ORCID Profile
0000-0002-4818-7017
Current Organisation
University of Sydney
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Publisher: Public Library of Science (PLoS)
Date: 21-02-2019
Publisher: Elsevier BV
Date: 10-2021
Publisher: Research, Society and Development
Date: 09-11-2022
DOI: 10.33448/RSD-V11I15.36104
Abstract: Objective: We described sedentary behavior during the COVID-19 pandemic in Brazilian older adults and explored whether highly sedentary behavior was associated with multimorbidity, physical activity levels, adoption of physical distancing, perceived social isolation, disability, and depressive symptoms. Methods: We surveyed 184 older adults and gathered information on sedentary behavior, multimorbidity, physical activity, adoption of social distancing, perceived social isolation, disability, and depressive symptoms. Then, we investigated the association between highly sedentary behavior and these factors. Results: 26% of participants reported high levels of sedentary behavior, spending 5 hours per day in sitting (median). Highly sedentary behavior during COVID-19 pandemic was associated with multimorbidity (OR: 2.78, 95% CI 1.12-6.89) and disability (OR: 1.08, 95% CI 1.02-1.16). Conclusion: The prevalence of highly sedentary behavior in older adults during the pandemic was 26%. High sedentary behavior was associated with disability and multimorbidity in them. These findings can be used to guide the academia, the public sector, and health professionals to develop integrated initiatives to monitor and to decrease sedentary behavior especially in older adults with disability and multimorbidity during and beyond the COVID-19 pandemic.
Publisher: Springer Science and Business Media LLC
Date: 05-07-2023
Publisher: American Academy of Pediatrics (AAP)
Date: 22-07-2022
Abstract: Up to one third of children may be diagnosed with growing pains, but considerable uncertainty surrounds how to make this diagnosis. The objective of this study was to detail the definitions of growing pains in the medical literature. Scoping review with 8 electronic databases and 6 diagnostic classification systems searched from their inception to January 2021. The study selection included peer-reviewed articles or theses referring to “growing pain(s)” or “growth pain(s)” in relation to children or adolescents. Data extraction was performed independently by 2 reviewers. We included 145 studies and 2 diagnostic systems (ICD-10 and SNOMED). Definition characteristics were grouped into 8 categories: pain location, age of onset, pain pattern, pain trajectory, pain types and risk factors, relationship to activity, severity and functional impact, and physical examination and investigations. There was extremely poor consensus between studies as to the basis for a diagnosis of growing pains. The most consistent component was lower limb pain, which was mentioned in 50% of sources. Pain in the evening or night (48%), episodic or recurrent course (42%), normal physical assessment (35%), and bilateral pain (31%) were the only other components to be mentioned in more than 30% of articles. Notably, more than 80% of studies made no reference to age of onset in their definition, and 93% did not refer to growth. Limitations of this study are that the included studies were not specifically designed to define growing pains. There is no clarity in the medical research literature regarding what defines growing pain. Clinicians should be wary of relying on the diagnosis to direct treatment decisions.
Publisher: BMJ
Date: 20-03-2017
DOI: 10.1136/BJSPORTS-2016-096943
Abstract: Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people. MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses. 27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies SMD = 0.27 95% CI 0.18 to 0.37 p<0.001). There was no evidence of an effect of health coaching on mobility (eight studies SMD = 0.10 95% CI -0.03 to 0.23 p=0.13), quality of life (eight studies SMD = 0.07 95% CI -0.06 to 0.20 p<0.05) or mood (five studies SMD = 0.02 95% CI -0.12 to 0.16 p=0.83). Health coaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-06-2019
DOI: 10.1097/J.PAIN.0000000000001639
Abstract: Emerging evidence suggests that musculoskeletal (MSK) pain should be viewed from a biopsychosocial perspective and consider the influence of family factors. We conducted a review with meta-analysis to provide summary estimates of effect of family history of pain on childhood MSK pain and explore whether specific family pain factors influence the strength of the association (PROSPERO CRD42018090130). Included studies reported associations between family history of pain and nonspecific MSK pain in children (age years). The outcome of interest was MSK pain in children. We assessed the methodological quality using a modified version of the Quality in Prognosis Studies instrument and quality of evidence for the main analyses using the GRADE criteria. After screening of 7281 titles, 6 longitudinal and 23 cross-sectional studies were included. Moderate quality evidence from 5 longitudinal studies (n = 42,131) showed that children with a family history of MSK pain had 58% increased odds of experiencing MSK pain themselves (odds ratio [OR] 1.58, 95% confidence interval 1.20-2.09). Moderate quality evidence from 18 cross-sectional studies (n = 17,274) supported this finding (OR 2.02, 95% 1.69-2.42). Subgroup analyses showed that the relationship was robust regardless of whether a child's mother, father, or sibling experienced pain. Odds were higher when both parents reported pain compared with one ([mother OR = 1.61 father OR = 1.59] both parents OR = 2.0). Our findings show moderate quality evidence that children with a family history of pain are at higher risk of experiencing MSK pain. Understanding the mechanism by which this occurs would inform prevention and treatment efforts.
Publisher: Springer Science and Business Media LLC
Date: 06-12-2019
DOI: 10.1007/S00586-018-5850-3
Abstract: To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain and to determine whether these associations differ between those born with low or full birthweight. The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthweight, weight gain and current BMI) among 2754 adult twins were investigated in three stages: total s le within-pair case-control for monozygotic and dizygotic twins together and within-pair case-control analysis separated by dizygotic and monozygotic. Results were expressed as odds ratios (OR) and 95% confidence intervals (CI). Birthweight was not associated with back pain (OR 0.99 95% CI 0.99-1.00), but a weak association was found between weight gain (OR 1.01 CI 1.00-1.01) or current BMI (OR 1.02 95% CI 1.00-1.05) and back pain in the total s le analysis. These associations did not remain significant after adjusting for genetics. The associations did not differ between those whose were born with low or full birthweight. Birthweight was not associated with prevalence of back pain in adulthood. Weight gain and current BMI were weakly associated with back pain prevalence in the total s le analysis but did not differ between those born with low or full birthweight. However, the small-magnitude association only just achieved significance and appeared to be confounded by genetics and the early shared environment. Our results suggest that a direct link between these predictors and back pain in adults is unlikely. These slides can be retrieved under Electronic Supplementary Material.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.SPINEE.2015.02.001
Abstract: The relationships between obesity and low back pain (LBP) and lumbar disc degeneration (LDD) remain unclear. It is possible that familial factors, including genetics and early environment, affect these relationships. To investigate the relationship between obesity-related measures (eg, weight, body mass index [BMI]) and LBP and LDD using twin studies, where the effect of genetics and early environment can be controlled. A systematic review with meta-analysis. MEDLINE, CINAHL, Scopus, Web of Science, and EMBASE databases were searched from the earliest records to August 2014. All cross-sectional and longitudinal observational twin studies identified by the search strategy were considered for inclusion. Two investigators independently assessed the eligibility, conducted the quality assessment, and extracted the data. Metaanalyses (fixed or random effects, as appropriate) were used to pool studies' estimates of association. In total, 11 articles met the inclusion criteria. Five studies were included in the LBP analysis and seven in the LDD analysis. For the LBP analysis, pooling of the five studies showed that the risk of having LBP for in iduals with the highest levels of BMI or weight was almost twice that of people with a lower BMI (odds ratio [OR] 1.8 95% confidence interval [CI] 1.6-2.0 I(2)=0%). A dose-response relationship was also identified. When genetics and the effects of a shared early environment were adjusted for using a within-pair twin case-control analysis, pooling of three studies showed a reduced but statistically positive association between obesity and prevalence of LBP (OR 1.5 95% CI 1.1-2.1 I(2)=0%). However, the association was further diminished and not significant (OR 1.4 95% CI 0.8-2.3 I(2)=0%) when pooling included two studies on monozygotic twin pairs only. Seven studies met the inclusion criteria for LDD. When familial factors were not controlled for, body weight was positively associated with LDD in all five cross-sectional studies. Only two cross-sectional studies investigated the relationship between obesity-related measures and LDD accounting for familial factors, and the results were conflicting. One longitudinal study in LBP and three longitudinal studies in LDD found no increase in risk in obese in iduals, whether or not familial factors were controlled for. Findings from this review suggest that genetics and early environment are possible mechanisms underlying the relationship between obesity and LBP however, a direct causal link between these conditions appears to be weak. Further longitudinal studies using the twin design are needed to better understand the complex mechanisms underlying the associations between obesity, LBP, and LDD.
Publisher: Wiley
Date: 05-11-2022
DOI: 10.1002/EJP.1878
Abstract: Spinal pain (SP), including neck and back pain, is common and often associated with poor mental health and reduced quality of life of adolescents. Contemporary understanding of SP favours a biopsychosocial approach, and emerging evidence suggests the stronger influence of psychological rather than other factors. We aimed to investigate if experiencing psychological distress in early childhood increases the risk of spinal pain with impact during adolescence. 1175 adolescents from a prospective cohort study (Raine Study Gen2) were included. Psychological distress was assessed at ages 2, 5, 8 and 10 using Child Behaviour Check List (CBCL). CBCL total and subscale scores (internalizing and externalizing symptoms) were converted to age‐standardized scores and dichotomized according to t‐scores ( =high distress). Life‐time spinal pain, including low back, mid back, or neck/shoulder, was measured at age 17. We were interested in adolescent SP with impact (care seeking, medication use, school absenteeism, daily activity interference, leisure activity interference) and defined cases as SP with impact (one or more) or greater impact (two or more) impacts. We investigated the longitudinal associations between childhood psychological distress and adolescent SP using univariate and multivariable logistic regression models. Psychological distress in childhood increased the odds of adolescent SP with impact by 33% (OR 1.33 95% CI 1.01–1.76), but not spinal pain with greater impact (OR 1.22 95% 0.83–1.80). Internalizing symptoms were associated with SP with greater impact and externalizing symptoms with SP with impact after adjusting for a range of potential child and family confounders. Psychological distress in childhood increases the risk of SP with impact in adolescence and may be a promising prevention target. Our findings provide evidence that psychological distress early in life is an independent risk factor for spinal pain with impact during adolescence. As psychological distress during childhood is potentially modifiable, it may be a promising target for research on the prevention of consequential spinal pain in adolescence. Identifying and addressing psychological distress in children may be an important component of best practice to reduce consequential spinal pain in adolescents.
Publisher: Public Library of Science (PLoS)
Date: 03-04-2017
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.SPINEE.2016.10.006
Abstract: Obesity is commonly investigated as a potential risk factor for low back pain (LBP) however, current evidence remains unclear. Limitations in previous studies may explain the inconsistent results in the field, such as the use of a cross sectional design, limitations in the measures used to assess obesity (eg, body mass index-BMI), and poor adjustment for confounders (eg, genetics and physical activity). To better understand the effects of obesity on LBP, our aim was to investigate in a prospective cohort whether obesity-related measures increase the risk of chronic LBP outcomes using a longitudinal design. We assessed obesity through measures that consider the magnitude as well as the distribution of body fat mass. A within-pair twin case-control analysis was used to control for the possible effects of genetic and early shared environmental factors on the obesity-LBP relationship. Data were obtained from the Murcia Twin Registry in Spain. Participants were 1,098 twins, aged 43 to 71 years, who did not report chronic LBP at baseline. Follow-up data on chronic LBP (>6 months), activity-limiting LBP, and care-seeking for LBP were collected after 2 to 4 years. The risk factors were BMI, percentage of fat mass, waist circumference, and waist-to-hip ratio. Sequential analyses were performed using logistic regression controlling for familial confounding: (1) total s le analysis (twins analyzed as independent in iduals) (2) within-pair twin case-control analyses (all complete twin pairs discordant for LBP at follow-up) and within-pair twin case-control analyses separated for (3) dizygotic and (4) monozygotic twins. No increase in the risk of chronic LBP was found for any of the obesity-related measures: BMI (men/women, odds ratio [OR]: 0.99 95 % confidence interval [CI]: 0.86-1.14), % fat mass (women, OR: 0.87 95% CI: 0.66-1.14), waist circumference (women, OR: 0.98 95% CI: 0.74-1.30), and waist-to-hip ratio (women, OR: 1.05 95% CI: 0.81-1.36). Similar results were found for activity-limiting LBP and care-seeking due to LBP. After the adjustment for genetics and early environmental factors shared by twins, the non-significant results remained unchanged. After 2 to 4 years, obesity-related measures did not increase the risk of developing chronic LBP or care-seeking for LBP with or without adjustment for familial factors such as genetics in Spanish adults.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.MSKSP.2018.10.001
Abstract: Musculoskeletal conditions are common health issues with great impact on in iduals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood. To systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan. MEDLINE, CINAHL, Scopus, Web of Science and EMBASE databases were searched from their inception to December 2017. Descriptors used in our search strategy were related to "perinatal factors" and "musculoskeletal pain". There were no language, age, sex or date restrictions. Meta-analysis was used to pool the estimates of association between perinatal factors and musculoskeletal pain. Among the six articles included in this systematic review, three were extracted for the meta-analysis. The pooled of three and two studies showed no association between chronic musculoskeletal pain and low birth weight (OR 1.8, 95% CI 0.9-3.8, I In adults, our meta-analysis showed no association between birth weight or pre-term birth and musculoskeletal pain, and the quality of the evidence was very low. Thus, the very low quality of evidence and limited number of studies do not suggest a direct clear association. Further high-quality longitudinal studies accounting for more relevant confounders are needed to better understand the complex mechanism that may operate between perinatal factors and musculoskeletal pain.
Publisher: Springer Science and Business Media LLC
Date: 18-06-2015
DOI: 10.1007/S00586-015-4055-2
Abstract: To investigate the relationship between different measures of obesity and chronic low back pain (LBP) using a within-pair twin case-control design that adjusts for genetics and early shared environment. A cross-sectional association between lifetime prevalence of chronic LBP and different measures of obesity (body mass index-BMI percent body fat waist circumference waist-hip ratio) was investigated in 1128 female twins in three stages: (i) total s le analysis (ii) within-pair case-control analysis for monozygotic (MZ) and dizygotic (DZ) twins together (iii) within-pair case-control analysis separated by DZ and MZ. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. BMI (OR 1.12 95% CI 1.02-1.26) and percent body fat (OR 1.15 95% CI 1.01-1.32) were weakly associated with lifetime prevalence of chronic LBP in the total s le analysis but were absent when shared environment and genetic factors were adjusted for using the within-pair case-control analysis. Greater waist-hip ratios were associated with smaller prevalence estimates of chronic LBP in the within-pair case-control analysis with both MZ and DZ twins (OR 0.67 95% CI 0.47-0.94). However, this association did not remain after the full adjustment for genetic factors in the MZ within-pair case-control analysis. BMI, percent of fat mass and greater depositions of fat and mass around the hips are associated with increases in chronic LBP prevalence in women but these associations are small and appear to be confounded by the effects of genetics and early shared environment. Therefore, our results do not support a causal direct relationship between obesity and chronic LBP.
Publisher: Revista Ciencias em Saude
Date: 05-08-2020
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.SPINEE.2017.04.008
Abstract: Telehealth has emerged as a potential alternative to deliver interventions for low back pain (LBP) however, its effectiveness has not been investigated. The aim of this review was to evaluate whether interventions delivered by telehealth improve pain, disability, function, and quality of life in non-specific LBP. This is a systematic review with meta-analysis. Seven databases were searched from the earliest records to August 2015. Eligible studies were randomized controlled trials that investigated the effectiveness of telehealth-based interventions, solo or in combination with other interventions, for non-specific LBP compared with a control group. Trials deemed clinically homogeneous were grouped in meta-analyses. Eleven studies were included (n=2,280). In chronic LBP, telehealth interventions had no significant effect on pain at short-term follow-up (four trials: 1,089 participants, weighted mean difference [WMD]: -2.61 points, 95% confidence interval [CI]: -5.23 to 0.01) or medium-term follow-up (two trials: 441 participants, WMD: -0.94 points, 95% CI: -6.71 to 4.84) compared with a control group. Similarly, there was no significant effect for disability. Results from three in idual trials showed that telehealth was superior to a control intervention for improving quality of life. Interventions combining telehealth and usual care were more beneficial than usual care alone in people with recent onset of LBP symptoms. There is moderate-quality evidence that current telehealth interventions, alone, are not more effective than minimal interventions for reducing pain and disability in chronic LBP. To date, modern telehealth media (eg, apps) and telehealth as an adjunct to usual care remain understudied.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.SPINEE.2017.02.004
Abstract: The relationship between sedentary lifestyle and low back pain (LBP) remains unclear and previous research has not accounted for genetic and early environmental factors. Our aim was to investigate if sedentary behavior is associated with the lifetime prevalence of persistent LBP and the risk of developing persistent LBP, care-seeking due to LBP, and activity limiting LBP when genetics and early environmental factors are accounted for. Both cross-sectional and longitudinal designs with a within-pair twin case-control were implemented. There were 2,148 twins included in the cross-sectional analysis whereas 1,098 twins free of persistent LBP at baseline were included in the longitudinal analysis. Sedentary behavior was the explanatory variable. Lifetime prevalence of LBP was the outcome variable in the cross-sectional analysis. The incidence of persistent LBP, care-seeking due to LBP, and activity limiting LBP were the outcome variables for the longitudinal analysis. This observational study was supported by a grant in 2012. No competing interests were declared. In the cross-sectional analysis, sedentary behavior was slightly associated with an increased prevalence of persistent LBP in females but not in males. This association was not apparent when genetics and early environmental factors were accounted for. We acknowledge that the small s le included in the co-twin analyses have yielded wide confidence intervals, and that caution should be exercised when interpreting and an association may not be ruled out. In the longitudinal analysis, sedentary behavior did not significantly increase the risk of persistent LBP, care-seeking due to LBP, or activity limiting LBP. Sedentary behavior is associated with concurrent LBP. However, this association is weak it only appears in females and decreases when accounting for genetics. Future studies using a twin design with larger s les should be conducted to further test these findings.
Location: Australia
No related grants have been discovered for Amabile Borges Dario.