An Association of Body Composition Components with the Menopausal Status of Patients with Low Back Pain in Tarn Taran, Punjab, India

The present study deals with the association of menopausal status of 146 patients (74 preand 72 postmenopausal women) with low back pain aged 35-55 years residing in and around Tarn Taran, Punjab, India, and their body composition components, viz. percent body fat and percent lean body mass. The results indicate strong association of percent body fat with all the ten pain measuring variables, viz. pain intensity (r=0.668), personal care (r=0.519), lifting (r=0.620), walking (r=0.648), sitting (r= 0.515), standing (r=0.471), sleeping (r= 0.533), sex life (r= 0.255), social life (r=0.664) and travelling (0.583) in post-menopausal patients with low back pain. the prevalence of low back pain increases in middle aged women (Adera et al. 1994; Lau et al. 1995; Yip et al. 2001). As women age they tend to be overweight and an additional burden is placed on the lower back causing various types of disabilities including low back pain. Keeping those complications in mind, in the present study an attempt has been made to investigate the association of percent body fat with height, weight and BMI in pre and post-menopausal patients with low back pain residing in and around Tarn Taran, Punjab, India. MATERIALS AND METHIODS A total of 146 purposively selected low back pain patients (74 pre-menopausal and 72 postmenopausal women) aged 35 55 years were considered as sample taken from in and around Tarn Taran, Punjab, India. The study was conducted during August, 2008 to January, 2009. All the patients were ambulatory and were judged to be significantly intelligent to understand the instructions of the experiment. The patients were further divided into two groups, viz. pre-menopausal women aged 35-45 years and postmenopausal women aged 46-55 years. The study was approved by the local ethics committee. Three anthropometric variables, viz. height, weight, BMI and two body composition components, viz. percent body fat and percent lean body mass, were measured on all the subjects. The height was recorded to the nearest 130 SHYAMAL KOLEY AND NAVTEJ KAUR SANDHU 0.1 cm, and weight was measured to the nearest 0.1 kg. after Weiner and Lourie (1969). BMI was calculated as weight (kg)/ height (m). Percent body fat was calculated after Womersley and Durnin (1977), with the formula: Women (17-68 years) Percent fat = 1.37 X BMI – 3.47; Men (1768 years) Percent fat = 1.34 X BMI -12.47. Percent lean body mass was calculated as 100percent body fat. Severity of disability in patients was estimated by Oswestry Low Back Pain Disability Questionnaire (Fairbank and Davies 1980). Data were analyzed using SPSS (Statistical Package for Social Science) version 7.5. Student’s t test was applied for the comparison of all the variables between pre and post menopausal patients with low back pain. Pearson’s correlation coefficients were also analyzed. A 5% level of probability was used to indicate statistical significance. RESULTS AND DISCUSSION Table 1 shows the severity of disability in pre and post menopausal women with low back pain applying modifying ODQ. In pre-menopausal women, the maximum percentage of disability (91.89%) were found in the category of minimal (0%-20% disability), followed by moderate (21%40% disability) (6.75%) and severe (41%-60% disability) (1.35%). In post-menopausal women, the maximum frequency (40.27%) was reported in severe category, followed by crippled category (61%-80% disability) (38.88%), moderate category (18.05%) and minimal category (2.77%). The distribution of mean values and standard deviations of ten pain measuring variables in pre and post-menopausal patients with low back pain is given in Table 2. Post-menopausal women have the higher mean values in all the ten variables than their pre menopausal counterparts, showing highly significant differences (P< 0.001) in pain intensity (t=15.41), personal care (t=13.24), lifting (t= 17.92), walking (t= 19.48), sitting (14.98), standing (t= 19.87), sleeping (t=18.31), sex life (t= 5.62), social life (t= 14.52) and in travelling (t= 15.15). Table 3 shows the distribution of mean values and standard deviations of five variables in pre and post-menopausal patients with low back pain. The post menopausal women have the higher mean values in weight (81.33 kg), BMI (34.38 kg/ m ) and percent body fat (43.62%) and lesser mean values in height (153.67cm) and percent lean body mass (56.39%) than the pre-menopausal women (66.30kg, 27.81 kg/ m , 34.67%, 154.32cm and 65.25% respectively). However, highly significant differences (p < 0.001) were noted in weight (t= 9.88), BMI (t=11.15), percent body fat (t=11.08 and percent lean body mass (t=11.12) between the preand post-menopausal patients with low back pain. Table 1: Severity of disability in preand post-menopausal patients with low back pain Status N Minimal Moderate Severe Crippled Bed-ridden (0%-20% (21%-40% (41%-60% (61%-80% (81%-100% disability) disability) disability) disability) disability) Abs. no. %age Abs. no. %age Abs. no. %age Abs. no. %age Abs. no. %age Pre-menopausal 74 68 91.89 5 6.75 1 1.35 Post-menopausal 72 2 2.77 13 18.05 29 40.27 28 38.88 Table 2: Distribution of mean values and standard deviations of ten pain measuring variables in preand post-menopausal patients with low back pain Variables Pre-menopausal women (n=74) Post-menopausal women (n=72) t value