Pelletier R, Purcell-Levesque L, Girard M-C, Roy P-M, Leonard G
School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), Sherbrooke, Quebec, Canada.
J Pain Res. 2020 Aug 7;13:2013-2021. doi: 10.2147/JPR.S256700. eCollection 2020.
Older adults are referred for outpatient physical therapy to improve their functional capacities. The goal of the present study was to determine if pain had an influence on functional outcomes in older adults who took part in an outpatient physical rehabilitation program.
A retrospective study was performed on the medical records of patients aged 65 and over referred for outpatient physical therapy to improve physical functioning (n=178). Pain intensity (11-point numeric pain scale) and results from functional outcome measures (Timed Up and Go [TUG], Berg Balance Scale [BBS], 10-meter walk test, 6-minute walk test and Functional Autonomy Measuring System [SMAF]) were extracted at initial (T1) and final (T2) consultations. Paired -tests were performed to determine if there were differences in functional outcome measures between T1 and T2 in all the patients. Patients were stratified to those with pain (PAIN, n=136) and those without pain (NO PAIN, n=42). Differences in functional outcome measures between T1 and T2 (delta scores) were compared between groups with independent -tests with Welch corrections for unequal variances. Pearson correlation coefficients between initial pain intensity and changes in functional outcome measures (T2-T1) were also performed. Correcting for multiple comparisons, a p-value of p≤0.01 was considered as statistically significant.
The TUG, BBS, 10-meter walk test, 6-minute walk test all demonstrated improvement between T1 and T2 (all p<0.01). There was no difference between groups for delta scores for TUG (p=0.14), BBS (p=0.03), 10-meter walk test (p=0.54), 6-minute walk test (p=0.94) and SMAF (p=0.23). Pearson correlation coefficients were weak between initial pain intensity and changes in functional outcome scores between T1 and T2 (r= -0.16 to 0.15, all p-values >0.10).
These results suggest that pain is not an impediment to functional improvements in older individuals who participated in an outpatient physical rehabilitation program.
老年患者被转介至门诊物理治疗以改善其功能能力。本研究的目的是确定疼痛是否会对参与门诊物理康复计划的老年人的功能结局产生影响。
对178例年龄在65岁及以上、因改善身体功能而被转介至门诊物理治疗的患者的病历进行回顾性研究。在初次（T1）和末次（T2）会诊时提取疼痛强度（11点数字疼痛量表）和功能结局测量结果（计时起立行走试验[TUG]、伯格平衡量表[BBS]、10米步行试验、6分钟步行试验和功能自主测量系统[SMAF]）。进行配对t检验以确定所有患者在T1和T2之间功能结局测量是否存在差异。患者被分为有疼痛组（PAIN，n = 136）和无疼痛组（NO PAIN，n = 42）。使用针对不等方差的韦尔奇校正的独立t检验比较两组之间T1和T2之间功能结局测量的差异（差值分数）。还计算了初始疼痛强度与功能结局测量变化（T2 - T1）之间的皮尔逊相关系数。校正多重比较后，p值≤0.01被认为具有统计学意义。
TUG、BBS、10米步行试验、6分钟步行试验在T1和T2之间均显示出改善（所有p < 0.01）。TUG（p = 0.14）、BBS（p = 0.03）、10米步行试验（p = 0.54）、6分钟步行试验（p = 0.94）和SMAF（p = 0.23）的差值分数在两组之间无差异。初始疼痛强度与T1和T2之间功能结局分数变化之间的皮尔逊相关系数较弱（r = -0.16至0.15，所有p值>0.10）。
这些结果表明，疼痛并非参与门诊物理康复计划的老年人功能改善的障碍。
