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Diabetes Mellitus Hastalarında Kronik Bel Ağrısı ile İlişkili Engelliliği Etkileyen Faktörler: Kesitsel Çalışma
Factors Influencing Chronic Low Back Pain-Related Disability in Patients with Diabetes Mellitus: A Cross-Sectional Study
Received Date : 29 Apr 2024
Accepted Date : 24 Sep 2024
Available Online : 02 Oct 2024
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Dilek BADAY KESKİNa, Sema HEPŞENb, Erman ÇAKALb
aKırıkkale University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kırıkkale, Türkiye bAnkara Etlik City Hospital, Department of Endocrinology and Metabolism, Ankara, Türkiye
Doi: 10.31609/jpmrs.2024-103656 - Makale Dili: EN
Turkiye Klinikleri Journal of Physical Medicine and Rehabilitation Sciences. 2025;28(1):30-7
ÖZET
Amaç: Çalışmanın amacı, diabetes mellitus (DM) hastalarında kronik bel ağrısına bağlı engellilik ile ilişkili faktörleri değerlendirmektir. Gereç ve Yöntemler: Eylül 2023-Ocak 2024 tarihleri arasında 224 DM hastası çalışmaya dâhil edildi. Kronik bel ağrısı ile ilişkili engellilik Oswestry Bel Ağrısı Engellilik Anketi [Oswestry Disability Index (ODI)] kullanılarak değerlendirildi. Ağrı yoğunluğu 100-mm görsel analog skala [visual analog scale (VAS)] kullanılarak değerlendirildi. Bulgular: Katılımcıların ortanca yaşı 56,0 (çeyrekler açıklığı, 50,0-62,0) idi. DM’li hastalarda kronik bel ağrısı prevalansı %31,3 idi. Kadın hastaların ortanca ODI skoru erkek hastalara göre daha yüksekti (p=0,002). Ortanca ODI skoru diyabetik nöropatisi olan hastalarda olmayanlara göre daha yüksekti (p=0,004). ODI skoru; beden kitle indeksi (BKİ) (r=0,209, p=0,003) ve VAS skoru (r=0,906, p<0,001) ile pozitif, eğitim süresi ile negatif korele idi (r=-0,215, p=0,001). Tek değişkenli regresyon analizinde, kadın cinsiyet (B=3,594, p=0,010), BKİ (B=0,226, p=0,021), eğitim süresi (B=-0,616, p=0,002), DM süresi (B=0,014, p=0,041) ve diyabetik nöropati varlığı (B=3,861, p=0,018) DM hastalarında kronik bel ağrısı ile ilişkili engellilik için bağımsız değişkenler idi. Çoklu doğrusal regresyon analizinde ise eğitim süresi DM’li hastalarda kronik bel ağrısı ile ilişkili engellilik için tek bağımsız değişken idi (B=-0,482, p=0,012) (R2=0,036). Sonuç: Klinisyenler DM hastalarında kronik bel ağrısı ile ilişkili engellilik için risk faktörlerinin farkında olmalıdır. Eğitim seviyesi düşük, kadın cinsiyette, BKİ yüksek, DM süresi uzun olan ve diyabetik nöropatisi olan hastalar kronik bel ağrısına bağlı engellilik açısından düzenli olarak takip edilmelidir.
Anahtar Kelimeler: Kronik bel ağrısı; disabilite; diabetes mellitus
ABSTRACT
Objective: To evaluate the factors associated with chronic low back pain (CLBP)-related disability in patients with diabetes mellitus (DM). Material and Methods: Two hundred and twenty-four patients with DM were included in the study between September 2023 and January 2024. Disability related to chronic LBP was evaluated using Oswestry Disability Index (ODI). Pain intensity was assessed using the 100-mm visual analog scale (VAS). Results: The median age of the participants was 56.0 years (interquartile range, 50.0-62.0). The prevalence of chronic LBP was 31.3% in patients with DM. Female patients had a higher median ODI score than in male patients (p=0.002). The median ODI score was higher in patients with diabetic neuropathy than in those without (p=0.004). The ODI score was positively correlated with body mass index (BMI) (r=0.209, p=0.003) and VAS score (r=0.906, p<0.001), and negatively correlated with education duration (r=-0.215, p=0.001). Univariate regression analysis showed that female gender (B=3.594, p=0.010), BMI (B=0.226, p=0.021), duration of education (B=-0.616, p=0.002), duration of DM (B=0.014, p=0.041), and presence of diabetic neuropathy (B=3.861, p=0.018) were associated factors for CLBP-related disability in patients with DM. Multivariate linear regression analysis showed that duration of education was a predictive variable for CLBP-related disability in patients with DM (B=-0.482, p=0.012) (R2=0.036). Conclusion: Clinicians should be aware of the risk factors for CLBP-related disability in patients with DM. Patients with lower years of education, female gender, higher BMI, longer duration of DM, and the presence of diabetic neuropathy should be followed regularly for CLBP-related disability.
Keywords: Chronic low back pain; disability; diabetes mellitus
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