Spinal Structural Canal Measurements And Their Relationships To Pain, Disability, And Physical Function Among Older Adults With And Without Chronic Low Back Pain
| Author(s) | Rodriguez, Christina | |
| Date Accessioned | 2016-09-19T17:13:15Z | |
| Date Available | 2016-09-19T17:13:15Z | |
| Publication Date | 2016-05 | |
| Abstract | In the United States, approximately 6 million older adults experience frequent low back pain (LBP) and 23% report suffering from LBP of moderate intensity. Among older adults, chronic LBP is associated with impaired physical function and is one of the most disabling chronic conditions. LBP may be accompanied by radicular symptoms, i.e. pain, numbness, tingling, and/or weakness, that radiates into the lower extremities. Clinical symptoms and spinal canal structural measurements (i.e. anteroposterior canal diameter (APCD), canal cross-sectional area (CCSA), and dural sac cross-sectional area (DSCSA)) have been used to diagnosis adults with chronic LBP, with and without leg pain, and to justify surgical interventions. Self-report measures assess a patient’s personal perception of function, while performance-based measures objectively assess a person’s ability to perform an activity. Thus, both types of measures are important in assessing a patient’s physical function and LBP-related disability. Among older adults with and without leg pain, there may be a relationship between the size of spinal canal structures, i.e. the spinal canal and the dural sac, and pain intensity, physical function, and disability. Relationships in the presence of LBP may differ from those found among older adults without LBP, while relationships found among older adults with chronic LBP + leg pain may differ from relationships found among older adults with chronic LBP only. Also located in the spinal canal is epidural fat, which has been proposed to be protective due to its anatomical location. What remains unknown is how this epidural fat is related to pain, physical function, and disability among older adults with chronic LBP with and without leg pain. Similarly, it is possible that relationships found among epidural fat and pain, function, and disability, among older adults with chronic LBP may differ from older adults without LBP. The specific aims of this thesis are: (1) to establish inter-examiner measurement reliability for structural spinal canal measurements among older adults with chronic LBP, (2) to assess for differences in structural spinal canal measurements among older adults with chronic LBP, chronic LBP + leg pain, and without LBP, (3) to examine relationships among structural spinal canal measurements and pain, physical function, i.e. self-report and performance-based, and disability, among older adults with LBP, LBP + leg pain, and without LBP, and (4) to examine epidural fat and its relationships to pain, physical function, and disability, among older adults with chronic LBP, chronic LBP + leg pain, and without LBP. Findings indicate that spinal canal structural measurement can be reliably determined. Measurements proposed in previous studies, i.e. APCD, CCSA, and DSCSA were not significantly different among older adults with and without chronic LBP and were not different between older adults with LBP as compared to those without LBP. Ratio spinal canal measurements emerged as a means of distinguishing between older adults with chronic LBP (with or without leg pain) and without LBP. Further, ratio measurements were associated with pain, physical function, and disability (beyond covariates) among older adults with chronic LBP but not among those without LBP. Epidural fat helps to explain LBP intensity, self-reported and performance-based physical function among older adults with chronic LBP without leg pain; greater epidural fat in those with lower LBP intensities and better physical function, supporting the theory that epidural fat may be protective. Future work is needed to evaluate these relationships longitudinally. | en_US |
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| URL | http://udspace.udel.edu/handle/19716/19617 | |
| Publisher | University of Delaware | en_US |
| Keywords | low back pain | en_US |
| Keywords | exercise science | en_US |
| Keywords | spinal structural canal | en_US |
| Keywords | older adults | en_US |
| Title | Spinal Structural Canal Measurements And Their Relationships To Pain, Disability, And Physical Function Among Older Adults With And Without Chronic Low Back Pain | en_US |
| Type | Thesis | en_US |