Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health.

OBJECTIVES: To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems. METHODS: Cross-sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used. RESULTS: The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR=1.70), daily TV use for more than 3hours (PR=1.17), use of laptop computer (PR=1.40), use of the cell phone in the supine position (PR=1.23), use of the cell phone in semi-supine position (PR=1.49), daily cell phone use for more than 3hours (PR=1.36), use of tablet (PR=1.67), daily tablet use for more than above 3hours (PR=1.46), and clinically important mental health problems (PR=2.62). CONCLUSION: There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.

Low back pain estimates in professional soccer: a systematic review and meta-analysis / Estimativas da dor lombar no futebol profissional: revisão sistemática e metanálise

ABSTRACT Objective: To evaluate the epidemiological and clinical characteristics of low back pain (LBP) in adult professional soccer players. Methods: Systematic review and meta-analysis. Results: The review included 44 studies. The pooled prevalence of LBP during ≤ 1 season was 1% (95%CI = 0-4%) in men. The pooled point prevalence of LBP was 25% (95%CI = 16-36%) in men and 28% (95%CI = 20-37%) in women. The pooled past-year prevalence of LBP was 34% (95%CI = 24-44%) in men. The pooled lifetime prevalence of LBP was 32% (95%CI = 25-39%) in men and 50% (95%CI = 32-69%) in women. The pooled frequency of LBP/total number of injuries was 2% (95%CI = 1-3%) in men and 4% (95%CI = 2-5%) in women. The pooled incidence rate of LBP/1,000 player-hours of exposure was 0.30 (95%CI = 0.17- 0.53) in men and 0.32 (95%CI = 0.06 -1.87) in women. The recurrence of LBP ranged from 3% to 63% in men. The intensity of LBP ranged from 1.68 (2.39) to 4.87 (2.14) points on a 0-10 scale (minimum = 0 and maximum = 8 points). The severity of LBP (days absent from professional activities due to pain) ranged from 2 (0) to 10 (19) days (minimum = 1 and maximum = 28 days). Conclusion: Adult elite soccer players have a substantial prevalence of LBP. The frequency and incidence of LBP (compared with other conditions and sports) seems to be low. Estimates of the recurrence, intensity, and severity of LBP are uncertain. Level of Evidence II, Systematic Review of Level II Studies.

RESUMO Objetivo: Investigar as características epidemiológicas e clínicas da lombalgia em jogadores profissionais de futebol. Métodos: Revisão sistemática e metanálise. Resultados: A revisão incluiu 44 estudos. A prevalência combinada de lombalgia em até uma temporada foi de 1% (IC95% = 0-4%) em homens. A prevalência pontual combinada de lombalgia foi de 25% (IC95% = 16-36%) em homens e 28% (IC95% = 20-37%) em mulheres. A prevalência combinada de lombalgia no último ano foi de 34% (IC95% = 24-44%) em homens. A prevalência combinada de lombalgia ao longo da vida foi de 32%(IC95% = 25-39%) em homens e 50% (IC95% = 32-69%) em mulheres. A frequência combinada de lombalgia/número total de lesões foi de 2% (IC95% = 1-3%) em homens e 4% (IC95% = 2-5%) em mulheres. A taxa de incidência combinada de lombalgia/1.000 jogador-horas de exposição foi de 0,30 (IC95% = 0,17-0,53) em homens e 0,32 (IC95% = 0,06-1,87) em mulheres. A recorrência de lombalgia variou entre 3-63% em homens. A intensidade da lombalgia variou entre 1,68 (2,39)-4,87 (2,14) pontos em uma escala de 0-10 (mínimo = 0; máximo = 8 pontos). A gravidade da lombalgia (ausência das atividades profissionais devido à dor) variou entre 2 (0)-10 (19) dias (mínimo = 1; máximo = 28 dias). Conclusão: Jogadores de futebol profissional apresentam alta prevalência de lombalgia substancial. A frequência e a incidência da lombalgia parecem ser baixas comparadas a outros esportes e condições. As estimativas de recorrência, intensidade e gravidade da lombalgia são incertas. Nível de Evidência II, Revisão Sistemática de Estudos de Nível II.

Percutaneous lumbar discectomy: a systematic review / Discectomia percutânea lombar: uma revisão sistemática

Introduction: Low back pain is a clinical condition with a multifactorial etiopathogenesis, which has a high socioeconomic impact, especially in the economically active population, as it is associated with frequent absenteeism and reduced quality of life. Through intervertebral disc degeneration, a progressive instability of the compromised region is observed, triggering a harmful positive feedback mechanism that further promotes intervertebral disc disease. Built by the interaction between the predisposing biopsychosocial components, a multidisciplinary therapeutic proposition is suggested. In persistent low back pain, treatment involves surgical procedures such as Percutaneous Lumbar Discectomy. Objectives: to evaluate the scientific evidence regarding the clinical outcomes and safety of this surgery. Method: systematic review duly registered in Prospero (CRD42022370811), based on the PICOD question, elaborated from a Boolean search in different databases for scientific articles, evaluated and selected in a paired way based on the eligibility criteria. In addition to extracting data related to the proposed objectives, the articles included were evaluated in relation to their level of evidence and strength of recommendation. Results: among the 12 articles included, it was observed that it is a clinically effective and safe procedure. In the set of evidences gathered, they are of high and moderate level of evidence with respective strength of recommendation strong/good and weak/moderate. Conclusion: Percutaneous Lumbar Discectomy promotes significant reduction of pain and increase in body functionality, in addition to preserving local musculoskeletal structures and preventing post-surgical joint instability. It is, therefore, a safe and clinically effective minimally invasive procedure for patients with herniated discs.

Introdução: a lombalgia é uma condição clínica de etiopatogenia multifatorial, que desencadeia um elevado impacto socioeconômico especialmente na população economicamente ativa, por associar-se ao absenteísmo frequente e à redução da qualidade de vida. Observa-se mediante a degeneração do disco intervertebral, uma instabilidade progressiva da região comprometida desencadeando um mecanismo de feedback positivo prejudicial que promove ainda mais a doença do disco intervertebral. Edificada pela interação entre os componentes biopsicossocial predisponentes, sugere-se uma proposição terapêutica multidisciplinar. Na dor lombar persistente o tratamento envolve procedimentos cirúrgicos como a Discectomia Percutânea Lombar. Objetivo: avaliar as evidencias científicas relativas aos desfechos clínicos e à segurança desta cirurgia. Método: revisão sistemática devidamente registrada no Prospero (CRD42022370811), fundamentada na pergunta PICOD acrônimo para Paciente, Intervenção, Comparação, Desfechos (outcomes) e Design, elaborada a partir de busca booleana em diferentes bases de dados por artigos científicos, avaliados e selecionados de forma pareado com base nos critérios de elegibilidade. Além da extração de dados relativos aos objetivos propostos, os artigos incluídos foram avaliados em relação ao respectivo nível de evidencia e força de recomendação. Resultados: dentre os 12 artigos incluídos, observou-se que se trata de um procedimento clinicamente efetivo e seguro. No conjunto de evidencias reunidas são de alto e moderado nível de evidencia com respectiva força de recomendação forte/boa e, fraca/moderada. Conclusão: a Discectomia Percutânea Lombar promove relevante redução da dor e aumento da funcionalidade corporal, além de preservar as estruturas musculoesqueléticas locais e prevenir a instabilidade articular pós-cirúrgica. Trata-se, portanto, de um procedimento minimamente invasivo seguro e clinicamente efetivo para os pacientes portadores de hérnia discal.

Application of vascular photobiomodulation therapy in individuals with low back pain and its relationship with global methylation / Aplicação da terapia por fotobiomodulação vascular em indivíduos com lombalgia e sua relação com a metilação global

ABSTRACT BACKGROUND AND OBJECTIVES: Low back pain is among the most disabling conditions worldwide, and among the epigenetic factors, methylation in CpG islands of gene promoter regions can modulate gene expression, potentially correlating with the development of the disease and providing insights into the choice of treatment. The objective of this study was to assess the efficacy of therapy using modified ILIB related to DNA methylation processes in low back pain. Secondary objectives of this study included investigating pain intensity, gender, sociodemographic data, and physical-functional profile. METHODS: This prospective study was conducted in a municipality in the southern region of Brazil. The sample consisted of 30 participants of both genders, with an average age of 41.77 years. The following aspects were analyzed: anthropometric characteristics, global methylation using the ELISA method, pain level, physical activity level, functional disabilities, and hesitancy level related to work and physical activity-related activities. RESULTS: A statistically significant association was observed between methylation levels before and after treatment application for the experimental and placebo groups (p < 0.005), demonstrating a mean responsiveness between methylation and treatment (d = 0.5). However, there were no other statistically significant associations correlated with the other work variables. CONCLUSION: The results obtained in this study suggest the need for further research related to the identification of specific genes in methylation, as well as the standardization of dosimetry used for transcutaneous ILIB laser application in the radial artery.

RESUMO JUSTIFICATIVA E OBJETIVOS: A lombalgia está entre as condições mais incapacitantes no mundo e; dentre os fatores epigenéticos, a metilação em ilhas CpG de regiões promotoras de genes pode modular a expressão gênica permitindo uma possível correlação ao desenvolvimento da doença, como também pode trazer esclarecimentos a respeito do tratamento a ser escolhido. O objetivo deste estudo foi verificar a eficácia da terapia através do uso do ILIB modificado relacionada ao processo de metilação de DNA na lombalgia. Os objetivos secundários deste estudo foram a investigação da intensidade da dor, sexo, dados sociodemográficos e perfil físico-funcional. MÉTODOS: Este estudo, desenvolvido em um município da região sul do Brasil, caracteriza-se como prospectivo. A amostra deste estudo foi composta por 30 participantes, de ambos os sexos, com idade média de 41,77 anos. Foram analisados os seguintes aspectos: características antropométricas, metilação global através do método ELISA, nível de dor, nível de atividade física, incapacidades funcionais e nível de hesitação para realizar atividades relacionada ao trabalho e atividade física. RESULTADOS: Observou-se associação estatisticamente significativa entre os níveis de metilação antes e a após aplicação do tratamento para grupo experimental e placebo (p<0,005) demostrando uma média responsividade entre as variáveis metilação e tratamento (d=0,5). No entanto, não houve nenhuma outra associação estatística correlacionada as demais variáreis do trabalho. CONCLUSÃO: Os resultados obtidos neste estudo sugerem que há necessidade mais estudos relacionados a identificação de genes específicos na metilação, além da necessidade de padronização de dosimetria utilizadas para aplicação do laser ILIB de forma transcutânea, em artéria radial.

Employee medical leave in mis-tlif or open-tlif in elective surgery in brazil / Licença médica do empregado no mis-tlif ou open-tlif em cirurgia eletiva no brasil / Licencia médica del empleado en mis-tlif o open-tlif en cirugía electiva en brasil

ABSTRACT: Objective: To compare the effects of the two techniques (minimally invasive transforaminal inter somatic lumbar fusion [MIS-TLIF] and open transforaminal lumbar interbody fusion [TLIF]) in the treatment of lumbar degenerative disease. Methods: This is a retrospective cohort study. The outcomes investigated were: intensity of low back pain, functional disability of the lumbar spine, discharge time, return to work, lumbar lordosis angle, cost of individual sources due to the period of work-related absenteeism, and societal perspective costs in the treatment of low-grade lumbar degenerative disease. The data was obtained through the analysis of data contained in the electronic medical records of 100 patients who underwent one of the two surgical techniques from January 2019 to May 2021 in a High Complexity Orthopedic Surgery. The outcomes investigated were set 12 months postoperatively. Results: No statistical differences were observed in terms of sex, age, employment, and diagnosis grade between groups. MIS-TLIF was associated with significant improvement in the intensity of low back pain, functional disability of the lumbar spine, discharge time, return to work, cost of individual sources due to the period of work-related absenteeism, and societal perspective costs. The variation in the lumbar lordosis angle of the MIS-TLIF group was smaller when compared to TLIF. Conclusion: Considering that MIS-TLIF was achieved with satisfactory short-term improvements, it may be used as an alternative strategy to TLIF to promote clinical and economical improvements in treating lumbar degenerative disease. Level of Evidence III; Comparative Retrospective Study.

RESUMO: Objetivo: Comparar os efeitos das duas técnicas (fusão intersomática lombar transforaminal minimamente invasiva [MIS-TLIF] e fusão intersomática lombar transforaminal aberta [TLIF]) no tratamento da doença degenerativa lombar. Métodos: Trata-se de um estudo de coorte retrospectivo. Os desfechos investigados foram: intensidade da dor lombar, incapacidade funcional da coluna lombar, tempo de alta, retorno ao trabalho, ângulo de lordose lombar, costa de fontes individuais devido ao período de absenteísmo relacionado ao trabalho e custos da perspectiva social no tratamento de doença degenerativa lombar de baixo grau. Os dados foram obtidos por meio da análise dos dados contidos nos prontuários eletrônicos de 100 pacientes submetidos a uma das duas técnicas cirúrgicas no período de janeiro de 2019 a maio de 2021 em uma Cirurgia Ortopédica de Alta Complexidade. Os resultados investigados foram definidos 12 meses após a cirurgia. Resultados: Não foram observadas diferenças estatísticas quanto ao sexo, idade, vínculo empregatício, grau de diagnóstico entre os grupos. O MIS-TLIF foi associado a melhora significativa na intensidade da dor lombar, incapacidade funcional da coluna lombar, tempo de alta, retorno ao trabalho, custo de fontes individuais devido ao período de absenteísmo relacionado ao trabalho e custos de perspectiva social. A variação do ângulo da lordose lombar do grupo MIS-TLIF foi menor quando comparado ao TLIF. Conclusão: Considerando que o MIS-TLIF foi alcançado com melhoras satisfatórias em curto prazo, pode ser usado como uma estratégia alternativa ao TLIF para promover melhorias clínicas e econômicas no tratamento da doença degenerativa lombar. Nível de Evidência III; Estudo Retrospectivo Comparativo.

RESUMEN: Objetivo: Comparar los efectos de dos técnicas (fusión lumbar intersomática transforaminal mínimamente invasiva [MIS-TLIF] y fusión intersomática lumbar transforaminal abierta [TLIF]) en el tratamiento de la enfermedad degenerativa lumbar. Métodos: Este es un estudio de cohorte retrospectivo. Los desenlaces investigados fueron: intensidad del dolor lumbar, incapacidad funcional de la columna lumbar, tiempo de alta, regreso al trabajo, ángulo de lordosis lumbar, costa de fuentes individuales debido al período de ausentismo relacionado con el trabajo y costos de perspectiva social en el tratamiento de enfermedad degenerativa lumbar de bajo grado. Los datos se obtuvieron a través del análisis de los datos contenidos en las historias clínicas electrónicas de 100 pacientes que se sometieron a alguna de las dos técnicas quirúrgicas durante el período de enero de 2019 a mayo de 2021 en una Cirugía Ortopédica de Alta Complejidad. Los resultados investigados se establecieron 12 meses después de la operación. Resultados: No se observaron diferencias estadísticas en cuanto a sexo, edad, ocupación, grado de diagnóstico entre grupos. MIS-TLIF se asoció con una mejora significativa en la intensidad del dolor lumbar, la discapacidad funcional de la columna lumbar, el tiempo de alta, el regreso al trabajo, la costa de fuentes individuales debido al período de ausentismo relacionado con el trabajo y los costos de perspectiva social. La variación en el ángulo de lordosis lumbar del grupo MIS-TLIF fue menor en comparación con TLIF. Conclusión: considerando que MIS-TLIF se logró con mejoras satisfactorias a corto plazo, puede usarse como una estrategia alternativa a TLIF para promover mejoras clínicas y económicas en el tratamiento de la enfermedad degenerativa lumbar. Nivel de Evidencia III; Estudio Retrospectivo Comparativo.

Quality of life analysis on patients after arthroplasty or lumbar arthrodesis / Análise da qualidade de vida em pacientes pós artroplastia ou artrodese lombar / Análisis de la calidad de vida en pacientes tras una artroplastia o artrodesis lumbar

ABSTRACT Objective: To perform a retrospective analysis of patients with degenerative disc disease of the lumbar spine undergoing arthrodesis or lumbar arthroplasty in terms of functional capacity and quality of life. Methods: Retrospective observational study analyzing the medical records of patients undergoing arthrodesis or lumbar arthroplasty, followed-up at an outpatient clinic from 2018 to 2020. Patient characteristics were evaluated; the quality of life through the results of the Short Form 36 Health Survey Questionnaire (SF-36) and the functional capacity using the Oswestry Disability Index (ODI) in the pre-surgical and post-surgical periods (6 months, 1 and 2 years). The criterion to establish statistical significance was p≤0.05. Results: Sixty-one patients were evaluated. After the surgical interventions, the individuals migrated from the classification of invalid (61.4%-64.6%) to minimal/moderate disability (17.7%-25.6%). There was a decline in ODI scores over time of follow-up (p≤0.001) as well as in SF-36 values (p≤0.001) for all surgical techniques. In this regard, evaluating the difference in means revealed the better performance of lumbar arthroplasty (p≤0.001). Conclusion: The data suggest that lumbar arthroplasty offers greater benefits to patients regarding functional capacity and quality of life. Level of Evidence III; Retrospective, descriptive, observational study.

Resumo: Objetivo: Realizar uma análise retrospectiva de pacientes com doença degenerativa discal da coluna lombar submetidos à artrodese ou artroplastia lombar em termos de capacidade funcional e qualidade de vida. Métodos: Estudo observacional retrospectivo de análise de prontuários dos pacientes submetidos à artrodese ou artroplastia lombar, acompanhados ambulatorialmente no período de 2018 a 2020. Foram avaliadas as características dos pacientes; a qualidade de vida através dos resultados do Questionário Short Form 36 Health Survey Questionnaire (SF-36) e a capacidade funcional utilizando o Oswestry Disability Index (ODI) nos períodos pré-cirúrgico e pós-cirúrgico (06 meses, 01 ano e 02 anos). O critério para estabelecer significância estatística foi valores de p≤0,05. Resultados: Foram avaliados 61 pacientes. Após as intervenções cirúrgicas, os indivíduos migraram da classificação inválido (61,4%-64,6%) para incapacidade mínima/moderada (17,7%-25,6%). Houve declínio nos escores do ODI ao longo do tempo de acompanhamento (p≤0,001) assim como nos valores do SF-36 (p≤0,001) para todas as técnicas cirúrgicas. Nesse quesito, a avaliação da diferença de médias revelou melhor desempenho da artroplastia lombar (p≤0,001). Conclusão: Os dados sugerem que a artroplastia lombar oferece maior benefício para os pacientes em termos de capacidade funcional e de qualidade de vida. Nível de Evidência III; Estudo retrospectivo, descritivo, observacional.

Resumen: Objetivo: Realizar un análisis retrospectivo de pacientes con enfermedad degenerativa del disco de la columna lumbar sometidos a artrodesis o artroplastia lumbar en términos de capacidad funcional y calidad de vida. Métodos: Estudio observacional retrospectivo analizando las historias clínicas de pacientes sometidos a artrodesis o artroplastia lumbar, seguidos en consulta externa desde 2018 hasta 2020. Se evaluaron las características de los pacientes; la calidad de vida a través de los resultados del Cuestionario de Encuesta de Salud Short Form 36 (SF-36) y la capacidad funcional utilizando el Oswestry Disability Index (ODI) en los periodos prequirúrgico y posquirúrgico (06 meses, 01 año y 02 años). El criterio para establecer la significación estadística fue p≤0,05. Resultados: Se evaluaron 61 pacientes. Después de las intervenciones quirúrgicas, los individuos migraron de la clasificación de inválidos (61,4%-64,6%) a invalidez mínima/moderada (17,7%-25,6%). Hubo una disminución en las puntuaciones del ODI a lo largo del tiempo de seguimiento (p≤0,001) así como en los valores del SF-36 (p≤0,001) para todas las técnicas quirúrgicas. En ese sentido, la evaluación de la diferencia de medias reveló un mejor desempeño de la artroplastia lumbar (p≤0,001). Conclusión: Los datos sugieren que la artroplastia lumbar ofrece mayor beneficio a los pacientes en términos de capacidad funcional y calidad de vida. Nivel de Evidencia III; Estudio retrospectivo, descriptivo, observacional.

[Low back pain during pregnancy]. / Lombalgia na gestação.

OBJECTIVE: Low back pain is a common complaint among pregnant women. It is estimated that about 50% of pregnant women complain of some form of back pain at some point in pregnancy or during the postpartum period. The aim of this study was to evaluate the frequency of low back pain during pregnancy and its characteristics. METHODS: Cross-sectional study with low-risk pregnant women. After approval by the Human Research Ethics Committee and receiving written informed consent, we included pregnant women over 18 years of age and excluded those with psychiatric disorders, previous lumbar pathologies, and receiving treatment for low back pain. RESULTS: We interviewed 97 pregnant women. The frequency of low back pain was 68%. The mean age was 26.2 years and the median gestational age was 30 weeks. Fifty-eight pregnant women declared themselves as brown (58%). Most (88.6%) were married or living in common-law marriage, fifty-six (57.7%) worked outside the home, and 71 (73.2%) had completed high school. Low back pain was more frequent during the second trimester of pregnancy (43.9%), referred to as a "burning" sensation in 37.8% of patients, with intermittent frequency in 96.9% of the women. The symptoms got worse at night (71.2%). Resting reduced low back pain in 43.9% of pregnant women, while the standing position for a long time worsened it in 27.2% of patients. CONCLUSION: Low back pain is common in pregnant women, has specific characteristics, and is more frequent in the second trimester of pregnancy. This indicates the need for prevention strategies that enable better quality of life for pregnant women.

Fear-avoidance beliefs increase perception of pain and disability in Mexicans with chronic low back pain.

BACKGROUND: Fear-avoidance beliefs are related to the prognosis of chronicity in low back pain in subacute stages, however in chronic pain, is no clear the influence of these factors; it has been suggested that the study population can determine the magnitude of influence on disability and pain of those suffering from back pain. Currently, information does not exist in the Mexican population. OBJECTIVE: To analyze the relationship between fear-avoidance beliefs with pain and disability in Mexicans with chronic low back pain; analyze potentials differences between subgroups according to the time of evolution. METHODS: Cross-sectional study in Mexicans with chronic LBP aged between 18 and 45. Data were collected on general socio demographic characteristics, time of evolution, body mass index, pain, disability and fear-avoidance beliefs. RESULTS: 33 men and 47 women, with an average age of 34.19±7.65 years. Higher scores of fear-avoidance beliefs were obtained in women (47.2±20.99 versus 38.5±9.7; p=0.05) and single participants (p=0.04). A positive correlation was found between disability (r=0.603, p<0.001) and pain (r=0.234, p=0.03) with high scores of fear-avoidance beliefs. Through generalized linear models for disability, total score of the fear avoidance beliefs questionnaire showed a standardized beta coefficient of 0.603, p<0.001 (R2 of 0.656); for pain showed a standardized beta coefficient of 0.29, p=0.01 (R2 of 0.721). CONCLUSION: The present study suggests that there is a strong relationship between pain severity, FABQ scores, and functional disability in Mexicans with chronic LBP.

Características demográficas y laborales del personal de enfermería con lumbalgia en hospital público de Corrientes, 2021 / Demographic and occupational characteristics of the nursing staff with low back pain in the public hospital of Corrientes, 2021

El dolor lumbar es una enfermedad laboral frecuente en enfermería, asociado a exigencias del cargo y múltiples causas. La intensidad varía según postura y actividad física, acompañándose de limitación dolorosa del movimiento, ser localizado, referido o irradiado. Objetivo: Determinar las características demográficas y laborales del personal de enfermería que presenta dolor lumbar de un hospital público de Corrientes, capital en el año 2021. Metodología: Diseño cuantitativo, transversal, observacional. Población 170 trabajadores de enfermería del hospital. Se incluyeron aquellos con dolor lumbar y que no cursaban enfermedades crónicas o invalidantes. Los datos se recogieron mediante cuestionario de elaboración propia, validado mediante prueba piloto. Variables: edad, género, formación en enfermería, frecuencia, intensidad y duración del dolor, principal tipo de dolor, tratamiento farmacológico y no farmacológico, principal situación generadora, tipo de trabajo realizado, turno y antigüedad laboral. Resultados: Se analizaron las respuestas de 115 trabajadores con dolor lumbar; amplitud etaria 22 a 62 años, promedio 36 años; 67% mujeres. El dolor lumbar fue diario en 22%, frecuente en 35%, ocasional en 43%. Según intensidad, 13% manifestó dolor leve, 47% moderado y 40% severo. El dolor era diario en 10% de jóvenes, en 20% de adultos jóvenes, en 45% de adultos intermedios y en 59% de adultos tardíos. En duración, el 73% lo padecía en forma aguda y el 27% crónica. En localización del dolor, el 75% indicó padecer dolor localizado y 25% irradiado. Principales situaciones generadoras de lumbalgia, 51% al movilizar pacientes, 23% al permanecer de pie, 18% al trasladar objetos pesados. En la percepción del personal sobre tipo de trabajo habitual, el 41% indicó pesado y 12% muy pesado. El 86%de los encuestados utilizó AINES. Conclusión: La intensidad del dolor lumbar es menor en el personal más joven respecto a los mayores. Los más jóvenes refieren dolor localizado, los de mayor edad dolor irradiado. El principal desencadenante del dolor lumbar es la movilización de pacientes[AU]

Low back pain is a common occupational disease in nursing, associated with the demands of the position and multiple causes. Te intensity varies according to posture and physical activity, accompanied by painful limitation of movement, being localized, referred or irradiated. Objective: To determine the demographic and labor characteristics of the nursing staff that presents low back pain in a public hospital in Corrientes, capital in the year 2021. Methodology: Quantitative, cross-sectional, observational design. Population 170 hospital nursing workers. Tose with low back pain and who did not have chronic or disabling diseases were included. Te data was collected through a self-prepared questionnaire, validated through a pilot test. Variables: age, gender, nursing training, frequency, intensity and duration of pain, main type of pain, pharmacological and nonpharmacological treatment, main generating situation, type of work performed, shif and work seniority. Results: Te responses of 115 workers with low back pain were analyzed; age range 22 to 62 years, average 36 years; 67% women. Low back pain was daily in 22%, frequent in 35%, occasional in 43%. According to intensity, 13% reported mild pain, 47% moderate and 40% severe. Pain was daily in 10% of youth, 20% of young adults, 45% of middle adults, and 59% of late adults. In duration, 73% suffered from it acutely and 27% chronically. In pain location, 75% indicated localized pain and 25% irradiated. Main situations that generate low back pain, 51% when moving patients, 23% when standing, 18% when moving heavy objects. In the perception of the personnel on the type of habitual work, 41% indicated heavy and 12% very heavy. 86% of those surveyed used NSAIDs. Conclusion: Te intensity of low back pain is lower in the younger staff compared to the older ones. Te youngest refer localized pain, the oldest radiated pain. Te main trigger of low back pain is the mobilization of patients[AU]

A lombalgia é uma doença ocupacional comum na enfermagem, associada às demandas do cargo e a múltiplas causas. A intensidade varia de acordo com a postura e atividade física, acompanhada de limitação dolorosa do movimento, sendo localizada, referida ou irradiada. Objetivo: Determinar as características demográfcas e laborais da equipe de enfermagem que apresenta lombalgia em um hospital público de Corrientes, capital no ano de 2021. Metodologia: Desenho quantitativo, transversal, observacional. População 170 trabalhadores de enfermagem hospitalar. Foram incluídos aqueles com lombalgia e que não possuíam doenças crônicas ou incapacitantes. Os dados foram coletados por meio de um questionário autoelaborado, validado por meio de um teste piloto. Variáveis: idade, sexo, formação do enfermeiro, frequência, intensidade e duração da dor, principal tipo de dor, tratamento farmacológico e não farmacológico, principal situação geradora, tipo de trabalho realizado, turno e antiguidade no trabalho. Resultados: Foram analisadas as respostas de 115 trabalhadores com lombalgia; faixa etária de 22 a 62 anos, média de 36 anos; 67% mulheres. A dor lombar foi diária em 22%, frequente em 35%, ocasional em 43%. De acordo com a intensidade, 13% relataram dor leve, 47% moderada e 40% intensa. A dor foi diária em 10% dos jovens, 20% dos adultos jovens, 45% dos adultos intermediários e 59% dos adultos tardios. Em duração, 73% sofriam agudamente e 27% cronicamente. Na localização da dor, 75% indicaram dor localizada e 25% irradiada. Principais situações que geram lombalgia, 51% ao movimentar pacientes, 23% ao fcar em pé, 18% ao movimentar objetos pesados. Na percepção do pessoal sobre o tipo de trabalho habitual, 41% indicaram pesado e 12% muito pesado. 86% dos entrevistados usaram AINEs. Conclusão: A intensidade da dor lombar é menor na equipe mais jovem em comparação com a mais velha. Os mais jovens referem dor localizada, os mais velhos referem dor irradiada. O principal desencadeador da lombalgia é a mobilização dos pacientes[AU]

Chronic low back pain in patients with systemic lupus erythematosus: prevalence and predictors of back muscle strength and its correlation with disability.

OBJECTIVE: To determine the prevalence of Chronic Low Back Pain and predictors of Back Muscle Strength in patients with Systemic Lupus Erythematosus. METHODS: Cross-sectional study. Ninety-six ambulatory patients with lupus were selected by non-probability sampling and interviewed and tested during medical consultation. The outcomes measurements were: Point prevalence of chronic low back pain, Oswestry Disability Index, Tampa Scale of Kinesiophobia, Fatigue Severity Scale and maximal voluntary isometric contractions of handgrip and of the back muscles. Correlation coefficient and multiple linear regression were used in statistical analysis. RESULTS: Of the 96 individuals interviewed, 25 had chronic low back pain, indicating a point prevalence of 26% (92% women). The correlation between the Oswestry Index and maximal voluntary isometric contraction of the back muscles was r=-0.4, 95% CI [-0.68; -0.01] and between the maximal voluntary isometric contraction of handgrip and of the back muscles was r=0.72, 95% CI [0.51; 0.88]. The regression model presented the highest value of R2 being observed when maximal voluntary isometric contraction of the back muscles was tested with five independent variables (63%). In this model handgrip strength was the only predictive variable (ß=0.61, p=0.001). CONCLUSIONS: The prevalence of chronic low back pain in individuals with systemic lupus erythematosus was 26%. The maximal voluntary isometric contraction of the back muscles was 63% predicted by five variables of interest, however, only the handgrip strength was a statistically significant predictive variable. The maximal voluntary isometric contraction of the back muscles presented a linear relation directly proportional to handgrip and inversely proportional to Oswestry Index i.e. stronger back muscles are associated with lower disability scores.

Is There Any Association between the Severity of Disc Degeneration and Low Back Pain? / Existe alguma associação entre gravidade de degeneração discal e dor lombar?

Abstract Objective To access the possibility that higher degrees of disc degeneration lead to higher levels of pain and dysfunction. Methods Magnetic resonance imaging (MRI) scans of 85 patients with low back pain lasting for more than 12 weeks were evaluated, and the degree of disc degeneration was quantified according to the Pfirrmann grading system. The Pfirrmann degree in each disc space from L1-L2 to L5-S1, the maximum degree of Pfirrmann (Pfirrmannmax) between the lumbar discs, and the sum of Pfirrmann (Pfirrmann-sum) degrees were correlated (through the Spearman test) with the Oswestry Disability Index (ODI) and the Visual Analogical Scale (VAS) for pain. Results In total, 87% of the patients had moderate to severe lumbar disc degeneration measured by Pfirrmann-max, and the most degenerated discs were L4-L5 and L5S1. There was a week to moderate correlation regarding the Pfirrmann-max (r » 0,330; p» 0.002) and the Pfirrmann-sum (r » 0,266; p» 0,037) and the ODI, and the Pfirrmann scores in L1-L2 were correlated with the ODI and the VAS. Conclusion Patients with chronic idiopathic low back pain frequently have moderate to severe lumbar disc degeneration, which has a negative impact on the quality of life of the patients. Low degrees of degeneration in L1-L2 might be related with higher degrees of pain and of functional disability.

Resumo Objetivo Avaliar a possibilidade de maiores graus de degeneração discal levarem a maiores dor e disfunção. Métodos Exames de imagem por ressonância magnética (IRM) de 85 pacientes com lombalgia idiopática por mais de 12 semanas foram avaliados, sendo quantificado o grau de degeneração discal de acordo com a escala de Pfirrmann. O grau de Pfirrmann em cada espaço discal de L1-L2 a L5-S1, o grau máximo de Pfirrmann (Pfirrmann-max) entre os discos lombares, e a soma dos graus de Pfirrmann (Pfirrmann-soma) foram correlacionados (por meio do teste de Spearman) com o Índice de Incapacidade de Oswestry (IIO) e a escala visual analógica (EVA) de dor. Resultados No total, 87% dos pacientes tinha degeneração discal moderada ou acentuada medida pelo Pfirrmann-max, sendo L4-L5 e L5-S1 os discos mais degenerados. Houve uma correlação de fraca a moderada entre o Pfirrmann-max (r » 0,330; p» 0.002) e a Pfirrmann-soma (r » 0,266; p» 0,037) e o IIO, e entre o grau de Pfirrmann em L1-L2 e o IIO e a EVA. Conclusão A degeneração discal lombar moderada ou acentuada é frequente em indivíduos com lombalgia crônica idiopática, e tem um impacto negativo na qualidade de vida dos pacientes. Pequenos graus de degeneração discal em L1-L2 podem determinar maior grau de dor e maior incapacidade funcional.

Perfil da dor lombar em trabalhadores dos restaurantes de uma universidade pública do sul do Brasil / Lower back pain profile in restaurant workers at a public university in southern Brazil

A realização das tarefas dos trabalhadores em restaurantes universitários (RUs) envolve movimentos repetitivos de coluna, levantamento de pesos excessivos e permanência na postura em pé por períodos prolongados de tempo, sendo indicada avaliação da região lombar desses trabalhadores. Assim, o objetivo deste estudo foi traçar o perfil da dor lombar em trabalhadores dos RUs de uma Universidade Pública do Sul do Brasil. Trata-se de estudo quantitativo observacional de corte transversal, no qual foram selecionados participantes de 18 a 59 anos, de ambos os sexos, que exerciam alguma função dentro dos restaurantes de uma universidade do sul do Brasil e que relataram presença dor lombar. Os participantes foram avaliados, por: questionário sociodemográfico, escala visual numérica da dor (EVN), amplitude de movimento (ADM) da coluna lombar e questionário Start Back Screening Tool Brasil (SBST). Os resultados são apresentados em frequência absoluta e relativa, correlação de Spearman, e as variáveis numéricas em média e desvio padrão ou mediana, mínimo, máximo. Foram incluídos no estudo 28 participantes sendo 71,4% mulheres, que possuíam média de idade de 36,3 (±10,8) anos. O relato de dor acima de 4 na EVN foi de 71,4% dos participantes e todos possuíam diminuição da ADM em todos os movimentos avaliados na coluna lombar. A maioria (71,4%) apresentou baixo risco para fatores psicossociais pelo SBST. O perfil dos trabalhadores de restaurantes da universidade avaliada é caracterizado por ser prioritariamente realizado por mulheres, sendo que estas trabalhadoras apresentaram quadro álgico intenso e limitação dos movimentos articulares na região lombar.

The tasks that workers in university restaurants (URs) perform involves repetitive movements of the back, lifting excessive weight, remaining in a standing posture for prolonged periods of time, and, thus, an evaluation of the lumbar region of these workers is indicated. Therefore, the objective of this study was to outline the profile of lower back pain in workers from the URs of a Public University in the South of Brazil. This is a cross-sectional, observational, quantitative study, in which participants aged 18 to 59 years, of both sexes, who performed some function within the restaurants of a university in southern Brazil and who reported the presence of lower back pain were selected. Participants were evaluated by a sociodemographic questionnaire, a visual analogue scale (VAS) for pain, a range of motion (ROM) of the lumbar spine evaluation, and the Brazilian Start Back Screening Tool (SBST) questionnaire. Results are presented as absolute and relative frequencies, with a Spearman correlation, and numerical variables as mean and standard deviation or median, minimum, and maximum. Twenty-eight participants were included in the study, 71.4% of whom were women, with a mean age of 36.3 (±10.8) years old. The report of pain above 4 in the VAS was 71.4% of the participants and all had a decrease in ROM in all movements evaluated in the lumbar spine. Most (71.4%) had low risk for psychosocial factors by SBST. The profile of restaurant workers at the evaluated university is characterized by being primarily performed by women, and these workers presented severe pain and limited joint movements in their lumbar region.

Prevalence of anxiety, depression and kinesiophobia in patients with low back pain and their association with the symptoms of low back spinal pain. / Prevalência de ansiedade, depressão e cinesiofobia em pacientes com lombalgia e sua associação com os sintomas da lombalgia.

OBJECTIVE: To evaluate the prevalence of anxiety, depression and kinesiophobia and their association with the symptoms of low back pain. METHODS: A total of 65 patients were divided into three groups: Organic, Amplified Organic and Non-Organic. They answered the Beck Anxiety Inventory, Beck Depression Inventory and Tampa Scale of Kinesiophobia and were evaluated according to their pain level using the Visual Analogic Scale. RESULTS: The average kinesiophobia scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 36.26, 36.21 and 23.06 points, respectively. Patients who were classified into the Organic group experienced the most kinesiophobia out of all 3 groups (p=0.007). The average anxiety scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 33.17, 32.79 and 32.81 points, respectively, with no significant difference among the groups (p=0.99). The average depression scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 32.54, 28.79 and 37.69 points, respectively, with no significant difference among the groups (p=0.29). CONCLUSION: There was no association between the groups and anxiety and depression. However, there was a positive correlation between kinesiophobia and the Organic group. Studies of other patient samples are needed to confirm the reproducibility and validity of these data in other populations.

Prevalence of low back pain in older Brazilians: a systematic review with meta-analysis.

INTRODUCTION: Prevalence of low back pain (LBP) is expected to increase worldwide with aging of the population but its prevalence in older people is not clear, mainly in developing countries. OBJECTIVE: To estimate the prevalence of LBP in older Brazilians. METHODS: Electronic searches on SciELO, LILACS, MEDLINE, EMBASE and CINAHL, as well as hand-searching identified studies investigating prevalence of LBP in older Brazilians aged 60 years or over. Two independent reviewers selected studies fulfilling the inclusion criteria, assessed risk of bias for each included study and extracted relevant data. Meta-analysis was conducted when enough homogeneity allowed and the GRADE system was used to summarize the overall quality of the evidence. RESULTS: Sixteen studies were included with a total of 28,448 participants. Data from point- and period-prevalence of LBP were obtained. Meta-analysis was conducted for 13 studies reporting point-prevalence. Pooled point-prevalence of LBP was 25.0% (95% CI 18.0-32.0). Other three studies investigated period-prevalence: one-week prevalence=15.0% (95% CI 13.0-18.0); six-month prevalence=43.0% (95% CI 42.0-44.0); and 12-month prevalence=13.0% (95% CI 11.0-16.0). Sensitivity analyses were performed for point-prevalence and exclusion of studies with poorer methodological quality tended to increase the estimated prevalence of LBP. CONCLUSION: Moderate-quality evidence showed that at any point in time one in four older Brazilians suffers from LBP. This was the first systematic review investigating nationwide data on the prevalence of LBP in older people and contributes important clinical and epidemiological evidence for policymakers.

Prevalence of anxiety, depression and kinesiophobia in patients with low back pain and their association with the symptoms of low back spinal pain.

OBJECTIVE: To evaluate the prevalence of anxiety, depression and kinesiophobia and their association with the symptoms of low back pain. METHODS: A total of 65 patients were divided into three groups: Organic, Amplified Organic and Non-Organic. They answered the Beck Anxiety Inventory, Beck Depression Inventory and Tampa Scale of Kinesiophobia and were evaluated according to their pain level using the Visual Analogic Scale. RESULTS: The average kinesiophobia scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 36.26, 36.21 and 23.06 points, respectively. Patients who were classified into the Organic group experienced the most kinesiophobia out of all three groups (p=0.007). The average anxiety scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 33.17, 32.79 and 32.81 points, respectively, with no significant difference among the groups (p=0.99). The average depression scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 32.54, 28.79 and 37.69 points, respectively, with no significant difference among the groups (p=0.29). CONCLUSION: There was no association between the groups and anxiety and depression. However, there was a positive correlation between kinesiophobia and the Organic group. Studies of other patient samples are needed to confirm the reproducibility and validity of these data in other populations.

Abordagem da lombalgia ocupacional na Atenção Primária / Occupational low back pain approach in Primary Care

A grande incidência de lombalgia na população leva a uma grande demanda de tratamento no nível básico, além de gerar gastos com crises agudas nos níveis secundário e terciário. Essa revisão sistemática busca entender quais abordagens seriam pertinentes à condição para que o médico da atenção primária consiga ter a conduta mais adequada e resolutiva. A pesquisa foi realizada na plataforma PubMed utilizando-se descritores "occupational", "low back pain", "primary care" e "approach", onde obteve-se 24 resultados posteriores a 2014 dos quais descartou-se 16 por não compreenderem o objetivo inicial. A partir da leitura buscou-se trazer abordagens eficientes no âmbito da atenção primária de modo a otimizar a resolutividade com base na literatura mais recente disponível. Os resultados apontaram a adoção de uma conduta multidisciplinar, bem como a associação de fármacos adjuvantes a analgésicos no tratamento farmacológico, como preconizado pelo Ministério da Saúde.

The high incidence of low back pain leads to high demand for treatment at the primary level and creates expenses with acute crises at the secondary and tertiary levels. This systematic review seeks to understand which approaches would be pertinent to the condition so that the primary care physician can take the most appropriate and resolving conduct. The research was carried out on the PubMed platform using descriptors "occupational", "low back pain", "primary care", and "approach", where 24 results after 2014 were obtained and 16 were discarded because they did not match the initial objective. After the reading, efficient approaches were shown in order to optimize the resolution based on the most recent literature available in the scope of primary care. The results indicated the adoption of a multidisciplinary approach and the association of adjuvant drugs with analgesics in pharmacological treatment, as recommended by the Ministry of Health.

A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain. / Estudo prospectivo de fatores prognósticos em lombalgia crônica tratados com fisioterapia: papel do medo-evitação e dor extraespinal.

OBJECTIVE: To identify the prognostic factors for conventional physical therapy in patients with chronic low back pain (CLBP). METHODS: Prospective observational study. PARTICIPANTS: One hundred thirteen patients with CLBP selected at the Spinal Disease Outpatient Clinic. MAIN OUTCOME MEASURES: Pain intensity was scored using the Numeric Rating Scale (NRS), and function was measured using the Roland-Morris Disability Questionnaire (RMDQ). RESULTS: The Fear-Avoidance Beliefs Questionnaire work subscale results (FABQ-work; odds ratio [OR]=0.27, 95% confidence interval [CI] 0.13 to 0.56, p<0.001) and extraspinal pain (OR=0.35, 95% CI 0.17 to 0.74, p=0.006) were independently associated with a decreased response to conventional physical therapy for CLBP. CONCLUSION: We identified high FABQ-work and extraspinal pain scores as key determinants of a worse response to physical therapy among CLBP patients, supporting the need for a special rehabilitation program for this subgroup.

A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain.

OBJECTIVE: To identify the prognostic factors for conventional physical therapy in patients with chronic low back pain (CLBP). METHODS: Prospective observational study. PARTICIPANTS: One hundred thirteen patients with CLBP selected at the Spinal Disease Outpatient Clinic. MAIN OUTCOME MEASURES: Pain intensity was scored using the Numeric Rating Scale (NRS), and function was measured using the Roland-Morris Disability Questionnaire (RMDQ). RESULTS: The Fear-Avoidance Beliefs Questionnaire work subscale results (FABQ-work; odds ratio [OR]=0.27, 95% confidence interval [CI] 0.13-0.56, p<0.001) and extraspinal pain (OR=0.35, 95% CI 0.17-0.74, p=0.006) were independently associated with a decreased response to conventional physical therapy for CLBP. CONCLUSION: We identified high FABQ-work and extraspinal pain scores as key determinants of a worse response to physical therapy among CLBP patients, supporting the need for a special rehabilitation program for this subgroup.

Treatment of non-specific chronic low back pain: resistance training with or without using weights? / Tratamiento de la lumbalgia crónica inespecífica: ¿entrenamiento de fuerza con o sin pesas? / Tratamento da lombalgia crônica inespecífica: treinamento resistido com ou sem pesos?

ABSTRACT Introduction: Dysfunction of the core muscles contributes to the persistence of pain in patients with chronic low back pain. Evidence shows that the active approach is beneficial in the rehabilitation of these patients. However, there is uncertainty as to the most effective methods or form of exercise, as the literature offers little guidance in this regard. Objective: To analyze and compare the impact on quality of life, function, flexibility, abdominal strength and abdominal fat rate in patients with non-specific chronic low back pain after a program of resistance training using two different forms of exercise. Methods: Thirty individuals, aged between 18 and 65 years, participated in the study. Twenty performed physical training program twice a week for eight weeks, and ten did not perform any physical exercises, but received guidance and pain relief. The physically active individuals were randomly divided in two groups and received similar resistance training, focusing on the same muscle groups. Ten performed training with dumbbells and bodybuilding machines (TRCP) and ten did not use this equipment (TRSP). All were assessed before and after the intervention, through questionnaires on quality of life and function, and tests for flexibility, abdominal strength and measurement of the abdominal fat rate. Results: In the intra-group comparison (initial vs eight weeks), there were no significant differences in quality of life in any of the groups. However, regarding function, the three groups showed significant improvement, with TRSP showing the best evolution. For flexibility and abdominal strength gain, TRCP showed the best evolution in both instruments. For decrease in abdominal fat rate, only TRCP showed significant differences. In the intergroup comparison, there were no significant differences for any of the evaluated outcomes. Conclusion: The two exercise programs were effective in improving function, flexibility and abdominal strength in patients with chronic, non-specific low back pain. However, there were no statistically significant differences in any of the outcomes in the comparison between groups. Level evidence II, Comparative prospective study.

RESUMEN Introducción: La disfunción de la musculatura del tronco contribuye para la persistencia del dolor en pacientes con lumbalgia crónica. La evidencia muestra que un enfoque activo para la rehabilitación de estos pacientes es beneficioso. Sin embargo, existe incertidumbre sobre qué método o modalidad es más eficaz, ya que la literatura existente ofrece poca orientación al respecto. Objetivo: Analizar y comparar el impacto en la calidad de vida, función, flexibilidad, fuerza abdominal y porcentaje de grasa abdominal en pacientes con lumbalgia crónica inespecífica, luego de realizar un programa de entrenamiento de resistencia utilizando dos modalidades diferentes. Métodos: Participaron del estudio 30 personas, entre 18 y 65 años; veinte de los cuales se sometieron a un programa de entrenamiento físico dos veces por semana durante ocho semanas, y diez no realizaron ejercicios físicos, pero recibieron orientación y medicación analgésica. Los individuos físicamente activos se dividieron en dos grupos, al azar, y recibieron un entrenamiento de resistencia similar, centrándose en los mismos grupos musculares. Diez se sometieron a entrenamiento con mancuernas y aparatos de musculación (TRCP) y diez no utilizaron esos equipos, realizando ejercicios funcionales (TRSP). Todos fueron evaluados antes y después de la intervención, mediante cuestionarios de calidad de vida y función, además de pruebas de flexibilidad, fuerza abdominal y medición del porcentaje de grasa abdominal. Resultados: En la comparación intragrupo (inicial x 8 semanas), no hubo cambios significativos en la calidad de vida en ninguno de los grupos. Para la función, los tres grupos mostraron una mejora significativa, con TRSP mostrando una mejor evolución. En cuanto a flexibilidad y aumento de la fuerza abdominal, TRCP se desempeñó mejor en ambos instrumentos. Para disminuir el porcentaje de grasa abdominal, solo TRCP mostró diferencias significativas. En la comparación intergrupal, no hubo diferencias estadísticamente significativas para ninguno de los resultados evaluados. Conclusión: Los dos programas de ejercicio fueron efectivos para mejorar la función abdominal, la flexibilidad y la fuerza en pacientes con dolor lumbar crónico inespecífico. Sin embargo, no hubo diferencias estadísticamente significativas en ninguno de los resultados en la comparación entre grupos. Nivel de evidencia II, Estudio prospectivo comparativo.

RESUMO Introdução: A disfunção da musculatura do tronco contribui para a persistência da dor em pacientes com lombalgia crônica. As evidências demonstram ser benéfica a abordagem ativa para reabilitação desses pacientes, porém, existem incertezas sobre qual método ou modalidade mais eficaz, uma vez que a literatura existente oferece poucas orientações nesse aspecto. Objetivo: Analisar e comparar o impacto na qualidade de vida, função, flexibilidade, força abdominal e percentual de gordura abdominal em pacientes com lombalgia crônica inespecífica, após a realização de programa de treinamento resistido utilizando duas modalidades diferentes. Métodos: Trinta indivíduos, entre 18 e 65 anos, participaram do estudo; sendo que 20 realizaram um programa de treinamento físico duas vezes por semana, durante oito semanas, e dez não realizaram exercícios físicos, porém receberam orientações e medicação analgésica. Os indivíduos ativos fisicamente foram divididos em dois grupos, aleatoriamente, e receberam treinamento resistido similar focado nos mesmos grupos musculares. Dez realizaram treinamento com halteres e aparelhos de musculação (TRCP) e dez não utilizaram esses equipamentos, realizando apenas exercícios funcionais (TRSP). Todos foram avaliados antes e após a intervenção, por meio de questionários de qualidade de vida e função, além de testes de flexibilidade, força abdominal e mensuração do percentual de gordura abdominal. Resultados: Na comparação intragrupo (inicial x oito semanas), não houve mudança significativa na qualidade de vida de nenhum dos grupos. No entanto, quanto à função, os três grupos apresentaram melhora significativa, com o TRSP demonstrando melhor evolução. Para flexibilidade e ganho de força abdominal, o TRCP demonstrou melhor evolução em ambos os instrumentos. Para diminuição do percentual de gordura abdominal, somente o TRCP apresentou diferenças significativas. Na comparação intergrupos, não houve diferença estatisticamente significativa para nenhum dos desfechos avaliados. Conclusão: Os dois programas de exercícios foram eficazes para melhora da função, flexibilidade e força abdominal em pacientes com lombalgia crônica inespecífica. No entanto, não houve diferença estatisticamente significativa em nenhum dos desfechos na comparação entre os grupos. Nível de evidência II, Estudo prospectivo comparativo.

Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health / Lombalgia em adolescentes e associação com fatores sociodemográficos, dispositivoseletrônicos, atividade física e saúde mental

Abstract Objectives: To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems. Methods: Cross-sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used. Results: The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR = 1.70), daily TV use for more than 3 hours (PR = 1.17), use of laptop computer (PR = 1.40), use of the cell phone in the supine position (PR = 1.23), use of the cell phone in semi-supine position (PR = 1.49), daily cell phone use for more than 3 hours (PR = 1.36), use of tablet (PR = 1.67), daily tablet use for more than above 3 hours (PR = 1.46), and clinically important mental health problems (PR = 2.62). Conclusion: There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.

Resumo Objetivos: Determinar a prevalência de lombalgia e analisar a associação com variáveis individuais e sociodemográficas, dispositivos eletrônicos, prática habitual de atividade física e problemas de saúde mental. Métodos: Estudo transversal com 1.628 alunos matriculados em escolas públicas na cidade de Bauru/SP. Para a coleta de dados: 1. aspectos demográficos e socioeconômicos; 2. dispositivos eletrônicos; 3. nível habitual de atividade física (Baecke); 3. saúde mental (SDQ); 4. Lombalgia (Questionário Nórdico). Foram usadas análises descritivas e de regressão logística bivariada e multivariada. Resultados: A prevalência geral de lombalgia foi 46,7% (IC de 95%: 44,27 a 49,11), os homens mostraram uma prevalência de 42,0% (IC de 95%: 36,63 a 43,41) e as mulheres mostraram uma prevalência de 58,0% (IC de 95%: 49,73 a 56,51), com diferença significativa. As variáveis associadas a dor na região lombar inferior foram: sexo feminino (RP = 1,70), tempo de uso de TV acima de 3 horas por dia (RP = 1,17), uso de notebook (RP = 1,40), uso de celular na posição supina (RP = 1,23), uso de celular na posição semissupina (RP = 1,49), tempo de uso de celular acima de 3 horas por dia (RP = 1,36), uso de tablet (RP = 1,67), tempo de uso de tablet acima de 3 horas por dia (RP = 1,46) e problemas de saúde mental clinicamente importantes (RP = 2,62). Conclusão: Há alta prevalência de lombalgia em alunos do ensino médio e forte associação ao sexo feminino, dispositivos eletrônicos e problemas de saúde mental.