有症状的腰椎管狭窄症社区居住老年人的神经肌肉属性与基于表现的活动能力之间的关联
Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis.
作者信息
Schmidt Catherine T, Ward Rachel E, Suri Pradeep, Kiely Dan K, Ni Pengsheng, Anderson Dennis E, Bean Jonathan F
机构信息
Center for Interprofessional Studies and Innovation, Massachusetts General Hospital Institute of Health Professions, Boston, MA.
New England Geriatric Research Education and Clinical Center, Veterans Administration Boston Healthcare System, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.
出版信息
Arch Phys Med Rehabil. 2017 Jul;98(7):1400-1406. doi: 10.1016/j.apmr.2017.02.028. Epub 2017 Apr 2.
OBJECTIVES
To identify differences in health factors, neuromuscular attributes, and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis; and to determine which neuromuscular attributes are associated with performance-based measures of mobility.
DESIGN
Cross-sectional; secondary data analysis of a cohort study.
SETTING
Outpatient rehabilitation center.
PARTICIPANTS
Community-dwelling adults aged ≥65 years with self-reported mobility limitations and symptomatic lumbar spinal stenosis (N=54).
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Short Physical Performance Battery score, habitual gait speed, and chair stand test.
RESULTS
Symptomatic lumbar spinal stenosis was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults, 54 (13%) met criteria for symptomatic lumbar spinal stenosis. Compared with participants without symptomatic lumbar spinal stenosis, those with symptomatic lumbar spinal stenosis had more comorbidities, higher body mass index, greater pain, and less balance confidence. Participants with symptomatic lumbar spinal stenosis had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared with participants without symptomatic lumbar spinal stenosis. Five neuromuscular attributes were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry.
CONCLUSIONS
Community-dwelling older adults with self-reported mobility limitations and symptomatic lumbar spinal stenosis exhibit poorer health characteristics, greater neuromuscular impairment, and worse mobility when compared with those without symptomatic lumbar spinal stenosis. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis.
目的
识别有症状的腰椎管狭窄症的社区居住老年人在健康因素、神经肌肉属性和基于表现的活动能力方面的差异；并确定哪些神经肌肉属性与基于表现的活动能力测量指标相关。
设计
横断面研究；队列研究的二次数据分析。
设置
门诊康复中心。
参与者
年龄≥65岁、自我报告有活动能力受限且有症状的腰椎管狭窄症的社区居住成年人（N = 54）。
干预措施
不适用。
主要结局指标
简短体能状况量表评分、习惯性步速和椅子站立测试。
结果
根据自我报告的神经源性间歇性跛行症状和影像学检查对有症状的腰椎管狭窄症进行分类。在430名社区居住的老年人中，54名（13%）符合有症状的腰椎管狭窄症标准。与无有症状的腰椎管狭窄症的参与者相比，有症状的腰椎管狭窄症患者有更多的合并症、更高的体重指数、更严重的疼痛和更低的平衡信心。与无有症状的腰椎管狭窄症的参与者相比，有症状的腰椎管狭窄症患者在躯干伸肌耐力、腿部力量、腿部力量不对称、膝关节屈曲活动范围（ROM）、膝关节伸展ROM和踝关节ROM方面有更大的损伤。在有症状的腰椎管狭窄症参与者中，五种神经肌肉属性与基于表现的活动能力相关：躯干伸肌耐力、腿部力量、腿部力量不对称、膝关节屈曲ROM和膝关节伸展ROM不对称。
结论
与无有症状的腰椎管狭窄症的老年人相比，自我报告有活动能力受限且有症状的腰椎管狭窄症的社区居住老年人表现出更差的健康特征、更大的神经肌肉损伤和更差的活动能力。在有症状的腰椎管狭窄症参与者中，较差的躯干伸肌耐力、腿部力量、腿部力量不对称、膝关节屈曲ROM和膝关节伸展ROM不对称与基于表现的活动能力相关。
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