Peat George, Thomas Elaine, Wilkie Ross, Croft Peter
Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, UK.
Disabil Rehabil. 2006 Dec 30;28(24):1543-9. doi: 10.1080/09638280600646250.
To determine whether the extent of multiple-site lower extremity joint pain contributes to disability in middle and old age and describe patterns of severity in site-specific measures amongst those with multiple-site pain.
Population-based, cross-sectional postal survey. Adults aged 50 years and over registered with three general practices and reporting pain lasting one month or longer in the previous year in at least one hip, knee, or foot were included. Respondents completed a generic measure of physical function and site-specific measures of severity for each relevant joint pain.
Of 2429 eligible participants, 1801 reported multiple-site lower limb joint pain. Lower limb joint pain count was independently associated with reduced physical function after adjusting for a range of covariates. The severity of pain and disability attributed to each site increased as the number of painful sites increased.
Many older people with joint pain in the lower limb have more than one joint affected. Generic and site-specific measures of disability both show the same pattern of reduced physical function. Treatment targeted at a single joint may have only a marginal effect on reducing disability in individuals with multiple joint involvement unless treatment is also conferring benefit at other sites.
确定多部位下肢关节疼痛的程度是否会导致中老年人群的残疾,并描述多部位疼痛患者在特定部位疼痛严重程度的模式。
基于人群的横断面邮寄调查。纳入年龄在50岁及以上、在三家全科诊所注册且报告在前一年至少一个髋部、膝盖或足部疼痛持续一个月或更长时间的成年人。受访者完成了一项身体功能的通用测量以及针对每种相关关节疼痛的特定部位严重程度测量。
在2429名符合条件的参与者中,1801人报告有多部位下肢关节疼痛。在调整一系列协变量后,下肢关节疼痛数量与身体功能下降独立相关。随着疼痛部位数量的增加,每个部位疼痛和残疾的严重程度也增加。
许多下肢关节疼痛的老年人有多个关节受累。通用和特定部位的残疾测量均显示身体功能下降的相同模式。针对单个关节的治疗对减少多关节受累个体的残疾可能只有边际效应,除非治疗也能在其他部位带来益处。