Abstract
OBJECTIVE: To determine the extent musculoskeletal (MS) pain in the low back and knee (weight-bearing (WB) joints), shoulder and wrist (non-weight bearing joints), and exercise self-efficacy mediates associations between overweight and obesity levels based on BMI (4 levels: overweight, obese class I, II, or III), physical function, emotional role, social interference, and physical activity (PA) levels. DESIGN: Cross-sectional study. SETTING: Four long-term nursing home facilities in the Northeast U.S. PARTICIPANTS: 99 overweight or obese (BMI > 25) nursing home employees. INTERVENTIONS: Self-reported survey administered to employees who met inclusion and exclusion criteria. MAIN OUTCOME MEASURES: General health status, physical function, emotional role, Exercise Self-Efficacy Scale (ESE), physical activity (PA), and frequency of pain at each joint. RESULTS: Reported pain frequency were 66.3%, 54.4%, 42.2%, and 24.1% for lower back, knee, shoulder, and wrist, respectively. Higher obesity levels were associated with lower physical function (r=-0.109, p=0.284). PA decreased with higher obesity levels (r=-0.248, p<0.05), particularly in moderate PA (r=-0.293, p<0.05). Obesity was associated with a lower ESE (r=-0.239, p<0.05). Wrist pain significantly mediated the effect of obesity on moderate physical function, emotional role, and ESE. ESE was a significant mediator between obesity and moderate and vigorous PA. CONCLUSIONS: Overweight and obese nursing home employees are at higher risk for developing musculoskeletal disorders due to high demand, low control jobs, and the associated biomedical compromises while working. To increase the effectiveness of weight loss interventions for this population, the mediating effects of MS pain with higher levels of obesity should be considered.