Daily Physical Activity and Functional Disability Incidence in Community-Dwelling Older Adults with Chronic Pain: A Prospective Cohort Study
Daily Physical Activity and Functional Disability Incidence in Community-Dwelling Older Adults with Chronic Pain: A Prospective Cohort Study
复制标题
患有慢性疼痛的社区老年人的日常体力活动和功能性残疾发生率：一项前瞻性队列研究
DOI：
10.1093/pm/pny263
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发表时间：
2018
期刊：
影响因子：
3.1
通讯作者：
Shimada Hiroyuki
中科院分区：
文献类型：
--
作者：
Makino Keitaro;Lee Sangyoon;Lee Sungchul;Bae Seongryu;Jung Songee;Shinkai Yohei;Shimada Hiroyuki
目的本研究探讨了患有慢性疼痛的社区老年人的日常身体活动与功能障碍发生率之间的关系。设计前瞻性队列研究。背景为日本社区。受试者在纳入基线评估的 5,257 名参与者中，分析了 693 名患有慢性腰背或膝盖疼痛并使用加速度计进行日常身体活动评估的参与者的数据。基线时使用加速度计测量轻强度体力活动持续时间），并根据国家长期护理保险制度跟踪每月功能性残疾发生率约两年。我们使用接受者操作特征曲线和约登指数确定了体力活动截止点对功能性残疾发生率的影响。采用Cox比例风险回归模型分析截点与残疾发生率之间的关联。结果在693名患有慢性疼痛的参与者中，69人（10.0%）在随访期间出现功能残疾。体力活动水平较低的参与者表现出明显更高的残疾风险。调整所有协变量后，功能障碍与步数（风险比[HR] = 1.79，95%置信区间[CI] = 1.02–3.14）和中等到剧烈强度体力活动持续时间（HR = 2.02，95% CI = 1.16–3.51）相关，但与低强度体力活动持续时间（HR = 1.72，95% CI= 0.97–3.05）。结论即使对于患有慢性疼痛的老年人来说，维持至少中等强度的体力活动也可能有效预防残疾。
ObjectiveThis study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain.DesignProspective cohort study.SettingJapanese community.SubjectsOf the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed.MethodsParticipants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence.ResultsAmong the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02–3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16–3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97–3.05).ConclusionsMaintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.