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

Wertli, Maria M.; Held, Ulrike; Campello, Marco; Weiner, Shira Schecter

doi:10.1186/s12891-016-0992-0

Cited by 30 publications

(23 citation statements)

References 50 publications

(45 reference statements)

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“…Having a normal BMI (as opposed to being overweight or obese) also increased the odds of successful outcome following mobilisations. Although BMI has been found not to affect the spontaneous recovery from neck pain 71 or long term treatment outcomes following a multimodal physiotherapy intervention for neck pain 72 , our findings suggest that it has a moderating role on the short term effectiveness of mobilisations.…”

Section: Velocitycontrasting

confidence: 69%

Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial

Lascurain-Aguirrebeña

Newham

Casado-Zumeta

et al. 2018

Musculoskeletal Science and Practice

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2018). Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial. Musculoskeletal Science and Practice,38,[83][84][85][86][87][88][89][90]. https://doi.Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial, Musculoskeletal Science and Practice (2018), doi: https://doi. ABSTRACTBackground: Neck pain is prevalent, costly and disabling. Cervical mobilisations are frequently used to treat it but their effectiveness has been questioned by several systematic reviews. Evidence suggests that better outcomes are achieved with mobilisations when they are applied to specific patient subgroups. A criteria for patients suitable for neck mobilisations has been proposed, but the effectiveness on this patient subgroup has not been tested.Objective: To assess the effectiveness of cervical mobilisations applied to a subgroup of patients with neck pain who fulfil specific criteria.Design: Randomised controlled trial.Method: 40 patients with neck pain attending a Physiotherapy clinic were recruited and randomised to a single session of either cervical mobilisations or motionless manual contact placebo. The immediate effects on global perceived effect, range of movement (ROM), movement velocity and movement associated pain were assessed.Results: mobilisation participants reported significantly better global perceived effect (p˂0.001) and improvements in movement associated pain (p=0.041). MobilisaƟons produced a significant increase in ROM in side flexion (p=0.006) and rotation (p=0.044) when compared with placebo, but only in patients with pre-intervention ROM restriction. 29-47% of all movement associated pains were resolved following mobilisations and 11-27% following placebo. Patients in both groups showed a significant (p<0.05) increase in movement velocity, but only in those who had a velocity restriction pre-intervention.Conclusions: Cervical mobilisations are effective in improving movement-associated pain, increasing ROM and velocity, and patient perceived improvement when applied to patients with neck pain that fulfil a criteria. Their use should be advocated.

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Section: Velocitycontrasting

confidence: 69%

Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial

Lascurain-Aguirrebeña

Newham

Casado-Zumeta

et al. 2018

Musculoskeletal Science and Practice

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“…Whilst the exact mechanisms and causality are unknown, adults with CLBP are more likely to present with obesity‐related comorbidities, such as coronary heart disease . Individuals with a higher BMI also have greater disability before and after treatment, and it may have an important biomechanical influence on functional recovery in those with CLBP . For example, those with CLBP and a BMI> 27 kg/m 2 have a 16% greater risk for remaining highly disabled at 1 year .…”

Section: Multidimensional Assessment Of Chronic Low Back Painmentioning

confidence: 99%

Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective

et al. 2019

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Nonspecific chronic low back pain (CLBP) is a common clinical condition that has impacts at both the individual and societal level. Pain intensity is a primary outcome used in clinical practice to quantify the severity of CLBP and the efficacy of its treatment; however, pain is a subjective experience that is impacted by a multitude of factors. Moreover, differences in effect sizes for pain intensity are not observed between common conservative treatments, such as spinal manipulative therapy, cognitive behavioral therapy, acupuncture, and exercise training. As pain science evolves, the biopsychosocial model is gaining interest in its application for CLBP management. The aim of this article is to discuss our current scientific understanding of pain and present why additional factors should be considered in conservative CLBP management. In addition to pain intensity, we recommend that clinicians should consider assessing the multidimensional nature of CLBP by including physical (disability, muscular strength and endurance, performance in activities of daily living, and body composition), psychological (kinesiophobia, fear‐avoidance, pain catastrophizing, pain self‐efficacy, depression, anxiety, and sleep quality), social (social functioning and work absenteeism), and health‐related quality‐of‐life measures, depending on what is deemed relevant for each individual. This review also provides practical recommendations to clinicians for the assessment of outcomes beyond pain intensity, including information on how large a change must be for it to be considered “real” in an individual patient. This information can guide treatment selection when working with an individual with CLBP.

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“…Wertli et al 13 found that disability and obesity are greater in physical therapy patients presenting with low back pain but not neck pain. Based on these observations, we conducted subanalyses on cervical spine surgery patients and lumbar spine surgery patients separately.…”

Section: Discussionmentioning

confidence: 99%

Outcomes After Spine Surgery Among Patients Who Have Had Prior Bariatric Surgery

Jensen

Garvey

Dawson

et al. 2018

Global Spine Journal

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Study Design:Retrospective cohort study.Objectives:We hypothesized that spine surgery patients with a history of bariatric surgery do not differ in expectations of surgery, perceived benefit of surgical intervention, or physician determined outcome of surgery from patients with no history of bariatric surgery.Methods:Patients seen in our spine clinic between January 1, 2 009 and December 30, 2 010 were reviewed. Included patients had a history of bariatric surgery and were 18 to 89 years old. We compared their expectations for recovery, self-perceived clinical outcome (Oswestry Disability Index [ODI] or Neck Disability Index [NDI] and visual analog scale [VAS]), satisfaction with surgery, and physician-perceived clinical outcome (Odom’s criteria) to a matched cohort with no such history. Patients were matched by type of surgery (approach, levels, and procedure), diagnosis, sex, body mass index (BMI), weight category, age, and smoking status.Results:Of 210 included patients, 89 underwent spine surgery. One bariatric patient could not be matched. Seventeen received cervical spine surgery; 71 received lumbar spine surgery. The 2 cohorts had similar expectations and satisfaction. Patients with no history of bariatric surgery tended to be more satisfied than the bariatric surgery patients, but not significantly so. ODI/NDI and VAS scores were statistically worse for the bariatric cohort. Differences were attributed to differences among lumbar spine surgery patients; neck surgery patients were not different. Odom’s scores were not different between the two.Conclusions:Postoperative expectations and satisfaction of bariatric patients are similar to those of nonbariatric patients. Bariatric patients receiving lumbar spine surgery experienced inferior clinical outcomes compared with nonbariatric patients. Cervical spine surgery bariatric patients have similar clinical outcomes as nonbariatric patients.

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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

Cited by 30 publications

References 50 publications

Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial

Immediate effects of cervical mobilisations on global perceived effect, movement associated pain and neck kinematics in patients with non-specific neck pain. A double blind placebo randomised controlled trial

Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective

Outcomes After Spine Surgery Among Patients Who Have Had Prior Bariatric Surgery

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