Mau Theresa, Barnes Haley N, Simon Corey B, Hetherington-Rauth Megan, Bauer Scott R, Strotmeyer Elsa S, Lane Nancy E, Rowbotham Michael C, Weaver Ashley A, Blackwell Terri L, Cai Yurun, Glynn Nancy W, Goodpaster Bret H, Cummings Steven R, Newman Anne B, Cawthon Peggy M, Kritchevsky Stephen B
San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA.
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
medRxiv. 2024 Oct 21:2024.10.19.24315822. doi: 10.1101/2024.10.19.24315822.
Musculoskeletal pain frequently accompanies the development of mobility disability and falls in old age. To better understand this, we aimed to quantify the impact of different pain measures-recalled pain and movement-evoked pain-on 400-meter walk and stair climb time in older adults participating in the Study of Muscle, Mobility and Aging (SOMMA).
In SOMMA (N=879, age=76.3 ± 5.0 years, 59% women, 84% Non-Hispanic White), participants completed usual pace 400m walk (avg=6.6 ± 1.2 min.) and repeat stair climb tests (avg=26.6 ± 7.2 sec.). Assessments of recalled pain included the Brief Pain Inventory short form (BPI-), total lower body pain (lower back, hips, knees, feet/ankles), stiffness (hip or knee), and Neuropathy Total Symptom Score (NTSS-6). Movement-evoked pain was assessed separately before and after the 400m walk and repeat stair climb tasks. Multivariable linear regression modeled the associations of pain with time to complete the tasks, reported as β[95%CI] expressed per SD increment of pain measure or β[95%CI] per pain categories, adjusted for age, sex, race, ethnicity, body mass index, prescription medications, and depressive symptoms.
Greater degree of any pain measure was associated with longer physical performance time, though intercorrelations between recalled pain measures varied (r=0.13-0.57, <0.05 for all). For each SD increment in lower body pain, participants had longer walk time (by 10.5 sec [6.1, 14.8]) and stair climb (by 0.6 sec [0.1, 1.1]). Compared to participants with no change in pain upon movement, walk time was longer in those with more pain upon movement (19.5 sec [10.3, 28.7]) (<0.001) but not those with less pain upon movement; stair climb showed similar patterns.
Recalled and movement-evoked pain measures were weakly correlated with one another but similarly associated with time to complete 400m walk and stair climb tests. Different pain assessments capture different functional domains of pain but have similar associations with physical performance in these older adults.
肌肉骨骼疼痛常伴随老年人行动能力障碍和跌倒的发生。为更好地理解这一现象，我们旨在量化不同疼痛指标——回忆性疼痛和运动诱发疼痛——对参与肌肉、运动与衰老研究（SOMMA）的老年人400米步行和爬楼梯时间的影响。
在SOMMA研究中（N = 879，年龄 = 76.3 ± 5.0岁，59%为女性，84%为非西班牙裔白人），参与者完成了正常步速的400米步行（平均 = 6.6 ± 1.2分钟）和重复爬楼梯测试（平均 = 26.6 ± 7.2秒）。回忆性疼痛评估包括简明疼痛问卷简表（BPI-）、下半身总疼痛（下背部、臀部、膝盖、足部/脚踝）、僵硬感（臀部或膝盖）以及神经病变总症状评分（NTSS-6）。在400米步行和重复爬楼梯任务前后分别评估运动诱发疼痛。多变量线性回归模型分析了疼痛与完成任务时间之间的关联，结果以每疼痛指标标准差增加量表示的β[95%置信区间]或按疼痛类别表示的β[95%置信区间]呈现，并对年龄、性别、种族、民族、体重指数、处方药使用情况和抑郁症状进行了校正。
任何疼痛指标程度越高，身体表现时间越长，不过回忆性疼痛指标之间的相互关联各不相同（r = 0.13 - 0.57，均P < 0.05）。下半身疼痛每增加一个标准差，参与者的步行时间延长（10.5秒[6.1，14.8]），爬楼梯时间延长（0.6秒[0.1，1.1]）。与运动时疼痛无变化的参与者相比，运动时疼痛更严重的参与者步行时间更长（19.5秒[10.3，28.7]）（P < 0.001），而运动时疼痛较轻的参与者则不然；爬楼梯情况类似。
回忆性疼痛和运动诱发疼痛指标之间相关性较弱，但与完成400米步行和爬楼梯测试的时间关联相似。不同的疼痛评估方法反映了疼痛的不同功能领域，但在这些老年人中与身体表现的关联相似。
