Cecchi Francesca, Molino-Lova Raffaello, Di Iorio Angelo, Conti Andrea Alberto, Mannoni Alessandro, Lauretani Fulvio, Benvenuti Enrico, Bandinelli Stefania, Macchi Claudio, Ferrucci Luigi
Fondazione Don Gnocchi, Presidio V. Caccini, V. Caccini 18, 50141 Florence, Italy.
J Gerontol A Biol Sci Med Sci. 2009 Dec;64(12):1316-24. doi: 10.1093/gerona/glp125. Epub 2009 Oct 1.
Hip pain (HP) and knee pain (KP) may specifically affect function and performance; few studies investigate the functional impact of HP or KP in the same population.
Population-based sample of older individuals living in the Chianti area (Tuscany, Italy) (1998-2000); 1006 persons (564 women and 442 men) were included in this analysis; 11.9% reported HP and 22.4% reported KP in the past 4 weeks. Self-reported disability and lower extremity performance, measured by 400-m walk test and by the short physical performance battery (SPPB, including standing balance, chair raising, and 4-m walk test), were compared in participants reporting HP or KP versus those free of these conditions; the relationship of HP or KP with performance and self-reported disability was studied, adjusting for age, sex, hip or knee flexibility, muscle strength, multiple joint pain, major medical conditions, and depression.
Participants reporting HP were more likely to report disability in shopping, cutting toenails, carrying a shopping bag, and using public transportation; those with KP reported more disability in cutting toenails and carrying a shopping bag. Participants reporting HP or KP had significantly lower SPPB scores. Adjusting by SPPB, pain no longer predicted self-reported disability, except for "HP-carrying a shopping bag."
In our cohort of older persons, those with HP reported disability in a wider range of activities than those with KP. Physical performance measured by SPPB was impaired in both conditions. Reduced lower extremity performance captures the excess disability associated with either HP or KP.
髋部疼痛（HP）和膝部疼痛（KP）可能会对功能和表现产生特定影响；很少有研究调查同一人群中HP或KP的功能影响。
以居住在基安蒂地区（意大利托斯卡纳）的老年人为基础的样本（1998 - 2000年）；本分析纳入了1006人（564名女性和442名男性）；在过去4周内，11.9%的人报告有HP，22.4%的人报告有KP。通过400米步行测试和简短体能测试电池（SPPB，包括站立平衡、从椅子上起身和4米步行测试）测量的自我报告残疾情况和下肢表现，在报告有HP或KP的参与者与无这些情况的参与者之间进行了比较；研究了HP或KP与表现和自我报告残疾之间的关系，并对年龄、性别、髋部或膝部灵活性、肌肉力量、多关节疼痛、主要医疗状况和抑郁进行了调整。
报告有HP的参与者在购物、剪脚趾甲、提购物袋和使用公共交通方面更有可能报告有残疾；有KP的参与者在剪脚趾甲和提购物袋方面报告有更多残疾。报告有HP或KP的参与者的SPPB分数显著更低。经SPPB调整后，除了“HP - 提购物袋”外，疼痛不再预测自我报告的残疾情况。
在我们的老年人群队列中，有HP的人报告的残疾活动范围比有KP的人更广。在这两种情况下，通过SPPB测量的身体表现均受损。下肢表现下降反映了与HP或KP相关的额外残疾情况。
