Low Disability Research Articles

Effects of Core Stabilization Exercises on Low Back Pain, Disability and Back Muscle Endurance in Patients with Lumbar Disc Herniation

Background: Lumbar disc herniation is a common musculoskeletal disorder leading to spinal degeneration. Core stability influences lumbar biomechanics, which improves muscle endurance through decreased pain of the lower back leading to minimal chances of disability.
 Objective: To determine the effects of Core stabilizing exercises on low back pain, disability and endurance of back muscles in Lumbar Disc Herniation patients.
 Methods: Randomized controlled trial was conducted on 52 patients . it was conducted 3 times a week for 30 minutes for 6 months. Participants allocated into two equal groups by lottery method. Group A was treated with controlled conventional treatment and core stabilizing exercises. Group B received only conventional treatment. This information was collected using NPRS and ODI. Besides this Biering-Sorenson and trunk flexion endurance tests were used. Probability sampling was used .Settings included AMTH, PSRD and NHMC. The study was conducted for 6 months. Ethical permission by ethical review board. data analysis by SPSS. This included male and female patients, age 20 to 60 years with disc herniation. Participants with recent surgery, inflammatory arthritis, cauda equina syndrome and spinal tumor were excluded.
 Results: After 8-weeks of core stabilization exercises, values of Group A are 1.93 for pain, 16.08 for disability, 1.27 and 40.54 for endurance whereas Group B showed values of 4.74 for pain, 34.08 for disability, 2.15 and 34.81 for endurance. Independent t-test showed significant difference between 2 groups with p value < 0.05. Results of current study showed considerable reduction in low back pain and disability, and a significant increase in back muscles endurance in the treatment group. 
 Conclusion: Core stabilization exercises were effective in improving function, reducing pain, reducing functional disability and enhancing endurance in patients of lumbar disc herniation and lower back pain

Heterogeneity of treatment responses in rheumatoid arthritis using group based trajectory models: secondary analysis of clinical trial data

BackgroundTraditionally rheumatoid arthritis (RA) trials classify patients as responders and non-responders; they ignore the potential range of treatment responses. Group Based Trajectory Models (GBTMs) provide a more refined approach. They identify patient subgroups with similar outcome trajectories. We used GBTMs to classify patients into subgroups of varying responses and explore factors associated with different responses to intensive treatment in a secondary analysis of intensive treatment in the TITRATE clinical trial.MethodsThe TITRATE trial enrolled 335 patients with RA: 168 patients were randomised to receive intensive management, which comprised monthly assessments including measures of the disease activity score for 28 joints (DAS28), treatment escalation when patients were not responding sufficiently and psychosocial support; 163 of these patients completed the trial. We applied GBTMs to monthly DAS28 scores over one year to these patients who had received intensive management. The control group had standard care and were assessed every 6 months; they had too few DAS28 scores for applying GBTMs.ResultsGBTMs identified three distinct trajectories in the patients receiving intensive management: good (n = 40), moderate (n = 76) and poor (n = 47) responders. Baseline body mass index (BMI), disability, fatigue and depression levels were significantly different between trajectory groups. Few (10%) good responders were obese, compared to 38% of moderate, and 43% of poor responders (P = 0.002). Few (8%) good responders had depression, compared to 14% moderate responders, and 38% poor responders (P < 0.001). The key difference in treatments was using high-cost biologics, used in only 5% of good responders but 30% of moderate and 51% of poor responders (P < 0.001). Most good responders had endpoint remissions and low disability, pain, and fatigue scores; few poor responders achieved any favourable outcomes.ConclusionGBTMs identified three trajectories of disease activity progression in patients receiving intensive management for moderately active RA. Baseline variables like obesity and depression predicted different treatment responses. Few good responders needed biologic drugs; they responded to conventional DMARDs alone. GBTMs have the potential to facilitate precision medicine enabling patient-oriented treatment strategies based on key characteristics.RegistrationTITRATE Trial ISRCTN 70160382.

Melatonin-loaded self-healing hydrogel targets mitochondrial energy metabolism and promotes annulus fibrosus regeneration

Intervertebral disc (IVD) herniation is a major cause of chronic low back pain and disability. The current nucleus pulposus (NP) discectomy effectively relieves pain symptoms, but the annulus fibrosus (AF) defects are left unrepaired. Tissue engineering approaches show promise in treating AF injury and IVD degeneration; however, the presence of an inflammatory milieu at the injury site hinders the mitochondrial energy metabolism of AF cells, resulting in a lack of AF regeneration. In this study, we fabricated a dynamic self-healing hydrogel loaded with melatonin (an endocrine hormone well-known for its antioxidant and anti-inflammatory properties) and investigate whether melatonin-loaded hydrogel could promote AF defect repair by rescuing the matrix synthesis and energy metabolism of AF cells. The protective effects of melatonin on matrix components (e.g. type I and II collagen and aggrecan) in AF cells were observed in the presence of interleukin (IL)-1β. Additionally, melatonin was found to activate the nuclear factor erythroid 2-related factor signaling pathway, thereby safeguarding the mitochondrial function of AF cells from IL-1β, as evidenced by the increased level of adenosine triphosphate, mitochondrial membrane potential, and respiratory chain factor expression. The incorporation of melatonin into a self-healing hydrogel based on thiolated gelatin and β-cyclodextrin was proposed as a means of promoting AF regeneration. The successful implantation of melatonin-loaded hydrogel has been shown to facilitate in situ regeneration of AF tissue, thereby impeding IVD degeneration by preserving the hydration of nucleus pulposus in a rat box-cut IVD defect model. These findings offer compelling evidence that the development of a melatonin-loaded dynamic self-healing hydrogel can promote the mitochondrial functions of AF cells and represents a promising strategy for IVD regeneration.

Chronic Low Back Pain: Prevalence, Impact on Quality of Life, and Predictors of Future Disability.

In primary healthcare settings, chronic low back pain (cLBP) is a widespread health issue with a great global impact. A cross-sectional analytical study was performed on 918 adults attending primary healthcare settings in Makkah, Saudi Arabia, to estimate the cLBP prevalence, its effect on health-related quality of life (QOL), and predictors of subsequent disability. The visual analog scale of pain(VAS), World Health Organization Quality of Life Scale (WHO-QOL), and Oswestry low back pain disability index (ODI) were used to assess back pain severity, impact on QOL, and physical disability, respectively. The prevalence of cLBP among adults attending primary care settings in Makkah City was 25.9%, and 88.6% of them had a limited range of motion of the spine. About 58.1% had abnormal radiological findings detected by MRI. Based on the VAS scale, most patients (83.8%) had mild pain. The median (IQR) QOL score was 70 (60-80). Minimal and moderate disability scores were prevalent among 16.2% and 65.7% of patients, respectively. Disability scores were independently predicted by a lower QOL score (beta = -0.39, 95%CI = -0.49 to -0.29, p < 0.001) and higher VAS scores (beta = 0.47, 95%CI = 0.38-0.56, p < 0.001). Furthermore, disability was independently associated with having post-void residual volume (PVRV) (beta = 5.84, 95%CI = 1.97-9.72, p = 0.004) and abnormal X-ray findings (beta = 7.10, 95%CI = 1.77-12.4, p = 0.010). cLBP is common among adults attending primary care settings in Makkah City; it is associated with moderate disability and lower health-related QOL.

Effects of Virtual Reality Exercises on Chronic Low Back Pain: Quasi-Experimental Study.

Low back pain is a common health problem globally. Based on the duration of pain, it is classified as acute, subacute, or chronic low back pain. Different treatment strategies are available to reduce chronic low back pain. Virtual reality (VR) is a novel approach in back pain rehabilitation. This study aimed to compare the effects of VR games on chronic low back pain. This quasi-experimental study was conducted among 40 patients with chronic low back pain. The data were collected using a nonprobability, convenient sampling technique. Patients visiting the Department of Physiotherapy, Government Services Hospital, Lahore, Pakistan, were recruited and equally divided into 4 groups. Group A received the Reflex Ridge game; group B received the Body Ball game; group C combined the 2 games without back-strengthening exercises; and group D combined the 2 games with back-strengthening exercises. The participants received 8 treatment sessions, with 3 sessions/wk. The outcomes were pre- and posttest measurements of pain intensity, low back disability, and lumbar range of motion. The repeated measurement ANOVA was used for inter- and intragroup comparison, with significance at P≤.05. The study comprised a sample of 40 patients with low back pain; 12 (40%) were female and 28 (60%) were male, with a mean age of 37.85 (SD 12.15) years. The pre- and posttest mean pain scores were 7.60 (SD 1.84) and 4.20 (SD 1.62) in group A, 6.60 (SD 1.776) and 5.90 (SD 1.73) in group B, 6.90 (SD 1.73) and 5.40 (SD 1.07) in group C, and 7.10 (SD 1.53) and 3.60 (SD 0.97) in group D, respectively. The mean pain score differences of group D (combining the Reflex Ridge and Body Ball games with back-strengthening exercises) compared to groups A, B, and C were -.60 (P=.76), -2.30 (P<.001), and -1.80 (P=.03), respectively. Regarding the range of motion, the forward lumbar flexion mean differences of group D compared to groups A, B, and C were 3.80 (P=.21), 4.80 (P=.07), and 7.40 (P<.001), respectively. Similarly, the right lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P=.04), 5.20 (P<.001), and 4.80 (P<.001), respectively. The left lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P<.001), 4.80 (P=.02), and 2.20 (P<.001). respectively, showing significant pre- and posttreatment effects. VR exercises had statistically significant effects on improving pain, low back disability, and range of motion in all groups, but the combination of Reflex Ridge and Body Ball games with back-strengthening exercises had dominant effects compared to the other groups. Iranian Registry of Clinical Trial IRCT20200330046895N1; https://en.irct.ir/trial/46916.

Effectiveness of unilateral percutaneous vertebroplasty for acute traumatic non-osteoporotic compression vertebral fractures.

Although vertebroplasty is a well-known treatment for osteoporotic and neoplastic compression fractures, there is limited evidence to support its use in traumatic compression fractures without osteoporotic degeneration. The purpose of this study was to evaluate the correlation of kyphosis and wedge angles with pain relief and functional outcome after percutaneous vertebroplasty. 38 patients who harbored acute traumatic non-osteoporotic compression vertebral fractures without neurological complications refractory to at least 5 days of conservative treatment were included in this study. Follow-up evaluations included pain (assessed with the visual analog scale) and medication use. Functional outcome was measured using Oswestry low back pain disability questionnaire. Cobb angles, Gardner angles and kyphotic angles were measured on the full-spine radiographs preoperatively and postoperatively. The axial pain visual analog scale score (8.05 ± 1.23 pre-op vs 1.18 ± 1.09 post-op, P < .05) and The Oswestry low back pain disability questionnaire score (33.45 ± 6.97 pre-op vs 4.47 ± 2.41 post-op, P < .05). The Cobb's angle (19.66° ± 8.68° pre-op vs 15.08° ± 7.51° post-op, P < .05), the Gardner's angle (17.72° ± 6.52° pre-op vs 14.13° ± 7.13° post-op, P < .05) and the kyphotic angle (17.51° ± 5.8° pre-op vs 8.81° ± 4.14°post-op, P < .05) were significantly reduced postoperatively therefore, local kyphosis was markedly restored after vertebroplasty. Our findings show that vertebroplasty for patients with traumatic spinal compression fractures reduces pain, improves mobility, reduces the need for painkillers, and significantly affects kyphotic angles.

AN AYURVEDIC APPROACH IN THE MANAGEMENT OF KATISHOOLA: A CASE STUDY

Background: Lower back pain can have causes other than underlying disorders, and this pain is the type that typically starts in the lower back and spreads to the buttocks and sacroiliac joints. People with chronic pain frequently struggle to balance work, family, and social obligations, which is a major contributor to disability around the world. This symptom affects 80% of people at some point in their lives. Alternative, efficient, non-invasive therapy modalities have received a lot of interest as a result of the rising prevalence of low back pain and the transient and decreased success rates of current invasive treatment methods. The primary symptom of Kati shoola, a Vata vyadhi, is Pain in Kati Pradesha. Methods: An Abhyanga, Swedana, and Kati Pichu treatment regimen was used to treat a 60-year-old Female patient with Low back ache. The patient received treatment for twenty-seven days. The response to treatment was noted, and symptom relief served as a measure of the therapeutic impact. Results &amp; Conclusion: Clinically, the severity of the cardinal symptoms was greatly reduced, and the overall score on the Oswestry low back pain disability scale and Roland-Morris low back pain and disability scale had shown significant improvement.

Correlation between Neck Muscle Endurance Tests, Ultrasonography, and Self-Reported Outcomes in Women with Low Cervical Disability and Neck Pain

Background: Neck pain (NP) is a frequent condition in women, characterized by exhibiting distinct clinical manifestations such as the presence of deep neck (DN) muscle weakness. Endurance and ultrasonography of the DN muscles, and patient-reported outcome measures, are commonly used outcomes in clinical practice. The aim of this study is to assess and correlate the endurance of the DN muscles and their morphological characteristics with pain intensity, neck disability and headache impact. Methods: An observational and correlational study was carried out. Eighty-two women were recruited, and endurance tests of neck flexor and extensor (chin tuck flexion test and neck extensor muscles endurance test), ultrasonography of the DN muscles, pain intensity, disability (neck disability index) and headache impact (HIT-6) were measured. Spearman’s rho was used to evaluate the correlation between the outcome variables, and a simple linear regression analysis was carried out to explain the model in detail. Results: Statistically significant negative correlations between the chin tuck neck flexion test and neck disability index (NDI) (r = −0.38; p &lt; 0.001) and HIT-6 (r = −0.26; p = 0.02) were found. The neck extensor muscles endurance test showed a negative correlation with NDI (r = −0.27; p = 0.01) and HIT-6 (r = −0.26; p = 0.02). The simple linear regression analysis showed an R squared of 26.7% and was statistically significant (NDI: R squared = 0.267; F = 3.13; p = 0.004) for NDI. Conclusion: A negative correlation between deep neck muscle endurance test results and self-reported outcome measures in women with low cervical disability and neck pain were observed. This suggests that lower endurance in the deep neck muscles may be associated with poorer self-reported symptoms and functionality in these patients. The chin tuck neck flexion test and deep extensor muscles endurance test could predict self-perceived neck disability in women with low cervical disability and NP.

Additional effect of pain neuroscience education to spinal manipulative therapy on pain and disability for patients with chronic low back pain: a randomized controlled trial

BackgroundSpinal manipulative therapy (SMT) demonstrates small effects on pain intensity in low back pain. Combining SMT with a psychosocial intervention like pain neuroscience education (PNE) could promote additional effect. ObjectivesTo evaluate the additional effect of PNE when combined to SMT on pain intensity and low back pain-related disability in patients with chronic low back pain (CLBP). MethodOne hundred and four patients with CLBP of both sexes aged between 18 and 55 years were treated with PNE + SMT compared to SMT alone. The primary outcome measures were pain intensity and disability post-treatment (4 weeks). Secondary outcomes were fear-avoidance beliefs, global perceived effect of improvement, and pain self-efficacy. Results were obtained immediately post-treatment and at three follow-ups (30-days, 90-days, and 180-days). ResultsNo significant between-group difference was observed for pain intensity and disability post-treatment. In contrast, our results showed a significantly longer additional effect for the group treated with SMT + PNE for the following outcomes: pain intensity (change baseline to 90 day follow-up = −0.90 [95% CI= −1.76, −0.4] and change baseline to 180 day follow-up = −1.19 [95% CI= −2.06, −0.32]) and low back pain-related disability, global perceived effect of improvement and pain self-efficacy (180th day follow-up). ConclusionThe results of this trial suggest the addition of PNE to SMT did not bring any additional effect on pain intensity and disability in the short term, but SMT + PNE can result in longer-lasting effects in patients with CLBP and that such an effect could be related to a possible mediator effect of pain self-efficacy.

Economic burden of nonoperative treatment of adult spinal deformity.

The purpose of this study was to investigate the cost utility of nonoperative treatment for adult spinal deformity (ASD). Nonoperatively and operatively treated patients who met database criteria for ASD and in whom complete radiographic and health-related quality of life data at baseline and at 2 years were available were included. A cost analysis was completed on the PearlDiver database assessing the average cost of nonoperative treatment prior to surgical intervention based on previously published treatments (NSAIDs, narcotics, muscle relaxants, epidural steroid injections, physical therapy, and chiropractor). Utility data were calculated using the Oswestry Disability Index (ODI) converted to SF-6D with published conversion methods. Quality-adjusted life years (QALYs) used a 3% discount rate to account for residual decline in life expectancy (78.7 years). Minor and major comorbidities and complications were assessed according to the CMS.gov manual's definitions. Successful nonoperative treatment was defined as a gain in the minimum clinically importance difference (MCID) in both ODI and Scoliosis Research Society (SRS)-pain scores, and failure was defined as a loss in MCID or conversion to operative treatment. Patients with baseline ODI ≤ 20 and continued ODI of ≤ 20 at 2 years were considered nonoperative successful maintenance. The average utilization of nonoperative treatment and cost were applied to the ASD cohort. A total of 824 patients were included (mean age 58.24 years, 81% female, mean body mass index 27.2 kg/m2). Overall, 75.5% of patients were in the operative and 24.5% were in the nonoperative cohort. At baseline patients in the operative cohort were significantly older, had a greater body mass index, increased pelvic tilt, and increased pelvic incidence-lumbar lordosis mismatch (all p < 0.05). With respect to deformity, patients in the operative group had higher rates of severe (i.e., ++) sagittal deformity according to SRS-Schwab modifiers for pelvic tilt, sagittal vertical axis, and pelvic incidence-lumbar lordosis mismatch (p < 0.05). At 2 years, patients in the operative cohort showed significantly increased rates of a gain in MCID for physical component summary of SF-36, ODI, and SRS-activity, SRS-pain, SRS-appearance, and SRS-mental scores. Cost analysis showed the average cost of nonoperative treatment 2 years prior to surgical intervention to be $2041. Overall, at 2 years patients in the nonoperative cohort had again in ODI of 0.36, did not show a gain in QALYs, and nonoperative treatment was determined to be cost-ineffective. However, a subset of patients in this cohort underwent successful maintenance treatment and had a decrease in ODI of 1.1 and a gain in utility of 0.006 at 2 years. If utility gained for this cohort was sustained to full life expectancy, patients' cost per QALY was $18,934 compared to a cost per QALY gained of $70,690.79 for posterior-only and $48,273.49 for combined approach in patients in the operative cohort. Patients with ASD undergoing operative treatment at baseline had greater sagittal deformity and greater improvement in health-related quality of life postoperatively compared to patients treated nonoperatively. Additionally, patients in the nonoperative cohort overall had an increase in ODI and did not show improvement in utility gained. Patients in the nonoperative cohort who had low disability and sagittal deformity underwent successful maintenance and cost-effective treatment.

Overrepresentation of Historically Underserved and Socially Vulnerable Communities Behind Levees in the United States

AbstractInfrastructure equity is an immediate concern with levees, constituting the backbone of the U.S. protection against flooding. Flooding patterns are exacerbated by anthropogenic climate change in several regions, posing a significant risk to the economy, safety, and well‐being of the nation. The evolving risk of flooding is shown to disproportionately affect historically underserved and socially vulnerable communities (HUSVCs). Here we compare the sociodemographic and socioeconomic composition of leveed and non‐leveed U.S. communities and show a substantial overrepresentation of HUSVCs in leveed areas at the state, regional, and national levels. Further, we analyze the proportion of communities designated as “disadvantaged” in leveed versus non‐leveed areas, revealing a substantially larger population of disadvantaged communities residing behind levees. Our analyses show that nationally, Hispanic are the most overrepresented population in leveed areas yielding a disparity percentage of 39.9%, followed by Native American (18.7%), Asian (17.7%), and Black (16.1%) communities. Communities characterized by low education, poverty, and disability exhibit a disproportionately higher presentation of 27.8%, 20.4%, and 5.4% in leveed areas across the U.S. In 43 states, disadvantaged communities are overrepresented behind levees, with a national disparity percentage of 40.6%. At the regional level, the highest disparity was observed in the Northeast (57.3%), followed by the West (51.3%), Southeast (38%), Midwest (29.2%), and Southwest (25%). The findings can enable decision‐ and policy‐makers to identify hotspots within HUSVCs that need to be prioritized for enhancing the integrity and climate adaptation of their levee systems.

Efficacy of orthotic support in mitigating low back pain and disability in low back pain sufferers.

Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoraco-lumbosacral orthosis are used for managing LBP. Explore and summarize quality literature on the efficacy of orthotic devices in the management of LBP. A systematic review and meta-analysis of the literature on the efficacy of orthosis in low back pain management conducted using electronic databases. Studies utilizing orthotic management alone or combined with other therapies for 2 weeks or above were included. A meta-analysis was performed on primary and secondary variables using Mean difference (MD), Inverse variance (IV), and fixed effect model with 95% CI, Physiotherapy Evidence Database (PEDro) scale, Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk bias. Out of 14671 studies, only 13 Randomized Controlled Trials (RCT) were deemed eligible for inclusion in this study, all level 1 evidence. We found that orthotics could significantly mitigate LBP (P-value < 0.00001). Similarly, a significant reeducation in LBP-associated disability was observed after orthotic intervention (P-value 0.004). Lumber orthosis plays a significant role in LBP and associated disability mitigations in sufferers of LBP.

RELIABILITY AND VALIDITY OF THE TURKISH VERSION OF THE GRADED CHRONIC PAIN SCALE 2.0

Purpose: To investigate the translation and cultural adaptation, the reliability and validity of the Turkish version of the Graded Chronic Pain Scale (GCPS) 2.0.&#x0D; Methods: The study was an observational and cross-sectional study translated and adapted into Turkish according to the Beaton protocol. Data was collected from eighty participants diagnosed with chronic low back pain (LBP) by a physician. Due to the pandemic, the scales were sent to patients via online form. Reliability was assessed using the test-retest method, parallel form method, and internal consistency. Validity was assessed using face, content, and construct validity analyses. &#x0D; Results: Cronbach's alpha was calculated as 0.89 to determine internal consistency. The intraclass correlation coefficient (ICC) was found to be 0.92 for the GCPS 2.0 total. Statisticaly significant correlation was found betweeen the GCPS 2.0 and the Oswestry Low Back Pain Disability Index (ODI) ( r = 0.759 p = 0.001) and between the GCPS 2.0 and the Roland-Morris Disability Questionnaire (RMDQ) (r = 0.777 p = 0.001). Factor analysis revealed a 2-factor structure.&#x0D; Conclusion: The Turkish version of the GCPS 2.0 is a valid and reliable measurement tool for patients with chronic LBP.

MiRNA-4769-5p/MBP and miRNA-1827/AR as key components in intervertebral disc degeneration: A network-based analysis approach

Intervertebral disc degeneration (IDD) is a common cause of low back pain and disability. Standard treatment of IDD is conservative therapies and surgical treatment, that have some limitations including low success rate. Therefore, there is a high demand for novel and more effective treatments which target the molecular mechanisms of the disease. The aim of present study was the identification of key miRNAs and target genes involved in intervertebral disc degeneration using a network-based analysis approach. Two datasets of miRNA and mRNA microarray profiling was obtained from gene expression omnibus (GEO) and analyzed using ExAtlas and GEO2R to find differentially expressed miRNAs and genes, respectively. Functional annotation was performed in DAVID database and miEAA tool. Protein-protein interaction network (PPIN) was created in STRING and analyzed using Cytoscape. MicroRNA target prediction was done using miRWalk database. Overlapping genes was identified using Venn diagram. Overall, 320 differentially expressed genes (DEGs) and 14 differentially expressed miRNAs with 1323 predicted targets was selected. Some gene ontology and pathway enriched terms were glycosaminoglycan binding, neutrophil degranulation, extracellular matrix organization, immune system, cell cycle, GTPase activity and MAPK signaling. Twenty-eight and 90 hub genes were identified after analyzing DEGs network and predicted miRNAs targets network, respectively. DEGs and targets networks had 5 and 4 clusters/functional module, respectively. Two hub genes of AR and MBP were common between networks, which were the targets of hsa-miR-1827 and hsa-miR-4769-5p, respectively. These miRNAs/targets potentially are good candidates for diagnostic (biomarker) and therapeutic applications. However, this was only a in silico study and many in vitro, in vivo and clinical evidences are needed for validation.

Prevalence of sufficient physical activity among general adult population and sub-populations with chronic conditions or disability in the USA.

Recently, the World Health Organization (WHO) released an updated global guideline on physical activity and sedentary behavior, including recommendations for sub-populations living with chronic conditions or disabilities. We aimed to examine the prevalence of meeting the WHO recommendations among these sub-populations in the USA. We conducted a cross-sectional study using data from the 2017 to 2018 cycle of the National Health and Nutrition Examination Survey (NHANES). We revealed variations in physical activity levels among individuals with chronic conditions and disability. US adults with diabetes, hypertension or disability had a lower prevalence of recommended physical activity levels than the general population. In addition, certain demographic groups such as being female, older and having lower socioeconomic status were associated with a lower likelihood of meeting the WHO recommendations on physical activity. Our findings underscore the importance of promoting physical activity levels among US adults, especially those with older age, low socioeconomic status, hypertension and disability.

Bidirectional association between handgrip strength and ADLs disability: a prospective cohort study.

Decreased handgrip strength (HGS) and activities of daily living (ADL) disability are common in aging populations. No studies have evaluated the bidirectional associations between HGS and ADL disability. This study aimed to explore the bidirectional effects of HGS and ADL disability. This study analyzed data from two waves (2011 and 2015) of China Health and Retirement Longitudinal Study (CHARLS). Low HGS is defined by the Asian Working Group for Sarcopenia criteria. Meanwhile, disability was assessed by ADLs scale. The prospective bidirectional association between HGS and ADL disability was examined using binary logistic regression. Subgroup analysis were performed according to age and gender. A total of 4,902 and 5,243 participants were included in the Stage I and Stage II analyses, respectively. On the one hand, low HGS was significantly associated with subsequent ADL disability. The odds ratio (OR) value of developing BADL disability and IADL disability were 1.60 (95% confidence interval (CI): 1.23-2.08) and 1.40 (95% CI: 1.15-1.70), respectively, in participants with low HGS. On the other hand, baseline ADL disability was associated with an increased risk of developing low HGS. The OR value of developing low HGS were 1.84 (95% CI: 1.34-2.51) and 1.46 (95% CI: 1.19-1.79) for participants with BADL disability and participants with IADL disability, respectively. Lastly, the strength of the bidirectional associations varied among subgroups. A significant bidirectional associations were identified between HGS and ADL disability. Interventions should be developed to prevent the development or progression of both low HGS and ADL disability.

Effect of Body Mechanics Training Program on Low Back Pain and Disability among Patients with Lumbar Disc Prolapse

Context: Lumbar disc prolapse is one of the most common spinal pathologies, which can be associated with debilitating pain and neurological dysfunction. Evidence suggests that patients with disc prolapse and low back pain must be taught proper body mechanics to move safely and with the least strain possible on their back.&#x0D; Aim: Evaluate the effect of body mechanics training program on low back pain and disability among patients with lumbar disc prolapse. Methods: A quasi-experimental research design (study and control group) was utilized to achieve the aim of this study. This study was conducted in the neurosurgery department and neurosurgery outpatient clinic at Benha University Hospital on a purposive sample of patients diagnosed with lumbar disc prolapse. Three tools for data collection were used; a Structured interviewing questionnaire for patients; a visual analog pain scale, and Oswestry low back pain disability questionnaire.&#x0D; Results: Showed that the total mean knowledge score for the study and control group was 33.500±3.862 and 8.140±6.402, respectively, after one-month post-program implementation, with a statistically significant difference between both groups. Also, 75% of the study group had mild pain, and 58% of the control group had moderate pain post-program implementation, with statistically significant differences between the study and control group post-program, where p=0.000. Regarding functional disability scores among study and control groups pre and one month after program implementation. It shows that (67% and 63%) of the study and control groups had severe disability pre-program implementation. In contrast, post-program implementation, 65% of the study group had moderate disability, while 13% of the control group had moderate disability.&#x0D; Conclusion: Implementing body mechanics training program for patients with lumbar disc prolapse improved knowledge, reduced pain severity, and reduced disability among the study group compared to the control group. A simplified colored booklet about using body mechanics when performing activities of daily living should be available for all patients with lumber disc prolapse.

Low back pain functional disability and associated factors: A cross-sectional study in Peruvian amateur athletes

Background: Low Back Pain Functional Disability is one of the most critical physical limitations found in athletes, even leading to their temporary or permanent retirement. In this sense, this research aimed to evaluate the frequency of lumbar functional disability and its associated factors. Methods: We designed transversal research and evaluated athletes from the Peruvian Sports Institute (IPD) of Ica in athletics, basketball, and table tennis. We administered a file to obtain demographic and epidemiological data. We identified low back pain with the DN4 instrument (Douleur Neuropathique 4 Questions) and lumbar functional disability with the athlete's disability index. Results: We evaluated 130 amateur athletes (table tennis=30, basketball=50, and athletics=50), with an average age of 23.9±8.2 years, and constituted 63.9% of men. 30% (CI95: 22.3-38.7%) of the population presented lumbar functional disability (moderate 56.4%, severe 30.8%, and very high 12.8%). Factors associated with lumbar functional disability were age (PR: 1.05, CI95: 1.01-1.09), female sex (PR: 2.21, CI95: 1.08-4.50) and neuropathic pain (PR: 0.35, CI95: 0.16-0.80). Conclusions: The frequency of lumbar functional disability is high among athletes who practice table tennis, basketball, and athletics. It is crucial to strengthen fitness programs accompanied by a periodic medical evaluation that allows the timely identification of injuries and potential functional disability due to low back pain.

Investigatıon of the effect of weight loss after laparoscopic sleeve gastrectomy on cobb angle, waist and back pain: a prospective study

BackgroundIn many studies, it has been stated that obesity causes severe increases in the risks of disc degeneration, vertebral fracture, low back, and back pain. One of the most effective treatment options for obesity is bariatric surgery. ObjectivesIn this study, the effect of weight loss on these parameters was investigated by evaluating the Cobb angle, low back, and back pain. SettingUniversity Hospital MethodsA total of 89 patients were included in the study. Laparoscopic sleeve gastrectomy (SG) was performed on all patients. In addition, Cobb angle, height, weight, and body mass index (BMI) measurements were recorded at each visit. Investigating the quality and quantity of low back pain and the loss of function caused by the patients; visual analog scale (VAS), Oswestry Low Back Pain Disability Questionnaire (OLBPDQ), Roland-Morris Disability Questionnaire (RMDQ), and SF-36 Quality of Life Questionnaire (SF36) were administered. ResultsAccording to the preoperative Cobb angles, the decrease in the 6th month (P = .029) and 12th month (P = .007) measurements after the operation was found to be statistically significant (P < .05), but it was found to be clinically insignificant. When the changes in RMDQ, OLBPDQ, VAS, and SF-36 scores were examined, the decrease in the 6th month (P = .001) and 12th month (P = .001) scores after the operation was found to be significant compared to the preoperative scores (P < .01). ConclusionsIn this study, weight loss after SG improved for patients with chronic low back and back pain and significantly improved their quality of life.

High Endplate Hounsfield Units Value Indicate Intervertebral Disc Degeneration Following Transforaminal Lumbar Interbody Fusion Surgery.

Lumbar disc degeneration (LDD) is a common cause of low back pain and disability, and its prevalence increases with age. The aim of this study is to investigate whether endplate Hounsfield unit (HU) values have an effect on lumbar disc degeneration (LDD) after transforaminal lumbar interbody fusion (TLIF) surgery in patients with degenerative lumbar stenosis. This study was a retrospective analysis of patients who underwent TLIF surgery in January 2016 to October 2019. One hundred and fifty-seven patients who underwent TLIF surgery for degenerative lumbar stenosis were enrolled in this study. Demographic data was recorded. VAS and ODI values were compared to assess the surgical outcomes in patients with or without process of LDD after TLIF surgery. Correlation analysis was performed to investigate associations between LDD and endplate HU value. Binary logistic regression analysis was carried out to study relationships between the DDD and the multiple risk factors. There was a statistically significant correlation between LDD, body mass index (BMI), age, paraspinal muscle atrophy, and total endplate scores (TEPS). Also, a strong and independent association between endplate HU value and LDD was found at every lumbar disc level (p < 0.01). After conditioning on matching factors, multivariate logistic regression analysis showed that higher endplate HU (odds ratio [OR]: 1.003, p = 0.003), higher TEPS (OR: 1.264, p = 0.002), higher BMI (odds ratio [OR]: 1.202, p = 0.002), a smaller cross-sectional area (CSA) of the paraspinal muscle preoperatively (OR: 0.096, p < 0.001) were significant predictors of LDD development after TLIF surgery. There is a significant association between LDD and endplate HU value after TLIF surgery in patients with degenerative lumbar stenosis. Beyond that, results from this study provide a mechanism by which high endplate HU value predisposes to LDD after TLIF surgery.