运动诱发疼痛、身体功能和感知压力：非裔和白种非西班牙裔老年人膝关节骨关节炎的种族差异观察性研究
Movement-evoked pain, physical function, and perceived stress: An observational study of ethnic/racial differences in aging non-Hispanic Blacks and non-Hispanic Whites with knee osteoarthritis.
机构信息
The University of Florida, Department of Community Dentistry and Behavioral Science, Gainesville, FL 32610, USA; The University of Florida, Pain Research and Intervention Center of Excellence, Gainesville, FL 32610, USA.
The University of Florida, Department of Community Dentistry and Behavioral Science, Gainesville, FL 32610, USA; The University of Florida, Pain Research and Intervention Center of Excellence, Gainesville, FL 32610, USA.
出版信息
Exp Gerontol. 2019 Sep;124:110622. doi: 10.1016/j.exger.2019.05.011. Epub 2019 May 30.
BACKGROUND
Knee osteoarthritis (OA) is a pervasive musculoskeletal condition, often exacerbated by movement-evoked pain (MEP). Despite established research demonstrating significant racial differences in OA pain, few studies have investigated ethnic/racial group differences in MEP and lower extremity function and their association with psychosocial factors, such as perceived stress. Therefore, the primary aims were: (1) to identify ethnic/racial group differences in persons with or at risk for knee OA pain based on MEP, physical performance, and perceived stress measures, and (2) to determine if perceived stress explains the relationship between MEP and function in non-Hispanic Blacks (NHBs) and non-Hispanic Whites (NHWs).
METHODS
A total of 162 NHB and NHW community-dwelling older adults (50-78 years of age) were included in this analysis from the Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD) cross-sectional cohort study. Demographic, anthropometric, pain and functional parameters were assessed using a battery of validated instruments. Descriptive statistics, parametric, and multivariate analyses were conducted to determine ethnic/racial differences in perceived stress, MEP, and function.
RESULTS
Our results support the hypothesis that among persons with knee OA pain, NHBs have significantly greater MEP and lower functional level, despite similar levels of perceived stress. However, perceived stress was more strongly related to MEP in NHB compared to NHWs. Differences in function were limited to walking speed, where NHWs demonstrated faster gait speed.
CONCLUSIONS
Our cross-sectional study demonstrated important ethnic/racial differences in MEP and function. Also, perceived stress had a stronger effect on MEP in NHBs, suggesting that perceived stress may more strongly influence pain with physical movement among NHB adults. MEP may be a clinically important pain outcome to measure in persons with OA, and these data warrant future research on the impact of stress on pain and functional outcomes in older adults, particularly in NHBs.
背景
膝骨关节炎（OA）是一种普遍的肌肉骨骼疾病，常因运动诱发的疼痛（MEP）而加重。尽管有研究证实 OA 疼痛存在显著的种族差异，但很少有研究调查 MEP 和下肢功能的种族/民族差异及其与心理社会因素（如感知压力）的关系。因此，主要目的是：（1）根据 MEP、身体表现和感知压力测量结果，确定膝 OA 疼痛患者或有患病风险的患者的种族/民族差异；（2）确定感知压力是否可以解释非西班牙裔黑人（NHB）和非西班牙裔白人（NHW）中 MEP 与功能之间的关系。
方法
本研究共纳入了 162 名来自社区的非西班牙裔黑人和非西班牙裔白人（50-78 岁），他们是非西班牙裔关节炎疼痛和限制理解研究（UPLOAD）的横断面研究队列的一部分。使用一系列经过验证的工具评估人口统计学、人体测量学、疼痛和功能参数。进行描述性统计、参数和多变量分析，以确定感知压力、MEP 和功能方面的种族/民族差异。
结果
我们的研究结果支持以下假设，即膝骨关节炎疼痛患者中，尽管感知压力相似，但 NHB 患者的 MEP 明显更高，功能水平更低。然而，感知压力与 NHB 患者的 MEP 相关性更强，而与 NHW 患者的相关性较弱。功能差异仅限于步行速度，NHW 组的步行速度较快。
结论
本横断面研究表明 MEP 和功能方面存在重要的种族/民族差异。此外，感知压力对 NHB 患者的 MEP 影响更大，这表明感知压力可能对 NHB 成年人的身体运动相关疼痛有更强的影响。MEP 可能是测量 OA 患者疼痛的一个重要临床指标，这些数据需要进一步研究压力对老年人（尤其是 NHB 人群）疼痛和功能结局的影响。
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