Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.
Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.
Top Spinal Cord Inj Rehabil. 2022 Summer;28(3):73-84. doi: 10.46292/sci21-00078. Epub 2022 Aug 17.
Individuals living with cerebral palsy (CP) or spina bifida (SB) are at heightened risk for chronic health conditions that may develop or be influenced by the impairment and/or the process of aging.
The objective of this study was to compare the incidence of and adjusted hazards for musculoskeletal (MSK) morbidities among adults living with and without CP or SB.
A retrospective, longitudinal cohort study was conducted among adults living with ( = 15,302) CP or SB and without ( = 1,935,480) CP or SB. Incidence estimates of common MSK morbidities were compared at 4 years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident MSK morbidities. The analyses were performed in 2019 to 2020.
Adults living with CP or SB had a higher 4-year incidence of MSK morbidity (55.3% vs. 39.0%) as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Fully adjusted survival models demonstrated that adults with CP or SB had a greater hazard for all MSK disorders; this ranged from hazard ratio (HR) 1.40 (95% CI, 1.33 to 1.48) for myalgia to HR 3.23 (95% CI, 3.09 to 3.38) for sarcopenia and weakness.
Adults with CP or SB have a significantly higher incidence of and risk for common MSK morbidities as compared to adults without CP or SB. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce risk of MSK disease onset/progression in these higher risk populations.
患有脑瘫（CP）或脊柱裂（SB）的个体患慢性健康状况的风险较高，这些健康状况可能由损伤和/或衰老过程引起或受其影响。
本研究旨在比较伴有或不伴有 CP 或 SB 的成年人中肌肉骨骼（MSK）疾病的发病率和调整后的发病风险。
对伴有 CP 或 SB（n=15302）和不伴有 CP 或 SB（n=1935480）的成年人进行了回顾性、纵向队列研究。在入组后 4 年比较常见 MSK 疾病的发病率估计。使用生存模型量化 MSK 疾病发病的未经调整和调整后的危险比。分析于 2019 年至 2020 年进行。
与不伴有 CP 或 SB 的成年人相比，伴有 CP 或 SB 的成年人 4 年 MSK 疾病发病率更高（55.3% vs. 39.0%），且差异具有临床意义。完全调整后的生存模型表明，伴有 CP 或 SB 的成年人患所有 MSK 疾病的风险更高；从肌痛的危险比（HR）1.40（95%CI，1.33 至 1.48）到肌肉减少症和虚弱的 HR 3.23（95%CI，3.09 至 3.38）。
与不伴有 CP 或 SB 的成年人相比，伴有 CP 或 SB 的成年人常见 MSK 疾病的发病率和风险显著更高。需要努力制定改进的临床筛查算法和早期干预措施，以降低这些高风险人群 MSK 疾病发病/进展的风险。
