Prevalence of musculoskeletal symptoms in obese patients candidates for bariatric surgery and its impact on health related quality of life

ABSTRACT Objective This study was designed to identify the major musculoskeletal symptoms of individuals with obesity, to assess their health-related quality of life, and to evaluate the correlation between the musculoskeletal symptoms and the individuals' health-related quality of life. Materials and methods Cross-sectional study. Instruments used "Nordic Musculoskeletal Questionnaire" and "The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)". Results In total, 41 subjects were evaluated, of which 90.15% were female. The mean age of the subjects was 40.78 ± 9.85 years and their mean body-mass index was 46.87 ± 8.08. All subjects reported musculoskeletal pain in at least one anatomical region and 80.49% had pain in three or more regions. The activity limitations due to pain were reported by 75.61% of them. The most affected regions by pain were the ankles and/or feet, lower back, knees and wrists/hands/fingers. The most associated regions with activity limitations due to pain were the ankles and/or feet, knees and lower back. The presence of pain showed a negative correlation with the domains physical functioning (PF), role-physical (RP) and body pain (BP). The activity limitations showed a negative correlation with the domains PF, BP, social functioning (SF) and role-emotional (RE). Conclusion Our data showed a high prevalence of musculoskeletal pain and limitation in activities due to pain in obese subjects. The musculoskeletal symptoms had negative correlations with physical and mental components of the health-related quality of life, highlighting the importance of ensuring that patients with obesity have access to interdisciplinary care, for the prevention and rehabilitation of musculoskeletal disorders.

Idiopathic Musculoskeletal Pain in Indian children-Prevalence and Impact on Daily Routine / Prevalência e impacto nas atividades diárias da dor musculoesquelética idiopática em crianças da Índia

ABSTRACT Objectives: To study the prevalence of idiopathic musculoskeletal pain (IMSP) in school going children and its impact on daily life. Methods: One thousand eighteen apparently healthy school children aged 5–16 years were assessed and analysed for IMSP and its associated problems. Standard tests for significance were applied. Results: One hundred and sixty-five (16.2%) children mostly males (55.2%) reported IMSP. Lower limbs (52.1%) were the most common location of pain. More than 1 year of pain history was present in 15%. Thirty-seven percent children complained of discomfort during walking, 30.9%, had pain during physical exercise, 29.2% had difficulty attending lessons and 4.2% had interference in pursuing hobbies. The children were also further sub grouped into preadolescents and adolescents. There was significant difference in pain duration and duration of each pain episode in the two groups (p = 0.01). A significant number of children (21.2%) with IMSP reported school absenteeism (p < 0.001). A significant number of adolescents had history positive for contact sports (p = 0.001). Sleep disturbances were also reported to be higher in children with IMSP (29% vs. 5.7%, p = 0.001). Other associated problems in children with IMSP found were day time tiredness (51.1%), headache (47.3%) and abdominal pain (24.8%). Conclusions: Prevalence of IMSP in school children aged 5–16 yrs was found to be 16.2% and a significant percentage of these children experience interference with daily activities including school absenteeism.

RESUMO Objetivos: Estudar a prevalência de dor musculoesquelética idiopática (DMEI) em crianças em idade escolar e seu impacto nas atividades diárias. Métodos: Foram avaliadas e analisadas 1.018 crianças em idade escolar aparentemente saudáveis entre cinco e 16 anos quanto à presença de DMEI e seus problemas associados. Foram aplicados os testes de significância padrão. Resultados: Relataram DMEI 165 (16,2%) crianças, em sua maior parte do sexo masculino (55,2%). Os membros inferiores (52,1%) foram a localização mais comum da dor. A história de dor presente havia mais de um ano foi encontrada em 15% das crianças; 37% delas queixaram-se de desconforto durante a caminhada, 30,9%, tinham dor durante o exercício físico, 29,2% tinham dificuldade de frequentar as aulas e 4,2% sofriam interferência na participação em passatempos. As crianças foram ainda subagrupadas em pré-adolescentes e adolescentes. Houve diferença estatisticamente significativa na duração da dor e na duração de cada episódio de dor nos dois grupos (p = 0,01). Uma quantidade significativa de crianças com DMEI (21,2%) relatou absentismo escolar (p < 0,001). Uma quantidade significativa de adolescentes tinha história positiva de prática de esportes de contato (p = 0,001). Os distúrbios do sono também foram relatados como maiores em crianças com DMEI (29% vs. 5,7%, p = 0,001). Outros problemas associados encontrados em crianças com DMEI foram o cansaço durante o dia (51,1%), a cefaleia (47,3%) e a dor abdominal (24,8%). Conclusões: A prevalência de DMEI encontrada em crianças entre cinco e 16 anos foi de 16,2%. Uma percentagem significativa dessas crianças relata interferência nas atividades diárias, incluindo absentismo escolar.

Mujeres trabajadoras con dolor crónico osteomuscular: análisis de caso / Working women with chronic musculoskeletal pain: a case series / Mulheres que trabalham com dor musculoesquelética crônica: análise de caso

Resumen El objetivo de este estudio fue conocer las experiencias de mujeres trabajadoras con dolor crónico osteomuscular. El diseño fue cualitativo con enfoque fenomenológico. La técnica utilizada fue entrevista en profundidad, realizada a cinco mujeres trabajadoras que consultaron por dolor osteomuscular mayor a 6 meses en los servicios de ortopedia y neurocirugía de un hospital en Guadalajara, México. Se encontró percepción de rechazo, segregación, discriminación y falta de apoyo en su ambiente laboral a causa de su dolor, y sentimientos de frustración e impotencia relacionados con su padecimiento de salud. Se percibe como barrera la mala percepción del personal de la salud y la falta de eficiencia en los procesos de incapacidad, reintegración y reubicación laboral. Las responsabilidades económicas y familiares son la principal motivación para continuar trabajando con la presencia de dolor osteomuscular crónico.

Abstract This study aimed to analyze the experience of working women suffering from chronic musculoskeletal pain, using a qualitative design with a phenomenological approach. The technique drew on in-depth interviews with five working women that presented to the orthopedics and neurosurgery departments of a hospital in Guadalajara, Mexico, with a complaint of musculoskeletal pain for more than six months. The study showed that the women felt rejection, segregation, discrimination, lack of support at the workplace, and feelings of frustration and powerlessness related to their health condition. The women also perceived as a barrier the lack of efficiency in disability proceedings and job reintegration or relocation. Financial and family responsibilities were their main reason for continuing to work despite their chronic musculoskeletal pain.

Resumo O objetivo deste estudo foi conhecer as experiências de mulheres que trabalham com dor musculoesquelética crônica. O projeto foi qualitativo com abordagem fenomenológica. A técnica utilizada foi a entrevista em profundidade, realizada com cinco mulheres que trabalham com dor musculoesquelética superior a seis meses em ortopedia e serviços de neurocirurgia de um hospital em Guadalajara, México. Foram percebidas a rejeição, a segregação, a discriminação e a falta de apoio no seu ambiente de trabalho por causa de sua dor e sentimentos de frustração e impotência relacionados com o seu estado de saúde. São observadas como uma má percepção a barreira do pessoal de saúde e a falta de eficiência nos processos de deficiência, a reintegração e a localização do trabalho. As responsabilidades econômicas e familiares são a principal motivação para continuar a trabalhar com a presença de dor musculoesquelética crônica.

The cognitive behavioral therapy causes an improvement in quality of life in patients with chronic musculoskeletal pain / A terapia cognitiva-comportamental causa melhora na qualidade de vida em pacientes com dor crônica musculoesquelética

Chronic pain causes functional incapacity and compromises an individual's affective, social, and economic life. OBJECTIVE: To study the cognitive behavioral therapy (CBT) effectiveness in a group of patients with chronic pain. METHODS: A randomized clinical trial with two parallel groups comprising 93 patients with chronic pain was carried out. Forty-eight patients were submitted to CBT and 45 continued the standard treatment. The visual analogue, hospital anxiety and depression, and quality of life SF-36 scales were applied. Patients were evaluated before and after ten weeks of treatment. RESULTS: When the Control Group and CBT were compared, the latter presented reduction of depressive symptoms (p=0.031) and improvement in the domains 'physical limitations' (p=0.012), 'general state of health' (p=0.045), and 'limitations by emotional aspects' (p=0.025). CONCLUSIONS: The CBT was effective and it has caused an improvement in more domains of quality of life when compared to the Control Group, after ten weeks of treatment.

Dor crônica provoca incapacidade funcional e compromete a vida afetiva, social e econômica de um sujeito. OBJETIVO: Estudar a eficácia da terapia cognitiva-comportamental (TCC) em um grupo de pacientes com dor crônica. MÉTODOS: Um ensaio clínico randomizado com dois grupos paralelos de 93 pacientes foi realizado. Destes, 48 foram submetidos à TCC e 45 continuaram o tratamento padrão. Foram aplicadas as escalas visual analógica de dor, hospitalar de ansiedade e depressão e de qualidade de vida SF-36 antes e após dez semanas do tratamento. RESULTADOS: Ao comparar o Grupo Controle e a TCC, o último apresentou redução dos sintomas depressivos (p=0,031), melhora nos domínios 'limitações físicas' (p=0,012), 'estado geral de saúde' (p=0,045) e 'limitações por aspectos emocionais' (p=0,025). CONCLUSÕES: A TCC foi eficaz e causou mais melhora nos domínios da qualidade de vida, quando comparada com o Grupo Controle, após dez semanas de tratamento.

Sleep, stress, neurocognitive profile and healthrelated quality of life in adolescents with idiopathic musculoskeletal pain

OBJECTIVES: The aims of this study were to measure levels of sleep, stress, and depression, as well as health-related quality of life, and to assess the neurocognitive profiles in a sample of adolescents with idiopathic musculoskeletal pain. METHODS: Nineteen adolescents with idiopathic musculoskeletal pain and 20 age-matched healthy control subjects were evaluated regarding their levels of sleep and stress, as well as quality of life, and underwent neurocognitive testing. RESULTS: The sample groups consisted predominantly of females (84%), and the socioeconomic status did not differ between the two groups. In addition, the occurrence of depressive symptoms was similar between the two groups; specifically, 26% of the idiopathic musculoskeletal pain patients and 30% of the control subjects had scores indicative of depression. Teenagers in the group with idiopathic musculoskeletal pain reported poorer quality of life and sleep scores than those in the control group. Regarding stress, patients had worse scores than the control group; whereas 79% of the adolescents with idiopathic musculoskeletal pain met the criteria for a diagnosis of stress, only 35% of the adolescents in the control group met the criteria. In both groups, we observed scores that classified adolescents as being in the resistance phase (intermediate) and exhaustion phase (pathological) of distress. However, the idiopathic musculoskeletal pain group more frequently reported symptomatic complaints of physical and emotional distress. The neurocognitive assessment showed no significant impairments in either group. CONCLUSION: Adolescents with idiopathic musculoskeletal pain did not exhibit cognitive impairments. However, adolescents with idiopathic musculoskeletal pain did experience intermediate to advanced psychological distress and lower health-related quality of life, which may increase their risk of cognitive dysfunction in the future.

Aspectos psicossociais do trabalho e dor musculoesquelética em professores / Psychosocial work-related factors and musculoskeletal pain among schoolteachers

This study aimed to investigate the association between work-related psychosocial factors and musculoskeletal pain (MP) among primary schoolteachers in the public school system in Salvador, Bahia State, Brazil. A cross-sectional epidemiological study included all 4,496 teachers from the system. A self-applied mail questionnaire was used to collect information on complaints of musculoskeletal pain in the upper limbs, lower limbs, and back (dependent variables), demand-control model quadrants (independent variables), and covariables. Multivariate logistic regression showed that teachers in high-stress jobs presented the highest MP rates, and that those with low-stress jobs had the lowest rates in all three body segments. Teachers in active jobs presented higher MP rates than those in low-stress jobs, particularly in the upper limbs and back. Higher MP prevalence rates were associated with heavier psychological demand in all three body segments and with limited job control in the upper limbs only.

Investigou-se a associação entre aspectos psicossociais do trabalho e queixas de dor musculoesquelética (DME) em professores. Um estudo censitário de corte transversal investigou 4.496 professores da rede municipal de ensino infantil e fundamental de Salvador, Bahia, Brasil. Informações sobre queixas de dor musculoesquelética em membros superiores, membros inferiores e dorso (variáveis dependentes), categorias do Modelo Demanda-Controle (variáveis independentes) e covariáveis foram coletadas num questionário padronizado autoaplicável. Análises de regressão logística multivariada revelaram que professores com trabalho de alta exigência apresentaram prevalência de DME mais elevada e professores em baixa exigência, prevalência mais baixa, em cada um dos três segmentos corporais estudados. Professores em trabalho ativo apresentaram prevalência de DME mais elevada do que professores em trabalho de baixa exigência, em membros superiores e dorso. Maiores taxas de prevalência de DME associaram-se à maior demanda psicológica nos três segmentos corporais e ao baixo controle sobre o trabalho em membros superiores, apenas.