Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
PLoS One. 2022 Nov 10;17(11):e0277083. doi: 10.1371/journal.pone.0277083. eCollection 2022.
Low back pain (LBP) is an important condition associated with high healthcare burden. However, the relationship of this condition with physical function (PF) and health-related quality of life (HRQoL) remains unclear. This is a cross-sectional study that aims to investigate the association between presence and intensity of non-chronic LBP with PF and HRQoL in middle-and older-aged adults. Participants answered questions about presence and intensity of LBP in the previous year, self-reported their PF and HRQoL (SF-12), and underwent objective measures of PF ([ExSPPB] including usual gait speed, narrow walk, chair stands, and standing balance), endurance performance ([EP] long-distance corridor walk) and fatigability. Generalized linear models and logistic regression models were performed. A total of 1500 participants (52.5% women, 70.3% white) aged 69.0 (SD 13.1) years were included. Of those, 642 (42.8%) reported LBP and the mean pain intensity was 4.1 (SD 2.2). After adjustments for potential confounders, presence of LBP was associated with lower self-reported PF (OR 1.73, 95% CI 1.27 to 2.37), lower physical component of HRQoL (β -0.03, 95% CI -0.04 to -0.02) and poorer chair stand performance (β -0.05, 95% CI -0.09 to -0.008). Higher intensity of LBP was associated with lower physical component of HRQoL (β -0.01, 95% CI -0.02 to -0.007), poorer ExSPPB performance (β -0.01, 95% CI -0.02 to -0.004), slower usual gait speed (β -0.01, 95% CI -0.02 to -0.004), lower total standing balance time (β -0.01, 95% CI -0.02 to -0.001) and higher fatigability (OR 1.13, 95% CI 1.01 to 1.25). The presence of non-chronic LBP was more consistently associated with lower self-reported PF, while higher intensity non-chronic LBP was associated with poorer objectively measured PF and fatigability. Collectively, this evidence suggests that although presence of pain may affect perception of function, greater pain intensity appears more strongly associated with unfavorable functional performance in mid-to-late life.
下背痛（LBP）是一种与高医疗负担相关的重要疾病。然而，这种疾病与身体功能（PF）和健康相关的生活质量（HRQoL）之间的关系尚不清楚。本研究旨在调查中年和老年人中慢性下背痛的存在及其严重程度与 PF 和 HRQoL 的关系。参与者回答了前一年是否存在和疼痛强度的问题，自我报告了 PF 和 HRQoL（SF-12），并接受了 PF 的客观测量（[ExSPPB]，包括一般行走速度、狭窄行走、坐站和站立平衡）、耐力表现（[EP]长距离走廊行走）和疲劳性。进行了广义线性模型和逻辑回归模型分析。共纳入 1500 名参与者（52.5%为女性，70.3%为白人），年龄为 69.0（SD 13.1）岁。其中，642 名（42.8%）报告存在下背痛，平均疼痛强度为 4.1（SD 2.2）。调整潜在混杂因素后，下背痛的存在与自我报告的 PF 降低有关（OR 1.73，95%CI 1.27 至 2.37），物理成分的 HRQoL 降低（β-0.03，95%CI-0.04 至-0.02）和较差的坐站表现（β-0.05，95%CI-0.09 至-0.008）。更高强度的下背痛与较低的 HRQoL 物理成分有关（β-0.01，95%CI-0.02 至-0.007），更差的 ExSPPB 表现（β-0.01，95%CI-0.02 至-0.004），更慢的一般行走速度（β-0.01，95%CI-0.02 至-0.004），较低的总站立平衡时间（β-0.01，95%CI-0.02 至-0.001）和更高的疲劳性（OR 1.13，95%CI 1.01 至 1.25）。非慢性下背痛的存在与自我报告的 PF 降低更一致，而更高强度的非慢性下背痛与更不利的客观测量的 PF 和疲劳性有关。综上所述，这些证据表明，尽管疼痛的存在可能会影响功能的感知，但更大的疼痛强度似乎与中老年人功能表现不良更为密切相关。
