Association between device-measured physical activity and lumbar Modic changes
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(2020) 21:630
RESEARCH ARTICLE
Open Access
Association between device-measured physical activity and lumbar Modic changes Marella Modarress Julin1,2,3*, Jesperi Saukkonen1,2, Petteri Oura1,2,4, Maisa Niemelä1,4, Juho-Antti Junno2,5,6, Juhani Määttä1,2, Jaakko Niinimäki1,4, Timo Jämsä1,4,7, Raija Korpelainen1,2,8 and Jaro Karppinen1,2,9
Abstract Background: Modic changes (MC) in the lumbar spine are considered one potential etiological factor behind low back pain (LBP). Multiple risk factors for MC have been suggested, including male gender, smoking and factors affecting hyperloading and mechanical stress such as high body mass index (BMI), strenuous physical work and high occupational and leisure-time physical activity (PA). So far, the effect of PA on the occurrence of MC has remained under debate due to contradictory findings. The purpose of this study was to investigate the possible association between device-measured moderate-to-vigorous PA (MVPA) (≥ 3.5 METs) and lumbar MC. Methods: The study had 1374 participants from the Northern Finland Birth Cohort 1966. At the age of 46–48, PA was measured by a wrist-worn accelerometer, and lumbar magnetic resonance imaging (MRI) was carried out to determine MC. We analyzed the association between Type 1 (MC1) and Type 2 (MC2) MC and daily amount of MVPA (min/day) using sex-stratified logistic regression models before and after adjustment for BMI, socioeconomic status, smoking, and accelerometer wear time. Results: Among men, increased amount of MVPA was positively associated with any MC (adjusted OR corresponding to every 60 min/day of MVPA 1.41; 95% confidence interval (CI) 1.01 to 1.95) and MC2 (OR 1.54; 95% CI 1.14 to 2.08), but not with MC1 (OR 1.06; 95% CI 0.80 to 1.39). Among women, we only found a positive association between MVPA and MC1 before adjustments (unadjusted OR 1.42; 95% CI 1.06 to 1.92). Conclusion: Among men, increased amount of MVPA was associated with increased odds of any MC and particularly MC2. Among women, MVPA was not independently associated with MC. Keywords: Physical activity, MVPA, Device-based measurements, Modic changes, Lumbar spine, Lumbar MRI, Cohort study, Vertebrae, Skeletal health
Background It has been suggested that Modic changes (MC) in the lumbar spine are associated with non-specific low back pain (LBP) [1–4], although a recent systematic review showed this association to be inconsistent [5]. MC are lesions of vertebral bone marrow adjacent to vertebral endplates seen in magnetic resonance imaging (MRI) * Correspondence: [email protected] 1 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014 Oulu, Finland 2 Center for Life Course Health Research, PO Box 5000, FI-90014 Oulu, Finland Full list of author information is available at the end of the article
and are further divided into Type 1 (MC1), Type 2 (MC2) and Type 3 (MC3) on the basis of their different appearances in T1- and T2-weighted images [1, 6–8]. It is believed that the same pathologic processes lead to differe
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