Disability and pain after anterior cervical decompression and fusion: A group-based trajectory analysis.

OBJECTIVES: This study aimed to identify the clusters of patients with different developmental trajectories of pain and disability after anterior cervical decompression and fusion (ACDF). METHODS: Group-based trajectory analysis among 318 patients undergoing the ACDF. RESULTS: Three developmental trajectories of disability were identified: "Steadily good functioning," "Improved functioning," and "Steadily poor functioning." Three developmental trajectories of neck pain were identified: "Worsened pain," "Pain relief," and "Steadily severe pain." Two developmental trajectories of arm pain were identified: "Decreased arm pain" and "Severe arm pain with only short-term relief." No associations were found between sex, preoperative pain duration, or body weight and probability to be classified into a particular disability trajectory group. Female sex (relative risk ratio (RRR) 1.78) and longer history of preoperative pain (RRR 2.31-2.68) increased the probability to be classified into a group with steadily severe neck pain. Longer history of preoperative pain increased the probability to be classified into group with severe arm pain with only short-term pain relief (RRR 2.68). CONCLUSION: After the ACDF, dissimilar developmental trajectories of pain and disability were identified between the patient clusters. While sex, preoperative pain duration, and body weight were not associated with differences in improvement in disability level, female sex and longer duration of preoperative pain were correlated with more severe neck and arm pain after surgery.

Concurrent changes in physical activity and physical functioning during retirement transition-a multi-trajectory analysis.

BACKGROUND: Physical activity and physical functioning have been reported to change over retirement transition, but the results have been inconsistent, and the two constructs have not been studied concurrently. The objective of this study was to examine concurrent changes in physical activity and physical functioning during transition to retirement among public sector employees, and to examine if occupation, sex, marital status, body mass index (BMI), alcohol consumption and smoking status are associated with observed different multi-trajectory paths. METHODS: 3,550 participants of the Finnish Retirement and Aging study responded to an annual survey on physical activity and physical functioning (SF-36) before and after retirement. Group-based multi-trajectory analysis was used to identify clusters with dissimilar concurrent changes in physical activity and physical functioning. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain cluster. RESULTS: Participants were 63.4 (SD 1.4) years old, 83% women, 65% professional workers. Four trajectories of concurrent changes in physical activity and physical functioning were identified, one with decreasing physical functioning and low activity, one with increasing high activity and stable high functioning and two with fluctuating moderate physical activity and stable high functioning. Single, women, obese participants and risk-users of alcohol were more likely to be classified into group with low physical activity and declining physical functioning. CONCLUSIONS: Low physical activity below the level usually recommended was associated with lower physical functioning during retirement transition. These findings could be useful when planning interventions for retirees to maintain their physical functioning level.

Physical activity and self-rated health during retirement transition: a multitrajectory analysis of concurrent changes among public sector employees.

OBJECTIVES: The aim of the study was to evaluate concurrent changes in physical activity and self-rated health during retirement transition over 4 years by multivariate trajectory analysis and to examine whether sociodemographic and lifestyle factors predict the probability of being classified to a certain subgroup of observed changes. DESIGN: Prospective cohort study. SETTING: Public sector employees. PARTICIPANTS: 3550 participants of the Finnish Retirement and Aging study. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants estimated on a yearly questionnaire their weekly hours of different types of activities converted to metabolic equivalent of task-hour/week. Self-rated health was assessed on a 5-point Likert-like scale from poor to excellent and dichotomised as suboptimal and optimal. Multivariate trajectory analysis was used to distinguish different subgroups of trajectories. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain trajectory group. RESULTS: Three trajectory groups were identified, all displaying increasing activity during retirement with a simultaneous decrease in perceived suboptimal health. Physical activity peaked at 18 months after retirement and then slightly decreased, except for initially highly physically active participants (9%) with good self-rated health, who demonstrated a constant high level of physical activity. Male gender, professional occupation, being married or cohabiting, body mass index <30 kg/m2, not smoking and using alcohol below risk levels were associated with higher physical activity and better self-rated health. CONCLUSION: Changes in physical activity and perceived health during retirement transition were interconnected. Both were improved during retirement transition, but the change was temporary. Longer follow-up studies are required to assess the changes over a longer period after retirement.

Multi-trajectory analysis of changes in physical activity and body mass index in relation to retirement: Finnish Retirement and Aging study.

BACKGROUND: Physical activity and body mass index (BMI) have been reported to change around retirement. The objective was to examine the concurrent changes in physical activity and BMI around retirement, which have not been studied before. In addition, the associations of different demographic characteristics with these changes were examined. METHODS: The prospective cohort study consisted of 3,351 participants in the ongoing Finnish Retirement and Ageing Study (FIREA). Repeated postal survey, including questions on physical activity and body weight and height, was conducted once a year up to five times before and after the retirement transition, the mean follow-up time being 3.6 years (SD 0.7). Group-based multi-trajectory modeling was used to identify several clusters with dissimilar concurrent changes in physical activity and BMI within the studied cohort. RESULTS: Of the participants, 83% were women. The mean age at the last wave before retirement was 63.3 (SD 1.4) years. Four clusters with different trajectories of physical activity and BMI were identified. BMI remained stable around retirement transition in all four clusters, varying from normal weight to class II obesity. The association of BMI trajectories with physical activity levels were inverse, however, each activity trajectory showed a temporary increase during the retirement transition. CONCLUSIONS: Retirement seems to have more effect on physical activity than BMI, showing a temporary increase in physical activity at the time of retirement.