Minetto Marco Alessandro, Giannini Alessandro, McConnell Rebecca, Busso Chiara, Torre Guglielmo, Massazza Giuseppe
Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
Department of Orthopaedic And Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy.
J Clin Med. 2020 Apr 23;9(4):1216. doi: 10.3390/jcm9041216.
Musculoskeletal disorders are debilitating conditions that significantly impair the state of health, especially in elderly subjects. A pathological triad of inter-related disorders that are highly prevalent in the elderly consists of the following main "components": sarcopenia, tendinopathies, and arthritis. The aim of this review is to critically appraise the literature relative to the different disorders of this triad, in order to highlight the pathophysiological common denominator and propose strategies for personalized clinical management of patients presenting with this combination of musculoskeletal disorders. Their pathophysiological common denominator is represented by progressive loss of (focal or generalized) neuromuscular performance with a risk of adverse outcomes such as pain, mobility disorders, increased risk of falls and fractures, and impaired ability or disability to perform activities of daily living. The precise management of these disorders requires not only the use of available tools and recently proposed operational definitions, but also the development of new tools and approaches for prediction, diagnosis, monitoring, and prognosis of the three disorders and their combination.
肌肉骨骼疾病是使人衰弱的病症,会严重损害健康状况,尤其是在老年人群体中。在老年人中高度流行的一组相互关联的病理性三联征由以下主要“组成部分”构成:肌肉减少症、肌腱病和关节炎。本综述的目的是批判性地评估与该三联征中不同疾病相关的文献,以突出病理生理共同特征,并为患有这种肌肉骨骼疾病组合的患者提出个性化临床管理策略。它们的病理生理共同特征表现为(局部或全身性)神经肌肉功能的渐进性丧失,并伴有疼痛、活动障碍、跌倒和骨折风险增加以及日常生活活动能力受损或残疾等不良后果的风险。对这些疾病的精确管理不仅需要使用现有工具和最近提出的操作定义,还需要开发用于这三种疾病及其组合的预测、诊断、监测和预后的新工具和方法。