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Ir J Med Sci ; 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31721041


BACKGROUND: Subjects with severe obesity (BMI > 40 kg/m2) have worse physical function and sleep less than lean people (BMI 18.5-25 kg/m2). METHODS: In 554 subjects with severe obesity, we compared physical function in those with normal sleep duration (NSD, 6-9 h/night), short sleep duration (SSD, ≤ 6 h/night) and long sleep duration (LSD, ≥ 9 h/night). RESULTS: The mean (±SD) age and BMI were 43.1 (± 11.1) years and 50.9 ± 8.6 kg/m2 respectively. One hundred ninety-six (35.4%) were male. More subjects in the NSD group (n = 256) were able to ascend and descend a step 50 times than in the SSD group (n = 247) or the LSD group (n = 51, 75.5% vs 62.8% vs 56.9%, p = 0.002). A similar observation was made for step speed (0.45 ± 0.11 vs 0.43 ± 0.10 vs 0.40 ± 0.11 steps/s respectively, p = 0.001). NSD participants were less likely to have fallen in the preceding year compared to LSD participants (21.1% vs 39.2%, p = 0.007) and also reported less low back pain compared to SSD participants (60.8% vs 75.9%, p = 0.004). CONCLUSIONS: In conclusion, abnormal sleep duration is associated with reduced physical function in non-elderly severely obese subjects. The effects of sleep hygiene interventions in this cohort warrant further assessment and may be beneficial to their physical function.

Eur J Pain ; 23(8): 1403-1415, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30963658


BACKGROUND: Musculoskeletal (MSK) pain is common in obese populations. Multidisciplinary Tier 3 weight management services (WMS) are effective in reducing weight; however, MSK pain as an outcome is not routinely reported post-WMS interventions. METHODS: Following ethical approval this retrospective design study using anonymized data from a national WMS established changes in anthropometric and pain prevalence and intensity scores as well as establishing variables predictive of achieving clinically significant changes (CSC) in pain scores. RESULTS: Of the 806 patients registered to the WMS (January 2011-February 2015), 59% (n = 476; CI = 56-62) attended their reassessments at 6 months. The overall mean age was 45.1 ± 12 years and 62% (n = 294) were female. At baseline 70% (n = 281; CI = 65-75) reported low back pain (LBP) and 59% (n = 234; CI = 54-64) had knee pain. At reassessment 37.3% (n = 177) of patients lost ≥5% body weight, 58.7% (n = 279) were weight stable (5% weight loss or gain) and 4.0% (n = 19) gained ≥5% body weight. Low back and knee pain prevalence reduced significantly for those who lost ≥5% body weight. Variables predictive of a CSC in LBP numerical rating scale (NRS) score included a higher baseline NRS score, weighing more, and rating losing weight as being important (p < 0.05). Higher baseline NRS and being younger resulted in higher odds of a CSC in knee pain NRS (p < 0.05). CONCLUSIONS: Overall this WMS was effective for clinical weight loss. For those who lost most weight prevalence of knee and LBP reduced. Imbedding pain management strategies within WMS's may provide a more holistic approach to obesity management. SIGNIFICANCE: Weight loss can reduce musculoskeletal pain, particularly for those who lose more weight. Imbedding pain management strategies within these services may provide a more holistic approach to obesity management.

Pain ; 158(7): 1342-1353, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28383311


Obesity is associated with numerous chronic diseases, including musculoskeletal (MSK) pain, which affects on quality of life (QoL). There is, however, limited research providing a comprehensive MSK pain profile of an obese cohort. This retrospective study used a patient database at a national weight management service. After ethical approval, anonymized patient data were statistically analyzed to develop a pain profile, investigate relationships between pain, sleep, and function, and explore variables associated with having low back pain (LBP) and knee pain. Overall, 915 individuals attended the weight management service from January 2011 to September 2015 [male, 35% (n = 318; confidence interval [CI] = 32-38); female, 65% (n = 597; CI = 62-68); mean age 44.6]. Mean body mass index was 50.7 kg/m [class III obese (body mass index ≥40 kg/m), 92% (n = 835; CI = 91-94)]. Approximately 91% reported MSK pain: LBP, 69% (n = 539; CI = 65-72) [mean Numeric Rating Scale 7.4]; knee pain, 58% (n = 447; CI = 55-61) [mean Numeric Rating Scale 6.8]. Class III obese and multisite pain patients had lower QoL and physical activity levels, reduced sleep, and poorer physical function than less obese patients and those without pain (P < 0.05). Relationships were found between demographic, pain, self-report, psychological, and functional measures (P < 0.05). Patients who slept fewer hours and had poorer functional outcomes were more likely to have LBP; patients who were divorced, had lower QoL, and more frequent nocturia were more likely to have knee pain (P < 0.05). Multisite MSK pain is prevalent and severe in obese patients and is negatively associated with most self-report and functional outcomes. This high prevalence suggests that pain management strategies must be considered when treating obesity.

Dor Lombar/diagnóstico , Dor Musculoesquelética/diagnóstico , Obesidade/diagnóstico , Qualidade de Vida , Adulto , Índice de Massa Corporal , Feminino , Nível de Saúde , Humanos , Dor Lombar/complicações , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/complicações , Dor Musculoesquelética/fisiopatologia , Obesidade/complicações , Obesidade/fisiopatologia , Medição da Dor , Estudos Retrospectivos , Autorrelato , Programas de Redução de Peso , Adulto Jovem
Physiother Res Int ; 10(4): 190-200, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16411614


BACKGROUND AND PURPOSE: Measuring static joint angles is important to clinicians involved in assessing, diagnosing and treating musculoskeletal disorders. New measurement techniques such as the Uillinn Method (UM) employ the relatively new technology of digital photography and software to form a virtual goniometer. It is of central importance that the errors associated such new measurement techniques are known. Precision in joint angle measurement is a challenge and errors can arise from three separate categories: equipment error, examiner error or biological error. The aim of the present study was to discover the amount of equipment error associated with the UM and to present guidelines for the optimal use of a photographic based measurement technique. METHOD: This was a non-clinical agreement study design that attempted to describe the best possible agreement between a mathematical control dataset and the angles calculated from the virtual goniometer, which in this case was the UM. When this was established, the effect of rotation and placing the angle at the periphery of the camera's field of view were tested. RESULTS: The repeatability coefficient (RC) between the UM and the control data under optimal conditions was 0.81 degrees; the typical error (TE) was 0.29 degrees (n = 120). When the angle appeared at the edge of the photograph the RC increased to 2 degrees and the TE to 0.73 degrees (n = 48). When 5 degrees rotation was introduced between the camera and the angle no increase in error was detected. However, increasing amounts of rotation above 5 degrees was proportional to increases in the RC (RC at 10 degrees = 2.3 degrees 20 degrees = 3.86 degrees; 30 degrees = 14.8 degrees; 40 degrees = 27.27 degrees) and the TE (TE at 10 degrees = 0.83 degrees; 20 degrees = 2.7 degrees; 30 degrees = 5.3 degrees; 40 degrees = 9.8 degrees) scores. CONCLUSION: Photographic-based joint angle measurement techniques are subject to error if careful procedures are not observed. Best procedures include photography from a perpendicular viewpoint and centring the lens on the target angle.

Antropometria/métodos , Diagnóstico por Computador , Articulações/fisiopatologia , Doenças Musculoesqueléticas/diagnóstico , Fotografação/métodos , Antropometria/instrumentação , Humanos , Doenças Musculoesqueléticas/reabilitação , Modalidades de Fisioterapia , Reprodutibilidade dos Testes , Método Simples-Cego , Interface Usuário-Computador