Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama City, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kitaku, Okayama City, Okayama, 700-8558, Japan.
J Orthop Sci. 2021 Sep;26(5):896-901. doi: 10.1016/j.jos.2020.08.007. Epub 2020 Sep 14.
Prevention and treatment for locomotive syndrome (LS) are important for extending healthy life expectancy. The 25-question geriatric locomotive function scale (GLFS-25) was developed to diagnose LS. The Fear-Avoidance model was proposed to explain pain chronicity. LS and chronic pain decrease activities of daily living; however, the relationships between LS and factors related to chronic pain in the Fear-Avoidance model are unknown. Objective of the current study was to assess the prevalence of LS and examine the factors of the Fear-Avoidance model and the GLFS-25 that affect the prevalence of LS in patients with chronic pain.
Participants included 281 patients (99 men, 182 women) aged over 40 years with chronic pain who visited our outpatient clinic for chronic pain. All participants completed the GLFS-25, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), and Athene insomnia scale (AIS). According to a GLFS-25 cutoff point, participants were divided into three groups (LS-2; GLFS-25 ≥ 16, LS-1; 7 ≤ GLFS-25 < 16, and non-LS; GLFS-25 < 7 points) and each parameter was compared among the groups, followed by multiple logistic regression analysis. Next, multiple linear regression analysis was performed to determine the factors associated with the GLFS-25.
Of all 281 patients, 241 (85.8%) patients were diagnosed with LS-2. Univariate analysis revealed there were significant differences in NRS, PCS, HADS anxiety, HADS depression, and AIS among groups. Multiple logistic regression analyses showed PCS was significantly associated with LS-2 prevalence. The GLFS-25 was positively correlated with NRS, HADS depression, AIS in multiple linear regression analysis.
We found that patients with chronic pain in our outpatient clinic had a significant rate of LS-2. The prevalence of LS-2 was significantly correlate with pain catastrophizing, and the GLFS-25 was significantly correlated with higher pain intensity, depression, and insomnia.
为了延长健康预期寿命，对运动综合征（LS）进行预防和治疗非常重要。为了诊断 LS，开发了 25 题老年运动功能量表（GLFS-25）。提出了恐惧回避模型来解释疼痛的持续性。LS 和慢性疼痛会降低日常生活活动能力；然而，LS 与恐惧回避模型中与慢性疼痛相关的因素之间的关系尚不清楚。本研究的目的是评估 LS 的患病率，并检查恐惧回避模型和 GLFS-25 的因素，这些因素会影响慢性疼痛患者 LS 的患病率。
参与者包括 281 名年龄在 40 岁以上的慢性疼痛门诊患者（99 名男性，182 名女性）。所有参与者都完成了 GLFS-25、数字评分量表（NRS）、疼痛灾难化量表（PCS）、医院焦虑和抑郁量表（HADS）和 Athena 失眠量表（AIS）。根据 GLFS-25 截断点，参与者被分为三组（LS-2；GLFS-25≥16，LS-1；7≤GLFS-25<16，非 LS；GLFS-25<7 分），并对各组之间的每个参数进行比较，然后进行多元逻辑回归分析。接下来，进行多元线性回归分析，以确定与 GLFS-25 相关的因素。
在所有 281 名患者中，241 名（85.8%）患者被诊断为 LS-2。单因素分析显示，三组之间 NRS、PCS、HADS 焦虑、HADS 抑郁和 AIS 存在显著差异。多元逻辑回归分析显示，PCS 与 LS-2 患病率显著相关。GLFS-25 与 NRS、HADS 抑郁和 AIS 在多元线性回归分析中呈正相关。
我们发现我们门诊的慢性疼痛患者 LS-2 的发生率显著。LS-2 的患病率与疼痛灾难化显著相关，GLFS-25 与更高的疼痛强度、抑郁和失眠显著相关。
