Б.Мөнх-Эрдэнэ

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Б.Мөнх-Эрдэнэ

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Баяртай 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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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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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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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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Association of Physical Performance with Mental and Physical Health-Related Quality of Life and Low Back Pain-Related Disabilities among Older Adults with Severe Obesity
(2024-09)
Bayartai, Munkh-Erdene
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Tringali, Gabriella
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De Micheli, Roberta
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Danielewicz, Ana Lúcia
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Sartorio, Alessandro
Background: Low back pain is one of the most prevalent musculoskeletal problems and continues to be the leading cause of disabilities worldwide. The aim of this study was to cross-sectionally investigate the association of physical performance with mental and physical health-related quality of life and low back pain-related disabilities among older adults with severe obesity. Methods: A total of 96 hospitalized older adults with severe obesity (45 males, 51 females, age: 69.7 ± 5.4 years; BMI: 43.7 ± 5.7 kg/m2) were recruited into the study. Physical performance, health-related quality of life, and low back pain-related disability were measured through physical performance tests, the 12-item short-form survey (SF-12), and the Oswestry disability index, respectively. Results: LBP-related disabilities, as well as physical health-related quality of life, were associated with all the physiological parameters measured by physical performance tests, including muscular strength, aerobic capacity, balance, and lower body flexibility (p < 0.05). In contrast, mental health-related quality of life was associated with fewer physiological parameters, such as primarily muscular strength (p < 0.05). Conclusions: These findings could provide important insights for developing rehabilitation strategies designed to improve LBP-related disabilities, as well as the physical and mental health-related quality of life, in older adults with severe obesity.
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Spinal Posture and Movement in Female Adolescents with Anorexia Nervosa
(2026-04)
Bayartai, Munkh-Erdene
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Tringali, Gabriella
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De Micheli, Roberta
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Grimoldi, Ilaria
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Abbruzzese, Laura
Background: Profound musculoskeletal alterations encompassing bones and soft tissues are common in people with anorexia nervosa (AN). This study aims to examine spinal posture and mobility in adolescents with AN, and to compare these outcomes with those obtained from normal-weight female controls. Methods: Spinal posture and movements were measured in 37 adolescents with AN and 31 normal-weight controls using the Idiag M360 scan tool, and between-group differences were analyzed using analysis of covariance. Results: Spinal postures and the lumbar-to-hip ratio were not different between subgroups. By contrast, AN had reduced thoracic (-21.8 degrees, p < 0.0001) and lumbar (-18.2 degrees, p < 0.0001) mobility in the frontal plane, as well as decreased hip flexion (-14 degrees, p = 0.001) and extension (-18.6 degrees, p < 0.0001) compared to the CG. Conclusions: Thoracic and lumbar spinal mobility, mainly in the frontal plane, and also hip mobility in the sagittal plane, are decreased in AN. These findings provide clinically relevant insights into spinal characteristics in adolescents with AN.
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Differences in three-dimensional spinal kinematics between individuals with chronic non-specific low back pain and age- and sex-matched asymptomatic controls
(2026-07)
Dambadarjaa, Batlkham
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Khuyagbaatar, Batbayar
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Boldbaatar, Damdindorj
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Avirmed, Baljinnyam
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Wong, Arnold Yl
BACKGROUND: Although people with chronic low back pain (LBP) appear to have altered spinal range of motion (ROM) or movement variability in the sagittal plane, it remains unclear whether these alterations can be observed in different spinal ROM tests or functional activities. The aim of this study to investigate three-dimensional spinal kinematics among individuals with chronic non-specific LBP during ROM and functional tests, comparing them with those in age- and sex-matched healthy individuals. METHODS: A total of 60 individuals (30 participants with and 30 without LBP), aged between 18 and 50 years participated in the study. The full-body Xsens system was employed to record the three-dimensional movements during ROM tests (flexion-extension, lateral bending, and axial rotation) and functional activities (single-leg standing, Hurdle step, squat, and picking up a box tests). RESULTS: Statistically significant between-group differences in some spine variables were observed during the ROM and functional tests (p < 0.05). Compared to healthy individuals, those with LBP demonstrated less movement in their spine [thorax flexion, difference between groups (Δ) = -15.9°, 95% CI -23.8° to -8.0°, p = 0.0001] and pelvis (pelvic flexion, Δ = -9.8°, 95% CI -17.1° to -2.5°, p = 0.009) during ROM tests, while these parameters moved more during functional tasks, such as greater lumbar flexion-extension during the single leg stance test (Δ = 12.5°, 95% CI 8.8° to 16.1°, p = 0.0001). CONCLUSION: These findings emphasize the significance of incorporating both ROM and functional tests in spinal assessments. Addressing impairments in these areas could be crucial for managing individuals with chronic LBP and tracking their progress.
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A satisfaction-focused CIPP evaluation of Mongolia's undergraduate occupational therapy program: a cross-sectional study
(Korean Society of Medical Education, 2025-12)
Sanjmyatav, Bulganchimeg
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Myagmar, Erdenetsetseg
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Liu, Karen P Y
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Lee, Janet Lok Chun
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Bayartai, Munkh-Erdene
PURPOSE: This study evaluated Mongolia's undergraduate occupational therapy program using the CIPP (Context, Input, Process, Product) model, drawing on feedback from students, alumni, faculty, and program managers to understand its current state and identify areas for improvement. METHODS: We conducted a cross-sectional survey using the CIPP evaluation model. The model-based questionnaire requested responses using a Likert scale from 1 to 5. Responses were collected from 34 students, 19 alumni, 24 faculty members, and five program management team members. They were analyzed quantitatively using descriptive and inferential statistics. RESULTS: All participants expressed satisfaction with the context, process, and product components of the occupational therapy program, with scores of 3.4 or higher. For the input component, the faculty members and program managers gave satisfactory ratings, while the students and alumni gave neutral ratings, on average. There was a significant difference between the average input scores of the first-year and third-year students, and between the first-year and fourth-year students (p<0.05). Lecturers teaching basic professional subjects rated the program's inputs higher than those teaching general subjects. On average, the students rated the program's "context" higher than alumni, while faculty members rated "input" higher than both students and alumni. Additionally, the program's managers rated "input" higher than the students (p<0.05). CONCLUSION: The occupational therapy program in Mongolia has been improving annually. While it is generally rated as "satisfactory," there is a need for enhanced resources to better support the program.

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