Musculoskeletal Science & Sports Medicine Research Centre, School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom.
School of Nursing, University of Central Lancashire, Preston, United Kingdom.
PLoS One. 2019 Feb 14;14(2):e0212437. doi: 10.1371/journal.pone.0212437. eCollection 2019.
The purpose of this study was to present and compare pain between adult males with Duchenne (DMD), Becker's (BMD), Limb-Girdle (LGMD) Facioscapulohumeral (FSHD) forms of Muscular Dystrophy (MD), and healthy controls (CTRL), using three different methods of assessment.
Pain was assessed using 1) a whole body visual analogue scale (VAS) of pain, 2) a generalised body map and 3) a localised body map.
All types of MD reported more VAS pain than CTRL, with 97% of all MD participants reporting pain; however, no differences were reported between types of MD. The generalised body map approach identified more frequent pain in the shoulders of FSHD (93%) than other groups (13-43%), hips of DMD (87%) and LGMD (75%) than other groups (0-29%), and legs of all MD (64-78%) than CTRL (25%). The localised body map approach identified common areas of frequent pain across types of MD, posterior distal leg and distal back, as well as condition specific regions of frequent pain, for example posterior trapezius in FSHD, and anterior hip pain in DMD and LGMD.
Using a single pain value (VAS), increased pain was reported by adults with MD compared to CTRL, with no clear differences between different MD groups, suggesting pain is symptomatic of MD. The use of the generalised body map approach, and to an even greater extent the localised body map approach, identified specific areas of frequent pain relevant to each individual condition. These results indicate that whist the commonly used generalised approach can be used to identify broad anatomical regions, the localised approach provides a more comprehensive understanding of pain, reflective of clinical assessment, and should be utilised in future research.
本研究旨在通过三种不同的评估方法，呈现并比较成年男性中杜氏肌营养不良症（DMD）、贝克型肌营养不良症（BMD）、肢带型肌营养不良症（LGMD）、面肩肱型肌营养不良症（FSHD）与健康对照组（CTRL）之间的疼痛差异。
疼痛通过以下三种方法进行评估：1）整体视觉模拟评分（VAS）疼痛评估，2）全身图谱评估，3）局部图谱评估。
所有类型的 MD 报告的 VAS 疼痛均高于 CTRL，所有 MD 参与者中有 97%报告有疼痛；然而，不同类型的 MD 之间没有差异。全身图谱评估方法发现 FSHD 肩部疼痛更为频繁（93%），高于其他组（13%-43%），DMD 和 LGMD 髋部疼痛更为频繁（87%和 75%），高于其他组（0%-29%），所有 MD 腿部疼痛更为频繁（64%-78%），高于 CTRL（25%）。局部图谱评估方法确定了常见的疼痛部位，包括各种类型 MD 的小腿和远背部、以及特定于病情的疼痛部位，例如 FSHD 的斜方肌后部，DMD 和 LGMD 的髋部前侧疼痛。
使用单一疼痛值（VAS），与 CTRL 相比，MD 成年人报告的疼痛增加，不同 MD 组之间没有明显差异，这表明疼痛是 MD 的症状。使用全身图谱方法，甚至更广泛地使用局部图谱方法，可以确定与每种疾病相关的特定频繁疼痛区域。这些结果表明，虽然常用的全身性方法可以用于识别广泛的解剖区域，但局部方法提供了对疼痛的更全面理解，反映了临床评估，应在未来的研究中使用。
