Rudy Thomas E, Weiner Debra K, Lieber Susan J, Slaboda Jill, Boston Robert J
Department of Anesthesiology, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Psychiatry, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Biostatistics, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Medicine, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Bioengineering, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Electrical Engineering, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA.
Pain. 2007 Oct;131(3):293-301. doi: 10.1016/j.pain.2007.01.012. Epub 2007 Feb 20.
Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. Many older adults remain quite functional despite CLBP, and because age-related comorbidities often exist independently of pain (e.g., medical illnesses, sleep disturbance, mobility difficulty), the unique impact of CLBP is unknown. We conducted this research to identify the multidimensional factors that distinguish independent community dwelling older adults with CLBP from those that are pain-free. Three hundred twenty cognitively intact participants (162 with moderate pain for 3 months, and 158 pain-free) underwent comprehensive assessment of pain severity, medical comorbidity (illnesses, body mass index, medications), severity of degenerative disc and facet disease, lumbar flexion, psychological constructs (self-efficacy, mood, overall mental health), and self-reported as well as performance-based physical function. Significant differences were ascertained for all 22 measures. Discriminant function analysis revealed that eight measures uniquely maximized the separation between the two groups (self-reported function with the Functional Status Index and the SF-36, performance-based function with repetitive trunk rotation and functional reach, mood with the Geriatric Depression Scale, comorbidity with the Cumulative Illness Rating Scale and BMI, and severity of degenerative disc disease). These results should help to guide investigators that perform studies of CLBP in older adults and practitioners that want an easily adaptable battery for use in clinical settings.
慢性下腰痛（CLBP）是老年人所患的最常见、了解最少且可能导致残疾的慢性疼痛病症之一。尽管患有CLBP，许多老年人仍保持相当的功能，而且由于与年龄相关的合并症往往独立于疼痛存在（例如，内科疾病、睡眠障碍、行动困难），CLBP的独特影响尚不清楚。我们开展这项研究以确定区分独立居住在社区的患CLBP老年人与无疼痛老年人的多维度因素。320名认知功能完好的参与者（162名有中度疼痛3个月，158名无疼痛）接受了疼痛严重程度、内科合并症（疾病、体重指数、药物）、椎间盘和小关节退变疾病严重程度、腰椎前屈、心理指标（自我效能感、情绪、整体心理健康）以及自我报告和基于表现的身体功能的全面评估。所有22项测量均确定存在显著差异。判别函数分析显示，八项测量能够独特地最大化两组之间的区分度（使用功能状态指数和SF - 36进行自我报告的功能、使用重复躯干旋转和功能性伸展进行基于表现的功能、使用老年抑郁量表进行情绪评估、使用累积疾病评定量表和体重指数进行合并症评估以及椎间盘退变疾病的严重程度）。这些结果应有助于指导对老年人CLBP进行研究的调查人员以及希望在临床环境中使用易于适配的成套评估工具的从业者。
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