title: Floor activities and degenerative spinal diseases.
abstract: BACKGROUND
  The typical oriental life style in Thailand involves significant time spent on activities on the floor. This introduces an abnormal load against the spine and can cause the low back pain leading to the degenerative change of the lumbosacral region.
  
  
  OBJECTIVE
  To determine whether various floor activities in the early adult life could result in late degenerative lumbar stenosis in the elderly patients. A case-controlled study was conducted. The patients having undergone spinal surgery according to the degenerative spinal stenosis were the case subjects. The control group consisted of the subjects having no significant back pain. The cases and the controls were matched by age, gender, and residence location. The data were collected from their medical records, roentgenograms and the standardized questionnaire. A variety of floor activities categorized by common behaviors in the Thai life style was recorded.
  
  
  RESULTS
  There were 65 matches of cases and controls. Fifty-four patients were female performing floor activities for more than 28 times/week or more than 2 hours/week for longer than 10 years significantly increased the risk of degenerative spinal diseases by more than 15 times when being compared to the control. The most predictable activities related to the degenerative spinal diseases were occupational, cooking, and latrine use.
  
  
  CONCLUSIONS
  Floor activities increased the risk of symptomatic degenerative spinal diseases in the Thai population. The question whether the prolonged postures of these routine activities could result in lumbar spinal stenosis needs more investigation in further studies.
authors.affiliation: Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wiwat
authors.initials: W
authors.lastname: Wajanavisit
authors.forename: Patarawan
authors.initials: P
authors.lastname: Woratanarat
authors.forename: Thanet
authors.initials: T
authors.lastname: Wattanawong
authors.forename: Wichien
authors.initials: W
authors.lastname: Laohacharoensombat
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005430:Floors and Floorcoverings; D006801:Humans; D008019:Life Style; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D012307:Risk Factors; D013130:Spinal Stenosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology