Ushio Michiko, Sumitani Masahiko, Abe Hiroaki, Mietani Kazuhito, Hozumi Jun, Inoue Reo, Tsuchida Rikuhei, Ushida Takahiro, Yamada Yoshitsugu
Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
JMA J. 2019 Sep 4;2(2):184-189. doi: 10.31662/jmaj.2019-0009. Epub 2019 Aug 6.
The current aging population has a major impact on public health. Locomotive syndrome (LS) is a condition that carries a high risk for developing systemic musculoskeletal disability.
Participants were patients with chronic pain (n = 415) who were examined at the Japanese multidisciplinary pain centers of the research consortium. They completed the 25-question geriatric locomotive function scale (GLFS-25; LS screening tool), an 11-point numerical rating scale (NRS) of pain intensity and its psychological distresses, health-related quality of life (HRQOL) questionnaire, and a survey of exercise habits. A multifaceted analysis of the relevance of the pain, psychological distresses, and LS were conducted using SPSS and AMOS software.
337 patients (81.2%) were found to have LS. The final model of a multifaceted analysis demonstrated good fitness for the "vicious cycle" model among the results of LS, pain intensity, impairment of self-efficacy, and depression; these parameters independently impaired HRQOL. Anxiety related to falling (GLFS-25) and exercise habits affected the model.
These findings indicate LS, LS-related pain, and psychological distress create a vicious cycle, resulting in the impairment of HRQOL. Treatment strategies for LS should inclusively focus on musculoskeletal disorders, pain, and pain-related psychological factors.
当前的人口老龄化对公共卫生有重大影响。机车综合征(LS)是一种发生全身性肌肉骨骼残疾风险很高的病症。
研究对象为在研究联盟的日本多学科疼痛中心接受检查的慢性疼痛患者(n = �15)。他们完成了25个问题的老年机车功能量表(GLFS - 25;LS筛查工具)、疼痛强度及其心理困扰的11分数字评定量表(NRS)、健康相关生活质量(HRQOL)问卷以及运动习惯调查。使用SPSS和AMOS软件对疼痛、心理困扰和LS的相关性进行了多方面分析。
发现337例患者(81.2%)患有LS。多方面分析的最终模型在LS、疼痛强度、自我效能受损和抑郁结果中显示出对“恶性循环”模型的良好拟合度;这些参数独立损害了HRQOL。与跌倒相关的焦虑(GLFS - 25)和运动习惯影响了该模型。
这些发现表明LS、与LS相关的疼痛和心理困扰形成了一个恶性循环,导致HRQOL受损。LS的治疗策略应全面关注肌肉骨骼疾病、疼痛以及与疼痛相关的心理因素。