Search

Purpose: Artery dysfunction is an early, integral stage in atherogenesis that predicts future cardiovascular events. Sedentary behavior, such as TV watching, is highly prevalent and associated with increased risk of developing cardiovascular diseases. This study investigated whether patterns of TV watching throughout childhood and adolescence were associated with artery function in adulthood., Methods: TV watching data were collected when participants of the Raine Study were aged 5, 8, 10, 14, 17, and 20 yr. Previous latent class analysis indicated three trajectory groups of TV watching: low TV (<14 h·wk -1 ), high TV (>14 h·wk -1 ), and increasing TV (change from low TV to high TV). At age 28 yr, participants were invited to undergo tests of brachial and femoral artery function by flow-mediated dilation (FMD). General linear models examined differences in artery function between TV trajectory groups for men and women., Results: Five hundred sixty participants (n = 261 women, n = 299 men) were included in the study. In women, the low TV group had significantly greater femoral artery FMD (10.8 ± 1.6%) than both High TV (9.0 ± 1.3%, P = 0.005) and Increasing TV groups (8.5 ± 1.3%, P < 0.001); these results were maintained following mediation analysis, including contemporaneous risk factors. There were no significant differences in femoral artery FMD between TV trajectory groups in men ( P = 0.955)., Conclusions: This study suggests that TV watching behaviors during childhood and adolescence may have legacy impacts on artery function at age 28 yr, particularly in women. This may increase the risk of atherosclerotic vascular pathologies in later life., (Copyright © 2023 by the American College of Sports Medicine.)

Purpose: Sitting at work can be associated with musculoskeletal pain, but the effect of reductions in sitting is not well understood. We examined relationships with musculoskeletal pain of changes in sitting, standing, stepping, and short and long bouts of these behaviors., Methods: Analyses pooled data from 224 desk workers (68.4% women; mean ± SD age = 45.5 ± 9.4 yr; body mass index = 28.1 ± 6.1 kg⋅m -2 ) in intervention trial. Device-assessed (activPAL3) sitting, standing, and stepping time and multisite musculoskeletal pain (Nordic Questionnaire; 12 body areas) were assessed at baseline, 3 months, and 12 months. Compositional data analyses in linear mixed-effects regressions examined relationships within 16 waking hours of the behaviors and their short and long bouts, with changes from baseline in acute and chronic multisite musculoskeletal pain at 3 and 12 months. Analyses were adjusted for initial group randomization and relevant covariates., Results: At 3 months, increased standing relative to changes in other compositions was significantly associated with increased multisite musculoskeletal pain (acute: β = 1.54, 95% confidence interval [CI] = 0.10 to 2.98; chronic: β = 1.49, 95% CI = 0.12 to 2.83). By contrast, increased stepping relative to changes in other compositions was significantly associated with reduced multisite musculoskeletal pain (acute: β = -1.49, 95% CI = -2.97 to -0.02; chronic: β = -1.87, 95% CI = -3.75 to -0.01). Neither sitting reduction relative to changes in other compositions nor changes in short bouts relative to long bouts of the behaviors were significantly associated with multisite musculoskeletal pain changes. At 12 months, there were no significant associations for any of the compositional changes., Conclusions: In the short term, while increasing standing with reduced sitting time can be unfavorable, concurrently increasing stepping could potentially reduce musculoskeletal pain. In the longer term, musculoskeletal pain may not be increased by moderate reductions in sitting time through spending more time standing or stepping., (Copyright © 2023 by the American College of Sports Medicine.)

Abstract: There is a need to better understand biological factors that increase the risk of persistent musculoskeletal (MSK) pain and heightened pain sensitivity. Knowing the heritability (how genes account for differences in people's traits) can enhance the understanding of genetic vs environmental influences of pain and pain sensitivity. However, there are gaps in current knowledge, including the need for intergenerational studies to broaden our understanding of the genetic basis of pain. Data from Gen1 and Gen2 of the Raine Study were used to investigate the heritability of MSK pain and pressure and cold pain sensitivity. Participants included parents (Gen1, n = 1092) and their offspring (Gen2, n = 688) who underwent a battery of testing and questionnaires including pressure and cold pain threshold testing and assessments of physical activity, sleep, MSK pain, mental health, and adiposity. Heritability estimates were derived using the Sequential Oligogenic Linkage Analysis Routines software. Heritability estimates for MSK pain and pressure pain sensitivity were significant, accounting for between 0.190 and 0.289 of the variation in the phenotype. By contrast, heritability of cold pain sensitivity was not significant. This is the largest intergenerational study to date to comprehensively investigate the heritability of both MSK pain and pain sensitivity, using robust statistical analysis. This study provides support for the heritability of MSK pain and pain sensitivity to pressure, suggesting the need for further convergence of genetic and environmental factors in models for the development or maintenance of these pain disorders., (Copyright © 2021 International Association for the Study of Pain.)

Study Design: Case-control study., Objective: Investigate the association between lumbar spine magnetic resonance imaging (MRI) findings and 5-year trajectories of low back pain (LBP) in young Australian adults., Summary of Background Data: The association between lumbar spine imaging findings and LBP remains unclear due to important limitations of previous research, such as a lack of clearly defined LBP phenotypes and inadequate controlling for age, which may substantially affect the association., Methods: Seventy-eight "case" participants with a previously identified "consistent high disabling LBP" trajectory from age 17 to 22 years and 78 "control" participants from a trajectory with consistently low LBP over the same time period, matched for sex, body mass index, physical activity levels, and work physical demands, were identified from Gen2 Raine Study participants. At age 27, participants underwent a standardized lumbar MRI scan, from which 14 specific MRI phenotypes were identified. Primary analyses used unconditional logistic regression, adjusting for covariates used in the matching process, to investigate the relationship between presence of each imaging finding and being a case or control. Secondary analyses explored those relationships based on the number of spinal levels with each MRI finding., Results: The odds for being a case compared with a control were higher in those with disc degeneration (Pfirrmann grade ≥ 3; OR = 3.21, 95% CI: 1.60-6.44; P = 0.001) or those with a herniation (OR = 1.90, 95% CI: 0.96-3.74; P - 0.065). We also found that the association became substantially stronger when either disc degeneration or herniation was present at two or more spinal levels (OR = 5.56, 95% CI: 1.97-15.70; P = 0.001, and OR = 5.85, 95% CI: 1.54-22.25; P = 0.009, respectively). The other investigated MRI findings were not associated with greater odds of being a case., Conclusion: Lumbar disc degeneration and herniation may be important contributors to disabling LBP in young adults. Further investigation of their potential prognostic and causal roles is indicated.Level of Evidence: 4., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The primary purpose of this study was to investigate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) in regard to work productivity (absenteeism and presenteeism) in early adulthood., Methods: A prospective study was performed using data from the Raine Study Generation 2 (Gen2) 22-year follow-up. The ÖMPSQ was completed at baseline, and absenteeism and presenteeism assessed at four intervals over the following 12 months., Results: In early adulthood, the full and short versions of the ÖMPSQ showed some predictive ability for work absenteeism but the Receiver Operator Characteristic demonstrated poor discrimination. There was no evidence of predictive ability for presenteeism., Conclusion: Further work is required to increase the fidelity of screening for risk of reduced work productivity at the population level., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 American College of Occupational and Environmental Medicine.)

Objectives: This study investigated spinal pain-related absenteeism at age 17 as a potential precursor to work presenteeism at age 23., Methods: A longitudinal study was performed with Raine Study Gen2 participants (n = 451). Spinal pain-related absenteeism from school/work was collected at the 17 year follow-up. Presenteeism (due to ill-health or any other reason) was collected quarterly during one year around the age of 23. Zero-inflated binominal regression analysis was conducted., Results: Participants with adolescent spinal pain-related absenteeism reported higher work presenteeism in early adulthood than those without pain (155.7 h/y compared to 77.7 h/y), with an incident rate ratio (95% confidence interval) of 1.41 (1.04 to 1.92) after adjusting for sex, occupational class and multimorbidity count., Conclusions: Targeting factors associated with absenteeism behaviours during early life may have significant benefits for future work productivity.

Objective: The aim of this study was to estimate the effect of spinal pain and mental ill-health conditions on work productivity in 22-year-old workers., Methods: A cross-sectional design using data from the Raine Study cohort (n = 867) including self-reported work productivity and self-report of health practitioner diagnosed medical conditions., Result: Mean (median, 25th-percentile, 75th-percentile) annualized cost of health-related absenteeism was $AUD1899 ($0, $0, $1738) per worker. Annualized cost of presenteeism was $AUD10,674 ($6573, $4003, $13,087) per worker. Spinal pain and mental ill-health conditions were associated with increased health-related absenteeism, but not presenteeism., Conclusion: Work productivity loss in young workers is a substantial problem needing priority attention. Addressing spinal pain and mental ill-health may improve productivity of this important sector of the workforce.

Purpose: To compare responsiveness of the Movement Assessment Battery for Children-2 (MABC-2) and segment kinematics and center of pressure measures in detecting intervention effects in children with developmental coordination disorder., Methods: Motion Analysis Laboratory (MAL) data from 21 children with developmental coordination disorder (mean age 11.0 years) in a randomized control trial were analyzed using effect size, minimal detectable difference, and parent and child report of meaningfulness (χ2 tests)., Results: The MABC-2 and MAL data showed moderate-large effect sizes (0.7-1.8). The MABC-2 detected large portions of children whose change exceeded the minimal detectable difference (47.6%-71.4%); MAL data detected small portions (0%-19.0%). Neither tool correlated well with meaningfulness (χ2 = 0.186-5.724; P > .10). Both tools detected change in the overall group; however, only the MABC-2 detected individual change exceeding potential measurement error., Conclusions: Although both assessment tools are responsive, they may be responsive to different types of change. Therefore, assessment constructs should be matched to intervention goals.

Purpose: This study compared regional lumbar (upper and lower), pelvis, trunk, and lower limb kinematics between elite male adolescent players with and without a history of low back pain (LBP) during the kick and flat serves as well as regional lumbar mobility and serving kinematics relative to the end of range., Methods: Seven players with a history of LBP and confirmed L4/L5 injury and 13 controls matched for age, height, mass, and performance underwent a three-dimensional motion analysis during serving trials and lumbar mobility assessments. Regional lumbar, pelvis, trunk, and lower limb kinematics were compared between pain/no pain and kick/flat serves using a series of 2 × 2 mixed-model ANOVA, with independent samples t-tests used to compare regional lumbar mobility between pain/no pain., Results: The pain group had significantly reduced lower lumbar mobility in every plane of motion than the no pain group. The pain group demonstrated less right lower lumbar and pelvis/shoulder rotation, greater right pelvic tilt, earlier peak right knee extension velocity during the drive phase of the tennis serves, and greater lower lumbar and pelvis left rotation, upper lumbar left lateral flexion, and anterior pelvis tilt during the forward-swing phase. All players approached their lumbar end of range during the serve., Conclusions: The results of this investigation suggest that a multidimensional LBP management and prevention strategy is required, including the assessment of regional spinal mobility, the lower limb and upper limb and spinal kinematics, and the integrated work between clinicians and coaches to adapt adverse technique.

Purpose: This study aimed to quantify and compare lumbar region kinetics in kick and flat serves performed by elite, adolescent male players with and without a history of low back pain (LBP). Lumbar region kinematics, as well as racquet velocity and the position of the ball at impact, was described to facilitate kinetic data interpretation., Methods: Twenty Tennis Australia adolescent male players participated; 7 had a history of disabling LBP and confirmed L4/L5 injury and 13 were age-, height-, mass-, and performance-matched controls. The VICON motion analysis system was used to record racquet, upper and lower limb, trunk, and lumbar movement during three "flat" and three "kick" serves. A customized mathematical model calculated lumbar region kinetics/kinematics, racquet velocity, and ball position at impact, and these are reported as if all players were right-handed. A series of 2 × 2 mixed-model ANOVA were used to compare between pain/no pain and kick/flat serves., Results: There was no significant difference in racquet velocity or ball position at impact between pain groups or serve types. The players with LBP reported significantly greater (mean difference = 1.5 N · kg(-1)) peak left lateral force than the control group. The flat serve was associated with significantly greater flexion moments (mean difference = 2.7 N · kg(-1)) than the kick serve., Conclusions: The lumbar region undergoes substantial loading during both the kick and the flat tennis serves, including lateral flexion forces approximately eight times those experienced during running. Given that these left lateral flexion forces are significantly greater in players with a history of disabling LBP and occur simultaneous with peak vertical force and extension and right lateral rotations, this may be an important LBP mechanism in this population.

Study Design: A cross-sectional comparative study between healthy controls and two subgroups of nonspecific chronic low back pain (LBP) patients., Objectives: To determine differences in trunk muscle activation during usual unsupported sitting., Summary of Background Data: Patients with LBP commonly report exacerbation of pain on sitting. Little evidence exists to confirm that subgroups of patients with nonspecific chronic LBP patients use different motor patterns in sitting than pain-free controls., Methods: A total of 34 pain-free and 33 nonspecific chronic LBP subjects were recruited. Two blinded clinicians classified nonspecific chronic LBP patients into two subgroups (active extension pattern and flexion pattern). Surface electromyography (sEMG) was recorded from five trunk muscles during subjects' unsupported "usual" and "slumped" sitting., Results: No differences in trunk muscle activity were observed between healthy controls and nonspecific chronic LBP groups for usual sitting. When the classification system was applied, differences were identified. Compared with no-LBP controls, the active extension pattern group presented with higher levels of cocontraction of superficial fibers of lumbar multifidus (12%), iliocostalis lumborum pars thoracis (36%) and transverse fibers of internal oblique (43%). while the flexion pattern group showed a trend toward lower activation patterns (lumbar multifidus, -7%; iliocostalis lumborum pars thoracis, -6%, and transverse fibers of internal oblique, -5%). The flexion relaxation ratio of the back muscles was lower for nonspecific chronic LBP (superficial lumbar multifidus: t = 4.5; P < 0.001 and iliocostalis lumborum pars thoracis:t = 2.7; P < 0.001), suggesting a lack of flexion relaxation for the nonspecific chronic LBP., Conclusion: Subclassifying nonspecific chronic LBP patients revealed clear differences in sEMG activity during sitting between pain-free subjects and subgroups of nonspecific chronic LBP patients.

Study Design: A comparative study., Objectives: To investigate sitting postures of asymptomatic individuals and nonspecific chronic low back pain (NS-CLBP) patients (pooled and subclassified) and evaluate the importance of subclassification., Summary of Background: Currently, little evidence exists to support the hypothesis that CLBP patients sit differently from pain-free controls. Although classifying NS-CLBP patients into homogeneous subgroups has been previously emphasized, no attempts have been made to consider such groupings when examining seated posture., Methods: Three angles (sacral tilt, lower lumbar, and upper lumbar) were measured during "usual" and "slumped" sitting in 33 NS-CLBP patients and 34 asymptomatic subjects using an electromagnetic measurement device. Before testing, NS-CLBP patients were subclassified by two blinded clinicians. Twenty patients were classified with a flexion motor control impairment and 13 with an active extension motor control impairment., Results: No differences were found between control and NS-CLBP (pooled) patients during usual sitting. In contrast, analyses based on subclassification revealed that patients classified with an active extension pattern sat more lordotic at the symptomatic lower lumbar spine, whereas patients with a flexion pattern sat more kyphotic, when compared with healthy controls (F = 19.7; df1 = 2, df2 = 63, P < 0.001). Further, NS-CLBP patients had less ability to change their posture when asked to slump from usual sitting (t = 4.2, df = 65; P < 0.001)., Conclusions: Differences in usual sitting posture were only revealed when NS-CLBP patients were subclassified. This highlights the importance of subclassifying NS-CLBP patients.