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首页> 外文期刊>BMC Musculoskeletal Disorders >Obesity is associated with more disability at presentation and after treatment in low back pain but not in neck pain: findings from the OIOC registry
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Obesity is associated with more disability at presentation and after treatment in low back pain but not in neck pain: findings from the OIOC registry

机译：肥胖与就诊时以及治疗后腰背痛而不是颈痛时的更多残疾相关：OIOC注册表中的发现

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Background The influence on the treatment response in patients with low back pain (LBP) and neck pain (NP) is unknown. The aim of the study was to investigate the influence of body weight in patients with low back pain (LBP) and neck pain (NP) on baseline and end of treatment disability. Methods Cross-sectional analysis of baseline factors. Longitudinal analysis of prospectively collected patient information at an outpatient physical therapy registry (data from June 2010 to December 2012). WHO-BMI classification was used: underweight, lean, overweight, obesity class I, obesity class II and III. The influence of body weight and a predefined set of confounders was analyzed by multiple regression models. Results In LBP, disability increased with increasing BMI [lean?=?reference, obesity class I Beta 5.41 (95?% CI 0.75; 10.07), obesity class II-III Beta 7.58 (95?% CI 2.13; 13.03)]. Compared to lean patients, disability after treatment improved in overweight subjects [Beta ?3.90 (95?% CI ?7.4; ?0.41)] but not in subjects with obesity class II–III [Beta 3.43 (95?% CI ?3.81; 10.68)]. There were insufficient patients in the sample with severe obesity and therefore this trend has to be confirmed. The likelihood for meaningful important change (MID) was similar in all BMI subgroups. For patients with NP, BMI was not associated with baseline disability, and did not predict end of treatment disability or the likelihood of a MID. These findings must be interpreted with caution as BMI subgroups did not meet the required sample size. Conclusion Overweight and obesity are associated with higher levels of disability before treatment in LBP patients, but not in NP. In severely obese patients class II–III with LBP the rate of MID was lowest indicating that these patients experienced the least treatment response compared to the other groups. Further studies should address the impact of severe obesity on the prognosis of LBP. In patients with LBP, severe obesity may be an important factor to consider during the physical therapy treatment. In particular, combined treatment strategies combining weight management, cardiovascular fitness, and low back pain rehabilitation should be investigated.
机译：背景技术对腰痛（LBP）和颈部疼痛（NP）的患者对治疗反应的影响尚不清楚。该研究的目的是研究体重对下腰痛（LBP）和颈部疼痛（NP）患者对基线和治疗残障的影响。方法对基线因素进行横断面分析。在门诊物理治疗登记处对预期收集的患者信息进行纵向分析（2010年6月至2012年12月的数据）。使用WHO-BMI分类：体重过轻，瘦弱，超重，肥胖I级，肥胖II级和III级。通过多个回归模型分析了体重和一组预定义的混杂因素的影响。结果在LBP中，残疾随着BMI的增加而增加[瘦弱=参考，肥胖I类Beta 5.41（95％CI 0.75; 10.07），肥胖II-III Beta 7.58（95％CI 2.13; 13.03）。与瘦弱的患者相比，超重受试者[Beta≥3.90（95％CI = 7.4; <0.41）]的治疗后残疾有所改善，但肥胖II-III类受试者[Beta 3.43（95％CI≥3.81; 10.68; 10.68] ）]。样本中有严重肥胖的患者不足，因此必须确认这种趋势。在所有BMI子组中，有意义的重要变化（MID）的可能性均相似。对于NP患者，BMI与基线残疾无关，并且不能预测治疗残疾或MID的可能性。由于BMI亚组未达到要求的样本量，因此必须谨慎解释这些发现。结论LBP患者治疗前超重和肥胖与残疾水平较高相关，而NP患者则不然。在患有LBP的II-III级严重肥胖患者中，MID的发生率最低，这表明与其他组相比，这些患者的治疗反应最少。进一步的研究应解决严重肥胖对LBP预后的影响。在患有LBP的患者中，严重肥胖症可能是在物理疗法治疗期间要考虑的重要因素。特别是，应研究结合体重管理，心血管健康和腰痛康复的综合治疗策略。

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