Association of Functional Disability and Biopsychosocial Factors in Older Adults With Low Back Pain Who Live in the Amazonas State Brazil: A Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to identify social and clinical factors associated with levels of functional disability (FD) in older adults with low back pain (LBP) in the city of Manaus, Amazonas, Brazil. METHODS: A cross-sectional study of 557 adults with LBP aged ≥60 years was completed. Sociodemographic and clinical features, pain intensity (Numeric Rating Scale), FD (Roland Morris Disability Questionnaire), physical activity (International Physical Activity Questionnaire-short version), body mass index, educational level, health perception, emotional level, and self-reported diseases were evaluated. Statistical analysis was used to verify the association between quantitative variables and a group; Student t test or Mann-Whitney test, and analysis of variance (normality assumption) or Kruskal-Wallis test (non-parametric), P value of less than .05. RESULTS: There were 81.3% female participants, 54.9% self-reported their race and/or skin color as brown, and 37.8% were sedentary. Pain intensity scores were 6.26 ± 2.19 in female participants and 5.82 ± 1.84 in male participants. Mean FD scores were 11.68 ± 6.08 for female participants and 9.61 ± 5.76 for males participants, although 39.7% of the total group presented with severe disability (score ≥14) and FD was associated with female sex (P = .001), physical activity (P≤ 0.001), body mass index (P≤ .001), emotional level (P < .001), and health perception (P < .001). CONCLUSION: In this group of older adults with LBP, FD was associated with female sex, level of physical activity, body mass index, emotional level, and health perception. Many factors that were identified with FD are modifiable; therefore, interventions, such as nutrition education and re-conceptualization of self-emotional and health perception, may have potential to help in preventing and reducing FD.

Attenuation of adjuvant-induced arthritis in rats by phonophoresis with an aqueous gel of the Amazonian plant Elaeoluma nuda (Sapotaceae).

BACKGROUND: Various species of the genus Pouteria (Elaeoluma) are used by the native population of Brazil because of, among other factors, their anti-inflammatory properties. The anti-inflammatory properties of the extract of the Amazonian plant Elaeoluma nuda were recently identified in prospective pharmacological studies. OBJECTIVES: The objective of this study was to assess the anti-inflammatory effect of phonophoresis with aqueous gel extract of E. nuda in rat adjuvant-induced arthritis. METHODOLOGY: Arthritis was induced in Lewis rats with an adjuvant. Phonophoresis with E. nuda gel was then administered daily and the results compared with those obtained with phonophoresis of diclofenac diethylammonium gel and ultrasound therapy without phonophoresis. Arthritis in the different groups was evaluated by plethysmometry. Proinflammatory cytokines TNF-α and IL-1α were quantified by cytometric bead array (CBA). RESULTS: The effect of phonophoresis of aqueous gel with E. nuda extract on arthritis in rats' paws (a 33% reduction compared with the controls) was the same as that produced by phonophoresis with diclofenac diethylammonium. Ultrasound therapy without phonophoresis produced no significant effect on the 21st day of therapy. There was a significant reduction in TNF-α and IL-1α levels in the group treated with phonophoresis with E. nuda gel (p=0.0042; p=0.0003, respectively). CONCLUSION: Our results demonstrate the anti-inflammatory effect of phonophoresis with E. nuda gel on cytokines TNF-α, IL-1α and adjuvant-induced arthritis.

Prevalence of Low Back Pain and Associated Factors in Older Adults: Amazonia Brazilian Community Study.

To investigate the prevalence of low back pain (LBP) and associated factors in the older adult Amazonia Brazilian community, a cross-sectional study was conducted to evaluate 700 participants that were ≥60 years old. Pain intensity and functional disability were assessed using the Numerical Pain Scale and the Roland Morris Questionnaire, respectively, and their sociodemographic, clinical, and behavior variables were collected, i.e., age, sex, education level, socioeconomic level, anthropometric measurements, physical activity, health perception, and emotional state. The punctual prevalence rates of LBP were 42.4% (95% CI: 38.2-46.6%), and for the last 365 days, these prevalence rates were 93.7% (95% CI: 91.3-95.6%), the mean pain and functional disability scores were 6.17 ± 2.13 and 11.30 ± 6.07, and the moderate-to-severe disability was 39.7%. Pain and functional disability were associated with sex, chronic diseases, body mass index (BMI), physical activity level, health perception, and emotional level. In conclusion, the prevalence of LBP was high (for both punctual and the last 365 days), but the variables associated with being female, fewer years of schooling, sedentary behavior, diseases related to diet and the cardiovascular system, and impaired emotional levels had a higher level LBP, even though they considered themselves in good health. These findings can aid with coordinated efforts from government and health professionals to help manage and promote the prevention of LBP by considering the older adult population's needs in the state of Amazonas.