Functional pain severity and mobility in overweight older men and women with chronic low-back pain--part I. Am J Phys Med Rehabil 2013 May;92(5):430-8
Date
03/13/2013Pubmed ID
23478453Pubmed Central ID
PMC3676903DOI
10.1097/PHM.0b013e31828763a0Scopus ID
2-s2.0-84876882554 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
OBJECTIVE: This study determined whether mobility and functional pain were different among older men and women with chronic low-back pain and varying body mass index levels.
DESIGN: This was a comparative, descriptive study of older adults with obesity with low-back pain (N = 55; 60-85 yrs). The participants were stratified on the basis of body mass index: overweight (25-29.9 kg/m), obese (30-34.9 kg/m), and severely obese (35 kg/m). The participants completed a functional test battery (walking endurance, chair rise, stair climb, 7-day activity monitoring, and gait parameters) and pain ratings with activity ("functional pain").
RESULTS: The functional pain scores during walking and stair climb were highest in the severely obese group compared with the overweight group (P < 0.05), but the functional test scores were not found to be significantly different by body mass index. Gait base of support was 36% greater and single/double support times were 3.1%-6.1% greater in the severely obese group compared with the overweight group (P < 0.05). The women had slower chair rise and stair climb times and had slower walking velocity than did the men. Daily step numbers were lowest in the severely obese group compared with the obese and overweight groups (2971 vs. 3511 and 4421 steps per day; P < 0.05) but were not different by sex. Normalized lumbar extensor, abdominal curl, and leg press strength values were lowest in the severely obese group, and the women had 18%-34% lower strength values than did the men for all three exercises (P < 0.05). Lumbar strength was associated with stair climb, chair rise, and walking endurance times. Body mass index was an independent predictor of walking endurance time but not of steps taken per day.
CONCLUSIONS: In this study, the persons with obesity reported higher functional pain values during walking and stair climb and had lower lumbar strength compared with the overweight participants. Rehabilitation strategies that include lumbar extensor strengthening may help improve functional mobility and walking duration, both of which can help with weight management in older adults with obesity with chronic low-back pain.
Author List
Vincent HK, Seay AN, Montero C, Conrad BP, Hurley RW, Vincent KRAuthor
Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Activities of Daily LivingAge Factors
Aged
Aged, 80 and over
Body Mass Index
Chronic Disease
Cohort Studies
Disability Evaluation
Exercise Test
Female
Humans
Low Back Pain
Male
Middle Aged
Mobility Limitation
Obesity
Obesity, Morbid
Overweight
Pain Measurement
Physical Endurance
Predictive Value of Tests
Regression Analysis
Walking
