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      Associations Between Trunk Muscle/Fat Composition, Narrowing Lumbar Disc Space, and Low Back Pain in Middle-Aged Farmers: A Cross-Sectional Study

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          Abstract

          Objective

          To investigate the association of trunk fat and muscle composition, lumbar disc space narrowing, and low back pain in middle-aged farmers.

          Methods

          Fat and muscle areas were identified using standard Hounsfield unit ranges for adipose tissue and skeletal muscle with computed tomography images at the mid-L4 vertebral level. Trunk fat mass, muscle mass, and fat/muscle mass ratio were calculated. Low back pain was assessed using the Oswestry Disability Index (ODI). The L4/5-disc space and low back pain were also assessed.

          Results

          Male had a higher total trunk, back, psoas, and abdominal muscle mass, and visceral fat; female had a higher subcutaneous fat mass and fat/muscle ratio. Pearson correlation coefficients with ODI for waist circumference, total fat mass, visceral fat mass, and fat/muscle ratio were all significant in female; only the fat/muscle ratio was significant in male. Pearson correlation coefficients with L4/5-disc space narrowing grades for visceral fat mass, total, back, and psoas muscle mass, and fat/muscle ratio, were all significant in female; total and back muscle mass, and fat/muscle ratio in male.

          Conclusion

          There were significant relationships between: fat indicators with low back pain; trunk muscle mass with lumbar disc degeneration; and fat/muscle ratio with both lumbar disc degeneration and low back pain. The fat/muscle ratio may be a useful index for low back pain.

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          Most cited references38

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          The Oswestry Disability Index.

          Jeremy C. T. Fairbank, Paul B Pynsent (2000)
          The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. This review is based on publications using the ODI identified from the authors' personal databases, the Science Citation Index, and hand searches of Spine and current textbooks of spinal disorders. To review the versions of this instrument, document methods by which it has been validated, collate data from scores found in normal and back pain populations, provide curves for power calculations in studies using the ODI, and maintain the ODI as a gold standard outcome measure. It has now been 20 years since its original publication. More than 200 citations exist in the Science Citation Index. The authors have a large correspondence file relating to the ODI, that is cited in most of the large textbooks related to spinal disorders. All the published versions of the questionnaire were identified. A systematic review of this literature was made. The various reports of validation were collated and related to a version. Four versions of the ODI are available in English and nine in other languages. Some published versions contain misprints, and many omit the scoring system. At least 114 studies contain usable data. These data provide both validation and standards for other users and indicate the power of the instrument for detecting change in sample populations. The ODI remains a valid and vigorous measure and has been a worthwhile outcome measure. The process of using the ODI is reviewed and should be the subject of further research. The receiver operating characteristics should be explored in a population with higher self-report disabilities. The behavior of the instrument is incompletely understood, particularly in sensitivity to real change.
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            Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography.

            N Mitsiopoulos, R N Baumgartner, S Heymsfield … (1998)
            Magnetic resonance imaging (MRI) and computerized tomography (CT) are promising reference methods for quantifying whole body and regional skeletal muscle mass. Earlier MRI and CT validation studies used data-acquisition techniques and data-analysis procedures now outdated, evaluated anatomic rather than adipose tissue-free skeletal muscle (ATFSM), studied only the relatively large thigh, or found unduly large estimation errors. The aim of the present study was to compare arm and leg ATFSM cross-sectional area estimates (cm2) by using standard MRI and CT acquisition and image-analysis methods with corresponding cadaver estimates. A second objective was to validate MRI and CT measurements of adipose tissue embedded within muscle (interstitial adipose tissue) and surrounding muscle (subcutaneous adipose tissue). ATFSM area (n = 119) by MRI [38.9 +/- 22.3 (SD) cm2], CT (39.7 +/- 22.8 cm2), and cadaver (39.5 +/- 23.0 cm2) were not different (P > 0.001), and both MRI and CT estimates of ATFSM were highly correlated with corresponding cadaver values [MRI: r = 0.99, SE of estimate (SEE) 3.9 cm2, P < 0.001; and CT: r = 0.99, SEE = 3.8 cm2, P < 0.001]. Similarly good results were observed between MRI- and CT-measured vs. cadaver-measured interstitial and subcutaneous adipose tissue. For MRI-ATFSM the intraobserver correlation for duplicate measurements in vivo was 0. 99 [SEE = 8.7 cm2 (2.9%), P < 0.001]. These findings strongly support the use of MRI and CT as reference methods for appendicular skeletal muscle, interstitial and subcutaneous adipose tissue measurement in vivo.
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              The association between obesity and low back pain: a meta-analysis.

              Rahman Shiri, Jaro Karppinen, Päivi Leino-Arjas … (2010)
              This meta-analysis assessed the association between overweight/obesity and low back pain. The authors systematically searched the Medline (National Library of Medicine, Bethesda, Maryland) and Embase (Elsevier, Amsterdam, the Netherlands) databases until May 2009. Ninety-five studies were reviewed and 33 included in the meta-analyses. In cross-sectional studies, obesity was associated with increased prevalence of low back pain in the past 12 months (pooled odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14, 1.54), seeking care for low back pain (OR = 1.56, 95% CI: 1.46, 1.67), and chronic low back pain (OR = 1.43, 95% CI: 1.28, 1.60). Compared with non-overweight people, overweight people had a higher prevalence of low back pain but a lower prevalence of low back pain compared with obese people. In cohort studies, only obesity was associated with increased incidence of low back pain for > or =1 day in the past 12 months (OR = 1.53, 95% CI: 1.22, 1.92). Results remained consistent after adjusting for publication bias and limiting the analyses to studies that controlled for potential confounders. Findings indicate that overweight and obesity increase the risk of low back pain. Overweight and obesity have the strongest association with seeking care for low back pain and chronic low back pain.
              Article 0 comments Cited 226 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Rehabil Med
                Journal ID (iso-abbrev): Ann Rehabil Med
                Journal ID (publisher-id): ARM
                Title: Annals of Rehabilitation Medicine
                Publisher: Korean Academy of Rehabilitation Medicine
                ISSN (Print): 2234-0645
                ISSN (Electronic): 2234-0653
                Publication date (Print): June 2022
                Publication date (Electronic): 30 June 2022
                Volume: 46
                Issue: 3
                Pages: 122-132
                Affiliations
                [1 ]Center for Farmers’ Safety and Health, Kangwon National University Hospital, Chuncheon, Korea
                [2 ]Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
                Author notes
                Corresponding author: Gowun Kim, Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Baengnyeong-ro 156, Chuncheon 24289, Korea. Tel: +82-33-258-9100, Fax: +82-33-258-9097, E-mail: gowun@ 123456knuh.or.kr
                Author information
                http://orcid.org/0000-0003-3404-6202
                http://orcid.org/0000-0002-7434-6675
                http://orcid.org/0000-0002-5694-8111
                Article
                Publisher ID: arm-21201
                DOI: 10.5535/arm.21201
                PMC ID: 9263327
                PubMed ID: 35793901
                SO-VID: 2d8bbabf-c710-4944-ac2f-e9dde0ab3b3c
                Copyright © Copyright © 2022 by Korean Academy of Rehabilitation Medicine
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 December 2021
                Date revision received : 26 May 2022
                Date accepted : 10 June 2022
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: abdominal fat,back muscles,farmers,intervertebral disc degeneration,low back pain
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: abdominal fat, back muscles, farmers, intervertebral disc degeneration, low back pain

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