Dear Jason,
Isn't it, in the end, the OR and RR studies that determine whether smoking
has a detrimental effect to such an extent that we as PTs should be
concerned with it? I don't want to defend smoking, and if I'd be working
with COPD patients that would still be smoking, I'd tell them over and over
again that it would be much better for them to quit smoking (simply because
they would then feel a whole lot better), but what good is it going to do
for an LBP patient if s/he stops smoking? An improvement of about 5% of the
pain VAS? And after how much time then? Obviously not within the couple of
weeks that we're treating them.
Then again, if I'd have a smoking patient with a bone union problem, I'd
slide this study under his/her nose:
http://www.aaos.org/wordhtml/press/2001pres/nr3-02.htm .....
R.,
Frank
----- Original Message -----
From: "Jason Steffe" <[log in to unmask]>
To: <[log in to unmask]>
Sent: woensdag 1 augustus 2001 1:07
Subject: Re: why is sitting bad??
Alistair,
The CI's were 95%. Deyo did adjust for age in his study and found that
people under the age of 45 had higher OR's than people over 45.
I haven't come across any studies investigating perfusion and nutrient
delivery of the intervertebral disc while smoking. We do know with
certainty that smoking does reduce perfusion to tissue in general terms due
to affinity of carbon monoxide to hemoglobin (CO binds quicker and stronger
to hemoglobin and thus prevents O2 from binding to the heme) as well as
vasoconstriction of smooth muscle. I would think that the same process has
to take place with discal perfusion and nutrient delivery, which isn't much
to begin with. Staying in line with extrapolation, other areas of the body
that have reduced nutrition and perfusion (blood flow) show distinct
patterns of being sites for tissue breakdown i.e. the critical zone of the
supraspinatus tendon at its insertion into the humerus and the infraspinatus
and long head of the biceps to a lesser degree. Diabetics also display
reduced healing ability and neuropathies, in effect, from impeded delivery
of nutrients and perfusion.
--------------------------------------------
Jason Steffe, PT, MS, MTC
Physiotherapy Associates
1901 Phoenix Blvd, Suite 205
College Park, GA. 30349
Ph: 770-907-1023
Fax:770-907-5608
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