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Guan J, Liu T, Gao G, Yang K, Liang H. Associations between lifestyle-related risk factors and back pain: a systematic review and meta-analysis of Mendelian randomization studies. BMC Musculoskelet Disord 2024; 25:612. [PMID: 39090551 PMCID: PMC11293147 DOI: 10.1186/s12891-024-07727-0] [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: 11/15/2023] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Mendelian randomization (MR) studies have an advantage over conventional observational studies when studying the causal effect of lifestyle-related risk factors on back pain. However, given the heterogeneous design of existing MR studies on back pain, the reported causal estimates of these effects remain equivocal, thus obscuring the true extent of the biological effects of back pain lifestyle-risk factors. PURPOSE The purpose of this study was to conduct a systematic review with multiple meta-analyses on the associations between various lifestyle factors and low back pain. METHODS We conducted a PRISMA systematic review and specifically included MR studies to investigate the associations between lifestyle factors-specifically, BMI, insomnia, smoking, alcohol consumption, and leisure sedentary behavior-and various back pain outcomes. Each meta-analysis synthesized data from three or more studies to assess the causal impact of these exposures on distinct back pain outcomes, including chronic pain, disability, and pain severity. Quality of studies was assessed according to STROBE-MR guidelines. RESULTS A total of 1576 studies were evaluated and 20 were included. Overall, the studies included were of high quality and had a low risk of bias. Our meta-analysis demonstrates the positive causal effect of BMI (OR IVW-random effects models: 1.18 [1.08-1.30]), insomnia(OR IVW-random effects models: 1.38 [1.10-1.74]), smoking(OR IVW-fixed effects models: 1.30 [1.23-1.36]), alcohol consumption(OR IVW-fixed effects models: 1.31 [1.21-1.42]) and leisure sedentary behaviors(OR IVW-random effects models: 1.52 [1.02-2.25]) on back pain. CONCLUSION In light of the disparate designs and causal effect estimates presented in numerous MR studies, our meta-analysis establishes a compelling argument that lifestyle-related risk factors such as BMI, insomnia, smoking, alcohol consumption, and leisure sedentary behaviors genuinely contribute to the biological development of back pain.
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Affiliation(s)
- Jianbin Guan
- Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China
| | - Tao Liu
- Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China
| | - Ge Gao
- Yan'an Medical University, Yan'an, 716099, China
| | - Kaitan Yang
- Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China
- Trauma Rehabilitation Department, Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China
| | - Haohao Liang
- Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China.
- Trauma Rehabilitation Department, Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China.
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Esparham A, Mehri A, Maher W, Khorgami Z. Impact of opioid-related disorders on complications in patients undergoing bariatric surgery: a propensity score-matched analysis of the national inpatient sample. Surg Endosc 2024:10.1007/s00464-024-11057-6. [PMID: 39085669 DOI: 10.1007/s00464-024-11057-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/06/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND The opioid crisis caused a huge health concern in the United States. Despite this, few studies have examined the influence of opioid-related disorders (OD) on outcomes after bariatric surgery. The major goal of this study is to determine the impact of OD on in-hospital outcomes for patients undergoing bariatric surgery. METHOD The National Inpatient Sample (NIS) database from 2016 to 2020 was used to evaluate patients with OD who underwent bariatric operations including sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. The non-OD comparison group was created using a propensity score match (1:1). Weighted analysis was carried out utilizing NIS-provided weights. The odds ratios were obtained using multivariate logistic regression. RESULTS A total of 159,455 patients who underwent bariatric surgery were evaluated. Propensity score matching and weighted analysis were used to compare 11,025 in the OD group and 11,025 in the non-OD group. OD was an independent predictor for postoperative complications (odds ratio: 1.29, 95% confidence interval: 1.19-1.39, p < 0.001). Among complications, OD was a predictor for bleeding complications, postoperative nausea and vomiting, anastomotic leak, and mechanical ventilation. In addition, the OD group experienced significantly longer lengths of stay (LOS) and a higher total hospital charges. CONCLUSION In patients undergoing bariatric surgery, OD is associated with a significantly higher risk of postoperative complications, as well as increased LOS and total hospital charges. These patients may benefit from further preoperative optimization, including decreasing the opioid dose and closer postoperative monitoring.
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Affiliation(s)
- Ali Esparham
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Mehri
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - William Maher
- Department of Surgery, University of Oklahoma College of Community Medicine, 1919 S. Wheeling Avenue, Suite 600, Tulsa, OK, 74104-5638, USA
| | - Zhamak Khorgami
- Department of Surgery, University of Oklahoma College of Community Medicine, 1919 S. Wheeling Avenue, Suite 600, Tulsa, OK, 74104-5638, USA.
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Kudchadkar G, Akinsiku O, Hefner M, Ozioma PU, Booe H, Dhurandhar NV. Shedding the weight of exercise for obesity management. Int J Obes (Lond) 2024:10.1038/s41366-024-01527-1. [PMID: 38693211 DOI: 10.1038/s41366-024-01527-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Gaurav Kudchadkar
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, 79409, USA
| | - Oluwatosin Akinsiku
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, 79409, USA
| | - Marleigh Hefner
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, 79409, USA
| | | | - Holli Booe
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, 79409, USA.
| | - Nikhil V Dhurandhar
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, 79409, USA.
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Davis ME, Blake C, O’Donoghue G. Comparison of time-matched aerobic, resistance or combined exercise training in women living with obesity: The EXOFFIT study. Obes Sci Pract 2024; 10:e749. [PMID: 38567266 PMCID: PMC10986633 DOI: 10.1002/osp4.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/01/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
Background Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date, literature on women with obesity has focused upon the evaluation of aerobic-based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort. Objective This study aimed to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes. Methods Sixty-seven women with obesity were randomly assigned to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups were trained x3 times/week for 12 weeks (up to 150-min/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass) and strength (5RM bench press, leg dynamometry, grip strength) and self-reported measures of physical activity, mood, sleep, pain and quality of life. Results Findings support the feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including body mass index (Effect size [ES] = 0.79, p = 0.04), BW (ES = 0.75, p = 0.05), %BF (ES = 0.77, p = 0.04), FM (ES = 0.83, p = 0.03) and WC (ES = 0.90, p = 0.02), physical activity (i.e., moderate physical activity [ES = 0.69, p = 0.07), mood (ES = 0.83, p = 0.03) and sleep (ES = 0.78, p = 0.04). Resistance was most promising for CRF (ES = 1.47, p = 0.002), strength (i.e., bench press [ES = 2.88, p=<0.001]) and pain (i.e., pain severity [ES = 0.40, p = 0.31]). Conclusions For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements. CLINICAL TRIAL REGISTRATION ISRCTN13517067.
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Affiliation(s)
- Mary E. Davis
- School of Public Health, Physiotherapy and Sports ScienceHealth Sciences BuildingUniversity College DublinDublinIreland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports ScienceHealth Sciences BuildingUniversity College DublinDublinIreland
| | - Gráinne O’Donoghue
- School of Public Health, Physiotherapy and Sports ScienceHealth Sciences BuildingUniversity College DublinDublinIreland
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5
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Tang HB, Jalil NIBA, Tan CS, He L, Zhang SJ. Why more successful? An analysis of participants' self-monitoring data in an online weight loss intervention. BMC Public Health 2024; 24:322. [PMID: 38287333 PMCID: PMC10826064 DOI: 10.1186/s12889-024-17848-9] [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: 07/11/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Self-monitoring is crucial for behavioral weight loss. However, few studies have examined the role of self-monitoring using mixed methods, which may hinder our understanding of its impact. METHODS This study examined self-monitoring data from 61 Chinese adults who participated in a 5-week online group intervention for weight loss. Participants reported their baseline Body Mass Index (BMI), weight loss motivation, and engaged in both daily quantitative self-monitoring (e.g., caloric intake, mood, sedentary behavior, etc.) and qualitative self-monitoring (e.g., daily log that summarizes the progress of weight loss). The timeliness of participants' daily self-monitoring data filling was assessed using a scoring rule. One-way repeated measurement ANOVA was employed to analyze the dynamics of each self-monitoring indicator. Correlation and regression analyses were used to reveal the relationship between baseline data, self-monitoring indicators, and weight change. Content analysis was utilized to analyze participants' qualitative self-monitoring data. Participants were categorized into three groups based on their weight loss outcomes, and a chi-square test was used to compare the frequency distribution between these groups. RESULTS After the intervention, participants achieved an average weight loss of 2.52 kg (SD = 1.36) and 3.99% (SD = 1.96%) of their initial weight. Daily caloric intake, weight loss satisfaction, frequency of daily log, and the speed of weight loss showed a downward trend, but daily sedentary time gradually increased. Moreover, regression analysis showed that baseline BMI, weight loss motivation, and timeliness of daily filling predicted final weight loss. Qualitative self-monitoring data analysis revealed four categories and nineteen subcategories. A significant difference in the frequency of qualitative data was observed, with the excellent group reporting a greater number of daily logs than expected in all categories and most subcategories, and the moderate and poor groups reporting less than expected in all categories and most subcategories. CONCLUSION The self-monitoring data in short-term online group intervention exhibited fluctuations. Participants with higher baseline BMI, higher levels of weight loss motivation, and timely self-monitoring achieved more weight loss. Participants who achieved greater weight loss reported a higher quantity of qualitative self-monitoring data. Practitioners should focus on enhancing dieters' weight loss motivation and promote adherence to self-monitoring practices.
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Affiliation(s)
- Hai-Bo Tang
- Faculty of Education, Yibin University, Yibin, 644000, China.
- Department of Psychology and Counselling, Universiti Tunku Abdul Rahman, Kampar, 31900, Malaysia.
| | | | - Chee-Seng Tan
- School of Psychology, College of Liberal Arts Wenzhou-Kean University, Wenzhou, Zhejiang province, 325060, China
| | - Ling He
- Faculty of Education, Yibin University, Yibin, 644000, China
- Department of Psychology and Counselling, Universiti Tunku Abdul Rahman, Kampar, 31900, Malaysia
| | - Shu-Juan Zhang
- , Sichuan Tianfu New District No. 3 Middle School, Chengdu, 610213, China
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Zhou M, Lu C, Yuan F. A Cross-Sectional Survey of Physicians' Knowledge and Awareness of Chronic Pain Associated with Rheumatoid Arthritis in Rheumatology Departments in Zhejiang Province, China. Int J Gen Med 2023; 16:5281-5288. [PMID: 38021058 PMCID: PMC10656835 DOI: 10.2147/ijgm.s432366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To assess physicians' knowledge and awareness of chronic pain associated with rheumatoid arthritis (RA) in Rheumatology departments throughout Zhejiang province to improve chronic pain relief in RA patients. Methods A cross-sectional questionnaire survey was conducted onsite and online among rheumatologists in tertiary and secondary hospitals across Zhejiang province, China. The questionnaire inquired about rheumatoid arthritis-related pain cognition, pain assessment, pain management protocols, and medication choice. Results Among the 150 questionnaires included, 98 were from tertiary hospitals, and 52 were from secondary hospitals. There was no difference in rheumatologists' perceptions of chronic pain in RA patients between tertiary and secondary hospitals. About 55.1% of rheumatologists from tertiary hospitals and 44.2% of rheumatologists from secondary hospitals utilized unstandardized pain assessment scales. About 46.9% of rheumatologists in tertiary hospitals and 36.5% of rheumatologists in secondary hospitals favored the numerical rating scale (NRS). About 87.8% of rheumatologists in tertiary hospitals and 71.7% of rheumatologists in secondary hospitals conducted pain assessment within 4 hours of admission. About 66.3% of rheumatologists working in tertiary hospitals and 32.7% of rheumatologists practicing in secondary hospitals believed their hospitals had pain departments. For RA patients who complained of pain for the first time, secondarily, or repeatedly, 48%, 26%, and 36.7% of rheumatologists preferred nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and opioid analgesics, respectively. For RA patients with mild, moderate, or severe pain, 74%, 6%, and 16% of rheumatologists preferred NSAIDs, glucocorticoids, and opioid analgesics, respectively. Conclusion The assessment and treatment of chronic pain associated with RA are not standardized. For management, more rheumatologists preferred NSAIDs and glucocorticoids.
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Affiliation(s)
- Meiju Zhou
- Department of Rheumatology and Immunology, Zhejiang Hospital, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Ci Lu
- Department of Rheumatology and Immunology, Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Fang Yuan
- Department of Rheumatology and Immunology, Zhejiang Hospital, Hangzhou, Zhejiang Province, People’s Republic of China
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7
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Curran F, Davis ME, Murphy K, Tersigni N, King A, Ngo N, O'Donoghue G. Correlates of physical activity and sedentary behavior in adults living with overweight and obesity: A systematic review. Obes Rev 2023; 24:e13615. [PMID: 37549689 DOI: 10.1111/obr.13615] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 04/01/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Abstract
Overweight and obesity are consistently associated with lower physical activity (PA) levels and greater sedentary behavior (SB) in population studies. To date, no review has evaluated the factors associated with these behaviors in the specific population who have developed obesity/overweight. The aim of this systematic review was to identify the correlates/determinants of SB and PA in adults with overweight and obesity. Five databases were searched for studies, which reported factors or outcomes relating to PA or SB in adults living with overweight/obesity, published from 1980 to 2021. The factors were categorized using a socioecological model, strength, and direction of association. Of 34,058 articles retrieved, 45 studies were included, and 155 factors were identified. Self-efficacy, intrinsic motivation, exercise enjoyment, self-perceived good health, and social support were consistently associated with higher levels of PA. Consistent negative correlations were married females, increased BMI, obesity severity, pain, number of comorbidities, lack of time, energy, and willpower, and hilly terrain. Few studies (n = 12) examined SB, and no evidence for consistent associations were found. This review identified several correlates specific to PA in this population. Further studies are required to identify directionality and distal correlates for PA and all correlate levels of SB.
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Affiliation(s)
- Fiona Curran
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Mary E Davis
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Kaitlyn Murphy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Natasha Tersigni
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Adam King
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nina Ngo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Gráinne O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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8
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Storm E, Bendelin N, Wessman KB, Johansson MM, Björk M, Dong HJ. Lifestyle changes are burdensome with my body broken by pain and obesity: patients' perspectives after pain rehabilitation. BMC Musculoskelet Disord 2023; 24:840. [PMID: 37880642 PMCID: PMC10599046 DOI: 10.1186/s12891-023-06961-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Despite the existing evidence regarding the interrelated relationship between pain and obesity, knowledge about patients' perspectives of this relationship is scarce, especially from patients with chronic pain and obesity after completing Interdisciplinary Pain Rehabilitation Program (IPRP). AIMS This qualitative study expands the understanding of patients' perspectives on how chronic pain and obesity influence each other and how the two conditions affect the ability to make lifestyle changes. METHOD A purposive sample of patients with Body Mass Index (BMI) ≥ 30 kg/m2 and who had completed an IPRP were recruited for individual semi-structured interviews. The transcribed interviews were analysed using latent content analysis and a pattern of theme and categories was constructed based on the participants' perspectives. RESULTS Sixteen patients (aged 28-63 years, 11 female, BMI 30-43 kg/m2) shared their experiences of chronic pain, obesity and lifestyle changes after IPRP. The analysis revealed one overall theme (lifestyle changes are burdensome with a body broken by both pain and obesity) and four categories (pain disturbing days and nights worsens weight control, pain-related stress makes lifestyle changes harder, a painful and obese body intertwined with negative emotions and the overlooked impact of obesity on chronic pain). Most participants perceived that their pain negatively impacted their obesity, but they were uncertain whether their obesity negatively impacted their pain. Nevertheless, the participants desired and struggled to make lifestyle changes. CONCLUSION After IPRP, patients with chronic pain and obesity perceived difficulties with self-management and struggles with lifestyle changes. They experienced a combined burden of the two conditions. Their perspective on the unilateral relationship between pain and obesity differed from the existing evidence. Future tailored IPRPs should integrate nutritional interventions and address the knowledge gaps as well.
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Affiliation(s)
- Elin Storm
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Nina Bendelin
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kim Bergström Wessman
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Maria M Johansson
- Department of Activity and Health in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
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Edwards SA, Martin SL, Rainey T, Whitaker G, Greenwood DC, Jones A, Sivan M. Influence of acute fasting on pain tolerance in healthy subjects: a randomised crossover study. FRONTIERS IN PAIN RESEARCH 2023; 4:1153107. [PMID: 37753146 PMCID: PMC10518402 DOI: 10.3389/fpain.2023.1153107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
Background Although chronic pain and obesity are global health crises with substantial healthcare costs, little is known about the relationship between pain perception and eating behaviours. Food consumption has been reported to provide an analgesic effect by the release of neurotransmitters modulating the pain network. However, whether short-term (acute) fasting affects pain perception remains unclear. Purpose This study aimed to investigate the effect of acute fasting on pain perception and whether attention and mood changes drove the observed changes. Patients and methods The cold pressor test (CPT) was used to investigate the pain tolerance of 25 healthy participants in both non-fasting and 12-h fasting sessions. They were randomised to either session with a crossover to the other after at least 24 h, with the experimenter blinded to the sessions. The pain tolerance was measured using a Stroop task in both attentive and distracted states. The Profile of Mood States (POMS) questionnaire was used to capture the mood, and a 10-point hunger scale was used to measure hunger. Mixed-effects models were used to investigate the influence of fasting and distraction on pain perception, accounting for the repeated measures. Results Fasting reduced CPT pain tolerance, with fasting participants twice as likely to withdraw their hands early (hazard ratio = 2.4, 95% CI: 1.3-4.5). Though men tolerated CPT pain longer than women, there was no evidence that men responded to fasting differently than women (p = 0.9). In addition, no evidence supporting that fasting affected attention or mood was found. Nonetheless, it increased hunger scores by 2.7 points on a 10-point scale (95% CI: 1.2-4.2) and decreased blood glucose concentration levels by 0.51 mmol/L (95% CI: 0.19-0.84). Conclusion Acute fasting reduces pain tolerance in the healthy participants, and this effect is independent of gender and attention or mood changes.
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Affiliation(s)
- Sophie A. Edwards
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Sarah L. Martin
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Timothy Rainey
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Grace Whitaker
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaiso, Valparaiso, Chile
| | - Darren C. Greenwood
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Anthony Jones
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Manoj Sivan
- The Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- Leeds Institute of Rheumatology and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
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10
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Andersson MLE, Thorén E, Sylwander C, Bergman S. Associations between chronic widespread pain, pressure pain thresholds, leptin, and metabolic factors in individuals with knee pain. BMC Musculoskelet Disord 2023; 24:639. [PMID: 37559026 PMCID: PMC10410998 DOI: 10.1186/s12891-023-06773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE The aim was to study associations between chronic widespread pain, widespread pain sensitivity, leptin, and metabolic factors in individuals with knee pain. A secondary aim was to study these associations in a subgroup of individuals with normal BMI. METHOD This cross-sectional study included 265 individuals. The participants were categorised into three different pain groups: Chronic widespread pain (CWP), chronic regional pain (ChRP), or no chronic pain (NCP). The pressure pain thresholds (PPTs) were assessed using computerised pressure algometry. Low PPTs were defined as having PPTs in the lowest third of all tender points. Leptin and metabolic factors such as BMI, visceral fat area (VFA), lipids, and glucose were also assessed. RESULT Sixteen per cent reported CWP, 15% had low PPTs, and 4% fulfilled both criteria. Those who fulfilled the criteria for CWP were more often women, more obese, and had increased leptin levels. In logistic regression, adjusted for age and gender, leptin was associated with fulfilling criteria for CWP, OR 1.015 (95% CI 1.004-1.027, p = 0.008). In logistic regression, adjusted for age and gender, leptin was associated with low PPTs, OR 1.016 (95% CI 1.004-1.029, p = 0.012). Leptin was also associated with fulfilling both criteria, adjusted for age, sex, and visceral fat area (VFA), OR 1.030 (95% CI 1.001-1.060), p = 0.040. CONCLUSION Leptin was associated with fulfilling the combined criteria for chronic widespread pain and low PPTs, even after adjusting for the visceral fat area (VFA). Longitudinal studies are needed to study the causal relationships between leptin and the development of widespread pain. TRIAL REGISTRATION clinicalTrials.gov Identifier: NCT04928170.
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Affiliation(s)
- Maria L E Andersson
- Spenshult Research and Development Centre, Halmstad, Sweden.
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
- School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden.
| | - Emelie Thorén
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Charlotte Sylwander
- Spenshult Research and Development Centre, Halmstad, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Centre, Halmstad, Sweden
- Primary Health Care Unit, Department of Public Health and Community Medicine, Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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11
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Afunugo WE, Li CY, Chou LN, Ward F, Snih SA. Pain, obesity, and physical function in Mexican American older adults during 20 years of follow-up. PM R 2023; 15:331-341. [PMID: 35322569 PMCID: PMC9500111 DOI: 10.1002/pmrj.12805] [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: 09/09/2021] [Revised: 02/18/2022] [Accepted: 03/16/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Pain remains largely undertreated in older adults irrespective of health care setting. Mexican American adults in the United States have a high age-adjusted prevalence of obesity. However, the association of pain and obesity with physical function is understudied in this population. OBJECTIVE To examine the association of co-occurring pain and obesity with physical function over 20 years of follow-up in a cohort of older Mexican Americans who scored ≥7 (moderate to high) in the Short Physical Performance Battery (SPPB) test and were nondisabled at baseline. DESIGN Longitudinal population-based study. SETTING Community-dwelling older adults from Southwestern United States. PARTICIPANTS Mexican American adults age 65 years and older. INTERVENTIONS Not Applicable. MAIN OUTCOME MEASURES Physical function was assessed with the SPPB test (standing balance, timed 8-ft walk, and five repeated timed chair stands). Participants at baseline were divided into four groups: no pain-no obesity (n = 869), obesity only (n = 282), pain only (n = 216), and pain-obesity (n = 159). Generalized Estimating Equation models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) of lower performance in physical function over 20 years as a function of pain-obesity grouping. RESULTS Participants with pain only (OR = 1.61, 95% CI = 1.34-1.95) and with co-occurring pain and obesity (OR = 2.32, 95% CI = 1.83-2.95) had significantly greater odds of physical function impairment over those with no pain-no obesity or obesity only, after controlling for all covariates. CONCLUSION Older Mexican American adults were at high risk for physical function impairment over time if they had pain or co-occurring pain and obesity. Early assessment and proper pain management as well as maintaining a healthy weight may reduce declines in physical function in older Mexican American adults.
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Affiliation(s)
- Wilma E. Afunugo
- School of Medicine. The University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy. The University of Texas Medical Branch, Galveston, TX, USA
| | - Lin-Na Chou
- Department of Preventive Medicine and Population Health. The University of Texas Medical Branch, Galveston, TX, USA
| | - Frank Ward
- Department of Nutrition, Metabolism, and Rehabilitation Sciences. The University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Nutrition, Metabolism, and Rehabilitation Sciences. The University of Texas Medical Branch, Galveston, TX, USA
- Division of Geriatrics & Palliative Medicine/Department of Internal Medicine. The University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging. The University of Texas Medical Branch, Galveston, TX, USA
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12
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Amiri S. The effect of exercise on health-related quality of life in persons with musculoskeletal pain: A meta-analysis of randomised control trials. Musculoskeletal Care 2022; 20:812-820. [PMID: 35686507 DOI: 10.1002/msc.1659] [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: 05/06/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Exercise has positive effects on musculoskeletal pain. In this project, the impact of exercise was studied on improving health-related quality of life in persons with musculoskeletal pain. METHOD The study design was a systematic review and meta-analysis. A search was conducted to find original studies in four sources, including PubMed, Web of Science, the Cochrane Library and Scopus, and this search was limited to the original articles published until April 2021, which were in English. For each study, the effect size was calculated. The analysis was based on the random-effects method. RESULT Twenty-Seven randomised control trial studies were included in the meta-analysis. The total population of participants in the meta-analysis was 1927 persons. Exercise improves health-related quality of life in these persons and the hedges' g was 0.66 (95% CI = 0.38-0.94; I2 = 88.29%). DISCUSSION Overall, based on the findings, exercise is associated with improving the health-related quality of life of persons with musculoskeletal pain, and therefore the health implications of this finding are beneficial to the general population and professionals.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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13
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Elma Ö, Brain K, Dong HJ. The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review. J Clin Med 2022; 11:jcm11195950. [PMID: 36233817 PMCID: PMC9571356 DOI: 10.3390/jcm11195950] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one’s dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Correspondence:
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14
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LaRowe LR, Williams DM. Activity-induced pain as a predictor of physical activity behavior among individuals with chronic pain: the role of physical activity enjoyment. J Behav Med 2022; 45:632-642. [PMID: 35501540 PMCID: PMC9308740 DOI: 10.1007/s10865-022-00318-1] [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: 09/13/2021] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
Nearly 70% of adults with chronic pain experience increased pain during activity, and this may reduce enjoyment of physical activity (PA), and subsequent PA intention/behavior. The goal of this study was to examine increased pain during activity as a predictor of PA, via its effects on PA enjoyment. Participants included 178 overweight/obese midlife adults with chronic pain who completed an online prospective survey. Results indicated that greater increases in pain during activity were associated with less PA enjoyment, and, in turn, lower intention to exercise over the next week (p < 0.05). Activity-induced pain also predicted lower total volume of PA at 1-week follow-up, and this relationship was mediated by PA enjoyment (p < 0.05). These findings have the potential to inform the refinement of PA promotion interventions for individuals with chronic pain.
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Affiliation(s)
- Lisa R LaRowe
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
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15
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Huang J, Xu Y, Xuan R, Baker JS, Gu Y. A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis. Front Psychol 2022; 13:886015. [PMID: 35846681 PMCID: PMC9277051 DOI: 10.3389/fpsyg.2022.886015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objective This systematic review aims to make a mixed comparison of interventions for kinesiophobia and individuals with musculoskeletal pain. Methods A comprehensive search strategy was conducted in the database of PubMed, MEDLINE, and Web of Science with the inclusion criteria: (1) randomized controlled design; (2) patients with musculoskeletal pain as participants; (3) treatments protocols of kinesiophobia as interventions or comparisons; (4) the score of Tampa Scale Kinesiophobia (TSK) as outcome measures. A network meta-analysis was used to synthesize the data after checking the model consistency. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Assessment Tool. Results Thirty-one studies were included in this review after a comprehensive search strategy with a low risk of bias and good consistency. According to the results of the network meta-analysis, a multi-modal treatment protocol had the highest probability to become the best choice in dealing with kinesiophobia caused by musculoskeletal pain, whereas psychological treatment protocols also showed a potentially positive effect on musculoskeletal pain-induced kinesiophobia. Conclusion Multi-modal protocols could be recommended as the preferred option when dealing with kinesiophobia caused by musculoskeletal pain. However, it is still worth mentioning that there are also potentially positive therapeutic effects of psychological interventions. Since the concept of kinesiophobia is based on the fear-avoidance model, the psychological mechanism should be paid enough attention to during treatment. Registration Number CRD42021286450.
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Affiliation(s)
- Jialu Huang
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yining Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Rongrong Xuan
- The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Julien S. Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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16
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Davis ME, Blake C, Cunningham C, Carson BP, O’Donoghue G. Comparison of time-matched aerobic, resistance or combined exercise training in women living with obesity: a protocol for a pilot randomised controlled trial-the EXOFFIT (Exercise for Obesity in Females to increase Fitness) study. Pilot Feasibility Stud 2022; 8:42. [PMID: 35189970 PMCID: PMC8862268 DOI: 10.1186/s40814-022-01003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/09/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Obesity in women has more than doubled in the past thirty years. Increasing research suggests that increased cardiorespiratory fitness (CRF) can largely attenuate the negative health risks associated with obesity. Though previous literature suggests that combined training may be the most effective for improving CRF in adults with obesity, there is minimal research investigating the efficacy of combined and resistance programmes in women with obesity. This article outlines a protocol for a parallel pilot study which aims to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for increasing CRF and strength and improving body composition and other health outcomes (i.e. quality of life). METHODS AND ANALYSIS Sixty women (aged 18-50) with obesity (body mass index [BMI] ≥ 30 and/or waist circumference ≥ 88 cm) who are physically inactive, have no unstable health conditions and are safe to exercise will be recruited from September 2021 to December 2022. The main outcome will be feasibility and acceptability of the intervention and procedures. Trial feasibility outcomes will be evaluated to determine if a definitive trial should be undertaken. Trial acceptability will be explored through follow-up qualitative interviews with participants. Secondary outcomes will include CRF (predicted VO2 max), anthropometrics (i.e. BMI), strength (5RM bench press, leg dynamometry, grip strength) and other health outcomes (i.e., pain). Participants will be block randomised into one of four trial arms (aerobic exercise, resistance training and combined training groups, non-active control group) and measurements will be completed pre- and post-intervention. The exercise groups will receive an individualised supervised exercise programme for 3× sessions/week for 12 weeks. The change in mean values before and after intervention will be calculated for primary and secondary outcomes. ANOVA and t-tests will be applied to evaluate within-group and between-group differences. If sufficient participants are recruited, the data will be analysed using ANCOVA with the age and BMI as covariates. DISCUSSION This pilot will provide data on the feasibility and acceptability of trial procedures and of the programmes' three progressive time-matched exercise interventions (aerobic, resistance and combined) for women living with obesity, which will help inform future research and the potential development of a full-scale randomised clinical trial. TRIAL REGISTRATION ISRCTN, ISRCTN13517067 . Registered 16 November 2021-retrospectively registered.
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Affiliation(s)
- Mary E. Davis
- Department: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland D04 V1W8
| | - Catherine Blake
- Department: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland D04 V1W8
| | - Caitriona Cunningham
- Department: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland D04 V1W8
| | - Brian P. Carson
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Gráinne O’Donoghue
- Department: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland D04 V1W8
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17
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Seyed MA, Mohamed SHP. Low Back Pain: A Comprehensive Review on the Diagnosis, Treatment Options, and the Role of Other Contributing Factors. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: In recent years, low back pain (LBP) is a growing major health issue around the world and mostly addressed in primary healthcare settings. This may be due to changing work environment including the nature of long sitting work hours, especially in the booming information and technology (IT) and Business Process Outsourcing (BPO) industry. LBP is normally considered as a combination of various types of pain and its related conditions, which eventually lead to disabilities.
AIM: In this article, the aim is to discuss the current and future perspectives of LBP mainly on diagnosis and therapeutic front of LBP.
METHODS: A search was performed using electronic databases, which include PubMed Central and Google Scholar, using the related key words “back pain and low back pain.” All related peer reviewed published articles were included regardless of the language, region, or the publication date.
RESULTS: Although the management of LBP both in terms of diagnosis as well as in the therapeutic options has witnessed considerable progress but challenges are still exist not only within countries but also in the regions and continents among various medical professionals. However, in the past few years, a huge array of coordinated but randomized multi-center clinical studies were performed and various detailed insight investigations have been done, and substantial clinical guidelines have become available. Hence, a new view on evidence-based management approach for LBP has significantly improved recently and discussed here.
CONCLUSION: Based on the available evidence and literature, this comprehensive review discusses the present and future perspectives of LBP mainly on diagnosis and therapeutic front for LBP. In addition, current intervention and prevention plans have failed to lessen the considerable burden of LBP and hence several areas which require more details, which deserves additional discussion to augment us through an understanding of this very important topic on improvements of multi tasked outcomes to benefit the affected patients.
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18
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Baillot A, Chenail S, Barros Polita N, Simoneau M, Libourel M, Nazon E, Riesco E, Bond DS, Romain AJ. Physical activity motives, barriers, and preferences in people with obesity: A systematic review. PLoS One 2021; 16:e0253114. [PMID: 34161372 PMCID: PMC8221526 DOI: 10.1371/journal.pone.0253114] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 05/30/2021] [Indexed: 12/28/2022] Open
Abstract
Background Although the benefits of physical activity (PA) are well known, physical inactivity is highly prevalent among people with obesity. The objective of this systematic review was to i) appraise knowledge on PA motives, barriers, and preferences in individuals with obesity, and ii) quantify the most frequently reported PA motives, barriers and preferences in this population. Methods Six databases (Pubmed, CINAHL, Psyarticle, SportDiscus, Web of science and Proquest) were searched by independent reviewers to identify relevant quantitative or qualitative articles reporting PA motives, barriers or preferences in adults with body mass index ≥ 30 kg/m2 (last searched in June 2020). Risk of bias for each study was assessed by two independent reviewers with the Mixed Methods Appraisal Tool (MMAT). Results From 5,899 papers identified, a total of 27 studies, 14 quantitative, 10 qualitative and 3 mixed studies were included. About 30% of studies have a MMAT score below 50% (k = 8). The three most reported PA motives in people with obesity were weight management, energy/physical fitness, and social support. The three most common PA barriers were lack of self-discipline/motivation, pain or physical discomfort, and lack of time. Based on the only 4 studies available, walking seems to be the preferred mode of PA in people with obesity. Conclusions Weight management, lack of motivation and pain are key PA motives and barriers in people with obesity, and should be addressed in future interventions to facilitate PA initiation and maintenance. Further research is needed to investigate the PA preferences of people with obesity.
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Affiliation(s)
- Aurélie Baillot
- Department of Nursing, University of Québec en Outaouais, Gatineau, QC, Canada
- Institut du savoir Montfort-Recherche, Ottawa, ON, Canada
- Centre de recherche du Centre Intégré de Santé et Services Sociaux de l’Outaouais, Gatineau, QC, Canada
- * E-mail:
| | | | - Naiara Barros Polita
- Department of Nursing, State University of Northern Paraná, Bandeirantes, PR, Brazil
| | - Mylène Simoneau
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Mathilde Libourel
- Faculty of Physical Activity Sciences, University of Sherbrooke and Research Center on Aging, CIUSSS de l’Estrie–CHUS, Sherbrooke, QC, Canada
- Institut des Sciences et Industries du vivant et de l’environnement, AgroParisTech, Paris, France
| | - Evy Nazon
- Department of Nursing, University of Québec en Outaouais, Gatineau, QC, Canada
| | - Eléonor Riesco
- Faculty of Physical Activity Sciences, University of Sherbrooke and Research Center on Aging, CIUSSS de l’Estrie–CHUS, Sherbrooke, QC, Canada
| | - Dale S. Bond
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI, United States of America
| | - Ahmed J. Romain
- Faculty of Medicine, School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
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Dong HJ, Dragioti E, Rivano Fischer M, Gerdle B. Lose Pain, Lose Weight, and Lose Both: A Cohort Study of Patients with Chronic Pain and Obesity Using a National Quality Registry. J Pain Res 2021; 14:1863-1873. [PMID: 34188533 PMCID: PMC8232849 DOI: 10.2147/jpr.s305399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/14/2021] [Indexed: 01/07/2023] Open
Abstract
Background It is known that chronic pain makes it difficult to lose weight, but it is unknown whether obese patients (body mass index ≥30 kg/m2) who experience significant pain relief after interdisciplinary multimodal pain rehabilitation (IMMPR) lose weight. Objective This study investigated whether obese patients with chronic pain lost weight after completing IMMPR in specialist pain units. The association of pain relief and weight change over time was also examined. Methods Data from obese patients included in the Swedish Quality Registry for Pain Rehabilitation for specialized pain units were used (N=224), including baseline and 12-month follow-up after IMMPR from 2016 to 2018. Patients reported body weight and height, pain aspects (eg, pain intensity), physical activity behaviours, psychological distress, and health-related quality of life (HRQoL). A reduction of at least 5% of initial weight indicates clinically significant weight loss. Patients were classified into three groups based on the pain relief levels after IMMPR: pain relief of clinical significance (30% or more reduction of pain intensity); pain relief without clinical significance (less than 30% reduction of pain intensity); and no pain relief. Linear mixed regression models were used to examine the weight changes among the groups with different pain relief levels. Results A significant reduction of pain intensity was found after IMMPR (p < 0.01, effect size Cohen’s d = 0.34). A similar proportion of patients in the three groups with different pain relief levels had clinically significant weight loss (20.2%~24.3%, p = 0.47). Significant improvements were reported regarding physical activity behaviour, psychological distress, and HRQoL, but weight change was not associated with changes of pain intensity. Conclusion About one-fifth of obese patients achieved significant weight reduction after IMMPR. Obese patients need a tailored pain rehabilitation program incorporating a targeted approach for weight management.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Elena Dragioti
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Health Sciences, Research Group Rehabilitation Medicine, Lund University, Lund, Sweden.,Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Varallo G, Giusti EM, Scarpina F, Cattivelli R, Capodaglio P, Castelnuovo G. The Association of Kinesiophobia and Pain Catastrophizing with Pain-Related Disability and Pain Intensity in Obesity and Chronic Lower-Back Pain. Brain Sci 2020; 11:brainsci11010011. [PMID: 33374178 PMCID: PMC7823580 DOI: 10.3390/brainsci11010011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022] Open
Abstract
Individuals affected by chronic lower-back pain and obesity have an increased risk of long-lasting disability. In this study, we aimed to explore the contribution of kinesiophobia and pain catastrophizing in explaining pain intensity and pain-related disability in chronic lower-back pain associated to obesity. A cross-sectional study on 106 participants with obesity and chronic lower-back pain was performed. We assessed pain intensity, pain disability, pain catastrophizing, and kinesiophobia levels through self-reporting questionnaire. Hierarchical regressions were performed to assess the role of pain catastrophizing and kinesiophobia on pain intensity and pain disability. According to the results, kinesiophobia, but not pain catastrophing, significantly explained both pain intensity and pain-related disability. Kinesiophobia might play a significant role in enhancing pain-related disability and the pain intensity in individuals with chronic lower-back pain and obesity. We encourage future studies in which beliefs and cognition towards pain might be a therapeutic target in interdisciplinary pain management interventions.
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Affiliation(s)
- Giorgia Varallo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.M.G.); (R.C.); (G.C.)
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale S. Giuseppe, 28824 Piancavallo (Verbania), Italy
- Correspondence: ; Tel.: +39-338-94-84-148
| | - Emanuele Maria Giusti
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.M.G.); (R.C.); (G.C.)
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale S. Giuseppe, 28824 Piancavallo (Verbania), Italy
| | - Federica Scarpina
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, 10124 Turin, Italy;
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale S. Giuseppe, 28824 Piancavallo (Verbania), Italy
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.M.G.); (R.C.); (G.C.)
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale S. Giuseppe, 28824 Piancavallo (Verbania), Italy
| | - Paolo Capodaglio
- Istituto Auxologico Italiano, U.O. di U.O. Riabilitazione Osteoarticolare, Ospedale S. Giuseppe, 28824 Piancavallo (Verbania), Italy;
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Turin, 10121 Turin, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.M.G.); (R.C.); (G.C.)
- Istituto Auxologico Italiano, IRCCS, Laboratorio di Psicologia, Ospedale S. Giuseppe, 28824 Piancavallo (Verbania), Italy
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Kauffman BY, Manning K, Rogers AH, Garey L, Gallagher MW, Viana AG, Zvolensky MJ. The Role of Anxiety Sensitivity in terms of Weight-related Impairment and Fatigue Severity among Adults with Obesity and Chronic Low Back Pain. COGNITIVE THERAPY AND RESEARCH 2020; 44:1132-1139. [PMID: 33746313 PMCID: PMC7968852 DOI: 10.1007/s10608-020-10124-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Obesity and chronic low back pain often co-occur and are associated with psychosocial and physical impairments such as weight-related impairment and fatigue. Yet, there is little understanding of psychological factors that may be associated with weight-related impairment and fatigue (a psychosocial factor) among this vulnerable population. METHODS Thus, the current study examined the role of anxiety sensitivity as it relates to self-reported weight-related impairment and fatigue severity among persons with obesity and chronic low back pain. Participants included a nationally representative sample of adults (N = 616) with co-occurring obesity and chronic low back pain (77.3% female, M age = 45.9 years, SD = 11.53). RESULTS Results revealed that anxiety sensitivity was associated with greater levels of weight-related impairment and fatigue severity after controlling for age, sex, body mass index (BMI), pain interference, and perceived general health. CONCLUSIONS The findings suggest that anxiety sensitivity may be a mechanistic target for better understanding and addressing weight-related impairment and fatigue severity among individuals with obesity and chronic low back pain.
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Affiliation(s)
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Andrew H. Rogers
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | - Andres G. Viana
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
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Dong HJ, Larsson B, Rivano Fischer M, Gerdle B. Facing obesity in pain rehabilitation clinics: Profiles of physical activity in patients with chronic pain and obesity-A study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). PLoS One 2020; 15:e0239818. [PMID: 32986777 PMCID: PMC7521725 DOI: 10.1371/journal.pone.0239818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 09/14/2020] [Indexed: 11/19/2022] Open
Abstract
Background The obesity epidemic has influenced pain rehabilitation clinics. To date, little is known about baseline level of physical activity (PA) in patients referred to pain rehabilitation clinics. We aimed to investigate the PA levels of patients referred to pain rehabilitation clinics and to evaluate the effect of excess weight on PA level. Methods and findings Data were obtained from the Swedish Quality Registry for Pain Rehabilitation between 2016 and 2017. These data included PA time (everyday PA and physical exercise per week), Body Mass Index (BMI), sociodemographic factors, chronic pain and psychological aspects (e.g., pain intensity, depressive and anxiety symptoms and insomnia problems). Insufficient PA was defined as less than 150 minutes per week. We performed logistic regressions as well as orthogonal partial least square regression to estimate the effects of excess weight on PA. Over one-fourth of the patients were classified as obese (BMI ≥30 kg/m2, 871/3110, 25.3%) and nearly one-third of these patients were classified as severely obese (BMI ≥35 kg/m2, 242/871, 27.8%). Time estimations for physical exercise varied among the BMI groups, but patients in the higher BMI category were more likely to spend less time on everyday PA. Compared to normal weight, mild obesity [odds ratio (OR) 0.65, 95% confidence interval (CI) 0.53–0.81] and severe obesity (OR 0.56, 95% CI 0.42–0.74) were associated with less PA. Mild obese patients had an elevated risk of 65% and severe obese patients had an elevated risk of 96% for insufficient PA. Increased pain intensity was positively related to insufficient PA (OR 1.17, 95% CI 1.06–1.29) among the obese patients. Conclusion Having low PA is very common for patients referred to pain rehabilitation clinics, especially for those with comorbid obesity. As a first step to increase PA, obese patients need to be encouraged to increase the intensity and amount of less painful daily PA.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- * E-mail:
| | - Britt Larsson
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Health Sciences, Research Group Rehabilitation Medicine, Lund University, Lund, Sweden
- Department of Neurosurgery and Pain Rehabilitation, Skane University Hospital, Lund, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Merkle SL, Sluka KA, Frey-Law LA. The interaction between pain and movement. J Hand Ther 2020; 33:60-66. [PMID: 30025839 PMCID: PMC6335190 DOI: 10.1016/j.jht.2018.05.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/14/2018] [Accepted: 05/05/2018] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical commentary. INTRODUCTION/PURPOSE Pain and movement are universally relevant phenomena that influence human experiences in readily observable ways. Improved understanding of pain-movement relationships can guide medical and rehabilitative approaches to recovery and decrease risk of dysfunctional long-term consequences of otherwise normal neuromuscular responses. Therefore, the overall intent of this article is to elucidate the relationships between pain and movement as they relate to clinical decision making. CONCLUSIONS Motor output is highly adaptable, can be influenced by multiple mechanisms at various levels along the nervous system, and may vary between individuals despite similar diagnoses. Therefore, interventions need to be individualized and consider both the types of motor response observed (ie, whether the response is protective or maladaptive), and the patient's acute physical activity tolerance when prescribing exercise/movement.
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Affiliation(s)
- Shannon L Merkle
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA; Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA.
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Laura A Frey-Law
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
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Fedders SR, Larsen LK, Huntjens P, Sondrup MA, Thomsen MK, Kjær C, Clausen LP, Bujold G, Gazerani P. Association between obesity and craniofacial muscles sensitivity: an experimental study in pain-free subjects. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2019; 11:138-148. [PMID: 31523361 PMCID: PMC6737431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/19/2019] [Indexed: 06/10/2023]
Abstract
The objective of this study was to investigate if any association exists between obesity and muscle sensitivity in the craniofacial region of healthy individuals with different body mass index (BMI). The study was designed as a parallel single blinded investigation approved by the North Denmark Region Committee on Health Research Ethics (N-20180029). Written informed consent was obtained from all participants. Subjects were divided into normal BMI (18.5-24.9 kg/m2) and high BMI (≥25.0 kg/m2). Measurement of body composition parameters was followed by pressure algometry applied on skin overlying masseter and temporalis muscles before and after a cold pressor test (CPT). Deltoid muscle was used as a reference point. Statistical analysis was carried out to investigate the difference in mean pressure pain threshold (PPT) values and the conditioned pain modulation (CPM) effect. Forty subjects were included (20 normal BMI and 20 high BMI). No significant difference was found in mean PPT values or mean CPM effect between the BMI groups (PPT: masseter P=0.763, temporalis P=0.425, deltoid P=0.595 and CPM effect: masseter P=0.396, temporalis P=0.463, deltoid P=0.484). Mechanical muscle sensitivity and CPM effect were sex-independent. No influence of BMI was identified on mechanical muscle sensitivity in the craniofacial region of healthy individuals.
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Affiliation(s)
| | - Lina Klitgaard Larsen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Pam Huntjens
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Maria Agerboe Sondrup
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Malene Kaasing Thomsen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Charlotte Kjær
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Line Pirk Clausen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Gabrielle Bujold
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
| | - Parisa Gazerani
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Aalborg, Denmark
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Bennell KL, Nelligan RK, Kimp AJ, Wrigley TV, Metcalf B, Kasza J, Hodges PW, Hinman RS. Comparison of weight bearing functional exercise and non-weight bearing quadriceps strengthening exercise on pain and function for people with knee osteoarthritis and obesity: protocol for the TARGET randomised controlled trial. BMC Musculoskelet Disord 2019; 20:291. [PMID: 31208435 PMCID: PMC6580522 DOI: 10.1186/s12891-019-2662-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Clinical guidelines recommend exercise as a core treatment for individuals with knee osteoarthritis (OA). However, the best type of exercise for clinical benefits is not clear, particularly in different OA subgroups. Obesity is a common co-morbidity in people with knee OA. There is some evidence suggesting that non-weight bearing exercise may be more effective than weight bearing exercise in patients with medial knee OA and obesity. Methods To compare the efficacy of two different exercise programs (weight bearing functional exercise and non-weight bearing quadriceps strengthening) on pain and physical function for people ≥50 years with painful medial knee OA and obesity (body mass index ≥30 kg/m2) 128 people in Melbourne, Australia will be recruited for a two group parallel-design, assessor- and participant-blinded randomised controlled trial. Participants will be randomly allocated to undertake a program of either weight bearing functional exercise or non-weight bearing quadriceps strengthening exercise. Both groups will attend five individual sessions with a physiotherapist who will teach, monitor and progress the exercise program. Participants will be asked to perform the exercises at home four times per week for 12 weeks. Outcomes will be measured at baseline and 12 weeks. Primary outcomes are self-reported knee pain and physical function. Secondary outcomes include other measures of knee pain, physical function, quality-of-life, participant-perceived global change, physical performance, and lower limb muscle strength. Discussion This study will compare the efficacy of two different 12-week physiotherapist-prescribed, home-based exercise programs for people with medial knee OA and obesity. Findings will provide valuable information to help inform exercise prescription in this common OA patient subgroup. Trial registration Australian New Zealand Clinical Trials Registry reference: ACTRN12617001013358, 14/7/2017 Electronic supplementary material The online version of this article (10.1186/s12891-019-2662-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - Rachel K Nelligan
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander J Kimp
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Ben Metcalf
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Paul W Hodges
- Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Verma A, Shete SU, Doddoli G. An integrated therapy approach for the management of obesity-associated disorders: A case report. J Family Med Prim Care 2019; 8:1491-1494. [PMID: 31143747 PMCID: PMC6510065 DOI: 10.4103/jfmpc.jfmpc_200_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Obesity (sthoulya), in general, is a significant health problem and is associated with several comorbidities and various discomforts that can cause negative impact on physical, mental, and social well-being of a person. In this case study, an obese patient was suffering from severe multiple joint pains (aam vata) and shortness of breath (shwaas) was unable to climb stairs, and had extreme difficulty in walking. The patient also suffered from stress-related complaints, such as sleep disturbances (anidra) and poor digestion. The treatment was aimed at restoring psycho-physiological and physical health of the patient. Ayurveda panchakarma therapy involves treatments such as snehana (oleation), svedana (sudation), and virechana (purgation), which are the line of treatment for obesity-related disorders. Furthermore, the patient was given special yoga postures to improve flexibility and movement of joints. The integrative therapy of Ayurveda panchakarma and yoga showed significant improvement in functional capacity, quality of life, and musculoskeletal pain.
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Affiliation(s)
- Anita Verma
- Scientific Research Department, Kaivalyadhama, Swami Kuvalayananda Marg, Lonavla, Pune, Maharashtra, India
| | - Sanjay U Shete
- Scientific Research Department, Kaivalyadhama, Swami Kuvalayananda Marg, Lonavla, Pune, Maharashtra, India
| | - Gururaj Doddoli
- Ayurveda Section, Kaivalyadhama, Swami Kuvalayananda Marg, Lonavla, Pune, Maharashtra, India
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Rosic G, Milston AM, Richards J, Dey P. Fear of falling in obese women under 50 years of age: a cross-sectional study with exploration of the relationship with physical activity. BMC OBESITY 2019; 6:7. [PMID: 30867933 PMCID: PMC6398230 DOI: 10.1186/s40608-019-0230-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/10/2019] [Indexed: 12/19/2022]
Abstract
Background An understanding of capacity for physical activity in obese populations should help guide interventions to promote physical activity. Fear of falling is a phenomenon reported in the elderly, which is associated with reduced mobility and lower physical activity levels. However, although falls are reportedly common in obese adults, fear of falling and its relationship with activity has not been investigated in younger obese populations. Methods In a cross-sectional study, fear of falling was measured in 63 women aged 18 to 49 years, with mean BMI 42.1 kg/m2 (SD 10.3) using the Modified Falls Efficacy (MFES), the Consequences of Falling (COF) and the Modified Survey of Activities and Fear of Falling in the Elderly (MSAFFE) scales. The choice of scales was informed by prior qualitative interviews with obese younger women. Physical activity levels were measured at the same time using the International Physical Activity Questionnaire. The mean score for fear of falling scales, with 95% confidence intervals, were estimated. Chi-square tests and t-tests were used to explore differences in age, body mass index and fear of falling scores between fallers and non-fallers. For each fear of falling scale, binomial logistic regression was used to explore its relationship with physical activity. Results Mean scores suggested high levels of fear of falling: MFES [mean 7.7 (SD 2.7); median 8.5]; COF [mean 31.3 (SD 9.4)]; MSAFFE [mean 25.9 (SD 8.7); median 23]. Scores were significantly worse in fallers (n = 42) compared to non-fallers (n = 21). MFES and MSAFFE were independently associated with lower levels of physical activity [odds ratio = 0.65, 95% Cl 0.44 to 0.96 and odds ratio = 1.14, 95% CI 1.01 to 1.28 respectively], when adjusted for age, BMI and depression. Conclusions This study confirms that fear of falling is present in obese women under 50 years of age. It suggests that it is associated with low levels of physical activity. These novel findings warrant further research to understand capacity for physical and incidental activity in obese adults in both genders and suggest innovative interventions to promote lifestyle changes and/or consideration of falls prevention in this population.
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Affiliation(s)
- Gilly Rosic
- 1Nepean Blue Mountains Family Metabolic Health Service, Nepean Clinical School, Kingswood, New South Wales and University of Sydney, Sydney, Australia
| | - Anne M Milston
- 2Faculty of Health and Wellbeing, University of Central Lancashire, Preston, Lancashire UK
| | - Jim Richards
- 3Allied Health Research Unit, University of Central Lancashire, Preston, Lancashire UK
| | - Paola Dey
- 4Faculty of Health and Social Care, Edge Hill University, Road, Ormskirk, St Helens, Lancashire L39 4QP UK
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Rustaden AM, Haakstad LAH, Paulsen G, Bø K. Does low and heavy load resistance training affect musculoskeletal pain in overweight and obese women? Secondary analysis of a randomized controlled trial. Braz J Phys Ther 2019; 23:156-163. [PMID: 30692018 DOI: 10.1016/j.bjpt.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/20/2018] [Accepted: 01/09/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Overweight and obesity are associated with musculoskeletal pain, particularly in the female population. However, regular resistance training may positively affect these complaints. OBJECTIVE The present study aimed to investigate between group differences in musculoskeletal pain in previously inactive women, allocated to three different resistance-training modalities available in health- and fitness clubs. METHODS This is secondary analysis from a single-blinded randomized controlled trial, including healthy women (aged 18-65) with a BMI (kg/m2) ≥25. The participants were allocated to 12 weeks (3 times/weekly) of either BodyPump (high-repetition low-load group session) (n=24), heavy load resistance training with a personal trainer (n=28), non-supervised heavy load resistance training (n=19) or non-exercising controls (n=21). Primary outcome was self-reported musculoskeletal pain in ten different body parts, measured with the Standardized Nordic Pain Questionnaire, at baseline and post-test. In addition, the study included sub-analyses of the participants when they were divided into high (≥28 of 36 sessions, n=38) and low (≤27 of 36 sessions, n=22) exercise adherence. RESULTS The analysis revealed no between group differences in musculoskeletal pain in any of the ten body parts. The results did not change when the participants were divided into high versus low adherence. CONCLUSIONS Twelve weeks of BodyPump, heavy load resistance training with a personal trainer and non-supervised heavy load resistance training did not show any effect on self-reported musculoskeletal pain in overweight women. CLINICAL TRIAL REGISTRATION NUMBER NCT01993953. (https://clinicaltrials.gov/ct2/show/NCT01993953).
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Affiliation(s)
- Anne Mette Rustaden
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
| | | | - Gøran Paulsen
- The Norwegian Olympic and Paralympic Committee and Confederation of Sport, Oslo, Norway
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Chethan K, Bhat SN, Zuber M, Shenoy SB. Patient-Specific Static Structural Analysis of Femur Bone of different lengths. Open Biomed Eng J 2018. [DOI: 10.2174/1874120701812010108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background:The femur bone is an essential part of human activity, providing stability and support in carrying out our day to day activities. The inter-human anatomical variation and load bearing ability of humans of different heights will provide the necessary understanding of their functional ability.Objective:In this study, femur bone of two humans of different lengths (tall femur and short femur) were subjected to static structural loading conditions to evaluate their load-bearing abilities using Finite Element Analysis.Methods:The 3D models of femur bones were developed using MIMICS from the CT scans which were then subjected to static structural analysis by varying the load from 1000N to 8000N. The von Mises stress and deformation were captured to compare the performance of each of the femur bones.Results:The tall femur resulted in reduced Von-Mises stress and total deformation when compared to the short femur. However, the maximum principle stresses showed an increase with an increase in the bone length. In both the femurs, the maximum stresses were observed in the medullary region.Conclusion:When the applied load exceeds 10 times the body weight of the person, the tall femur model exceeded 134 MPa stress value. The short femur model failed at 9 times the body weight, indicating that the tall femur had higher load-bearing abilities.
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Mohd Sallehuddin S, Mohamad Nor NS, Ambak R, Abdul Aziz NS, Mohd Zaki NA, Omar MA, Aris T, Nor Hissam NS, Rajadurai SAL, Ayob NH. Changes in body pain among overweight and obese housewives living in Klang Valley, Malaysia: findings from the MyBFF@home study. BMC Womens Health 2018; 18:101. [PMID: 30066647 PMCID: PMC6069687 DOI: 10.1186/s12905-018-0597-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Obesity leads to the increase of pain at different parts of the body and it is a potential marker for complications of chronic diseases. This paper aims to assess changes in the body pain among overweight and obese housewives who participated in the My Body is Fit and Fabulous at home (MyBFF@home) study. METHODS Housewives aged 18 to 59 years old from the MyBFF@home study were selected and pain was measured using the Visual Analogue Scale (VAS) questionnaire. VAS measured the pain intensity at different parts of the body (score of 0-10). Data were collected at base line, 3 months and 6 months among the housewives in both the control and intervention group. Pain scores and other variables (age, Body Mass Index (BMI) and waist circumference) were analysed using SPSS version 22. RESULTS A total of 328 housewives completed the VAS questionnaires at baseline, while 185 (56.4%) of housewives completed the VAS at 3 months and 6 months. A decreasing trend of mean pain score in both groups after 6 months was observed. However, the intervention group showed a consistent decreasing trend of pain score mainly for back pain. In the control group, there was a slight increment of score in back pain from baseline towards the 6 months period. Older housewives in both groups (aged 50 years and above) had a higher mean score of leg pain (2.86, SD: 2.82) compared to the other age group. Higher BMI was significantly associated with pain score in both groups. CONCLUSION There were some changes in the level of body pain among the housewives before and after the intervention. Older obese women had a higher pain score compared to younger obese women. Pain was associated with BMI and change in BMI appears to be beneficial in reducing body pain among overweight and obese individuals.
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Affiliation(s)
- Syafinaz Mohd Sallehuddin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noor Safiza Mohamad Nor
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rashidah Ambak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nur Shahida Abdul Aziz
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nor Azian Mohd Zaki
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nur Salihah Nor Hissam
- Kuala Lumpur General Hospital, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | | | - Nor Hafizah Ayob
- Kuala Lumpur General Hospital, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
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Paley CA, Johnson MI. Abdominal obesity and metabolic syndrome: exercise as medicine? BMC Sports Sci Med Rehabil 2018; 10:7. [PMID: 29755739 PMCID: PMC5935926 DOI: 10.1186/s13102-018-0097-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022]
Abstract
Background Metabolic syndrome is defined as a cluster of at least three out of five clinical risk factors: abdominal (visceral) obesity, hypertension, elevated serum triglycerides, low serum high-density lipoprotein (HDL) and insulin resistance. It is estimated to affect over 20% of the global adult population. Abdominal (visceral) obesity is thought to be the predominant risk factor for metabolic syndrome and as predictions estimate that 50% of adults will be classified as obese by 2030 it is likely that metabolic syndrome will be a significant problem for health services and a drain on health economies. Evidence shows that regular and consistent exercise reduces abdominal obesity and results in favourable changes in body composition. It has therefore been suggested that exercise is a medicine in its own right and should be prescribed as such. Purpose of this review This review provides a summary of the current evidence on the pathophysiology of dysfunctional adipose tissue (adiposopathy). It describes the relationship of adiposopathy to metabolic syndrome and how exercise may mediate these processes, and evaluates current evidence on the clinical efficacy of exercise in the management of abdominal obesity. The review also discusses the type and dose of exercise needed for optimal improvements in health status in relation to the available evidence and considers the difficulty in achieving adherence to exercise programmes. Conclusion There is moderate evidence supporting the use of programmes of exercise to reverse metabolic syndrome although at present the optimal dose and type of exercise is unknown. The main challenge for health care professionals is how to motivate individuals to participate and adherence to programmes of exercise used prophylactically and as a treatment for metabolic syndrome.
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Affiliation(s)
- Carole A Paley
- 1Research & Development (Ward 12), Airedale NHS Foundation Trust, Skipton Road, Steeton, Keighley, West Yorkshire BD20 6TD UK.,2School of Clinical and Applied Sciences, Leeds Beckett University, Portland Building, City Campus, Leeds, LS1 3HE UK
| | - Mark I Johnson
- 2School of Clinical and Applied Sciences, Leeds Beckett University, Portland Building, City Campus, Leeds, LS1 3HE UK
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Wang Y, Lombard C, Hussain SM, Harrison C, Kozica S, Brady SRE, Teede H, Cicuttini FM. Effect of a low-intensity, self-management lifestyle intervention on knee pain in community-based young to middle-aged rural women: a cluster randomised controlled trial. Arthritis Res Ther 2018; 20:74. [PMID: 29665829 PMCID: PMC5905125 DOI: 10.1186/s13075-018-1572-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 03/19/2018] [Indexed: 11/25/2022] Open
Abstract
Background Knee pain is common with obesity and weight gain being important risk factors. Previous clinical trials have focused on overweight or obese adults with knee pain and osteoarthritis and demonstrated modest effects of intense weight loss programs on reducing knee pain despite very significant weight loss. There has been no lifestyle intervention that targets community-based adults to test its effect on prevention of knee pain. We aimed to determine the effect of a simple low-intensity self-management lifestyle intervention (HeLP-her), proven in randomised controlled trials to improve lifestyle and prevent weight gain, on knee pain in community-based young to middle-aged rural women. Methods A 1-year pragmatic, cluster randomised controlled trial was conducted in 649 community-based women (aged 18–50 years) to receive either the HeLP-her program (consisting of one group session, monthly SMS text messages, one phone coaching session, and a program manual) or one general women’s health education session. Secondary analyses were performed in 390 women who had knee pain measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and 12-month follow-up. “Any knee pain” was defined as a WOMAC pain score ≥ 1. Knee pain worsening was defined as an increase in WOMAC pain score over 12 months. Results Thirty-five percent of women had “any knee pain” at baseline. The risk of knee pain worsening did not differ between the intervention and control groups over 12 months. For women with any knee pain at baseline, those in the intervention arm had a lower risk of knee pain worsening compared with those in the control arm (OR 0.37, 95% CI 0.14–1.01, p = 0.05), with a stronger effect observed in women with body mass index ≥ 25 kg/m2 (OR 0.28, 95% CI 0.09–0.87, p = 0.03). Conclusions In community-based young to middle-aged women, a simple low-intensity lifestyle program reduced the risk of knee pain worsening in those with any knee pain at baseline, particularly in those overweight or obese. Pragmatic lifestyle programs such as HeLP-her may represent a feasible lifestyle intervention to reduce the burden of knee pain in the community. Trial registration ACTRN12612000115831, registered 24 January 2012. Electronic supplementary material The online version of this article (10.1186/s13075-018-1572-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Catherine Lombard
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia.,Department of Nutrition and Dietetics, Monash University, Melbourne, Australia
| | - Sultana Monira Hussain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Cheryce Harrison
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia
| | - Samantha Kozica
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia
| | - Sharmayne R E Brady
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Sharma G, Nor-Hanipah Z, Haskins IN, Punchai S, Strong AT, Tu C, Rodriguez JH, Schauer PR, Kroh M. Comparative Outcomes of Bariatric Surgery in Patients with Impaired Mobility and Ambulatory Population. Obes Surg 2018; 28:2014-2024. [PMID: 29435811 DOI: 10.1007/s11695-018-3132-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aims to characterize complications, metabolic improvement, and change in ambulation status for patients with impaired mobility undergoing bariatric surgery. MATERIAL AND METHODS Individuals undergoing primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from February 2008 to December 2015 were included. Impaired mobility (WC) was defined as using a wheelchair or motorized scooter for at least part of a typical day. The WC group was propensity score matched to ambulatory patients (1:5 ratio). Comparisons were made for 30-day morbidity and mortality and 1-year improvement in weight-related comorbidities. RESULTS There were 93 patients in the WC group matched to 465 ambulatory controls. The median operative time (180 vs 159 min, p = 0.003) and postoperative length of stay (4 vs 3 days, p ≤ 0.001) was higher in the WC group. There were no differences in readmission or all-cause morbidity within 30 days. The median percent excess weight loss (%EWL) at 1 year was similar (WC group, 65% available, 53% EWL vs AMB group, 73% available, 54% EWL); however, patients with impaired mobility were less likely to experience improvement in diabetes (76 vs 90%, p = 0.046), hypertension (63 vs 82%, p < 0.005), and obstructive sleep apnea (53 vs 71%, p < 0.001). Within the WC group, 62% had improvement in their mobility status, eliminating dependence on wheelchair or scooter assistance. CONCLUSION Patients with both obesity and impaired mobility experience similar rates of perioperative morbidity and weight loss at 1 year compared to ambulatory controls. However, improvement in weight-related comorbidities may be less likely with impaired mobility.
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Affiliation(s)
- Gautam Sharma
- Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Zubaidah Nor-Hanipah
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Selangor, Malaysia
| | - Ivy N Haskins
- Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Suriya Punchai
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Andrew T Strong
- Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Chao Tu
- Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.,Quantitiatve Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - John H Rodriguez
- Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.,Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Phillip R Schauer
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Matthew Kroh
- Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA. .,Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA. .,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA. .,Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
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Brain K, Burrows T, Rollo ME, Hayes C, Hodson FJ, Collins CE. Population Characteristics in a Tertiary Pain Service Cohort Experiencing Chronic Non-Cancer Pain: Weight Status, Comorbidities, and Patient Goals. Healthcare (Basel) 2017; 5:E28. [PMID: 28613245 PMCID: PMC5492031 DOI: 10.3390/healthcare5020028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/29/2017] [Accepted: 06/07/2017] [Indexed: 11/16/2022] Open
Abstract
We describe the characteristics of patients attending an Australian tertiary multidisciplinary pain service and identify areas for nutrition interventions. This cross-sectional study targets patients experiencing chronic pain who attended the service between June-December 2014. Self-reported data was captured from: (1) an Electronic Persistent Pain Outcomes Collaboration (ePPOC) referral questionnaire, incorporating demographics, pain status, and mental health; (2) a Pain Assessment and Recovery Plan (PARP), which documents patients' perceived problems associated with pain and personal treatment goals. The ePPOC referral questionnaire was completed by 166 patients and the PARP by 153. The mean (SD) patient age was 53 ± 13 years, with almost 60% experiencing pain for >5 years. Forty-five percent of patients were classified as obese (BMI ≥ 30 kg/m², mean (SD) BMI was 31 ± 7 kg/m²), with a mean waist circumference of 104 ± 19.4 cm (SD). The most frequent patient nominated treatment goals related to physical activity (39%), followed by nutritional goals (23%). Traditionally, pain management programs have included physical, psychosocial, and medical, but not nutritional, interventions. By contrast, patients identified and reported important nutrition-related treatment goals. There is a need to test nutrition treatment pathways, including an evaluation of dietary intake and nutrition support. This will help to optimize dietary behaviors and establish nutrition as an important component of multidisciplinary chronic pain management.
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Affiliation(s)
- Katherine Brain
- School Health Science, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2305, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2305, Australia.
| | - Tracy Burrows
- School Health Science, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2305, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2305, Australia.
| | - Megan E Rollo
- School Health Science, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2305, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2305, Australia.
| | - Chris Hayes
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia.
| | - Fiona J Hodson
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia.
| | - Clare E Collins
- School Health Science, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2305, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2305, Australia.
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King WC, Chen JY, Belle SH, Courcoulas AP, Dakin GF, Flum DR, Hinojosa MW, Kalarchian MA, Mitchell JE, Pories WJ, Spaniolas K, Wolfe BM, Yanovski SZ, Engel SG, Steffen KJ. Use of prescribed opioids before and after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis 2017; 13:1337-1346. [PMID: 28579202 DOI: 10.1016/j.soard.2017.04.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/04/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Limited evidence suggests bariatric surgery may not reduce opioid analgesic use, despite improvements in pain. OBJECTIVE To determine if use of prescribed opioid analgesics changes in the short and long term after bariatric surgery and to identify factors associated with continued and postsurgery initiated use. SETTING Ten U.S. hospitals. METHODS The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study. Assessments were conducted presurgery, 6 months postsurgery, and annually postsurgery for up to 7 years until January 2015. Opioid use was defined as self-reported daily, weekly, or "as needed" use of a prescribed medication classified as an opioid analgesic. RESULTS Of 2258 participants with baseline data, 2218 completed follow-up assessment(s) (78.7% were female, median body mass index: 46; 70.6% underwent Roux-en-Y gastric bypass). Prevalence of opioid use decreased after surgery from 14.7% (95% CI: 13.3-16.2) at baseline to 12.9% (95% CI: 11.5-14.4) at month 6 but then increased to 20.3%, above baseline levels, as time progressed (95% CI: 18.2-22.5) at year 7. Among participants without baseline opioid use (n = 1892), opioid use prevalence increased from 5.8% (95% CI: 4.7-6.9) at month 6 to 14.2% (95% CI: 12.2-16.3) at year 7. Public versus private health insurance, more pain presurgery, undergoing subsequent surgeries, worsening or less improvement in pain, and starting or continuing nonopioid analgesics postsurgery were significantly associated with higher risk of postsurgery initiated opioid use. CONCLUSION After bariatric surgery, prevalence of prescribed opioid analgesic use initially decreased but then increased to surpass baseline prevalence, suggesting the need for alternative methods of pain management in this population.
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Affiliation(s)
- Wendy C King
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
| | - Jia-Yuh Chen
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Steven H Belle
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Anita P Courcoulas
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - David R Flum
- Department of Surgery, University of Washington, Seattle, Washington
| | | | - Melissa A Kalarchian
- Department of Psychiatry, University of Pittsburgh School of Medicine, and Duquesne University School of Nursing, Pittsburgh, Pennsylvania
| | | | - Walter J Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Konstantinos Spaniolas
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Bruce M Wolfe
- Department of Surgery, Oregon Health Sciences University, Portland, Oregon
| | - Susan Z Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Scott G Engel
- Neuropsychiatric Research Institute, Fargo, North Dakota
| | - Kristine J Steffen
- Neuropsychiatric Research Institute, Fargo, North Dakota; Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota
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De Gregori M, Muscoli C, Schatman ME, Stallone T, Intelligente F, Rondanelli M, Franceschi F, Arranz LI, Lorente-Cebrián S, Salamone M, Ilari S, Belfer I, Allegri M. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach. J Pain Res 2016; 9:1179-1189. [PMID: 27994480 PMCID: PMC5153285 DOI: 10.2147/jpr.s115068] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in modulating the efficacy of analgesic treatments, including opioids. These main topics were addressed during the first edition of the Study In Multidisciplinary Pain Research workshop: “FYD (Feed Your Destiny): Fighting Pain”, held on April 7, 2016, in Rome, Italy, which was sponsored by a grant from the Italian Ministry of Instruction on “Nutraceuticals and Innovative Pharmacology”. The take-home message of this workshop was the recognition that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment. Some foods and supplements used in personalized treatment will likely improve clinical outcomes of analgesic therapy and result in considerable improvement of patient compliance and quality of life. From our current perspective, the potential benefit of including nutrition in personalizing pain medicine is formidable and highly promising.
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Affiliation(s)
- Manuela De Gregori
- Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Study in Multidisciplinary Pain Research Group; Young Against Pain Group, Parma, Italy
| | - Carolina Muscoli
- Study in Multidisciplinary Pain Research Group; Department of Health Sciences, Institute of Research for Food Safety and Health, University "Magna Graecia" of Catanzaro, Parma, Italy; IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy
| | - Michael E Schatman
- Study in Multidisciplinary Pain Research Group; US Pain Foundation, Bellevue, WA, USA
| | | | - Fabio Intelligente
- Study in Multidisciplinary Pain Research Group; Chronic Pain Service Anestesia Day-Surgery, IRCCS Humanitas Research Hospital, Rozzano
| | - Mariangela Rondanelli
- Study in Multidisciplinary Pain Research Group; Department of Public Health, Section of Human Nutrition and Dietetics, Azienda di Servizi alla Persona di Pavia, University of Pavia, Pavia
| | - Francesco Franceschi
- Study in Multidisciplinary Pain Research Group; Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
| | - Laura Isabel Arranz
- Study in Multidisciplinary Pain Research Group; Department of Nutrition, Food Sciences and Gastronomy, University of Barcelona, Barcelona
| | - Silvia Lorente-Cebrián
- Study in Multidisciplinary Pain Research Group; Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Maurizio Salamone
- Study in Multidisciplinary Pain Research Group; Metagenics Italia srl, Milano; Italian Lifestyle Medicine Association, Bari, Italy
| | - Sara Ilari
- Study in Multidisciplinary Pain Research Group; IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy
| | - Inna Belfer
- Study in Multidisciplinary Pain Research Group; Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Massimo Allegri
- Study in Multidisciplinary Pain Research Group; Department of Surgical Sciences, University of Parma; Anesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliero, Universitaria of Parma, Parma, Italy
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Cooper MA, Kluding PM, Wright DE. Emerging Relationships between Exercise, Sensory Nerves, and Neuropathic Pain. Front Neurosci 2016; 10:372. [PMID: 27601974 PMCID: PMC4993768 DOI: 10.3389/fnins.2016.00372] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/02/2016] [Indexed: 01/09/2023] Open
Abstract
The utilization of physical activity as a therapeutic tool is rapidly growing in the medical community and the role exercise may offer in the alleviation of painful disease states is an emerging research area. The development of neuropathic pain is a complex mechanism, which clinicians and researchers are continually working to better understand. The limited therapies available for alleviation of these pain states are still focused on pain abatement and as opposed to treating underlying mechanisms. The continued research into exercise and pain may address these underlying mechanisms, but the mechanisms which exercise acts through are still poorly understood. The objective of this review is to provide an overview of how the peripheral nervous system responds to exercise, the relationship of inflammation and exercise, and experimental and clinical use of exercise to treat pain. Although pain is associated with many conditions, this review highlights pain associated with diabetes as well as experimental studies on nerve damages-associated pain. Because of the global effects of exercise across multiple organ systems, exercise intervention can address multiple problems across the entire nervous system through a single intervention. This is a double-edged sword however, as the global interactions of exercise also require in depth investigations to include and identify the many changes that can occur after physical activity. A continued investment into research is necessary to advance the adoption of physical activity as a beneficial remedy for neuropathic pain. The following highlights our current understanding of how exercise alters pain, the varied pain models used to explore exercise intervention, and the molecular pathways leading to the physiological and pathological changes following exercise intervention.
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Affiliation(s)
- Michael A Cooper
- Department of Anatomy and Cell Biology, University of Kansas Medical Center Kansas City, KS, USA
| | - Patricia M Kluding
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center Kansas City, KS, USA
| | - Douglas E Wright
- Department of Anatomy and Cell Biology, University of Kansas Medical Center Kansas City, KS, USA
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38
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King WC, Chen JY, Belle SH, Courcoulas AP, Dakin GF, Elder KA, Flum DR, Hinojosa MW, Mitchell JE, Pories WJ, Wolfe BM, Yanovski SZ. Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity. JAMA 2016; 315:1362-71. [PMID: 27046364 PMCID: PMC4856477 DOI: 10.1001/jama.2016.3010] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
IMPORTANCE The variability and durability of improvements in pain and physical function following Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) are not well described. OBJECTIVES To report changes in pain and physical function in the first 3 years following bariatric surgery, and to identify factors associated with improvement. DESIGN, SETTING, AND PARTICIPANTS The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study at 10 US hospitals. Adults with severe obesity undergoing bariatric surgery were recruited between February 2005 and February 2009. Research assessments were conducted prior to surgery and annually thereafter. Three-year follow-up through October 2012 is reported. EXPOSURES Bariatric surgery as clinical care. MAIN OUTCOMES AND MEASURES Primary outcomes were clinically meaningful presurgery to postsurgery improvements in pain and function using scores from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (ie, improvement of ≥5 points on the norm-based score [range, 0-100]) and 400-meter walk time (ie, improvement of ≥24 seconds) using established thresholds. The secondary outcome was clinically meaningful improvement using the Western Ontario McMaster Osteoarthritis Index (ie, improvement of ≥9.7 pain points and ≥9.3 function points on the transformed score [range, 0-100]). RESULTS Of 2458 participants, 2221 completed baseline and follow-up assessments (1743 [78.5%] were women; median age was 47 years; median body mass index [BMI] was 45.9; 70.4% underwent RYGB; 25.0% underwent LAGB). At year 1, clinically meaningful improvements were shown in 57.6% (95% CI, 55.3%-59.9%) of participants for bodily pain, 76.5% (95% CI, 74.6%-78.5%) for physical function, and 59.5% (95% CI, 56.4%-62.7%) for walk time. Additionally, among participants with severe knee or disability (633), or hip pain or disability (500) at baseline, approximately three-fourths experienced joint-specific improvements in knee pain (77.1% [95% CI, 73.5%-80.7%]) and in hip function (79.2% [95% CI, 75.3%-83.1%]). Between year 1 and year 3, rates of improvement significantly decreased to 48.6% (95% CI, 46.0%-51.1%) for bodily pain and to 70.2% (95% CI, 67.8%-72.5%) for physical function, but improvement rates for walk time, knee and hip pain, and knee and hip function did not (P for all ≥.05). Younger age, male sex, higher income, lower BMI, and fewer depressive symptoms presurgery; no diabetes and no venous edema with ulcerations postsurgery (either no history or remission); and presurgery-to-postsurgery reductions in weight and depressive symptoms were associated with presurgery-to-postsurgery improvements in multiple outcomes at years 1, 2, and 3. CONCLUSIONS AND RELEVANCE Among a cohort of participants with severe obesity undergoing bariatric surgery, a large percentage experienced improvement, compared with baseline, in pain, physical function, and walk time over 3 years, but the percentage with improvement in pain and physical function decreased between year 1 and year 3. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00465829.
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Affiliation(s)
- Wendy C King
- University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Jia-Yuh Chen
- University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Steven H Belle
- University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | | | - Katherine A Elder
- Oregon Health and Science University, Portland5Now with Pacific University, Forest Grove, Oregon, and the Oregon Health and Science University, Portland
| | | | | | | | - Walter J Pories
- Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | | | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
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Toft BS, Uhrenfeldt L. The lived experiences of being physically active when morbidly obese: A qualitative systematic review. Int J Qual Stud Health Well-being 2015; 10:28577. [PMID: 26400462 PMCID: PMC4580712 DOI: 10.3402/qhw.v10.28577] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 11/14/2022] Open
Abstract
The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: "Identity" with the three subthemes: "considering weight," "being able to," and "belonging with others." The theme and subthemes were merged into a meta-synthesis: "Homecoming: a change in identity." The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of "homecoming" when active.
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Affiliation(s)
- Bente Skovsby Toft
- Department of Lifestyle Rehabilitation, Horsens Regional Hospital, Brædstrup, Denmark.,Department of Research, Horsens Regional Hospital, Denmark;
| | - Lisbeth Uhrenfeldt
- Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark.,Danish Centre of Systematic Reviews: An Affiliate Centre of the Joanna Briggs Institute, Aalborg, Denmark
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