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无症状老年人衰弱与肩部功能之间关联的前瞻性研究。

A Prospective Look at the Link Between Frailty and Shoulder Function in Asymptomatic Elderly Individuals.

作者信息

Kinnucan Elspeth, Molcjan Matthew T, Wright David M, Switzer Julie A

机构信息

Roseville Medical Center, Kaiser Permanente Medical Group, Roseville, CA USA.

University of Minnesota, Minneapolis, MN USA.

出版信息

Geriatr Orthop Surg Rehabil. 2018 Jun 21;9:2151459318777583. doi: 10.1177/2151459318777583. eCollection 2018.

Abstract

INTRODUCTION

The relationship between shoulder function and overall function in the elderly patients is not well understood. It is hypothesized that there is an increased tolerance of shoulder dysfunction in this population. The purpose of our study was to investigate and better understand the relationship between shoulder function, general musculoskeletal health, and frailty in the elderly patients.

MATERIALS AND METHODS

The dominant shoulders of 75 individuals aged ≥65 years without known dominant shoulder pathology were assessed. Demographic data were collected. Functional evaluation was conducted by administering the Constant, American Shoulder and Elbow Surgeons (ASES), and the Short Musculoskeletal Function Assessment (SMFA) questionnaires. Shoulder range of motion and strength were measured and the Fried frailty phenotype was calculated. Mean age of the patients was 73.6 years. Sixty-seven percent of the patients were female. Mean body mass index was 31.2 kg/m.

RESULTS

Twenty-eight percent of the patients reported the use of an assistive device for ambulation. As frailty increased among the 3 Fried frailty phenotypes (robust, prefrail, and frail), patients had statistically significant lower mean Constant scores ( < .0001), ASES scores ( < .0001), higher overall SMFA scores ( < .0001), and an increase in the use of assistive device for ambulation. Individuals who reported the use of an assistive device for ambulation had lower Constant and ASES scores ( < .0001 and = .045, respectively) and higher overall SMFA scores ( < .0001). There was no evidence of correlation between body mass index and any of the other measures.

CONCLUSIONS

Frailty and the use of an assistive device for ambulation correlate with poor shoulder function in patients who do not register shoulder complaints and have no known shoulder pathology.

LEVEL OF EVIDENCE

Level IV, Prognostic.

摘要

引言

老年患者肩部功能与整体功能之间的关系尚未得到充分理解。据推测,该人群对肩部功能障碍的耐受性有所增加。我们研究的目的是调查并更好地理解老年患者肩部功能、一般肌肉骨骼健康与虚弱之间的关系。

材料与方法

对75名年龄≥65岁、无已知优势肩病变的个体的优势肩进行评估。收集人口统计学数据。通过使用Constant、美国肩肘外科医师学会(ASES)和简短肌肉骨骼功能评估(SMFA)问卷进行功能评估。测量肩部活动范围和力量,并计算Fried虚弱表型。患者的平均年龄为73.6岁。67%的患者为女性。平均体重指数为31.2kg/m。

结果

28%的患者报告使用了辅助行走设备。在3种Fried虚弱表型(健壮、虚弱前期和虚弱)中,随着虚弱程度增加,患者的平均Constant评分在统计学上显著降低(<.0001),ASES评分显著降低(<.0001),总体SMFA评分显著升高(<.0001),且使用辅助行走设备的情况增加。报告使用辅助行走设备的个体Constant和ASES评分较低(分别为<.0001和=.045),总体SMFA评分较高(<.0001)。没有证据表明体重指数与任何其他测量指标之间存在相关性。

结论

在没有肩部疼痛主诉且无已知肩部病变的患者中,虚弱和使用辅助行走设备与肩部功能差相关。

证据水平

IV级,预后性。

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