Department of Physical Therapy.
Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC.
Clin J Pain. 2021 Dec 24;38(4):241-249. doi: 10.1097/AJP.0000000000001016.
Despite high prevalence estimates, chronic low back pain (CLBP) remains poorly understood among older adults. Movement-evoked pain (MeP) is an understudied factor in this population that may importantly contribute to disability. This study investigated whether a novel MeP paradigm contributed to self-reported and performance-based function in older adults with CLBP.
This secondary analysis includes baseline data from 230 older adults with CLBP in the context of a prospective cohort study. The Repeated Chair Rise Test, Six Minute Walk Test, and Stair Climbing Test were used to elicit pain posttest LBP ratings were aggregated to yield the MeP variable. Self-reported and performance-based function were measured by the Late Life Function and Disability Index (LLFDI) scaled function score and Timed Up-and-Go Test (TUG), respectively. Robust regression with HC3 standard errors was used to model adjusted associations between MeP and both functional outcomes; age, sex, body mass index, and pain characteristics (ie, intensity, quality, and duration) were utilized as covariates.
MeP was present in 81.3% of participants, with an average rating of 5.09 (SD=5.4). Greater aggregated posttest MeP was associated with decreased LLFDI scores (b=-0.30, t=-2.81, P=0.005) and poorer TUG performance (b=0.081, t=2.35, P=0.020), independent of covariates. LBP intensity, quality and duration were not associated with the LLFDI or TUG, (all P>0.05).
Aggregated posttest MeP independently contributed to worse self-reported and performance-based function among older adults with CLBP. To understand long-term consequences of MeP, future studies should examine longitudinal associations between MeP and function in this population.
尽管慢性下背痛（CLBP）的患病率很高，但老年人对其仍知之甚少。运动诱发的疼痛（MeP）是该人群中研究不足的一个因素，它可能对残疾有重要影响。本研究调查了一种新的 MeP 范式是否会对老年 CLBP 患者的自我报告和基于表现的功能产生影响。
本二次分析包括前瞻性队列研究中 230 例老年 CLBP 患者的基线数据。使用重复椅子起立测试、六分钟步行测试和爬楼梯测试诱发疼痛，对 posttest LBP 评分进行汇总，得出 MeP 变量。自我报告和基于表现的功能分别通过老年生活功能和残疾指数（LLFDI）的功能评分和计时起立行走测试（TUG）来衡量。使用 HC3 标准误差稳健回归来对 MeP 与两种功能结果之间的调整关联进行建模；年龄、性别、体重指数和疼痛特征（即强度、质量和持续时间）被用作协变量。
81.3%的参与者存在 MeP，平均评分为 5.09（SD=5.4）。更大的汇总 posttest MeP 与较低的 LLFDI 评分（b=-0.30，t=-2.81，P=0.005）和较差的 TUG 表现（b=0.081，t=2.35，P=0.020）相关，独立于协变量。LBP 强度、质量和持续时间与 LLFDI 或 TUG 无关（均 P>0.05）。
汇总后的 posttest MeP 独立于老年 CLBP 患者的自我报告和基于表现的功能更差。为了了解 MeP 的长期后果，未来的研究应该在该人群中检查 MeP 与功能之间的纵向关联。
