Department of Orthopedics, Moji Medical Center, Moji-ku, Kitakyushu 801-8502, Japan.
Department of Orthopedics, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Medicina (Kaunas). 2024 Jul 27;60(8):1217. doi: 10.3390/medicina60081217.
: Osteoporotic vertebral fractures in older patients cause lower back pain and abnormal posture, resulting in impaired activities of daily living (ADLs). Assessing pain using self-reported assessment tools is difficult, especially in patients with moderate-to-severe cognitive impairment. Recently, observational assessment tools have been used when self-reported ones were difficult to administer. No studies have reported the usefulness of observational assessment tools in patients with acute-phase orthopedic disorders without complication. This study aimed to examine the availability of observational tools for pain assessment in patients with lumbar vertebral fractures. : Patients admitted to our hospital with acute-phase vertebral fractures were enrolled in this prospective observational study. Pain was assessed using Japanese versions of the Abbey pain scale and Doloplus-2 observational assessment tools, and the Numerical Rating Scale, a self-reported assessment tool. To compare the pain assessment tool, we examined whether each tool correlated with ADLs and ambulatory status. ADLs were assessed using the Barthel Index. Ambulatory status was assessed using the Functional Ambulation Categories and the 10-m walking test. : Similar to the Numerical Rating Scale scores, assessments with the Abbey pain scale and Doloplus-2 showed significant decreases in scores over time. A significant positive correlation was observed between the self-reported and observational assessment tools. Each pain assessment tool was significantly negatively correlated with ADLs and ambulatory status. : When self-reported assessment with the Numerical Rating Scale is difficult for patients with cognitive impairment, pain can be estimated using the Abbey pain scale and Doloplus-2 observational assessment tools.
老年骨质疏松性椎体骨折可导致腰背痛和姿势异常，从而影响日常生活活动（ADL）。使用自我报告评估工具评估疼痛比较困难，尤其是对于中度至重度认知障碍的患者。最近，当自我报告评估工具难以实施时，已经开始使用观察性评估工具。尚无研究报告在没有并发症的急性骨科疾病患者中使用观察性评估工具的有效性。本研究旨在探讨观察性疼痛评估工具在腰椎骨折患者中的可用性。
本前瞻性观察性研究纳入了因急性椎体骨折而入院的患者。使用 Abbey 疼痛量表和 Doloplus-2 观察性评估工具的日文版以及自我报告评估工具数字评定量表评估疼痛。为了比较疼痛评估工具，我们检查了每种工具与 ADL 和步行能力之间的相关性。ADL 使用巴氏指数评估，步行能力使用功能性步行分类和 10 米步行测试评估。
与数字评定量表评分相似，Abbey 疼痛量表和 Doloplus-2 的评分随时间呈显著下降趋势。自我报告和观察性评估工具之间存在显著正相关。每种疼痛评估工具均与 ADL 和步行能力呈显著负相关。
当认知障碍患者难以进行自我报告评估时，可以使用 Abbey 疼痛量表和 Doloplus-2 观察性评估工具来估计疼痛。
