Obesity is associated with more disability at presentation and after treatment in low back pain but not in neck pain: findings from the OIOC registry
| Autor: | Shira Schecter Weiner, Ulrike Held, Marco Campello, Maria M. Wertli |
|---|---|
| Přispěvatelé: | University of Zurich, Wertli, Maria M |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty 2745 Rheumatology 610 Medicine & health Overweight Severity of Illness Index Body Mass Index 03 medical and health sciences Disability Evaluation 2732 Orthopedics and Sports Medicine 0302 clinical medicine Rheumatology Risk Factors Internal medicine Weight management Severity of illness medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Obesity Registries Cardiovascular fitness Pain Measurement Neck pain Neck Pain business.industry Middle Aged Low back pain Cross-Sectional Studies Treatment Outcome Physical therapy Female 10029 Clinic and Policlinic for Internal Medicine medicine.symptom Underweight business Body mass index Low Back Pain 030217 neurology & neurosurgery Switzerland Research Article |
| Zdroj: | Wertli, Maria Monika; Held, Ulrike; Campello, Marco; Schecter Weiner, Shira (2016). Obesity is associated with more disability at presentation and after treatment in low back pain but not in neck pain: findings from the OIOC registry. BMC musculoskeletal disorders, 17(140), p. 140. BioMed Central 10.1186/s12891-016-0992-0 BMC Musculoskeletal Disorders |
| DOI: | 10.1186/s12891-016-0992-0 |
| Popis: | BACKGROUND The influence on the treatment response in patients with low back pain (LBP) and neck pain (NP) is unknown. The aim of the study was to investigate the influence of body weight in patients with low back pain (LBP) and neck pain (NP) on baseline and end of treatment disability. METHODS Cross-sectional analysis of baseline factors. Longitudinal analysis of prospectively collected patient information at an outpatient physical therapy registry (data from June 2010 to December 2012). WHO-BMI classification was used: underweight, lean, overweight, obesity class I, obesity class II and III. The influence of body weight and a predefined set of confounders was analyzed by multiple regression models. RESULTS In LBP, disability increased with increasing BMI [lean = reference, obesity class I Beta 5.41 (95 % CI 0.75; 10.07), obesity class II-III Beta 7.58 (95 % CI 2.13; 13.03)]. Compared to lean patients, disability after treatment improved in overweight subjects [Beta -3.90 (95 % CI -7.4; -0.41)] but not in subjects with obesity class II-III [Beta 3.43 (95 % CI -3.81; 10.68)]. There were insufficient patients in the sample with severe obesity and therefore this trend has to be confirmed. The likelihood for meaningful important change (MID) was similar in all BMI subgroups. For patients with NP, BMI was not associated with baseline disability, and did not predict end of treatment disability or the likelihood of a MID. These findings must be interpreted with caution as BMI subgroups did not meet the required sample size. CONCLUSION Overweight and obesity are associated with higher levels of disability before treatment in LBP patients, but not in NP. In severely obese patients class II-III with LBP the rate of MID was lowest indicating that these patients experienced the least treatment response compared to the other groups. Further studies should address the impact of severe obesity on the prognosis of LBP. In patients with LBP, severe obesity may be an important factor to consider during the physical therapy treatment. In particular, combined treatment strategies combining weight management, cardiovascular fitness, and low back pain rehabilitation should be investigated. |
| Databáze: | OpenAIRE |
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