Determination of physical parameters associated with self-efficacy in patients with chronic mechanic low back pain.

BACKGROUND: Self-efficacy that is associated with various pain-related disabilities such as chronic low back pain (LBP), should be questioned besides physical assessments. OBJECTIVES: To investigate the physical factors associated with self-efficacy in patients with chronic mechanic LBP. METHODS: One hundred nine patients diagnosed as chronic mechanic LBP (65 females, 44 males) between 20-50 years old were included to this study. The intensity of LBP was assessed by using a 10-cm Visual Analogue Scale. For musculoskeletal fitness measurement; muscle strength, muscle endurance, and flexibility tests were applied. Functional Reach Test for balance evaluation, Self-Efficacy Scale for self-efficacy measurement, Roland-Morris Disability Questionnaire for disability level evaluation were used. RESULTS: We found a moderate negative correlation between self-efficacy and pain intensity (r=-0.506); a negative and strong correlation between self-efficacy and disability level (r=-0.654) (p< 0.05). Self efficacy had a significant association with right (r= 0.265) and left (r= 0.290) lateral side bending flexibility (p< 0.05). According to multiple regression analysis results, it was found that disability level had a significant effect on self-efficacy (ß=-2.014; p< 0.01). CONCLUSIONS: Poor musculoskeletal fitness and pain intensity may cause decreasing self-efficacy but the major determinant of decreased self-efficacy was low-back related disability scores.

Is grand multiparity a risk factor for osteoporosis in postmenopausal women of lower socioeconomic status?

OBJECTIVE: We aimed to determine whether grand multiparity is a risk factor for osteoporosis among postmenopausal women of lower socioeconomic status. PATIENTS AND METHODS: We conducted a single center study between February 2012 and February 2013 on 50-60 year old postmenopausal women of lower socioeconomic status without a history of medical disease. Women with a body mass index (BMI) between 20 and 25 were included in the study. The grand multiparous group (group A) consisted of 38 women with 10 or more deliveries. Women with a history of three or fewer deliveries composed the control group (group B). Dual-energy x-ray absorptiometry was used to measure the bone mineral density (BMD) of the proximal femur neck and lumbar spine (L1-L4). RESULTS: The mean ages of groups A and B were found to be 54.3 ± 2.5 and 53.1 ± 2.7 years, respectively. Average parity in groups A and B was 11.1 ± 1.7 and 2.4 ± 0.7, respectively. Time since the onset of menopause was 3.6 ± 2.7 years in group A and 6.0 ± 2.9 in group B. The prevalence of osteoporosis was similar in both groups (71.1%-81.4%, p = 0.273). We found that grand multiparity was an ineffective indicator of either femoral or lumbar osteoporosis (p = 0.87 and p = 0.26), but osteoporosis five years after the onset of menopause was found to be significantly higher (p = 0.02). CONCLUSIONS: The duration of menopause is an independent risk factor of osteoporosis. However, the number of pregnancies is neither a determinant nor a protective factor for osteoporosis in postmenopausal women coming from a low socioeconomic background.