Oswestry Disability Index is a better indicator of lumbar motion than the Visual Analogue Scale

The Spine J에 9월에 게재된 논문 입니다. 일상생활을 하는데에 있어 불편함 정도를 나타내는 ODI와 허리와 다리의 통증지수를 나타내는 VAS를 비교하여 어떤것이 요추의 움직임을 나타내는 지표로서 더 적절한 평가도구인지를 평가하는 연구 입니다.

VAS보다 ODI가 요추 움직임을 나타내는 임상평가항목으로서 더 적절하다는 결론 입니다^^

링크 타고 가시면 전문 보실 수 있습니다~

*Title: Oswestry Disability Index is a better indicator of lumbar motion than the Visual Analogue Scale.

일상생활 장애지수(ODI)는 통증지수(VAS)보다 요추의 움직임을 나타내는 지표로서 더 좋다.

*Authors: Ruiz FK, Bohl DD, Webb ML, Russo GS, Grauer JN

*Bibliography: SpineJ. 2014 Sep 1;14(9):1860-5.

BACKGROUND CONTEXT

The utility of various outcome measures that are used in both research and clinical practice have been studied, but the connection with range of motion (ROM) has not been well documented.

PURPOSE

To assess objectively the postulated correlation of lumbar complaints (based on standardized outcome measures) with extremes of lumbar ROM and functional ROM (fROM) with activities of daily living (ADLs) as assessed with an electrogoniometer.

STUDY DESIGN/SETTING

clinical cohort study

PATIENT SAMPLE

▶Subject: undergo a lumbar intervention (injection, decompression, and/or fusion)

OUTCOME MEASURES

1) Visual Analogue Scale (VAS)

2) Oswestry Disability Index (ODI)

-for axial extremity, lower extremity, and combined axial and lower extremity

METHODS

-Pain and disability scores were assessed with the VAS score and ODI.

-Electrogoniometer was used to measure ROM (extremes of motion in three planes) and fROM (functional motion during 15 simulated activities of daily living).

-Pain and disability scores were analyzed for statistically significant association with the motion assessments using linear regression analyses.

RESULTS

▶Subjects: 28 men and 39 women

▶Average age: 55.6 yrs(18-79 yrs)

-The ODI and VAS were associated positively (p<.001).

-Combined axial and lower extremity VAS scores were associated with lateral and rotational ROM (p<.05), but not with flexion/extension or any fROM.

-Similar findings were noted for separately analyzed axial and lower extremity VAS scores.

-ODI correlated inversely with ROM in all planes, and fROM in at least one plane for 10 of 15 ADLs (p<.05).

CONCLUSIONS

-Extremes of lumbar motion and motions associated with ADLs are of increasing clinical interest.

-ODI appears to be a better predictor of these motion parameters than the VAS (axial extremity, lower extremity, or combined) and may be more useful in the clinical setting when considering functional movement parameters.

Obesity is associated with reduced disc height in the lumbar spine but not at the lumbosacral junction: 비만도는 요천추부 접합부가 아닌 요추의 디스크 높이 감소와 연관성이 있다

Brief review

이 연구는 비만도가 요천추부 접합부가 아닌 요추의 디스크 높이 감소와 연관성이 있다는 주제의 cross-sectional study 입니다.

비만도와 디스크 높이, 요천추부의 요통간의 연관성을 보기 위하여 연구 대상자 72명의 MRI를 흉추12번(T12)~천추까지 촬영하여, 이 자료를 가지고 L1-L2~L5-S1의 디스크 높이를 측정하였습니다. 또, 비만도(BMI)를 측정하였고, 이전 2주간의 요통도 평가하였습니다.

결과적으로 전체 요추 디스크의 높이가 비만인 그룹이 비만이 아닌 그룹에 비해 감소되는 양상을 보였습니다. 특히 비만도는 L1-2와 L3-L4에서 디스크 높이의 감소와 연관성을 보였고, 요천추부 접합부에서는 유의한 관련성이 없었습니다.

그리고 요추 디스크의 높이는 최근의 요통과는 유의한 연관성이 없었습니다.

비만도는 요추에서 디스크 높이의 감소와 연관성이 있지만, 요천추부 접합부에서는 관련이 없다는 결론 입니다. 초록이 너무 길다면 아래 키포인트만 보세요!

비만일수록 디스크 높이가 낮아지는 양상을 보인다면, 다양한 질환으로 이어질수도 있겠네요.. 비만은 만병의 근원!

*Title: Obesity is associated with reduced disc height in the lumbar spine but not at the lumbosacral junction

비만도는 요천추부 접합부가 아닌 요추의 디스크 높이 감소와 연관성이 있다.

*Authors: Urquhart DM, Kurniadi I, Triangto K, Wang Y, Wluka AE, OʼSullivan R, Jones G, Cicuttini FM

*Bibliography: Spine(Phila Pa 1976). 2014 Jul 15;39(16):E962-6

STUDY DESIGN

Cross-sectional, community-based study

OBJECTIVE

To investigate the relationships between obesity, disc height, and low back pain in the lumbosacral spine.

SUMMARY OF BACKGROUND DATA

Although obesity is a recognized risk factor for low back pain, our understanding of the mechanisms for this is limited.

The evidence for an association between obesity and spinal structural changes is also conflicting.

METHODS

-Seventy-two participants underwent magnetic resonance imaging from the T12 vertebral body to the sacrum. 

-Disc height was measured from L1-L2 to L5-S1.

-Body mass index(BMI) as measured and low back pain in the previous 2 weeks was assessed.

RESULTS

-연구 대상자들의 demographic data

-요천추부에서 비만도와 디스크 높이의 연관성

-요추와 요천추부 디스크 높이와 최근 요통과의 연관성

-The mean and total lumbar disc heights were reduced in obese individuals compared with nonobese individuals.

-Although obesity was associated with reduced disc heights at the L1-L2 and L3-L4 levels, there were no significant relationship at the lumbosacral junction.

-Both mean and total lumbar disc heights were negatively associated with recent pain after adjusting for age, sex, and height.

-There were no significant relationships between disc height and recent pain at the lumbosacral junction.

CONCLUSION

-Obesity was associated with reduced disc height in the lumbar spine, but not at the lumbosacral junction, suggesting these joints may have different risk factors. 

-There was also evidence for an inter-relationship between obesity, lumbar disc height, and recent pain, suggesting that structural changes have a role in back pain and may in part explain the association between obesity and back pain.

Dynamic stability of the trunk during unstable sitting in people with low back pain

Brief review

spine저널에서 이번 달에 출판된 논문 입니다.

*Title: Dynamic stability of the trunk during unstable sitting in people with low back pain

*Authors: Freddolini Marco, Strike Siobhan, Lee Raymond

*Bibliography: Spine (Phila Pa 1976). 2014 May1;39(10):785-90.

STUDY DESIGN

Cross-sectional study

OBJECTIVE

To evaluate the dynamic stability and kinematics of the trunk during unstable sitting.

To determine the differences in these biomechanical parameters between healthy participants and participants with low back pain (LBP).

SUMMARY OF BACKGROUND DATA

Patients with LBP exhibited alterations in trunk kinematics while performing different dynamic tasks and in static posture as a result of pain. It is not clear if changing in trunk motion may reduce postural control and the ability to perform a balancing task.

METHODS

Group1: 23 participants with LBP

Group2: 31 healthy participants

*Protocol:

1) participants were sitted on a custom-made swinging chair

2) To regain the balance after tilting the chair backward for 10° and 20°

-Lumbar spine, pelvis, and chair motions were recorded using FASTRAK sensors.

-The thoracolumbar curvature of all participants was also evaluated in the standing position.

-The angular displacement of the chair was fitted in an equation describing the underdamped second-order response to a step input.

RESULTS

Kinematic analysis showed that the hip range of motion increased whereas spine range of motion angle decreased in participants with LBP for both tilt angles (P < 0.05). There were no significant differences between the 2 subject groups in the time required to regain balance, and the natural frequency and damping ratio of the kinematic equation. Lumbar lordosis significantly decreased in LBP group.

CONCLUSION

Participants with LBP showed trunk postural and movement adaptations that seems to be compensatory strategies to decrease the risk of further injuries and aggravation of the symptoms, but their ability to regain the balance was not affected by LBP. Clinicians should encourage patients with LBP to remain active while they are experiencing pain.