From chronic low back pain to disability, a multifactorial mediated pathway: the InCHIANTI study
Angelo Di Iorio1, Michele Abate, Jack M Guralnik
1Department of Medicine and Sciences of Aging, Laboratory of Clinical Epidemiology, University G. D'Annunzio Chieti, Italy. a.diiorio@unich.it
Spine
|December 20, 2007
Summary
Low back pain (LBP) significantly impacts daily activities in older adults. However, lower extremity function performance measures can explain much of this association, except for carrying shopping bags.
Area of Science:
- Gerontology and Rehabilitation Medicine
- Epidemiology of Musculoskeletal Disorders
- Functional Status Assessment
Background:
- Low back pain (LBP) is highly prevalent in older adults, negatively affecting functional status.
- Limited research explores the pathways from LBP to disability, often overlooking crucial confounders.
Purpose of the Study:
- To determine if lower extremity function performance measures confound the link between LBP and self-reported disability in daily activities.
- To investigate the role of specific basic and instrumental activities of daily living (IADLs) in this association.
Main Methods:
- Clinicoepidemiologic study in the Chianti area, Italy, involving 956 participants aged 65+.
- Assessed LBP, lower extremity function (Short Physical Performance Battery, walking tests), and disability in ADLs/IADLs.
- Considered confounders: depressive symptoms, trunk range of motion, and hip-knee-foot pain.
Main Results:
- Participants with LBP reported more difficulty with most daily activities.
- LBP was associated with disability in bathing, laundry, chores, toenail cutting, shopping, and carrying bags.
- This association, except for carrying bags, became non-significant after adjusting for lower extremity function.
Conclusions:
- The relationship between LBP and self-reported disability is influenced by performance measures.
- Performance-based tests assessing functional consequences of LBP are vital for designing targeted interventions.
- These findings can inform disability prevention and treatment strategies for individuals with LBP.
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