exercise [AQU], and yoga-Pilates) that measured efficacy on LBP symptoms, and at least one other outcome such as perceived disability, QOL, physical function, and body composition. RX, AQU, and Pilates exercise programs demonstrated the greatest effects on pain reduction, perceived disability, QOL, and other health components. The highest adherence rate occurred with RX and AQU exercise programs, indicating that these types of programs may provide a greater overall impact on relevant outcomes for overweight-obese LBP patients. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Joseph G Wasser
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL∗
| | - Terrie Vasilopoulos
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(†)
| | - Laura Ann Zdziarski
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(‡)
| | - Heather K Vincent
- Department of Orthopedics and Rehabilitation, Division of Research, UF Orthopaedics and Sports Medicine Institute (OSMI), PO Box 112727, Gainesville, FL 32611(§).
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