Low back pain in adult female caregivers of children with physical disabilities.

BACKGROUND: Low back pain (LBP) in occupational settings has been studied extensively. There are fewer studies on LBP in domestic settings, especially in an informal caregiving setting. OBJECTIVES: To compare the prevalence of LBP in adult female primary caregivers of children with physical disabilities who need assistance with transfers (eg, moving from a bed to a wheelchair) with the prevalence of LBP in adult female primary caregivers of children with nondisabling medical illnesses and to evaluate the factors associated with LBP. DESIGN: A 15-minute, self-administered, cross-sectional survey. SETTING: University-based clinics. Subjects Ninety consecutive adult female caregivers of children presenting to a pediatric physical medicine and rehabilitation clinic and 23 consecutive adult female caregivers of children presenting to a pediatric endocrine clinic were studied. General exclusionary criteria included the following: male sex, a history of back surgery or fracture, the caregiver was younger than 18 years old at the time of the completion of the questionnaire, or the caregiver was caring for any child younger than 2 years old. Caregivers visiting the pediatric endocrine clinic were excluded if they were caring for 1 or more children needing assistance with transfers. MAIN OUTCOME MEASURES: The dependent variable was the presence of LBP. The independent variables were mood, work status, amount of lifting at work, physical functioning of the child, demographic variables of the caregiver, and demographic variables of the child. RESULTS: The prevalence of having LBP (71.1%) in the physical medicine and rehabilitation group is higher than the prevalence (43.5%) in the endocrine clinic group (odds ratio, 3.2; 95% confidence interval, 1.25-8.21). The prevalence of having LBP (80.3%) when the child required physical assistance with transfers was significantly higher than the prevalence (40.5%) when the child did not require physical assistance with transfers (odds ratio, 2.56; 95% confidence interval, 2.56-14.0). Forward multiple logistic regression showed that the factors related to LBP in the caregiver were the transferability of the child, mood of the caregiver, and a history of LBP in the caregiver. CONCLUSIONS: The prevalence of LBP is higher in caregivers of children needing assistance with transfers. This increased prevalence is associated with the transferability of the child and mood of the caregiver. Results of this study suggest that physical and psychological factors both contribute to the presence of nonoccupational LBP.

Physical functioning in female caregivers of children with physical disabilities compared with female caregivers of children with a chronic medical condition.

OBJECTIVES: To evaluate if physical functioning is different in female caregivers of children with physical disabilities compared with female caregivers of children with nondisabling medical illnesses, and to investigate the factors associated with functioning level. DESIGN: Cross-sectional survey. SETTING: University-based clinics. PATIENTS: Ninety consecutive female caregivers of children presenting to a pediatric physical medicine and rehabilitation (PM&R) clinic, and 23 presenting to a pediatric endocrine clinic. INTERVENTION: Fifteen-minute self-administered survey. MAIN OUTCOME MEASURES: The dependent variable measured was physical functioning (physical functioning subscale of the Short Form-36). Independent variables measured were the average back pain severity over the last week (100-mm visual analog scale), mood (using the Center for Epidemiologic Studies-Depression Scale), work status, amount of lifting at work, caregiver demographics, child demographics, and the physical functioning ability of the child (measured using the WeeFIM scale). RESULTS: The mean (SD) physical functioning score of caregivers of children in the pediatric PM&R clinic was 80.6 (21.9), which was less than the score of 90.2 (17.6) for caregivers in the pediatric endocrine clinic (mean difference, 9.6; 95% confidence interval, -0.9 to -18.4). The physical functioning score of 77.7 (22.9) in caregivers of PM&R clinic children with a WeeFIM scale score of 1 to 4 was significantly worse than the 90.5 (14.8) in female caregivers of children with a WeeFIM score of 5 to 7 (mean difference, 12.8; 95% confidence interval, -2.0 to -23.6). This decrease is associated with the average pain severity, mood, and total length of time of back pain in the previous 12 months. Regression analysis shows that pain severity and caregiver mood are significantly related to the physical functioning status of the caregiver. CONCLUSIONS: Physical functioning is decreased in female caregivers of children with a physical disability. This decrease is associated with caregiver pain severity and mood.