Sharma Siddhartha, Gohil Riddhi, Patel Sandeep, Kishore Kamal, Singh Amarjeet, Rajnish Rajesh K, Dhillon Mandeep S
Orthopaedics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND.
Biostatistics, Postgraduate Institute of Medical Education and Research Chandigarh, Chandigarh, IND.
Cureus. 2021 Nov 2;13(11):e19212. doi: 10.7759/cureus.19212. eCollection 2021 Nov.
Background Owing to the coronavirus disease 2019 (COVID-19) pandemic, a nationwide lockdown was imposed in India, with strict confinement measures imposed on the elderly. Because mobility and regular physical activity are considered to be the key determinants of musculoskeletal health, this study aimed to investigate the effect of lockdown and confinement measures on the musculoskeletal health and activities of daily living of the urban geriatric population. Methodology A cross-sectional survey was conducted among the elderly aged ≥60 years. The survey instrument consisted of a questionnaire, a modified Nordic Musculoskeletal Questionnaire (mNMQ), and the Barthel activities of daily living (ADL) index. The net mNMQ score and Barthel ADL index were compared before and during the lockdown. Univariate and multivariate analyses were performed to determine which factors could result in the worsening of the net mNMQ score. In addition, floor and ceiling effects of the net mNMQ score were determined. Results In this study, a total of 105 out of 150 eligible participants were enrolled. A significant decline in physical activity status was noted during the lockdown. Overall, 54.3% of the respondents reported that their medical services were impacted during the lockdown. The net mNMQ score showed a significant worsening during the lockdown (P < 0.0001). A statistically significant increase in the modified NMQ score was noted for the lower limb (P < 0.0001) and spine (P = 0.002), but not for the upper limb (P = 0.052). Elderly whose medical services were impacted during lockdown had significantly worse net mNMQ scores than those whose services were not impacted (odds ratio = 6.16; 95% confidence interval = 2.51-15.08; P = 0.0001). Age, gender, ambulatory status, increase in body weight, and indulgence in exercise before and during lockdown had no effect on the change in the net mNMQ score. A significant ceiling effect was noted in the mNMQ score; however, no floor effect was noted. Conclusions Lockdown and confinement measures resulted in a significant decline in physical activity as well as the overall musculoskeletal health of the urban geriatric population in the present study. Hence, policymakers should ensure uninterrupted medical care to the elderly during extended periods of confinement and develop optimal home-based physical activity programs to counter the problems associated with sedentarism.
背景 由于2019年冠状病毒病（COVID-19）大流行，印度实施了全国范围的封锁，并对老年人实施了严格的隔离措施。由于活动能力和定期体育活动被认为是肌肉骨骼健康的关键决定因素，本研究旨在调查封锁和隔离措施对城市老年人群肌肉骨骼健康和日常生活活动的影响。
方法 对60岁及以上的老年人进行了横断面调查。调查工具包括一份问卷、一份改良的北欧肌肉骨骼问卷（mNMQ）和巴氏日常生活活动（ADL）指数。比较了封锁前和封锁期间的mNMQ净得分和巴氏ADL指数。进行单因素和多因素分析以确定哪些因素可能导致mNMQ净得分恶化。此外，还确定了mNMQ净得分的地板效应和天花板效应。
结果 在本研究中，150名符合条件的参与者中共有105名被纳入。在封锁期间，身体活动状况显著下降。总体而言，54.3%的受访者表示他们的医疗服务在封锁期间受到了影响。封锁期间，mNMQ净得分显著恶化（P<0.0001）。下肢（P<0.0001）和脊柱（P=0.002）的改良NMQ得分有统计学意义的增加，但上肢没有（P=0.052）。在封锁期间医疗服务受到影响的老年人的mNMQ净得分显著低于服务未受影响的老年人（优势比=6.16；95%置信区间=2.51-15.08；P=0.0001）。年龄、性别、步行状态、体重增加以及封锁前和封锁期间是否进行锻炼对mNMQ净得分的变化没有影响。mNMQ得分存在显著的天花板效应；然而，未观察到地板效应。
结论 在本研究中，封锁和隔离措施导致城市老年人群的身体活动以及整体肌肉骨骼健康显著下降。因此，政策制定者应确保在长期隔离期间为老年人提供不间断的医疗护理，并制定最佳的居家体育活动计划，以应对与久坐不动相关的问题。
