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PubMed1991

Promoting physical activity and a healthful diet among children: results of a school-based intervention study.

BACKGROUND: National health objectives call for improved diet and more regular physical activity among children. We tested the effects of a school-based program to improve students' diet and physical activity behavior at school. METHODS: Two of the four elementary schools in one Texas school district were assigned to intervention and two to control conditions. The three intervention components were classroom health education, vigorous physical education, and lower fat, lower sodium school lunches. Nutrients from school lunches and the total day and the amount of physical activity students obtained during physical education were assessed as outcome. RESULTS: Analysis of school lunches showed declines from base line to posttest in the two intervention schools of 15.5% and 10.4% for total fat, 31.7% and 18.8% for saturated fat, and 40.2% and 53.6% for sodium; posttest values were lower in the intervention schools. Observation of physical activity during physical education classes indicated an increase in the intervention schools from baseline to posttest in the percent of time children engaged in moderate-to-vigorous physical activity from less than 10% of class time at baseline to about 40% of class time at posttest; posttest values were higher in the intervention schools than in the control schools. CONCLUSIONS: This efficacy study demonstrates the feasibility of substantially modifying school lunches and school physical education to improve children's diet and physical activity behavior at school.

Child↗
PubMed1997

Physical activity in a multiethnic population of third graders in four states.

OBJECTIVES: This research assessed the amount of daily physical activity in a multiethnic sample of US third-grade students. METHODS: Physical activity interviews were conducted with 2410 third graders from 96 schools in four states. Blood pressure, cholesterol, body mass index, timed run for distance, physical-activity self-efficacy, and perceived support for physical activity were also assessed. RESULTS: Students reported a daily average of 89.9 minutes of moderate to vigorous physical activity, 34.7 minutes of vigorous activity, and 120.4 minutes of sedentary behavior; however, 36.6% obtained less than 60 minutes of moderate to vigorous physical activity daily, and 12.8% reported less than 30 minutes. Boys reported more physical and sedentary activity than girls; White children reported more activity than Black or Hispanic children; California children reported the most activity and Louisiana children the least. Geographic location, male gender, lower cholesterol, higher perceived efficacy in physical activity, and higher social support were associated with more physical activity. CONCLUSIONS: Average reported activity met the Year 2000 objectives; however, many students reported less than recommended amounts of activity. These findings support the need for health promotion programs that increase the number of physically active children.

Analysis of Variance↗
PubMed2001

Challenges and opportunities for measuring physical activity in sedentary adults.

Increasing the physical activity of typically sedentary adult populations is at the forefront of the public health agenda. This review addresses the challenges in defining and measuring physical activity in this target group, for a number of purposes, namely, scientific or academic inquiry, surveillance, clinical application and programme evaluation. First, we clarify the conceptual distinctions between the terms sedentarism, physical inactivity, physical activity and energy expenditure. Next, we review and compare the utility of different approaches for quantifying and expressing physical activity in these populations. Physical activity in typically sedentary populations is most likely a simple pattern of behaviour that has been largely obscured by existing measures and its expression as energy expenditure. Existing self-report methods are practical, but suffer from floor effects and recall bias. Walking, the most important activity to assess in this target group, is very difficult to measure through self-report methods. Motion sensors are more appropriate for quantifying physical activity behaviours in typically sedentary populations. Of the 2 types of motion sensors - the accelerometer and the pedometers--the latter is more appealing because it is both an affordable and a 'good enough' measure of physical activity, specifically ambulatory activity. Although a common measurement approach would greatly facilitate our understanding of physical activity behaviour patterns, the selection of an approach ultimately depends on the purpose of the study and to a great extent, its budget. Researchers, clinicians and practitioners interested in accurately capturing the lower end of the continuum of physical activity (that is characteristic of sedentary populations) must thoughtfully consider the relative advantages and disadvantages of the available approaches.

Adult↗
PubMed2006

Physical activity and self-perceived health status.

OBJECTIVES: Recently more attention has been focused on the impact of physical activity on modification of self-perceived heath status in adults. The objective of the study was to evaluate the level of occupational and non-occupational physical activities and their correlation with self-perceived heath status among economically productive individuals. MATERIALS AND METHODS: Physical activity of the subjects studied was evaluated by the Seven Day Physical Activity Recall (SDPAR) questionnaire among randomly chosen residents of the city of Lódź (n = 598, including 299 women and 299 men). The examination of the subjective health assessment was conducted based on the analogue visual scale. RESULTS: The multifactorial logistic regression analysis indicated that weekly energy expenditure on occupational physical activity (kcal/week) did not play a significant role in self-perception of health status among men or women. Neither did the outcome of the study provide evidence for the significant effect of housework load on self-perceived health status among the study participants. However, a sufficient level of leisure-time physical activity in a beneficial way affects health-related self-perception of the examined subjects. In the group of men expending 1000 kcal/week or more on leisure-time physical activity, the risk for poor health-related self-report was significantly lower than among men declaring no energy expenditure on this activity (adjusted odds ratio (OR = 0.29, 95% CI: 0.13-0.66). Among females not taking up any recreational physical activity, the risk of low self-perceived health status was also higher than in females reaching a satisfactory level of recreational physical activity (adjusted OR = 0.38, 95% CI: 0.17-0.87). CONCLUSIONS: Preventive programs aimed at improving subjective health assessment through the increased leisure-time physical activity should be addressed to all economically productive individuals and particularly to people of older age groups and above all to females.

Adult↗
PubMed2006

Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial.

BACKGROUND AND PURPOSE: Aquatic physical therapy is frequently used in the management of patients with hip and knee osteoarthritis (OA), yet there is little research establishing its efficacy for this population. The purpose of this study was to evaluate the effects of aquatic physical therapy on hip or knee OA. SUBJECTS: A total of 71 volunteers with symptomatic hip OA or knee OA participated in this study. METHODS: The study was designed as a randomized controlled trial in which participants randomly received 6 weeks of aquatic physical therapy or no aquatic physical therapy. Outcome measures included pain, physical function, physical activity levels, quality of life, and muscle strength. RESULTS: The intervention resulted in less pain and joint stiffness and greater physical function, quality of life, and hip muscle strength. Totals of 72% and 75% of participants reported improvements in pain and function, respectively, compared with only 17% (each) of control participants. Benefits were maintained 6 weeks after the completion of physical therapy, with 84% of participants continuing independently. DISCUSSION AND CONCLUSION: Compared with no intervention, a 6-week program of aquatic physical therapy resulted in significantly less pain and improved physical function, strength, and quality of life. It is unclear whether the benefits were attributable to intervention effects or a placebo response.

Exercise Therapy↗
PubMed1988

[Relationships among self concept, perception of aging and physical aging].

Although everyone grows old, perception about the aging process and aging as measured physiologically vary widely. Perceptions of aging have psychologically influence on physical aging. This study was to examine the relationships between, self-concept, perception of aging, and physical aging in the elderly and to contribute to the theory development which may direct nursing intervention to promote well-being of the aged. Subjects were 70 women residents of a nursing home for the elderly in Seoul. Data collection was done from May 15 to June 15, 1988 using interview schedules and mechanical instruments. The instruments were selected items from the Health Self Concept Scale developed by Jacox and Stewart for self concept, and Secord and Jourad's Body Cathexis Scale and Osgood's Semantic Differential Scale for perception of aging. Physical aging was measured by mechanical instruments, inspection, questions, and palpation. The data were analysed for mean, t-test, ANOVA, and Pearson Correlation Coefficient using an S.P.S.S computerized program. The results of the analysis were as follows. 1. The mean level of self concept for the subject group was 16.97 (SD = +/- 6.17) in a range from 6-30. The mean level of perception of aging was 39.6. (SD = +/- 6.51) in a range from 13-65. The mean level of physical aging was 14.09 (SD = +/- 2.05) in a range from 8-40. 2. Relationships among self-concept, perception of aging, and physical aging. 1) There was a positive relationship between self-concept and perception of aging (r = 0.4461, p = 0.000). 2) There was a negative relationship between physical aging and perception of aging (r = -0.2975, p = 0.006). 3) There was a tendency toward a negative relationship between physical aging and self-concept, but not a significant relationship (r = -0.1033, p = 0.197). 3. 1) No general characteristic variables were related to self concept. 2) The general characteristic variable related to the level of perception of aging was religion (t = 4.17, p = 0.001). 3) The general characteristic variable related to the level of physical aging was age (F = 12.008, p = 0.000). There was a significant relationship between self-concept and perception of aging, and between physical aging and perception of aging. Therefore nursing intervention should focus on promoting a positive perception of aging and strengthening self-concept during the physical aging process.

Aged↗
PubMedDate not supplied

Physical exercise and health: a review.

BACKGROUND: Physical activity results in increased exercise capacity and physical fitness, which may lead to many health benefits. Individuals who are more physically active appear to have lower rates of all-cause mortality, probably due to a decrease in chronic diseases including coronary artery disease (CAD). This may result from an improvement in cardiovascular risk factors in addition to enhanced fibrinolysis, improved endothelial function, decreased sympathetic tone, and other yet undetermined factors. METHODS: We reviewed the literature on physical activity and health with particular reference to the benefits derivable by engaging in regular physical activity. The MEDLINE/PUBMED and bibliographic searches for English language studies were used. RESULTS: Physical inactivity is now considered a risk factor for Cardiovascular diseases (CVD). Regular exercise results in an increase in exercise capacity and lower myocardial oxygen demand leading to cardiovascular benefits, including lower mortality rates. Physically active individuals suffer from fewer ailments than do less-active individuals. Physical activity reduces cardiovascular risk through lowering of blood pressure, improved glucose tolerance, reduced obesity, improvement in lipid profile, enhanced fibrinolysis, improved endothelial function and enhanced parasympathetic autonomic tone. CONCLUSION: Physical exercise has many health benefits and the evidence for this continues to accumulate. Health care professionals should incorporate counselling to patients for physical exercise in their daily clinical practice, while health policy makers and community physicians should see to implementation of this at the community level.

Cardiovascular Diseases↗
PubMedDate not supplied

Physical function, employment and quality of life in end-stage renal disease.

INTRODUCTION: The impact of end-stage renal disease (ESRD) on quality of life (QoL) can be measured in terms of physical, psychological and social consequences, including the ability to work. SUBJECTS AND METHODS: This multi-center, cross-sectional study explored relationships between QoL, employment status and physical function in ESRD patients aged 18-65 years, via a customised interviewer-administered questionnaire, which included the SF-36 health survey. The International Labour Office method was applied to describe employment rate. RESULTS: 144 patients (85 male, 49 female), comprising 49 haemodialysis (HD), 35 peritoneal dialysis (PD) and 60 renal transplant (TX) patients were studied. Mean age was 44 +/- 12 years. 32 were voluntarily not working, leaving 112 in the labour force. Of the latter, 49% were unemployed, in contrast with the concurrent national rate of 10%. QoL in the ESRD group was reduced in the SF-36 physical and social dimensions compared to population norms. Unemployed ESRD patients scored significantly lower than those employed in physical function, role physical, bodily pain, general health, vitality and role emotional scales. Logistic regression demonstrated that multiple comorbidities (p<0.005), a premorbid physical occupation (p<0.05) and poor physical function (p<0.05) predicted unemployment in ESRD independent of all other variables. Multiple regression showed that age (p<0.05), female sex (p<0.05) and a diagnosis of musculoskeletal disease (p<0.005) were independent predictors of poor physical function. CONCLUSIONS: These findings suggest that vocational rehabilitation of ESRD patients must consider physical function and occupational demands as well as co-morbidity and that musculoskeletal disease is key factor in impaired physical function.

Adolescent↗
PubMed2000

[Is physical activity important in treatment and rehabilitation of cancer patients?].

BACKGROUND: In the past, patients suffering from cancer and other chronic diseases were told to avoid physical activity in order to rest and reduce discomfort. Recently, many studies have published new scientific evidence which indicates that physical activity may be an important factor in the rehabilitation for several chronic diseases. However, less is known about the importance of physical activity in the treatment and rehabilitation of cancer patients. MATERIAL AND METHODS: We performed a search on Medline and Pubmed. A total of 38 studies focusing on the importance of physical activity in the treatment and rehabilitation of cancer patients are included in the present study. RESULTS: The performed studies that have assessed the effects of physical activity on quality of life following cancer diagnosis, consistently suggest that physical activity may improve quality of life for cancer patients and influence fatigue. No information exists on whether physical activity increases survival. The limitations of these clinical studies include small sample size, lack of adjustment for possible confounders, and short intervention spans. INTERPRETATION: Physical activity is not part of the usual cancer rehabilitation program, yet clinical studies are promising and important. More studies are needed to improve our understanding of the effects and feasibility of physical activity for different groups of cancer patients. Furthermore, the importance of physical activity in relation to surgery, current conventional chemotherapy and radiation for these patients needs to be studied if we are to reduce the knowledge gap regarding the potential role of exercise in rehabilitation programmes for cancer patients compared with patients with other chronic diseases.

Controlled Clinical Trials as Topic↗
PubMed2001

[Physical activity and management of obese patients].

Physical activity is recognized as an integral part of obesity treatment, in association with other therapeutic means. A major benefit of physical activity is the association with better long-term maintenance of weight loss. Physical activity has also positive psychological effects and increases quality of life. An evaluation of the usual level of physical activity and inactivity is needed for each patient. Physical activity counselling should be individualized and graded, in a perspective of individual progression. In subjects with massive obesity, remobilization based on physiotherapy techniques is the first step. All patients should be given simple advice to decrease sedentary behavior: use the stairs instead of the escalators, limit the time spent seated, etc. In general, current physical activity recommendations for the general population fit well with a majority of obese patients, i.e. a minimum of 30 minutes/day of moderate intensity physical activity (brisk walking or equivalent) on most, and preferably all, days of the week. Physical activities of higher intensities (endurance training programme) can be proposed on an individual basis. The type of physical activity required for long-term weight maintenance, and the question of adherence to physical activity recommendations in obese patients should be further investigated.

Exercise↗
PubMed2002

[The association between physical workload and low back pain clouded by the "healthy worker" effect].

INTRODUCTION: Both physical and psychosocial workplace factors are considered risk factors for low back pain (LBP). However, today, no consensus has been reached regarding the exact role of these factors in the genesis of LBP. MATERIAL AND METHODS: Questionnaire data were collected at baseline for 1,397 (and after five years for 1,163) men and women aged 31-50 years at baseline. LBP (any LBP within the past year; LBP < or = 30 days in total during the past year; LBP > 30 days in total during tha past year) was analysed in relation to physical workload (sedentary, light physical, and heavy physical work) using logistic regression and controlling for age, gender, and social group. The proportions af workers changing between the workload groups over the five-year period were analysed in relation to LBP status. RESULTS: A baseline no statistically significant differences in LBP outcomes were found for workers exposed to sedentary, light physical, or heavy physical work. This was true for both genders and all age and social groups. At follow-up these was a statistically significant dose-response association between any LBP and long-standing LBP during the past year and increasing physical workload at baseline, also after controlling for age, gender and social group. Subjects with a heavy physical workload at baseline changed significantly more often to sedentary work, if they had experienced LBP for more than 30 days out of the past year. DISCUSSION: Having a sedentary job might have a protective or neutral effect in relation to LBP, whereas having a heavy physical job constitutes a significant risk factor. Because og migration between exposure groups (the "healthy worker" effect), longitudinal studies are necessary for investigating the associations between physical workload and LBP.

Adult↗
PubMed2002

Changes in urinary zinc and copper with strenuous physical exercise.

BACKGROUND: Air rescue trainees in the Japan Air Self Defense Force participate in a curriculum that includes 24 wk of strenuous physical training. The trace minerals zinc and copper are directly involved in many physiologic processes that are altered by physical exercise of this sort. It has also been demonstrated that urinary excretion of catecholamines (adrenaline and noradrenaline) increases during both mental work and physical exercise. HYPOTHESIS: Air rescue trainees will exhibit changes in trace mineral excretion and catecholamine levels that vary with the type of training undertaken. METHODS: The levels of urinary zinc (Zn), copper (Cu), noradrenaline (NAd), and adrenaline (Ad) were determined in 11 air rescue trainees before and after daily training sessions for consecutive 3- or 4-d periods during four phases of the curriculum, as follows: control (Cont), classroom instruction without physical exercise; preliminary (Prelim), daily exercise sessions for increased physical strength; basic (Basic), a combination of lectures and demanding physical exercise; and simulated mountain rescue (Sim). RESULTS: The mean urinary concentrations of Zn and Cu increased significantly after sessions with physical exercise (Prelim, Basic, and Sim), but remained unchanged for Cont. The NAd levels also increased significantly after training with physical exercise. In contrast, Ad levels increased significantly after sessions in all phases, both with and without physical exercise. CONCLUSIONS: The urinary levels of Zn, Cu, NAd, and Ad rose with strenuous exertion, whereas only Ad responded to both physical and mental tasking.

Adult↗
PubMed2004

[Study on the reliability and validity of international physical activity questionnaire (Chinese Vision, IPAQ)].

OBJECTIVE: To study the reliability and validity of Chinese version of International Physical Activity Questionnaire (IPAQ) and to provide an instrument for physical activity measurement in Chinese-spoken population. METHODS: Test-retest reliability was systemically assessed in 94 participants sampled from college students. Questionnaires were completed twice with a three-day interval. The validity was established in 39 volunteers by Caltrac accelerometer monitoring and 24-hour activity recording for seven consecutive days. RESULTS: Both long vision (LV) and short vision (SV) had intraclass correlation coefficients above 0.7 for physical activity. The total energy expenditure measured by LV, SV and PA records were 264.5 +/- 260.9, 185.4 +/- 128.9 (compared with activity records, P < 0.05) and 250.5 +/- 141.2 MET-min/d respectively. Energy expenditure of moderate physical activity were 81.7 +/- 165.4, 32.0 +/- 42.5 (compared with activity record, P < 0.05) and 61.3 +/- 72.0 MET-min/d. Caltrac accelerometer was moderately correlated with LV (r = 0.50) and SV (r = 0.63) while SV measured total daily energy expenditure was lower than activity records. When participants were categorized into two groups according to their time spent in physical activity above or below the target level, proportions of agreement of questionnaires and 24-hour activity records were high, including vigorous physical activity above 90% and moderate physical activity above 70%. LV, SV and activity records were measured during sedentary condition at an approximate level. CONCLUSIONS: Both LV and SV of IPAQ appeared to have acceptable reliability and validity, compared to other physical activity instruments that were used in various large epidemiological studies. The total or physical energy expenditures were similar between LV and activity records. For activity levels, the proportion of agreement were similar between activity records and LV or SV. However, SV underestimated the energy expenditure of total and moderate physical activity.

Adult↗
PubMed2004

Estimation of physical activity by different questionnaires in overweight subjects and patients with Type 2 diabetes mellitus: relationship with anthropometric and metabolic variables.

AIM: This study assessed the level of physical activity in overweight and obese subjects, and overweight and obese patients with Type 2 diabetes mellitus (T2DM). It also compared their physical activity level with that of the general population and investigated benefits of physical activity on anthropometric and metabolic parameters and blood pressure in the studied groups of patients using Baecke's questionnaire and the Lipid Research Clinics Physical Activity (LRC PA) questionnaire. The two questionnaires were also compared in the evaluation of benefits. METHODS: Physical activity level and other parameters (body weight, body height, body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, lipoprotein and creatinine concentrations in the blood, concentration of fasting glucose and HbA1c in the blood, albuminuria-to-creatinuria ratio) of 136 subjects and their relationships were investigated during their out-patient visits. RESULTS: No difference in physical activity level was found among the four groups of investigated patients. The comparison between the level of physical activity in the investigated patients and the general population obtained by Baecke's questionnaire revealed a lower sports index in all groups of investigated men and obese women with diabetes mellitus. Our results confirm the benefit of physical activity on a high number of investigated parameters in the studied patients. The Baecke's questionnaire was found to estimate the effects of physical activity on metabolic and anthropometric parameters, as well as blood pressure, better than the LRC PA questionnaire, especially the two-point scoring system. CONCLUSIONS: LRC PA and especially Baecke's questionnaires are valuable aids in the estimation of physical activity level and its benefits in overweight and obese patients and patients with T2DM.

Adult↗
PubMed2005

[Characteristic of physical activity among adults in urban population in Poland].

UNLABELLED: Regular leisure-time physical activity plays an important role in health promotion and noncomunicable disease prevention. The aim of this study was to analyze physical activity (including leisure-time, occupational and household activities) in representative sample of 1029 adults in Lodz. Moreover contribution of different type and intensity physical activities to total weekly energy expenditure was analysed. Physical activity was determined by the interviewer-administrated Seven Day Physical Activity Recall (SDPAR). RESULTS: The mean age of study participants was 45.8 +/- 11.7 years old. The analysis of the type of physical activity revealed that leisure-time, occupational and housework energy expenditure (of moderate or higher intensity) constituted 2.3%, 23.3% and 10.9%, respectively, of the whole energy expenditure in subjects examined. In the study group, contribution of low intensity (> or = 1,5 METs), moderate (4 METs), high and very high intensity (> 4 METs) physical activity to total weekly energy expenditure was 3.1, 55.8% and 21.8% respectively. CONCLUSIONS: This study results suggest that effective programs need to be taken to increase leisure-time physical activity among adults in Lodz. Programs promoting an active lifestyle should encourage to participation in moderate and higher intensity physical activities (if no health contra-indications). It can be effective strategy to achieve level of physical activity recommended by experts in health promotion and noncomunicable disease prevention.

Adult↗
PubMedDate not supplied

Physical activity and ethnicity: evidence from the Canadian Community Health Survey.

BACKGROUND: A large proportion of the Canadian population lives a sedentary lifestyle. Few data are available describing the physical activity behaviours among specific ethnic groups in Canada, so the purpose of this study is to examine the relationship between ethnicity and the level of self-reported physical activity. METHODS: Pooled data from cycles 1.1 (2000/01) and 2.1 (2003) of the cross-sectional Canadian Community Health Survey (ages 20-64 yrs; N = 171,513) were used for this study. Weighted prevalences of self-reported leisure-time moderate (> or = 1.5 kcal x kg(-1) day(-1) (kkd)); moderate to high (> or = 3 kkd) and high physical activity (> or = 6 kkd) were calculated, and multiple logistic regression models were used to quantify the odds of being physically active across ethnic groups, after adjustment for several covariates (White referent group). RESULTS: The rank order of prevalence of being moderately physically active by ethnicity was: White (49%), Other (48%), NA Aboriginal (47%), Latin American (40%), East/Southeast Asian (39%), Black (38%), West Asian/Arab (36%), South Asian (34%). Aboriginal men and women had the highest prevalences of being physically active at > or = 3 kkd (M = 32%, F = 22%) while East/Southeast Asian (19%) and East Asian/Arab men (19%), and South Asian women (12%) had the lowest prevalences. After accounting for covariates, Aboriginal men were at elevated odds of being physically active compared to Whites (> or = 3 kkd, OR=1.6, p < 0.05; > or = 6 kkd, OR = 2.7, p < 0.05). Only 7% and 3% of Canadian men and women, respectively, were active at > or = 6 kkd. CONCLUSION: These results suggest that the prevalence of physically active Canadian adults varies by ethnicity. Strategies to promote physical activity and prevent physical inactivity should consider these findings.

Adult↗
PubMed1991

[Physical activity habits among adults in Nord-Trøndelag].

This article describes the physical activity of 61,732 adults in the Norwegian county of Nord-Trøndelag. We collected information about physical activity by questionnaire during the Nord-Trøndelag Health Survey in 1984-86. Non-attendents are systematically analyzed and discussed. The article also deals with problems of defining physical activity. The frequency of physical activity gives a different measure of physical activity than does intensity and duration. 15% of the women and 14% of the men were totally inactive. If we consider physical activity at a level high enough to have a preventive effect as regards development of disease, for example, we found that 65% did not practise physical activity often enough or with sufficient intensity or duration. The groups of men aged 70-79 years and women aged 60-69 years contained the persons who practised physical activity most often, while the 20-29 age group contained those who practised physical activity with greatest intensity and for the longest time. We used age, sex, education, residential municipality and physically strenuous work as variables explaining inactivity and high activity. All the variables made a significant contribution to the logistic regression, but gave a better persons characterization of highly active than of inactive persons.

Adult↗
PubMed1994

Contribution of neuromuscular impairment to physical functional status in patients with lumbar spinal stenosis.

OBJECTIVE: To evaluate the relationship between neuromuscular impairment and physical functional status in patients with lumbar spinal stenosis. METHODS: Cross sectional analysis of 217 consecutive patients with lumbar spinal stenosis referred to 3 teaching hospitals. Physical functional status was measured with the physical dimension of the Sickness Impact Profile (P-SIP). Physical and radiological findings were abstracted from clinical records. The neuromuscular findings included pin sensation, strength, deep tendon reflexes and vibration. They were aggregated in a neuromuscular impairment index (NMI). Univariate relationships of the P-SIP and the NMI were analyzed with nonparametric methods. The determinants of physical functional status were evaluated using multiple linear regression models. RESULTS: In 148 patients with complete clinical data, objective weakness of the lower extremity as measured at rest was not related to physical functional status in univariate analyses. Decreased vibration was common and was associated with balance disturbance and reduced physical functional status, reflecting the importance of proprioception loss. In the multivariate regression analysis, neuromuscular deficit explained only 2.5% of the variance in physical functional status. The primary determinants of physical functional status were pain, depression, comorbid conditions and work status. CONCLUSION: While neuromuscular impairment is an indispensable feature of the diagnostic evaluation, its value in assessing outcome is limited. The decision whether to intervene surgically in patients without cauda equina syndrome or rapidly progressive neurological deficits should therefore be driven by pain and physical disability rather than the degree of neuromuscular impairment.

Aged↗