Б.Мөнх-Эрдэнэ

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Bayartai Munkh-Erdene

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Effectiveness of Virtual Reality in Undergraduate Nursing Education on Pneumonia
(MDPI AG, 2025-08-05)
Gochoosuren, Gankhuyag
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Bayartai, Munkh-Erdene
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Ganpurev, Gantsatsral
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Enkhtuya, Narantsetseg
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Dashnyam, Solongo
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Changes in the Oswestry Disability Index after a 3-Week In-Patient Multidisciplinary Body Weight Reduction Program in Adults with Obesity
(2022-06)
Bayartai, Munkh-Erdene
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Luomajoki, Hannu
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De Micheli, Roberta
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Tringali, Gabriella
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Marazzi, Nicoletta
The aim of this study was to examine the short-term changes in disability after an inpatient, multidisciplinary body weight reduction program (BWRP) in adults with obesity. A total of 160 individuals (males: 52, females: 108, BMI > 35 kg/m2) hospitalized for a 3-week multidisciplinary BWRP were recruited into the study. Body composition, lower limb muscle power, fatigue severity, and disability were measured at the beginning and end of the intervention by means of bioimpedance analysis, a stair climbing test (SCT), the Fatigue Severity Scale (FSS), and the Oswestry disability index (ODI), respectively. At the end of the 3-week BWRP, an average body weight reduction of 5.0 kg (CI 95% −5.3; −4.6, p < 0.001) was determined, as well as an improvement in all parameters measured. Clinically meaningful reductions in disability were observed in the moderate disability (Δ = −11.8% CI 95% −14.3; −9.3, p < 0.001) and severe disability (Δ = −15.9% CI 95% −19.6; −12.2, p < 0.001) groups. Reductions in disability were explained only by improvements in the SCT (Δ = −2.7 CI 95% −4.1; −1.4, p < 0.001) and the FSS (Δ = −0.3% CI 95% −0.4; −0.1, p < 0.001). These findings demonstrate the importance of incorporating approaches into a BWRP that increase lower limb muscle power and decrease fatigue severity and thus reduce disability in adults with obesity.
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Surgical interventions for degenerative lumbar spinal stenosis: a systematic review with network meta-analysis
(2024-10)
Chen, Lingxiao
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Guan, Bin
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Anderson, David B
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Ferreira, Paulo H
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Stanford, Ralph
BACKGROUND: Several surgical options for degenerative lumbar spinal stenosis (LSS) are available, but current guidelines do not recommend which one should be prioritized. Although previous network meta-analyses (NMAs) have been performed on this topic, they have major methodological problems and could not provide the convincing evidence and clinical practical information required. METHODS: Randomized controlled trials (RCTs) comparing at least two surgical interventions were included by searching AMED, CINAHL, EMBASE, the Cochrane Library, and MEDLINE (inception to August 2023). A frequentist random-effects NMA was performed for physical function and adverse events due to any reason. For physical function, three follow-up time points were included: short-term (< 6 months post-intervention), mid-term (≥ 6 months but < 12 months), and long-term (≥ 12 months). Laminectomy was the reference comparison intervention. RESULTS: A total of 43 RCTs involving 5017 participants were included in the systematic review and 28 RCTs encompassing 14 types of surgical interventions were included in the NMA. For improving physical function (scale 0-100), endoscopic-assisted laminotomy (mean difference: - 8.61, 95% confidence interval: - 10.52 to - 6.69; moderate-quality evidence), laminectomy combined with Coflex (- 8.41, - 13.21 to - 3.61; moderate quality evidence), and X-stop (- 6.65, - 8.60 to - 4.71; low-quality evidence) had small effects at short-term follow-up; no statistical difference was observed at mid-term follow-up (very low- to low-quality evidence); at long-term follow-up, endoscopic-assisted laminotomy (- 7.02, - 12.95 to - 1.08; very low-quality evidence) and X-stop (- 10.04, - 18.16 to - 1.93; very low-quality evidence) had a small and moderate effect, respectively. Compared with laminectomy, endoscopic-assisted laminotomy was associated with fewer adverse events due to any reason (odds ratio: 0.27, 0.09 to 0.86; low-quality evidence). CONCLUSIONS: For adults with degenerative LSS, endoscopic-assisted laminotomy may be the safest and most effective intervention in improving physical function. However, the available data were insufficient to indicate whether the effect was sustainable after 6 months. TRIAL REGISTRATION: PROSPERO (CRD42018094180).
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A systematic review on the associations between low back pain and frailty in community-dwelling older adults
(2025-09)
Bayartai, Munkh-Erdene
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Lam, Sum Yi
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Chan, Kei Yan
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Lau, Wai Ying
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Lee, Suet Ying
BACKGROUND: Frailty and low back pain (LBP) may negatively affect each other in older adults, yet no systematic review has summarized their cross-sectional, temporal, or causal associations. Exploring these associations could provide valuable insights for reducing frailty risk in older adults with LBP. This systematic review aimed to consolidate evidence on the association between frailty and LBP in older adults. METHODS: Four databases (EMBASE, CINHAL, MEDLINE, and SPORTDiscus) were systematically searched from their inception until July 31, 2024. Studies investigating the association between LBP, regardless of chronicity, or LBP-related disability and frailty in older adults were included. LBP was defined as pain occurring between the 12th ribs and inferior gluteal folds. Due to the lack of consensus on the definitions of older adults or frailty, studies were included based on the authors' definitions. Three pairs of independent reviewers screened abstracts and full texts, extracted data, assessed risk of bias, and determined the certainty of evidence. RESULTS: Out of 1,690 articles identified, six cross-sectional studies and one prospective study were included. Low-certainty evidence from four cross-sectional studies suggested that both acute and chronic LBP, with odds ratios from 1.34 to 7.50, separately showed significant correlation with frailty. Pre-frail or frail older adults reported higher chronic LBP intensity, scoring 0.5 to 0.8 points more on the numeric rating scale, and greater LBP-related disability, with scores 1.7 to 7.2 points higher on the Roland Morris Disability Questionnaire, compared to non-frail counterparts. However, there was low-certainty evidence that acute LBP intensity was unrelated to frailty. Very low-certainty evidence from the prospective study indicated that higher acute LBP intensity and disability were associated with transitioning from non-frail to prefrail or frail status. CONCLUSIONS: Our systematic review revealed that older adults with higher LBP intensity or associated disability were more likely to have prefrail or frail status, albeit with low-certainty evidence. However, the findings are limited by the small number of studies, especially prospective research. Future high-quality research should clarify the causation between LBP intensity or disability and frailty in community-dwelling older adults. Research should also explore potential mediators or moderators influencing the LBP-frailty association. These findings could help develop effective prevention and rehabilitation strategies to mitigate the impacts of LBP on frailty, or vice versa.
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Differences in spinal postures and mobility among adults with Prader-Willi syndrome, essential obesity, and normal-weight individuals
(2023)
Bayartai, Munkh-Erdene
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Luomajoki, Hannu
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Tringali, Gabriella
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De Micheli, Roberta
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Grugni, Graziano
INTRODUCTION: Spinal kinematics/motion are reported to be altered in adolescents and adults with essential obesity, while no information is available in patients with Prader-Willi syndrome so far. The aim of this study was to examine cross-sectionally the characteristics of spinal postures and mobility in 34 patients with PWS, in 35 age- and sex-matched adults with essential obesity, and in 37 normal-weight individuals. METHODS: Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Differences in spinal posture and mobility between the three groups were determined using a two-way analysis of variance. RESULTS: Adults with Prader-Willi syndrome had greater thoracic kyphosis [difference between groups (Δ) = 9.60, 95% CI 3.30 to 15.60, p = 0.001], less lumbar lordosis (Δ = -6.50, 95% CI -12.70 to -0.30, p = 0.03) as well as smaller lumbar and hip mobility than those with normal weight. DISCUSSION: Although the characteristics of the spine in patients with Prader-Will syndrome appear to be similar to that found in subjects with essential obesity, Prader-Willi syndrome was found to influence lumbar movements more than thoracic mobility. These results provide relevant information about the characteristics of the spine in adults with Prader-Willi syndrome to be taken into careful consideration in the management of spinal conditions. These findings also highlight the importance of considering the musculoskeletal assessment of spinal postures and approaches targeting spinal and hip flexibility in adults with Prader-Willi syndrome.
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Spinal Postures and Mobility in Children with Achondroplasia vs. Age- and Sex-Matched Healthy Individuals: A Preliminary Report
(2024-04)
Bayartai, Munkh-Erdene
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Luomajoki, Hannu
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Aliverti, Andrea
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LoMauro, Antonella
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Tringali, Gabriella
Background: Achondroplasia is a rare genetic disease, yet the most common form of dwarfism, characterized by limb shortening and disproportionate short stature along with musculoskeletal changes, such as postural deviations. Although postural changes in the spine in children with achondroplasia have been well investigated, little is known about the association of achondroplasia with spinal movements/mobility. Methods: This preliminary study aims to explore the association of achondroplasia with spinal mobility in children with achondroplasia compared to age- and sex-matched healthy individuals. Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were determined using a two-way analysis of variance. Results: Children with achondroplasia had smaller thoracic lateral flexion [difference between groups (Δ) = 20.4°, 95% CI 0.1°-40.6°, p = 0.04], lumbar flexion (Δ = 17.4°, 95% CI 5.5°-29.4°, p = 0.006), lumbar extension (Δ = 14.2°, 95% CI 5.7°-22.8°, p = 0.002) and lumbar lateral flexion (Δ = 19.6°, 95% CI 10.7°-28.4°, p < 0.001) than age- and sex-matched healthy individuals, except for thoracic extension (Δ = 16.5°, 95% CI 4.4°-28.7°, p = 0.009) which was greater in children with achondroplasia. No differences were observed in global spinal postures between the two groups. Conclusions: Spinal mobility appears to be more influenced by achondroplasia than global spinal postures in childhood. These results also highlight the importance of considering the musculoskeletal assessment of segmental spinal postures and rehabilitative interventions aimed at promoting spinal flexibility in children with achondroplasia.
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Identifying Key Predictors of Sarcopenic Obesity in Italian Severely Obese Older Adults: Deep Learning Approach
(2025-04)
Cândido, Leticia Martins
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Bae, Jun-Hyun
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Kim, Dae Young
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Bayartai, Munkh-Erdene
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Abbruzzese, Laura
Background/Objectives: Sarcopenic obesity (SO), the coexistence of sarcopenia and obesity, poses serious health risks, such as increased mortality. Despite its clinical significance, key predictors of SO remain unclear, especially in severe obesity. This study aimed to identify independent predictors of SO in Italian older adults with obesity using a deep learning neural network. Methods: A cross-sectional study was conducted with hospitalized older adults diagnosed with severe obesity. SO was defined according to the 2022 ESPEN/EASO Statement Criteria, based on skeletal muscle function assessed by the five-repetition sit-to-stand test (5-SST) and body composition parameters evaluated using Dual X-ray Absorptiometry. A total of 42 independent variables were analyzed. Data normalization was performed using MinMaxScaler, and an optimal neural network architecture was selected via grid search with stratified 5-fold cross-validation. Model performance was assessed using accuracy, precision, recall, F1-score, AUC-ROC, and AUPRC metrics. Results: The correlation analysis revealed strong negative associations between SO and handgrip strength (HGS) (r = -0.785) and appendicular lean mass (ALM) (r = -0.745), as well as moderate correlations with 5-SST (r = 0.603), 30-second chair stand test (r = -0.474), 6-minute walking test (6m-WT) (r = 0.289), and waist circumference (WC) (r = 0.127). The deep learning model achieved an average classification accuracy of 72%, with a precision of 83% and an AUC of 0.9333. Conclusions: The main key predictors of SO were HGS, ALM, 5-SST, 30s-SST, 6m-WT, and WC in the early detection of this condition. The findings highlight deep learning's potential to improve SO diagnosis, risk assessment, clinical decision-making, and prevention in severely obese older adults.
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Association of accelerometer-measured physical activity, back static muscular endurance and abdominal obesity with radicular pain and non-specific low back pain
(2023-05)
Bayartai, Munkh-Erdene
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Määttä, Juhani
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Karppinen, Jaro
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Oura, Petteri
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Takatalo, Jani
Low back pain (LBP) is the leading cause of disability worldwide and often associated with lifestyle factors. However, studies further examining the role of these lifestyle factors in non-specific low back pain in comparison with radicular pain are sparse. The aim of this cross sectional study was to investigate how diverse lifestyle factors are associated with LBP. The study population of 3385 middle aged adults with and without low back pain was drawn from a large Birth 1966 Cohort. Outcome measures were steps per day, abdominal obesity, physical activity and endurance of the back muscles. Back static muscular endurance, abdominal obesity and physical activity were measured by means of the Biering-Sørensen test, waist circumference and a wrist worn accelerometer, respectively. Logistic regression analysis was applied to estimate associations of back static muscular endurance, abdominal obesity and accelerometer-measured physical activity with non-specific low back pain and radicular pain. An additional 1000 steps per day were associated with 4% lower odds of having non-specific low back pain. Participants with abdominal obesity had 46% higher odds of having radicular pain, whereas increases of 10 s in back static muscular endurance and 10 min in daily vigorous physical activity were associated with 5% and 7% lower odds of having radicular pain, respectively. In this population-based study, non-specific low back pain and radicular pain were associated with different lifestyle and physical factors at midlife. Non-specific low back pain was associated only with the average daily number of steps, whereas abdominal obesity was the strongest determinant of radicular pain, followed by vigorous physical activity and back static muscular endurance. The findings of this study contribute to better understand the role of lifestyle factors in both non-specific low back pain and radicular pain. Future longitudinal studies are required to explore causality.
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Differences in spinal posture and mobility between adults with obesity and normal weight individuals
(2023-08)
Bayartai, Munkh-Erdene
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Luomajoki, Hannu
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Tringali, Gabriella
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De Micheli, Roberta
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Abbruzzese, Laura
The aim of this study was to cross-sectionally investigate the relationships between obesity and spinal posture as well as mobility by comparing the spinal parameters between adults with obesity and normal-weight individuals. The spinal parameters were measured in 71 adults with obesity and 142 normal-weight individuals using a radiation-free back scan, the Idiag M360. Differences in spinal posture and movements between the two groups were determined using a two-way analysis of variance. Adults with obesity had greater thoracic kyphosis [difference between groups (Δ) = 6.1°, 95% CI 3.3°-8.9°, p < 0.0001] and thoracic lateral flexion (Δ = 14.5°, 95% CI 5.1°-23.8°, p = 0.002), as well as smaller thoracic flexion (Δ = 3.5°, 95% CI 0.2°-6.9°, p = 0.03), thoracic extension (Δ = 4.1°, 95% CI 1.1°-7.1°, p = 0.008), lumbar flexion (Δ = 10.4°, 95% CI 7.7°-13.5°, p < 0.0001), lumbar extension (Δ = 4.8°, 95% CI 2.2°-7.4°, p = 0.0003) and lumbar lateral flexion (Δ = 12.8°, 95% CI 9.8°-15.7°, p = < 0.0001) compared to those with normal weight. These findings provide relevant information about the characteristics of the spine in adults with obesity to be taken into careful consideration in the prescription of adapted physical activities within integrated multidisciplinary pathways of metabolic rehabilitation.
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Differences in Spinal Posture and Movement Between Adult Females with Anorexia Nervosa and Age- and Sex-Matched Normal-Weight Controls
(2025-05)
Bayartai, Munkh-Erdene
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Tringali, Gabriella
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Micheli, Roberta De
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Bondesan, Adele
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Ventura, Enrica
Background: Anorexia nervosa is an eating disorder characterised by distorted eating behaviour, physical and mental health problems, and the highest mortality rate among psychiatric disorders. Although anorexia nervosa appears to be associated with alterations in the spine, studies investigating the characteristics of spinal postures and mobility in individuals with anorexia nervosa are scarce to date. The present study aims to examine the relationship between anorexia nervosa and spinal posture and mobility by comparing people with anorexia nervosa to age-matched, normal-weight controls. Methods: Spinal posture and mobility were evaluated using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were assessed using a two-way analysis of variance. Results: Adult females suffering from anorexia nervosa exhibited reduced lumbar [difference between groups (Δ) = 10.5°, 95% CI 4.6°-16.5°, p < 0.001] and thoracic (Δ = 8.8°, 95% CI 2.4°-15.2°, p = 0.007) curvatures compared to normal-weight controls. The only difference observed in spinal movements between the two groups was thoracic flexion, which was greater in individuals with anorexia nervosa (Δ = 8.4°, 95% CI 2.1°-14.4°, p = 0.009). Conclusions: These findings emphasise the need to consider spinal posture and thoracic mobility in the musculoskeletal assessment of anorexia nervosa. Interventions aimed at improving spinal postures may help to develop effective rehabilitative strategies for addressing spinal problems associated with anorexia nervosa and thus contributing to counteract the possible further worsening with advancing age.

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